A mother’s question about a nurse’s authority during a tense delivery highlights a crucial, yet often misunderstood, aspect of maternity care. Many families wonder if a labor and delivery nurse must simply follow a doctor’s lead, even when concerns arise. The reality is that a nurse carries an independent professional duty to protect the health of both the mother and the baby.
The Nurse’s Independent Duty
A labor and delivery nurse is a licensed professional, not just a doctor’s assistant. In the eyes of the law and medical standards, they are held accountable for the care they provide. This means they have a clear responsibility to question plans and to speak up if they believe a situation is becoming unsafe. They are not shielded from liability by the fact that a doctor was in charge. This professional obligation forms the foundation for understanding when the nurse must step in during labor.
The Real Policy of the Chain of Command
Hospitals are not naive to disagreements or the high-stakes nature of labor. For this reason, most have a formal “chain of command” policy. This is not a theoretical idea but a written procedure a nurse must follow. If a nurse identifies a concerning fetal heart rate pattern, like one deteriorating from Category 2 toward Category 3, and the attending doctor does not share their concern, the nurse has a duty to escalate. They can call the charge nurse, the nursing supervisor, or even another physician. This process exists to prevent a dangerous drift in care.
When The Nurse Must Step In During Labor
Escalating a concern can be uncomfortable, as no one wants to challenge a colleague. However, when the potential outcome is a severe birth injury like hypoxic-ischemic encephalopathy (HIE), the duty to the patient must outweigh workplace discomfort. In reviewing birth injury cases, it is often evident where a nurse noted troubling signs but did not activate the chain of command. This failure is when families are left with painful questions. Thankfully, most deliveries involve seamless teamwork. But the high stakes mean everyone must be prepared for the moment when the nurse must step in during labor.
If you have more questions regarding your baby’s HIE brain injury at birth, do not hesitate to contact me. You can find out more about me below and remember that it does not cost you an money initially to speak with me about your baby’s story.
Marcus B. Boston, Esq.
9701 Apollo Dr. Suite 100
Largo, Maryland 20774
301-850-4832
1-833-4 BABY HELP
