Monday Med Mania

Coordination of Response to Obstetrical Emergencies

Since my area of specialty is high risk obstetrics, I spend a lot of time reviewing and analyzing medical records relative to obstetrical malpractice cases. As an obstetrical nurse for almost twenty years it really gives me a lot of grief when I review medical records to realize coordination of response to obstetrical emergencies has been mismanged to the point of malpractice. This seems to be a constant within almost every malpractice case I review.

The major elements that fall within this issue include:

• Failure to anticipate and prepare
• Failure to commuicate
• Failure to fully understand responsbilities

Obstetrical nurses must understand that the possibility of obstetrical emergencies can occur at any time, especially when high risk patients and/or use of induction agents are involved. A poorly coordinated response results in panic and chaos ultimately creating a situation that places both mother and baby in danger. A poor outcome is then directly contributed to events that were both avoidable and incompetent.

The use of emergency simulation drills on obstetrical units does help to better prepare for obstetrical emergencies; however, all staff including physicians must be on board to effectively coordinate the response. On the other hand, if the obstetrical staff fails to acknowledge the reality of a high risk situation, then simulation drills are rendered useless.

For coordination of response in obstetrical emergencies to be effective there are four seperate and distinct factors that must take place:

• Anticipation
• Preparation
• Communication
• Delegation

These are the four factors I identify within medical records of an obstetrical malpractice case. I really hate to say it, but most of the cases I am asked to consult for will reveal a breakdown in one or more of these four areas. With the number of obstetrical law suits escalating, it is imperative that obstetrical nursing supervisors properly educate their staff the significance of obstetrical emergency response.

For more information on this subject matter and obstetrical staff education, contact Marinna Cook, RN, CLNC at mcook@cook-legalnursing.com or call (661) 368-2290.