Re: Amnioinfusion
From: Anna Meenan, MD (annam@uic.edu)
Wed Nov 2 11:09:08 2005
Welcome to the List, Jamie. Feel free to post more often rather than
just lurk. I always like to hear the nurse side of a discussion.
--
Anna Meenan, MD
At Wed, 2 Nov 2005, Jamie wrote:
>
>Quick intro first. I 'm a L&D nurse sidelined by latex allergy and
>general birth junkie. I get my fix by lurking here and debating birth
>on other boards. So you know my bias, 4 of my 5 children were born at
>home. I intend to remain mostly a lurker here.
>
>IRT the amnioinfusion disagreement, a clear and current policy would
>have protected the nurse. If the order was counter to the policy, she
>would be risking her own license and livelihood in following it. If the
>order was covered by the policy, she was clearly wrong and needs
>education. If there is no clear policy, once should be written to
>protect both the nurse and the physician. Nurses are in a difficult
>position as well. We can be held responsible for following orders that
>are unsafe or practicing inconsistently with hospital policy. At the
>same time, in many hospitals, policies are not kept current, placing us
>in the position of choosing between a policy that may not protect us b/c
>it is unsafe, and an order that goes counter to policy which leaves us
>equally unprotected. Reading this list over the past year has given me
>a much more sympathetic view of OBs in this litigious climate. I'm sure
>it is difficult when your own career is constantly at risk to remember
>that others may be in the same position. In the specific situation
>described, I would have left the infusion running, carefully observed
>IUPC pressures as well as the patient for symptoms of increased IUP, and
>if I was unsure of the safety of continuing contacted the physician to
>discuss the order. Especially given that the treatment improved the
>decels.
>
>At Tue, 1 Nov 2005, RModugno@aol.com wrote:
>>
>>In a message dated 10/31/2005 8:19:50 PM Eastern Standard Time,
>>forcep@intercom.net writes:
>>
>>Thats why obstetrical units need a Chairman of the Department who has
>>control of policy over physicians and nurses. And should be paid by the
>>monster, the Hospital,which should have the deep liabilty pocket.
>>
>>Exactly! This is a medical decision, not a nursing one!
>>
>>Robert Modugno MD MBA FACOG
>>Marietta, GA
>
>--
>Jamie
>