Re: Intrapartum GBBS Prophylaxis

From: Joanne Bulley, MD (islesannie@yahoo.com)
Mon Sep 4 14:08:39 2006

But if both the Pedi association(s) and the ObGyn association say to not be treating certain population then the nursing push (who does not carry the finaly responsibility or liability) to be overzealous with the Mom's treatment while baby is in utero is just plain wrong.

If the RN(S) WANT that level of responsibility and decision making - then go get the proper training - be that MD or Midwife (depending on the locale) -- but the L&D RN should not be trying to be the MD when that is not his or her credentials.

just my 2 cents worth.

Joanne

At Mon, 4 Sep 2006, Jamie wrote: >
>Thus, the well-meaning L and D and nursery nurses are just trying to
>look out for their patients--laudable, no doubt. What they may not have
>in their personal knowledge bases is the benefit of the large studies
>and scientific recommendations about which we're talking. That is where
>education such as that which Art suggested may be helpful.
>
>I think most nurses would appreciate the knowledge, but since they don't
>have the power to prevent overzealous treatment of babies with
>questionable GBS status, they'd still be in a difficult position-do I
>push for this unnecessary treatment now in order to prevent the more
>invasive unnecessary treatment later?
>
>At Sun, 3 Sep 2006, Garry E. Siegel, M.D. wrote:
>>
>>The big issue I hear about is that the the "stuff" the baby has to go
>>through is different if the Mom has been treated or not, or if they've
>>only gotten one dose (i.e. they come in, are known GBS carriers at
>>term, and only get one dose because they--gasp--deliver before the
>>second dose is due in 4 hours) instead of two.
>>
>>Some L and D nurses have asked me not to start Pit or AROM so that the
>>second dose could get in. Nowhere in the guidelines is there a
>>suggestion to alter obstetric management for those reasons.
>>
>>Thus, the well-meaning L and D and nursery nurses are just trying to
>>look out for their patients--laudable, no doubt. What they may not have
>>in their personal knowledge bases is the benefit of the large studies
>>and scientific recommendations about which we're talking. That is where
>>education such as that which Art suggested may be helpful.
>>
>>That said, all the education in the world won't work for everyone--that
>>is why policy or orders may need to be written based on current
>>guidelines.
>>
>>Garry
>>

--
Joanne Bulley, MD
Keene, NH, USA



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