Posted by My OB said WHAT?!?.
Apr
26
Posted by My OB said WHAT?!?.
“We Can’t Tell How Long It Will Take Anesthesia To Get Here…”
“We can’t tell how long it will take anesthesia to get here…one hour, two hours, five hours???” -Staff to a woman asking how long it would take to have an anesthesiologist arrive.
There are 32 comments to this post.
Jane, perhaps this anesthesiologist was doing an emergency C-section and thats why staff didn’t know how long it would take. This comment doesn’t really seem like it fits here with all the other horrendous things that have been said. I realize that this staff member is not validating her concerns or anything, but still.
[Reply]
Heather P Reply:
April 26th, 2010 at 8:19 pm (Quote)
Emergency c-sections don’t take five hours. Also, what happens if someone else has an emergency during that five hours?
[Reply]
Knitted in the Womb Reply:
April 26th, 2010 at 9:01 pm (Quote)
Actually, the sad reality that many women are not told is that anesthesiologists are not always “in house” 24/7 at smaller hospitals. So depending on traffic patterns and how far away the anesthesiologist lives, the wait time for anesthesia can be very unpredictable.
Even in hospitals with in house anesthesia, often there is only one team on weekends, so if the team is doing a cesarean, they are unavailable if another emergency comes up.
[Reply]
rlgunger Reply:
April 26th, 2010 at 9:06 pm (Quote)
Exactly!! Even when we (I’m a nurse) do call the docs, they aren’t always very forthcoming when we ask them how long of a wait the mom can expect. It would have taken this nurse/staff two seconds longer to explain this to the mom. It’s too bad that she didn’t take the time to explain.
[Reply]
Was this mother asking because she was requesting pain relief? Or because she wanted to know what her options were?
Because if she was exploring her options, then lying to her would benefit them, in that she would request meds right away so she wouldn’t be forced to wait later when the pain got more intense.
[Reply]
I’ve had two doctors say that mom needs to have an epidural in place for a VBAC in case they need to do an emergency cesarean. Another doctor (we’ll give him a bit of credit here) said “if the hospital can’t provide anesthesia for an emergency, they shouldn’t be doing births.” For a change, I agree with him.
[Reply]
Lilly Reply:
April 26th, 2010 at 5:21 pm (Quote)
Doesn’t it take 15 minutes for epidural medicine to take affect? So in a ‘true’ emergency, 15 minutes is WAY too long, so an epidural ‘just in case’ makes no logical sense.
For your second half, I fully agree with that.
[Reply]
Jane Reply:
April 26th, 2010 at 5:24 pm (Quote)
In a TRUE emergency they will get that baby out in three minutes, anesthesia or none. I know a woman whose doctor ruptured her membranes, baby came down on the cord; baby’s heart stopped; they gutted her like a fish and resuscitated the baby. And then the anesthesiologist arrived.
[Reply]
atyourcervix Reply:
April 26th, 2010 at 6:26 pm (Quote)
The surgeon can do a quick local anesthestic injection into the surgical site before doing such a drastic, emergent c-section. It’s not optimal to do it this way, unless it truly is life or death (like your example). Worse comes to worse, they could have a CRNA come up and possibly give some kind of IV sedation.
[Reply]
I’ve had the exact thing said to me during my second birth as a reason to get the epidural *right now*. I said OK, you can run a line and then when I feel the need we’ll start the meds. Whaddya know they turned it up full volume from the very beginning w/a firm refusal, would not turn it off because “It might not work again”, and then I got to experience a cesarean for failure to wait at 10 cm! My last baby was born at home.
[Reply]
atyourcervix had this to say,
Apr 26, 2010 @ 6:24 pm (Quote)
The truth of the matter regarding anesthesiologists, epidurals, hospitals and emergencies is this: In a hospital with 24/7 in house anesthesia coverage, L&D is the lowest on the list of priorities for epidural placement for pain relief. That being said, however, if there is an emergent c-section, the anesthesiologist will be there immediately. It’s different when a life is at stake (emergency c-section) versus the option of pain control for a normal bodily function (epidural for labor). Plus, some anesthesiologists are just jerks and hate coming to L&D to place epidurals – period.
[Reply]
Jane Reply:
April 27th, 2010 at 3:30 pm (Quote)
That’s their job. If they don’t want to place epidurals, they shouldn’t be working in anesthesiology at a hospital that does births. If there are anesthesiologists who routinely take hours to go to L&D for no reason other than “didn’t feel like answering the page,” then they need to be fired and new anesthesiologists hired.
Yes, clearly epidural for pain relief is a different priority than providing anesthesia for surgery. But if they establish a pattern of not showing up because they can’t be bothered, then they need to be finding another job and the hospital needs to be paying an anesthesiologist who actually, you know, provides anesthesia.
[Reply]
Stephanie - Home with the Kids had this to say,
Apr 27, 2010 @ 2:03 pm (Quote)
Was this the hospital I delivered my first at? I was being induced at 41.5 weeks, and when that pitocin hit I quickly realized I was going to need the epidural. Finally got one 3 hours later. My poor nurse was frantic trying to get the guy over, but it took forever.
[Reply]
All the more reason to encourage and support a drug free birth. One less thing to worry about. A more appropriate response could have been, “I’m sorry you’re still in pain, but they’ll get here as quickly as they can. In the meantime, how can I help?”
