How many is too many

Specialties Ob/Gyn

Published

The hospital that I am employed at has promoted their unit as Family Centered. This seems great for advertising purposes, but they have never followed up on guidelines for the public. Consequently, we are constantly trying to work around crowds (anywhere from 2-12 or more) in the room while you are trying to admit a patient or in the hallways during the delivery or even in the room during delivery if it is a young girl. This seems so unprofessional to me that the hospital would allow this and it is very difficult to work around. Also, there seems that this would be a huge HIPPA violation. Is this the way it is around the rest of the country or is it just my area where the hospitals are all in competition with each other and are afraid they will lose business if they put limits?

Specializes in Nurse Manager, Labor and Delivery.

We kinda promote family centered stuff...but we only allow 3 support people in the room while the patient is laboring..period. No switching off...no can we come in and just say hi stuff. After the patient delivers..they can have a reasonable crowd. It seems to work for us. I am like you...I can't stand the crowds and folks in the halls. We have a locked unit now...and we have to answer this hideous bell when someone rings it....I would just like it one time...if it would shock them if they lay on it tooooo long.....lol...just kidding of course.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I wish it were more like that where I work. we have TOO many around, milling in hallways, having to be asked REPEATEDLY to go to the waiting room, not listen at the door or sit all over the hall---- and sometimes, there are 4 or more in the room when the birth is going on. It's insane. IF they ask, I tell them only3 (two at mom's head, one to man the camera, if they have it) support people because that is all that can fit w/o getting totally in the way and being hazardous. Most of the time, this works. But our doctors don't set limits, so we can't make them the "bad guys" ....we are stuck w/this one.

This is an issue where it is soo nice to have a very specific policy. You can always fall back on, "Our policy states...".

In my opinon, this is where "baby story" type shows have done a disservice to the L&D profession, and the laboring mom. So many family/friends want to "get in on the action" just so they can say they were there. These people loose sight of their role to the laboring woman. Rarely, do I see support people actually be "supportive". More often than not they sit and stare, then go off and brag to their friends.

So, a policy is nice. We hand out little badges that say "Support". I try to also talk up the role of the support person so they realize that they are there to assist the laboring mom.

Specializes in Nurse Manager, Labor and Delivery.

Laboring has certainly become a spectator sport. Most times they do just sit there and stare...or talk or EAT in front of the patient like it is a party. They turn off the air because they are cold..they want blankies and pillows and water and ice...moreso than the poor patient. Sometimes I just bite my tongue. And how about those fathers who sleep all night long after the baby is born, not helping out poor mom at all. They are my absolute favorite.

The hospital that I am employed at has promoted their unit as Family Centered. This seems great for advertising purposes, but they have never followed up on guidelines for the public. Consequently, we are constantly trying to work around crowds (anywhere from 2-12 or more) in the room while you are trying to admit a patient or in the hallways during the delivery or even in the room during delivery if it is a young girl. This seems so unprofessional to me that the hospital would allow this and it is very difficult to work around. Also, there seems that this would be a huge HIPPA violation. Is this the way it is around the rest of the country or is it just my area where the hospitals are all in competition with each other and are afraid they will lose business if they put limits?

You'll get used to it and you will decide what works for your unit. First of all, we do NOT allow people to stand in the halls and we do enforce that. If they are not in the room with the patient, they have to be in the waiting room. If we have a problem (which is rare) we just have the security guard come up and stroll through.

As far as people in the room, go with what works for the patient and get a moment to speak privately to her when you kick everyone out (for an exam for instance). Find out what she wants. For me, if someone is not helping or being supportive, I either give them a job to do or I get rid of them. Those people lose interest really fast anyway!

HIPPA has to do with medical records. It doesn;t work as an excuse for a lot of people in the room (although we would like it to). You'll get more comfortable with it as time goes on. We have been doing it for years this way and it doesn't bother us much. There is the occasional time when it does, but we deal with it at the time.

As far as the HIPPA goes, out hospital is investigating having them sign a release stating anyone in the room is authorized to hear medical conversations, including OB/GYN history such as herpes etc.... because you could get into trouble discussing the patient's medical history in front of everybody who's there in the room. Personally, I ask everyone to leave while we discuss medical history and domestic violence history.

Specializes in LTC, Home Health, L&D, Nsy, PP.
We kinda promote family centered stuff...but we only allow 3 support people in the room while the patient is laboring..period. No switching off...no can we come in and just say hi stuff. After the patient delivers..they can have a reasonable crowd. It seems to work for us. I am like you...I can't stand the crowds and folks in the halls. We have a locked unit now...and we have to answer this hideous bell when someone rings it....I would just like it one time...if it would shock them if they lay on it tooooo long.....lol...just kidding of course.

Oh my gosh! We have one of those bells too ... and no desk clerk! It drives me batty! LOL

What kills me is that the majority of women do not want all of these people around during their labor/delivery. The family members are usually just overbearing and pushy and insist on being in there. Usually they are just being nice, trying not to hurt certain family members' feelings. Our policy states that only 2 people can be in the room at one time, but it allows people to switch off which is really annoying with our security door system, which the nurses answer because we do not have a unit secretary. It takes too much of our nursing time to answer the door ten thousand times a day to let people in and out. During delivery, we also allow only 2 people but if the doctor "okays" it they can have a 3rd person which really gets cramped. (By the way, why are doctors allowed to change hospital policy?) Our labor rooms are so extremely small, not at all like the new birthing rooms that most hospital rooms have these days. You would think they'd get the picture when I'm forever saying "excuse me, I need to get to...." It blows my mind that people just stand there with that deer in the headlights look while I'm trying my best to serve my patient, at the same time trying to avoid them as an obstacle. I know it's an exciting time for patients and family, but why would you want to interfere with a patient's care or even subject them to harm in an emergency situation? Anything can and sometimes will go wrong during a delivery and when the room is crowded with unecessary persons there is no room to carry out your work when time is of the essence. *sigh* Sorry to rant, but this is my greatest pet peave. :o

I know what you mean. Recently I had to resuscitate a baby unexpectedly at delivery and one woman ran over with her camera and said, "can I take pictures now?" I wanted to reply, "don't you think it would be nice if the baby were pink first!" But of course I didn't.

Specializes in NICU.

I agree with the "A Baby Story" stuff! I once saw an episode with no fewer than 12 people in the delivery room, including a school-aged boy who lived down the street! WTF??? :uhoh3:

I'm still of the school that if you weren't at the conception, you shouldn't be at the delivery.

Specializes in Nurse Manager, Labor and Delivery.
I agree with the "A Baby Story" stuff! I once saw an episode with no fewer than 12 people in the delivery room, including a school-aged boy who lived down the street! WTF??? :uhoh3:

I'm still of the school that if you weren't at the conception, you shouldn't be at the delivery.

AMEN sister. I love it

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