Published
I'm very laid back, easy to get along with, pretty much can get along with anyone, but I've been at a new place for 3 weeks and mostly it's ok, tho they do some things kinda weird (like the whole unit running into the room for EVERY d-cel) but, wow, I wanted to ring this girl's neck, and our personalities are clashing BIG TIME>
She busted into my patients room after knocking VERY loudly and shouts. HIIII (in a squeaky obnoxious voice) I'm ______I'm here to catch your baby" and then immediately comes over to the bed where myself and the midwife are pushing with the patient and starts CHEERING "PUSHHHHH, PUSHHHHHH" and CLAPPING HER HANDS, I kid you not! I looked at the midwife and we both turned around and GLARED at her.
Mind you this patient was going natural, we had the lights dim, we had a very good environment going on and she ruined it all. Mind you we were NOT close to delivery, far from it. I never even called out for help.
She proceeded to STAY in the room for a few minutes, we did NOT need her help and finally I said, "Uhm, I'm good, I'll call when I'm ready" and she got SOOOO offended.
She has an attitude and a chip on her shoulder and she is sooooo incompetent, she said she's been an L&D nurse for 5 years but she just graduated.
I had to "orient" with her, and granted, I only get 1 day of orientation becuase I'm a traveler, all I needed to be shown was the computer system and wehre they kept their "stuff" i'm pretty keen on the aspects of birth, etc. And she couldnt' keep her mouth shut or get out of my way or anything.
I really am not good at confronting people and I dont want to make any waves, but this girl is really going to be a problem if she keeps busting into my rooms and acting like that.
I'm really just venting here and for anyone who managed to read all this, please vent with me about obnoxious, unhelpful coworkers :)
It sounds like that nurse was totally absorbed in her own world; like she didn't stop to think about the impact of her actions on others. What an annoying nurse. I might mention to her that she interrupted the patient's labor process and that this patient was doing a natural labor, etc., and ask her not to walk into a pt's room doing the same thing again.
I was a very quiet "laborer" and would've been highly offended by an RN cheerleading.
It also helps to ask the laboring mom what works for her. Some actually LIKE and ASK for counting and encouragement. Others want us to keep our mouths shut. It is not about us, you are right. It's their birth experience and it's our job to simply facilitate, not make things happen, as our egos would like to think.
Oh I agree - some women want and need the counting to keep them focused. And that is fine.
steph
I am sometimes quiet and nondirective, other times loud and directive depending on the situation and the patient's desires. Recently I was doing "quiet and nondirective" and another RN came in for the delivery (our practice is to have 2 NRP trained RNs in each delivery--just in case) and started counting and being very directive. After the delivery (which was very soon after her arrival), I pulled her aside and explained that I like to coach my own patients and in the future, would she not coach my patients the way I don't coach her patients when I come into one of her deliveries to "catch". She took it well, but then I'm an old L&D nurse and she's still pretty new and respects me.
I also plan to get her copies of some articles on the benefit of non directed pushing vs prolonged val salva pushing, but haven't looked any up yet. Anyone have any references at their fingertips?
I am sometimes quiet and nondirective, other times loud and directive depending on the situation and the patient's desires. Recently I was doing "quiet and nondirective" and another RN came in for the delivery (our practice is to have 2 NRP trained RNs in each delivery--just in case) and started counting and being very directive. After the delivery (which was very soon after her arrival), I pulled her aside and explained that I like to coach my own patients and in the future, would she not coach my patients the way I don't coach her patients when I come into one of her deliveries to "catch". She took it well, but then I'm an old L&D nurse and she's still pretty new and respects me.I also plan to get her copies of some articles on the benefit of non directed pushing vs prolonged val salva pushing, but haven't looked any up yet. Anyone have any references at their fingertips?
I have seen the articles about non-directed pushing and even some dangers involved in valsalva pushing (injury to the perineum, higher rate of incontinence). I was thinking of starting a thread about it and asking what people are doing. I am at a teaching hospital and would like to change the practice to a more evidenced-based one to send these residents off with more up-to-date info. I will definitely be looking into this this week at work. They have FINALLY let us back into CINAHL and PubMed and I am making that my first comprehensive search.
I'm usually charge RN on a midnight shift w/lots of "newer" nurses. I try to attend most births (mainly for support/another pair of hands/gopher). I try to mimic what their primary nurse is doing. The only time I try to intervene, is if I see that the patient isn't pushing effectively, mostly by either not feeling the "spot" or some such thing. I try to suggest to mom to either change position, put hands under thighs, use towel for pulling... I give her/dad the explanation of why (so that the new RN learns too) she might need to change what she is doing, help with positioning.... but I make sure the primary RN knows that she (not me) is running the show.
You can't learn everything there is to know during orientation, alot of it is "hands on". Lord knows, sometimes I still need someone else to double check a lost cervix, start an IV. Somedays you've got it, somedays you can't find the door on the barn!
If verbal coaching is needed during pushing, usually we just tell mom to push the most comfortable way for her, dad does the coaching. We don't yell (maybe because it is the middle of the night), but sometimes you do need to get into your patients face, especially if she's losing it. I have no problem telling everyone in the room to shut up, get moms attention, and tell her to concentrate on me, listen only to me. There's nothing worse than 2 RNs, dad, nursery RN, mom, other support persons, all yelling something different!
Stand up to this nurse. It's not her patient, or her delivery. Talk to her. Maybe this is the only way she knows how to do deliveries. TEACH HER!
SmilingBluEyes
20,964 Posts
It also helps to ask the laboring mom what works for her. Some actually LIKE and ASK for counting and encouragement. Others want us to keep our mouths shut. It is not about us, you are right. It's their birth experience and it's our job to simply facilitate, not make things happen, as our egos would like to think.