lost all self-esteem

[garfieldrn]

I have been in L&D for a little over a month now and have been feeling pretty good until the other night. I had a patient walk in a half a hour before the end of shift and when I checked her I swore she was complete, I didn't feel any cervix just the head. Anyways, I called her doctor right awhile and she was feeling really uncomfortable stating she wanted to push. I checked her again just to make sure the baby is not coming and it still felt like she is complete. well, right before I was going to go home the doctor showed up but I left and day shift took over. Anyways, when I went back to work the next day, one of the day nurse told me that the patient was only 6 cm and that I didnt know what I was doing. :nono:That doctor had to wait 40 mins before that patient could deliver. I felt really embarassed and I felt like I lost all my self-esteem. I'm now dreading going back to work cuz my mojo is gone. I've been pretty accurate with my VE's so I don't know what happen?

[Spritenurse1210, BSN, RN]

Its ok. Its better that you called the doctor too early than too late..she is probably just frustrated because the doctor threw a temper tantrum.

[NurseCard, ADN]

You mean it took 40 minutes for the mom to deliver the baby, or 40 minutes before the mom could start pushing?

Do you KNOW, that you know how to check a cervix for correct dilation? I mean, I don't know much about ob/gyn nursing... but I would imagine that these things happen sometimes? You've only been working as a nurse for a month? If you feel like you need to brush up on a skill such as checking a cervix, I wouldn't worry so much, just ask another more seasoned nurse to go over things with you and make sure you've really got the skill down pat, so that NEXT time something like this happens, you can KNOW for sure that yes, you knew what you were doing!

Not trying to say that you didn't know what you were doing this time... again, I know squat about ob/gyn but how could a woman go from fully dilated to 6 cm? Can that actually happen? Maybe the nurse was mad because the doctor got mad at HER because for whatever reason, the delivery took longer than he would have liked, and he took it out on her, and so she found a way to take it out on you. Basically, she could have been lying.

BUT, nonetheless, since you are feeling less than confident.. just have a seasoned nurse go over things with you. You are new! There's no shame in brushing up! Then like I said, next time this happens you will be able to say "she was fully dilated, I KNOW SHE WAS!", and go on.

[LizzyL&DRN]

I had a VERY experienced nurse RUSH a patient back from triage stating she was Complete. When I checked her, she was actually 1 CM! She was just completely effaced and it was very difficult to feel. That wasn't fair of that nurse to tell you that you didn't know what you were doing! You did just fine, and so what that it took 40 min for her to deliver! At least he was there for delivery and didn't miss it. You did fine, don't beat yourself up. Mom and baby are fine right? That's what matters. GOOD JOB!!

[flygirl43]

Dr's are arrogant......don't take it on your shoulders!

[Valerie Salva, BSN, RN]

No one is perfect.

So the doc had to wait. He'll live.

Don't let one mistake that didn't hurt anyone get in your way.

[bagladyrn, RN]

It can feel that way when the cervix is completely effaced and the cervical opening is still way around posterior to the baby's head. I think all of us who have been doing this for years have made this error on some occasion. That's why if I do an initial check in which someone seems to be complete I slide my fingers all the way around behind the head just to be sure. That day nurse surely has done the same herself but likely won't admit it. If the head was really low (as they frequently are when the cervix is way posterior and completely effaced like this that would explain the patient's discomfort and urge to push.

As for the doc, don't sweat it - if it isn't that, they'll complain because they had to run in fast the next time.

[garfieldrn]

thanks everyone for the esteem boaster, it always makes me feel better letting it out on this chat. And thanks a whole bunch bagladyrn, I think what you describe is what had happened, it all make sense now.

[ifyouwereme]

L and D is so stressed. I can't stand doctors, sometimes. When you get a kind one, it's so shocking. Maybe this is not the field for me, I sometimes wonder. Or maybe it's the setting. She was mad cuz the doctor took out his/her frstrations on the nurse.

Keep it moving. Don't let the idiots get you down.

[SmilingBluEyes]

Don't give up on yourself. I have with over 11 years' experience, still had to have others back me up on uncertain SVE. Also, I have been wrong, too, even after years of doing this. It's not an exact science and we all can make a mistake. Sounds lik this is not one to stew over. Your patient was fine, and you are learning. Go easy on yourself, please.

[ShannonSRN]

If you ever unsure, have another RN check behind you. NEVER be ashamed or upset if you were wrong! I have had other nurses check behind me, a cervix can be paper thin and 1 cm and feel complete.

Any nurse who tells you that you don't know what you're doing should be ashamed of herself, you are always going to be in a learning curve regardless how long you've been a OB nurse. The minute you feel you know everything, you should quit...

[Suzanna4]

Oh boy, 40 minutes. That must seem like a lifetime, since OB doctors know that their chosen field of work is always textbook . Yes, I am only a nursing student, but I have also seen in my years as a doula, multiple nurses say a patient is complete, only to have an OB come in and say they are not. Were they mistaken? Or is it really possible for a cervix to go "backwards"? I don't know, but I wouldn't be to hard on yourself. Birth is a wildcard, and it's hard enough without co-workers telling you that you don't know what you are doing!