Where do your Miscarrages admit into

[JHUBRAIN]

Hello all - We are having a very heated debate at our hospital. Our OB dept will not admit any Pt who has had a miscarrage unless they are over 22 weeks

They say (OB dept) that they are a Mother-Child unit - and these pts can go to a MedSurg floor (not a mother anymore they say). Well I can tell you that our MedSurg Nurses are the best, but they know nothing about checking Fundes and how much blood , etc. We had a very close call when a 19 week women lost her child and bleed so much she had to have an emergency Surg. Thank God the Nurse that had her on the Ortho floor had the sense to get the doc on the phone right away. She previously called the OB dept and they said they were to busy to check on her. Well - there is also the greif therapy / PRIDE instructions that these patients also need (our hospital offers a burial place for all miscarrages / any fetal remains and does a service every six months - Very Cool I think) and our MedSurg Nurses are running after 6 - 7 Pts on days and I am afraid these type things would be missed - So my question (after all the ranting - Thanks for listening) "Where do your miscarrages / DNC admit into and do they recieve any special care?"

Thanks to all and God Bless - JHUBRAIN

[Q.]

That is so cool. I have had two miscarrages. The first one they left me alone in the room (in the ER) with the remains in a specimin dish for like 15 minutes. I can't even describe the massive depression and flashbacks I had for months after that.

Oh my god. How utterly horrible. I'm so sorry that happened to you. That is inexcusable.

[SmilingBluEyes]

that IS horrible. SOMEONE there in the ER needs a wee bit of TRAINING. I am sorry anyone would go through that. And I can understand the flashbacks and nightmares. This is what I mean. Understanding and being able to care for people having gone through miscarriage and ectopic losses is lacking. People fall through the cracks and not too many seem to care.

I think the concept of a hospital helping dispose of remains according to the patient's choice is a beautiful thing. I wish I had had that chance. I guess up even as far as up to 15 weeks, it's just medical "waste". I do know part of the problem I had with healing was not having anyone to say "Goodbye" to.....(probably sounds crazy to some of you)

So kudos to that hospital. I think that is just beautiful.

[palesarah]

that IS horrible. SOMEONE there in the ER needs a wee bit of TRAINING. I am sorry anyone would go through that. And I can understand the flashbacks and nightmares. This is what I mean. Understanding and being able to care for people having gone through miscarriage and ectopic losses is lacking. People fall through the cracks and not too many seem to care.

I think the concept of a hospital helping dispose of remains according to the patient's choice is a beautiful thing. I wish I had had that chance. I guess up even as far as up to 15 weeks, it's just medical "waste". I do know part of the problem I had with healing was not having anyone to say "Goodbye" to.....(probably sounds crazy to some of you)

So kudos to that hospital. I think that is just beautiful.

The law in NH, at least, is up to 20 weeks or so many grams (I forget the weight cut off) the remains are still considered a "surgical specimen"

Luckily the nurse in charge of our bereavement program set up a program with a local nursing home- the owner will, free of charge to the parents and hospital, do a group cremation of remains which are interred in a memory garden every 3 or 6 months if the parents do not want to make arrnagements themselves. He will also do indivual cremations at no cost or low cost if that is what the parents desire. The owner is a wonderful man, very respectful; we're grateful that he is willing to provide such a service.

As for the original question, we don't usually see losses before 14-16 weeks on my floor; I think earlier losses are usually handled in the ER or on an outpt basis if the pt needs a D&C. We usually only get the patients if it's a later loss, whether spontaneous or requiring induction. We give our patients the quietest room on the floor, farthest away from the nursery, and after delivery they have the option of going to another floor (usually the mixed peds/med-surg floor next door to us; they also take gyn surgicals and our post-partum overflow in busy stretches). Many of our patients actually choose to stay with us until they are ready for discharge.