Hospital procedures, what to fight (birth plan)

[Lisa1970]

The first thing that happens when you arrive at L&D here is you have to call from outside of labor and delivery. Fine, that is acceptable, it is for security. But, once inside, you stand at the nurses station while the make you explain to them why you are there. You do this even if you have had a massive break of the waters and are standing there with a towel between your legs dripping on the floor. This can take a while as the nurse questions you standing there. You do this even though you called ahead, you called your doctor, and your doctor called ahead to give instructions to what is to be done in your care.

That is #1 thing I take issue with. I do not see a point to that. Unless someone can explain to me why I was having to stand with a towel between my legs, fluid dripping because the towel was soaked, discussing everything at the nurses station, in front of many strangers who were there to visit someone, including children, then here is my plan. When I walk in and the nurse demands to know why I am there, I will simply tell her the doctor sent me up. IF she demands that I tell her anyway, I will refuse. I will tell her to call my doctor if she wants to discuss it. If she asks 3 times, then I will tell her to call the nursing supervisor as I am not justifying my doctors orders. I have found in the past that the nurses do have the orders from the doctor and the reason you are there, but will still question you. The first couple of times this happened, I thought the questioning, while STANDING in a public area at the nurses station like that was due to the doctor forgetting to call in that I am coming. But I asked why and they informed me it was standard procedure. So now I am going to make it my standard procedure to not answer their questions. I will also refuse to stand long if I do not feel up to it. So if my water is broken and I am dripping on the floor and they are not sure they want to give me a private room to go to, I will tell them I will wait in the restroom or whereever while they make up their minds.

Thing #2, when I do finally get to a room, and they continue on with their question, which includes my medical history, I am going to refuse that too. The reason is this. They have my medical history, it is right there, in front of them. They ask me this while I can see for myself they are looking at it. They do not type it in, they simply make me repeat it all. I have also asked them why they do this, and they say to make sure it is all correct. Fine and dandy, but it has been all correct every single time I have been there. This is my 10th pregnancy. I am tired of having to go over and over and over every single detail. They know it, they have it in front of them. This is not a neccesary thing. My doctor knows it all off the top of her head. My doctor will be writing the orders. The nurse just needs to know those orders and to follow them. One thing that happens when I have to retell every single thing in my history is I am laying on my back the entire time, trying to explain everything to her. Then she always makes some comment at some point. Sometimes, it is even a remark about the number of children I have had or why didn't I give up, or even launching an all out argument over my decision for a VBAC even though the doctor already agreed so nothing she is going to say is going to have me change my mind.

Thing #3, the IV. They always want blood and an IV. BUT, they never want to take the blood from my hand. They actually will refuse. In the past though, they could only get blood from my hand so they go around blowing all my veins and going for very painful areas before they will try my hand. One time, they even went for my shoulder and were talking my ankles and STILL had not tried my hand. I have no clue why they did that. I had to complain and finally, they tried my hand and got it on the first try. They were amazed. Reality is, they should have listened to me in the first place. The phlebologist at my OBs office always gets my blood the first time because she is a nice person and has a clue. The nurses at the hospital seem clueless, rude, and controlling. For IV's, they generally will go through their entire staff before they call the anestesiologist in. I am not tolerating this the next time. Next time, I am flat out telling the nurse...3 tries, that includes all nurses put together, and they are done. No more chances. The next person to stick me will have to be a real anestesiologist (who can always get it in) or no one. One big problem with them going over and over again is they blow veins that a decent medical professional could have gotten. When I have been to the hospital for something, I generally come out looking like I have been beaten. When they have blown all the typical veins, they will go for more painful and off place type veins. So there is fine reason behind why I am saying no to things being like that. It causes not just stress, but then makes it almost impossible for the person that should have been there in the first place to do it. In fact, one time, when I was supposed to have an IV, they blew so many veins, and started talking a central line and then concluded they did not need to go that far. I was just dehydrated from a serious UTI. Had they have brought in the proper person in the first place, then he would not have had to show up after all that time and find all my veins blown.


OK..so I know these 3 things sound b-i-tchy, but I have solid reasons, even medically sound reasons, to follow these rules in the future. I do not need the stress of arguing with a nurse over whether I belong there. It is very stressful to try to explain how far a part your contractions are only to be informed you were a whole minute off and must not really understand what a contraction is. It is beyond stressful to try to relax so you can get through the contractions, while arguing your having a vbac, with a nurse, when your doctor already agreed. And I have learned that repeating to the controlling nurse multiple times that your doctor is fine with it does not stop her from telling you that your baby could die. (I am not scared that my baby could die, but rather disturbed by her lack of knowledge of birth).

