Patient Requests

[carofl93]

State is Florida.

I am not sure if this post belongs here or in the military section, but since it is more healthcare related I will start here and move it if need be.

My husband is active duty Air Force and all of our medical care is handled through the military hospital on our base and TriCare insurance. I am 3 months away from the delivery of our second child and want to ensure that this birth experience goes better than my first disastrous delivery.
I have prepared a very short memo making 2 requests of the OB staff as follows:

I would like to request that there be no student involvement in my care and delivery. I realize that Eglin is a teaching hospital and did allow a student to be present and overly involved in the birth of my first child but do not wish to do so with this birth.
I would also like to let all involved parties know that I will not accept a blood transfusion under any circumstances. This is not a religious preference, simply my own personal preference. During the pre-operative segment of my prior emergency caesarian section, I was berated for ten minutes over my choice and would like the respect I am due as a patient.
I would like to thank you very much for respecting my wishes and for the care I and my child will be receiving. I feel that these are very simple requests and I do hope that they will be accomplished with minimal disruption to all involved parties.

Here is my question:
If this request is notarized and added to my file, are the staff legally bound to honor my requests?

Thank you.
Carol

 

[ellencee]

carofl93
Your request to have no student involved or observing must be honored.
Without a court order, your request to receive no blood transfusion can not be honored. The hospital has the right to refuse to have you as a patient and has the right to refuse to deliver your child if you refuse to receive a blood transfusion if it is needed. You are asking the hospital to allow you to bleed to death and to deny you life-saving measures for yourself and possibly your baby. No facility should honor a request such as this. Hospitals who honor religious requirements for no blood transfusions do so at a great liability risk and usually have legal advice and legal contracts for such patients.

If you have the willies about receiving blood products, as I do, then go now and begin to donate your own blood that can be stored and transfused back to you in the event you need a blood transfusion.

There is a blood product (fluid) that is available for use when blood can not be transfused or type and crossmatch can not be done in a timely manner, like at the scene of an accident or in the case of severe trauma. One bag of this product provides as much fluid 'load'/benefits as does 3 bags of RL or D5W and has oxygen carrying ability the same as whole blood. In the event of hemorrhage, the hospital could administer this product if the hospital is one of the facilities now providing this measure but this would only be a short-term measure if you have hemorrhaged significantly.

You need to decide which you want: death for yourself instead of a blood transfusion and/or death of your infant instead of a blood transfusion OR to sign permission to receive a blood transfusion in the event of significant blood loss.

Remember, the hospital has the right to refuse to have you as a patient if you continue to refuse to receive blood transfusions in the event of significant hemorrhage.

EC

 

[carofl93]

Thank you so much EllenCee!

Thank you so much EllenCee!!!

I was hoping that you would be able to answer my questions. I am so relieved to know that they will have to respect my request for no student involvement. That was my major worry because the majority of my labor was watched over by a totally clueless student who asked for help only when my son's heart rate started decelling and the nurses told her to get the doc quickly. The blood issue isn't so bad because both myself and my husband are of the same type and he can donate for my use before the birth if they won't take my blood as they wouldn't for the first child.

Again, thank you so very much. I really appreciate your time and assistance.
Carol

 

[rmet4nzkx]

Congratulations! Is this a hurricaine baby? I wish you well with your delivery.

 

[carofl93]

Thank you very much Rmet! No, this one isn't a hurricane baby LOL...it was conceived in June...and planned this time too :O. This is the last one for us and will be a true surprise right up until it's born.

Carol

 

[ellencee]

carofl93
Hey, you're welcome! Remember to read the admission and consent for treatment forms; sometimes those forms include a statement that students, interns, externs, etc. will be assisting as part of the regular team. If the forms include such a statement, ask for and complete a waiver/refusal to allow before you sign the admission and consent for treatment forms.

Baby is due in March and Dad has less than three full months in which to donate blood. He needs to get to the hospital ASAP and start donating. It's nearly the middle of January (yikes!) and he needs to try and get three units saved by the time the baby comes; two would do in usual circumstances but three is often recommended.

Someone once wished me "Happy Baby"; I wish the same for you..."Happy Baby"!

EC

 

[carofl93]

Thank you again EllenCee.

My hubby set up an appt today to donate for me, and I have a regular appt next Wed, but I will call my doc to see if they'll take blood from me as well.

Thank you for the heads up on the paperwork. It's been 2 years since the last baby and I've been wracking my brain trying to remember if there was anything in the paperwork I signed then that asked about student involvement. I do remember the docs asking if I minded having a student check on me from time to time, and I do remember finally being angry enough to kick the student out when my epidural stopped working and the student informed me that I was mistaken...part of my reason for not wanting student involvement this time. I realize that she was only learning, but I knew that I shouldn't have been in that sort of pain if it were still going and she was sooo much younger than I was LOL. It's still uncertain if I will go natural or have another section, but as long as we end up with a healthy live baby, I will be satisfied.
Thank you for the baby wishes. I will keep everyone updated on what we get LOL. We've had the ultrasound to make certain that all is well with this one, but chose not to determine sex since our son's ultrasound was misread and we were shown his uterine artery...big shock when he popped out minus those parts LOL.

Thanks again,
Carol

 

[BlondiePB]

Carol,
You were in my thoughts at the end of you know what season. The PM feature was dismantled then. Glad to know you and the family are well. Hope you had the damage repaired that Ivan caused. There's still lots of interesting "fall out" from the havoc down here. Can't say I blame you regarding the students. I won't even let a physician assistant see me anymore. We want to know whether it's a boy or girl too and how you are after delivery.

Best wishes,

BlondiePB

 

[carofl93]

LOL...I won't say the name of that season either! I hope your fallout isn't as bad as ours turned. Our homeowner's insurance went belly up and filed for bankruptcy shortly before they sent the adjustor to our house. They're still hunting for the report the adjustor was supposed to have sent in. We got notified about this 3 days before Xmas and were told that we would lose our insurance coverage on the 15th of this month. Luckily we were able to find a company that is willing to insure our place...it was built in 1964 and has the old round glass fuses.
I hope that your damage has been fixed or is in the process of being repaired.
I will definitely keep you all updated on this baby

Carol

 

[carofl93]

baby update

My notes to the OB staff have all been accepted and placed into my files as well as having a copy on hand at the civilian hospital where the baby will be delivered due to construction at our military facility.
My husband has donated blood for me, and luckily they took a unit from me right before it was too late for them to accept my own.
The docs have decided that it will be safer to do another C-section since I am at 34 weeks and the baby is transverse. It's not what I had planned but it will be worth another scar and week away from home to get our last healthy baby. The baby should arrive on the 3rd of March unless Mother Nature decides to speed things up...
I will keep you updated
Carol

 

[carofl93]

Baby Update

Donald Eugene was born last Monday, March 7th at 10:26 AM. He weighs 7.5 pounds and is 19 inches long, with a full head of hair. The c-section went very well. The surgeon had a perfusionist (sp) and a cell saver in the OR just in case there was a problem. Donald had some problems because he swallowed and inhaled meconium, and spent a week in the ICN in Pensacola, but is healthy and home now.

Thank you for all of the wonderful advise and baby wishes!

Carol and Family

 

[rmet4nzkx]

Congratulations!