Ever have an OB refuse to come for an emergent strip?

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Specializes in L&D,Mother/Baby, WHNP,Educator,NICU.

Hi,

I'm wondering if any of you have ever encountered this situation. I was taking care of a laboring pt who was a family practice pt who had deep variables during UCs. The OB was called for a consult by the FP doc and then the OB reviewed the strip and said she wasn't going to do a C/S at that time. Then 2 hrs later the FHR went down to the 80's for 8-9 min. The charge nurse called the OB for a crash section and the OB said,"I'm not coming, she's not my pt!":mad:

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Specializes in PICU, Sedation/Radiology, PACU.

If the OB were on-call for the facility at that time, then I find it hard to believe he wouldn't be liable for his inaction. Was there a family-practice OB who was supposed to be coming in to cover the patient? What usually happens when patients who aren't being followed by the OB come in laboring?

What was the end result of the situation?

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Specializes in L&D,Mother/Baby, WHNP,Educator,NICU.

Usually what happens is that the FP attending call the OB attending that their pt needs a consult or C/S. However, in this case the FP attending was downstairs and was running to get up to the unit and didn't have time to call the OB for the consult. Instead the charge nurse did which the OB didn't like.:mad: The charge nurse and primary nurse got the pt ready for a C/S and eventually the charge nurse got the OB to come and do the surgery, but the baby ended up in the NICU w/a blood pH of 7.0 something. I was so shocked that this would happen. Also I had a pt who was in labor and was "difficult" and needed her epidural replaced. The anesthesiologist replaced it but said he wasn't coming back to help the pt if she needed rebolusing. That unit has BIG problems with their MDs IMO so I quit and took a position elsewhere. I was just wondering if any other L&D nurses had problems like this with the MDs??:eek:

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Specializes in Nurse Leader specializing in Labor & Delivery.

No, but I did have a physician refuse to come in for a teen pg with a 22-week pregnancy who was in labor 2ry to untreated UTI. In spite of the family insisting that the physician come in, and talking about lawsuits for not trying to stop labor or transport her to a higher acuity facility, the physician would not come in, and simply said "call me if she hemorrhages." That was a great shift.

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Specializes in L&D,Mother/Baby, WHNP,Educator,NICU.

I'm sorry to hear that!!!

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Specializes in ER.
No, but I did have a physician refuse to come in for a teen pg with a 22-week pregnancy who was in labor 2ry to untreated UTI. In spite of the family insisting that the physician come in, and talking about lawsuits for not trying to stop labor or transport her to a higher acuity facility, the physician would not come in, and simply said "call me if she hemorrhages." That was a great shift.

I don't work in this area but I can tell you from when I was a paralegal, the last thing this doc wanted was to touch the chart or patient when it reeks of a lawsuit. No on wants their name on it. Evil? yes. Reality? Also, yes. Also, its why I got out of that industry.

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I don't work in this area but I can tell you from when I was a paralegal, the last thing this doc wanted was to touch the chart or patient when it reeks of a lawsuit. No on wants their name on it. Evil? yes. Reality? Also, yes. Also, its why I got out of that industry.

Understand about a doc not wanting to get involved in a potentially bad legal case-but if he's the doctor of record on call, isn;t he already involved?

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Specializes in Nurse Leader specializing in Labor & Delivery.
Understand about a doc not wanting to get involved in a potentially bad legal case-but if he's the doctor of record on call, isn;t he already involved?

Exactly. She was this patient's primary physician. She can't just dump the patient when she comes in in preterm labor.

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It's crazy......Thank God we always have both high/low risk RD on duty. However, I would bring that OB to court if I were that pt. 7.0 is a bit hypoxic.....Hope the best for the bebe...........

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Specializes in L&D, OR, postpartum, pedi, OBGYN clinic.

My MD's are pretty good, never had them refuse for a bad baby, anesthesia was a gem most of the time.

I get the most push back from clinic questions!

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Specializes in OB.

I haven't had this problem with an OB, but have experienced it with anesthesia refusing to come in for an epidural. My reply was "Okay then I am charting that you have been informed of the patient's pain, request for an epidural and the order for it. I am charting that you are stating you will not come in now. Is that correct?"

He was there in 10 minutes. (Needless to say I had not yet charted.) I never had a problem with him again.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Back when I worked at a facility that didn't have in-house anesthesia, when we would call at 2am to request an epidural, they would actually ask what her dilatation was, and argue that it's too soon! You are NOT the OB, get your a$$ in here and do your job!

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