Nurse manager says you can't refuse iv

[paintedbison]

Due to financial reasons we may deliver at a very medical hospital here because it is the only thing our insurance covers. I used to work there several years ago (as a nurse on an ob floor).

I was talking to a friend of mine who works in the nursery and asking her about transitioning the baby at bedside instead of in the nursery and the possibility about her coming in to do the baby. Anyways, she wound up talking to the l&d nurse manager about me. The manager said that they would "not allow me" to refuse an iv. I could refuse the iv fluids, but not the access. She said "it would be required".

Okay, first of all, how the heck can they not allow me to refuse an IV? I'm just wondering exactly what will play out when they say "we need to start an iv" and then I say no.

I'm also wondering if I should just get a heplock... if refusing it is just going to turn into a bigger fight than it's worth. I'm pretty opposed to that idea, though. Doesn't really seem fair that I get something I don't want because others can't understand what they are legally allowed to do...

[Belle]

For my first birth an IV was "required" as well. We had talked to my OB about it in advance and it was the one thing from our birth plan that he put his foot down about. Low and behold he was on vacation during the birth.

When I got there the nurses wanted to put in an IV. I simply said, "I'd rather not" And they shrugged and said "Okay" I could tell they didn't like pushing such things on moms. I had awesome nurses. They later informed me that the doctor on called "Okayed it for now" When the on-call doc arrived she wanted me to put one in. I politely declined again and they had me sign a AMA. I finally ended up getting a hep-lock 2 pushes before she was born that was absolutely useless.

Second baby was born at home. I'd had it with fighting for things I didn't want.

Anyway, I suppose the point of that is that nothing is really "required" and you can refuse to consent to anything.

[paintedbison]

The funny thing is the doctor I'm going to see will supposedly okay no iv access. The nurse manager said that order would not matter because they will place an iv access. I'm totally baffled by her comments.

[dogmom327]

Has she not heard of "consent"?

[Belle]

Originally Posted by paintedbison

The funny thing is the doctor I'm going to see will supposedly okay no iv access. The nurse manager said that order would not matter because they will place an iv access. I'm totally baffled by her comments.

They can't place it if you don't cooperate with them. IV access just makes it easier for them to give you things you don't want. I couldn't believe how fast they got the hep-lock in my arm when they thought they needed it. It was placed while I was pushing. If they can do it that fast, then they can wait until they actually need it. They took it out about 30 minutes after dd1 was born and it wasn't used for anything. Can you tell I'm still bitter about it?

[paintedbison]

Originally Posted by dogmom327

Has she not heard of "consent"?

yeah... that's what I'm wondering. And if she hasn't heard of it, what exactly are they going to do to me?

[lifeguard]

I would focus my discussions on this (& other issues with the doctor). Many hospitals have "policies" but the doctor often has the right to overrule these. Where I delivered they have delivery rooms that are essentially operating rooms where they move you to deliver. My doctor felt it was unnecessary & so his patients were "permitted" to deliver in the regular rooms where we laboured. There were a couple other policies he overruled with me including an iv even though I had GD.

[Mama Poot]

They should allow a heplock. However, if they keep trying to hook you up to fluids with it, I'd just keep removing the tube and shutting off the pump (sometimes it rawks to have a mom that's an RN!) They can't conceivably "make" you have an IV. Unless they're gonna strap you down to the bed or something, which obviously they cannot do.

[peainthepod]

AFAIK, they can't force you to take an IV unless you're incapacitated or otherwise unable to give consent.

Ask that nurse manager if she's ever heard of the term "medical battery". I imagine all talk of a forced IV will end pretty fast.

[the_lissa]

This hospital has a nursery for health babies? I didn't think hospitals had those any more.

[dogmom327]

Originally Posted by the_lissa

This hospital has a nursery for health babies? I didn't think hospitals had those any more.

When I first got pregnant with DS we were in Salt Lake City and DH really wanted a hospital birth. Part of the tour was the nursery where all babies were required to spend hours 2-3 or 4 after birth for "observation". There were about 3 newborn babies in there when we toured. Laying there with just their diapers, no on attending to them (a nurse was in the room but not right with each baby), no parents in sight. The person doing the tour assured us that dad could go with the baby but I'm guessing it's not encouraged. She also pointed out how great it is for the mom to be without her baby for a few hours right after birth :

Needless to say that ended any discussion of a hospital birth--I put my foot down. Home birth it was!

