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Discussion

Breech scare

I just statrted a new contract with a very small hospital. They have 2 OB docs and 30-40 deliveries a month. "they don't do deliveries at night" is what I was told by the other nurse working there with me on nights. Well, since I started there they have started delivering at night! LOL! Definitely had a pretty bad scare the other night (2nd night) g2p1 came in ruptured while getting out of wheelchair to bathroom, light mec. Anyway.. get her to bed start asessment, call report, doc says go ahead and check her. WELL... she is 6/100 and BREECH!!!! I call the doc back he says stat US, no problem, right? Wrong... Radiology has to be called out at night and it will take 45 minutes. Then paitent starts having "pushing pains" HOLY MOLY... she is complete and butt is at +1. Teach patient panting no pushing run and call the OB. He is ho-humming around (this particular doc doesn't like to come out at night and I found out he lives almost 1 hour away. I told him we hadn't had u/s yet but I knew what I was feeling. I told him that either way if he didn't beleive me about presentation he needed to come anyway because she was complete. I was thinking I don't have time to argue with you.just get you A#$ here! So I go back to room and she is REALLY panting. I pray like I have never prayed before for a patient. Get her in trendelenberg, I called to desk and asked the other nurse (nursery) to bring me terb. Well, troops started showing up for c/s ONE HOUR LATER!!!! Delivery time was 1 1/2hr from time of complete. The OB wanted anesthesia to sit her up for spinal. Not a one stick spinal of course, it took him 5 tries. Apgars...3/7/8. The whole time the c/s going the doc is griping about "having a day job too". I was in shock. He was giving me such a hard time about him having to come out in the middle of the night. See, two nights before this one of his patients precipted because he didn't make it(that was the first time I had met him). I told him "well I couldm't deliver thsi one for you" he kept on and on. Finally I said "well maybe you should have gone into dermatolgy" He didn't like that at all. Then later I found out he told the other OB doc he didn't like me.

THE NERVE of this guy. He never once said thanks or even showed any type of appreciation. The family was very appreciative because they knew the seriousness of this. The family kept asking me..it is gonna be alright, right. I didn't know what to say. I DIDN'T truely know if it was gonna be OK. My mind was replaying over and over how to deliver a breech if necessary. But only seeing it done I was SCARED. Later I joked... I din't know who had passed more meconium...me or the baby!!! LOL

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Any of you OB/L&D nurses - does your hospital attempt breech lady partsl deliveries at all, or is a breech an automatic C-section?

He's an IDIOT and should be shot. You go into OB, you gotta expect some crazy hours.

Our hospital will deliver some babies breech, depending on other factors (what type of breech, size of baby, health care provider).

sounds perty fargin dangerous to me.

scary.

Dermatology LOL. How do you not deliver at night anyway transfer everyone at dusk. If they come to the hosp. @ nite you can't turn them away. You would think if a hosp. has OB they would have to be 24/7. Just thinking out loud.

At our hospital we only c/s'd breeches - no vag deliveries!

When your contract is up, go to Burger King and buy this guy one of those paper crowns and tell him he has been crowned KING of A$$HOLES! And I thought I worked w/ the world champ. Amber you need a serious vacation. Didn't you work on a hellacious antenatal unit awhile back?

  • Author

What they meant by not delivering on nights was that they hydrate and sedate and keep that up (or try to) until AM. This doc even had me Terb a 36+weeker.

And yes, THat is me, one in the same that worked the hellacious antepartum at a different hospital. I thought I WAS getting a vacation by getting out of that hospital. My friends at the hospital I trained at called me the s*it magnet. They even got me a keychain before I left that said "chaos, panic, disorder...my job here is done".

I don't know whether or not they deliver breech lady partslly at this hospital. I doubt it since there isn't any type of NICU. Just one lone nursery nurse. AND... I definitely don't want to precip a breech!

Your doc is looking for trouble! What happens if you have a cord prolapse? You can't schedule those just for dayshift.

He should stay in a sleeproom, or get an apartment close by, but it may take a lawsuit to convince him of that.

With the butt at +1 why didn't they just deliver the poor woman. I can tell you that if I was complete and pushy there would be no 1 1/2 hour wait before I got that baby out- don't care if it was sideways! (Well maybe not sideways)

We have a doc that won't get out of bed until the woman is complete and then says "don't let her push!" as he drives in at 90 mph. The cops have chased him into the hospital parking lot a couple of times.:eek:

Anyway, he was a dink, and probably everyone who works there knows it. You could consider him not liking you a compliment.

  • Author

When this doc got there he said he wasn't going to check her. He said if it wasn't breech he would just flip the baby over like it was. I was like "whatever makes you happy...crack is crack!" Well he did check her and I read in the progress notes later he documented butt was at +3!!! Even still... let her sit for almost 30 min with this anesthesia quack trying to put in a spinal. In to OR time...0109 cut time...0132!!!

"BUTT"...whatcha gonna do?!?!?!

I can't believe at +3 and second baby, he didn't just deliver her.

With first time Moms, it's automatic CS. But for multips, depends on presentation, and who's on that night. We have a great group of docs and midwives who are really low intervention. I love, love, love them.

And they all sleep at the hosp when they are on call. Even if they don't have a pt in labor.

I'm not an OB nurse and perhaps I am spoiled because I work in a larger city hospital but I cannot fathom an OB doc not being inhouse.......what an awful situation to be placed in......

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