Since I have learned that labor and delivery staff are generally not there to help with labor, they are just there to do what I listed above, I am thinking I am going to put it on my birth plan, which I will post on my door and in the room, that they are not to be in the room when they do not need to be basically. I am not sure how to word that yet. But past experience has shown me (and I have given birth enough to know what it is like here) that all the nurses do is ask you a lot of questions, give you IVs, take your blood, refill the paper on the labor strips, that is about it. They generally have nothing good or positive to bring in to the experience, so I would rather they just stay away from me at all possible times. I want to relax and not spend my time trying to entertain them.

(oh, one time, my nurse was Indian. We have a big Indian population here, nothing I gave much thought to. She asked me if I liked Indians! I was so taken off guard. Should I have asked her if she liked white people? I was still nice and all, but not sure her point. This was before I finally recently decided that I am not engaging in these conversations with the nurses. I have concluded that I am just too nice to everyone and need to set down some firm limits).

I really need to get this worded all right and planned ahead of time because I tend to fold and do whatever people ask of me and I want to not be miserable and crying and stressed over mean nurses. I actually wish I could have a "practice" run so that I can make sure I can handle it. I am stressing big time over how this is all going to go. But if I have learned nothing else, I have learned that it is best to avoid all conversing with the staff, keep it to the doctor, only discuss things with the doctor, and just repeat to the nurses that if they have an issue with the doctors orders, they need to discuss it with the doctor. If I do not manage to be firm enough about this, I will spend my entire time there stressed out and arguing with them. My doctor knows me and she knows my birth plan. I do not need some nurse, or nurses, making my life difficult.

[cappuccinosmom]

On #1, I think you would be asking for a lenghty argument, actually. "I'm here to give birth, Dr. So-and-so told me to come in, they're expecting me upstairs." I have had three hospital births and the front desk check in has been minimal and not at all a problem. If you're wanting to avoid arguments/confrontations, I'd say be nice to the front desk nurse. Make sure whoever comes with you has your insurance cards at the ready and can answer the questions for you if need be. Sure, it seems stupid to questioning a laboring woman, but it's not the nurses fault and she'll be more likely to "pass" you along quickly to L&D if you just let her do her job, stupid as it may be.

#2 and #3, I bet you could deal with these firmly but without being confrontational. "This is my tenth baby, you have my history. Is there anything *new* that you need to know? If not, then you have in your hands everything about me that you need".

And for the blood drawing, could you get your doctor to order blood draws from your hand, and have it put in your chart? That way you can just tell them they don't touch your arms, just your hands, and it's write there in the chart with the doctor's orders.

[Belle]

#1 is easy. Tell them that they are violating your HIPPA rights by interogating you in front of stangers. I'm sure they'll have a copy framed on the wall nearby and you can point out which specific passages they're violating. The same goes for EMTALA. They'll have a copy of it nearby too. A break of your water is a clear indication that labor has begun and they can't refuse to admit you at that point.

#2. I agree with the previous poster. Tell them this is your tenth pregnancy and you (they) already have your medical history on file and you're not going to repeat it again while in labor.

#3 Tell them flat out that you won't consent to allow them an IV/hep-lock unless they put it in your hand. If they argue with you then that's too bad for them. I guess they'll just have to "permit" you to drink fluids instead of the IV.

Upon looking up some stuff on EMTALA, I discovered this.

# Based upon past citations by CMS, advisory letters from CMS, and past litigation, it is our considered opinion that a medical screening examination should contain the following elements: Log entry with disposition
1 Triage record
2 On-going vitals recorded
3 Oral history
4 Physical exam of affected systems
5 Physical exam of potentially affected systems and known chronic conditions
6 Any testing necessary to rule out the presence of legally defined emergency medical conditions
7 Use of on-call personnel PRN to complete above
8 Use of on-call physicians PRN to diagnose and stabilize patient
9 Resolution of abnormal findings or test results by normalization (serial values) or explanation of why they are not significant to the presentation
10 Discharge/transfer vitals
11 Adequate documentation of all above

http://www.medlaw.com/handout.htm So they are required to ask you your medical history per EMTALA rules. I would just reiterate that they already have your history on record and you relieve them of the obligation of asking it of you again.

