Aerin has been scheduled for an MRI in preparation for her upcoming surgery. Since she's so young, she'll be sedated. Because of HIPAA, there are now 2 recovery rooms at the hospital. One is a regular recovery room and one is a step-down recovery room. Family members are not allowed in the first recovery room to protect patients' privacy. This is the room where the patients wake up. They are transferred when they are alert.
So my poor little baby has to wake up from anesthesia, scared, woozy, and in pain, without her mother. I'm so sad and furious and just beside myself. I would gladly trade away all of my privacy rights to spare Aerin the additional fear and pain of waking up without me. She should not have to go through that - she's going to suffer enough. I have calls in to my surgeon, pediatrician, and the anesthesiologist to see if an exception can be made somehow (maybe they'll take her straight to step-down). The nurses were as nice as could be and very sympathetic, so I think there's a good chance.
It makes me sick to think of all the children who have to wake up without their parents after they've already been through an ordeal. Is protecting patient privacy worth this? Not to me. Not today.
[ August 03, 2007, 03:33 PM: Message edited by: Mrs.M ]
Posted by Xaposert (Member # 1612) on :
quote:would gladly trade away all of my privacy rights to spare Aerin the additional fear and pain of waking up without me.
But the question is, would you really give up all of your daughter's medical privacy rights just so she doesn't have to wake up without you in this one instance?
Posted by Javert Hugo (Member # 3980) on :
Note the username: that's Tres's devil's advocate face.
I hope you find a resolution - it's essential that you be there when your baby wakes up.
Posted by Mrs.M (Member # 2943) on :
quote:would you really give up all of your daughter's medical privacy rights just so she doesn't have to wake up without you in this one instance?
Absolutely. And my husband's and my mother's and anyone else's if it would let me ease her pain and fear.
And since this is the same hospital, it will likely be the same situation with her surgery.
Posted by Noemon (Member # 1115) on :
Both times I've been under general anesthesia I've been way too out of it when I've come to to really be aware of who was and wasn't around me, if that's any consolation.
Posted by hansenj (Member # 4034) on :
Same here...but then, I was a teenager, not a baby. I bet they'll make an exception in your case, Mrs. M. I think they should make a policy where mothers can be in the first recovery room if the child is under a certain age!
Posted by Dagonee (Member # 5818) on :
Noemon, that's the same for me, but Mrs.M says patients are transferred "when they are alert," which means there will be some time when Aerin could benefit from her mother's presence but won't be able to.
I doubt it's actually a choice between HIPAA and the ability for babies to wake up with their mothers so much as a choice between this particular way of complying with HIPAA and the ability for babies to wake up with their mothers. Which isn't very comforting in this situation, but means it's likely that they can do something about it if they choose to do so.
Posted by ketchupqueen (Member # 6877) on :
This is a sad misinterpretation of HIPAA, to me; I think that parents should have the right to be with minor children evey step of the way that's not in a sterile environment (and you might look into that; there may be a way they can put her in a private room or something.)
But I have to say that I am glad that my children's medical records are private, so when DCFS decides to snoop into them, the doctor and clinic and hospital refuse to give them up without a court order.
Posted by Belle (Member # 2314) on :
If hospitals were really serious about patient privacy, then they would not keep medical charts still out in the hallways where any passerby could take one and read it, and they would not still have semi-private rooms. Unless it's changed since I was last admitted - but I kinda doubt it.
So, they instead enforce silly rules like this one but don't make a change on something so blatantly obvious as actually ensuring patients have private rooms because that will hit them on the bottom line.
Posted by ketchupqueen (Member # 6877) on :
(And I know it won't give you any comfort to know that you are right, but when I came out of anesthesia I WAS aware of who was there, and that my mom was holding my hand. I was 12. I think it would be beneficial for both of you for you to be there.)
Posted by Xaposert (Member # 1612) on :
quote:Absolutely. And my husband's and my mother's and anyone else's if it would let me ease her pain and fear.
What if it would ease her pain and fear right now, but would cause her far greater pain and fear later in life?
Posted by Dagonee (Member # 5818) on :
Maybe this isn't the best time to engage in a philosophical interrogation of a mother who's upset about not being able to be with her baby after surgery.
