Hysterectomy question

[emtlpn]

I'm a long time lurker, first time poster. I would like some advice, if y'all don't mind. I'm getting a hysterectomy on April 25th and will have my pre-op dr visit for questions and signing my consents on April 7th.

My hysterectomy is by choice due to excessively long, painful periods (there is a much longer story behind all of that, but I will spare you all the details). I am infertile and have a history of 5 miscarriages.

The hospital where I am getting the procedure is the same one I did my ob rotation in school. I just remembered yesterday that the floor that has the laboring moms and the newborn nursery is the same unit where I will be staying post surgery. The rooms are private, but in a row of 3 rooms you could have a mix of laboring moms, recovering moms, and post-gyn/ob patient. While I'm choosing to have this surgery and not having due to a medical emergency like cancer, I'm still uncomfortable with having to be around moms and fresh babies, especially because of my sadness over my inability to have a child of my own.

In your opinion, would I be unreasonable to request to be on a Med/surg floor post surgery? I know I can request anything, but get turned down. I fully realize that the H stands for hospital, not the Hilton, but am I wrong for not wanting to be around all that "baby joy."

I realize that I will have to be around parents and babies in the real world after surgery, but I can control that exposure to an extent. Thanks for your help.

[quazar]

I don't think there's anything wrong with it, however, a couple of hospitals where I've worked were super strict about where the GYN patients went post op, and refused to change their locations. I would sit down and talk to your doctor, heart to heart, and explain your reasons. I would think a sympathetic MD could affect change for you. I'm so sorry for your losses, and I hope your surgery goes well.

[klone, MSN, RN]

It would absolutely be reasonable to request that. Good luck to you.

[CrunchRN, ADN, RN]

Absolutely request it.

[RainMom]

Yes, request it. We generally send our hysterectomy pts to the OB unit but sometimes due to high census there, we send them to our med-surg. Wishing you a fast recovery.

[emtlpn]

Yes, request it. We generally send our hysterectomy pts to the OB unit but sometimes due to high census there, we send them to our med-surg. Wishing you a fast recovery.

At the risk of sounding argumentative, can I ask why you think sending a post hysto pt to an OB floor is a good idea? I understand that you are dealing with the same area for recovery purposes, but, from my perspective, it seems a bit cruel.

Ladies who have just given birth are generally feeling quite happy, while ladies who have just had a hysterectomy are often dealing with at least some sense of loss, i.e. loss of fertility, loss of (feeling) feminity, grief over significant life changes, etc. In my opinion, placing these ladies so close to representations of the one thing in life they will never have, especially immediately post-op, feels almost purposely mean-spirited. Factor in the sudden and, sometimes extreme, hormonal changes brought about by a total hysterectomy and I think that we as health care providers are adding fuel to an already difficult fire.

Now certainly there are ladies who come through this surgery with little to no emotional difficulty, but I question whether those ladies are the norm. (I truly do wonder. I'm a Pediatric Nurse. Ob/Gyn is most decidedly not my area of expertise and I will gladly yield the floor to those who do have experience in the area.). To me, I would think that the more kind placement for hysterectomy patients would be on a Med/surg or general floor. As I stated before, my surgery is not life sustaining or saving, but a more aggressive, and thus permanent solution to a problem I have had for many years. I have had a few years to adjust to the fact that my body is incapable of producing and sustaining a pregnancy. The ladies I especially worry about are the young ladies diagnosed with uterine cancer (as an example) who want to have children and just haven't had the chance. These folks are learning that they have cancer and the only way to stop its progression is to have this radical surgery. These ladies are trying to heal from major surgery and when they walk the halls as they are instructed to do post op, all they see are fresh brand new babies and happy mommies and daddies. I know life is not fair, but I just can't advocate for being a part of a system that encourages life to kick you when you are down.

Again, please forgive me if I sound argumentative. It is not at all my intent. I guess I'm just trying to understand lines of thought that I disagree with.

[RainMom]

I'm totally with you on that. I really don't know why it is that we typically send hysters to OB. I have thought the same as you, that it really didn't seem necessary & can be mentally hurtful. The only thing I can think of is that our OB/GYNs like all their pts in the same place, they are more familiar with the nurses there & probably think it's nicer for the pt because our OB has newer furnishings & all private rooms compared to medsurg.

It also didn't make sense to me when a 5 day post c-section was admitted to my ortho floor with pre-eclampsia (which I didn't know was possible at the time). I tried to reason with the supervisor & OB unit over that one but apparently that is policy here; once baby is born & you're discharged, readmission is to another floor, even if it's later that day & related to the pregnancy. I had to have an OB nurse come and at least do the fundal assessment, along with bringing me a breast pump.

[klone, MSN, RN]

I can address that. The vast majority of hyst patients are post-menopausal. They're not grieving the loss of their fertility.

The physicians like for all of their patients to be on the same unit, which makes it easier for rounding.

Keep in mind that the physicians are used to ordering all their patients to go to OB after surgery. That's just where their mind goes when writing orders.

Where to to go after surgery for recovery is a conversation that should take place with the physician in your pre-op appointment. And a stellar physician would broach that topic him/herself when they know there might be grief issues. But usually, it's just not something they think about.

[quazar]

At the hospitals where I've worked that the GYN/OB patients were all on the same floor, the hospitals were small community hospitals and I think it had more to do with bed space/staffing and the MDs wanting all of their patients on the same floor to round, as you stated. In larger teaching hospitals where I've worked, there were separate floors and it was not a problem. Just my personal experience.

[emtlpn]

Thank you everyone for your input. While I still don't agree with placing post hysto pts on an OB floor, I appreciate your advice and well wishes. I see my dr on 4/7 and will definitely request alternative placement. Hopefully I'll get it, but if not, oh well, at least I tried. I should only be at the hospital for 1 day and night. If I can survive being my sister's birth coach 2 days after my 4th miscarriage, I can survive almost anything.

[jenrninmi, MSN, RN]

My two cents? A lot of the times our hysters don't even realize they are on the OB floor. They just know they are in a beautiful, brand new hospital. They never hear babies cry and they are being much better taken care of (if I do say so myself) then an understaffed med/surg floor. We are a baby friendly designated hospital, so babies stay in their mom's rooms all the time. So if a hysterectomy patient is up walking the hall, there will be no big nursery window where people can view sleeping/crying babies. (So old school). I hope it all works out for you!

[blackribbon]

The same doctors that do the hyst are the same ones delivering babies and c-sections. You are going to get better care if you are on the unit that knows those doctors and the doctors know the nurses. Women specialty floors tend to be nicer too...just a fact. There are also less infections, less psych patients....less drug addicts..less potential for violence patients... and the list goes on (got to protect those babies). On a med/surg unit, you may be paired up with a little old lady who is actively dying...I think that being with happy families is the better option. Also, not all ob patients are happy...some have babies in the NICU who are struggling to live...some have lost their babies...some are ectopic pregnancies that had to be terminated...they are all on the same unit. I'd just ask for a end room away from the hustle and bustle and stay within my specialty area.