Patient Compliant...Taking it Really Hard

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Specializes in OB.

Just needing some love this morning:

Got a labor patient last night; quickly got the picture that she was a "VIP"; SO a physician, has a doula, wants a private room post-partum, even though we are full. I was very accommodating; as I am with every patient, no matter who they are. They wished for a Bradly-like experience, which I got orders for (against our normal rountine) and made the best situation out of our outdated and limited resources. Things were going great; I felt I had a good rapport with them all. My style is very quiet and gentle and I felt like we were having a good night.

Patient requested an epidural after much debate with her support persons. After wards, I attempted to place a Foley before shift change, and to examine her so I could give the doc an update, as is her rountine. The patient, though the whole shift, seemed super sensitive; to the tape on her IV to the EFM belts to the blankets on the bed. I know labor patients are hyper-aware, but it was pretty extreme. That being said, even though I talked her through the whole procedure, she screamed and jumped and sure enough; I put the Foley in the lady parts. Duh! I explained what happened and that we'd have to do it again, but I would let the next shift do it, so she would be more numb. They seemed okay with that. I apolgized, left the room to get another Foley kit handy and came back. The SO then procedued to berate me and say that I "poked" his wife twice, once during a vag exam and then during the Foley insertion and that I should be more careful as "women's urethra and lady parts are very distinct." All I could say is I was sorry. Maybe I have thin skin (okay, I really do!) but I have never felt so small. I know I am gentle and competent; I just am beating myself up. I know where he is coming from; it's so hard to see a loved one in pain. But....geez! In five years of nursing, I haven't felt so rotten.

Talked to my boss after shift, and she really listened and made me feel better. Just another night......

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Specializes in Surgery, Tele, OB, Peds,ED-True Float RN.

Maybe in a text book they are distinct, but I have seen a good many RN's and MD's that could not find the urethra because of swelling, discharge, and the baby's head putting pressure on the urethra. My guess is that he was not an OB MD??? Do not feel bad and next time stand up for yourself and explain the reason for the catheter insertion trouble with confidence. And as for poking his wife during a PV exam... What the heck is he talking about??? What did he think you poked??? I know how nerve racking it is to have a MD as a pt or family of a pt. Sounds like you know what you're doing!

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Specializes in OB.

Thank you for the support! He was actually a hospitalist....I can see how being out of his comfort zone in OB was stressful. Next time I will stand up for myself; at least then I would be able to say my side without seeming like he "scared" me.

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Specializes in Hospital Education Coordinator.

A swollen labia makes a whole different world vs. non-pregnant female.

But this lady ( and I use the term loosely) sounded like a diva anyway. If you did not fall to the temptation to tell her to shut up and be still then I think you did great.

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I probably would have said something like, " I understand that you're concerned about your wife's well being. I understand that she's uncomfortable. However, if she would sit still during the procedure she wouldn't have to endure it twice". With confidence but in a noncondescending voice.

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Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

I know this isn't helpful to the situation but if she was so sensitive how in the heck did she get pregnant?:uhoh3:

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Specializes in LTC.

and do they realize that a human being is about to come out of her lady parts? lol. Oh but you poked her, that's so much worse.

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hmm even non delivering ladies anatomy is confusing compared with the textbooks i have placed in a lady parts once, its not unkown.

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If she hadn't jumped, you would have gotten it in.

Just shrug it off.

Maybe he would like to do it?

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I think I would have been very tempted to hand him the equipment and let the SO do it. See if he has more luck. I'm willing to bet he wouldn have the same results. It is not easy to spot a urethra on a laboring woman. It's nice that he is watching out for her, but he should have backed off enough to allow you to do your job.

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Don't be too hard on yourself :) I had to straight cath a pt and missed so I had to call my former preceptor who told me I was an idiot for missing so it can happen. The funny part about it is that the pt does this herself...I just laughed at it and took it as a learning experience :)

What I have learned is that no matter what a "horrible" nurse a family may think you are, the next family will make you remember why you are a nurse in the first place. So chin up

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Specializes in L& D / GI NURSE.

he's an example of overconfident Dr. that when they get in a bind that don't ask for help... Just a jrk

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