They did a c-section without anesthesia

PMFB-RN, RN · Dec 13, 2006

There are hospitals in the UP of Michigan that don't even have a DOCTOR on staff - not even in the ER.

*** Not just in the UP of MI either. Many small hospitals all over rural America have no doctor of any kind available 24/7. I used to be a frequient visitor to the ER of our local 12 bed hospital. After 5:00PM or any time on the weekend there was no doctor in the building. There was (and still is) a fantastic NP that runs the show. She has stitched me up half dozen times, flicked tiny bit of shredded brass out of my cornia with an 18ga needle, given me IV antibiotics after I stepped on a nail that first passed through my manure covered boot (I used to be a dairy farmer), set broken fingers, diagnosed and treated various broken bones in my feed, hands and arms, delivered our first born child and lots of other stuff. Total staff there was the NP, an RN, and a CNA. If they had many full beds maybe another RN or LPN.

cozmo_blozmo · Dec 13, 2006

So please tell us how you exope

So please enlighten us as to how a hospital with a solo anesthesia provider is suppose to live at a hospital 24/7 265 days a year?

I don't think having an CRNA in-house 24/7 makes a facility a Level I trauma center.
The fact is, we aren't talking about some things that can be done TEMPORARILY by another doctor or nurse...Anesthesia is Anesthesia. If you don't have at minimum a CRNA there, then someone shouldn't have to choose between getting a surgery without property pain control and dying when immediate transport is not possible, and more is required to stablize a patient.
I'm not saying that rural hospitals should be able to do everything and every hour....anesthesia is just something that I cannot believe hospitals "skimp" on. It's just too important.

kimdanielrn · Dec 13, 2006

I'm seen this before. I'm a NICU nursem and the baby was in distress.....The mother had no IV access....They had to hold her down to the bed. The epidural never worked. This hospital had a very good PR team.

Mrs.S · Dec 14, 2006

wow, that kinda boggles my mind that some of you have seen this bfore...doesn't sound like it happens too often though. I'm still perplexed as to why a local wasn't used; I'm wondering if it would have gone deep enough? anyway, thanks for your responses. I haven't gotten any answers to my questions at work yet, but I've had some time off so...if I find anything interesting out I'll update.

thanks again

heartICU · Dec 14, 2006

I'm seen this before. I'm a NICU nursem and the baby was in distress.....The mother had no IV access....They had to hold her down to the bed. The epidural never worked. This hospital had a very good PR team.

Patient had an epidural yet no IV access? Hmmm...something fishy here.

allnurses Guide · Dec 14, 2006

Patient had an epidural yet no IV access? Hmmm...something fishy here.

We can't do an epidural w/o IV access . . .. maybe the access was lost . . . . still it only take a few seconds to start a new IV.

More info is definitely needed . .

steph

jrussole · Dec 14, 2006

Why are you people jumping all over my case? Why can't you be civil? I made a err and omitted "general", excuse me. That is the problem with nurses most of us are so busy to jump down someone's throat for a comment or an opinion. I don't need to be corrected. If this person received a cut without anesthesia whether it be general or local it is still an incident and needs to be reported. No one should ever be subjected to such pain. And yes, most women would undergoe the pain in order to save their baby. But that is another discussion, isn't it. Your replies to my answer were without question, offensive to me. Stop being know it alls! I can't stand nurses like you. You took my words, screwed around with them and turned them inside out. And for what reason? Do you feel superior now?

SmilingBluEyes · Dec 15, 2006

i ask we keep this thread civil. asking questions is one thing; grilling or making accusatory posts, quite another. i hate to have to close the thread because a lot can be learned by sharing various experiences and thoughts. please, if you feel tempted to attack someone, walk away from the computer and think before you post. please, converse here as you would among your professional peers at work or an ob conference.

thank you.

imenid37 · Dec 15, 2006

Patient had an epidural yet no IV access? Hmmm...something fishy here.

We do need Iv access to do an epidural. It could have come out. I had Patient who was extremely obese not too long ago become diaphoretic and hypotensive post-epidural. Guess what slipped out as she sweated away. The IV that took 3 nurses and 4 sticks to insert. Luckily, anesthesia stuck her and got it back in on try #2 for him. Sometimes the IV comes out d/t Murphy's Law, not because we are bad nurses, etc. Both mom and baby recovered and did fine. Things do happen. Ithink it is good to discuss things like this, calmly because you never know what situation you may find yourself in.

mitchsmom · Dec 15, 2006

We can't do an epidural w/o IV access . . .. maybe the access was lost . . . . still it only take a few seconds to start a new IV.
More info is definitely needed . .
steph

One of ours didn't have IV access, either, she was bleeding out and no one could get it until the baby was already out (mom was still on the table)...

She didn't have an epidural though; same deal, we have to have IV access for that but yeah it could have gone bad... sometimes stories are hard without all the details :)

StatRNNJ97 · Dec 17, 2006

No anesthesiologist in house? No way! One bad outcome and it changes a nurses perspective! Have had true stat c/s in Labor and Delivery and without the Anesthesiologist in-house no doubt baby and possibly Mom would not have survived! Even if its a level 1 hospital - no excuse for not having in house anesthesia 24/7. I know its my opinion but...it my license also that I worked hard for and I am not willing to compromise in any way, especially with liability and lawsuits these days! I love working in Labor and Delivery and hope to keep it that way

Jolie, BSN · Dec 17, 2006

No anesthesiologist in house? No way! One bad outcome and it changes a nurses perspective! Have had true stat c/s in Labor and Delivery and without the Anesthesiologist in-house no doubt baby and possibly Mom would not have survived! Even if its a level 1 hospital - no excuse for not having in house anesthesia 24/7. I know its my opinion but...it my license also that I worked hard for and I am not willing to compromise in any way, especially with liability and lawsuits these days! I love working in Labor and Delivery and hope to keep it that way

I don't think anyone would argue that having immediate access to anesthesia is ideal, but there are areas of the country where this is simply not possible.

I worked in the NICU for 9 years before having my first child, and swore that I would NEVER deliver at any facility that did not have a Level III NICU, as I had seen too many neonatal complications that could have been prevented or minimized by immediate access to a NICU, rather than relying on transport. But by the time I was pregnant, we were living in a rural area of PA, where the nearest hospital with a Level III NICU was hours away. I gained a new respect and appreciation for the competencies required of nurses who work in rural hospitals. They managed my very complicated pregnancy extremely well, and enabled me to deliver a healthy baby.

It simply isn't possible for every hospital to offer every service. While practicing in a rural setting may be unsettling for some nurses, there are others who thrive on the challenge, and provide excellent care to their patients despite having limitations.