[LoganBsMom]

Originally Posted by paintedbison

The funny thing is the doctor I'm going to see will supposedly okay no iv access. The nurse manager said that order would not matter because they will place an iv access. I'm totally baffled by her comments.

Pretty sure that is illegal. You can't do an invasive procedure (no matter how minor) with out a doctors order. You have plenty of rights, I didn't read everyones responses, but I would say, just say no. I am a nurse (not l&d) and if a patient refuses something I explain why we think they need it, they still say no that is their right. And as long as the nurse charts that you refused, there is no liability to the hospital. And really, are they going to tie you down and put it in, I don't think so. I would be careful about "just going along with it" to avoid confrontation, that tends to start a cycle. And make sure dh/partner knows what you want so that when you are incoherant they can advocate for you. Good luck.

[lookingforaname]

Aw, I'm sorry for another setback, Stacey.

Grr nurse mangager. Doesn't look hopeful for a tub, eh?

[ollineeba]

So she wants you to get the saline lock, but you don't want it? That is not a battle that I would fight right now, I'd just tell them at the time that you've decided you will not be getting one. If it's that important to you, don't budge.

When I had dd I didn't want an IV, either, but compromised and got a saline lock. If I had felt really strongly about it, I wouldn't have given in, but it didn't get in the way or bother me much.
Do what you feel most comfortable with. Good luck!

[brendaziz]

Personally I don't see the biggie about a heplock. But that's just for me. It might be a tad annoying but for me the pros outweigh the cons. Having access to my veins w/o having to search for one in case of emergency can save minutes that u may not have time for. Definitely almost never the case and i know it's very "what if" but with this one I tend to fall on the side of caution. When I was in labor it took the nurses a VERY long time to find my vein when i needed it and I would've preferred to have that done right away as opposed to when I was having crazy contractions. Even most midwives I know feel much more comfortable with that in case of emergency. But I def understand not wanting to labor and birth with a "what if" mentality. If you don't want it I don't know that they can "force" you- but if they feel that strongly about it they'll prob feel strongly about other things you may not want also. I would say pick your battles and maybe save your fighting for something that may be actually really detrimental or hugely against what you believe- but definitely if you feel really strongly about this then fight this battle. Just make sure you weigh pros and cons of everything first.
Good luck with everything!

[the_lissa]

I had a saline lock with my last birth because of a previous pph. It was hell, and I won't do it again unless I had a real reason.

[kltroy]

Personally, I don't think I'd fight the saline-lock battle. I had one for my VBAC birth 5 months ago and while it was an annoyance, they never ever accessed it. And my nurse promptly removed it as soon as the baby was out. If you mostly labor at home they won't have too much time to mess with that sort of nonsense anyway

[paintedbison]

Okay... I posted about this on another forum I belong to for ob nurses (that is not a natural birth place... just a nursing place). I am now hearing insurance could refuse to pay for the ENTIRE hospital stay if I refuse an IV because it is part of the "consent to treat".

Anyone ever heard about that? If insurance isn't going to pay for this anyways because I don't want an iv then it's not worth doing the hospital birth. And is insurance going to refuse to pay because I refuse IV fluids? pitocin?

I am beyond frustrated...

[stik]

Nurses are not medical billing specialists.

Why would your health insurance co care if you declined an IV? They aren't in the business of enforcing hospital policy. They are almost definitely paying the hospital a pre-negotiated rate for every delivery regardless of what the mom accepts or declines. The form the hospital submits to the ins. co. for payment does not have a ticky box on it that says "pt. was less-than-100% compliant, pay us more."

The consent to treat form is how the hospital handles malpractice liability. You should feel free to modify it or refuse to sign it. It has nothing to do with what your insurance company pays.

[ollineeba]

I think that's a load. I've heard that before in regards to coercing women to cave to other hospital procedures over on the VBAC board and the ICAN list, but I'm pretty sure it was all bull.