OB Triage-wondering how other hopsitals compare to mine

[HardDaysNight]

At my hosital, all of our OB patients present to the ER, where they are assessed and then sent to us if further monitoring is required. Once we receive them, they are again assessed (fetal monitoring and another admission assessment) and the doctor is notified of the results. However, if they are determined to be in false labor by the nurse, they cannot be discharged home until the physician sees them. Thus, they sometimes stay overnight just for braxton hicks contractions (which sucks for the patient!). In other hospitals where I've worked, we were able to discharge them with the doctor's phone order (for false labor). My hospital states that every other hospital is wrong and that it is an EMTALA issue. How do you guys do it at your hospital? I'd like to get feedback on my scope of practice as an L&D nurse and other hospitals' policies and procedures.

HardDaysNight:confused:

[midwife2b]

I understand the ER part of it But what if the patient is actually admitted to the labor and delivery unit to be observed. Can I discharge them from the hospital even though the patient is not actually an ER patient?

At my facility once the patient is transferred from the ED to L&D she is actually "discharged" from the ED; we then do the paperwork to get her an L&D account number and hence, she is no longer an ED patient.

If she comes to the ER as a trauma pt. (MVC, domestic violence, etc.) she has to be cleared by the ER doc/trauma head in order to go to L&D. We follow the same rules as any other patient who comes in with a trauma; Their account number reflects a "trauma admission" and they can go to any unit without having all that ridiculous paperwork repeated.

Complicated rules and regs...