Published Feb 1, 2005
RNLaborNurse4U
277 Posts
There is a doctor that I work with....he likes to break the bed, use stirrups, vacuum and fundal pressure (ugh) on every single delivery. No matter if she's a primip or grand multip.
Well....hehe....good patient advocate that I am...I had one of his patients yesterday. She wasn't too fond of him (going to him by default, he was the closest OB, she lost her previous OB). She had a prior SVD with no comps.
Well well well, while Mr Stirrup man went looking for his infamous stirrups to add to the bed (we don't have them on most of our birthing beds, or in the rooms - they are RARELY used), I had her pushing. I mean, vigorously pushing. I wanted to get this baby to crowning+ before he came back in the room, carting his darn stirrups. Back in the room he comes - complaining that he couldn't find his darn stirrups, and no one knows what he was talking about (the type he wanted), and here I have the patient crowning with pushes. Bed is not broken - why bother? She can easily pass this baby out, not anticipating shoulder problems, etc. With his back turned to the patient while she's pushing, here comes the head....I tell him - "hey, no need for those stirrups here....and you wanna get some gloves on?" ..... while I'm starting to deliver the head. He quickly dons gloves, acting flustered because he has an unbroken bed, no stirrups, and god-forbid no vacuum or fundal pressure (cause I sure as heck am NOT doing it for him), and a normal delivery occurring right before his eyes!
In the end....no epis, no vaccum to this little one's head, no lacs even!
Hehe....score one for the nurse who advocated for her patient.
Afterwards....he complains to me "what if I needed forceps? or a vaccum? You're not going to be able to hold her legs up." Wanna bet buddy? I do it all the time for the other docs. And if we have an operative delivery like that, there is always a 2nd RN in the room.
:balloons: It was an excellent birth, and I hope I can help this doc see the light of a non-operative delivery, and how wonderful it can be.
Jen
L&D RN
palesarah
583 Posts
good for you! Way to advocate for your patient :)
SmilingBluEyes
20,964 Posts
That doctor sounds dangerous. Glad you stepped in there to advocate. But what about next time? Too bad you have to struggle w/these sorts of outdated and dangerous practices.
BETSRN
1,378 Posts
There is a doctor that I work with....he likes to break the bed, use stirrups, vacuum and fundal pressure (ugh) on every single delivery. No matter if she's a primip or grand multip. Well....hehe....good patient advocate that I am...I had one of his patients yesterday. She wasn't too fond of him (going to him by default, he was the closest OB, she lost her previous OB). She had a prior SVD with no comps.Well well well, while Mr Stirrup man went looking for his infamous stirrups to add to the bed (we don't have them on most of our birthing beds, or in the rooms - they are RARELY used), I had her pushing. I mean, vigorously pushing. I wanted to get this baby to crowning+ before he came back in the room, carting his darn stirrups. Back in the room he comes - complaining that he couldn't find his darn stirrups, and no one knows what he was talking about (the type he wanted), and here I have the patient crowning with pushes. Bed is not broken - why bother? She can easily pass this baby out, not anticipating shoulder problems, etc. With his back turned to the patient while she's pushing, here comes the head....I tell him - "hey, no need for those stirrups here....and you wanna get some gloves on?" ..... while I'm starting to deliver the head. He quickly dons gloves, acting flustered because he has an unbroken bed, no stirrups, and god-forbid no vacuum or fundal pressure (cause I sure as heck am NOT doing it for him), and a normal delivery occurring right before his eyes!In the end....no epis, no vaccum to this little one's head, no lacs even!Hehe....score one for the nurse who advocated for her patient.Afterwards....he complains to me "what if I needed forceps? or a vaccum? You're not going to be able to hold her legs up." Wanna bet buddy? I do it all the time for the other docs. And if we have an operative delivery like that, there is always a 2nd RN in the room. :balloons: It was an excellent birth, and I hope I can help this doc see the light of a non-operative delivery, and how wonderful it can be. JenL&D RN
You go, Jen! Score a BIG one for the nurse!
ER1010
92 Posts
Maybe a dumb question, but why are stirrups less preferable than holding a leg? I would think I would like the stability from a stirup...
Dawn27
45 Posts
I have personally tried pushing with legs in stirrups and it is the most unnatural position to try to give birth to your baby. In the end I asked if I could turn on one side and deliver that way so much easier so much more comfortable.
canoehead, BSN, RN
6,901 Posts
:balloons: :rotfl:
You da NURSE! Excellent job :chuckle
Zhlake
74 Posts
ITA. I think the better question is "Laying on her back??? WHY???"
Good question.....probably doctor's preference.....even though my epiduralized patients usually end up with a pillow under their hip at delivery - I conveniently "forget" to remove it when I get them pushing. Hehehe
L&D Nurse
Good question.....probably doctor's preference.....even though my epiduralized patients usually end up with a pillow under their hip at delivery - I conveniently "forget" to remove it when I get them pushing. HeheheJenL&D Nurse
Epidural or not, sit them straight up! Let nature work.
The stirrups did not upset me as much as his routine use of FUNDAL PRESSURE. Stirrups are useful for extremely heavy people, when holding their legs for an hour or more can be taxing. I am not against their use in all cases. But fundal pressure in labor is NOT warranted, and in fact, is dangerous.
Mermaid4
281 Posts
Great job! But I find it ironic that you don't have stirrips available. We don't use them very often but I am happy they are there when we need them. Ironic that we rarely use fundal pressure, vacuums or forceps but the stirrips are on the bed, if needed. I have no problem with that.