[mom2reenie]

It sounds like you are fighting hospital procedure with #1/2 and the nurses have no control over those events, so fighting the nurses will get no where, except labeling you as a difficult patient, which will in turn make them less hesitant to follow your other requests. Those might be things you can call and talk to an administrator and head nurse beforehand and see if you can request it not happen, but those two sounds like you'd be fighting a losing battle and cause more stress.

#3, I'd have your doctor put in your medical charts and then all you have to say is "My doctor said ... and please refer to my chart or call my doctor if you are wanting to do it differently."

[shellnurse]

I'm a nurse myself and I'm quite frustrated that nurses treated you so badly!

I have to say I had the same issue with the staff when I gave birth. I'm writhing in agony and the admit nurse is asking me questions repeatedly, badgering me about my weight (which I have issues over so I chose to let my MW record it and not tell me) When I told her I didn't know my wt. She said she would just put down the number written in my chart. (Um... why are you asking me if it's right there in front of you!!!) I was livid.

I do think it's a good idea to make sure your OB/MW know of your issues and you can talk to the nurse manager-or director of nursing as they may be able to alert the staff of your desires. I do think that if you are bellowing and generally being a "nuisance", they will attempt to rush you into a room and may input info into the chart themselves if you appear unable to answer questions.

Headphones? Claiming you are deaf? Don't speak English? I mean honestly, nurses do more than put in IVs and follow dr's orders. They should be able to figure out you've done this before and step in when medically necessary, but otherwise leave you alone.

Also- your body is your own-why not keep your hands at your sides and insist that an anesthesiologist place the IV the first time, rather than suffering through many nurses first?

Sincerely hoping you get the treatment you and all laboring women deserve!

[Lisa1970]

I have found the nurses to be rather unpleasant in their care and concern and their questioning in public areas. There is no way I am standing there giving my history, while standing in a hallway with a towel clinched between my legs again and a little boy with a large group of people staring at me. I really want my privacy this time. Plus, I can never figure out why the nurses will argue the doctors orders with you. I don't even know how many times the doctor ordered something and the nurse will argue with me and make it clear that they do not agree with what the doctor ordered. Last time, when I really needed to be there, I walked out because it was so bad. I have had to leave one hospital and go to a different one over bad nurses. Now I just see them as an obstacle and just want to get the medical care the doctor ordered, without the pain of begging and pleading with a nurse to do it. Other than arguing with you, I am trying to figure out what the nurses do do. Doctors give them orders, they follow them sometimes, but they give no labor support, they are not helpful at all. Last time I gave birth, for some odd reason, they sent my 11 yr old son in while my legs were in stirrups and the baby was emerging from my body. No clue why they did that either.

I keep getting told to hire a doula, but when I have interviewed a couple, they make it clear that their job is to make me comfy so that I can avoid drugs. They do not manage the nurses. They do not tell the nurses what to do. But what I really need is someone to deal with the cranky nurses.

The "triage" is not really triage. I do know a hospital I went to once, many years ago, where there was a triage sort of system for labor and delivery. I know ERs are that way too. But here is where you are in the hallway, getting the rundown to the nurse who will question you about why you are there. But it is not just a question, it is more of a rundown. Last time, I literally was so torn down by the length rude questioning (the questioning was not within reason at all) that I ended up in tears and going home without even being seen. I never even got checked in. In a real triage, they would take you in a room, ask you why you are there, take your vitals. They would write down while you are there. They would not diagnos you are attempt to tell you to go home in the triage. If you try to ask medical advice in a triage, as a policy, they generally will tell you that you will need to ask the doctor, they do not give out medical advice. I have never heard of anyone else, anywhere else, going in to labor and delivery and being told by a nurse that they don't belong there, when the doctor told them to be there and the nurse has not even so much as taken a temp or blood pressure. The time where my water was broken, it was a good 15 minutes of being in the hallway before I got to go to a room. They knew I was coming. I was not offered a chair, I was simply left standing at the nurses station.

