Connect with Healthcetera
Monday, April 29, 2024
HomeStandard Blog Whole Post (Page 277)

A growing number of states across the country are establishing state-sanctioned mandates that women seeking abortions undergo a mandatory transvaginal or transabdominal ultrasound. In addition to being a violation of womens rights, these mandates raise the question of unnecessary medical requirements or what’s referred to as futile care – it doesn’t further the health of the patient and runs up the cost of health care. The politicalization of medical practices and standards of care in providing reproductive health services demands our serious attention. 

Barbara Glickstein, Co-director CHMP

Here’s a repost  of an article by Robin Marty originally posted in RH Reality Check. 

In the wake of the Virginia forced transvaginal ultrasound debate in Virginia, bill supporters have tried to justify their bil by stating that ultrasounds are the “gold medal standard” of pre-abortion care.  But are they?

As one midwife explains in an article on The Clinical Advisor, unless a patient presents with an issue that would have a medical practitioner suspect an ectopic pregnancy, often they aren’t used at all.

Robyn Carlisle, MSN, CNM, WHNP, full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J., writes:

I recently saw a patient in the office for amenorrhea, severe left-sided pelvic pain, and a positive home pregnancy test. I ordered blood work and a stat ultrasound to rule out ectopic pregnancy. When I mentioned the ultrasound, the patient balked and confided that she was uncertain whether she wanted to continue the pregnancy.

My patient felt that an ultrasound would just complicate an already painful decision to terminate the pregnancy. I explained to her that while I understood her apprehension, given her clinical presentation, we needed to ensure this was not a tubal pregnancy and move forward with the ultrasound.

Under normal circumstances in New Jersey, this patient would not have needed an ultrasound to confirm her pregnancy, especially if she was considering an abortion. Unfortunately, not all women have this choice.  Read the rest of the post here.

A growing number of states across the

Barbara Glickstein is a boomer, co-Director of CHMP and loves the millennials.

millenials_splash

photocredit: cpcc.edu

The thing about predictions is – well, things like  Google, Twitter or Facebook come along. Who knew? I love the digital world and stay pretty connected myself. It helps living with two hyperconnected multitasking millennial  kids. I need to adapt and thrive digitally to stay relevant.

In the ancient past, when I wasn’t texting, I’d call my kid’s mobile phones, they’d never pick up and I’d leave a voice message. The following would then happen:

My mobile phone would ring, I’d answer it, and they’d say,  “hey, what’s up ?”

Me: “Oh I left you a voice message.”

Them: ” I didn’t listen to it – what’s up?”

Me: I’d repeat what I said on voice mail.

It took me a few times before I figured it out. Don’t leave a voice mail message. They showed me what a waste of time it was dialing into your phone’s voice mail – listening to it and then returning the call. Smart millenniums try not to waste time. This often leads them to being accused of desiring instant gratification. Sometimes that’s true but I think they’re on to something bigger.

I used to think that most work meetings could have been a memo. Now, I think they could have been a text message.

A Pew Internet/Elon University survey asked people to predict to the year 2020 and how this cohort will do with their hyperconnected lifestyles. Who knows what we’ll be calling it in 2020 but probably not hyperconnected. Read the report here.

I just signed up  to Pinterest. I’m not a millennial or early adaptor. But I try not to be too far behind from those leading the way.

Barbara Glickstein is a boomer, co-Director of

Amanda Trujillo, RN

Amanda Trujillo, RN

Would you want Amanda Trujillo to be your nurse?

Amanda Trujillo is a master’s-prepared nurse who was working the night shift at Banner Del E. Webb Medical Center in Arizona in early 2011. One of her patients was a critically ill 60 year old woman who had been scheduled for evaluation for a transplant.

According to Amanda, she assessed the woman’s knowledge of her illness and says that the patient didn’t understand her disease, the lab tests, medications, or the self-care that would be needed to recover from a liver transplant for which she was being evaluated. By Amanda’s assessment, no one had ever discussed hospice care with her, even though a consulting physician had noted in the chart that the only two options for the patient were transplant or hospice. Amanda believed that the attending physician’s failure to discuss this option with the patient was an ethical breach of the concept of informed consent.

Amanda had worked on a transplant unit for five years at another hospital and was used to having conversations with patients about preparing for the evaluation and post-transplant self-management.  Amanda says that, after talking with the night charge nurse, she accessed the current hospital’s educational materials and prepared a binder of information that she reviewed with the patient. When the patient said that she wanted to go home to be with her father and think about what she wanted, Amanda made a referral for a hospice case management consultation as she had done before without any objections from physicians or the hospital administration. She documented everything in the patient’s record and reported her ethical concerns to the charge nurse.

According to Amanda, she was fired by the hospital for her advocacy on behalf of the patient after the transplant service’s physician expressed his fury at the change in the patient’s decision. Amanda was told that had interfered with the patient’s surgery and that it was not in her scope of practice to make a referral to hospice case management for a consultation without the approval or order of the physician in charge of the patient’s case. The hospital filed a complaint with the Arizona State Board for Nursing.  Amanda, as a single mother, found herself unemployed and an “untouchable” in the eyes of other employers.

Amanda Trujillo, RN

Amanda Trujillo, RN

Would you want Amanda Trujillo to be your nurse?

Amanda Trujillo is a master’s-prepared nurse who was working the night shift at Banner Del E. Webb Medical Center in Arizona in early 2011. One of her patients was a critically ill 60 year old woman who had been scheduled for evaluation for a transplant.

According to Amanda, she assessed the woman’s knowledge of her illness and says that the patient didn’t understand her disease, the lab tests, medications, or the self-care that would be needed to recover from a liver transplant for which she was being evaluated. By Amanda’s assessment, no one had ever discussed hospice care with her, even though a consulting physician had noted in the chart that the only two options for the patient were transplant or hospice. Amanda believed that the attending physician’s failure to discuss this option with the patient was an ethical breach of the concept of informed consent.

Amanda had worked on a transplant unit for five years at another hospital and was used to having conversations with patients about preparing for the evaluation and post-transplant self-management.  Amanda says that, after talking with the night charge nurse, she accessed the current hospital’s educational materials and prepared a binder of information that she reviewed with the patient. When the patient said that she wanted to go home to be with her father and think about what she wanted, Amanda made a referral for a hospice case management consultation as she had done before without any objections from physicians or the hospital administration. She documented everything in the patient’s record and reported her ethical concerns to the charge nurse.

According to Amanda, she was fired by the hospital for her advocacy on behalf of the patient after the transplant service’s physician expressed his fury at the change in the patient’s decision. Amanda was told that had interfered with the patient’s surgery and that it was not in her scope of practice to make a referral to hospice case management for a consultation without the approval or order of the physician in charge of the patient’s case. The hospital filed a complaint with the Arizona State Board for Nursing.  Amanda, as a single mother, found herself unemployed and an “untouchable” in the eyes of other employers.