nurse only attended births

moz · Apr 28, 2003

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.

(sorry so long winded)

KELLYGIRL · Apr 28, 2003

I agree completely. I wouldn't want that responsibility either. I have only participated in OB as a student, and saw a Dr at every delivery. What do the other nurses say about this?

KELLYGIRL · Apr 28, 2003

I agree completely. I wouldn't want that responsibility either. I have only participated in OB as a student, and saw a Dr at every delivery. What do the other nurses say about this?

memphispanda, RN · Apr 28, 2003

I don't know what's typical either. What I do know is that my last baby was nurse delivered. It was my third. The nurse called the doc and said he needed to get there immediately (I had only pushed once, but he was crowning). All he had to do was walk from his office, across the walkway, to my room. He made it about 20 minutes after she called, which was about 18 minutes after the baby arrived.

I hope you find some answers for your situation though...it sounds like you are expected to deal with a lot more than is expected many places.

memphispanda, RN · Apr 28, 2003

I don't know what's typical either. What I do know is that my last baby was nurse delivered. It was my third. The nurse called the doc and said he needed to get there immediately (I had only pushed once, but he was crowning). All he had to do was walk from his office, across the walkway, to my room. He made it about 20 minutes after she called, which was about 18 minutes after the baby arrived.

I hope you find some answers for your situation though...it sounds like you are expected to deal with a lot more than is expected many places.

moz · Apr 28, 2003

Most of the nurses seem to be ambivalent, it's happened so often the older nurses just say thats what happens if they don't want to come here and risk waiting. I almost think the newer nurses like it, I do too, to an extent. Its an awesome thing to help bring a baby into the world. I've actually seen a couple who were reallly close, the dr on his way and the nurse actually coaching the pt to push hard instead of pant, or grunt. One nurse in particular told me on one 12 hr night shift she caught 3 babies.

moz · Apr 28, 2003

Most of the nurses seem to be ambivalent, it's happened so often the older nurses just say thats what happens if they don't want to come here and risk waiting. I almost think the newer nurses like it, I do too, to an extent. Its an awesome thing to help bring a baby into the world. I've actually seen a couple who were reallly close, the dr on his way and the nurse actually coaching the pt to push hard instead of pant, or grunt. One nurse in particular told me on one 12 hr night shift she caught 3 babies.

sbic56, BSN, RN · Apr 28, 2003

Moz

This happens fairly often where I work as well. Small hospital, obs have no back up coverage, so they don't want to spend alot of time there if they are trying to see pts. in the office, they could be in surgery or especially if it is at night and they could lose hours of sleep. I am not saying it is right, but that is the situation sometimes. I have found that babies that come that fast are apt to have less problems delivering, again not to say having no doc at delivery is a good thing. I have caught around a dozen, two in one shift one night. I would never encourage a patient to push the baby out if I knew the doc was nearby, but I do think we all need to be prepared for the occasional nurse asssited delivery. (I would like to get paid for it, though. Yeah, right.)

sbic56, BSN, RN · Apr 28, 2003

Moz

This happens fairly often where I work as well. Small hospital, obs have no back up coverage, so they don't want to spend alot of time there if they are trying to see pts. in the office, they could be in surgery or especially if it is at night and they could lose hours of sleep. I am not saying it is right, but that is the situation sometimes. I have found that babies that come that fast are apt to have less problems delivering, again not to say having no doc at delivery is a good thing. I have caught around a dozen, two in one shift one night. I would never encourage a patient to push the baby out if I knew the doc was nearby, but I do think we all need to be prepared for the occasional nurse asssited delivery. (I would like to get paid for it, though. Yeah, right.)

Jolie, BSN · Apr 28, 2003

Does your unit have a policy requiring the doc or midwife to be present in the hospital for patients in active labor? I can't imagine working anywhere that did not have this requirement. Our docs must come in to the hospital when their patients are 4 cm or greater. Even this policy doesn't completely eliminate "surprise" deliveries, but it goes a long way toward cutting back on them.

Both of my deliveries became suddenly complicated when I was in the pushing stage (one was a complex presentation with her hands to her face, and got stuck, the other prolapsed her cord). I had the utmost confidence in my nurses, but thank God my OB was immediately available to handle those crises.

Jolie, BSN · Apr 28, 2003

Does your unit have a policy requiring the doc or midwife to be present in the hospital for patients in active labor? I can't imagine working anywhere that did not have this requirement. Our docs must come in to the hospital when their patients are 4 cm or greater. Even this policy doesn't completely eliminate "surprise" deliveries, but it goes a long way toward cutting back on them.

Both of my deliveries became suddenly complicated when I was in the pushing stage (one was a complex presentation with her hands to her face, and got stuck, the other prolapsed her cord). I had the utmost confidence in my nurses, but thank God my OB was immediately available to handle those crises.