My doctor and I already agreed to a vbac. But when I went in for a problem a couple months ago (turned out to be a UTI) the nurse informed me I had to have a csect. I told her no, I am having a vbac. She informed me I did not have a choice and my baby would die if I did not. She brought in backup to tell me how foolish it was for me to have a vbac. I was months from delivering and this was not their choice, so why the long lecture? I realized I never should have even gotten in to the discussion with them in the first place. They really put me on the spot. They said my baby was too big to fit through my pelvis. Ummm..they were not my doctor, they were 2 nurses. It was months before I was due to give birth, it might have been around 24 weeks. They insisted I need to schedule a birth. I reassured them many times that my OB had already approved of this. Then I think, if I would have refused to discuss anything to begin with, I would not have spent what must have been a hour or so getting the 5th degree over my birth plans, months before the delivery, with 2 nurses who have nothing to do with it.

Nurses do not do any sort of labor support. At least not here. With one child I had, the nurse did come in and do labor support when I was pushing. Other than that, I have never had a nurse come in and help out at all in labor. I have had 2 deliveries that were natural, not by my choice. I have had csects where there were no painkillers after. DH and I did agree now that he will not leave the hospital at all while I am there. We are taking a list of hospital administrators, including nursing supervisors, and their direct lines. I am like the magnet for bad nurses. Now I am close to delivery and in such a bad mood, it is intolerable. I am so on edge on how to put up with these nurses. I think the best way is to keep private, keep the communication about my care between the nurse and the doctor, and then me and the doctor. But I am not going to discuss my care with the nurse. I want the nurse to just follow doctors orders and not try to discuss any of it with me.

Thing is also, from what I know from friends in the medical field, these are older friends, nurses jobs are not to argue with the patients. They are supposed to follow doctors orders. So I cannot get why it seems that a portion of the time, I simply end up arguing with the nurses over why the doctor ordered this and explaining my doctor and justifying the doctor. I bend over backward to be accomodating, and it never gets me anywhere. But I am the patient. Why am I accomodating them instead of the other way around? (some of the comments are in reference to the fact I don't vaccinate, I do vbac, which I have done before, I breastfeed, I homeschool..so I am not exactly "mainstream" I am always nice, but why do they have to be judgemental and punish me for this?)

[Lisa1970]

Originally Posted by shellnurse

I'm a nurse myself and I'm quite frustrated that nurses treated you so badly!

I have to say I had the same issue with the staff when I gave birth. I'm writhing in agony and the admit nurse is asking me questions repeatedly, badgering me about my weight (which I have issues over so I chose to let my MW record it and not tell me) When I told her I didn't know my wt. She said she would just put down the number written in my chart. (Um... why are you asking me if it's right there in front of you!!!) I was livid.

I do think it's a good idea to make sure your OB/MW know of your issues and you can talk to the nurse manager-or director of nursing as they may be able to alert the staff of your desires. I do think that if you are bellowing and generally being a "nuisance", they will attempt to rush you into a room and may input info into the chart themselves if you appear unable to answer questions.

Headphones? Claiming you are deaf? Don't speak English? I mean honestly, nurses do more than put in IVs and follow dr's orders. They should be able to figure out you've done this before and step in when medically necessary, but otherwise leave you alone.

Also- your body is your own-why not keep your hands at your sides and insist that an anesthesiologist place the IV the first time, rather than suffering through many nurses first?

Sincerely hoping you get the treatment you and all laboring women deserve!

Thank you! You seem to really understand! I try to figure out why I always get the bad nurses. I am fat? I have a big family so they figure they can give me the worst nurse? I have no idea. It has not been bad every time, but the bad times are the ones who really make it stand out and ruin everything else. I wanted this birth experience to be a good experience. But at this point, I am in such an awful mood..sort of crying and worried and upset. I have grown to see the nurses as an obstacle. I am thinking over all my births and trying to figure out if a nurse has ever been helpful. There are ones that were not bad. There are ones that were bad. But there has never been a nurse that made me feel better.

