Total accident of course. Needless to say the attending was very angry about this.
This was a g2p1 lady. She had a 15-month-old at home. Of course even with an epidural, she had a ton of pressure with her contractions. The resident did a sve she was 10/100/0. Resident said it would be best to labor down so that patient wouldn't be pushing for hours. Patient was confused, miserable and very frustrated of course, practically in tears. I stayed with her for the next hour, helped her through her contractions and checked her again. Still at 0 station. So, I called the resident, can I do a test push with her, she is very miserable. Resident says, "sure, go ahead and start pushing with her, but let her know she can stop and rest if she needs to". So, I document this and start pushing with the patient. Doing a sve at the same time so I could feel if she was moving the baby. Not moving the baby with her pushes yet, so coached her on this. I can feel just minimal movement, and let patient know this when she asked. She asks how long I think it's going to be and I said I think it's going to be a while yet as baby is really not moving. Well, I think this is all the patient needs to hear because with her next contraction, she pushes that baby right on down. The labia begin to spread and I say, "well, awesome! ok, hold on, let's call the doctor to come in." (We use Voceras where I work and I was able to call the resident while I was sitting on the patient's bed). Resident is on her way, she calls the attending as well who is also in house, sleeping (this is 3 in the morning) With the next contraction, patient is not even pushing, the uterus is doing everything. Well, baby is now crowning and is continuing to make it's way out. I call out the room to get some help...Baby was out 30 seconds before resident is in room. Then 30 seconds later attending is in room.
I can't help but feel horrible this happened. The attending is livid with me. "I want to know why I stayed all night waiting to deliver my patient, but still missed the delivery??!!" I went over exactly what happened. I think the resident should have let the patient give some trial pushes when she did her sve and felt the patient was complete and at 0 station. Especially when the patient was so miserable.
I know this may not be the only time this happens, but not sure what else I could have done in this situation?
How did your first deliveries turn out? Any bad situations? Did you get repramanded? I talked to my clinical coordinator and she says, "hey, it happens. It's not the last time it's going to happen."
