For those who are not familiar, “Dr. Happy” is an internal medicine hospitalist who has very strong (and sometimes bizarre) opinions on many areas of health care. For instance, he has been known to defend Michael Jackson’s doctor for setting up a Dr. Frankenstein’s lab in his home, and often accuses nurses of not having critical thinking skills.
Thus, I was presently surprised to see Dr. Happy defending home birth based on scientific and common sense evidence. Thank you Dr. Happy (that is until you write the next obnoxious post degrading advanced practice and staff nurses), for spreading some common sense.
So my six-year-old daughter just asked me, “Mom, what is the difference between a doctor and a nurse?” My answer should have been immediate and confidant, but it wasn’t. I could have talked about the different education and training requirements. The difference in licensing and practice acts. I could have explained medical versus nursing philosophies. But, she is only six years old. Those explanations would have been way over her head. So, I stammered and stumbled and told her that doctors diagnose and treat diseases, and nurses help and listen to patients and help doctors. I said we work together as a team to help people. (Ugh, yucky stupid explanation. I know!). My daughter sat for a minute and then said, “Oh, I thought doctors are boys and nurses are girls.” NOOOOOOOOOOOOOOO!
My conversation with my daughter was eye-opening and scary to me. She lives with a very strong, feminist, nurse advocate, yet she believes nursing means you are are woman. Nothin’ else. This makes me very sad. I failed at explaining to my own daughter what a nurse is. I KNOW what a nurse is, but I could not explain it to my 6 year old.
So, dear readers, I need your help. How would you explain to a 6 year old what the difference is between a doctor and a nurse?
The best public health ad I have ever seen. Ever. I have tears in my eyes and goosebumps on my flesh. This is how advertising should be done! Beautiful!
Imagine if you will. You just delivered a baby in a hospital. After recovery the baby is transferred to the nursery so you can rest. In the middle of the night a baby is brought to you by an aide, “Your baby wants you!,” so you can nurse him. You breastfeed your baby, half asleep. A nurse walks in, astonished. She tells you that you are not feeding your own baby, but someone else’s. You breastfed the wrong baby.
What would you do? How would you feel? You just breastfed a baby who was not yours. It was a mistake. Human error. No physical harm was done to the moms or babies involved. But…….what would you do?
I can only surmise what I would have done, or felt if I was put in this situation. I can not imagine that it would be very traumatic for me to breastfeed another woman’s child in my exhaustion. I would guess my attitude would have been, oops, oh well. I may have felt very differently if it was MY baby who was breastfed by another woman. But that is not what happened in this case in point. I can never really know how I would have felt, or what I would have done.
When something like this happens in reality, when the wrong baby is brought to the wrong mom, litigation may follow. Regardless of harm done. Human error, mistakes, are inevitable in a hospital setting, and they are often unforgivable but the public.
So again I ask, what would you have done if you breastfed the wrong baby?
A very super thank you to one of my favorite blogs, The Preemie Experiment. Blog owner Stacey is hosting a book give away based on the work of the above animator and author. As written by Stacey:
Micro-Preemie Power, by Scott Wright, is a comic book journaling the NICU experience of Scott and Jodi Wright as they find themselves unexpectedly giving birth to a micro preemie. Their son, Morgan, was born 3 1/2 months premature weighing in at 1 pound 8 ounces.
This comic book is a very compelling and brutally honest look at life in the NICU. I can speak of the realities of the NICU as a nurse, but not as a parent, which is the REAL reality. The Wright family has given many NICU families a gift with the publication of this book. It is a gift of the unabashed truth of what parents go through while trying to survive the NICU.
I would also like to thank the authors for not portraying the NICU nurses as dead-behind-the-eyes, silicone enhanced, over-sexed, doctor- stalking sluts, that the majority of the media portrays as the reality of us nurses. Just sayin’.
Happy one year anniversary to Reality Rounds! A one year anniversary should be celebrated with paper, ironically, since this blog is written on a computer. So I have decided to write my blog on paper from now on.
I have no idea what direction this blog will take in 2010. I had no idea what the direction this blog would take in 2009. It started out as a nursing blog with my commentary on medical stories in the media. It seems to have taking a turn as more of a blog on birth and neonatal issues, which is fine because I seem to talk about these issues constantly in my real life. But what the hell is the point of my blog? I have no clue!
One day I would like this blog to mean something. I would love it to help people in some way. I would love to come out of anonymity, and share my knowledge of neonatal issues and nursing as an open forum. I feel there are a lot of voices that need to be heard regarding long-term issues with prematurity, issues of women’s rights in childbirth and health, and the role of nurses as health care providers. I would ultimately like this blog to not be so much my opinions of women’s and children’s health issues, but a forum for others’. So we will see.
Thanks to everyone for reading and commenting. I have learned so much from the comments and from other blogs! I have even gotten to meet some of my favorite bloggers in person (Science and Sensibility, Stand and Deliver, Mom’s Tinfoil Hat) . Too cool (waves). I would also like to give a shout out to the blogs who have supported me and sent me the most traffic. Without further ado, and in no particular order:
*Now go give them a click or two. They are wonderful women writers (and blogs are predominantly written by men, by the way), so let’s give them some lovin’.