I do not even get the point of the nurses beyond IVs and shots. What are they supposed to do? Because I have seriously wondered if they are supposed to do something beyond what they have done. When I was little, I was in the hospital a lot due to a chronic medical problem. They would bring snacks and refill my water back then at least. When I was little enough, they would walk me to the playroom. Ok..I don't want to be walked to the playroom now, LOL. But..you get the idea. Now, the only thing I have seen the nurses do in the last several years is what I have described above. And even getting painkillers after a csect is difficult. I remember when I had my first. I did not have insurance. That was awful! I could not get an epidural. After the csect, I was shoved in to a recovery room with no call button and left there for a few hours, alone. I got no food that day even though the csect was 7:30am. I know it was common for hospitals to treat non-insured patients that way (I live in a major city). When I had my 2nd, we had great insurance. I got the epidural. I got labor support when it was time for pushing. I recall that as being a good birth experience and a vbac. But then from my 3rd child on down, it has just been remarks about vbacing (you would think after a few vbacs, they would leave you alone), wow what a big family I have-am I going to stop now?, comments about homeschoolers, a lot of comments about the vaccinating, claims that it is illegal to not have the vit K shot. I do not have one positive thought of a nurse since the 3rd child. Oh..the nurses were nice when I was in the hospital a short while back over a non-pregnancy thing, it was not labor and delivery. I had to have surgery and the nurse was pleasant. But I have never seen the level of interrogation as I have at the labor and delivery unit I am supposed to deliver at this time. I am just waiting for them to start water boarding the patients before admitting them. Oh, and all I went through last time, all happened before even being admitted at all. So I ended up leaving 30 minutes in to the visit without ever being processed, just interrogated. But the doctor said she wanted me there and was mad I left. But what was I supposed to do?

[gcgirl]

Originally Posted by mom2reenie

It sounds like you are fighting hospital procedure with #1/2 and the nurses have no control over those events, so fighting the nurses will get no where, except labeling you as a difficult patient, which will in turn make them less hesitant to follow your other requests. Those might be things you can call and talk to an administrator and head nurse beforehand and see if you can request it not happen, but those two sounds like you'd be fighting a losing battle and cause more stress.

#3, I'd have your doctor put in your medical charts and then all you have to say is "My doctor said ... and please refer to my chart or call my doctor if you are wanting to do it differently."

ITA. #1/#2 shouldn't be an issue, but it sounds like hospital policy stuff. At our hosp, we preregistered and they had all my info already, so we sped right in. There was none of that "why are you here and what's your medical history" crap. #3 was at my discretion, based on my circumstances. Sorry you have to go through this.

[cileag]

Well, I'm also a labor and delivery nurse and am sorry that you've had such a poor experience with my peers. It does sound as if either the hospital you deliver in is understaffed, or staffed with poor nurses.

A couple of things though---as Belle pointed out, there are things beyond our control that we are supposed to ask due to the system of checks and balances that the medical culture (i.e the hospital, the HMOs, local and national laws), and often double checking a basic medical history, current medications, and drawing labs (usually not drawn by nurses btw, but lab techs) are part of that. However, it doesn't excuse their rudeness or apathy. And if someone is in hard labor, than it's typically delayed or minimized to only the most essential things.

All of those things are the reason that although I think we do a reasonable job in our local hospital of support unmedicated birth and have a great group of CNMs there that have helped de-institutionalize the protocols, I'm choosing to birth at home. But I don't know if that's an option for you.

I think that it's fine to say firmly but politely that you've had no changes in your medical history, and to tell them you're a difficult IV stick (in fact, I really like it when people do tell me that so that I can either go with what usually works or go straight to the specialized IV team if I don't feel confident about getting the IV in). And on your birth plan, I'd say simply that you prefer to labor alone and request a quiet environment with as few people as possible--I think that gets your point across without saying, "I hate nurses."

And btw, the care you receive SHOULD NOT be based on your insurance. I never know if my patients have insurance or not, and it is completely unethical to treat patients based on their ability to pay.

As to being asked multiple questions by the front desk person, all you have to say is give the bare minimum, "Hi, I'm Sara, my water broke and I'm here because Dr. Wonderful told me to come in." If they follow up with personal questions, you could say, "Do you mind if we talk in private? I'd rather not go into detail here."

Good luck with your next birth. Odds are you have to have a better nurse than what you've been describing. I hope you do.

[Lisa1970]

What I would really like to know, in detail, what are they supposed to be doing vs what I have had done. Like, having me repeat myself over and over again why I am there, being questioned over semantics....grammar correct in something I said where I did not use bad grammar. When I am standing there, in public, justifying why my doctor told me to come. And doing this with a fever and sick.

Seriously...what is the job description of the labor and delivery nurse? What do I have the right to expect? What rights do I even have...if any? What is normal and typical for the way things go. Those are my questions.

[lifeguard]

Sounds like you've had some bad experiences.

