Re: Hospital admissions for obstetric patients
From: Rita Kucmierz (ritakuc@comcast.net)
Sat Oct 28 01:49:45 2006
ICU nurses cannot read fetal monitor strips? This one does--after 12 years
in ICU (which I still do prn) I jumped the fence into women's health
promotion hoping to make a difference in the things that I saw in ICU.
There are instances such as you described that this has been advantageous
for my patients. I think that it would be beneficial to have more nurses
trained in both specialties and hospitals should provide fetal monitoring
classes for their ER and ICU nurses.
Rita Kucmierz MSN RN-C WHNP
>----- Original Message -----
From: "Meenan, Anna" <annam@uic.edu>
To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
Sent: Friday, October 27, 2006 10:29 PM
Subject: Re: Hospital admissions for obstetric patients
> 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
