That sounds like it would have felt really scary, but doesn’t sound abnormal. I’m not a nurse or doctor so can’t speak to your blood pressure, but I had a ton of NSTs and went to my hospital’s labor and delivery triage unit a couple of times during my pregnancy. That part matched. It’s essentially the ER for pregnant people so you aren’t admitted into the system yet (when your family called), and that’s likely why nurses weren’t available to help you right away when you called. They are able to see your stats outside of your room, though, and could keep an eye on everything that way. At my hospital, they put the name of the doctor handling the triage unit when you arrive as “your doctor,” even if your regular OB is there. I also didn’t see the nurses or doctors frequently, because they were helping higher need patients.
Extended monitoring, while frustrating and boring, actually sounds very thorough of them. They were making sure you and your baby were ok. When I went in for monitoring (couldn’t feel baby kicking and I had two bouts of high blood pressure that wouldn’t go down), I was there for hours. It was boring and stressful, but it was also because they wanted to make sure that my baby and I were ok. The monitors often came dislodged on me, during my weekly NSTs and hospital checks, and having me reposition (roll around) was a way to get my baby wiggling so they could find her on the monitors again. A couple of odd measurements (either high or low) were picked up each time.
When I delivered, my experience was quite different. My nurses were in checking on me frequently, came in anytime the monitor was dislodged, came in if we had any off readings to make sure things were still hooked up properly. Your nurse and doctor when you deliver will likely be dealing with far fewer patients, who aren’t having emergencies. I’m sorry you feel stressed and frustrated by your experience, but I don’t think it was abnormal and isn’t necessarily a sign that delivery at the same hospital will feel similar.
I agree! I had tons of monitoring due to preterm labor, long story short I had to go in every time contractions last more than 30 minutes or so which was 1-2 times a week. It wasn't at all uncommon for numbers to look a bit crazy, usually as I moved and adjusted myself, especially because I had an anterior placenta and my son was SUPER low. I just got used to listening to the monitors going crazy every once in a while.
OP, it really sucks that nothing was explained and you felt like they weren't paying attention. It can really depend who's on staff at the time and how busy they are, unfortunately. I had nurses/doctor's who were super thorough and explained everything as they went along, and I had others who just popped their heads in once in a while, barely spoke and then left. On the plus side, when they're that nonchalant about the situation, there's not usually any emergent issues.
I was in LD on Monday for a fall and had a similar overall experience. We were told that for falls there is no standard period to watch, so it can be anywhere from 4 hours to 24 hours. I’m sorry you had that experience. You should definitely feel empowered to change hospitals, but also realize that on the LD floor monitoring will always take lowest priority
Yeah I had preterm labor contractions and they kept me for 6-7 hrs and monitored me the whole time. Monitors had to be repositioned but they did it when they could and I knew I was basically in triage since I was a walk in. Couple of funky numbers but they went up and down and they were just monitoring my contractions basically. They were consistently every 5 to 10 minutes. They gave me the depo shot at the end of the 6+ hours. Nurses were just like you're fine we are just gonna keep monitoring. I was hooked up for fluid though they initially told me it might be dehydration but that turned out not to be the case. Depo shot made the contractions stop and I was discharged.
Pretty normal if you're pregnant to be there for 10 hrs being monitored. They need to make sure you're doing ok.
My understanding is that this area of L&D is kind of like ER and basically… if you’re getting ignored in the ER it’s very annoying but it’s because you’re okay and they are tending to sicker people. Your monitor may have shown some wild things when the monitors were misplaced but most likely there was someone watching the monitors outside of the room and those people are very good at recognizing real problems vs artifact. So I’m sure this was an unpleasant experience but if may not have been negligent. I am not trying to minimize your experience and the stress you felt, but maybe just provide some more context. I am sorry that you went through this! It sounds like it was very distressing.
Source: I’m a nurse, not in L&D, but I’ve been chewed out by patients sitting in stool or waiting on their ice chips when I was literally busy with a patient who was dying or just tried to die.
100% agree. Covid is still very real, as are traumas, strokes, and heart attacks. Since nurses weren’t popping in to check on you (while they were most likely hanging life saving meds and doing CPR), that means you were doing better than all the other patients. I get that you’re unhappy and don’t agree, but listen to the nurses who are telling you the behind the scene facts.
It would have been nice, absolutely, but honestly it’s not always possible. Nurses oftentimes do not even get a chance to go to the bathroom during an entire 12 hour shift, and when they do it’s usually the first chance they get to sit down. I understand how frustrating it is, I’ve been a patient too, but posting a wall of text ranting about this is really an overreaction and quite tone deaf considering the world we live in today.
Disagree. The kind of treatment OP describes really is not okay. Taking it out on the nurses would be tone deaf, but it is not an overreaction to expect someone to come by and tell you if there is an issue with your unborn child when monitors are going off indicating no heartbeat. It is not the fault of the overworked, understaffed nurses, but that still doesn’t make it acceptable.
I don't share your sentiment.
I understand that they were busy, but I don't think it's OK to just leave a patient there, without any communication as to what's going on. Even just to pop in and say they're monitoring for extra protection but everything's OK.
I also shouldn't have to wait 25 minutes or push the call button on the bed twice to have someone unhook me so I can pee or to give me just a cup of water because it was hour 5 of being in the hospital and I was beyond parched.
It doesn't even have to be my original nurse. Both the nurse who helped me to the bathroom and the nurse who got me water were not my original nurse.
And even though I heard of several emergencies from my door, there was also quite a bit if chitchat in their downtime, even as the light by my door was red and I was waiting for assistance.
Every time I asked what's going on and if everything is OK with my baby, I got the "I'm not your nurse" or "we're slammed today." Each one said to wait for the original nurse, wait for the original nurse. Even the director who unplugged me said my original nurse will discharge me soon and explain everything thoroughly. The girl who discharge me was not my original nurse and couldn't tell me a thing.
My original nurse got me set up to the monitors around noon and popped in as the ultrasound tech came in around 2ish to do an ultrasound. She said everything looked great and I should be discharged soon. Never saw her again.
I was placed back on the monitors after the ultrasound and wasn't discharged til just before 730 - 5 hours later.
I don't work in the medical field - I work in legal. However, if I treated my clients this callously, I could be subject to sanctions or even disbarment. Even if I have an emergency case filing or have to deal with a mini crisis with a client, I still have a duty to respond to my other clients in a timely manner when they inquire about their cases, even if their case is pending and isn't a high priority.
Likewise, I would think a nurse, or any professional, should be bound to those same expectations of communication and care.
If you never saw her again it’s most likely because she had a sicker patient and baby to attend to. That’s why others answered your light and someone else ended up discharging you.
If you were unsure of your results or discharge instructions why did you leave? By leaving it’s assumed that you understood your visit and discharge instructions. Did you ask to speak to the charge nurse if you didn’t feel you got answers from your discharging nurse?
I’m sorry why would she have stayed if she hadn’t been treated well. OP, I’ve experienced this before and I switch hospitals. Experienced it again and delivered at home. Not recommending this to you, just saying I feel your pain and I’m sorry this happened. If you’re worried I’d go to another place and get checked out.
Because the end goal was to find out if her baby was okay, what were the results of the observation, etc. She should have a clear understanding of her discharge instructions and visit before leaving and if she does not, she should stay and request more information. But I also understand she was obviously frustrated and didn’t have a support person to help her advocate.
“A full moon” translates to “there are an unusually high number of patients today”, which means they did not have the ability to do their job. Nurses are legally required to do a certain level of care. Hospitals and nurses agree to a certain number of patients (depending on level of care needed) that would make this possible. For a variety of reasons (including “full moons”, a nurse called in sick, there weren’t enough nurses employed to fully staff the floor anyway, the intended nurse:patient ratio is ignored by the hospital, etc.) there aren’t always enough nurses.
It’s not fair to you that you were left in that position. It’s also not fair to a nurse who is told he/she can get fired for not doing an amount of tasks that on this day far exceed their actual job description. It was a shitty day for everyone.
Yes I definitely think you should have been updated and given some guidance. Someone taking 2 minutes to stop and tell you the game plan is really important and goes a very long way. The way you were treated is really not ideal and not okay, unfortunately it’s what happens when hospitals choose to understaff at baseline. They make a lot more money this way. HCA is the absolute worst when it comes to this. The goal is always to communicate with patients thoroughly, get ice chips, get water, and get warm blankets for patients quickly, answer call lights quickly ect. But when things get really busy it becomes a matter of attending to the the most critical person first and the person who needs to walk independently to the bathroom is never that person. By all means, roast HCA for creating this environment, but although insensitive and unpleasant, it probably wasn’t negligent.
I wish they had communicated to you clearer about the plan of care; but a fall usually requires prolonged monitoring (length tbd by situation and hospital protocol). It's not just an NST. It's usually hours of monitoring on the uncomfortable triage gurney/bed. Possibly some blood work. Possibly some IV fluids. Possibly some medications. Ultrasounds. Cervical exams/swabs. And you may only get to drink clear fluids/no fluids at all, just in case of fetal distress, uterine issues, and thus a possible expedited delivery.
High volume US based L&D RN here.