Posted by BlackBlade (Member # 8376) on :
quote:Originally posted by Dagonee: Maybe this isn't the best time to engage in a philosophical interrogation of a mother who's upset about not being able to be with her baby after surgery.
This man speaks the truth.
I pray that if ulimately you are not allowed to be with your daughter, that she will come to with her wits about her and her bravery intact.
I was extremely loopy when I came out of general anesthesia, I took on the characteristics of a broken record and kept asking my mother "Why wasn't the surgery done?" She assured me it had been and almost immedietly I fell asleep again. I did that 3 times before I was deemed alert enought to be taken home.
I probably slept another 4-5 hours after being taken home.
Posted by romanylass (Member # 6306) on :
I am so sorry...that seems wrong. Poor little Aerin.
Posted by FlyingCow (Member # 2150) on :
I can't remember a time when Tres picked a "good" time to engage in philosophical interrogation.
Posted by Xaposert (Member # 1612) on :
Hmmm... neither can I, for that matter.
Posted by Valentine014 (Member # 5981) on :
This makes me sick. This was not how HIPAA was supposed to be. It was meant to protect private information from nosy people who have no right to it, not to keep a mother from her toddler post-surgery. I am really angry about this. I hope you fight them on this. Personally, I'd threaten to contact a lawyer (or actually do it) and see if this isn't really poor interpretation of the act. Have they forgotten about your daughter's other rights? Doesn't she have the right to be with her mother as soon as possible after the surgery is over?
Posted by BannaOj (Member # 3206) on :
Isn't Mrs. M's husband a lawyer?
AJ
Posted by Synesthesia (Member # 4774) on :
Dood, it's a child. A toddler. Aren't the parents already aware of the child's medical issues? I say push them to let you have the right to be with your baby when she wakes up. There should be exceptions to these sort of rules.
quote:What if it would ease her pain and fear right now, but would cause her far greater pain and fear later in life?
I doubt this would be the case. The opposite would be true.
Posted by Dagonee (Member # 5818) on :
Synthesia, they're almost certainly worried about the privacy of other patients in the room.
Posted by Synesthesia (Member # 4774) on :
Ok, that makes sense... But a child shouldn't wake up alone after surgery though...
Posted by Dagonee (Member # 5818) on :
I totally agree.
Posted by ElJay (Member # 6358) on :
She wouldn't wake up alone. She'd wake up with nurses instead of her mother.
Still not good, but the way you phrased it makes it sound much worse than it is.
Posted by Dagonee (Member # 5818) on :
I know babies for whom that would be worse - they handle being alone better than being near strangers. So it's better than a baby with no one to care for her, but it's not comforting to the baby, which is what MrsM is worried about.
Posted by ketchupqueen (Member # 6877) on :
Yeah. My kids would FREAK OUT if a parent was not in the room when they woke up from surgery.
Posted by Icarus (Member # 3162) on :
This was not the case when my daughter had surgery a couple months or so ago. I mean, I didn't see her until she was in the step-down room, not the recovery room, but she was still asleep when she got to the step-down room. (And she also awoke asking why the surgery had not been done yet!) She was not alert for a good-sized while after she was brought to me.
Posted by Artemisia Tridentata (Member # 8746) on :
quote:This makes me sick. This was not how HIPAA was supposed to be. It was meant to protect private information from nosy people who have no right to it,
It's even worse than that. The "LAW" was written to prevent an employeer from using medical information when making an employment decision. All the rest of the mess is the bureaucratic "interpretation" of the law. The cost of compliance is phenomenal and as it is unfunded, represents a tax on everyone of us.
Posted by BlackBlade (Member # 8376) on :
quote:(And she also awoke asking why the surgery had not been done yet!)
Glad to see its a trend of some sort and not solely a result of my wiring.
Posted by ClaudiaTherese (Member # 923) on :
This has always been the policy in all hospitals I have worked (or been cared for as a patient) in, even before HIPAA came into being. That includes my open heart surgery as a child -- only medical professionals were permitted in the immediate recovery room, with parents in the step-down room. I believe this was because many things need to be done in immediate recovery which are often upsetting to non-professionals (removal of various tubes, etc.) and there is more of a potential for emergent cardiac resuscitation, etc.
