Wishes Regarding Students in Birth Plans

Specialties Ob/Gyn

Published

I've been reading a lot of birth plans on the web - the one I use with my clients has been currently hijacked by my computer. I know that I include this question on my birth plan about students (nursing and residents) in the room during L&D. Usually it states, "I request that no students be involved in my care." I've found that in my private doula practice I haven't run into anyone having problems regarding this preference. In the hospital, since most of the pts are Medicaid, usually they don't get a choice.

I'm just wondering, if you are in a teaching hospital, have you had any problems with pts refusing to have students in with them and how is this handled? I know that if I had private insurance, I probably would not want to have students. Yes, I know they need to learn somehow but with this issue I need to draw a line. Now, if I was a Medicaid pt, I don't think I'd have a choice and wouldn't question the issue.

How is this handled?

Specializes in OB, lactation.
I just feel that a teaching hospital is just that and the patient should recognize that it isn't fair to interfere with that process.

I didn't want extra people interfering with my process.

When I had my first at a very busy teaching hospital I requested no students. I had heard that lots of students came through and I was already very nervous about the birth and just the regular peolple being around seeing me in all my glory. Like someone else said, I wanted it as calm and quiet as possible, and honestly, knowing that I had experienced people working on me made me more at ease. In the end, I did end up letting a nursing student cath me after my epidural anyway. Overall I just wanted to be alone with my family as much as possible so I wouldn't be so nervous. I didn't even want to start breastfeeding in front of anyone but my husband! LOL I kept trying to wait until everyone left. :) (you don't even know how funny that is in retrospect)

During births 2 and 3 I wouldn't have minded at all as long as it was one person at a time.

I do understand that students need people to learn on, but I also think it is a person's right to refuse.

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After reading through this thread again, I realized I didn't differentiate between Med Student and Nursing Student! I had absolutely no problem with having a nursing student in any part of my childbirth experiences. It was the medical students that were a real pain in the rump!

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I just wanted to emphasize that I realize that students need to learn SOMEWHERE. If I didn't have some sexual abuse issues, it wouldn't be a problem. Since I work with some clients who have these issues, I fight for them to not have their privacy disrupted at this vulnerable time. I work with them to take the fear out of childbirth, and I feel that this is a small request to make for a positive birth memory for one who has fears regarding strangers attending them when they are least ready for it.

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Specializes in OB, Post Partum, Home Health.

I have been frustrated with the students that our hospital has had lately. I know that everyone needs to learn, but it seems that lately the students have no respect for the patients and only want to see a birth. I can't tell you how many times I have heard "I will be in the ER, call me when she is ready to deliver, I need to see a delivery." It is like they are bored with the labor process and only want to see the birth. I have become quite the witch about this lately because I refuse to let students come in to my patients delivery unless they hang out, meet the patient and the patient consents. I don't feel that it is right to let anyone that doesn't need to be in the room just waltz right in to stare at the patients naked crotch because they want to. OK, I'll stop now!!!!

Oh, no I guess I won't. While we are on the subject of students, isn't it required that students have an instructor with them? We have one school that for the last several months has been sending us students and we have never seen and instructor and I don't feel that I am paid enough to be the RN and the nursing instructor, in addition, I work on a very busy unit and although I am more than willing to let students do procedures (with and instructor) quite honestly, I usually don't have time to teach the students how to do the procedures and supervise them!!!

OK, now I will stop!!!!!!!!!

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After reading through this thread again, I realized I didn't differentiate between Med Student and Nursing Student! I had absolutely no problem with having a nursing student in any part of my childbirth experiences. It was the medical students that were a real pain in the rump!
I didn't differentiate either. I certainly wouldn't mind having a student nurse or OB course RN in the room with my regular nurse. Me, my hubby, the cnm, and a nurse (and one student, if they are there) I could handle...I know everyone there is working in/for the best interest of me and my baby. But a lot of times where I work, the MED students come rushing in as delivery is imminent, without anyone having asked the mommy to be if it's okay. Talk about a circus!! I hate it when they do that. It's like the patient isn't even there, she's a "mechanical teaching tool" that spits a baby out for them. Like a birth/lady partsl repair simulator they can work on hard, technical skills with or something. :uhoh3:

I would feel much better if they just took the time to ask the mom/dad ahead of time if it would be okay for a med student to observe the delivery, and I think it would leave a better impression of the place with the mom.

