Frustrations about L&D nursing

BETSRN · Mar 2, 2005

My main frustration is dealing with the crowds you deal with in L&D. If my hospital would take more of a responsible and professional view of what is involved with a laboring patient in the hospital setting, life would be easier for me. You can't treat hospital births like home births when your dealing with monitoring anesthesia and potential problems with a delivery when we use alot of intervention that can create problems that have to be dealt with. I can't bond with a crowd and the general public doesn't have any respect for the hospital environment they are in. I think I'm getting too old for this anymore.

I laughed when you said you were too old for this anymore. Sometimes I find myself saying the same thing and I am only 55 years young and love nursing! It is usually, also, around this visitor issue as well. I think a lot of us deal with this.

Unfortunately, hospitals are all into this "customer service" thing as well as this doctors are customers as well. Makes me tired!

SmilingBluEyes · Mar 2, 2005

Everyone is nursing's customer. That is not just OB. And yes, it does make me tired, too. And I am not by any means "old".

JaneyW · Mar 2, 2005

I just thought of another one ... Pt's who come in who are laughing and can't even answer your questions because they are too involved in the television show they are watching, then rate their pain at 10 on a 0-10 scale! You hook them up to the monitor and they aren't contracting, their cervix is thick and closed, then later they bluntly tell you that they are "tired of being pregnant and ready to get this over"! GRRRRRRRRRRRRR! Sooooooo ... you explain that they are only 34 weeks - you explain everything that could happen if they delivered right now - you send them home and spend an hour wrapping up their triage chart - and they come back two days later to replay the entire scene!!!!!!!

I hear you! You forgot the part where these people are on MediCal (or whatever your state's assistance is!) and they decide to come in for "pain" when their boyfriend gets home at 2am from the bar and they're mad at him. You can smell the alcohol on him and they have dragged their poor little two year old along for the ride and the kid is crying and grumpy. Don't get me started!!! And we have to send newborns home with these people. I'm not talking about true abuse, just bad dysfunctional situations.

SmilingBluEyes · Mar 2, 2005

oh yea, major pet peeve of mine, too janey.

riern · Mar 3, 2005

I agree with everyone of your frustrations.....thought I'd add a few more...

--the boyfriend who comes in at 2am smelling like pot and demands a work excuse for the day.

-- the patient who comes in with her 3rd preg and doesn't understand why she's hurting (round ligament pain) and so tired all the time--she has a 2 year old and 9 month old at home--can't we just do something for her.

--the patient who comes in via ambulance, you know the 34 wk tired of being preg one mentioned earlier, and her family gets to the hospital before the ambulance but no one could give her a ride.

-- the drug addicted mom who denies doing any drugs and wants to know what we gave her baby to make them positive for cocaine and marj.

-- the family of 50 who thinks they can all stand in the middle of the hallway in the unit and watch, hear, comment on and see every thing and everyone. How dare we ask them to wait in the waiting room.

-- the visitor who goes to the medical floor and visits a peds pt on isolation with RSV before coming to visit the newborn ..... and how dare we say a word to her!!

OH I could go on and on and on. You just gotta love them though. I've done other things and always come back to OB. It's just in my blood. As I've gotten older I've learned to just smile at some of them and shake my head.

I guess people aren't so different anywhere are they?

tryingtomakeit, RN · Mar 3, 2005

I agree with everyone of your frustrations.....thought I'd add a few more...
--the boyfriend who comes in at 2am smelling like pot and demands a work excuse for the day.
-- the patient who comes in with her 3rd preg and doesn't understand why she's hurting (round ligament pain) and so tired all the time--she has a 2 year old and 9 month old at home--can't we just do something for her.
--the patient who comes in via ambulance, you know the 34 wk tired of being preg one mentioned earlier, and her family gets to the hospital before the ambulance but no one could give her a ride.
-- the drug addicted mom who denies doing any drugs and wants to know what we gave her baby to make them positive for cocaine and marj.
-- the family of 50 who thinks they can all stand in the middle of the hallway in the unit and watch, hear, comment on and see every thing and everyone. How dare we ask them to wait in the waiting room.
-- the visitor who goes to the medical floor and visits a peds pt on isolation with RSV before coming to visit the newborn ..... and how dare we say a word to her!!
OH I could go on and on and on. You just gotta love them though. I've done other things and always come back to OB. It's just in my blood. As I've gotten older I've learned to just smile at some of them and shake my head.
I guess people aren't so different anywhere are they?

