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recently had the opportunity to work with a new doc at a hospital as an agency nurse. i had an interesting conversation with him. He seems to think it is a good idea to use pitocin to augment contractions to get the baby out instead of having them push when possible, He also has a standing order to go up on the pit 4mu q15 minutes and stop at 50mu.
i was just curious to get your thoughts on this one.I will let you see my opinion later:).
well i only had the pleasure of working with him once. I took an agency assignment at another hospital for a one day to see if i liked it there. well lets say i have no plans on going back, it was one hell of a shift. I was to tired ,stressed and angry to even engage him on the issue at the moment. I can not remeber when i worked in such a horrible setting, i was only experienced nurse there and the others barely knew where anything was at, i got approx 20 minutes of orientation be fore being set free. I have done lots of agency assignments and this was one of the worst.
he just happened to top things of with this little gem of information. i wanted to strangle him but was to damn tired.
I worked with a Dr about 35 years ago who did 30 deliveries a month--this in addition to office hours, a gyn practice, and time off with his new 2nd wife. He did it by bringing in all the women with a favorable Bishop's score and pitting them, so that most of his patients delivered on the same day of the week and during the day. The patients loved it. I thought they and he were crazy, and was glad when my family and I moved to a different community.
James, you are in good company here hon. :) Most of us think pit is THE DEVIL!!!
I hate hate hate hate hate hate hate hate HATE social/convenience inductions. If I ever use enough drugs and/or have a head injury and become a nurse manager, I'll try like hell to block as many social inductions as possible.
MAN I hate those things!!!!!!!!!!!
i just went to a seminar given by judy poole last week. she said drs. who are pitting pt's who are fully are getting sued because of shoulder dystocias and that it is hard to defend these folks against lawsuits. we have dr's who do this all of the time. thank god we do not have a lot of kids getting stuck. i think it's really just impatience. the doctor feels that pt. is not pushing hard and fast enough and they want to crank up the intensity of those uc's so they can go home and go to sleep a little faster or wherever else.
Well, Mark, I think that doc has serious control issues. I think a lot of people dislike doctors because some of them get that "god" complex about them where they want to control EVERYTHING. I guess he just wants to make sure he's the one delivering the babies, KWIM? Ugh. creepy.
My daughter's birth was an induction at 38 weeks, partly because I have a history of fast labor and my doctor and I were afraid I wouldn't make it to the hospital, but also because my husband was very ill at the time (he was in the hospital with a leg infection for 3 weeks, and was released just 8 days before my daughter's birth) and had a PICC line with antibiotics, was on several diff medications, etc., and could hardly walk. We had NOBODY who could be available 24-7 to watch our then 18 month old son if I were to go into labor naturally. The only person who could do that was my BIL, who lived 45 minutes away. With the scheduled induction, we were able to have close relatives arrange a schedule to help us out and watch our son. I have to say that my doctor was very careful, and never would have allowed the induction if my cervix hadn't been favorable and if he thought there was any risk. At my last checkup 2 days before the induction, I was already 3cm. The induction was with pitocin, and honestly, I thought the whole thing was better than my first labor, which was wild, fast, scary, and dissapointing. This labor was fast, but comfortable and almost pleasant. I'm forever in debt to my awesome doctor and L/D nurse. :kiss
As far as the Dr who delivered all his patients on the same day, that seemed a little screwy. It does sound like maybe he went overboard. For reference, what is a Bishop's score? Is it some kind of way for them to tell if a woman is ready for labor or not?
Here is the Bishop's Scoring System: (in a nutshell in not too perfect words):
You score the following areas" Dilatation, Effacement (%), station (-3 to +1, or +2), Cerivcal consistency (firm to soft), and Cervical position (posterior to mid, to anterior).....
You get a zero (poorest result) up to a 3 (best condition in that area) and add them up....getting 1 all the way up to 10 ( I believe). 10 is optimal for inducing labor, theoretically. I just don't see this used much anymore. But kinda sums up Bishop's Scoring. Hope this helps!
SmilingBluEyes
20,964 Posts
Mark that is INHUMAN someone should give him some GOLYTELY and tell him not to shyt, even if HE gets an URGE !! SEE how the HELL he likes that! UGH, this burns my britches bigtime, the sadist.