Cesarean sections

[seanymph]

We are a small hospital that does approximately 350 deliveries per year. I would like to hear from similar size hospitals on what your policies are for scheduled c-sections. Specifically if they are scheduled for an early AM section what time do you have them come in for admission? Also do they go through presurgical screening and when are their labs drawn? Thank you.

[OB/GYN NP]

I don't still work in this hospital, but I worked in a small hospital soon after graduating from Nursing school, and we did scheduled C/Sections on our unit. Our OB/GYN's all had their own first assistants that they liked to use (personal scrub nurses), and the ubnit provided the second scrub and the circulator. The patient came to outpatient lab 48 hours before their Section and had their labs drawn. The Docs gave the patients their orders for labs when the patient was in the office to see them, then the patient came in to the OP lab. The only other pre-op screening they had was that the Docs did mini-physicals before their surgery, when the patient was in the office last before surgery. Our patients arrived to the hospital 2 hours pre-op. So if we had an 8:00 Section (popular time for our Docs), the patient arrived at 6AM. Hope this helps!

[luv l&d]

we have pts. show up 2 hrs prior. at that time we do labs,efm,iv and consents. we then have anethesia see them and off we go. if they don't have a first assist, the perinatal nurse practioner will first and we provide the scrub and circulator. neonatal nurse practioner attends all c/s.

[at your cervix]

We usually call our scheduled c section pt's the day before and give them instructions-clear liquids after mn, npo 4 hours prior to surgery, which home meds to take, which not to take etc.. We then have them come in 2 hours before start time, do NST, start IV, draw labs (usually off the IV start, they love only being stuck once!), sign consents, shave etc.

This seems to work out very well, except when the surgery start time is right at shift change!!!!!

[moz]

We are a small hospital doing about 20 deliveries a month. Our pt are told to come at 5:30 or 6:00 for a 7:30 section. What usually happens is they get there to check in after 6, if they're not preregistered it takes even longer for them to get to our dept where we prep them, including lab draw. I have asked for them to make sure all are told to arrive at 5 or 5:30 so we have time and are not so rushed, because surgery is always there straight up at 7 am, in the midst of report wanting the pt and paperwork. Also we still have 6am vitals and stuff on our other patients. We night nurses take care of the c/s preps and do the admission assessment. I feel bad for the pt that comes at 6:30, already nervous in anticipation of the surgery, and we have to rush to get her ready. It's not fair to her.

[AlaskaKat]

We are a small hospital doing between 20 - 30 births per month. We usually have the scheduled c-sections come in the day before and do all the teaching, paperwork and labs and anesthesia visit. Then we have them come at about 6 am (usually 7:45 surgery) to do their IV, NST, anything else that didn't get done.