Originally posted by HazeK:
<STRONG>with a heavy motor blockage from an epidural, about 75% of our docs prefer a "passive 2nd stage" until +2 station....on dayshift, while they are so busy in the offices! About 25% are still "old school" & want us to push when pt is complete. Suggestion: When you can, avoid lying...or you'll get a reputation for it! Instead, I just don't check "heavy epi" patients after 8-9 cms until pt c/o strong pelvic pressure or I see small var decels w/ each contraction...usually are +1 or+2 by then!
Also, having done OB x 19 years in a unit w/ high epidural rate...must suggest you weigh each patient's need for an epi BEFORE 4 cms very carefully!!! You stated "up til now, I only lied about her being 4 cm so she could get her epidural.." I must suggest that in many cases giving an "early" epi is not in the patient's best interest! The pre-epi bolus is going to slow down her labor all by itself...then the heavy epi may slow it down even more! I HAVE given early blocks on very special occasions (PIH, "sh_tty tracings", very young teens who are frightend) but would suggest that active labor is NOT even well established until the pt is 4 cms! How about a nice HEAVY dose of narcotics instead? We often use Stadol 2mg+Phenergan 25 mg IVP for the "writhing, screaming" 2-3 cm patients!
hope this helps!
Greetings All Nurses,
I have to agree with Hazel on all points! I am an advocate for "Natural Childbirth" and as such I think epi's only set the client up for a C-Section. But I have as a Doula suggested a analgesic like "Nubain". I like Nubain becuase it does not have the respitory depression like narcotic analgesics, as Nubain is a narcotic antagonist, in the same classification as Narcon, yet has analgesic properties. As a Natural Childbirth advoacte I want the client to take as many breaths as possible to evacuate built up lactic acid from the muscles, especially from these under used muscle groups, LOL. KEGAL, KEAGAL, KEGAL!
Originally posted by amberm72:
It appears as if you could be under some scrutiny regarding your "practice" at work. Lying to phsicians is an absolute no-no and one you will be caught and punished harshly. It looks like you work at Pullman hospital on the WSU campus---I know who your manager is and will be contacting them soon. I hope you can clean up your act! </STRONG>
I have my thoughts on this post too. First of all this person is new to the board and may not know it's purpose or the ethics. Geezzz this was her first post, Welcome amberm72! I think we as a group need to ethically realize this is bullentin board's purpose is to share in safe place, information, strength, hopes, and dreams. It is not a place to "lurk" or gather information against other nurses. But amberm72 has a valid point it just her methods are in error! She IMHO should have PM'd (Private Messaged) Alisha rather than make a threat! There is two sides to this coin. We want autonomy as a Professional group, we must also except part of this is the ability to discapline our members! The only process I know of is the Board and that is not really what am talking about. What I am talking about is peer/professional review. Since I do not know of a method to address this type of issue, I think amberm72 is only saying what she knows to do. It is wrong (unethical) practice to lie to get an order! It is also unethical to use this forum for the purpose of catching nurses doing short cuts or similar things! So we as a group (call it the bullentin board nurses group) should form a committee for this issue and send our suggestion to the board of nursing in each of our states, so that we can do our own peer review without fear of loss of licensure, LOL
Have a Blessed Day,
[ May 19, 2001: Message edited by: jamistlc ]