nankie

haha...that's just what my supervisor said - "is she kidding? she's pregnant for the first time with twins, at age 47 - and she thinks her friends don't know it's IVF!?" She also added,"she perfectly fine with baring her big belly in front of friend (during the test), but yet you're supposed to know that she doesn't want to talk in front of her..." I still feel badly though, as the patient IS entitled to keep it a secret if she wants. And she told me she cried for hours over it! And I usually try to be so alert to not divulging any confidential info (abortions, donor egg, gender of the baby if parents don't know). Guess in this day and age, I just didn't see IVF in that category. (I happen to have an 18 yr old daughter born thanks to IVF myself!) I just wish she had alerted me in the beginning - but when I mentioned that to her during the phone call, she said the responsibility was on me, not her. Oh well, live and learn... I like the idea some suggested, of explicitly asking for permission first. But that could possibly cause issues too. Most patients just walk into the exam room with SO - so it could be awkward to ask the patient in front of the SO - I could just see hubby saying, oh you have something to hide from me? So then I'd have to ask the SO to step out to ask the patient in privacy, if it was ok to talk in front of others? Gets kind of convoluted! Thanks again for all the supportive comments!

No, unfortunately, I did not explicitly ask...guess I just assumed if the patient didn't say anything, then it was ok with her that her friend remained in the room. Thank you for all the supportive comments! I feel better now, seeing that I am not the only one who saw the situation that way.

The pt (47 yr old with twins) was an out-patient who came in for a routine non-stress test. Her friend was sitting in a chair in the room, near us. I was reviewing her history from her chart and mentioned her IVF. The pt glared at me, and I realized I spoke out of line, and tried to back peddle by saying, oh I must have confused you with another patient....and then nothing more was said. But a few days later she called me up, very angrily, and told me I caused her tremendous distress, because she had not told her friend about the IVF. I felt awful and apologized profusely. She also reported it to my supervisor, who fortunately, was very sympathetic to me. Perhaps because I have worked there for 32 years, and have never had a patient complain about me before. I guess I hadn't thought of it as highly sensitive information, because we see many IVF patients who generally bring it up freely. Also, if she allowed the friend to stay in the room with her during the test, I figured she was ok with her hearing what went on. Wrong! So, just putting it out there, so no one else makes the same mistake I did!

$44 per hour - Los Angeles, 29 years experience, OB (but you can barely buy a house around here for less than $700,000!)

then they should pay for it!

If it is the one I think it is (taught by a Meredith Fresquez...or something close to that) I took it many years ago (80s or 90s?). I remember I felt it was a good course, and worthwhile to attend - but the "certification" was just for the didactic part - they still recommended that you get clinical practice back at your own facility, to be truly certified. Also, because it was given near me in southern California, I only had to spend somewhere between $100 and $200, if I recall correctly. Don't know if I would spend $1000. There's still nothing to compare with the day to day experience of just doing ultrasounds, and having someone more experienced pointing things out to you.

Thank you very much for the replies. But does anyone here work in a hospital that has a dedicated unit solely for Antepartum Testing?

In L&D, we have hospital-supplied scrubs - but can wear our own if we want.

At my hospital (about 200 deliveries a month) we have a lactation specialist on duty daily (except weekends) for several hours a day. At other times, it falls to the nurses.

At my hospital, way back when, NST's were done in Labor & Delivery. For many years now we've had a separate unit - Perinatal Testing - that was just down the hall from L&D - that was solely dedicated to NST's and AFI's during normal business hours (occasionally PTL, early labor, or other observation patients are seen when L&D is busy) . Off hours patients still go to L&D. Myself and one other RN staff this unit. Now they want to move us to a different part of the hospital, several floors away from L&D. We are not happy! We are concerned about the logistics of transferring pts. in urgent situations, sharing the ultrasound with L&D, having to do AFI's, and the occasional VE, sterile spec, etc. on pt's in recliner chairs - because the new rooms we are moving to are former offices and do not have enough room for beds. They do not even have sinks! We will have to use waterless gels. Is that acceptable for a pt care area? One more question. How do you handle docs reading the NST? We fax our report and the NST to the doctor's office on the day of the test, if WNL - if abnormal we call them at the time of the test before sending the pt home. They are then supposed to read test, sign and fax it back to us within 24 hours. This being the real world, however, many of the pts are delivered before the doc ever signs the test, if then! I sometimes worry about legal liability if we should miss something. Anyway, just very curious how it is done at other hospitals. Thanks for any input.