I'm getting written up! (Very long)

[rn4babies63]

I'm getting written for an incident in which was completely misunderstood. Yesterday, I had a 20 year-old patient that was being induced for labor. On admission, she was asked what her plans were for pain control (part of our admission process). She stated " I don't want an epidural because I'm scared to get one". When I asked her what her concerns were, she stated she was afraid to be paralyzed and that the OB told her she may die if she gets one. I explained to her exactly how the procedure is done and although there are risks, these would be explained to her by anesthesia and the risk of paralysis or death were extremely low and that I've personally never seen either occur in 13 years of OB experience at 3 differant hospitals. I also told her that IV medication certainly was also an option and she could "play it by ear" and to just let me know what she decides when the time comes. Well, after several hours of increasing pain, the IV pain medication was becoming ineffective. She asked me at one point if she could have an epidural and I explained to her the the doctor only allows his patients to have epidurals once they are 5CM. Several exams later, she was finally 5 CM. When I told her the result of the exam, she stated "Can I have my epidural now?" So, I called anesthesia and she got her epidural without any difficulty and delivered a healthy baby girl 1 1/2 hours later with no complications. So here's the problem.. .......When the doctor showed up while the family was in the waiting room during the epidural, they complained to him that she was coerced into getting the epidural and that they didn't want her to have it The doctor was raving mad and complained to my charge nurse about this. 2 charge nurses talked to the patient and she told them that she was not coerced in any way and that she asked for the epidural and all I did was answer her questions and explain the procedure. She also told them that was embarassed by the behavior of her family regarding this. The S/O told them that he didn't want her to have it and since she was only 20 years old she couldn't make the decision for herself (he proudly announced he was 37 years old). On rounds the next day, our clinical coordinator asked the patient and family if they were happy with their experience and they never mentioned anything about this. However, the doctor is still insisting that I get written up! I've never had any issues with him but he is VERY anti-epidural and always tells his patients they WILL end up with a c-section, they WILL be paralyzed and MAY very possibly die from it rather than explains the risks. I merely was answering my patients questions and educating her and the family. And yes, there was a written as well as a verbal order from the doc allowing here to have it. I have a perfect 12 year attendance record at this facility and have never been reprimanded for anything and always get excellent evaluations. This is not fair! Sorry so long but I need some advice!

[Batman24]

I really think the clinical coordinator is mistaken. They don't have to write you up here. No way...no how. Ask to see written policy of this.

Is she saying it is because of a family complaint?! If yes, she's lying and doing this because she's appeasing the doctor. You have every reason to be livid and I wouldn't take it quietly or lying down. The family said they had no complaints and were satisfied and the patient has no issues. It should end at that. I'd ask them to advise the doctor to do the write up if he wants one so badly. And I'd be polite but firm about all of this. I also wouldn't sign it in a million years as it's inaccurate. You can flat out let them know that. You are paying the price for the patient going against her doctor's wishes and that's unfair. Let them know you feel you are being harassed because of that. They don't like hearing the word harassed.

The woman consented to the epi not just to you but the anestheiologist as well. Are they stating the doctor be written up too because it was forced on her?! Of course not. She consented. I would ask if doctor is being written up because if they have to write you up they would have to do the same to him because he actually performed the procedure not you. I mean a complaint is a complaintm right?! This is absurd.

I agree with Jolie about reporting him to the board. He deserves it. His practices are barbaric and he lies to patients. It needs to stop.

And if there is a write up don't sign it. Write a letter and ask all those supporting you to do the same. And attach a copy of the epi consent form to it.

[imenid37]

RN4babies...Do we work together??? This doctor has an evil twin and I work with him. What an *ss! As for the 37 year old impregnator, I don't see why admin. cares if he is satisfied, as long as the patient is satisfied. There goes the hotel mentality again. Gotta give that fake "customer service." The family is probably what I term "unpleasable." They are nasty people who love to cause a stink. I am very sorry to hear you are being treated this way. Ask your manager if she would prefer to be writing you up because the patient begged for an epidural and you listened to the family instead. The patient is in control of what she wants for pain NOT the family. I had a man get right in my face one night and yell because his girlfriend got an epidural while he was outside smoking (for over an hour). I told him I am responsible to do what the patient wants and he is not in a postion to order me around unles he would like to be the one giving birth. Only thing there was I was with a decent doctor who backed me up.

