I had a very frustrating experience today and could use some input!
Where I work, the average stay for a c-section is 3 days (day of, day 1, day 2, day 3). However, it isn't uncommon for a pt to stay for the 4th day (about 25% do). Like I said, this is fairly common. I have been led to believe by my charge nurses that this 96 hour policy is mandated by some sort of law, and that if for some reason this isn't accepted by an insurance company, our hospital will write this day off as a "perk" for the pt. My coworkers & I have been doing this for the 2 years I've worked there, and it was happening long before I started there.
Fast forward to today! I had a 3 day c-section whose baby is in NICU, and she desired to stay until tomorrow. When I mentioned this to her doc, he claimed to know absolutely nothing about this 4 day thing, and absolutely REFUSED to let her stay. I first mentioned this to my coworkers, who got nowhere with him. Then I took it to my clinical managers, who squirmed their way around the issue and refused to give me a concrete answer. I then took it to utilization review, who informed me that her insurance COULD NOT refuse to pay for the 4th day. When I told this to the doc, he went on & on about money, the bottom line, and how it would be beneficial to get the pt out (& make room for another I assume $ $ $ ).
Ultimately, he cancelled the d/c, but was visibly upset with me. This upsets me as it is a doc I usually have a good relationship with. But it comes down to this, I'll lose less sleep having the doc pissed at me that I would have if I woud have sent the pt home upset with me. I was outraged that I was ridiculed so much for being my patient's advocate, by both the doc & my coworkers, and was told to just "let it go". I'm also frustrated that even my supervisors couldn't back me up on it, or at least give me a clear answer. I find it hard to believe that we've been doing it this long if it's against anyone's standards.
Anyone's input on this situation and their own unit practices would be greatly appreciated! I'm so sorry that this is so long!
BTW, the pt, a nurse herself, hugged me and thanked me for going to such great lengths for her!