Wednesday, April 9, 2008

The Shine and a New Doc

We have a new doc, let's call him Dr Newbie, that started taking call not too long ago. He has managed to alienate every single one of us midwives already! He is a couple years out of residency but comes from a much smaller practice than ours (I believe he was doing an average of 5 births a month -we do over a hundred). It's apparent to me that he is very much still 'green'. It makes me uncomfortable to work with someone who isn't that much more sure of themself than I am! For example...

1. He told me I needed to get a patient in Robinson's for pushing...umm...huh? Do you mean McRobert's (a position that involves momma's knees behind her ears, meant to be used for shoulder dystocias but many nurses and OBs use for routine pushing).

2. The head was at a +2 station - when momma pushed effectively, we could see the head easily. He claimed she was at a 0 station.

3. He 'suggested' I put in an IUPC (intrauterine pressure catheter) because 'we' couldn't tell when her contractions were or how effective they were. Hmmm, she cam in at 3:30 8cms...complete and pushing at 4pm. Uh, seems pretty effective to me, not to mention she was going natural and therefor feeling great urge to push with each contraction (which was about every 2-3 minutes). Furthermore, how do you get a IUPC in when the head is at +2? Believe it ir not, I got it in...and am kicking myself now for allowing myself to feel pressured to do this. A few minutes more of hoovering he left the room to go 'deliver' another one of my patients who had progressed much more rapidly than I thought she would. The minute he walkded out, I pulled that stupid thing out - she was pushing it out anyway :p

4. The baby was 10 pounds 6 ounces...he didn't bother to come back and check on me. But fortunately I have had my share of postpartum hemorrhages, and I managed this one just fine.

So, god bless the nurse, she didn't take any orders from him but instead waited for me to give them. Everyone was looking at him like he was nuts, and looking at me to see what I wanted to do. Oh, and he told the nurses in the other delivery, he wants methergine at every delivery he does.

He has also told someone that he does everything by the 'book', every woman gets an IV, pushes in stirrups, continuous EFM, etc. was he every hired with this attitude and philosophy? Well, needless to say, the "physician extenders" (a rather derogatory term used by the owner of the practice that refers to advanced practice nurses) were not given an opportunity to interview. Let's chalk up another one for the good ole boys network!

So the shine is off the new job now. At a provider meeting recently, it was pretty clear to me that we are not respected as professionals. The owner told us we were not 'equals'. I understand they have more education but come on! Talk about rude and disrespectful. I really left the meeting with a bad taste in my mouth. *sigh*

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