Quick background: I work in a small hospital birth center in a rural area. We serve patients from up to 75+ miles away. Two dedicated L&D rooms, 5 PP rooms, 2 antepartum/PP rooms and one multipurpose room (AP, triage, PP, and L&D if needed). Biggest baby boom ever was in August with 59 births.
Typical staffing: Days 3RNs, 1RN/LPN, and 1 CNA; PMS 2RNs, 1RN/LPN, 1CNA; and nocs 2RNs and 1 CNA with 1RN/LPN on call. These nurses cover L&D, AP, PP and nursery.
Anesthesia is on call at home with a 20 minute get here time, same for entire surgical crew, after hours and on weekends. We only have a single crew on call during off hours.
So, here's the issue. OB schedules 2 inductions on Saturday. One a prime and one a VBAC that lost twins after emergency c-section late 2nd trimester/early 3rd trimester - last year. Already have 3 mom's and two babes. Of course, both inductions go to he** in a hand basket at the same time. Called a C-section on one for non-reassuring FHTs, then walks into the other room with fetal brady and tells the nurses, never mind, this one goes first and get the other one ready to go downstairs to the other OR.
Reason for induction: patients didn't know why they were being induced, MD just asked if they wanted to come in on Saturday, when he was on call, and have the baby - and not yet 39 weeks:nono: :nono:
We have OBs that will insist on AROM on a latent labor pt. even when we are doubling up patients in private rooms and giving them the desk telephone number because there is only one call light in each room. :nono: And have two others in active labor:madface: :madface:
The question: is there some sort of mechanism for the RNs to report or have these decisions reviewed by a higher authority? Do you have authority to tell a doctor that he/she cannot induce a 38 week VBAC on a weekend? Can you tell a doc not to AROM or pit augment a GBS+ mom before getting her 2nd dose of ABX?
Any thoughts would be greatly appreciated. Thanks for letting me rant. You folks are great.