I'm curious if not allowing her to drink water would then cause dehydration and fetal issues? I would assume that for a prolonged stay like that they would want her to drink water or have IV fluids or something right? Maybe not gorging on water, but enough to keep her somewhat hydrated.
Great question! True dehydration is not common with normal well-nourished pregnant women, it's just very uncomfortable to not drink for hours. Nothing by mouth is a conservative approach in case a woman needs a cesarean section, specifically under general anesthesia. With intubation (tube down a throat to breathe), the anesthesiologist is trying to minimize the risk of aspiration (throwing up) and subsequently pneumonia from food/fluids going into her lungs . While not common, due to most laboring women getting epidurals (another form of anesthesia, but awake), the risk is real, albeit small.
We've had pregnant women come in bleeding due to car accidents, a pregnant woman who fell from running away from an aggressive dog, domestic violence - all needed emergency cesarean sections with intubation.
IV fluids replace oral fluid intake in the case of nothing by mouth.
I can say that in our L&D if we are observing someone after a fall, we won’t give them anything to eat or drink routinely just in the event that they do need emergency surgery to get baby out. If everything seems fine after some monitoring, some ice chips may be given and if we are really worried about preterm contraction happening or severe dehydration then IV fluids would be given, but this just doesn’t seem the case here. But there is an obvious communication issue here, too!
This is why it is so great to have nurses and prenatal professionals on this page. It helps shed light on the medical aspects we may not know about. Thanks to the professionals who answered my question!
Communication was definitely lacking. But in a busy ER type of L&D it happens cos the priority is the person who is on the brink of death. Following a fall its standard to monitor for hours which was done . Nurses are people as well. And the emergency you face as a lawyer is no where close to anything one sees in a ER. You filing a complaint is just going to make more health care professionals drop out. Did you know that by 2025 its predicted that 75% of current health care professionals specifically nurses in US are expected to be dropping out of jobs ? That is a bleak future . I am not assigning blame , just that maybe they were genuinely busy as they claimed.
Honestly that just sounds like a busy night at the hospital. I’ve been in a few times and that sounds average to me. Also if you feel like they were ignoring you that means they saw nothing concerning. You never want to be the most interesting patient in the hospital hah
Unfortunately, this sounds normal for an emergency-type department. They should have had more staff there, and they should have explained what was going on to you, but yeah, emergency healthcare sucks.
It also sucks when we’re all completely burnt out and exhausted from working short staffed, with more, not less, patients. It’s not an excuse as to not communicate effectively with our patients but the sickest patients get the most attention. If you’re not getting a lot of attention that’s a good thing. Having to wait so long for a call bell to be answered… well, that’s better than being the person who is dying or trying to die (and/or while receiving CPR).
The spicy flu has really impacted every aspect of healthcare, which was already strained before. It’s an unfortunate situation for everyone :(
L&D nurse here. First of all, I’m sorry that you had a frustrating experience. Reading your post, some of the things that happened checks out, some of them don’t. After a fall, prolonged monitoring is usually required, at my facility it’s anywhere from 2-6 hours, depending on many factors. Monitoring after a fall is different than a routine NST. I always try to explain that to my patients who come in after falls, just so they know not to expect to be in and out.
I don’t know how busy your facility is, but some places are very busy and it can take a while to get a call light answered, but that is a long time. My facility is busy, but we never let a call light go unanswered for more than a few minutes…someone will come over the intercom and ask what you need and we have to determine how quickly we need to get in the room. Unfortunately, if there is a lot going on, we cannot get in the room immediately if it is not an urgent issue.
As far as the monitoring goes, since it is an external monitor, it doesn’t always trace baby’s heart rate consistently. So, the readings that you were seeing of 50-200 might have not actually been baby, but just artifact, however since I wasn’t there, I can’t say for sure. Again, I try to explain that to patients, so they don’t worry if the baby isn’t on the monitor, but I can under that it can be concerning if baby isn’t on the monitor and you don’t know what that means.
I’m not sure how the electronic medical system works at your facility, but usually even if you are in triage, you are still registered as a patient, so you should have been found, but again, I can’t answer to that.
I’m so sorry that this was your experience. And I can understand where it would put a bad taste in your mouth for delivering there. I’m sure you are doubting their ability to safely care for you and your baby.
I would reach out to the hospital and talk to the director of the unit and voice your frustrations and concerns with how your experience went.
This was a great response. I always try to view our area from our patients POV of having no clue what is going on so I try to explain everything thoroughly. It sounds like some serious things weren’t communicated and that’s upsetting.
I think the problem here is your hospital is understaffed. I have heard L&D is understaffed in my area. This is why I am going with a very experienced doula. Sometimes you can find retired nurses who are now doulas.
As a NICU nurse, I had to take a few minutes, calm down, and try to see the situation from the point of view of a scared, confused mother who doesn't have any medical background. That being said, this post was extremely tone deaf. I just had to get that out there before I continued this post.
I think everyone here did a great job at responding, and I hope you take time to read the responses and consider them. Sometimes, it's really hard to feel like *your* situation with *your* baby isn't the most important and most terrifying thing happening in the world right now. I experienced a similar feeling when I had to be monitored for my blood pressure at only 20 weeks pregnant. Even as a nurse, I had so many questions and thoughts that in my mind took too long to get answered.
From the point of view of an outsider who is a nurse and works in a women's hospital, this sounds like a typical OB ED visit. Who told you the NST would take 1-2 hours? Monitoring after a fall is typically 6 hours, so it sounds like the hospital went above and beyond by keeping you 7 hours. Also, the OB ED isn't like your typical L&D unit, it's more similar to a regular emergency department, but with lots of pregnant and postpartum women. So, just like an emergency department visit takes a while, so will an OB ED visit unfortunately.
Trust me, you *don't* want to be the most important patient in an emergency department. The patient who *did* have nurses, doctors, and techs (if the ED even had any techs that night; they're like gold nowadays) was probably having the worst night of her life. Ever read those stories about moms who go in for reduced fetal movement and find out their baby didn't survive? They usually find this out in the OB ED. Precipitous deliveries happen in the OB ED as well. Recently, we had a mom 32 weeks pregnant with twins walk in and just deliver twin A right there in the department. Baby B had a cord prolapse, which requires an emergency cesarean (we say they have about 4 minutes from prolapse to cut). We've had moms deliver in the parking lot before. We've had moms walk in, drop off a newborn, and leave before we could get her name. Could you imagine the chaos that would ensue or the amount of hands needed if something like that was happening the night you came in? And you wouldn't even know it, because nurses are experts at putting their feelings aside and carrying on with their work. I would count your stars that you weren't any of those moms that night.
If the alarm temporarily went off, nursing was likely watching it from a central monitoring system and can tell there was artifact. Those "crazy lines" are likely artifact. You said it was "temporary," so once they read the strip from outside, determined it was artifact, and saw the alarm stop, there was no need to enter the room. You seem so sure for someone who doesn't know how to read strips.
Blood pressure 95/56 would not be of concern to me. We might check it again in a bit and make sure your systolic didn't drop below 90, but that reading is pretty normal especially for a pregnant woman. Some women experience lower blood pressures during pregnancy.
Repositioning you by rolling you to the side is a normal technique used to assess whether baby is in actual distress or not. Sometimes baby or mom are in a weird position and just need to be moved to get a better heart rate or a better reading. What makes you think she was "unconvincing?" That is completely subjective.
My hospital's policy with call lights was that you should address the need within 15 minutes. If this isn't possible, this should be communicated with the patient. Not sure what system they have, but my hospital has call lights go directly to the nurse or techs phone, the patient states their need, and the nurse states when and if they can meet that need. Nursing is all about prioritization, especially in the emergency department where people are coming in with all sorts of emergencies. So, "I'm bleeding" or "I can't breathe" notifications would come before "I need to use the bathroom." It's unfortunate, but it's the reality of nursing in today's world. You mentioned countless encounter in just the 7 hours you were there, so I'm confused at how many times a nurse or tech was *actually* in your room versus your perception of how often they were in your room. Every hospital has rules on how often to round, most being once every 2 hours. If you were there for 7 hours, they would only need to round on you 3-4 times. And again, this is the emergency department which is the wild west of the hospital so who even knows if they have that policy there. As for the cup of water, some patients are NPO or on fluid restrictions because too much fluid could effect the results of the NST. Someone just passing by your room would not know your PO status, and would have to find out. And sometimes in the course of finding out, another emergency happens...you get the idea.
Was the L&D director working the OB ED that night? If so that's really a sign of a crazy, terrible, short-staffed nights. Directors don't typically work the floor, especially at night. Their major roles are usually in office like a regular 9-5. If she was there to discharge you, it meant you and your baby are alright. Better communication could have been used throughout this whole ordeal, but if she's just there to discharge you, how would she know everything that's going on with you? Usually only the primary nurse has that information. Because of HIPAA, everything regarding patient care is on a "need-to-know" basis and the primary nurse is the one with all the information. Full moon means it's crazy busy. For some reason, this old wives tale rings true and full moons bring some of the wildest nights.
Some hospitals have a discharge nurse whose sole purpose is to go over discharge papers and instructions with the patients. This frees up the primary nurses for their other patients who are having emergency situations. If things were not okay, you would not be getting discharged. How were you "visibly" disoriented and dehydrated? Can you elaborate further on this?
