Re: VBAC immediately available policy
From: Jamie (ajfields@pine-net.com)
Tue Feb 7 10:58:13 2006
No, you are correct. They physician ends up with the responsibility.
The client SHOULD, and that's whay makes me sad
At Mon, 6 Feb 2006, Efrain Ramirez wrote:
>
>I disagree wholeheartedly --ACOG stated those rules -- "immediately
>available" means exactly that-- trying to bend the definition is, IMHO,
>cheating... the one who takes the responsibility will be the physician
>- don't make me laugh if you argue that the patient will...please....
>
>Ef
>
>>At Mon, 6 Feb 2006, Jamie wrote:
>>
>>The VBAC advocates weren't the ones who made the rules about what
>>constitutes immediately available. I think it's incredibly sad that
>>women and their doctors can not develop a level of trust that allows for
>>an honest explanation of the risks, and a decision by a client (okay,
>>patient) who takes responsibility.
>>
>>At Mon, 6 Feb 2006, D. Ashley Hill wrote:
>>>
>>>At Mon, 6 Feb 2006, Efrain Ramirez wrote:
>>>>
>>>>Lawyers will be laughing at us -- us trying to define "immediately
>>>>available" --Jesus!!!! - if ACOG wanted it another way - it should say -
>>>>within 15 minutes - 30 minutes, 2 nanoseconds -- I no longer do VABC's
>>>>--it is not wort it..period..
>>>>
>>>>At our hospital, although it has in-house anesthesia - if there is a
>>>>VBAC - the Ob, and everything that surrounds him--OR crew, etc , must be
>>>>in house...any other way would be ---somebody said "suicide"?
>>>
>>>That's probably the safest course for the patient (and the risk
>>>managers) but the least attractive for the ob and anesthesia team. I
>>>wonder how hospitals that no longer "allow" VBACs handle patients who
>>>refuse a repeat cesarean. Does the on-call team have to come in and
>>>stand by for the entire labor trial? Can you imagine how hot the on call
>>>ob and anesthesiologist would be if a patient previously unknown to them
>>>showed up, refused a repeat section, but hospital bylaws mandated that
>>>they stay in house the entire labor? I think VBAC advocates are unaware
>>>of the number of patients in the office or operating room who may go
>>>unattended while the physician is on the labor unit with one patient who
>>>demands a VBAC. Sure, it's great for her, but not so hot for the
>>>several dozen patients awaiting care for what may be equally important
>>>health care needs.
>>>
>>>Ashley
>>>
>>>--
>>>D. Ashley Hill, MD
>>>Associate Director
>>>Department of Obstetrics and Gynecology
>>>Florida Hospital Family Practice Residency
>>> and Loch Haven Ob/Gyn Group
>>>Orlando, Florida
>>>
>>--
>>JFields, RN, BSN
>>
>--
>“ The greatest obstacle to knowledge is not ignorance,
>it is the illusion of knowledge.” Daniel J. Boorstin - Historian
>
--
JFields, RN, BSN
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