Re: Hospital admissions for obstetric patients
From: Meenan, Anna (annam@uic.edu)
Sat Oct 28 11:19:38 2006
Well, you are definitely an asset for your
hospital, but if anyone at ours suggested that
L&D nurses should be cross-trained for the ICU,
they'd have a riot on their hands. I recall a
major fuss being raised when the whole
Mother/Baby thing started and everyone had to be
cross-trained for nursery and postpartum.
Anna Meenan, MD
>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
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