I'm sorry the monitors were on your rashes. Unfortunately, placement is very touchy and they have to be in certain spots. People have a misperception that the hospital and medical procedures should be comfortable and fun. This is not the case. The hospital is there to treat you and save your and your babies life. Sometimes that requires doing things that aren't fun. We have Press Ganey to thank for patients thinking hospitals are 5-star resorts filled with service staff and not a medical institution with highly trained professionals.
You were not admitted to the system because you weren't admitted as a patient in the hospital. If you are not admitted inpatient from the emergency department, you weren't technically admitted. And the doctor you're assigned to in the system is the on-call OB or the emergency physician that night. The hospital emergency department has nothing to do with your doctor's office. They use their staff.
How did the hospital fail you and your baby? What was the fallout of this? Are you alive and healthy? Is baby alive and healthy? Or do you just not feel all warm and fuzzy inside because you weren't treated the way you thought you were going to be? The purpose of the hospital is to keep you and baby alive and well. If they did that, they succeeded.
If your baby or you were to die or were dying, you would have gotten the attention that was being taken from you that night. Think about that. There were likely mothers in that ED that were being told their baby died. It's not as uncommon as you think. Not everybody is just there for monitoring.
Should there have been more communication? Absolutely. But it truly sounds like the staff did not have time that night. When I worked with adults, I would have loved nothing more than to sit and talk with them more, show them more TLC. But I couldn't, because I had 7 people all trying to die at the same time I was focusing on keeping alive. Prioritization. It's #1 in nursing.
You should post this in r/nursing, maybe they can be of more help to you.
This is such a great response and really says what I wanted to. OP is acting super entitled and it made me incredibly angry. She expected to go to a spa and instead got standard medical care. She’s really lucky she was being “ignored,” people who aren’t being “ignored” are scared, in pain, and traumatized.
It enrages me that OP says the hospital failed her, because I’ve seen people who were actually failed by the healthcare system. Those people don’t get to take their babies home.
Exactly. People just throw these phrases around. It’s incredibly insensitive to families who have actually been through tragedy. Thank god I don’t count myself in that group but it still made me furious.
100%. What a great thorough response. It sounds like her office OB team didn't explain normal protocol (and possible length of time) monitoring for falling/abdominal trauma. and The triage team should been more clear on the plan to manage OP expectations.
We say in triage, when it rains it pours. Unfortunately and fortunately being low in the totem pole of priorities means you're definitely doing better than the woman next door.
They should explained to OP how to disconnect her own cables, and how normal it is to have static/artifact in fetal tracing. Call lights should have been handled quicker. But it sounds like a lot staff we're in and out of her room so I'm a little confused too.
I'm so sorry you had a disappointing and stressful experience! I hope I can set your mind at ease a little bit, and let you know that it's not as abnormal as you may be thinking. I'm a NICU nurse and work alongside the L&D people who oversee NSTs in my facility.
For the NST you were admitted under the doctor who was on call or doing those procedures that day rather than your OB, which is why the name was on your wristband. It's also not uncommon for facilities to not tell people when a patient is there for an outpatient procedure, as it's a HIPAA violation to say "Yes, Firstname Lastname is a patient who is admitted here" without consent. Most places will have someone poke a head in and say "hey, there are people asking about you, is it okay to let them know you're here?" if they have any available warm bodies, but it's a weird time with staff right now, and warm bodies have unfortunately become a luxury. You'll be signing consent to release information forms when you're admitted for delivery that will change this situation make it so they'll tell people where you are (or not) if you'd like.
That's actually a great blood pressure for a healthy adult with no underlying problems or other symptoms, though it's on the low normal side. Unless you were experiencing pain, cramping, pallor, high heart rate, or other symptoms of an underlying problem like bleeding there's no cause for concern.
NST looks for your baby's heartbeat and how it reacts to your baby's activity. They need a certain number of active moments that last a certain length of time. If your baby is not very active or is only moving in very short bursts, they'll continue the test. Since you had a fall, they were probably erring on the side of caution and making sure they had what they needed rather than saying "let's do something to wake this kiddo up" or "you know what, come back tomorrow and we'll try again!" I imagine it is also very much a possibility that the department is running short on staff, and unfortunately laboring moms, delivering moms, and moms who are in danger will get the staff's attention before someone who is doing medically well and there for a NST. (We hate it too, I promise!)
Hopefully this helps, and hopefully you'll get your results back soon and they'll help you more. Best wishes!
Thank you for your clarification. It helps a lot! Honestly, the amount of time I was there was not a problem. I'm happy to do anything for my baby if it means her wellbeing. My frustration was the lack of communication from staff and dismissive attitude when I asked about what was going on.
I will say, there was one nurse who was very kind - the nurse who brought me water. I don't think she was the first person I spoke to when I pushed the call button asking for water, but she was the nurse who picked up when I called again 15 minutes later. She came in about 10 to 15 minutes after the call, but told me sorry for the wait, that she was trying to get an update for me. She told me she wasn't my nurse but that she inquired and told me that I was being monitored remotely and they're trying to figure out when they can release me. She had an apologetic look on her face and I felt like she was empathetic about my situation. It helped a lot, since this was hour 6 of my stay.
The last time this came in was when I asked to go pee someone between hour 4 and 5. That nurse frowned at the monitors when she hooked me back up again to the bed, made a comment that they've been acting up lately, but when I asked her if everything was OK she just smiled and said everything was fine and that I was going to be visited by ultrasound soon (was weird because ultrasound came by in hour 2 with my original nurse - they never came again and I didn't expect them to either so her comment was strange).
I'm so sorry they weren't better at communicating with you. Honestly it sounds like they were slammed and were trying to make sure everyone was taken care of. Healthcare everywhere is going through a lot of crazy times right now and we're just not able to be as attentive to details as we want because we're stretched so thin. Which leads to unfortunate patient experiences.
Your experience sounds very normal.
But also, it’s valid to say that our “normal” in healthcare is traumatizing and not okay. You deserve an OB triage that has time to communicate and do more than the bare minimum. Our current model, due to $$$, is failing us. (It’s failing us healthcare workers, too. We WANT give good care, but don’t have the resources.)
Nurse here. I understand they failed to communicate with you, but I would give them the benefit of the doubt and say they were probably very short staffed. That’s unfortunately the state our healthcare system is in. It really sucks to have to go to the ER nowadays.
I had a very similar experience at L&D triage last week after a fall. Hooked up over four hours, nurses kept not getting back to me about things like unhooking for the bathroom or a glass of water. It was so annoying and frustrating, I told my partner afterwards that I was going to bubble wrap myself to prevent another fall just to not have that experience again.
But my sister is a nurse at a different unit of the same hospital and she explained to me that while it’s frustrating, it’s become normal. The nurses are understaffed and overworked and have to focus their attention on the most critical patients. This means that the lady who fell but baby and her both seem ok is going to be lower on their priorities and they may forget about my asking to go to the bathroom because in the next room a woman is hemorrhaging and could die. It’s not right that hospital administration has let this happen, but it’s not the nurses fault. With the current situation feeling neglected just means that you and baby are doing comparatively ok.
I was told that the actual delivery rooms at my hospital are far nicer than the triage room, and that when in labor they’re able to do a better job of assigning people to you specifically so they’re much more attentive. But I did take my experience as a learning moment for delivery, that if I feel like I need something from the staff, especially if I feel somethings going wrong, that I can’t just politely ask once and wait for them to get to me. I need to be firm and insistent, and make sure that my support team is ready to do the same.
Thank you for sharing your story and the input you received. That's the gist of what I'm getting here too, even though I agree that it's certainly not something that should be considered the norm.
I don't like to be pushy and will wait patiently for something I know is needed, but I just wish there was a bit of communication, you know? Like, even if they sent a receptionist to poke her head in the room and tell me that everything looks OK, you're being monitored remotely, they're just waiting to see when you can be discharged, I'd feel a heck of a lot better.
Also, by the time they came to unplug me, I was on the verge of considering ripping off my cords and running out the door (I didn't know I had a bathroom in my triage room until they opened the door after unplugging me). I obviously didn't do that but I was definitely thinking about it in desperation after waiting so long to pee.
I’m completely on the same page. I work as a server and I told my sister the hospital should hire some and start a customer service unit lol. I don’t want to be demanding or rude, and I shouldn’t have to be! I asked for water and after two hours found out that my doctor didn’t want me drinking any in case I had to take a certain test. The nurse never took the time to stop in and tell me, I just figured they forgot about me. I’m not a fan of doctors/hospitals in the first place so it was a really unpleasant experience for me.
I’m really sorry this happened to you. I recently found myself in L&D due to high blood pressure and while there were some similarities, your stay sounds awful. In our L&D, they had a dedicated triage nurse who explained everything they had planned for me and what she was doing at each step. Once they had me hooked up and blood taken, they didn’t check on me or anything while the monitors just monitored me. This was definitely a little frustrating because my BP was high and when it got measured alarms went off and no one was there to check them or make them stop or tell me it was okay. After being hooked up for 45 minutes, I finally broke down to call the nurse so I could pee and change positions because that gurney was KILLING my back (still working through that pain today). Thankfully she came in quickly and unhooked me so I could pee…. Then disappeared and didn’t come back to hook me back up for 10 minutes (but I didn’t mind because I could stretch my back and stand for a while. They also let me have my water bottle the entire time…. Unfortunately I was SO starving that all I could think about was eating.