I know it seems like parents should be there even through that, if you love your child, but many many people react in unexpected ways and make it difficult to access and care for all the patients. I think this was what has driven hospital policy where I worked prior to HIPAA.
I wonder if it has just become easier to blame it on "federal law" than on "hospital policy"?
Regardless, you and Aerin will be in my thoughts, Mrs. M. I hope she does well and that it is over quickly for all of you.
---
Edited to add: It seems to be rare to remember anything of substance from immediate recovery. The patients are still usually very groggy by the time they get to stepdown. I remember two things: one was having my feet hurt where they were flat on the bed, and I pointed to them; the other was taking a gasp after they pulled out the breathing tube. Both of these memories are for less than two seconds or so.
[For context: I have been under general anesthesia for 6 procedures in my life, but two were only cardiac catheterizations. The others were actual surgeries.]
Posted by Bob_Scopatz (Member # 1227) on :
I work with HIPAA restrictions quite a bit. My advice on this is to argue it with them. As others have said, the letter of the law is not anywhere nearly as restrictive as what many in health care interpret it to be. That's because they all live in fear of the dreaded "fines and penalties." But, HIPAA is not a reason for them to set up situations where a minor child is not accessible to her parents.
There may be medical or liability reasons, but those can be either understood or argued on their own merits.
What I find is a lot of institutions and government agencies hiding their restrictions under a blanket known as HIPAA so they don't have to explain them or have them make logical sense to the people involved. "Sorry, it's a Federal offense if we do x."
Well...no, often it isn't
I don't really know why they would exclude parents from the 1st stage of recovery. I can guess at reasons, some of them actually pretty reasonable from a hospital's perspective. But ultimately, I don't think HIPAA has any bearing on this policy, despite what they're telling you.
You might want to get a copy of the law from the Federal Register. It's an interesting read in spots, but mostly very boring.
Posted by dkw (Member # 3264) on :
I did part of my chaplaincy internship in a children's hospital (pre- HIPAA). That hospital had recently changed their policy to allow parents to be with their children immediately following surgery, in the ER trauma rooms, and during attempted resuscitations. The only rule was that someone from the hospital but not part of the medical team needed to be with the parent if it was a "code" situation in case they needed assistence. Generally that would be the chaplain or a social worker.
This was considered quite a progressive policy -- my understanding was that it was more usual for parents to be removed from the room during any "scary" stuff.
Posted by ketchupqueen (Member # 6877) on :
Yeah, hospitals like to do that-- the first hospital I delivered a baby at (Presbyterian of Dallas) even made my husband leave the room while I had my epidural put in. (Despite promising me that he could be there through the whole thing, and would never have to leave me.)
I was not a happy camper. (The hospital I delivered my second at just had a policy that husbands must be sitting in a chair if they remained in the room, in case they fainted.)
Posted by CaySedai (Member # 6459) on :
ketchupqueen: I insisted that my husband leave the room during the administration of my epidural during my first labor - and he didn't. Then when the anaethesiologist (sp?) hit a nerve and I screamed, it was his own fault he was there. I tried to warn him.
It's odd to me that one hospital insists that no nonmedical personnel be present in the recovery room so that other patients' privacy is not compromised, while another hospital (the one in our area) has no problem with me accompanying my husband into the presurgery waiting room where I could see other patients waiting for surgery, and their relatives could see my husband and me. I've also accompanied my husband and each of my children, as well as my mom (twice) in the ER and seen other patients and overheard what was being discussed in those cases.
Mrs. M: It seems to me that it would be common sense to let you be with Aerin after she wakes up from her MRI for her comfort.
Posted by rivka (Member # 4859) on :
quote:Originally posted by ClaudiaTherese: This has always been the policy in all hospitals I have worked (or been cared for as a patient) in, even before HIPAA came into being. That includes my open heart surgery as a child -- only medical professionals were permitted in the immediate recovery room, with parents in the step-down room. I believe this was because many things need to be done in immediate recovery which are often upsetting to non-professionals (removal of various tubes, etc.) and there is more of a potential for emergent cardiac resuscitation, etc.
