Epidural placement as a "spectator sport"

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Specializes in 4 years peds, 7 years L and D.

Had a spouse of a patient yesterday that threw a good fit when the anesthesiologist asked him to leave so the epidural could be placed. It is just their policy, we have had a few dads hit the floor, plus we want the patent to listen to us and lean on us during the procedure and not be draped over hubby and not paying attention and holding still. Anyway, for whatever their reasons, the MDs just want it that way and we have to respect it. Are we the only ones that do this..ask the support person to leave? I had never thought about it, and most dads run happily out the door...but this dad came back in and proceeded to generally make me feel like crap the rest of the day ( and his wife did nothing to help BTW :uhoh3: )...kill the messenger right?

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Specializes in Adult internal med, OB/GYN, REI..

I have had this same exact thing happen to me multiple times. I do not blame them, however it really peeves me off that i am sitting there wasting our time arguing their hardheadedness when their spouse or partner is in pain!!! jeez! I guess its just too bad that some folks ahd to ruin it for the rest of them by not knowing when to sit down!

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Specializes in 4 years peds, 7 years L and D.

We have one doc who wont even argue. He just walks out, says "let me know when you want your wife to have the epidural"...

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Specializes in Adult internal med, OB/GYN, REI..

Nice... leave it to the Anesth to be personable! Argh!

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Specializes in L & D; Postpartum.

Most of our anesthesiologists have the support person leave the room too. I always tell the family in advance, and if they have an issue with, I let the MD has it out. It's not MY policy, although I fully support it. Too much about birthing these days is a spectator sport. Maybe I'm just getting old, or I've been doing it too long, but I agree that without a roomful of folks, or in this case the spouse, the mom can and most times will be able to hold still and do what we need her to do better. It all makes for a better placement and usually quicker also.

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Specializes in Adult internal med, OB/GYN, REI..

I agree with spectator sport theory-- i get so frustrated when there is trash all over the room, people rushing in and out of the room constantly, bringing in food while the mom is NPO and hogging up the space. very counterintuitive in my opinion--its like i want to say- if your are not going to supprt her, why are you even here?

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Specializes in MICU.

I'm very impressed by L&D nurses... it was my 1st choice when I started nursing school, but dealing with upteenth visitors was too much!!

For the record, my ex-husband threw up when they tried to insert my epidural. Both times, neither of which worked anyway. I wish someone had asked him to step out!!

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

I had two epidurals. I did not want the person putting it in distracted!!

And I would've killed anyone who brought food or drinks in the room while I was NPO.

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

To clarify, the two epidurals were for two different babies, both c-section, both anesthesiologists were very good, but for the first section, it was the CRNA who really got me through it. It's rather unnerving to know you're going to be cut open while awake. She was great and talked me through it.

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We use to allow one support person in during the epidural, until the case where the Dad passed out, bumped his head, and died. So now, the CRNA's don't allow anyone in. Although, some of the anesthesiologists do. :p So I guess, technically, it's not an official policy though they say it is.

Most people gripe a little, saying "everyone has to leave? Even her husband.... mom..... sister?" But they go, without arguing once I tell them the reason behind it.

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I think the statement that birth is not a spectator sport is true beyond words. I also strongly agree that there should be limits to the number of people present for epidural placement. I am one-hundred percent behind staff advocating for patients and limiting visitors when necessary.

However, having worked extensively as a Doula I always found the request to sit or leave during placement a little odd (These requests only popped up when I moved to the East coast). Keep in mind that I was never a private Doula, but always directly employed by the hospitals where I attended births.

I felt that it was my job to keep moms comfortable and calm during placement so that they would focus on their RN and MDA. If I could keep them calm the medical staff could do what they needed to do expediently and safely. Sometimes the RN was going to do a much better job than I could manage keeping a particular Mom calm and then I knew it was time to back off. But 99.9% I felt it was my job to provide a continous presence to Mom and support the staff as well. Maybe I am an odd bird, but other Doulas may feel the same way. So if a Doula is working as an appropriate (no personal agenda, good relationship with pt) advocate/support person your institution may discuss allowing them to stay during epidural placements. Just a gentle suggestion.

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Specializes in NICU.

When I had my baby (at my own hospital) they told my husband that he had to either step out or sit in a chair across the room on the non-business end of the procedure. I leaned on the nurse. Before things got going they had my husband and I sign a form saying that we understand that anything not a natural part of birthing couldn't be filmed. Epidural, forceps, vacuum, etc.

Hey he was just happy that he no longer had to grind his fingers to the bone rubbing my back--I had all back labor. Haha.

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