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OB: Family in the LDR and the poop hits the fanFrom: Garry Siegel (garrys@mindspring.com)Wed Dec 27 21:00:19 2000
We all have debated about who can be in the LDR, how many, video, etc. A couple of days ago, I had a low forceps with rotation (LOP, Kiellands, +2) for distress under a fair epidural in a multip. Unbeknownst to me, she had a multiracial child (didn't know that until it came out), and her husband, who was not there, is not the father. Only her mother was there, and this patient was a bit young, and a bit slow. I give this background because after the delivery, she had a long vaginal sidewall tear up to the fornix, and it was a bear to repair. I had to get the L and D nurse to suit up, as well as an OR tech, two lights, vag hyst retractors, etc. It was repaired fine, but it took a good amount of time, and I was concentrating and working very hard, such that I really didn't chat with the patient or Mom much. After completion, the Mom walked out behind me, and asked for a word. Sensing her unhappiness (maybe with me, the delivery, the whole nine yards), she unloaded on me about how I "butchered her daughter", yada, yada, essentially told her to shut up, and she insisted that I call my partner (the patient's regular doc) now--it was midnight. Well, I've done damage control with the patient privately (no Mom, but a nurse as a witness the next day), documented like crazy, and basically have done all that I can do. Here's the issue: Next time, when I see that I'm going to have a difficult and/or lengthy repair, I think that I'm going to ask the family to leave, even if it is a husband (hmm. . .), under the guise that we are "operating", and that we don't have visitors in operations. I think that the family knowing nothing beats is better than them seeing what can be misconstrued, and they've already been there for the birth. This is the first time I've ever felt that I needed to ask family to leave, and regret not having done so. What do others think and do? Would you fire this patient at 6 weeks? I don't feel inclined to, as I think it will generate ill will. I am not inclined to communicate with the mother again, as I have no duty to her. Garry
-- Garry E. Siegel, M.D., F.A.C.O.G. Roswell, GA Private Practice
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