The most “popular” day in the United States to give birth is (drum roll please)…………Wednesday! Wonder why that is? Hmmmm. What sucks is I work every Wednesday, and it is always crazy busy on Wednesdays. Now I know why. The least “popular” day in the United States to give birth is (drum roll please)……….Sunday! Wonder why that is? Hmmmm.
On a side note, I thought is was kinda cool that super model Giselle Bundchen gave birth to her first-born at home, in her bathtub. I wonder if there is a higher rate of homebirths for celebrities. It must be very intimidating for them to give birth in a hospital, with paparazzi and stalkers waiting in the wings. I would also be worried about an unscrupulous health care worker leaking my info to the press, or posting a sneaky picture of me crowning on Facebook. Anyway, just thought it was a cool story.
The The New York Times picked up on the recent Cochrane review that concluded eating and drinking during labor is not harmful (or helpful, although satiating hunger seems helpful to me). Historically hospitals restricted food and fluids to laboring moms, due to the possible risk of being put under general anesthesia, and vomiting and aspirating during the surgery. This is such a rare risk that making all labor patients NPO (Nothing By Mouth) does not make sense. I won’t go over the debate (I personally believe it is A-OK to eat during labor. Heck, I snuck food into my own delivery, and ended up with a C-Section, and survived to blog about it!) because I do not want to beat a dead horse. What I found interesting in the NYT’s article were some of the quotes embedded in the article. They actually made me laugh, and I do not think this was a comedy piece. Here is what I thought was funny, in a not-so-funny kind of way:
Dr. Tranmer, (a nursing professor…yeah!) who said she had seen all too many women in labor complaining of thirst and dry mouth resort to sucking wet washcloths. This just makes me sad. The thing is, I believe her! The image of laboring moms sucking on washcloths seems so pathetic and demeaning. Thankfully I have not witnessed this. I have furiously spooned ice chips into laboring women’s dry mouths, but never had them suck on a wet washcloth. Jeez!
“My own view of this has always been that you could say one shouldn’t eat or drink anything before getting into a car on the same basis, because you could be in an automobile accident and you might require general anesthesia,” said Dr. Marcie Richardson, an obstetrician and gynecologist at Harvard Vanguard Medical Associates in Boston, who was not connected to the new study. I have never heard of this analogy, and I like it. I may use it at work! It’s funny because I have heard of (she who will not be named) some anti-home birth advocates saying things like delivering at home is like driving without a seat-belt, or some weird sh*t like that, so I like when the car analogies are U-turned (tee hee) around.
“From an anesthesiologist’s perspective, they missed the boat on this one,” said Dr. Craig M. Palmer, chairman of the committee on obstetrical anesthesia for the American Society of Anesthesiologists. They looked at the impact on the progression of labor, but to be honest, that’s not an issue for anesthesiologists. Our primary concern is patient safety.” Oh Craig, you are my hero. I completely agree with you. The researchers did ignore you, and that was mean! We can never predict who may need an emergency C-Section. I have seen women walk in off the street who have eaten, gasp, and have needed a crash C-Section right on the spot. So I propose that ALL pregnant women with a viable gestation, become NPO until they deliver. This is the safest way. We can insert central or PICC lines at around 23 weeks gestation, and have home health nurses hang total parental nutrition once a day. At around 36 weeks, all pregnant women should have Foley catheters inserted, so we are not futzing around in the OR and wasting time, in case she needs that emergency C. Let’s see, is there anything else I’m forgetting? How about weekly abdominal shaves? Sounds about right.
The NYT article was an enjoyable read. Not so enjoyable was reading the comments. I should know better!
I was alerted to this story from a comment left by a reader. There is a very emotional case causing controversy in Canada. It revolves around a three-month old infant who suffered catastrophic and irreversible brain damage during delivery. The infant’s physicians want to remove the infant from the ventilator stating that removing the child from the ventilator is medically reasonable, ethically responsible and appropriate. The parent’s do not want their son Isaiah removed from life support, and sought a court order to stop the physicians from doing so. According to the CBC-Canada news article, the case currently stands as follows : “An Alberta Court of Queen’s Bench justice has ordered an Edmonton hospital not to remove a ventilator that is keeping a three-month-old infant alive until a court hearing can be held on his medical condition.”
This story illustrates the real life difficulties of “deciding” on futile care for any human being. When the case involves an infant, it is even more emotionally and ethically challenging, since the infant can not speak for themselves. So who should decide futile care? Should it be the patient’s physicians who are keeping the patient alive with their treatments? Should it be the patient’s family (in the above case the parents), who will bear the ultimate burden of either grief from the loss of the child, or burden from caring for a severely disabled child. Or, should it be the courts supported by expert opinion and detached involvement?
In ethical cases like these, there is never a black or white, right or wrong answer. What ever answer you feel is right, will be wrought with other ethical questions to follow.