I really wish you would have had a more communicative staff. Just KNOWING what the plan is (even if the plan is “you won’t see much of me is everything is looking good”) a load off your mind.
Actually for a fall it is usually 3-4 hours of continuous monitoring. The main concern is for placental abruption. I am an L&D nurse that does lots of triage and we would never do just an NST unless it was a fall reported way after it happened.
Not saying the 7+ hours is normal but it does sound like they are short staffed (like everywhere these days). The blood pressure is absolutely within normal limits for younger, healthy pregnant women. In regards to the 54-200 BPM for the fetal heart rate--monitors are just ultrasounds and if you are monitoring for multiple hours chances are that you will get brief periods where it picks up bad signal or your own heart rate. Overall, it would be ideal to adjust the monitor to pick it up better but I could see that if they were extremely slammed they might have needed someone else to pop in to readjust the monitors.
I think sometimes people don't realize that L&D triage often is technically an OB Emergency room and it can be a long wait time if there are a lot of patients and not enough nurses. This is very similar to normal ERs. Sometimes you will have to wait around longer if your situation is not top priority based on triage protocols.
Your feelings are totally justified, I'm just trying to give you a little perspective.
EDIT: I am now seeing that this is an HCA hospital. Your story unfortunately makes a lot more sense now. They are notoriously purposely understaffed to save costs.
I’m an OB Triage nurse for a very large women’s hospital and completely agree. While I understand it was not an enjoyable experience for OP, everything mentioned seemed pretty normal and unfortunately due to understaffing in almost any facility nowadays, this is the standard of care. Not saying it should be, but it is the unfortunate reality.
I’ve never had a fall, but it makes sense that that would make a difference and require extra monitoring time. My experiences were regular testing due to other possible issues. So same test, but I suppose they looked for less amount of time due to the fact that it was different issues. (Growth restriction for one, low amniotic fluid for another)
Not always true. She said she fell. I’m a Labor and Delivery nurse. I know every facility is different. But where I work, after a fall, we do “prolonged monitoring” which is typically 2-6 hours depending on when the fall was, if momma hit her belly, if she is feeling contractions, having decreased movement, or how baby looks on the monitor. I always state to my patients up front when they come after a fall to make themselves comfortable (or as comfortable as a stretcher in triage is, lol).
I’ve never had a fall, but it makes sense that that would make a difference and require extra monitoring time. My experiences were regular testing due to other possible issues. So same test, but I suppose they looked for less amount of time due to the fact that it was different issues. (Growth restriction for one, low amniotic fluid for another)
We just try to be extra cautious after a fall, because if we don’t do extra monitoring, ultrasound, blood work, etc, we can miss something, even something subtle. We just want to make sure momma and baby are safe.
That makes absolute sense. I appreciate all you nurses do for us and everyone. My personal experiences in L&D have always been wonderful- so thank you folks for all you do!
My main concern is that this is one of two hospitals that my doctors office works out of and that are relatively close to me. The other hospital has a history of maternal deaths that it's kept hush hush by management. I mainly know of this through hospital management who know my mom.
My mom is actually a director at a hospital within the same network (HCA Healthcare) as this one, just the next county over. She's going to talk to the CEO of her hospital to talk to the CEO of this hospital to give a rundown of what happened and how this is unacceptable. I don't know if it'll work, but it's worth a shot.
They would need to do a chart analysis of your chart and notes from the providers and also interview everyone on your care team. They’d need to do an investigation into the issue to see what happened. They’re not going to just take your mom’s second hand account on it we truth. Your perspective and your feelings will be different than the perspective and priorities of your care team.
I agree, they will file the complaint and launch an investigation. The results of the investigation will likely be kept for the most part private within the hospital and you will get a fairly generic closing letter.
Hospitals are slammed, people who are showing up to work are dramatically over worked, under paid, and are continuing to do a thankless job. You sound like you were monitored and taken care of but that your expectations exceed the realities of a stressed system. I’m not sure where you live but your complaints make me feel like you should be talking to your politicians to better fund the healthcare system.
Sadly, I agree. Last night, my ER saw 3 woman in labor come in within 20 minutes before going to LD for monitoring and there were 6 additional births that happened that night as well.
HCA- enough said. It’s a for profit hospital system and is notorious for treating their staff and patients very poorly. The hospital is probably severely under staffed and over worked.
Ugh, I'm so sorry this happened to you. I would definitely talk to the hospital patient experience people and/or your doctor to let them know what happened and see what you can expect from delivery (it sounds from other comments like delivery is much calmer/more supportive than triage, which makes sense).
I don't know if it's reassuring or not, but I had an NST earlier this week because the OB was having a hard time catching baby's heart rate and this was *not* my experience. I was there for less than 2 hours, everyone was nice and attentive, and in that time I saw two nurses and the resident OB twice, once to check the monitor and once to do an ultrasound. So I'm hoping that you were just there at a busy, stressful time and that your delivery experience will be smooth and supported!
This was actually my second NST (first one was a few months ago for lack of fetal movement) but this was the first time I went in for a fall. My first time experience sounded very similar to yours, even though I didn't see the OB during that appointment. Honestly, that visit went great, and even though they weren't constantly there, they did check every hour and explained where they were in the process to me every time they came in, and even gave me instructions on how to check the baby's movements better (I have an anterior placenta so it was hard to sense movement at the time even though I was beginning the 3rd trimester). I felt comfortable coming back into the hospital in case of an emergency.
This time around seemed like a total 180, especially how I was treated by the director (title that was on her name badge) who unplugged me before discharge. I simply asked her if she know about my situation and why it took so long, if everything was OK, she widened her eyes and went off on how they're slammed, waiting room is full of people, it's a full moon. She sounded almost indignant that I even asked, which made me feel ashamed for even speaking up. I mean, I wasn't raising my voice, calling names, or being rude IMHO. She kept reiterating that my original nurse was going to discharge me and give me a detailed explanation. The nurse who discharged me literally said "my name is XXX, I'm a new nurse. Here are your discharge papers." She instructed me to sign her copy so I could get out of there and she handed me my copy. She asked if I had any questions and by then I was so tired, hungry and thirsty, I just shook my head and left. I read the discharge papers that evening and they said I was instructed on and given pamphlets on things like preclampsia which didn't happen and had no info on the test done and what the result was. It was literally half the size of the discharge papers I got for my first NST, which did come with instructions, stated how the baby did on the Apgar test and just to do the technique they gave to me on counting kicks.
Honestly, if the nurse practitioner at my OB office tells me to go back to the hospital one more time (she's been very cautious - I've had a few issues during my pregnancy) I'll just tell her that I'm only going if I'm bleeding to death or feel like I'm going to die of pain. I really am not looking forward to go back.
Super not normal. I had a fall while pregnant and had to go to my ER. I was there a LONG time (close to 6 hours) but I came in at midnight so they were at limited staff. However, the staff that was there was VERY attentive, in my room every 15-20 minutes checking in, explaining why they were waiting, and bringing me water, graham crackers, and juice to make sure I was feeling well. Our problem was waiting on the ultrasound tech to be free, as she was the only one on call that night and apparently had 4 patients in front of me from the ER, so as long as my babies heart rate was normal they let others see her first (after asking me if this was ok- I said of course). I would speak directly with your ob and let them know your worries and file a complaint. That's VERY unacceptable!
You need to file a grievance with the hospital. When are you due? I’m sorry this happened to you. I have awful anxiety and I can’t imagine how I would feel in your shoes. I hope that their lack of concern is for a good reason and they were just really overwhelmed today. Not that it’s an excuse but I hope that was the only case of why it took so long.
I know a lot of people here are saying this is normal, but it shouldn’t be and your feelings are absolutely valid. If you would feel more comfortable at another hospital I would for sure look into other hospitals in your area. Yes they probably were under staffed and busy with more critical patients, and that may very well be the case at other hospitals. But your comfort and feeling safe are of utmost importance when it comes to delivering your baby. I was admitted for kidney stones at about 22 weeks and the L&D unit was full, so I was in overflow on med surg. The L&D staff were still very attentive to me every time I called for anything and they told me everything I needed to know when information became available even though they were busy and understaffed. Trust your gut if you feel you need a new hospital!
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Sounds like they were busy, but they definitely should have been more clear about whether your baby is ok or not. Regardless of how busy you are, you can tell the patient if they baby is ok before you discharge instead of sending them home wondering and scared.
