pt husband keeps moving the toco!

[lannisz]

What is wrong with some people? I would NEVER touch any equipment being used on a family member or in their room, even as a nurse! Last week I had a pt coming in for an induction. Her husband kept moving the toco around saying " this isn't working - she's having contractions but the monitor isn't picking it up so I moved it." This happened more than once. WTH? He's watched us place the monitor a few times and he's suddenly an expert? He thinks he can just place it anywhere.... and do a better job than the nurse? (my preceptor has 27 years of OB experience!) I have also walked into the pt room before and seen family members trying to get on the computer (where we chart), changing settings on pumps, you name it. How do you handle patients and family members who think it's OK to touch the medical equipment and settings? Do we need signs on everything saying DO NOT TOUCH?

[NurseNora, BSN, RN]

All very good responses about the charting angle. Had you been in the room palpating contractions? Were they recording? Did you feel anything when the patient reported feeling a contraction?

Sometimes (especially with the "fluffy" patient) you have to sit (or stand--I tell my patients that since I'm old and fat, I sit as much as possible as I claim the doctor's stool for myself) at the bedside with your hand on the fundus for a long time, moving the toco after each contraction you feel that doesn't record. When the family sees what I'm doing and how long it took to get it adjusted properly, they don't tend to move it. I also explain to them during this time how the toco works, that the height of contractions on the monitor doesn't tell us anything about the strength of the contractions in the woman.

The only time I have a problem with someone messing with the toco is when I have a woman who so desperately to be in labor that she pushes on the toco to "make" a contraction show up. But you can tell them because when you sit with them for 20 min, they don't have any contractions. Then when you leave they start "contracting" again q2m.