pregnant anesthesia providers

[Allda]

Hello!

I am translating a medical book into Polish and as I have never worked in a US hospital, I don't understand a few things in the following passage. I think OB-GYN nurses might be the right people to help :)

The passage is about pregnant anesthesia providers and their job hazards.

"Pregnant anesthesia providers are often pleasantly surprised to find that their departments are supportive and flexible. It is generally the policy of *training programs* not to ask a woman to do a case she is not comfortable doing.Programs will also usually make *allowances in the posting* and *call schedules*to combat theever-present fatigue problem."

As I don't know much about the hospital employment policy in the US nad English is not my mother tongue , I don't understand what "training programs" refer to, plus what "allowances in the call schedules are". Actually I don't know what "call schedule" is. Is it a night duty? As for the "training programs'- do pregnant anesthesia providers attend them or it means lectures and seminars ABOUT pregnant employees, not FOR them.

Thanks for any hints!

One more question. What is the meaning of "reproductive outcomes" in the following sentence:

"Women in stressful jobs may have poorer reproductive outcomes."

Does it mean : they find it more difficult to get pregnant (=fertility) or it can harm their pregnancy (= bad for the fetus)?

[NurseKitten, MSN, RN]

"Training programs", in this sentence, I think would refer to the anesthesia schools themselves. Nurse anesthesia training programs are 24-36 months long, in the United States. They are programs for training nurses to become anesthesia providers.

"Call schedules" and "allowances" would refer to the schedule of which anesthesiologist or nurse anesthetist would be required to respond if there were an emergency need for surgery. If someone came in, and needed anesthesia in the middle of the night, whoever is "on call" must come in to help.

As for the question of poorer reproductive outcomes, I think both your statements could be true. It makes sense that women in stressful jobs could have both trouble becoming pregnant and trouble during their pregnancy.

Might I suggest a literature search to see if there are any journal articles addressing the topic of women in high stress job and their rates of infertility and pregnancy complications?

Good luck.

[Allda]

Thank you very much. Your answer has ben very helpful !

[NurseNora, BSN, RN]

I know at one time there was an increased risk of miscarriage for nurse anesthesists giving general anesthesia. Now that there have been improvements in keeping the anesthesia gasses from circulating to the general room air, that may no longer be the case.

A pregnant anesthestist may find it difficult doing a D&C on a woman who miscarried at the same gestational age as she is now, or doing a C Section for a dead or grossly malformed baby. She may find the smell of some cancer cases too much for her during the first trimester when vomiting is a real problem. Or she may be extremely fatigued and be allowed to take shorter hours, or less night hours, or something like that. Those are some of the "allowances" that may be made.

[NurseKitten, MSN, RN]

The higher rates of miscarriage actually stem from situations in which nitrous oxide is used and there is no scavenging system.

This mostly occurs in office-based anesthesia, and was discovered in Europe where midwives who were doing home births administering N2O were experiencing a higher rate of miscarriage.

[NurseNora, BSN, RN]

"Scavenging system" was the term I couldn't think of; Thanks. I've been doing L&D long enough to remember when the put the scavenging systems in. I can remember walking into a room with a loose connection and smelling the Penthrane.