[soulofme]

Pointing the idiot dart at the Doc and S/O....

[travduck, BSN, RN, CNM]

"you can also include your written defense, and get those who interviewed the girl, as well as get the girl herself to write a letter of support for you. Then the whole packet may be in your file, but it will be quite clear that you did nothing wrong." "You should write all of this up very objectively, make yourself a copy, give one to the DON, and one to your charge nurse. "

Don't wait for the "doctor?" to take the offensive. Do the above NOW. Then go home and sleep well. In the writie up you are free to state that you understand the Dr (?) Soandso is upset, displeased whatever and that you feel that you did no wrong. Get this into your file in advnce of any nasties that he wants to play at. You might also attach a copy of the epidural consent. This would place the anesthesiologist squarely in your corner in the event of future retaliation by this dr(?), as to have done an epidural against the wishes of (at that time) his patient would not only be assault but battery; both with very legal consequences. Keep a copy of all documents for yourself in an off campus safe spot. If necessary delete patient name but retain their id number.

Bad doc are everywhere trying to cover their posteriors with the bodies of nurses, and too often getting away with it.

Hang in and be extra glad that you have a sane nurse management team.

[southernbeegirl, BSN, RN]

yet another example of family members dictating medical care. im so sorry you are going thru this!

[wooh, BSN, RN]

I have to agree that the anesthesia provider needs to be written up right along with you. If not, then this is being done just to appease the OB. Did anyone other than the OB hear the family's complaints? Wonder if the OB made them up?

[nerdtonurse?, BSN, RN]

That's the first thing I thought -- write up the OB for "fostering a hostile work environement."

[Batman24]

I have to agree that the anesthesia provider needs to be written up right along with you. If not, then this is being done just to appease the OB. Did anyone other than the OB hear the family's complaints? Wonder if the OB made them up?

And even if the family did complain why would they ever be able to dictate what the patient does and doesn't receive in this situation as the patient is of sound mind?! It's ridiculous. If families dictated patient care and we listened half my patients would be dead by now. No joke.

I do wonder if the OB riled this whole thing up. And it is a hostile working environment if he pits families and patients against one another, families and nurses against one another, and nurses are being put into a position where they will be retaliated against for advocating for their patient and assisting with a patient request. The nurses can't win in this situation and it needs to stop. Perhaps this OB needs a write up too.

[Batman24]

That's the first thing I thought -- write up the OB for "fostering a hostile work environement."

I actually meant to quote you on this part. It is a hostile working environment if he pits families and patients against one another, families and nurses against one another, and nurses are being put into a position where they will be retaliated against for advocating for their patient and assisting with a patient request. The nurses can't win in this situation and it needs to stop. Perhaps this OB needs a write up too.

Can anyone tell I'm worked up over this?! :angryfire

[Batman24]

Can you imagine if OP gets written up?!

"Doc mad patient had mind of her own and had epi done. Blames nurse. SO also mad patient decided on pain meds. Blames nurse. Bad nurse helped their patient, provided great care, was an excellent patient advocate, terrific eductator, patient praises nurse, we know nurse did nothing wrong but we'll write nurse up anyway because it's much more important that doc and SO are happy. I mean who really cares about patient rights anyway?! The patient wanted epi and gave consent for it but we should ignore patient in future to appease doc and SO. Patient can then say nurse ignored their request and we can blame nurse for that too." Yeesh.

[arelle68]

Please forgive me, dear male nurses, for my comment regarding men, which was deemed to be belittling by jm394. It was rude and wrong. I am sorry. It won't happen again.

[Silkiebyrd]

I am sorry you are going through this...but you were in the right. The doctor probably knows it too. This is an example of admin. allowing him to persist in educating his pts. and their families with BS about medical procedures. You are probably one of the first nurses to go against what he tells them and he finds that he doesnt like it. Sounds like a power issue with him. You are right and like they have said...dont sign the write up....and add an addendum telling your side of the problem.