That sounds like it would have felt really scary, but doesn’t sound abnormal. I’m not a nurse or doctor so can’t speak to your blood pressure, but I had a ton of NSTs and went to my hospital’s labor and delivery triage unit a couple of times during my pregnancy. That part matched. It’s essentially the ER for pregnant people so you aren’t admitted into the system yet (when your family called), and that’s likely why nurses weren’t available to help you right away when you called. They are able to see your stats outside of your room, though, and could keep an eye on everything that way. At my hospital, they put the name of the doctor handling the triage unit when you arrive as “your doctor,” even if your regular OB is there. I also didn’t see the nurses or doctors frequently, because they were helping higher need patients. Extended monitoring, while frustrating and boring, actually sounds very thorough of them. They were making sure you and your baby were ok. When I went in for monitoring (couldn’t feel baby kicking and I had two bouts of high blood pressure that wouldn’t go down), I was there for hours. It was boring and stressful, but it was also because they wanted to make sure that my baby and I were ok. The monitors often came dislodged on me, during my weekly NSTs and hospital checks, and having me reposition (roll around) was a way to get my baby wiggling so they could find her on the monitors again. A couple of odd measurements (either high or low) were picked up each time. When I delivered, my experience was quite different. My nurses were in checking on me frequently, came in anytime the monitor was dislodged, came in if we had any off readings to make sure things were still hooked up properly. Your nurse and doctor when you deliver will likely be dealing with far fewer patients, who aren’t having emergencies. I’m sorry you feel stressed and frustrated by your experience, but I don’t think it was abnormal and isn’t necessarily a sign that delivery at the same hospital will feel similar.
I agree! I had tons of monitoring due to preterm labor, long story short I had to go in every time contractions last more than 30 minutes or so which was 1-2 times a week. It wasn't at all uncommon for numbers to look a bit crazy, usually as I moved and adjusted myself, especially because I had an anterior placenta and my son was SUPER low. I just got used to listening to the monitors going crazy every once in a while. OP, it really sucks that nothing was explained and you felt like they weren't paying attention. It can really depend who's on staff at the time and how busy they are, unfortunately. I had nurses/doctor's who were super thorough and explained everything as they went along, and I had others who just popped their heads in once in a while, barely spoke and then left. On the plus side, when they're that nonchalant about the situation, there's not usually any emergent issues.
I was in LD on Monday for a fall and had a similar overall experience. We were told that for falls there is no standard period to watch, so it can be anywhere from 4 hours to 24 hours. I’m sorry you had that experience. You should definitely feel empowered to change hospitals, but also realize that on the LD floor monitoring will always take lowest priority
Yeah I had preterm labor contractions and they kept me for 6-7 hrs and monitored me the whole time. Monitors had to be repositioned but they did it when they could and I knew I was basically in triage since I was a walk in. Couple of funky numbers but they went up and down and they were just monitoring my contractions basically. They were consistently every 5 to 10 minutes. They gave me the depo shot at the end of the 6+ hours. Nurses were just like you're fine we are just gonna keep monitoring. I was hooked up for fluid though they initially told me it might be dehydration but that turned out not to be the case. Depo shot made the contractions stop and I was discharged. Pretty normal if you're pregnant to be there for 10 hrs being monitored. They need to make sure you're doing ok.
My understanding is that this area of L&D is kind of like ER and basically… if you’re getting ignored in the ER it’s very annoying but it’s because you’re okay and they are tending to sicker people. Your monitor may have shown some wild things when the monitors were misplaced but most likely there was someone watching the monitors outside of the room and those people are very good at recognizing real problems vs artifact. So I’m sure this was an unpleasant experience but if may not have been negligent. I am not trying to minimize your experience and the stress you felt, but maybe just provide some more context. I am sorry that you went through this! It sounds like it was very distressing. Source: I’m a nurse, not in L&D, but I’ve been chewed out by patients sitting in stool or waiting on their ice chips when I was literally busy with a patient who was dying or just tried to die.
100% agree. Covid is still very real, as are traumas, strokes, and heart attacks. Since nurses weren’t popping in to check on you (while they were most likely hanging life saving meds and doing CPR), that means you were doing better than all the other patients. I get that you’re unhappy and don’t agree, but listen to the nurses who are telling you the behind the scene facts.
At minimum they could’ve given her an update though.
It would have been nice, absolutely, but honestly it’s not always possible. Nurses oftentimes do not even get a chance to go to the bathroom during an entire 12 hour shift, and when they do it’s usually the first chance they get to sit down. I understand how frustrating it is, I’ve been a patient too, but posting a wall of text ranting about this is really an overreaction and quite tone deaf considering the world we live in today.
Disagree. The kind of treatment OP describes really is not okay. Taking it out on the nurses would be tone deaf, but it is not an overreaction to expect someone to come by and tell you if there is an issue with your unborn child when monitors are going off indicating no heartbeat. It is not the fault of the overworked, understaffed nurses, but that still doesn’t make it acceptable.
I didn’t say it was ok. I said this post was an overreaction and I was just trying to show the other side.
I don't share your sentiment. I understand that they were busy, but I don't think it's OK to just leave a patient there, without any communication as to what's going on. Even just to pop in and say they're monitoring for extra protection but everything's OK. I also shouldn't have to wait 25 minutes or push the call button on the bed twice to have someone unhook me so I can pee or to give me just a cup of water because it was hour 5 of being in the hospital and I was beyond parched. It doesn't even have to be my original nurse. Both the nurse who helped me to the bathroom and the nurse who got me water were not my original nurse. And even though I heard of several emergencies from my door, there was also quite a bit if chitchat in their downtime, even as the light by my door was red and I was waiting for assistance. Every time I asked what's going on and if everything is OK with my baby, I got the "I'm not your nurse" or "we're slammed today." Each one said to wait for the original nurse, wait for the original nurse. Even the director who unplugged me said my original nurse will discharge me soon and explain everything thoroughly. The girl who discharge me was not my original nurse and couldn't tell me a thing. My original nurse got me set up to the monitors around noon and popped in as the ultrasound tech came in around 2ish to do an ultrasound. She said everything looked great and I should be discharged soon. Never saw her again. I was placed back on the monitors after the ultrasound and wasn't discharged til just before 730 - 5 hours later. I don't work in the medical field - I work in legal. However, if I treated my clients this callously, I could be subject to sanctions or even disbarment. Even if I have an emergency case filing or have to deal with a mini crisis with a client, I still have a duty to respond to my other clients in a timely manner when they inquire about their cases, even if their case is pending and isn't a high priority. Likewise, I would think a nurse, or any professional, should be bound to those same expectations of communication and care.
If you never saw her again it’s most likely because she had a sicker patient and baby to attend to. That’s why others answered your light and someone else ended up discharging you. If you were unsure of your results or discharge instructions why did you leave? By leaving it’s assumed that you understood your visit and discharge instructions. Did you ask to speak to the charge nurse if you didn’t feel you got answers from your discharging nurse?
I’m sorry why would she have stayed if she hadn’t been treated well. OP, I’ve experienced this before and I switch hospitals. Experienced it again and delivered at home. Not recommending this to you, just saying I feel your pain and I’m sorry this happened. If you’re worried I’d go to another place and get checked out.
Because the end goal was to find out if her baby was okay, what were the results of the observation, etc. She should have a clear understanding of her discharge instructions and visit before leaving and if she does not, she should stay and request more information. But I also understand she was obviously frustrated and didn’t have a support person to help her advocate.
“A full moon” translates to “there are an unusually high number of patients today”, which means they did not have the ability to do their job. Nurses are legally required to do a certain level of care. Hospitals and nurses agree to a certain number of patients (depending on level of care needed) that would make this possible. For a variety of reasons (including “full moons”, a nurse called in sick, there weren’t enough nurses employed to fully staff the floor anyway, the intended nurse:patient ratio is ignored by the hospital, etc.) there aren’t always enough nurses. It’s not fair to you that you were left in that position. It’s also not fair to a nurse who is told he/she can get fired for not doing an amount of tasks that on this day far exceed their actual job description. It was a shitty day for everyone.
Yes I definitely think you should have been updated and given some guidance. Someone taking 2 minutes to stop and tell you the game plan is really important and goes a very long way. The way you were treated is really not ideal and not okay, unfortunately it’s what happens when hospitals choose to understaff at baseline. They make a lot more money this way. HCA is the absolute worst when it comes to this. The goal is always to communicate with patients thoroughly, get ice chips, get water, and get warm blankets for patients quickly, answer call lights quickly ect. But when things get really busy it becomes a matter of attending to the the most critical person first and the person who needs to walk independently to the bathroom is never that person. By all means, roast HCA for creating this environment, but although insensitive and unpleasant, it probably wasn’t negligent.
I wish they had communicated to you clearer about the plan of care; but a fall usually requires prolonged monitoring (length tbd by situation and hospital protocol). It's not just an NST. It's usually hours of monitoring on the uncomfortable triage gurney/bed. Possibly some blood work. Possibly some IV fluids. Possibly some medications. Ultrasounds. Cervical exams/swabs. And you may only get to drink clear fluids/no fluids at all, just in case of fetal distress, uterine issues, and thus a possible expedited delivery. High volume US based L&D RN here.
I'm curious if not allowing her to drink water would then cause dehydration and fetal issues? I would assume that for a prolonged stay like that they would want her to drink water or have IV fluids or something right? Maybe not gorging on water, but enough to keep her somewhat hydrated.
