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  1. Aug 20, '05 by Minou
    Hi ,
    I am curious about how other L&D nurses deal with an admitted primip, not ruptured , irregular uc's, not really progressing, but oh soooo in pain
    ( 1/th/high ), this being the reason for admit, and refusing pitocin ...and BTW, you only have 5 labor beds and are backed up with pts waiting for a bed. Now I am all for pt rights and stuff but....do you just babysit her or what ? too high for an "asrom" , of course, you could send her walking but she still officially has a bed....it can be very frustrating... And she has a right to decide how she wants to do it....do you give her a choice : you take the Pit or you hit the road ? well that would be rude, so how do you solve this ?
    Minou

  2. 37 Comments so far...

  3. Aug 20, '05 by Atlnurstudt
    Have you had a baby w/ pitocin? It's not fun stuff! :roll
  4. Aug 20, '05 by sbic56
    Quote from Minou
    Hi ,
    I am curious about how other L&D nurses deal with an admitted primip, not ruptured , irregular uc's, not really progressing, but oh soooo in pain
    ( 1/th/high ), this being the reason for admit, and refusing pitocin ...and BTW, you only have 5 labor beds and are backed up with pts waiting for a bed. Now I am all for pt rights and stuff but....do you just babysit her or what ? too high for an "asrom" , of course, you could send her walking but she still officially has a bed....it can be very frustrating... And she has a right to decide how she wants to do it....do you give her a choice : you take the Pit or you hit the road ? well that would be rude, so how do you solve this ?
    Minou
    She's not in labor and doesn't want to be induced with the pitocin. She has that choice, but I think it is perfectly appropriate to get the care provider to discuss discharge with her. She can go home for now, take a tub bath, walk, whatever helps until she is ready to make a decision. Sometimes prodromal labor is a real pain, literally, but it is a fact of life. If she refuses to discharge, perhaps the doc will order a shot of morphine to take the edge off. Sometimes that will relax the mom enough so she can actually go into labor on her own. Of course, if there is not a non-laboring bed in the area, that doesn't help with opening up a bed for the next patient.
  5. Aug 20, '05 by kastas
    I'd have to leave it up to the MD. Luckily, most of our MDs support us. If I say she is 1/th/high and we are short on staff/beds and doesn't want to be augmented. S/he will d/c her and tell her to come back when the pain is unbearable (can't walk or talk thru contrax or srom) or she wants to be "helped along". We have had people refuse to go home and we d/c them anyway and let them walk the hospital grounds. 9 times out of 10 they get bored and go home anyway. OR their contrax stop/slow (imagine that) and they realize we were right when we told them this was probably really really early labor or false labor.
  6. Aug 20, '05 by kastas
    Quote from sbic56
    She's not in labor and doesn't want to be induced with the pitocin. She has that choice, but I think it is perfectly appropriate to get the care provider to discuss discharge with her. She can go home for now, take a tub bath, walk, whatever helps until she is ready to make a decision. Sometimes prodromal labor is a real pain, literally, but it is a fact of life. If she refuses to discharge, perhaps the doc will order a shot of morphine to take the edge off. Sometimes that will relax the mom enough so she can actually go into labor on her own. Of course, if there is not a non-laboring bed in the area, that doesn't help with opening up a bed for the next patient.
    We were replying at the same time. I agree with the pain med. We often give it to them and make sure they have a safe ride home. They are often more willing to labor the early stuff at home when the pain meds kick in.
  7. Aug 20, '05 by babyktchr
    I guess my first thought is...why was the patient admitted to begin with? Irregular contractions and 1cm and thick...sheesh. My inclination would've been to medicate her and send her home.
  8. Aug 20, '05 by sbic56
    Quote from kastas
    We were replying at the same time. I agree with the pain med. We often give it to them and make sure they have a safe ride home. They are often more willing to labor the early stuff at home when the pain meds kick in.
    I wish we could do that...once we give them the morphine, they are ours!

    I agree with the gentle nudge out the door; they are often just not aware that this is not labor. They figure it out when the real thing comes, though! :wink2:
  9. Aug 21, '05 by Minou
    I'm glad to see these responses...Here i am thinking i'm not a "supportive" l&d rn....well, the pt did'nt want to go home although we told her she wasn't in active labor and the doc didn't want to p.o. family. but yeah, I would've gladly given her a shot of demerol and off you go.... too painful to walk, to painful to go home... I work days so night shift ended up babysitting her and into the next day when she thought it wasn't fun anymore, she gave in, had pit with an epidural and delivered the next night... ouffffff !
  10. Aug 21, '05 by Question
    Quote from Minou
    Hi ,
    I am curious about how other L&D nurses deal with an admitted primip, not ruptured , irregular uc's, not really progressing, but oh soooo in pain
    ( 1/th/high ), this being the reason for admit, and refusing pitocin ...and BTW, you only have 5 labor beds and are backed up with pts waiting for a bed. Now I am all for pt rights and stuff but....do you just babysit her or what ? too high for an "asrom" , of course, you could send her walking but she still officially has a bed....it can be very frustrating... And she has a right to decide how she wants to do it....do you give her a choice : you take the Pit or you hit the road ? well that would be rude, so how do you solve this ?
    Minou
    http://www.mercola.com/blog/2005/aug...fe_as_hospital

    Maybe women that are are low risk that want to do it natural could think about what is in this article (home births). The link also has a free link to the full text in the BMJ 2005. Check it out!! At least at home with a properly trained health care provider they will be somewhere that is not always rushed and behind trying to make them do something they really do not want to do. When people are in pain they are very vulnerable and I think their concerns should be addressed and the request granted it at all possible when it come to doing things natural or not (unless there is a serious issue).
  11. Aug 21, '05 by fergus51
    I'm all for supporting women's choices when it comes to their birth. That's why that woman should be offered pain control and then sent home. She doesn't need to be in the hospital at that point.