[Reply]
I’m a chronic pain sufferer and I went over my need for pain medication after the birth of my child repeatedly in my prenatal appointments and it was supposed to be in my charts for L&D/MotherBaby unit to prescribe me my meds for the jump in pain after the birth. It took over 12 hours for a doctor to okay medication because “you were a vaginal birth, we don’t know what to do with you”, and it took the intervention of the peds doctors who happened to walk in on me crying for them to send me home with a prescription anti-inflamitory, they wanted me to take ibprofen! It wasn’t the anesetheologist in my case, but the regular doctors staffing l&d and mother/baby unit can apparently be just as useless when it comes to releaving pain. My post partum was horrifically painful and none of the doctors seemed to care since I wasn’t a c-section patient!
[Reply]
We are a level 3 hospital, which means we have anesthesia here 24/7. We have 15 labor beds, 4 triage beds, and 3 ORs. We are assigned one CRNA to cover 24 hours. They have a room to crash in on the unit. I have seen lidocaine used to numb the lower abd once d/t an emergent, get the baby out now C/S. She was also given catamine(sp)so she wouldn’t remember the surgery itself. Anesthesia’s approach to epidurals for years for labor has been “Women have been having babies for years without epidurals”. That attitude is changing d/t patient satisfaction scores, keep the comments coming. What could be happening to delay anesthesia is 1. the CRNA is in the OR, the pt can code, she may have a lot of scar tissue if she has endometriosis, which can attach to the colon, uterus, bladder, wherever. She can hemorrage and end up with a hysterectomy. If it’s busy in L&D, it’s usually busy in the OR, where crap can hit the fan. 2.Gunshots, knife or head injuries will always trump us, unless it is an emergent C/S. The anesthesiologist may have to come to begin the section until the CRNA is free to take over, or another CRNA is free to take over. There could be 5 women ahead of you for an epidural. Ideally, the OR will send up another CRNA to help but it’s not a promise. a bunch of us are like white on rice. We dog the CRNA until our assigned pt gets their epifural. There are those of us that do spend the time at the bedside supporting mom and family. That time can be cut short, if our other patient or baby starts having problems or if we are given an admission. Ideally, we have one high risk patient and one low risk, however, there are times when we may have three patients d/t staff calling in sick or the bus pulls up out front giving us 7 patient’s to be triaged to decide if admission is needed. I love what I do, but honestly,the expectation from all the regulatory bodies, hospital and BON is crushing us. What in the world are we going to do with an additional 30 million people added to our healthcare system? It will flood the healthcare system. There aren’t enough doctors or nurses to care for this flood. Keep in mind, the baby boomers are beginning to retire and we make up a significant nursing population. A really significant portion. The epidural situation is not right or fair and I really get irritated the physicians says to you, the patient, you can have an epidural on request.
[Reply]
Sadly I have seen a c-section turn into 8 hours in the OR because of some unforeseeable events that ended with a cancer diagnosis.
Both hospitals I’ve worked at have had 24/7 anesthesia with a CRNA dedicated to L&D just for epidurals and c-sections with an MD for back up, since no one can be in two places at once.
[Reply]
I think that while the nurse definitely could have been nicer about it, it’s possible that she honestly didn’t know. Someone up above said that it took three hours to get her epidural so in a non-emergency situation there probably really is no telling how long it will take.
[Reply]
Melyssa- do you want a medal or a pat on the back or something? I’ve done two drug free vaginal births now and would also never take an epidural because I’m not comfortable with the risks associated with them. Plus having done it twice I know that the pain is something I can handle.
That doesn’t meant that there aren’t women out there who would prefer to have them and that is their decision to make. If a woman wants an epidural, she should have one just as a woman who wants a natural childbirth should have one if at all possible. I support women having options in childbirth and that doesn’t just mean only the options that I agree with.
[Reply]
C.Pratt Reply:
June 17th, 2011 at 6:16 pm (Quote)
Sarah B,
She should get a medal, but they don’t hand those out do they? Not even for having the courage to face the pain in order to avoid the associated risks. After all, an epidural increases the risks of complications and need for other interventions, so avoiding one at least for that reason IS honorable if you ask me.
[Reply]
Add Your Comment.
Thank heaven that hospital never has to do a crash C-section. (oy)
[Reply]
Lilly Reply:
April 26th, 2010 at 4:05 pm Lilly(Quote)
That’s what I was thinking. Comforting to know I’m in a place that can handle any type of emergency. Ugh.
[Reply]
Jane Reply:
April 26th, 2010 at 4:15 pm Jane(Quote)
When you ask a medical practitioner why you should birth in a hospital,they say you need to be there because in case of an emergency, they can act right away to save your baby.
But….I guess not.
[Reply]
KDB Reply:
April 27th, 2010 at 7:00 am KDB(Quote)
Maybe they used to, but that was before they started using the cable company as a hiring pool. “Someone will be there to do your epidural between the hours of 11 and 4.”
[Reply]
Jane Reply:
April 27th, 2010 at 7:04 am Jane(Quote)
ROTFLOL! “Your medical emergency has been scheduled for next Thursday. Please make sure you’re home. A medical tech will call four hours before your appointment to verify.”
[Reply]