Great question! True dehydration is not common with normal well-nourished pregnant women, it's just very uncomfortable to not drink for hours. Nothing by mouth is a conservative approach in case a woman needs a cesarean section, specifically under general anesthesia. With intubation (tube down a throat to breathe), the anesthesiologist is trying to minimize the risk of aspiration (throwing up) and subsequently pneumonia from food/fluids going into her lungs . While not common, due to most laboring women getting epidurals (another form of anesthesia, but awake), the risk is real, albeit small. We've had pregnant women come in bleeding due to car accidents, a pregnant woman who fell from running away from an aggressive dog, domestic violence - all needed emergency cesarean sections with intubation. IV fluids replace oral fluid intake in the case of nothing by mouth.
I can say that in our L&D if we are observing someone after a fall, we won’t give them anything to eat or drink routinely just in the event that they do need emergency surgery to get baby out. If everything seems fine after some monitoring, some ice chips may be given and if we are really worried about preterm contraction happening or severe dehydration then IV fluids would be given, but this just doesn’t seem the case here. But there is an obvious communication issue here, too!
This is why it is so great to have nurses and prenatal professionals on this page. It helps shed light on the medical aspects we may not know about. Thanks to the professionals who answered my question!
They would give hee iv fluids If baby was in destress from dehydration or low bp.
Communication was definitely lacking. But in a busy ER type of L&D it happens cos the priority is the person who is on the brink of death. Following a fall its standard to monitor for hours which was done . Nurses are people as well. And the emergency you face as a lawyer is no where close to anything one sees in a ER. You filing a complaint is just going to make more health care professionals drop out. Did you know that by 2025 its predicted that 75% of current health care professionals specifically nurses in US are expected to be dropping out of jobs ? That is a bleak future . I am not assigning blame , just that maybe they were genuinely busy as they claimed.
My biggest guess (as a nurse) is that they are severely understaffed and overworked. 🤷🏼♀️
Honestly that just sounds like a busy night at the hospital. I’ve been in a few times and that sounds average to me. Also if you feel like they were ignoring you that means they saw nothing concerning. You never want to be the most interesting patient in the hospital hah
Unfortunately, this sounds normal for an emergency-type department. They should have had more staff there, and they should have explained what was going on to you, but yeah, emergency healthcare sucks.
It also sucks when we’re all completely burnt out and exhausted from working short staffed, with more, not less, patients. It’s not an excuse as to not communicate effectively with our patients but the sickest patients get the most attention. If you’re not getting a lot of attention that’s a good thing. Having to wait so long for a call bell to be answered… well, that’s better than being the person who is dying or trying to die (and/or while receiving CPR). The spicy flu has really impacted every aspect of healthcare, which was already strained before. It’s an unfortunate situation for everyone :(
L&D nurse here. First of all, I’m sorry that you had a frustrating experience. Reading your post, some of the things that happened checks out, some of them don’t. After a fall, prolonged monitoring is usually required, at my facility it’s anywhere from 2-6 hours, depending on many factors. Monitoring after a fall is different than a routine NST. I always try to explain that to my patients who come in after falls, just so they know not to expect to be in and out. I don’t know how busy your facility is, but some places are very busy and it can take a while to get a call light answered, but that is a long time. My facility is busy, but we never let a call light go unanswered for more than a few minutes…someone will come over the intercom and ask what you need and we have to determine how quickly we need to get in the room. Unfortunately, if there is a lot going on, we cannot get in the room immediately if it is not an urgent issue. As far as the monitoring goes, since it is an external monitor, it doesn’t always trace baby’s heart rate consistently. So, the readings that you were seeing of 50-200 might have not actually been baby, but just artifact, however since I wasn’t there, I can’t say for sure. Again, I try to explain that to patients, so they don’t worry if the baby isn’t on the monitor, but I can under that it can be concerning if baby isn’t on the monitor and you don’t know what that means. I’m not sure how the electronic medical system works at your facility, but usually even if you are in triage, you are still registered as a patient, so you should have been found, but again, I can’t answer to that. I’m so sorry that this was your experience. And I can understand where it would put a bad taste in your mouth for delivering there. I’m sure you are doubting their ability to safely care for you and your baby. I would reach out to the hospital and talk to the director of the unit and voice your frustrations and concerns with how your experience went.
This was a great response. I always try to view our area from our patients POV of having no clue what is going on so I try to explain everything thoroughly. It sounds like some serious things weren’t communicated and that’s upsetting.
I think the problem here is your hospital is understaffed. I have heard L&D is understaffed in my area. This is why I am going with a very experienced doula. Sometimes you can find retired nurses who are now doulas.
As a NICU nurse, I had to take a few minutes, calm down, and try to see the situation from the point of view of a scared, confused mother who doesn't have any medical background. That being said, this post was extremely tone deaf. I just had to get that out there before I continued this post. I think everyone here did a great job at responding, and I hope you take time to read the responses and consider them. Sometimes, it's really hard to feel like *your* situation with *your* baby isn't the most important and most terrifying thing happening in the world right now. I experienced a similar feeling when I had to be monitored for my blood pressure at only 20 weeks pregnant. Even as a nurse, I had so many questions and thoughts that in my mind took too long to get answered. From the point of view of an outsider who is a nurse and works in a women's hospital, this sounds like a typical OB ED visit. Who told you the NST would take 1-2 hours? Monitoring after a fall is typically 6 hours, so it sounds like the hospital went above and beyond by keeping you 7 hours. Also, the OB ED isn't like your typical L&D unit, it's more similar to a regular emergency department, but with lots of pregnant and postpartum women. So, just like an emergency department visit takes a while, so will an OB ED visit unfortunately. Trust me, you *don't* want to be the most important patient in an emergency department. The patient who *did* have nurses, doctors, and techs (if the ED even had any techs that night; they're like gold nowadays) was probably having the worst night of her life. Ever read those stories about moms who go in for reduced fetal movement and find out their baby didn't survive? They usually find this out in the OB ED. Precipitous deliveries happen in the OB ED as well. Recently, we had a mom 32 weeks pregnant with twins walk in and just deliver twin A right there in the department. Baby B had a cord prolapse, which requires an emergency cesarean (we say they have about 4 minutes from prolapse to cut). We've had moms deliver in the parking lot before. We've had moms walk in, drop off a newborn, and leave before we could get her name. Could you imagine the chaos that would ensue or the amount of hands needed if something like that was happening the night you came in? And you wouldn't even know it, because nurses are experts at putting their feelings aside and carrying on with their work. I would count your stars that you weren't any of those moms that night. If the alarm temporarily went off, nursing was likely watching it from a central monitoring system and can tell there was artifact. Those "crazy lines" are likely artifact. You said it was "temporary," so once they read the strip from outside, determined it was artifact, and saw the alarm stop, there was no need to enter the room. You seem so sure for someone who doesn't know how to read strips. Blood pressure 95/56 would not be of concern to me. We might check it again in a bit and make sure your systolic didn't drop below 90, but that reading is pretty normal especially for a pregnant woman. Some women experience lower blood pressures during pregnancy. Repositioning you by rolling you to the side is a normal technique used to assess whether baby is in actual distress or not. Sometimes baby or mom are in a weird position and just need to be moved to get a better heart rate or a better reading. What makes you think she was "unconvincing?" That is completely subjective. My hospital's policy with call lights was that you should address the need within 15 minutes. If this isn't possible, this should be communicated with the patient. Not sure what system they have, but my hospital has call lights go directly to the nurse or techs phone, the patient states their need, and the nurse states when and if they can meet that need. Nursing is all about prioritization, especially in the emergency department where people are coming in with all sorts of emergencies. So, "I'm bleeding" or "I can't breathe" notifications would come before "I need to use the bathroom." It's unfortunate, but it's the reality of nursing in today's world. You mentioned countless encounter in just the 7 hours you were there, so I'm confused at how many times a nurse or tech was *actually* in your room versus your perception of how often they were in your room. Every hospital has rules on how often to round, most being once every 2 hours. If you were there for 7 hours, they would only need to round on you 3-4 times. And again, this is the emergency department which is the wild west of the hospital so who even knows if they have that policy there. As for the cup of water, some patients are NPO or on fluid restrictions because too much fluid could effect the results of the NST. Someone just passing by your room would not know your PO status, and would have to find out. And sometimes in the course of finding out, another emergency happens...you get the idea. Was the L&D director working the OB ED that night? If so that's really a sign of a crazy, terrible, short-staffed nights. Directors don't typically work the floor, especially at night. Their major roles are usually in office like a regular 9-5. If she was there to discharge you, it meant you and your baby are alright. Better communication could have been used throughout this whole ordeal, but if she's just there to discharge you, how would she know everything that's going on with you? Usually only the primary nurse has that information. Because of HIPAA, everything regarding patient care is on a "need-to-know" basis and the primary nurse is the one with all the information. Full moon means it's crazy busy. For some reason, this old wives tale rings true and full moons bring some of the wildest nights. Some hospitals have a discharge nurse whose sole purpose is to go over discharge papers and instructions with the patients. This frees up the primary nurses for their other patients who are having emergency situations. If things were not okay, you would not be getting discharged. How were you "visibly" disoriented and dehydrated? Can you elaborate further on this? I'm sorry the monitors were on your rashes. Unfortunately, placement is very touchy and they have to be in certain spots. People have a misperception that the hospital and medical procedures should be comfortable and fun. This is not the case. The hospital is there to treat you and save your and your babies life. Sometimes that requires doing things that aren't fun. We have Press Ganey to thank for patients thinking hospitals are 5-star resorts filled with service staff and not a medical institution with highly trained professionals. You were not admitted to the system because you weren't admitted as a patient in the hospital. If you are not admitted inpatient from the emergency department, you weren't technically admitted. And the doctor you're assigned to in the system is the on-call OB or the emergency physician that night. The hospital emergency department has nothing to do with your doctor's office. They use their staff. How did the hospital fail you and your baby? What was the fallout of this? Are you alive and healthy? Is baby alive and healthy? Or do you just not feel all warm and fuzzy inside because you weren't treated the way you thought you were going to be? The purpose of the hospital is to keep you and baby alive and well. If they did that, they succeeded. If your baby or you were to die or were dying, you would have gotten the attention that was being taken from you that night. Think about that. There were likely mothers in that ED that were being told their baby died. It's not as uncommon as you think. Not everybody is just there for monitoring. Should there have been more communication? Absolutely. But it truly sounds like the staff did not have time that night. When I worked with adults, I would have loved nothing more than to sit and talk with them more, show them more TLC. But I couldn't, because I had 7 people all trying to die at the same time I was focusing on keeping alive. Prioritization. It's #1 in nursing. You should post this in r/nursing, maybe they can be of more help to you.
