fundal pressure

[mark_LD_RN]

Is fundal pressure ever an appropriate nursing intervention?

we are having a little debate over this, some are saying that it is never to be used . what do you think? do you use it?

[BETSRN]

Lizzy L&D. Someone needs to investigate that doc who uses the fundal pressure. Your description is very scary! I would make sure you talk to your hospital's risk manager ASAP! Please.

[AlaskaKat]

Once when I was a student (1996), I went to the Philippines with a transcultural nursing course. We did mainly L&D, with some NICU as well. At one of the very first deliveries I went to, the labor nurse actually jumped up onto the bed next to the mom's shoulder, facing her belly and applied fundal pressure with the force of her whole body for a long time, throughout the entire second stage. My eyes musta popped out of my head because afterwards she asked me if I was OK and explained to me that first time moms "never know how to push". Yikes! I asked my instructor about it after all was said and done and she told me to never never do that, and that their practice at that particular hospital was modeled after the standard of care in the US about 20 years ago. Scarey stuff...I didn't know anyone was still doing it here. Never once has it come up for me in practice.

[BETSRN]

i do the fake manuever it seems to make them happy!

I think I would say that "faking it" could be misconstrued by the patient/family in court. Even if you fake it and there is a problematic outcome, you could NOT defend yourself in court, stating that you "faked it." It would seem to me better to question the doc at the time and tell him that it is NOT standard of care. You are the patient advocate. better you have to endure the wrath (he'll get over it) of the doc than be involved in a lawsuit. Any lawyer worth his salt is going to be able to bring in every study that shows fundal pressure to be contraindicated and then you're screwed. You could never prove that you were faking it.

Document your refusal everywhere you need to.

[SmilingBluEyes]

Once when I was a student (1996), I went to the Philippines with a transcultural nursing course. We did mainly L&D, with some NICU as well. At one of the very first deliveries I went to, the labor nurse actually jumped up onto the bed next to the mom's shoulder, facing her belly and applied fundal pressure with the force of her whole body for a long time, throughout the entire second stage. My eyes musta popped out of my head because afterwards she asked me if I was OK and explained to me that first time moms "never know how to push". Yikes! I asked my instructor about it after all was said and done and she told me to never never do that, and that their practice at that particular hospital was modeled after the standard of care in the US about 20 years ago. Scarey stuff...I didn't know anyone was still doing it here. Never once has it come up for me in practice.

WOW what an amazing opportunity. I would love to travel there to learn and see things in a different environment. What a great learning opportunity you had. But lots of bad ideas out there....here and abroad. So much we all have to learn.