You mentioned your dh will be there the entire time this time (has he been unable to be so in the past?) - can he act as your liaise? Literally write at the top of your birth plan & on the door to room - Please speak to dh, I do not wish to be interrupted, or something to that tune? Can he be assertive for you?

Arrival: Go to the desk for check in - have dh pull up a chair for you & then he answers all the questions - you tune out, literally.

Could you also tell your doctor about your anxieties about the nurses & the check-in procedure? Maybe your doctor would be able to make a point of being there when you arrive & help smooth the transition into the hospital for you.

With the iv I would definitely insist on the 3 try rule - that seems reasonable. Again - have your doctor make a specific note on your chart. I am curious why you need to give blood at all (the iv is standard)? What do they need the blood draw for?

If you're anything like me once you are unhappy with someone (ie. the nurses) it's hard to not give off negative vibes to them which just tends to deteriorate things further. As much as possible I would try to not engage with them at all. Don't hold discussions, just close your eyes & make it clear you're focussing on what your body is doing & make it clear to dh that is his clue to step in & get rid of them.

I hope this birth you have a more positive hospital experience.

[Lisa1970]

Here is what I have for my birth plan. I am going to have the doctor sign it at the next visit. I think maybe I should make multiple copies too. Should I post it on the door? chart? or where?


Here it is...can you think of any better wording or anything to ask?


Birth Plan

1) My birth plan is not up for debate.

2) I do not debate or justify doctors orders with anyone but the doctor.

3) keep noise and people in the room to a bare essentual minimum.

4) Three tries to poke for an IV and 3 tries to get blood for the entire staff is my limit. This is not 3 tries per person on the staff. It won't be happening again after that by anyone but the actual anestesiologist.

5) I do not retell medical histories or orders you already have in hand.

6) My husband does not leave the room for anything, not even to check me in. The hospital has the capacity to come to the room and handle it and that is how it can be handled.

7) Always knock and ask before entering the room.

I was thinking I need to write up a separate plan for the baby...no shots, no bath, and returned to me asap. Oh, and this time, I want to see him before he is 6 hrs old. I am hoping to get to see him within this time by h aving dh stay with him so I want to put in the orders that dh stays with him even when he goes to the nursery. If a daddy is hanging over him in the nursery, perhaps it won't be the standard 4-6 hr time window there. The doctor already knows what I am requesting on this and she says it is reasonable so I am thinking of trying to cope with and get through the birth first, and then tack this plan up just before the baby is born to give minimal time for the nurses to get angry over this.

[Lisa1970]

Originally Posted by Belle

#1 is easy. Tell them that they are violating your HIPPA rights by interogating you in front of stangers. I'm sure they'll have a copy framed on the wall nearby and you can point out which specific passages they're violating. The same goes for EMTALA. They'll have a copy of it nearby too. A break of your water is a clear indication that labor has begun and they can't refuse to admit you at that point.

#2. I agree with the previous poster. Tell them this is your tenth pregnancy and you (they) already have your medical history on file and you're not going to repeat it again while in labor.

#3 Tell them flat out that you won't consent to allow them an IV/hep-lock unless they put it in your hand. If they argue with you then that's too bad for them. I guess they'll just have to "permit" you to drink fluids instead of the IV.

Upon looking up some stuff on EMTALA, I discovered this. http://www.medlaw.com/handout.htm So they are required to ask you your medical history per EMTALA rules. I would just reiterate that they already have your history on record and you relieve them of the obligation of asking it of you again.

The Oral history is only 1 thing out of 11 on that list. I do not see the reason to have to debate my reason for being there, in the hallway, in public, in front of strangers, while I stand, for considerable amount of time. Not like they write down anything you say then. I never was even checked in last time but spent 30 minutes there debating my need to be there. The doctor sent me there. My vitals were not even taken, nothing. I was torn down and humiliated. I do not want to be doing that while in labor. The doctor was upset I left, but what other choice did I have? If they felt the need to take an oral explanation and force me to defend myself in the hallway, in front of strangers, for all that time, why couldn't they have done the other 10 things? Why do they get to pick and chose which of those things to do? And I don't think defending my presence counts as oral history. #1 was referring to the part where I have to stand in the hallway, in public, with no place to sit and no privacy at all, defending my presence there. This is something that can take a certain amount of time while in pain, water broken, and anything else. And it is not of the "my water broke" and that is the end of it sort of thing. It is of the my water broke, are you sure? yes, I am sure, it is dripping all over the floor. Well, you can't really be sure, we will have to run tests. Fine, I am happy with tests. I don't know, what time do you think your water broke? Ummm..I don't know, half hour ago? Half hour ago? How do you not know. If your water is supposedly so broken, how do you not know how long. Well, I did not look at the clock. Breaking water is a pretty big thing, how did you not look at the clock? I don't know, but it has been a while. Didn't the doctor let you know my water broke when she called in? <nurse sighs heavily as if to be really bothered by your stupidity now> yes. Then why am I being asked this. We need to get things straight. So was it a half hour ago? I don't know, it might be 45 minutes. So which is it, half hour or 45 minutes?

