Re: OB: Family in the LDR and the poop hits the fan

From: Paul Prior MD (pprior@clover.net)
Wed Dec 27 22:13:41 2000


On Wed, 27 Dec 2000 22:00:51 -0600, garrys@mindspring.com (Garry Siegel) wrote:

...deleted...

>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.

I usually do, in part because often nurses are bringing in other equipment and I can't count how many times some relative has contaminated my table (and that's just the ones I know about...). Baby is out, send them along with the baby to the nursery window and get to work. I let husband stay (though usually encourage him to accompany baby to nursery as well, but some do stay), but ask him to stay up top away from my table. Haven't had any big problems with this approach.

>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.

Doesn't sound like -she- is the problem. Maybe mom will settle down once the situation is a bit more stable, she may have just been taking out her frustration on an easy target - you. Treat the patient with kid gloves and hope mom turns her anger elsewhere.

>I am not inclined to communicate with the mother again, as I have no
>duty to her.

Absolutely.

--
Actually I would be interested in people's habits with regards to the
following:

answers are: a - everyone stays and video is fine (all other, no video) b - let everyone stay c - let only husband/FOB stay d- let nobody except patient stay

1) Vaginal delivery, likely fetal distress 2) After delivery of head, shoulder dystocia is noted 3) Routine operative vaginal delivery for arrest of 2nd stage 4) operative vaginal delivery for fetal distress 5) routine 3 or 4th degree repair. 6) extensive vaginal repair as described above

personally for me it's c b c b c

--
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