Published Aug 28, 2007
q12RN
63 Posts
When you do your cx exam on a pt who is in to be checked and you call them 2cm and 50%, BTW I can easily fit 2 fingers through the cervix and the baby'd head is easily palpated so she's probably closer to a 3, I cal her 2 cm to err on the cautious side. Dr comes in and calls her 1-1/2 cm! Where do these family practice Dr's get their experience from?
NPinWCH
374 Posts
It's not limited to family docs, nor is it limited to telling a pt she is less dilated than your assessment. We have an OB who ALWAYS disagrees with EVERY RN and tells the pt they are at least 1 cm less dilated than the nurse said.
On the other hand we have a family doc who will tell a primip at her 36wk check that she's 3cms and could go anytime. Of course when she shows up 2-3 days later because she thinks she's in labor and I check her and tell her she's only 1cm/thick and high she'll say, "Well, Dr. K told my I'm 3...so how did I go backwards?"
It drives me nuts!! :smackingf
Music in My Heart
1 Article; 4,111 Posts
That's when you really have to fight the urge to say something like, "Well honey, you know men always have a distorted sense of size..." (presuming said doc is a man, of course). :trout:
HazeKomp, BSN, RN
146 Posts
problem in the business forever!!
between other nurses' exams and doctors' exams varying so much,
the poor patients get so confused.
I always teach them that VE's are very SUBJECTIVE, and can vary significantly between examiners, which is why, when they are MY labor patient, I will limit VE's to me, to facillitate consistency!
KellNY, RN
710 Posts
Where do these family practice Dr's get their experience from?
We have the opposite problem here. Family Med will call their induction 5cm/100%/0station. No problem right? Well, when they were 1cm/25%/-2 two hours ago, and they're a primip and they've had maybe 4 contractions that they didn't even feel....
:uhoh21:
Or, they'll call up to check on Pt(they don't have the central monitoring, since they don't hang out on the OB floors) and we'll say "Yeah, she's a little uncomfortable, no stadol yet, ctx q5-7min, baby looks great." I get in response "Why didn't you call!?!? I'll be right up!". They rush up, huffing and puffing and panting...thinking the Pt is about to deliver. A primip. Who, 4 hours ago was C/L/H. Wha--??
Not to mention, we have to walk them through the whole admit orders. From what "admit labs" are (CBC/RPR/T&S) to what the fluid and rate should be.
Whenever there's a family med pt here for cervidil, the nurses draw straws as to who has to take them, because they're so hard to deal with.
And I'm sorry. It sounds like I'm bashing family med. Maybe I am. Some of them are really sweet people. But they add so much extra work for us, so much drama/stress for us and pt, etc.
I'm gonna have nightmares about Family Med tonight, lol.
LDRNMOMMY, BSN, RN
327 Posts
We have one OB who is notorious for sending patients over who are 5cm. Well they usually end up being 2 or 3 cm! I always tell my patients that cervical exams will vary from person to person.