Where would you have placed this pt?

[deespoohbear]

Maybe this should be on the OB-Gyn Board, but I will post it here since there is such a wide variety of nurses on this board.

We had a pt come in the other day to our hospital. She had delivered almost a 12 lb baby at home, and suffered an uterine ruptured. We brought to our facility by EMS, almost dead. Rushed to immediate surgery, then to ICU. After two days in ICU, she is ready to be transferred out of the ICU. What department would you have placed this pt in 1) Med-surg or 2) OB? I am kind of conducting an informal survey.

PS-Baby was perfectly healthy, happy, and signing up for linebacker at Notre Dame.

[Fgr8Out]

From a Med-Surg Nurse perspective... the patient would do well on a Med-Surg Unit... private room... and Nursing to get in touch with the Post-Partum Unit to arrange for teaching.

We don't have a specific "gyne" Unit either... it's Med-Surg, Post Partum or some other place too unthinkable to mention

I'd take the patient in a heartbeat....

Peace:)

[deespoohbear]

Catching up....been on vacation for a few days.

We do not have an gyn floor. M/S, OB, ICU, and ER pretty much covers the acute care at our small facility. Our floor normally gets all the hysterectomies, and other gyn surgeries. I don't have a problem taking care of hysterectomies and other gyn surgeries, just the fresh PP case. The pt refused to let the surgeon take out her uterus :eek: . I guess he stitched it the best he could under the circumstances. If this pt gets pregnant again I don't want to be anywhere near the place when delivery time comes. I am sure it won't be pretty.

Thanks for all the replies on here. I really appreciate everyone's responses. :kiss

[ERQueen]

Isn't a mother with an STD considered an infection risk? As long as the staff does not cross-contaminate (i.e. wash hands between patients), how is there an increased risk just by this patient being on the same floor? The OB nurses in our hospital are well-versed in how to deal with post-surgical patients. They get all OB-GYN post-ops. They are also very good at dealing with emergencies. All of our rooms are separate. At the last hospital I worked, Labor & Delivery and Post-Partum were separate entities, making it even easier to place all OB patients in this area. IMHO, OB-GYN is not just for labor or post-partum, but for OB-GYN complaints. It just seems that if we can place MRSA and TB patients on the same floor as other semi-healthy individuals, we should be able to place a post-op hysterectomy on an OB-GYN floor. However, also IMHO I think that she could have been able to receive quality care in either place. It's just that the baby might not get as much quality time with mom in these formative days post-partum.

[OBNURSEHEATHER]

She should have gone to OB. We take post ops all the time, what the heck do they think a c-section is? And we take patients all the time that needed a little pit stop in ICU. Sounds like they just had their panties all in a wad.

I would be more concerned with the liability of having a newborn in the hospital that isn't a patient. Just a sticky situation. But if it has to be done, better on an OB floor than a med/surg. As long as mom and family had a good understanding of infant security measures.

Heather

[deespoohbear]

Heather-

We didn't keep the baby. The baby was never admitted to our hospital. Just Mom. Family tended to the baby's needs while Mom was in ICU and unable to tend to baby D/T her condition. The family is very close knit and there was someone with Mom 24/7. Our OB dept is very "funny" about what kind of pts they will take. The real kicker on this whole situation is that when the pt was discharged to go home we had to use OB's discharge paperwork instead of M/S. I thought that was funny, since the whole time we were told "she is an M/S pt."

[OBNURSEHEATHER]

Originally posted by deespoohbear

Heather-

We didn't keep the baby. The baby was never admitted to our hospital. Just Mom.

Oh, I caught that part. But I thought I read that the baby was still at the bedside, being taken care of by a family member? I could be confusing threads. That's just a big liability for the hospital.

Kind of off topic, but sometimes when one of our babies goes to NICU, it will still go home with mom, it's just dc'd from the unit. We handle this by coordinating our dc times with NICU, and we all walk out together. Once I walked into a pt's room and the NICU baby was there. The pt. said, "Oh, they discharged her to us." No notice, warning, report, nothing. But then mom decided to hang out awhile, and here I have this respiratory distress NICU baby that I'm just supposed to ignore? I reamed NICU out for that one!

BLAH, BLAH, BLAH.... I seem to have diarrhea of the mouth today...

Heather

[SmilingBluEyes]

This lady would have come to OB in my hospitals,I am quite certain. And she would have had her baby rooming in w/her while we helped them bond and initiate infant/mom-self care teaching and breastfeeding assistance when she was up to it. Why not OB? Like others said, we are a "dirty" floor really. Only the NURSERY is really "Clean"....when the rules are strictly adhered to.( sigh that is another thread altogether,along the lines of "insane visitors")......

[mark_LD_RN]

definitely should have gone to ob

[Jamesdotter]

In my hospital she would have come to OB. We have all single rooms. The baby could come at any time (or all the time) as long as a family member was there--in fact, that's why she would come to OB, so the baby could "visit".

[night owl]

nanananbooboo,

people like you shouldn't be allowed to breed!

[SmilingBluEyes]

ummm ok night owl. i will bite. whatzzzup w/that?

[fedupnurse]

I was thinking the post op GYN floor or OB as long as she didn't need tele monitoring. By the way, is that child eating with a fork yet???