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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.
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?
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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.
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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!
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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.
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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.
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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.
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(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.)
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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?
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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.
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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.
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I can't remember a time when Tres picked a "good" time to engage in philosophical interrogation.
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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?
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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.
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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.
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Yeah. My kids would FREAK OUT if a parent was not in the room when they woke up from surgery.
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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.
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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.
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posted
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.]
Posts: 14017 | Registered: May 2000
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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.
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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.
Posts: 9866 | Registered: Apr 2002
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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.)
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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.
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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.)
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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.
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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?
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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.
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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.
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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.
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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".
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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.
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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.)
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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.
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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.
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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.
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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.
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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.
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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. 
