Quote from phriedomRN
I know that we aren't always going to see the happy endings. I can accept that. What I have trouble with is calling a doc, repeatedly, for issues and getting poor responses. At almost the exact same time as the doc finally shows up, we start having heart tone issues. Issues that continued and
worsened over the next 40 minutes. Issues that resulted in a very very bad outcome.
My resource nurse was involved, and had been. Everyone who ended up in the OR with us said they didn't know of anything else I could have done. I made the phone calls, gave the appropriate information and documented the responses. I still feel like 3 day old dung.
I can't concentrate, haven't been sleeping since it happened. I've cried more in the last week than I think I have in my entire life. I haven't the slightest idea of where to go from here. This kid would have been fine if I could have picked up the scapel myself, but I couldn't, and I don't know how to handle that. I know there's going to be legal action, and I'm really freaked out by that too. Help, prayers, advice, cya-tips? Anyone? I'm dying here!
Having had a startlingly similar experience myself a few years back, some things come to mind you need to do:
1....JURIS PRUDENCE. In other words, do not discuss this situation with anyone who was and/or is not involved in this sad circumstance. (including ALLNURSES.COM!) Any legal questions and issues, need to be taken to legal counsel. Also, if there are strips, documentation, etc. laying around, get these to your manager and have these things kept there---not for open speculation and discussion by staff. Rumors are not needed nor wise at this time. This is not to "hide" anything, but to keep order to it. And this situation should not be discussed or speculated on by people who have no knowledge or involvement.
2....I hope you spoke to that poor family and conveyed how sorry you are. I don't mean, taking blame (whether it exists on your part or not) but really respecting the fact this family is hurting, terribly, and needs to hear you are heartily sorry and did all you could do to improve or help the situation. They need to hear that the staff all very much care about what happened and that they are truly sorry for the outcome. Beyond that, say little to nothing.
3....Get to a counselor for debriefing. Or better, ask your manager to set up a debriefing session for all involved employees/doctors in the situation. Ideally, this should take place very soon, when feelings and emotions are raw and get them "out" in a safe place. You must not shut down, this must be talked about and you will find your emotions will overcome you if you don't have a professinal outlet to take them to. Trust me on this. Ask about employee "EAP" programs-----they provide counseling----and it won't cost you money to get such help.
4....As soon as you can, "get back on that horse and ride again". Your first instinct may well be to want to stop caring for labor patients or do your job. Take some time you need to get it together---but not too long. And again, if you are too traumatized to return to work , or be effective at work, in a week or two, follow-up counseling is an imperative.
5....Be good to yourself. Yes, you will go over the events of that situation over and over again in your mind's eye. But don't neglect your need for sleep, proper nutrition, TLC from loved ones. Please, do not be afraid to ask for help from those who care when you need it.
6.....Make sure your documentation is flawless and truthful. IF there is an incident report to be done, do it and very soon. Remember, do not assign blame in the patient chart for anything that occurred. These observations are to be made in an incident report. Do not be afraid to get help doing this report from your manager or charge nurse who was on shift when this happened.
7.....Good luck. I have been there and it's enough to make you want to quit forever. I am fortunate ( I guess) in that nothing I did contributed to the situation that occured, rather, it seems the baby had some congenital problems that were unknown that contributed. This does not make things better for the family but at least I knew I did not harm the baby myself by anything I did.
8.....Believing in a Higher Power helped me. I just believe, that soul elected not to enter this life at that exact time, either because timing or the environmental conditions were wrong. I believe that soul would be born when things were right, not before. Babies do die, despite our best intentions. Sometimes, we have to acknowledge we are not any more than mere humans, doing our best and have to give up that sense of power or control that we "did" anything wrong. In no place more than OB, is this harder to do. Outcomes are expected to be perfect each and every time. This is not possible. Prayer is all I could do to get through this, in the end. And knowing, that little soul will join us when he/she is ready, sure helped me. It helped my involved coworkers, too.
9....Going to work may be tough at times, at least in the first few weeks after this occurence. For me, the sense of dread I felt was awful. "Armchair quarterbacking" is so common---everyone thinks they could have done it better and "sees so clearly" all the "mistakes" you made! I had some coworkers who were less than kind and were whispering about me and the others involved. I nipped that in the bud and told them if they had something to say, say it to me directly. I also asked my manager to pull in the reins, if for nothing but again, juris prudence. Discussing this openly meant all of them could be implicated if they were not very careful. That stopped that and soon, I got support from some of them. Others, you can't help. Just be STRONG and take it one day at a time, as they say.
I feel for you. Hang in there and get advice where you need it---be it from Risk Managers, your unit manager, charge nurse, or counselors, or even your own attorney, if that becomes necessary. I feel horrible for that family----just awful. And I feel awful for all involved. These situations are so hard for everyone involved.