Re: Bad Day...

[Guest guest]

In a message dated 4/30/99 9:04:38 PM Eastern Daylight Time,

zlomke@... writes:

<<

I agree. When the " c " word is used right after the first dose of

prostaglandin gel is placed, I know I'm going to be fighting all day...

>>

OK, have to vent guys. ALthough it sounds like some of you must endure this

torture way more frequently than I, I also know that you guys know what kind

of birth I am " accustomed too " so here is the ugly story!

I am assigned to precept an orientee that has been absolutely awful! My job

(assigned by manager) was to " objectively evaluate where she is in her

orientation, clearly document, and make recommendations " . OK, so usually no

problem, since I most of the time have experienced " techy " OB nurses who are

learning " laid back " birth, right? Well not today. She's awful and I have to

endure her and a shitty assignment.

I am assigned an induction (you all know how I feel about inductions!!!

Ugggggg!)

for post dates 41 3/7 weeks, primip, 300+ lbs, who's Mom is an ex- OB nurse

(from a million years ago) and Mom-in law is the head of a high tech

perinatal clinic. The doc (Who I HATE working with, has the highest

intervention rate of anyone and is notorious for getting in my face about

everything! - but always says how much he " respects me " ). The doc wanted to

schedule her for a " Primary cesarean section for failure to engage " a few

weeks ago, when she hit term. Pt refused stating she wanted a trial of

labor, doc agrees but only if done very soon " .

She arrives, already says " well if it doesnt go well, I'm just going to have

a C/S " and I of course give her the " pep talk " . Got to be positive, lets

giove it the best shot, etc.

Here's the short version.

PGE2 gel 0730

PGE2 gel again 0930

AROM 1030

Pit 1130

She started thick, closed, floating

Starting having mild ctx, not needing to breathe or anything. by 1300 she is

2 cm, 75%, -2 I am please as punch!!!

Doc says, she'll never do it...I should " put my shoes covers on now " , I

grumble...give him the speech in trusting etc. He laughs and leaves. I

called him names mentally and move on, after all, I'm " winning " at this point

right?

1610, he decides his other induction has been pushing too long and sections

her...for NO ADEQUATE REASON, and announces my pt is next. KNOWING IT WILL

INFURIATE ME!!!!

I laugh casually and walk off.

After his section he comes in and sits with my patient and DELIBERATLEY

manipulates the conversation to make her feel she needs a section. Things

like

" I wish I could tell you I thought you could deliver vaginally...but.... "

" I dont want you to labor and be a hero " , " What do you think...do you want to

go on with this pain? "

It was the worst thing I had ever seen!

I follow him out of the room and chewed his ass! Went on and on about how he

manipulated the conversation etc. He has a medical student with him that

says to me " I think he left the foor wide open for them " , I tell him to be

quiet, he knows NOTHING! Doc says " Its 5pm on Friday " ! I say, I guess you

think this is funny huh? Then I will chart that in the notes if he doesn't

come around, accused him of blatant malpractice, and told him I already had

little respect for him and now had NONE. I refused to continue caring for

his patient! He tells me to " not get in such a tizzy over it...it's not a

relative of mine " and then he said, OK, if you're going to be like that, I'll

let her go another hour! Recheck her and then section her.

I was so pissed off.

Meanwhile the parents had gotten wind of all this conversation, and the Mom

comes out and hugs me, thanking me for being a pt advocate etc. I told her I

had signed off as her nurse and she begs me to stay on and care for her. The

patient also asks me to please stay, " You're the only one on my side " she

says. I know now, I must follow chain of command to get action.

Big problem here now, the doc is also our chief of high risk staff!!!!!!

Anyway, pt NOW kicking into good labor,breathing, sititng ob gym ball etc.

He comes in at 6pm, says she is not making good change.

I check her and she's 5cm, 100, -1

Now what do I do.....hmmmm. I was so pissed!

I found him sitting down eating dinner, he says " is she prepped/ "

I said...I'm calling the manager, you lied to that patient, I examined her

and she is 5, 100,-1.

He says, your word against mine.

My shift over at 7pm. Next nurse on, manager arriving to " handle it all " , I

leave, devastated.

Pt was sectioned at 2010 for " failure to progress "

Manager calls to tell me she is in a tough spot, he denies that he was

intentionally sectioning her. Says my exam was wrong. Etc. You know how it

goes.

She tells me she has no reason to doubt me, there have been many complaints

about him but it takes time to gather stats etc. She will try and make sure I

do not have to care for any of his patients for awhile, please, please stay.

I am an example of professionalism in nursing. " She supports me 100%, yeah

right, but the patient still got sectioned for NO REASON!!!!!!And she did

nothing to prevent it.

Next day I have to face this family. They are hugging me, crying, saying how

wonderful I am. Is this a consolation? No. I failed as a pt advocate.

I don't know if I can work like this. I don't know if I can wait till the

stats are in and he is out! Thats why I left the other place I worked....I

don;t want to do technobirth anymore!

I am so sick of this all.....I need a vacation. Thanks for listening.

Jan

[Guest guest]

Jan,

I'm so sorry you had such a tough day. I hate those days!!

Jean