July 29, 2007

Why?

I had a patient last night come in, 1st baby, contracting every 3 minutes, dilated 3cm 100% effaced. She wanted to try without an epidural and thought that the birthing tub would be great. Call the on call doc, who is notorious for being an ass about pain control in labor, and he of course said no tub and to call back if she makes cervical change. Patient is very uncomfortable despite efflurage, birthing ball and rocking chair. Short time later, she's 4 cm. Call him back. Can she get in the tub? No. How about IV pain medication? No, but she can have an epidural if she's making good change. This doc usually gives IV pain meds, and there was NO reason why he wouldn't give it to this patient. Patient decides she'll get the epidural for some relief, even though all she wanted was something to take the edge off for a bit. After her epidural was placed, she asked me why he wouldn't allow her to get IV meds. I was professional, but I had to tell her that I had no idea. Maybe she would have gotten an epidural anyway, but now she'll always wonder if she would have been able to do it. I just don't understand what happened here. He has been frustrated with some staff for different things, some things that were out of everyone's control, but it isn't right to make the patients suffer for it. And that's how it seems to me. If anyone has any insight as to why, that would be great. Because none of us here can figure it out.

3 comments:

AtYourCervix said...

That doctor is an asshole. I would have just told the patient she could get in the tub. As long as my patients have a reactive NST, I take them off the monitor to ambulate/use the tub.

A. said...

Primip or multip? Was he afraid she'd get IV meds, make change and end up too far along to get an epidural later, and then he'd get grief from her for not "being able" to get an epidural????

I'm assuming her strip reactive for IV meds?

Weird. Our docs are fine w/ it as long as the strip is good.

On the other hand, ours are not fine about ambulating and using the tub. Basically NO ONE does either. They are so afraid of getting sued they get strapped down the second they arrive and stay on continuous monitoring. And the nurses just think it's normal. They are at the point that they freak if someone even mentions walking. Of course, the MD's also break water as soon as possible.

I try to encourage my labor checks that are in early labor to go home until they are in more active labor for this reason!!!!!

Anonymous said...

Geesh,
I am obnoxious as a patient, I wouldn't have asked you about the tub...I would have just run it myself. You would have come in and found me there...and what could you do? I'm so big with baby and my own fat, you'd have to make a scene to get me out. Poor girl, she might have made it a bit longer at least with the tub. I also drink bringing my own water bottle which I mostly drink with the nurse out of the room...because they have to leave so much.

Dawn