It certainly was the case when I had my appendix out, and that was over 20 years ago. Then again, I don't really remember much of either room, although I do have a vague memory of wanting my mother, and then she was there. (I think it is far more likely that I had been moved than she had, although that's not how it seemed to fuzzy me at the time.)
Posted by ketchupqueen (Member # 6877) on :
See, my mom was a nurse who worked for Kaiser (where I was having my procedure done.) They were going to let her be in the operating room, too, but they didn't get her the correct form and at the last minute she was not allowed.
So maybe that's why it was different for me. But I do remember being in one recovery room, and my mom standing behind the nurses who were checking my vitals (they were probably getting ready to move me), then the next time I opened my eyes, I thought it had only been a few seconds, but two hours had passed and I was in a different room-- then I closed my eyes just for a second and the next time I opened them ANOTHER two hours had passed.
But I'll agree, I was only conscious for about half a second of being in the first room, and I only have one memory from when I was Aerin's age-- so I doubt she would remember that split second for long.
Posted by Dagonee (Member # 5818) on :
quote:This has always been the policy in all hospitals I have worked (or been cared for as a patient) in, even before HIPAA came into being. That includes my open heart surgery as a child -- only medical professionals were permitted in the immediate recovery room, with parents in the step-down room.
This has been the policy at both the surgeries I've had and the ones I've waited for others at, but in all 4 cases the patient was in the step-down room (assuming that's the room people are allowed to be in) well before alertness.
Does that vary from hospital to hospital?
Posted by JennaDean (Member # 8816) on :
quote:Originally posted by ketchupqueen: Yeah, hospitals like to do that-- the first hospital I delivered a baby at (Presbyterian of Dallas) even made my husband leave the room while I had my epidural put in. (Despite promising me that he could be there through the whole thing, and would never have to leave me.)
I was not a happy camper. (The hospital I delivered my second at just had a policy that husbands must be sitting in a chair if they remained in the room, in case they fainted.)
Yeah, I can see why they'd need that policy. Hubby was holding me up while they put the epidural in, and he saw a tube with a drop of blood on the end of it, and told the nurse: "You'll have to hold her!" and just barely made it to a chair. After that I sent him out of the room when I had epidurals, and let my mom help me. She's tough.
Hubby's great in every other way, but he's not good with blood.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Dagonee: ... in all 4 cases the patient was in the step-down room (assuming that's the room people are allowed to be in) well before alertness.
Does that vary from hospital to hospital?
I think there may a difference between medical and non-medical persons' use of the word "alert," as well.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Artemisia Tridentata: The "LAW" was written to prevent an employeer from using medical information when making an employment decision. All the rest of the mess is the bureaucratic "interpretation" of the law.
There is actually much more to the Act itself than this. I'm not sure if this is the time and place to go into it, though.
Posted by JennaDean (Member # 8816) on :
I haven't read ALL of it, but from everything I can gather, it was meant to protect private medical information. Not to keep parents from knowing about their child's medical condition or being able to be with them if they're not awake.
I'm of the camp that believes there may be other legitimate reasons for them to not want non-medical people in that first recovery room, but it's not prohibited by HIPAA. It may be just easier for them to blame it on "gov't regulations".
Posted by sndrake (Member # 4941) on :
quote: Aerin has been scheduled for an MRI in preparation for her upcoming surgery. Since she's so young, she'll be sedated. Because of HIPAA, there are now 2 recovery rooms at the hospital. One is a regular recovery room and one is a step-down recovery room. Family members are not allowed in the first recovery room to protect patients' privacy. This is the room where the patients wake up. They are transferred when they are alert.
This policy almost killed a friend of ours. She has post-polio syndrome and uses a ventilator at night - she will suffocate in her sleep without it.
She went into a local hospital for some surgery. In the recovery room - against the orders the attending physician allegedly left - our friend was disconnected from the vent because she was "coming out" of anesthesia. Breathing while reclining is difficult. She can't move her arms much and she was unable to speak.
So she spent a lot of time in that bed, struggling for air, knowing if she lost consciousness she'd never wake up. Finally, she got *someone's* attention who seemed to be on the ball.
I expect that if she has to go in for surgery again, she'll *demand* a family member be present in the recovery room, considering what happened last time.