See..way prior to this point is where I want to walk out. And I do not consider this to be a reasonable obtaining of my "oral history." But this is along the lines of the dressing down you must endure in the hallway before they will grant you a room.

[cappuccinosmom]

#1 was referring to the part where I have to stand in the hallway, in public, with no place to sit and no privacy at all, defending my presence there. This is something that can take a certain amount of time while in pain, water broken, and anything else. And it is not of the "my water broke" and that is the end of it sort of thing. It is of the my water broke, are you sure? yes, I am sure, it is dripping all over the floor. Well, you can't really be sure, we will have to run tests. Fine, I am happy with tests. I don't know, what time do you think your water broke? Ummm..I don't know, half hour ago? Half hour ago? How do you not know. If your water is supposedly so broken, how do you not know how long. Well, I did not look at the clock. Breaking water is a pretty big thing, how did you not look at the clock? I don't know, but it has been a while. Didn't the doctor let you know my water broke when she called in? <nurse sighs heavily as if to be really bothered by your stupidity now> yes. Then why am I being asked this. We need to get things straight. So was it a half hour ago? I don't know, it might be 45 minutes. So which is it, half hour or 45 minutes?

Wow. I did not understand that this is what you were going through when I wrote my original response.

That is horrendous. What kind of idiotic way to behave is that??? Was she on a power trip or something? Ugh. I totally understand why you're upset now.

Is there no way for you to pre-register? Is your doctor aware of what you went through last time? Anything he or she could do about it?

[laohaire]

Seriously... home birth?

That birth plan is not going to assure a peaceful birth at the hospital. Nurses don't like to be antagonized any more than anyone else, and it comes off as totally antagonistic. It's not that I blame you, but it's not going to be effective. You're coming in FIGHTING so they will FIGHT you.

Consider staying at home and calling all the shots?

[meganmarie]

I assume there is a reason you are returning to the same hospital? I'm not sure I understand that part. It sounds to me like you are taking the same approach as in previous births and hoping to somehow achieve a different result this time. But that will require you, instead of relaxing and focusing inwards on your labor, to engage in hostile interactions with various hospital staff and be constantly on the defensive. Sounds like a pretty crappy way to give birth.

If this hospital has frustrating procedures - and it certainly sounds like they are prioritizing paperwork over patient care in a pretty horrible way - why reward them with your business? Is there any way to switch care providers and/or hospitals? And, hopefully, send the hospital admin a letter to tell them the reason they lost you as a patient! Or, look into homebirth - with so many previous births behind you, seems like you are an experienced mom and could do great at home with a good midwife!

I'm sure there is probably something about your situation that makes a change difficult, otherwise you wouldn't be posing this approach as your solution. But its never too late to make a change... even if it means driving a longer distance or paying a little extra, it sounds like it might be worth it.

[meganmarie]

What I would really like to know, in detail, what are they supposed to be doing vs what I have had done. Like, having me repeat myself over and over again why I am there, being questioned over semantics....grammar correct in something I said where I did not use bad grammar. When I am standing there, in public, justifying why my doctor told me to come. And doing this with a fever and sick.

Seriously...what is the job description of the labor and delivery nurse? What do I have the right to expect? What rights do I even have...if any? What is normal and typical for the way things go. Those are my questions.

Ok, if these are your questions: yes, you have the right to expect a different kind of experience. The entry procedures you are describing are NOT universal at all hospitals. I have heard of this kind of thing (having to go through triage, check-in procedures, medical forms, etc.) from other moms, but many hospitals have abandoned this and streamlined so that laboring moms are not forced to go through what you describe. I've heard horror stories like yours...but I've also heard very different, better stories.

