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Discussion

Conflicts in the delivery room

Had a very sad situation the other night:

My pt was a G1P0 14YO girl that I assumed care of as she was complete. Her PGM had legal custody of her; her mother (who I really think was on drugs - very erratic behavior) had been allowed to visit the child occasionally and was to be present in the room when the pt delivered, along with the grandmother.

So we start pushing and the grandmother and the mother are like fighting over helping the pt - who gets to hold a leg and someone is counting too slow and who gets to hold the baby first and who gets to cut the cord and who loves the pt more . . . the pt's mother was very distracting to me and taking my attention away from the pt - a very frustrating delivery for me. Number one, I felt like I needed to be engrossed with my pt at a very vulnerable time in her life and be encouraging with her and I really felt like her family was taking me away from her, pulling me to the side; relentlessly asking me the same questions over and over again. And they were pulling me into it, "Well, the nurse SAID ___"

How do you guys handle awkward situations in the room like this? I really tried to be polite to all parties involved and I feel like I failed my pt that night. Her whole childhood had been taken away from her. I wanted to make that experience as positive as possible for her and now she will always remember her family fighting while she was having a baby.

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I have actually pulled aside, and asked such people to leave the room, unless they can keep their drama out of the delivery experience. And if they get ugly about it, I have no qualms about involving the charge nurse and the house supervisor/security PRN. You set limits early on. You tell them the one who is your priority is the patient and if they cannot behave in a supportive and helpful manner, they will be asked to leave the labor/delivery room and unit, if need be. It's never fun,but you can't allow a circus environment to take over.

I would have politely asked them to step out of the room for a moment and explain to them if they can't be calm and supportive for their daughter/granddaughter's sake, they will either have to leave the birthing room or they will be escorted from the unit. We usually don't have to deal with this since the OBs we work with don't deal with drama and I have seen several people excused from a delivery sternly by one of our physicians. You definately earned a gold star for that frustrating experience.

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I have actually pulled aside, and asked such people to leave the room, unless they can keep their drama out of the delivery experience. And if they get ugly about it, I have no qualms about involving the charge nurse and the house supervisor/security PRN. You set limits early on. You tell them the one who is your priority is the patient and if they cannot behave in a supportive and helpful manner, they will be asked to leave the labor/delivery room and unit, if need be. It's never fun,but you can't allow a circus environment to take over.

Yep - firm from the start that this is not the place to be idiots.

steph

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