Posted by Scott R (Member # 567) on :
Mrs M:
Good luck to you and your daughter.
All:
This is what I like about Hatrack.
Posted by ketchupqueen (Member # 6877) on :
Jenna, that's funny.
My husband was a vet tech for 7 years, he used to assist in surgery and all kinds of things. A big needle doesn't scare him.
I was in too much pain (being on 12 units of pitocin at the time) to argue with them. (Much.)
He tried but he tends to be pretty non-confrontational. (After it was all there we had a talk about how he was there to be my advocate since I couldn't do it myself, and what I would like to happen if the situation ever arises again.)
Posted by Dagonee (Member # 5818) on :
quote:I think there may a difference between medical and non-medical persons' use of the word "alert," as well.
Very possible.
Artemisia, there's much, much, much more to HIPAA than that. There's even much more to just the portion of HIPAA that covers privacy.
Posted by Icarus (Member # 3162) on :
CT, are you still checking your PMs over at Sakeriver?
Posted by Shigosei (Member # 3831) on :
Mrs. M, I wish Aerin and your family the best with her MRI and surgery. I hope you're able to find a way to be with her when she wakes up.
I found this thread very interesting, and now I've got some good things to keep in mind if I ever undergo surgery.
Posted by larisse (Member # 2221) on :
Mrs. M, I am wishing the very best for Aerin throughout her MRI and her surgery.
I hope they do allow you to be with her as she wakes up. She is a tough little girl, and I am sure she will do fine, but nothing compares to having a loved one be there when you wake up from something like that.
Is it possible that a nurse that Aerin is very familiar with can be there when she wakes up if they end up not letting you be there? It isn't much of a solution, but perhaps it would ease some anxieties.
Posted by Wendybird (Member # 84) on :
Mrs.M continue pushing to be with your child. We have never been denied being by Stephen's side after any sedation or surgery since he was born. Different hospitals have different policies. Does your doc work with a different hospital that will allow you to be there?
Prayers for you and your family.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Icarus: CT, are you still checking your PMs over at Sakeriver?
I haven't checked in over there in some time. Did you need to reach me about something?
---
Edited to add: email sent
Posted by Belle (Member # 2314) on :
I'm in the camp that says keep pushing, of course, but if it turns out that you can't be there, don't let it get to you so much that you pass along unneeded anxiety to Aerin. More than likely, she will remember nothing of the first recovery room - heck, after my major surgery when I diagnosed with cancer I lost two whole days.
Aerin knows her Mom and Dad love her, and will be there for her. A few minutes in a recovery room without them won't affect that.
If it makes you feel any better, my oldest two both had to have tubes in their ears for chronic ear infections. They were carried away from me by a nurse while I stayed in a waiting area, put to sleep, the procedure done, then brought back to me by the same nurse. They were both awake when the nurse brought them back, but neither was crying or upset. Rather, they were groggily looking around, and slipping in and out of consciousness. I'm certain they had no memory of waking without me.
Posted by Eaquae Legit (Member # 3063) on :
I had a general anaesthetic for my wisdom teeth. I was apparently "awake" before they let my mother into the room, but I don't remember it at ALL. Which is odd, given my reactions to drugs (I metabolise them very rapidly).
Posted by andi330 (Member # 8572) on :
I didn't realize that was standard policy. When I had an upper endoscopy recently, my driver was allowed to sit with me in recovery. Nobody even mentioned it. She wasn't even related to me.
Posted by ClaudiaTherese (Member # 923) on :
"Recovery" from an endoscopy essentially is stepdown, I think.
Posted by Dagonee (Member # 5818) on :
quote:Originally posted by ClaudiaTherese: "Recovery" from an endoscopy essentially is stepdown, I think.
OK, that makes the difference in lay v. medical usage of "alert" much clearer. I've had endoscopies, and if everything that happens after that is part of the "alert" phase then I doubt Aerin will be aware prior to the stepdown room.
(I'm assuming the difference is between general anesthesia and the happy drugs you get with endoscopies.)
Posted by mackillian (Member # 586) on :
With the surgery I had at the end of May, I wasn't alert until I was in step-down. However, it took me a bit of time to come out of it and I know I heard the nurse comment to Nathan that I must be a cheap date.