I didn't go through anything like you did. I arrived late in labor for both births, at 2 different hospitals, and in both cases I was whisked through the doors up to my L&D room with zero conversation. My DH may have spoken to someone, but if so it didn't take long and I wasn't even aware of it. I was pre-registered, never had to do any paperwork or re-answer any questions upon entry. I think we may have gone back and signed some forms afterwards! My nurses were completely focused on the business at hand. They were respectful of my birth plan. They kept things quiet and interruptions to a minimum. I had NO IV and NO heplock at either birth (which I had obtained permission for from my OB/CNM ahead of time). No arguments. No needles.

So - there IS a different way. An L&D nurse is supposed to support you, and many of them are trying hard to do that. But, there Are hospitals where the nurses have become so beaten down by policies and procedures and requirements that they seem no longer incapable of doing their real job. Maybe these nurses will be reprimanded if they don't follow the steps they've been ordered to take. Nurses aren't given, at many hospitals, ANY freedom to take a different approach to support a patient.

That, to me, is as much the fault of the hospital as the nurses, and is why I would strongly recommend visiting and touring any other hospitals within a 90 minute drive of your location to see what their approaches are.

[Beccadoula]

Are you quite sure a hospital birth is what you want if this is the only hospital to choose from? Also, it sounds like the hospital needs a change of policy - not an upset mom trying to force them to change as she's humiliated and frustrated at their desk. I suggest that you get in to visit the hospital board of directors and explain to them how nicely this policy plays out for their reputation. You might be able to get a group of moms together to meet with them and talk about your serious concerns about their rules. I've heard of moms getting major things changed by doing this. It may take more than one attempt, but I think you could do it.

I am very sorry you've had such bad experiences!!!

[Lisa1970]

Originally Posted by cappuccinosmom

Wow. I did not understand that this is what you were going through when I wrote my original response.

That is horrendous. What kind of idiotic way to behave is that??? Was she on a power trip or something? Ugh. I totally understand why you're upset now.

Is there no way for you to pre-register? Is your doctor aware of what you went through last time? Anything he or she could do about it?

My doctor is aware and assures me it won't happen again. But I heard a few weeks ago that they did a lot of staff cuts. I am quite certain that increasing the patient load of already tense and mean nurses is not going to make them nicer.

I was going to switch to the birth center. The one on my insurance is full for my due date. The midwife is too. (she would have been a home birth, not the birthing center one).

I did stick around with this doctor due to some things that would take a short bit to explain and I need to go now because I have my prenatal massage in 18 minutes so I need to head out. Thanks so much for all your help everyone. I appreciate it. I have been so stressed and that is no way to enter labor in.

[tireesix]

Originally Posted by Lisa1970

Birth Plan

1) My birth plan is not up for debate.

I would like my birth plan to be followed as closely as possible, if something unexpected happens, I and my husband will decide on the next course of action.

2) I do not debate or justify doctors orders with anyone but the doctor.

When the Doctor has requested for me to attend the hospital, I expect his/her wishes to be respected and prefer not to be questioned over his/her decision.



3) keep noise and people in the room to a bare essentual minimum.

I find birthing easiest for my self with the bare minimum of staff in the room. If more staff is needed, I wish to be consulted before more people are brought in.


4) Three tries to poke for an IV and 3 tries to get blood for the entire staff is my limit. This is not 3 tries per person on the staff. It won't be happening again after that by anyone but the actual anestesiologist.

My veins are difficult, the only person I am prepared to allow put in the heplock is the anaesthesiologist due to previous experiences.

5) I do not retell medical histories or orders you already have in hand.

My medical history has not changed since the last time I was here. If you need extra information I would like to be taken to a private room in order to provide my personal information.

6) My husband does not leave the room for anything, not even to check me in. The hospital has the capacity to come to the room and handle it and that is how it can be handled.

I wish for my husband to be with me at all times, as a result, I would like all paper work, checking in to be done in my room.


7) Always knock and ask before entering the room.

Please knock and ask before entering the room, it can be embarrassing and distracting having people just coming and going.


Please remember that while labouring I will be going through a lot physically and emotionally. I believe in treating people with respect and kindness as that is how I like to be treated, so please respect my body, my space and the situation I am in and I will do the same for you.

Any use?