I started a new job in December at a larger hospital, avgs 30-40 deliveries a month. I know that doesn't sound large but at my last job a good month was 20.
I have personally delivered more babies in the few months I've worked here than the 8 yrs I worked previously.
I was wondering how common nurse attended deliveries are at your facilities.
Last week had a g2, 1st babe pushed hrs and had forceps. This ob-gyn wanted to be called when she was complete. I called him, reported also that she was only a little pushy, he then stated to call him again when I could see head. Well, this kid was high, she would push and he would hit the pelvic bone, then slip back. We tried a few different small position changes, then 30 min of no progress I put her on the birthing stool on the floor. She immediately leaned forward like she was gonna fall on the floor. I got the mom behind her and s.o. in front of her, looked and there was crowning. I hit the call light and no one came to help (found out later it didn't work) the family ran to get another nurse and she delivered while the dr was being called, tight nuchal cord. My other deliveries that I did here the drs just didn't make it and they should have, except one who walked in complete.
At the other hospital the drs at night would come in when they were complete, or making some progress like they would be complete soon. I appreciate that. I like catching babies, but if something goes wrong, I don't want that responsiblity. If I wanted to do that I would get training and become a midwife.
Specializes in ER,Neurology, Endocrinology, Pulmonology.
Reading all these posts, I am wondering..why is MD allowed to be present only for the actual minutes of delivery? Couldn't this be dangerous? Nevermind the stress that the poor nurse (doing it ALONE) and mom have to endure?
We have 2 major hospitals within minutes of each other in my small city. I have lived here 10 years and last week was the first time I heard of a full term baby and mom ( who also has a 3 year old) dying at the same time during childbirth, while on premises.
apparently, this poor woman was related to some people we know, so I am going to find out what happened. i just couldn't believe that these days it is possible to lose a healthy woman to childbirth.
Anagrey, I can see where you may feel that it would be very stressful to the nurse/patient who are involved in the nurse assisted delivery, although, when it happens, it is generally quick and the patient is ready to have the baby and doesn't care who delivers, as long as they know what they are doing. Quick deliveries are nearly always the most uncomplicated ones. Maternal death is certainly not much of a concern with these type of deliveries. I did my 11th one just this week (still counting, HazeK) and it used happened alot more often when I worked the night shift! Certainly, it is best to have the doc there, but every OB nurse should be trained to deliver a baby when necessary.
I attend high risk deliveries, with a hopitalist pediatrician. Frequently we arrive before the ob, and have to wait for the delivery, as they instruct the mother to breathe. Sometimes I feel that this puts much more stress on the baby, if mom has been pushing for a couple of hours, and having variables, or baby is tachy...I want the baby out. Trouble is the docs don't want to be called until the baby is crowning, and we really don't know how long it's going to take. I went to one delivery recently, a 35 weeker...actually I went twice, doc said she wasn't ready yet. Then she preciped when he was delivering another baby......we can't win!
At my hospital we use to have alot of nurse assisted deliveries, now we have nurse supervised deliveries.
What I mean is this.
We have a staff ARNP on the L&D floor at night. Anytime a doc appears that he can't make it, she will go in and supervise... ALSO.... they call in the ER Doc... Which is a HOOOT! Has anyone ever seen a ER doc come to L&D? It is quite comical! He basically stands there and supervises the final moments while the RN and ARNP deliver the baby. Usualy the OB comes in and finishes things up at this point.
My friend was able to catch the head of a precip, just as the ER doc ran into the room. He was able to catch the rest only after the nurses pushed him into it.
Count me among those who have stopped counting how many babies I have caught. It just happens.
All L&D nurses should be skilled at baby catching because it WILL happen. At my very first job, I had a wonderful group of OB docs who would teach us how to catch babies. That teaching protected the mom/babies, the docs and the nurses. A calm nurse who knows how to deal with tight nuchal cords, shoulder dystocia, nonreassuring babies, etc. can do what needs to be done.
One place I worked wanted the ER docs to be called for the birth which we did for a while, until so many bad things happened that they decided that wasn't such a good idea afterall. The ER docs did not have as much knowledge and skill as the L&D nurses in catching babies.
ITA. Who else best to catch the baby in the absence of the OB than the nurse? After assisting with countless deliveries, an experienced OB nurse is clearly more capable of performing a delivery than an ED doc. It is part of the job. (And an exhilerating one at that!)
I have yet to catch my first baby after over a year in OB. It is a rare event where I work because there is almost always someone around, so if needed we call overhead for any OB or midwife in house to come to the LDR. I am so glad we are trained to catch babies so that I know what to do if (WHEN) it does happen.
Looking at these posts, I am so lucky that in my hospital we have the "luxury" of 24-hr access to anesthesia...we are able to pick up a phone in the LDR and have NICU resus come downstairs in seconds...I realize how rare this is. I can't even imagine working in a unit that does less than a thousand deliveries a month. We do at least 1200-1300. The other day we broke our 24-hr record of deliveries-- 78.
Anagray, BSN
335 Posts
Reading all these posts, I am wondering..why is MD allowed to be present only for the actual minutes of delivery? Couldn't this be dangerous? Nevermind the stress that the poor nurse (doing it ALONE) and mom have to endure?
We have 2 major hospitals within minutes of each other in my small city. I have lived here 10 years and last week was the first time I heard of a full term baby and mom ( who also has a 3 year old) dying at the same time during childbirth, while on premises.
apparently, this poor woman was related to some people we know, so I am going to find out what happened. i just couldn't believe that these days it is possible to lose a healthy woman to childbirth.