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Frustrations of hospital birth.

The following is a letter of resignation written by an R.N. to her supervisor in labor and delivery. It provides some valuable insights; we have changed the names so the hospital would not be identifiable. Dear June,

Please find enclosed my statement of resignation and a note to the nursing staff. As an afternote, I thought I would explain to you another reason I felt working at [this hospital] might not be appropriate for me after all. It has to do with philosophy of practice. I do want to stress, however, that my reason for leaving was, as I stated, primarily related to scheduling difficulties and that the following issue was only a contributing factor which influenced me on an emotional level in that it supported my decision to leave.

On October 11th I had a patient who was a gravida I [having her first baby] and who spoke no English. She had a fairly uncomplicated, spontaneous labor. When this patient's cervix had a "lip," I heard the residents planning to do a forceps delivery on her, for practice, since she had a good epidural. My preceptor explained to me that there was nothing she could do to intrude.

Once fully dilated, the patient was allowed to push for 5 minutes, at which time the resident determined that she was not a good pusher and therefore should be delivered by forceps immediately. No fetal distress was noted. The mother of the patient was prohibited entry into the delivery room and sat outside crying. The patient requested her mother's presence and was refused. Fortunately, the patient did have an excellent epidural and the baby came out in good coodition, although his face was bruised.

At a later date, I heard another nurse refer to the residents "practicing" forceps on patients and I learned that this is considered acceptable practice. It was explained to me that multiparas [women having second or subsequent babies! are generally used for this purpose.

I know from experience that such unindicated use of forceps is not necessary in order to train residents. Many other hospitals do not do this. I think that had I stayed at [this hospital] long enough to see the above practice repeat itself a few times, I would probably have been disturbed to the point of needing to resign at that time.

When I interviewed for the position, I was assured by [name deleted] and one of the midwives that [this hospital's] L & D is as family centered as is possible in a high risk unit. In light of the above, I doo't think I need to comment on the validity of this.

I know that the medical profession has a long way to go in learning to respect the integrity of the patient as a human being, and that we, as nurses, can help in the process of educating physicians to do this. It is to the credit of any nurse who remains in such a situation and accepts the challenge of playing the role of patient advocate in the face of such adversity. My priority at this time, however, is to learn and grow in a patient-centered, family-centered environment; not to struggle with fighting the wrongs of the system. My hat is off to those of you who do that which I do not currently have the desire nor the energy to do.

I know, June, that this letter will not have been pleasant to read. Maybe, at some point, its perspective will be useful.

There are things I much appreciated about working at [this hospital], i.e., the birthing rooms, the deliveries by midwives, the respect given to individual styles of nursing. I thank you for your non-judgmental attitude while I was making the difficult decision to leave. It certainly made a difference that I was respected for doing what was right for me.

[This hospital] is fortunate to have you back. I hope you find satisfaction and success in your return to work there.
COPYRIGHT 1993 Association of Labor Assistants & Childbirth Educators
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1993, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:unwarranted use of forceps during delivery prompts nurse to resign
Publication:Special Delivery
Date:Sep 22, 1993
Previous Article:Uterine monitoring: more profitable than effective?
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