Friday, October 10, 2008

Worn Out

Sheesh...today wore me out! I don't really know why, but it was just intense from the start! My induction (I really do love inductions, I'm going to miss them when I go to nights...) was a multip, but you would never know it. Not in a million years. She was a typical "princess" that belonged to our "princess" doctor. The doctor is really good, but if she a) is in a grouchy mood b) just flat out doesn't like you or c) things don't go just her way, there is trouble ahead. Trouble started pretty quick...

The induction got there late, so I was late getting her IV started. She was freaked out about the whole induction thing, even though things were the same way with her first baby (also an induction). As we're walking into the room she asks me "Now what is this induction thing about, and how does it work" so, starting out at square one, it was like that all day. I really don't mind explaining things to my patients, in fact, I like it because it reassures me that I know what I'm doing. Anyway, but every little step in detail kinda wore me out after 12 hours. But anyway, there were no written/signed pitocin orders on the chart, so as I'm walking out of the room after getting the IV started and the patient on the monitor the doc's coming around the corner. I said, "Ah, I was just getting ready to call for pitocin orders." That started the fit about why the pit wasn't started yet. the gal had been in the hospital physically for less than 30 minutes. So, first bump in the road...

2nd bump in the road continued the pitocin battle, I was only at 8mu of pit and the gal was hypersteming. She was already having an anxiety attack because it was about 1000 and she hadn't delivered yet (she came in 2cm/60%). I had turned her pit down to about 6mu and when the doctor came over at 1030, there were only 2 contractions showing on my 7min screen. So I got the "why is her pit only at 6mu" grill from the doc, and then she called her less dilated than I just had so that ticked the patient off. It was just this ongoing battle all afternoon. We need an order to go above 20mu of pit, so I got that order, then when I called to let the doc know I was at 30mu, I got the order to keep going. Not without an IUPC, not on my nursing license! So that didn't make the doctor happy either.

I feel like a wimp, because to hear about my day it really wasn't that bad. But I don't like making docs upset, and it's too early to start developing bad reputations with them. But I gotta stand up for myself, right? Anyway, so then with a 1735 delivery, I was lucky to get out of there by about 1915. I'm pooped, and glad that I have the weekend + Monday off!

THANK YOU!!!! For all of the comments and suggestions about epidurals, pain meds, natural childbirth. Like I said, I have learned so much from hearing from both nurses who face the same situations that I do, and also from mom's who have been-there-done-it. Wow! After today, if any nurses have suggestions on getting along with doctors, and how to defend yourself/patient if a doc is going against a protocol, or even something that you just have a bad gut feeling about I would love to hear it!

Hope everyone has a GREAT weekend!

Babies today: 1M
Babies total: 20M/15F = 35
Vag:14M/14F = 28
C/S: 6M1F = 7

2 comments:

  1. Get other nurses to help back you up when you have to be confrontational with some docs. Also, it helps to have clinical studies to back up the "why" for when you cut back on the pitocin with the presence of hyperstim. We have a great article on our education board at work -- I'll have to find out the specifics for you.

    WTG girl! You're doing a great job, by the way.

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  2. I have no suggestions, just real appreciation for you for the advocating you do/will do for your moms!!!!

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