To call or not to call

[OKNurse2be]

I am a nursing student, and I am having a discussion with a friend who is roughly 35 weeks with 3rd baby ( haven't learned all the technical terms yet ) and who has had a history of pre-term delivery, pre eclampsia and such. She is experiencing episodes of tachycardia and weakness and dizziness. I told her she should think about visiting L&D, which is where this whole discussion of whether or not one should call ahead or not came up. I have had 3 children of my own, and with each one I was told that if there was any doubt, where I thought I might be in labor or anything that concerned me as we got closer to due date that it was okay to just show up at the L&D unit. She told me that she would NEVER just show up unless she was about to deliver. In my mind, I would think that if I was concerned enough to call then the nurse on the receiving end would tell me to come in to be checked anyway, so why take up their time at the unit to answer the telephone. I am just curious on how this is handled in your units, and how you feel about answering phone calls vs. just having pt show up. I realize that there are issues, and there are ISSUES when it comes to pregnancy, and I am not addressing the calls regarding a little twinge, but more the "I think I am in labor" "I think my water broke" calls. So, let me know what you think.

[klone, MSN, RN]

People show up all the time to be checked out. No call necessary.

[OKNurse2be]

I am more curious about what the staff would prefer a pt do, not what people end up doing. How does the staff feel about the calls vs. people showing up?

[beachmom]

We're fine with people showing up. However it's nicer for us if they call first so we can be ready for them. Also, a lot of people call with things they are quite worried about, but are just normal pregnancy stuff, and we can tell them no need to come in.

[Jolie, BSN]

Unless it's a dire emergency like sudden onset of severe pain or bleeding where there is a clear need for immediate treatment, call first. And I would suggest that you call your provider, not the birthing unit, especially during normal office hours.

If you have a minor concern, your doctor or midwife would probably prefer to see you in the office so that you can be evaluated without him/her having to leave a waiting-room full of patients to come see just you. Many minor concerns can be better addressed in the office setting without the expense and hassle of a hospital visit and the approval process that many insurance companies require for unplanned hospital visits. If you decide to just show up on the birth unit without having notified your provider first, you may end up being seen by a resident or house physician who knows nothing about you and doesn't have access to your records. Not ideal. You may also end up responsible for a sizable bill if your insurance doesn't view your visit as necessary.

Even if you are relatively certain that your issue will require a hospital visit, it is still preferable to call ahead so that your doctor/midwife knows that you will be going there, and so that the unit can plan staffing accordingly. If they know that a patient with a history of PTL and pre-eclampsia is on her way in, they may choose to keep an extra nurse on, or may notify the NICU so that they can plan accordingly.

So is it an absolute must to call your provider ahead of time? No, but it may allow for better planning and utiization of resources.

[babyktchr, BSN, RN]

Calls are always appreciated...

[PinkNBlue, BSN, RN]

Ditto everyone else. And if she's experiencing dizziness and tachycardia with a hx of pre eclampsia, I recommend doing it now.

[OKNurse2be]

Update on my friend: She finally called the doctor after awakening with racing pulse in the middle of the night. Doctor tested for pre-e, but that came up negative, however he is referring her to cardio due to heart murmur and her Hemoglobin dropped from 11 something to just over 9, which would account for the weakness and dizziness. Now we are just waiting to see if she makes it all the way or not. I doubt she will.