Hold that Push!

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!

Agree with above:

next stop: risk manager. Make sure you CYA always in OB.

Good luck.

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!

Don't sign. You did the right thing. The baby was ready and that's the most important thing, whether doc was ready or not.

what the hell is the go with these drs carrying on when women birth and they miss it? It's childbirth dummy! It unpredictable!!:confused:

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.

moz, any update on what happened w/ that inservice sheet?

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 :)

I think you did the right thing. Dr. E should have thanked you not send around some piece of paper, which I would not sign. Keep up the good work.

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.

Definately send that on to someone in risk management, or corporate compliance. You may endanger your job, but your other choice is to endanger your license and more importantly, the lives of your patients. Dr. E obviously isn't doing what she's doing because she cares about her patients. For your Manager not to go to bat for you and your patients is appalling!