I have become quite the witch about this lately because I refuse to let students come in to my patients delivery unless they hang out, meet the patient and the patient consents. I don't feel that it is right to let anyone that doesn't need to be in the room just waltz right in to stare at the patients naked crotch because they want to.

Amen to that!

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I didn't differentiate either. I certainly wouldn't mind having a student nurse or OB course RN in the room with my regular nurse. Me, my hubby, the cnm, and a nurse (and one student, if they are there) I could handle...I know everyone there is working in/for the best interest of me and my baby. But a lot of times where I work, the MED students come rushing in as delivery is imminent, without anyone having asked the mommy to be if it's okay. Talk about a circus!! I hate it when they do that. It's like the patient isn't even there, she's a "mechanical teaching tool" that spits a baby out for them. Like a birth/lady partsl repair simulator they can work on hard, technical skills with or something. :uhoh3:

I would feel much better if they just took the time to ask the mom/dad ahead of time if it would be okay for a med student to observe the delivery, and I think it would leave a better impression of the place with the mom.

Amen to that!

I would have hit the roof if anyone came rushing in at the last minute to see the birth. And I would have sent them packing. When I am a CNM I won't allow anyone to do that to a mom. That is completely unacceptable. I think when I am an RN I am going to tell them the mom said she doesn't want anyone at the birth other than necessary medical personnel, such as her dr/cnm, the nurse and peds, if necessary. GRRR!! :angryfire

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Specializes in cardiac, diabetes, OB/GYN.

In some teaching hospitals, when you sign the admission sheet, you are signing your consent to have students although we did attempt to honor wishes as much as possible since the med students would often be allowed but not the nursing students..Finally we convinced the people at the doc offices to let the patients know that at a teaching hospital, there may be cause for some students to be there..Mostly we worked it out well...As for not seeing anyone all night, I couldn't go along with that because they need to be seen at least once to determine that they are ok, even with vs on mom or baby, or weight of the baby. Just because a patient refuses that doesn't mean they shouldn't be peeked in on, or, if it is busy, they might not be able to be accomodated to that degree, although, as above, we do attempt to honor pt wishes to the best we can....

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I guess that's why I like a community hospital versus a teaching one. No one need interfere w/the "process" of our patients and their birth experiences. They have the absolute right to control who is in the room at all times. This is how it should be. It is THEIR birth experience, not the resident's or the nursing students'. It should be reserved as a priveledge for them to be there, if the patient allows it.

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I'm a nursing student.. on my first day on the postpartum floor, my first patient kindly let me know that she didn't want me to care for her. It really wasn't a big deal. She told me that she had a very "traumatic" birth experience and that she didn't want nursing students or medical students to practice on her. I later found out from her RN that she thought I would be practicing starting IV's on her, LOL!!!

i agree, every patient has the right to refuse a student.

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Oh, no I guess I won't. While we are on the subject of students, isn't it required that students have an instructor with them? We have one school that for the last several months has been sending us students and we have never seen and instructor and I don't feel that I am paid enough to be the RN and the nursing instructor, in addition, I work on a very busy unit and although I am more than willing to let students do procedures (with and instructor) quite honestly, I usually don't have time to teach the students how to do the procedures and supervise them!!!

OK, now I will stop!!!!!!!!!

Don't forget about when you were a student!!!

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With my first child, I would not have been comfortable with students observing the birth. However, after having three babies, I would welcome the opportunity for a student to share in such an incredible experience!

It's a very individual decision.

Michelle

this was exactly how i felt. I was asked if a med student could help deliver and all i could hear from that was INEXPERIENCED! this was my first (and only) baby and i wanted someone who had done this thousands of times. Also i had been in there so long that i was irritable, had been through several shift changes already (docs, cnas and Rns) and had already been through 2 student nurses trying to get my IV and 1 Rn trying 3 times before Iv therapy had to be called. So my "student" experience didn't start out great, and I am ashamed to admit at this point I was rather snippy with the nurses about the IV thing (but dang it HURT being poked 7 times!) I think if i were to have another and it was uncomplicated I wouldn't mind students because now I don't have this overwhelming fear of the unknown. And once she was born i was fine with students coming in doing stuff for me and her (as long as with her i also got to ask the RN and MD questions not just the students.)

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Excuse me, but Medicaid patients should have the same rights as everyone else. Why should they be treated any differently or practiced on more than others. In my hospital, we treat everyone the same, no matter what their insurance is. It would seem to me that this is a form of discrimination. Do you encourage your residents etc to completely disregard a patient's rights becuse of their insurance? I don't mean to sound harsh, but I am appalled by your statements above.

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