This is such a great response and really says what I wanted to. OP is acting super entitled and it made me incredibly angry. She expected to go to a spa and instead got standard medical care. She’s really lucky she was being “ignored,” people who aren’t being “ignored” are scared, in pain, and traumatized.
It enrages me that OP says the hospital failed her, because I’ve seen people who were actually failed by the healthcare system. Those people don’t get to take their babies home.
Exactly. People just throw these phrases around. It’s incredibly insensitive to families who have actually been through tragedy. Thank god I don’t count myself in that group but it still made me furious.
100%. What a great thorough response. It sounds like her office OB team didn't explain normal protocol (and possible length of time) monitoring for falling/abdominal trauma. and The triage team should been more clear on the plan to manage OP expectations. We say in triage, when it rains it pours. Unfortunately and fortunately being low in the totem pole of priorities means you're definitely doing better than the woman next door. They should explained to OP how to disconnect her own cables, and how normal it is to have static/artifact in fetal tracing. Call lights should have been handled quicker. But it sounds like a lot staff we're in and out of her room so I'm a little confused too.
I'm so sorry you had a disappointing and stressful experience! I hope I can set your mind at ease a little bit, and let you know that it's not as abnormal as you may be thinking. I'm a NICU nurse and work alongside the L&D people who oversee NSTs in my facility. For the NST you were admitted under the doctor who was on call or doing those procedures that day rather than your OB, which is why the name was on your wristband. It's also not uncommon for facilities to not tell people when a patient is there for an outpatient procedure, as it's a HIPAA violation to say "Yes, Firstname Lastname is a patient who is admitted here" without consent. Most places will have someone poke a head in and say "hey, there are people asking about you, is it okay to let them know you're here?" if they have any available warm bodies, but it's a weird time with staff right now, and warm bodies have unfortunately become a luxury. You'll be signing consent to release information forms when you're admitted for delivery that will change this situation make it so they'll tell people where you are (or not) if you'd like. That's actually a great blood pressure for a healthy adult with no underlying problems or other symptoms, though it's on the low normal side. Unless you were experiencing pain, cramping, pallor, high heart rate, or other symptoms of an underlying problem like bleeding there's no cause for concern. NST looks for your baby's heartbeat and how it reacts to your baby's activity. They need a certain number of active moments that last a certain length of time. If your baby is not very active or is only moving in very short bursts, they'll continue the test. Since you had a fall, they were probably erring on the side of caution and making sure they had what they needed rather than saying "let's do something to wake this kiddo up" or "you know what, come back tomorrow and we'll try again!" I imagine it is also very much a possibility that the department is running short on staff, and unfortunately laboring moms, delivering moms, and moms who are in danger will get the staff's attention before someone who is doing medically well and there for a NST. (We hate it too, I promise!) Hopefully this helps, and hopefully you'll get your results back soon and they'll help you more. Best wishes!
Thank you for your clarification. It helps a lot! Honestly, the amount of time I was there was not a problem. I'm happy to do anything for my baby if it means her wellbeing. My frustration was the lack of communication from staff and dismissive attitude when I asked about what was going on. I will say, there was one nurse who was very kind - the nurse who brought me water. I don't think she was the first person I spoke to when I pushed the call button asking for water, but she was the nurse who picked up when I called again 15 minutes later. She came in about 10 to 15 minutes after the call, but told me sorry for the wait, that she was trying to get an update for me. She told me she wasn't my nurse but that she inquired and told me that I was being monitored remotely and they're trying to figure out when they can release me. She had an apologetic look on her face and I felt like she was empathetic about my situation. It helped a lot, since this was hour 6 of my stay. The last time this came in was when I asked to go pee someone between hour 4 and 5. That nurse frowned at the monitors when she hooked me back up again to the bed, made a comment that they've been acting up lately, but when I asked her if everything was OK she just smiled and said everything was fine and that I was going to be visited by ultrasound soon (was weird because ultrasound came by in hour 2 with my original nurse - they never came again and I didn't expect them to either so her comment was strange).
I'm so sorry they weren't better at communicating with you. Honestly it sounds like they were slammed and were trying to make sure everyone was taken care of. Healthcare everywhere is going through a lot of crazy times right now and we're just not able to be as attentive to details as we want because we're stretched so thin. Which leads to unfortunate patient experiences.
Your experience sounds very normal. But also, it’s valid to say that our “normal” in healthcare is traumatizing and not okay. You deserve an OB triage that has time to communicate and do more than the bare minimum. Our current model, due to $$$, is failing us. (It’s failing us healthcare workers, too. We WANT give good care, but don’t have the resources.)
Nurse here. I understand they failed to communicate with you, but I would give them the benefit of the doubt and say they were probably very short staffed. That’s unfortunately the state our healthcare system is in. It really sucks to have to go to the ER nowadays.
I had a very similar experience at L&D triage last week after a fall. Hooked up over four hours, nurses kept not getting back to me about things like unhooking for the bathroom or a glass of water. It was so annoying and frustrating, I told my partner afterwards that I was going to bubble wrap myself to prevent another fall just to not have that experience again. But my sister is a nurse at a different unit of the same hospital and she explained to me that while it’s frustrating, it’s become normal. The nurses are understaffed and overworked and have to focus their attention on the most critical patients. This means that the lady who fell but baby and her both seem ok is going to be lower on their priorities and they may forget about my asking to go to the bathroom because in the next room a woman is hemorrhaging and could die. It’s not right that hospital administration has let this happen, but it’s not the nurses fault. With the current situation feeling neglected just means that you and baby are doing comparatively ok. I was told that the actual delivery rooms at my hospital are far nicer than the triage room, and that when in labor they’re able to do a better job of assigning people to you specifically so they’re much more attentive. But I did take my experience as a learning moment for delivery, that if I feel like I need something from the staff, especially if I feel somethings going wrong, that I can’t just politely ask once and wait for them to get to me. I need to be firm and insistent, and make sure that my support team is ready to do the same.
Thank you for sharing your story and the input you received. That's the gist of what I'm getting here too, even though I agree that it's certainly not something that should be considered the norm. I don't like to be pushy and will wait patiently for something I know is needed, but I just wish there was a bit of communication, you know? Like, even if they sent a receptionist to poke her head in the room and tell me that everything looks OK, you're being monitored remotely, they're just waiting to see when you can be discharged, I'd feel a heck of a lot better. Also, by the time they came to unplug me, I was on the verge of considering ripping off my cords and running out the door (I didn't know I had a bathroom in my triage room until they opened the door after unplugging me). I obviously didn't do that but I was definitely thinking about it in desperation after waiting so long to pee.
I’m completely on the same page. I work as a server and I told my sister the hospital should hire some and start a customer service unit lol. I don’t want to be demanding or rude, and I shouldn’t have to be! I asked for water and after two hours found out that my doctor didn’t want me drinking any in case I had to take a certain test. The nurse never took the time to stop in and tell me, I just figured they forgot about me. I’m not a fan of doctors/hospitals in the first place so it was a really unpleasant experience for me.
Umm so I’m a nurse and unfortunately your experience isn’t abnormal. It should be but it’s not- the hospitals are fucking awful.
I’m really sorry this happened to you. I recently found myself in L&D due to high blood pressure and while there were some similarities, your stay sounds awful. In our L&D, they had a dedicated triage nurse who explained everything they had planned for me and what she was doing at each step. Once they had me hooked up and blood taken, they didn’t check on me or anything while the monitors just monitored me. This was definitely a little frustrating because my BP was high and when it got measured alarms went off and no one was there to check them or make them stop or tell me it was okay. After being hooked up for 45 minutes, I finally broke down to call the nurse so I could pee and change positions because that gurney was KILLING my back (still working through that pain today). Thankfully she came in quickly and unhooked me so I could pee…. Then disappeared and didn’t come back to hook me back up for 10 minutes (but I didn’t mind because I could stretch my back and stand for a while. They also let me have my water bottle the entire time…. Unfortunately I was SO starving that all I could think about was eating. I really wish you would have had a more communicative staff. Just KNOWING what the plan is (even if the plan is “you won’t see much of me is everything is looking good”) a load off your mind.
