Question for my fellow RNs of the OB world..

[harry Krishna]

Just when I think I've heard it all..... last night (I work in an ER) a woman came up to triage, full term, and having contractions, I called up to the L+D unit to give them a heads up and the nurse's response was "is she JUST in labor, or does she have cold sx. because if she does she can't come up here". I thought she was joking but she said no patients w/ cold sx could come to her unit. I asked her "so where does she have to go to give birth then?" (Which did not go over too well) and she replied "she goes to the Peds unit) She then demanded I take her temp. before sending her up.

I've worked in many ER's and have never heard of this policy. Am I missing something here or is this facility wrong?

HK

[fergus51]

We've had some really inapropriate send ups from the ER.... But, I think it has more to do with a fear of liability than a desire to bug us in ob. Most people know how litigious OB has become and so if a doctor or nurse is an emergency worker they may feel very uncomfortable caring for a pregnant woman (just like I would feel looking after an MVA). A friend of mine works in emerg and she is the "typical" emerg personality (she knows no fear and is a take charge, assertive type) and we always joke that she knows no fear.... EXCEPT pregnant women!

[judy ann]

We have excellent flight nurses in Denver, and one of the first med-evac programs in the nation. Those nurses can scrape a guy off the pavement in 37 pieces, and bring him to ER with a heartbeat. Just don't ask them to be responsible for a pregnant healthy person who is only being transported for treatment for labor at 34 weeks. One flight service often takes an OB nurse along, the other service has dedicated flight nurses who do all the OB flights. It works well, but it feels funny to have the flight nurse uneasy about something relatively simple.

[athomas91]

as for the thread where anything over 20 wks automatically goes to ob w/o triage.....watch yourselves....

our ED has the same policy - over 20 wks w/ a l/d specific issue (ie: not a cold) goes upstairs AFTER a quick abc assessment.....

about 6 mos ago an ambo calls in stating they have a 30 wker in labor - and are told to go upstairs - when she rolled in i looked at her ashen gray color and listlessness and said - she needs to stay down here for a min.... but that policy wasn't in place the - so she was sent upstairs - she ended up coming right back down and put back in the ambo and taken to a nearby trauma center (no transfer orders, no md eval, no accepting doc.....MAJOR HIPPA VIOLATION) -

she had ruptured and they took her to emerg. surg. and ended up saving both her and the baby.... but that nurse lost her job...

and if we would have had that policy - she would have had vitals, iv's ect.. and gone straight to emerg. surg at our facility....

a quick abc check guards both the patient and the ER nurses from liability -

[dawngloves, BSN, RN]

When I was 34 weeks I broke my toe and the ER was going to send me to L&D. I told them that was stupid as I only waddled into a table and the only thing that made contact was said toe!

And I didn't want to be monitored for an hour and wheeled to the other end of the hospital when x ray was right next door to the ER.

I convinced them!:chuckle

[HazeK]

crazied charge nurse!

we isolate pregnant, laboring women w/ chickenpox, pneumonia, scabies, HIV, etc, why not a cold?

Duh!

isn't this basic Nursing101 ???

Haze

[L&D_RN_OH]

I guess we are a little different. We get ALL pg pts in L&D. ALL. Including flu, UTI's, pylelo, MVA's, etc. I remember one MVA pt, 34 wks, who had a fractured pelvis. She was kept in L&D until she had her ortho surgery, then came back to L&D after surgery. Like I said, our ER doesn't really triage OB pts, unless they are brought in by squad with a non OB complaint, or less than 20 wks supposedly, although we get those too.

[MAGIK GIRL]

harry,

have you gotten an answer to your question yet?

mg:confused:

[gypsyatheart]

I think "the answer" is that for as many different facilities there are, there are that many ways of doing things differently! As evidenced by all these different replies.... The OP should actually check HIS facilities policies and follow them, even though they may not make sense!