The other night at work I had a 17 year old primip come in saying she was contracting every 5min. (She'd been in a few days earlier for this too). Nothing shows on the monitor and I palpate nothing when she says she's having a contraction. Her exam is 3-4cm and 80%, same as in the office previous day. When she came in she was pretty much crying, but after an hour she didnt change so I sent her home with vistaril and she was much calmer. I also gave her the standard advice about take a bath, drink plenty of water etc. etc.
Her mom called about 1/2 hr before change of shift, saying that her contractions were now 3 min apart and she was way more uncomfortable now. There wasnt much else I could say except come back. She showed up at change of shift so I didnt take care of her, but she was howling when she got up to our floor...however again no contractions on monitor or by palpation and no cervical change.
So my question is....what do you do with these pts.? How do you know if they just have no pain tolerance or if maybe there is something else going on...some medical issue or something?
I didnt get a chance to get her mom alone and ask more about her daughter, but she did have a friend there who kept rolling her eyes, so that gave me some insight.
I just feel bad and am not sure what to tell these people. She said if she keeps coming in here, she feels like we are going to hate her. Which of course I said no we aren't...but of course it's going to frustrate us and piss off our doctors...she's only 38 weeks. (And I would like to say here that I would rather she come in if she thinks she's in labor so please dont take my comment about frustration the wrong way).
but why test her??? On the basis that she is young???? Would you suggest the same for the 44 yr old proffesional with no social problems?
Her pain is REAL to her..its her pain, and she needs help, not judgement. Two lives at risk here, from being judgemental, based on age and social history.
We have moms of all ages come in and out of the revolving door OB unit for the purpose of momma-baby-daddy-family-drama or whatever every night. Forgive me if I have become a bit cinical.
I am a mother of 3 born at home with midwives. I support natural birth and am kind to laboring women. I have been a nursery nurse for the better part of 16 years. I am one of the 'nicer' ones, actually. I take time to show the dads how to do sacral pressure when the OB nurses don't bother, etc. etc...
This is a forum for professionals to post and vent.
Speaking of judgemental... you are judging ME on one comment.
Oh, I am very calm..I just find your judgement of the op's patient offensive. and the suggestion of delivering a placebo to trick her into some kind of false security scary. please Dont tell me to calm down either,Iv'e got to this ripe old age without having to be advised such by a stranger.
Oh, I am very calm..I just find your judgement of the op's patient offensive. and the suggestion of delivering a placebo to trick her into some kind of false security scary. please Dont tell me to calm down either,Iv'e got to this ripe old age without having to be advised such by a stranger.
I don't see what is so offensive about my orriginal post. I listed reasons she might be acting the way OP described. I agreed that other causes of pain besides labor should be ruled out for hers and her baby's safety and so she doesn't get sent home with pain from a real problem/infection, etc. I even suggested getting the visitors out of the room and sitting down to have a heart to heart with her and find out what's going on and what her perceptions are. Discussing fears with a laboring mom can often times reduce anxiety and thus pain for them.
As to the placebo comment, I said, "too bad you can't..." & followed it with a winking smiley graphic. I know giving a placebo would be inappropriate to do. I would never do such a thing. It was just a tongue in cheek comment between professionals.
For a calm person, you sure use a lot of !!!!!!!!'s.
I was in the ER 3 times during my 2nd pregnancy with excruciating pain. Finally, when I realized that I wasn't going to get any help at the hospital, I stayed home and literally pulled my hair out, smashed my head into the washing machine to ease my pain. I was throwing up all day everyday because I was in so much pain and anxiety thinking I was losing my baby. I had to quit my job.
Then at 9months preg. I went to an emergicare and the nurse said I probably had gall stones and was surprised that Dr. didn't check me for it sooner. Nurse was right and I had surgery after baby was born.
My whole point is that maybe this girl's pain is related to something else.
Sorry guys, and apologies to 33-Weeker, for going on so. Had just finished a long nightshift with a dying baby and did feel a bit over emotional. Again, apologies to all for hi-jacking this interesting thread.
danissa, LPN, LVN
896 Posts
but why test her??? On the basis that she is young???? Would you suggest the same for the 44 yr old proffesional with no social problems?
Her pain is REAL to her..its her pain, and she needs help, not judgement. Two lives at risk here, from being judgemental, based on age and social history.