Re: Hospital admissions for obstetric patients
From: Meenan, Anna (annam@uic.edu)
Fri Oct 27 22:28:45 2006
Exactly. This lady had recently done enough coke
to stroke her out, had BP 230/130, was at risk
for abruption and preterm labor. ICU nurses
cannot read fetal monitor strips.
Anna Meenan, MD
> The nurses were afraid of not recognizing labor in the unconscious
>pregnant patient and called us down to assess her at the slightest
>change. They were also afraid of a fetal demise on their watch.
>
>At Fri, 27 Oct 2006, Efrain Ramirez wrote:
>>
>>I am curious as why were they uncomfortable..
>>
>>Ef
>>
>>>At Fri, 27 Oct 2006, Meenan, Anna L. wrote:
>>>
>>>Agree with that totally. We recently had a cocaine addict who stroked out
>>>at 33 weeks. The ICU nurses were completely uncomfortable with her and
>>>when she woke up enough to be sent out of ICU, nobody on the maternity
>>>floor wanted her there. Finally got the MFM boys to take her across the
>>>river. They have an inpatient unit where folks are comfortable with both
>>>complicated pregnancies and medical problems.
>>>
>>>Anna Meenan, MD
>>>
>>>On Fri, October 27, 2006 10:52 am, Jamie wrote:
>>>> The same tends to go for nursing. Putting an OB patient on any other
>>>> unit gives the nurses the vapors. Even ER nurses, IME, can't get rid of
>>>> pregnant patients fast enough. Consulting physicians should be careful
>>>> that their orders are understood, though, by nurses not familiar with
>>>> their specialty, and might have to specifically order assessments that
>>>> are taken for granted in their area.
>>>>
>>>> At Fri, 27 Oct 2006, R. Daniel Braun wrote:
>>>>>
>>>>>AMEN!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
>>>>>Dan
>>>>>
>>>>>On 10/27/06, Zachariah Newton <zbnewton@bellsouth.net> wrote:
>>>>>>
>>>>>> Ashley-
>>>>>>
>>>>>> Leaving puristics aside, the ob is the triage officer for all medical
>>>>>> care
>>>>>> during pregnancy. This is the source of trust for the patient, and,
>>>>>> frankly,
>>>>>> any consultant who sees an ob patient with heavy trepidation. Such
>>>>>> patients,
>>>>>> as in your posit, are usually really sick and really sick. A phalanx of
>>>>>> consultants typically flow through the assessment. The consultants, if
>>>>>> watched closely, frequently have the palsy of trepidation, derived from
>>>>>> the
>>>>>> pregnancy status. A general is needed to contain the process from
>>>>>> getting
>>>>>> out of hand. On your service, you are in control, the key element. The
>>>>>> consultants provide assessment & recommendations, but remain in harness
>>>>>> on
>>>>>> your service.
>>>>>>
>>>>>> As the patient's advocate in a delerious system of health care, admit
>>>>>> her
>>>>>> to
>>>>>> your service, reins in hand, and send out the requests for
>>>>>> consultation.
>>>>>> You
>>>>>> can then make your own judgment on accepting recommendations for
>>>>>> intervention that we have all seen can be wildly off the wall and
>>>>>> inappropriate on basis of pregnancy status.
>>>>>>
>>>>>> zbn
>>>>>> ---
>>>>>>
>>>>>>>>>> ----- Original Message -----
>>>>>> From: "D. Ashley Hill" <dahmd@cfl.rr.com>
>>>>>> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
>>>>>> Sent: Thursday, October 26, 2006 11:24 PM
>>>>>> Subject: Hospital admissions for obstetric patients
>>>>>>
>>>>>> > Listmembers:
>>>>>> >
>>>>>> > I have always been of the opinion that patients with a non-obstetric
>>>>>> > medical problem should be admitted to the physician best suited to
>>>>>> care
>>>>>> > for that problem, with consultation by an obstetrician or
>>>>>> perinatologist
>>>>>> > if indicated. (For example, patients with cardiac problems are
>>>>>> admitted
>>>>>> > to a cardiologist and patients with end-stage renal disease are
>>>>>> admitted
>>>>>> > to a nephrologist)
>>>>>> >
>>>>>> > Others believe that all OB patients should be admitted to the OB,
>>>>>> with
>>>>>> > consultation by other specialists as indicated. Does anyone have
>>>>>> > experience and opinions on either of these schemes? Thanks in
>>>>>> advance.
>>>>>> >
>>>>>> > Ashley
>>>>>> >
>>>>>> > --
>>>>>> > D. Ashley Hill, MD
>>>>>> > Associate Director
> >>>>> > Department of Obstetrics and Gynecology
>>>>>> > Florida Hospital Family Practice Residency
>>>>>> > Medical Director, Loch Haven Ob/Gyn Group
>>>>>> > Division Director, Dept. of Ob/Gyn, Florida Hospital Orlando
>>>>>> > Orlando, Florida
>>>>>> >
>>>>>>
>>>>>--
>>>>>R. Daniel Braun
>>>>>
>>>>> "The way to health is an aromatic bath and scented massage
>>>>> everyday".
>>>>> Hippocrates
>>>>>
>>>> --
>>>> JFields, RN, BSN
>>>>
>>--
>>ì The greatest obstacle to knowledge is not ignorance,
>>it is the illusion of knowledge.î Daniel J. Boorstin - Historian
>>
>
>--
>JFields, RN, BSN
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