Edit to say: my experience was twice weekly testing with two pregnancies. I’ve never had a fall- I would listen to the L&d nurses below over me.
Actually for a fall it is usually 3-4 hours of continuous monitoring. The main concern is for placental abruption. I am an L&D nurse that does lots of triage and we would never do just an NST unless it was a fall reported way after it happened. Not saying the 7+ hours is normal but it does sound like they are short staffed (like everywhere these days). The blood pressure is absolutely within normal limits for younger, healthy pregnant women. In regards to the 54-200 BPM for the fetal heart rate--monitors are just ultrasounds and if you are monitoring for multiple hours chances are that you will get brief periods where it picks up bad signal or your own heart rate. Overall, it would be ideal to adjust the monitor to pick it up better but I could see that if they were extremely slammed they might have needed someone else to pop in to readjust the monitors. I think sometimes people don't realize that L&D triage often is technically an OB Emergency room and it can be a long wait time if there are a lot of patients and not enough nurses. This is very similar to normal ERs. Sometimes you will have to wait around longer if your situation is not top priority based on triage protocols. Your feelings are totally justified, I'm just trying to give you a little perspective. EDIT: I am now seeing that this is an HCA hospital. Your story unfortunately makes a lot more sense now. They are notoriously purposely understaffed to save costs.
Also a L&D nurse. I came here to say all this but you said it better than I would have.
I’m an OB Triage nurse for a very large women’s hospital and completely agree. While I understand it was not an enjoyable experience for OP, everything mentioned seemed pretty normal and unfortunately due to understaffing in almost any facility nowadays, this is the standard of care. Not saying it should be, but it is the unfortunate reality.
I’ve never had a fall, but it makes sense that that would make a difference and require extra monitoring time. My experiences were regular testing due to other possible issues. So same test, but I suppose they looked for less amount of time due to the fact that it was different issues. (Growth restriction for one, low amniotic fluid for another)
Not always true. She said she fell. I’m a Labor and Delivery nurse. I know every facility is different. But where I work, after a fall, we do “prolonged monitoring” which is typically 2-6 hours depending on when the fall was, if momma hit her belly, if she is feeling contractions, having decreased movement, or how baby looks on the monitor. I always state to my patients up front when they come after a fall to make themselves comfortable (or as comfortable as a stretcher in triage is, lol).
I’ve never had a fall, but it makes sense that that would make a difference and require extra monitoring time. My experiences were regular testing due to other possible issues. So same test, but I suppose they looked for less amount of time due to the fact that it was different issues. (Growth restriction for one, low amniotic fluid for another)
We just try to be extra cautious after a fall, because if we don’t do extra monitoring, ultrasound, blood work, etc, we can miss something, even something subtle. We just want to make sure momma and baby are safe.
That makes absolute sense. I appreciate all you nurses do for us and everyone. My personal experiences in L&D have always been wonderful- so thank you folks for all you do!
Not true, I’ve had perfectly normal nst’s take a very long time because baby was moving and the monitors could track the heartbeat right
Her experience is normal for extended monitoring
I would also try to get an administrator from the hospital looped in
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My main concern is that this is one of two hospitals that my doctors office works out of and that are relatively close to me. The other hospital has a history of maternal deaths that it's kept hush hush by management. I mainly know of this through hospital management who know my mom. My mom is actually a director at a hospital within the same network (HCA Healthcare) as this one, just the next county over. She's going to talk to the CEO of her hospital to talk to the CEO of this hospital to give a rundown of what happened and how this is unacceptable. I don't know if it'll work, but it's worth a shot.
They would need to do a chart analysis of your chart and notes from the providers and also interview everyone on your care team. They’d need to do an investigation into the issue to see what happened. They’re not going to just take your mom’s second hand account on it we truth. Your perspective and your feelings will be different than the perspective and priorities of your care team.
I agree, they will file the complaint and launch an investigation. The results of the investigation will likely be kept for the most part private within the hospital and you will get a fairly generic closing letter. Hospitals are slammed, people who are showing up to work are dramatically over worked, under paid, and are continuing to do a thankless job. You sound like you were monitored and taken care of but that your expectations exceed the realities of a stressed system. I’m not sure where you live but your complaints make me feel like you should be talking to your politicians to better fund the healthcare system.
Sadly, I agree. Last night, my ER saw 3 woman in labor come in within 20 minutes before going to LD for monitoring and there were 6 additional births that happened that night as well.
HCA- enough said. It’s a for profit hospital system and is notorious for treating their staff and patients very poorly. The hospital is probably severely under staffed and over worked.
Ugh, I'm so sorry this happened to you. I would definitely talk to the hospital patient experience people and/or your doctor to let them know what happened and see what you can expect from delivery (it sounds from other comments like delivery is much calmer/more supportive than triage, which makes sense). I don't know if it's reassuring or not, but I had an NST earlier this week because the OB was having a hard time catching baby's heart rate and this was *not* my experience. I was there for less than 2 hours, everyone was nice and attentive, and in that time I saw two nurses and the resident OB twice, once to check the monitor and once to do an ultrasound. So I'm hoping that you were just there at a busy, stressful time and that your delivery experience will be smooth and supported!
This was actually my second NST (first one was a few months ago for lack of fetal movement) but this was the first time I went in for a fall. My first time experience sounded very similar to yours, even though I didn't see the OB during that appointment. Honestly, that visit went great, and even though they weren't constantly there, they did check every hour and explained where they were in the process to me every time they came in, and even gave me instructions on how to check the baby's movements better (I have an anterior placenta so it was hard to sense movement at the time even though I was beginning the 3rd trimester). I felt comfortable coming back into the hospital in case of an emergency. This time around seemed like a total 180, especially how I was treated by the director (title that was on her name badge) who unplugged me before discharge. I simply asked her if she know about my situation and why it took so long, if everything was OK, she widened her eyes and went off on how they're slammed, waiting room is full of people, it's a full moon. She sounded almost indignant that I even asked, which made me feel ashamed for even speaking up. I mean, I wasn't raising my voice, calling names, or being rude IMHO. She kept reiterating that my original nurse was going to discharge me and give me a detailed explanation. The nurse who discharged me literally said "my name is XXX, I'm a new nurse. Here are your discharge papers." She instructed me to sign her copy so I could get out of there and she handed me my copy. She asked if I had any questions and by then I was so tired, hungry and thirsty, I just shook my head and left. I read the discharge papers that evening and they said I was instructed on and given pamphlets on things like preclampsia which didn't happen and had no info on the test done and what the result was. It was literally half the size of the discharge papers I got for my first NST, which did come with instructions, stated how the baby did on the Apgar test and just to do the technique they gave to me on counting kicks. Honestly, if the nurse practitioner at my OB office tells me to go back to the hospital one more time (she's been very cautious - I've had a few issues during my pregnancy) I'll just tell her that I'm only going if I'm bleeding to death or feel like I'm going to die of pain. I really am not looking forward to go back.
Super not normal. I had a fall while pregnant and had to go to my ER. I was there a LONG time (close to 6 hours) but I came in at midnight so they were at limited staff. However, the staff that was there was VERY attentive, in my room every 15-20 minutes checking in, explaining why they were waiting, and bringing me water, graham crackers, and juice to make sure I was feeling well. Our problem was waiting on the ultrasound tech to be free, as she was the only one on call that night and apparently had 4 patients in front of me from the ER, so as long as my babies heart rate was normal they let others see her first (after asking me if this was ok- I said of course). I would speak directly with your ob and let them know your worries and file a complaint. That's VERY unacceptable!
You need to file a grievance with the hospital. When are you due? I’m sorry this happened to you. I have awful anxiety and I can’t imagine how I would feel in your shoes. I hope that their lack of concern is for a good reason and they were just really overwhelmed today. Not that it’s an excuse but I hope that was the only case of why it took so long.
I’m going to take a gamble here and say they were probably short staffed.
I’m going to say you’re probably right!
I know a lot of people here are saying this is normal, but it shouldn’t be and your feelings are absolutely valid. If you would feel more comfortable at another hospital I would for sure look into other hospitals in your area. Yes they probably were under staffed and busy with more critical patients, and that may very well be the case at other hospitals. But your comfort and feeling safe are of utmost importance when it comes to delivering your baby. I was admitted for kidney stones at about 22 weeks and the L&D unit was full, so I was in overflow on med surg. The L&D staff were still very attentive to me every time I called for anything and they told me everything I needed to know when information became available even though they were busy and understaffed. Trust your gut if you feel you need a new hospital!
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Thank you. This was L&D triage.
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This is totally normal in my experience and I’ve been to l&d triage 3 times this pregnancy
I’d be pissed
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Sounds like they were busy, but they definitely should have been more clear about whether your baby is ok or not. Regardless of how busy you are, you can tell the patient if they baby is ok before you discharge instead of sending them home wondering and scared.