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H&P for elective inductions

Posted

Specializes in L&D, Antepartum. Has 9 years experience.

Hello,

I have question for you L&D RNs out there. I had a 2100 scheduled cervidil induction come in who I had prenatals for but no H&P. I assessed her, did an SVE and called the MD for orders. I also told the MD that I had no H&P and that, according to hospital policy, I could not start the induction unless I had one. She asked how long has that been a policy and I told her it has been for some time and it had been reiterated at the OB meeting. I offered for her to fax me one or email me one. She said this is getting too complicated, send my pt home and I will have her rescheduled at "Big Box Baby Hospital" instead. I told her that is fine if she wants to do that but I find it hard to believe that "Big Box Baby Hospital" doesn't have that same policy. She said they didn't. I asked her to tell the pt herself, which she did by phone. The pt told me the MD said she was too busy and to reschedule blahblahblah. I told the pt the truth, that we could not start because hospital policy is that we have and H&P and the MD could not provide one at this time so she rescheduled. Poor pt!

I called by Director and she agreed with me. She said the CMO agreed that it is JC that regulates that all ELECTIVE procedures have an H&P before starting. So, anyone starting elective inductions without an H&P out there? Or having the same issue with MDs? This is the 4th time in a month that the MDs have been flipping out on us because of this issue. Its not my fault that your staff didn't send one over with the prenatals. It is very frustrating for the RNs and the pts.

Thanks!

Sorry to hear this is an issue. You absolutely did the right thing. At my hospital, we have the same policy. I absolutely would not start an induction without a current H&P (I believe per policy, our H&Ps must have been done within the last week).

Katie71275

Specializes in L&D. Has 2 years experience.

Our docs put an H&P in when they are doing there orders. Usually there is also one on the chart,but they always put one in when admitting the patient to the unit. It's required.

Alikatz08

Specializes in Labor and Delivery. Has 4 years experience.

That's too bad that you had to deal with the difficult situation/doctor. I completely agree that you did what was correct by following policy and speaking up. I work at a large academic/teaching hospital where we have an abundance of residents who complete the H&P's for all patients (elective inductions included) when the patient arrives after seeing the patient in their designated room. Sounds like the doctor in your situation couldn't be bothered to do a little extra paperwork (lazy) and needs to get it together.