I guess thats why I love reading what you guys have to say so much. It lets me know we all live in the same world and I'm not alone with my frustrations! :loveya:

cabbage patch rn · Mar 3, 2005

The frequent practice of inductions is one of my greatest frustrations. I guess it wouldn't be quite so bad if they would actually wait until mom is actually due, but we have many, many inductions at 37-39 weeks. It's exhausting. And at least 50% end up being failed inductions as you would expect. Our doctors usually end up letting mom rest overnight and then re-pit the next day and of course those moms end up being sections on that 2nd day. What a bunch of stress and crap to put an unborn baby through because you are selfish and can't wait 2 more weeks when the baby is actually ready to be born. I don't understand why doctors can't grow balls and tell their patients "no" when they come into the office asking to be induced early. A little education would go a long way, but this takes time and they aren't willing to spend the extra time with their patients to explain why uterine receptors aren't as sensitive to pitocin at 37 weeks. And we as nurses can talk until we are blue in the face but the patients aren't going to listen to us. In the past, I've tried to educate these women, telling them that if they wait a couple of weeks, the success rate will be much higher, heaven forbid they go into labor on their own. Of course, 5 minutes after talking with them, they opt for the c-section that the doctor is offering as being the "only way" to get the baby out. :angryfire

SmilingBluEyes · Mar 3, 2005

OMG yes we share all those same frustrations, don't we. It's a good thing I do love what I do....and don't let all these get me down too much. I guess being per diem is so helpful, too, so I don't deal with all of this fulltime. Hence, low burnout risk.

imenid37 · Mar 3, 2005

My BIG frustration is the duplication of documentation on NOT ONE but TWO computer systems which do not communicate w/ each other. ARRRRRGGGGGHHH!!!!! Plus most of the info. we have gather (about two tractor trailers full) has already been obtained on the prenatals. We are asking something new just about every week. Soon we will go out and check their oil and tire pressure too. I don't REALLY have PMS today but I will also tell you my two biggest gripes w/ pt's are abused women who come in pg every year, esp. when the guy is beating their young children too (sorry two small children beaten to death in our area in past 2 months by "boyfriends" and another little 4 year old about 75 miles from here too by her coke snorting stepdad) and those who expect nurses to have the knowledge of Einstein and Plato while they treat us like we clean the restrooms at McD's ... :angryfire and my all time worst gripe... BEING PULLED TO MED-SURG or to babysit psych pt's/drunks in the ER. Thankfully most of our pt's in ob are great and most of the other nurses are too. I think we do a difficult job and rarely get the credit we deserve.

parteiranagua · Mar 4, 2005

The frequent practice of inductions is one of my greatest frustrations. I guess it wouldn't be quite so bad if they would actually wait until mom is actually due, but we have many, many inductions at 37-39 weeks. It's exhausting. And at least 50% end up being failed inductions as you would expect. Our doctors usually end up letting mom rest overnight and then re-pit the next day and of course those moms end up being sections on that 2nd day. What a bunch of stress and crap to put an unborn baby through because you are selfish and can't wait 2 more weeks when the baby is actually ready to be born. I don't understand why doctors can't grow balls and tell their patients "no" when they come into the office asking to be induced early. A little education would go a long way, but this takes time and they aren't willing to spend the extra time with their patients to explain why uterine receptors aren't as sensitive to pitocin at 37 weeks. And we as nurses can talk until we are blue in the face but the patients aren't going to listen to us. In the past, I've tried to educate these women, telling them that if they wait a couple of weeks, the success rate will be much higher, heaven forbid they go into labor on their own. Of course, 5 minutes after talking with them, they opt for the c-section that the doctor is offering as being the "only way" to get the baby out. :angryfire

Ditto... :crying2:

but in my case the mom dont know much and the dics want them to be induced.. for big babies, small babie,s risk of hypertension, over 40 weeks etc... in other words a false true justification what can u do!!!

lately? 2 or 3 inductions every other day and of course 4-3 c/s q week...

:angryfire

Ginny Doula RN SNM

rn1947 · Mar 6, 2005

What quidelines do you use to base staffing? I've been an OB-NICU nurse for 35 years and have also managed some OB units in the past. My new position as a charge nurse (manager making less money!) is challenging. I've worked as staff with all the nurses and I feel their pain when I'm not granted additional staff during busy times. Management seems to want everyone to work more efficiently-they site observations of poor coping skills instead of grasping what it is we do in a small-do it all-OB unit.

lauriesalRNC · Mar 6, 2005

Let's see:

1) 19 yr olds with 3-4 kids from all different fathers who still do not use birth control and keep coming back pregnant AGAIN.

2) the docs attitudes. I work in a community hosp where the docs do not have to sleep at the hosp when they are on call unless they have someone in labor, and we do not have OB residents. If they get called in the middle of the night and have to come in they tend to get very testy. :uhoh3: I feel like telling them... this is what you signed up for....if you dont like getting up at 4am to deliver a baby... QUIT!

UOTE=RNLaborNurse4U]What are some of your frustrations about your job in L&D?

For me...I can list quite a few, but I'll keep it simple:

1 - Triple and quadruple charting - more time spent on paperwork/computerized charting means less time I can spend with my patients. :uhoh21:

2 - The girls/women who are on public assistance and come in every 1-2 years bearing another child onto our already overly burdened welfare system. :angryfire

3 - Sometimes, feeling like you need to clone yourself so that you can adequately care for all of the patients you are assigned. On our really busy days, we can sometimes have 2-3 active labor patients at once. :eek:

Jen

L&D RN