I also flipped off Nathan somewhere in between the IV sedative they gave me right before the interscalene block and the actual put-you-to-sleep IV. But I don't remember said flip-off because once the anesthesiologist started the first IV, all I remember is him starting to walk to the other side of the bed, and then bam! I was waking up in step-down.
o_O
Mrs. M, I hope you can get the hospital to let you be with your daughter from recovery to step-down. Posted by Mrs.M (Member # 2943) on :
Thank you so much for all the prayers and good wishes. I shouldn't have just ranted and then abandoned the post, but it's been a hectic summer.
Good news! I'll just cut and paste from my blog.
quote:I just spoke to the MRA Department at St. Mary's and I feel better. They will allow me to stay with Aerin until they put her under and they will let me into the recovery room the second she shows the slightest sign of waking up. They'll even put the Pedialyte in her own sippy cup. The nurse could not have been more helpful and reassuring. She even gave me her direct number if I have any more questions.
I'm glad everything turned out all right. I wasn't around when you made the initial post (bad stuff going on in early July) but I just want to say that I ran into a problem with HIPPA when I had my son. They said we couldn't be in the nursery with him if there were other babies in there with him. Well, I think they were full of **** because we had almost gone to another hospital which specifically said we could be with our child at ALL times no matter what. They wanted to keep taking him away from me to go on the warmer. (Something I wasn't happy about, either, to be honest.) When it came time to circumcise him, we absolutely INSISTED On being there with him through the whole thing. They gave us a lot of grief (it was a lousy hospital...definitely going somewhere else next time) and eventually they took the other babies out and put them in the hallway where anyone could see them to protect them from our prying eyes while we were with our son!!!
Privacy is important, but some interpretations of this law go over the top. One of these days it would be nice if we could use some common sense.
P.S. I went under general anesthesia on the 4th of July (part of my lousy beginning of the month) and came out fairly quickly. I was very glad my husband was there when I woke up.
Posted by JenniK (Member # 3939) on :
I say yay to Mrs. M that she is able to be with her little one. As I understand it, they are mostly concerned about other patients' privacy. It would seem silly to try to keep a minor child's privacy from her parent as the parent makes all medical decisions for the child, at least I would find that a silly practice.
As for the "aware" business, every surgery I have had I have woken up in recovery completely aware (and usually in pain) of what was going on around me. The last time involved having an impacted wisdom tooth removed. As I have a fear of needles and the sight of my own blood, they had to knock me out. The problem this time is that I woke up in the middle of the procedure and saw the Dr putting a silver instrument into my mouth and felt an inordinate amount of pain. I remember the technician (assistant or whatever you wanna call her) telling me it would be ok (this helped as I had gone to school with her from grammar through high school), then they upped the dose of whatever sedative they had given me and I woke up after the procedure was completed. The nurse woke me and told me some instructions as she was getting ready to take me to what I presume is "step down" recovery where my sister was waiting. She told me that she would repeat it all to my sister as I would not remember anything she had said due to the anesthesia....needless to say I remembered EVERYTHING she had said and was aware of everything going on. I did not fall back asleep, and when she came to change the gauze pad in my mouth I screamed and almost (but not quite) fainted at the sight of all of that blood that had come from my mouth. So you see, it really depends on the patient and the situation as to whether they will be aware or not upon waking. ( of course I also remember the Dr in the recovery room when I had my tonsils taken out telling the nurse that he wanted to keep me overnight instead of as an out patient as he was concerned that my throat might hemorrhage, before being taken to a room where my mom was waiting. The next day a few hours after being sent home, it did in fact do exactly that!)
I am very glad to hear that Mrs. M will be able to be there so that her child will not be as frightened of the goings on around her as I was upon recovery. God bless and I will pray for an easy procedure and recovery for Aerin.
![[Wink]](wink.gif)
Hubby was holding me up while they put the epidural in, and he saw a tube with a drop of blood on the end of it, and told the nurse: "You'll have to hold her!" and just barely made it to a chair. After that I sent him out of the room when I had epidurals, and let my mom help me. She's tough. ![[Frown]](frown.gif)
![[Smile]](smile.gif)