So, I'm extremely frustrated about my night last night. I had a 39 wk G1P0 who came in with SROM. She was contracting at this point about every 5-6mins and at 3cms. We admit her. The doctors decide that she should be put on pitocin. Apparently they hadn't looked at her strip while deciding this. So, I bring it to their attention that the baby is flat, no accels, no decels, and absent to minimal variability at best. Our protocol states that in order to start pitocin they must have a reactive strip. She clearly did not. They decided to wait an hour and reassess her. In the mean time, I gave her a little bolus, turned her on her side, and gave her an ice pop thinking that the kiddo might perk up. No go. So I "buzzed" the baby. She perked up for a whole 5-7mins then went back to her flat little self. Finally, I call the doctors let them know the situation had continued to be the same and I didn't start the pitocin. He and his upper level review the strip. They proceed to inform me that the baby can still have a good strip even though it has no accels and wanted me to start the pitocin. I still called the variability absent to minimal, no accels, no decels. In the meantime, they checked her she's 4cm's and they put in an FSE and IUPC. I know the pt is on a "clock" so to speak being ruptured and all, but I just can't bring myself to start pitocin on this lady. At the same time, she's not getting anywhere fast with her body's inadequate effort. Which brings me to my question? Was I right to not start the pitocin? Clearly not the worst strip I've ever seen, but doesn't look good enough for pit to me. Some people at work were telling me as long as I was documenting that they reviewed the strip which was non-reactive and that they told me to start the pit anyway I was covered. In the end, if (god forbid) something were to happen to that baby, I'm the one that pushed the start button on that pump not the doctors. I'm also that one thet is responsible to follow protocol. Correct? What is the point of having a protocol if you don't follow it? :angryfire
