Inappropriate care by MD-just venting

[rdhdnrs]

I work full time in a university setting and part time in a private hospital. Friday I was in the private one. I had a 16-year-old, nervous, with a nervous mom. The girl had some pressures, her platelets fell a little bit, she had 2+ urine protien. The doc wouldn't let me start her on mag ("That'll just slow things down")!

Anyway, baby's pretty high, we get the epidural so we can break her water!!! this is one of those chicks who run up the bed when you try to check her. She progresses to 4cm/100%/-1 when the doc comes and checks her. By this time the baby's heartrate is 170's and mom's temp is 99.4. I tell the doc, who says give her tylenol!!! So this girl has been complaining about pain in her upper back. I think it's just tension, and she agrees. When the doc is in the room to check her, she c/o this pain. Doc says, "Is it worse during contractions?" WTF??? Of course the girl says yes. Doc tells me to turn the pit off, she'll be back in an hour and a half to check her. When she comes back cervix is unchanged and she calls a section. Oh, and the time is now 1730!! Then she gets mad because anesthesia is not immediately available.

I didn't feel like much of a nurse, especially when the baby's temp after delivery was 101.4.

What should I have done? Anything? Or should I just write it up to private practice? This is really bugging me.

Lisa

:(

[sleepqd]

The standard answer is "Go up your chain of command", but you and I both know this doesn't always work. All I can suggest is to document the *fecal matter* out of it, hopefully to be picked up for peer review. Either way, you have covered your own gluteus maximus.

How sad for this girl to have this experience. How sad that this doctor has no more compassion. How sad that you had to interface between the two.

[GailWHNP]

I, like sleepqd, would do my best charting and also hope for chart review if it's a medical decision made by the doc. If the doc was rude to either me or the patient, I would write it up. Sometimes it does good cuz the nursing administration follows up on those complaints whereas the physician board would follow up on the other, and seldom is anything done. As a matter of fact, I've *never* seen anything done by the physicians! Would be curious to hear how others handle such situations.

Gail