Annoying Doctor Award

[33-weeker]

I am still fuming from a delivery I just attended. This particular OB is really annoying! I'm about ready to refuse to catch any more of his babies.

First, he comes in fussing because the L&D nurse uncovered his delivery table (3 minutes before he got there) after the G6 P5 - who went from 3 to complete in 20 minutes - stated she would not wait on him any longer and was going to start pushing. All she did was pick off the plastic underpad for catching the liquids and put it under mom without contaminating his table. Here he is complaining in front of the family about how nothing is sterile anymore...yada, yada, yada.

The mom got narcs less than an hour before baby was born, so I had narcan on stand-by and ambu within very easy reach. Doc is taking his sweet time drying baby and clamping cord - as he reaches across himself with his right hand to the delivery table he always insists be placed on his left side ( :smackingf)and nearly snaps baby's cord / prolapses mom's uterus, then he finally hands breathing but blue baby to me after the one minute time has elapsed.

Of course, I give blowby O2 as I dry baby off since baby is centrally blue. He then procedes to come over to the warmer and ask me what I plan to give for APGARs, "So what do you think the score is... 9:9?"

Me: "Well, no, 8 for the first one. Two off for color"

Him, condencendingly, "That baby looked pretty pink to me. That's a 1, not a 0."

Me, "I had to give blow-by"

He cuts in, "Giving O2 is not a reason to take off for the score."

Me, " No, what I'm saying is the baby was blue so I had to give blow-by. By the time you handed her to me the first minute had already passed."

Him, " I still say she looked pinker than that."

I bit my lip at this point... took a deep breath and said nicely but firmly, "If you want to sign your name to the score then you can give a 9:9, but if I'm sigining my name to it, I'm scoring what I saw."

He shut up.

AHHHGGGRRRRRRR!!!!!!!!!!!!

I'm so tired of this little creep arguing over stuff he has no business getting involved in. (It's not like I was trying to give the kid a 3 or something, ya know?!) By bringing up negative comments in front of the family, he is increasing liability for all of us.

We've taken our complaints all the way to administration, but he keeps up with this nonsense.

Thanks for letting me vent.

[LightningRN]

We have doctors that don't like when we give low apgars (not that you did). I call them like I see them though. I try to give the maximum points I can, but I'm sorry when I have to bag a baby I'm not gonna be giving 9:9 apgars. This frustrates me too.

[ragingmomster, BSN, MSN, RN]

We have recently had issues with MD's and RN's disagreeing about APGARs.

We went back to our policy though and it clearly states that the RN gives the score unless the RN has not seen the baby to assess. One of our NICU MD's tried to shout me down and I just let him blow off steam and then put what I assessed the APGAR's as.

We sometimes hit a snag when the MD at the OR table takes her/his own sweet time clamping and showing off the baby to the parents and we ask them for the first APGAR. I won't assign it if I don't get the baby at the warmer until after the 1 minute mark and our babies don't get admitted until both scores are assigned. I have walked an MD through the scores more than once to get them to apply one.

End point to my post is, go back and check your policy, use it to CYA.

[Selke]

You have my empathy. When I have to work with a@@&)*es I feel they can't pay me enough to be there and put up with their cr#)% without saying what I really want to say. You guys should find ways to write him up, or talk with the manager, or head of OB for your facility, or something.

Besides, where did this jerk get the idea a lady partsl birth is a sterile procedure, anyway? :trout:

[feebebe23]

I once had a doctor complaining in front of the up in stirrups patient about steril this....steril that.... I smiled to him and the patient and stated "Good thing a lady partsl delivery is not a steril technique, it's a clean technique" The patient had no idea that I was talking about. But the doctor did....and he shut up.

[33-weeker]

With this doc, saying that would have only furthered the argument/discussion and made it worse. We've learned just to shut up for the most part when he does this. He eventually stops when he has no one to argue with. He just caught me off guard that day. Next time I'll respond with, "do you want to give the first apgar?... I can sign document that you gave it if you like."

[feebebe23]

once I had a precip nurse delivery.....i was lucky this was a wonderful doc and he was joking with the patient about all the red lights.....when I smiled and told the doc apgars 9/9 he told me that "he who delivers can not assign apgars" because they could be biased.

I have seen doctors who have disagreed with apgars make a note that infant had "spont resp and good tone while being passed to NBN RN"

I to have made noted in my chart when I disagree with apgars....it's all you can do.

[Mrs.S]

we have an anesthesiologist who is a real weiner like that, trying to tell all the nurses how to do their jobs. not long ago I attended a section delivery as the baby RN, and the kid was breathing spontaneously but just a little shell-shocked, needed a bit of blow-by. This anesthesiologist was all over the warmer, "this kid doesn't look good--give me your stethoscope! yeah, this kid's not moving much air! we need NICU here.." OK we most definitely did NOT need NICU but circulating RN called anyway since this dork kept INSISTING...of course by the time NICU arrived the child was completely pink and screaming and I looked like the idiot. I would have liked to take the stethoscope and strangle him with it...

anyway, he gets the Annoying Doctor Award where I work

[canoehead, BSN, RN]

The docs calling for a 5 min APGAR at 3 minutes annoyed the hell out of me.