I had a G2p1 spontaneous labor with an epidural. It was dayshift, she went complete, I had her give a push, and nothing. I called Dr.E (for evil lol) & told her exactly that, and the baby looked great. She stated she would see 2 more patients at clinic then head over to OB. Within a matter of minutes, the fetal heart rate dropped- 70's. Not just an early, they were staying down. I had her push and the head came down nicely, and had another nurse throw some O2 on her and call Dr.E. She told the office staff it was urgent, and got put on hold, so she hollered at the unit secretary to call her stat. She missed the delivery by 2 minutes, and was visibly angry. She never discussed any of it with me or the other nurse, she went directly to the nurse manager and "threw a fit" I'm told. Now, there is an inservice sheet everyone must sign saying basically we will not push Dr.E's patients, even if FHTs are low; instead do other interventions. I haven't read or signed anything yet, as I was working nights this weekend and didn't see our nurse manager.
:banghead:Why not TALK to me, go over the strip with me, anything?
Specializes in Clinical Research, Outpt Women's Health.
Whata nice thank you for your saving her butt. Geez. The baby and parents thank you. Respectfully decline to sign and say that they need to write that as a policy and procedure and have it approved through proper channels for you to be able to follow it.
I wouldn't second guess your decision at all. You could try the other interventions while pushing....oxygen on, IV fluid open, and even have her push on her left side, but ultimately it is your job to make sure mom and baby are safe, regardless if the doc is in the house or not. I definitely wouldn't sign that paper and would sit down with the nurse manager and explain your reasoning! Good job!!! I'm sure the mom and baby thank you for their health!
Please take a copy of the in-service and sign-in sheet to your risk manager and hospital legal counsel. They need to know the dangerous extent to which your manager is willing to appease an unreasonable physician. We know that AWHONN standards run contrary to this "information" your manager is pushing (no pun intended), and it is AWHONN standards to which you will be held in a court of law. Your manager's in-service won't mean squat at that point.
Absolutely correct. I wouldn't sign that form with a gun to my head and none of you should either. If your risk management dept. sees it they will be sure to make this form disappear immediately. HUGE liability issue.
Do a rewrite on that paper stating what it REALLY says-"Dr. E doesn't give a _ _ _ _ about his pts or their babies, so if there are problems, remember-Dr. E's ego ALWAYS comes FIRST!
Specializes in all areas of ob-gyn nursing. er. pacu..
i agree, do not sign that paper. i have worked in ob for 21 years and all of our docs say if the patient is ready to deliver, can't control the urge to push, the baby's heart drops...decels...then the nurses should go ahead and deliver the baby.
I wouldn't sign the paper. If that's how that doctor wants it do those other things first O2 a little turn, page them (make sure it's documented what time you called and did those interventions) Then push...if it's out in 2 pushes good. If mom has any urge at all there is no "don't let her push"...wish some docs had to go really bad and they couldn't then they might think don't push :)
That's just dumb that she's angry with you for having the pt push! She should be thankful that you tried the other interventions but had the common sense to know that this baby didn't like where it was at and need to come out. Good judgement call. Doc or no doc you had a healthy baby! Oh, and I definitely would NOT sign that paper. You'd be in big trouble if you had a bad outcome because you wouldn't let a pt push.
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CrunchRN, ADN, RN
4,555 Posts
Whata nice thank you for your saving her butt. Geez. The baby and parents thank you. Respectfully decline to sign and say that they need to write that as a policy and procedure and have it approved through proper channels for you to be able to follow it.