A few weeks ago I had a primip in active labor who thought she would probably want an epidural, but wanted to try walking in the room, labor ball, etc while the contractions were still manageable. I was supportive of this plan but also made it clear that the epidural was available when she was ready for it. When I ran into the doc in the hallway, he said "labor ball????" (like, "why the hell are you messing around with that, just get her the epidural.") I told him she wanted to hold off on the epidural for awhile and be up and moving while she still could. He just rolled his eyes. whatever.
So when she finally did request her epidural, I already had everything ready to go so I paged anesthesia and started the fluid bolus right then. The anesthesiologist was not super prompt about it, and by the time my patient received her epidural she was very uncomfortable and starting to feel pushy. The MD came in as the epidural was being put in, patient moaning and groaning, and scolded me in fromt of everyone! "I knew you were going to wait too long to get her her epidural!!" and was just pissy in general through the whole delivery!!
Afterwards I confronted him about it (very professionally) and told him exactly what had happened, and he pretended like we were best buddies and all was well with the world, and that the anesthesiologist was the one he was upset with. but he had definitely been inappropriate with me in the delivery.
This evening I had a patient in active labor who, also, knew she wanted an epidural but wanted to try ambulating etc while the contractions were tolerable, which, again, I was supportive of but let her know that the epidural was available whenever. The MD was on the floor for about an hour after she gave me the order for nubain/epidural prn and probably asked me four times if she had gotten her epidural yet! Each time I told her that the patient wants to hold off a little while and be up walking around for now, and then when the patient requested just some nubain the doc hissed, "why doesn't she just take the epidural??" all exasperated.
as a nurse new to L&D this stuff frustrates and confuses me! Shouldn't it be supported and encouraged if a patient wants to be up and moving in labor?? epidurals certainly aren't without their risks, either.
VickyRN, MSN, DNP, RN
49 Articles; 5,349 Posts
Discouraging epidurals can be "bad" for business:
https://allnurses.com/forums/f165/stormy-days-nurse-childbirth-educators-raleigh-129712.html