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Re ron address From: diaasm (diaasm@soficom.com.eg) Fri Dec 29 13:11:06 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: K Dew: "Re: "multiracial baby" was family in LDR" Previous message: diaasm: "Re ron address" >From nobody@medispecialty.com Fri Dec 29 14:11:05 2000 Received: (from nobody@localhost) by mail.medispecialty.com (8.9.3/8.9.3) id OAA06604 for OB-GYN-L@OBGYN.NET; Fri, 29 Dec 2000 14:11:05 -0600 Message-Id: <200012292011.OAA06604@mail.medispecialty.com> Date: Fri, 29 Dec 2000 14:11:05 -0600 (CST) Errors-To: postmaster@medispecialty.com Reply-To: eramirez@icepr.com From: eramirez@icepr.com (Efrain Ramirez) To: OB-GYN-L@OBGYN.NET In-Reply-To: <200012280400.WAA13146@mail.medispecialty.com> X-Original-Sender: @ 196.12.188.39 Subject: Re: OB: Family in the LDR and the poop hits the fan At Wed, 27 Dec 2000, Garry Siegel wrote: > >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. > By definition, LDR is a stressful site (extreme joy -fear -etc.)- some people act, speak under the influence - anyhow - When I sense that the repair of the tear or whatever - is going to be a tedious, laborious and stressful one, I take the patient to OR - I believe it's the most convenient place for everyone - you have all the available tools at hand and lack of unsolicited comments -etc. About documentation - what did you document - in the progress notes - besides describing your procedures? I think a straight with the patient is the right thing to do - proceed accordingly. >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 > -- "Do not take life too seriously. You will never get out of it alive." Marianne Williamson Next message: K Dew: "Re: "multiracial baby" was family in LDR" Previous message: diaasm: "Re ron address"

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