Jewelry in the OR - MisInformation - page 2

by sandiegojames

14,569 Views | 13 Comments

Having just finished reading a prior post about jewerly in the operating room on patients I found there was a bit of mis information and lack of understanding regarding jewelry on patients in the OR and bovies in general. ... Read More


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    Witchy, we typically agree in many of our posts but I have to disagree with this one. There isn’t a difference between receiving blood products and having jewelry removed when it comes to honoring cultural or religious beliefs.

    We had a female patient that was Indian (country of India I don’t remember what state). She had not taken her necklace off and it was a long one. One of the nurses was getting ready to remove it because it had not been taped down. The anesthesiologist was an Indian and flipped out. It would turn out that had we removed the necklace and they (the couple) found out, the husband could leave her because it is a break of the vows. The anesthesiologist compared it to the same as adultery.
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    Sheesh, really? We have a fairly large Indian poulation here but I've never run across that.

    Most of my dealings have been with people from this country who just don't want to take their stuff off. Also, many of them don't understand the whole NPO thing. We also had one family who claimed we lost Grandpa's dentures-this guy didn't even have them in when he came to us. Come to find out, Grandpa's dentures were getting a little on the shabby side and the son-in-law thought it would be a hoot if they could get the hospital to spring for a new set. They found they old dentures upstairs in his bedside drawer..One of the daughters had a conscience attack and confessed the whole thing!

    A necklace I'm not going to have a problem with-unless it gets in the way of surgery. I have to admit though, I'm also a firm believer that when people come to this country, they have to realize that there is a certain amount of acclimation that should happen...I don't think that the OR staff should be scrambling to accomodate various demands and whims of certain cultures..But I know that is almost a whole other controversial topic, so I'm going to leave it alone.
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    I know this thread is old, but I wanted to leave a note just in case someone else found it like I did while researching this issue. I am a patient/patient's spouse and am appalled at the attitude taken by some nurses in this thread. My research so far suggests that while there is some risk here (burns, virtually nonexistant; swelling, real but rare; loss, real but both minor and controllable through taping) that on the whole the risk to the patient is very slight, indeed. The patient is already giving informed consent to being cut upon and having large foreign objects inserted where the sun never shines and that consent is frequently being given in situations which are entirely elective. Is there any reason why informed consent through a signed specific waiver is not sufficient for this very minor risk as well? I find the comments to the effect that this shouldn't be allowed because it might complicate a nurse's job or because the nurse is responsible for patient safety to be exceptionally arrogant in this case. Should surgery (for unrelated reasons) be refused to patients with self-inflicted medical or physical conditions because those conditions may make the nurse's job more complicated? As for patient safety, I've always been under the impression that it was the patient's primary right to decide on the basis of informed consent what was and was not going to be done to him. Sure there are things which are so risky or inappropriate that a caregiver should have the right to decide not to give care even if the patient is willing to give informed consent to them, but this simply isn't one of them in light of the fact that the only real risk is swelling and that the informed consent can certainly provide for a cut-off if that occurs. Fortunately the hospitals and outpatient surgery centers where I and my spouse usually get surgery don't care about this: they ask us to remove our wedding rings but are immediately willing to just tape them down if we decline (and I do not recall ever having to sign a waiver on that point, but perhaps I have). It has only been in the last few days when we have encountered, for the first time in our lives (both over 60 yoa), a surgery center which is outright refusing to allow surgery if we do not have my spouse's wedding ring cut off in advance (it's loose on the finger, but cannot be removed otherwise due to arthritic increase in the size of the finger joint). Since the physician involved does not do surgery anywhere else (and will not step up to the plate to get the center to change its policy even though he's an owner of the center), we'll be taking our business elsewhere. Though in this case it's a matter of not being able to remove the ring, if it were me it would be an — admittedly sentimental — refusal to remove the ring that's been on my finger without being removed even a single time since my spouse put it there 25 years ago. Before someone says, "But isn't the clear-thinking thing to do to set aside your sentimentality or minor inconvenience in order for your safety?" let me say that neither my spouse nor I would have any objection to our ring being cut off during surgery if swelling develops, at that point necessity must overcome sentimentality or inconvenience, but it should be _our_ choice whether or not to take the minor risk that that necessity might arise.
    Last edit by PtWRing on Feb 2, '12 : Reason: typos
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    As a former OR nurse and current med-malpractice defense attorney, I offer the following observations and opinions: jewelry and other valuables should be left at home. Reasons: 1. Safety. PtWRing does not realize that finger swelling can occur after the patient is under surgical drapes and the hands are no longer visible. Sorry, but OR nurses and anesthesia providers are not going to monitor a patient's fingers throughout surgery. Also, by the time swelling occurs, it may be too late to cut the ring to prevent damage. And the risk of burns is minimal but so long as we can prevent burns, we will. 2. Risk. Why bring a valuable to the OR or hospital and risk it getting lost, stolen, etc. I am reminded of a claim where the patient left a laptop unsecured in his room when he was transported to another facility for a procedure, notwithstanding that he was cautioned by the hospital not to leave valuables in his room. When his laptop disappeared, he wanted the hospital to pay for it. Sorry, no dice. And yes, it is an "inconvenience" for OR nurses to keep up with patient valuables. The OR staff is under tremendous pressure to be safe and efficient. The OR nurse's focus is on maintaining safety and sterility in the OR, not on securing jewelry that can be left at home. While I sympathize with PtWRing's situation vis-a-vis her husband's wedding ring, I hope she will keep an open mind regarding why patients are asked to remove rings before going to the OR.
    ORoxyO and Rose_Queen like this.


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