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Risky Behaviors in the Labor & Delivery Room

by Katlyn Joy | August 12, 2013 12:00 AM0 Comments

As if there weren't enough to worry about, a new study about to be published in the American Journal of Obstetrics & Gynecology finds that nearly 90 percent of doctors and nearly 100 percent of nurses observed risky behavior or shortcuts that could compromise patient safety in the delivery room.

The study questioned 3200 doctors, midwives and nurses about behaviors such as not washing hands or changing gloves, or other behaviors that revealed either a lack of respect for coworkers or an inability to perform their job properly.

More concerning, 77 percent of the nurses, 60 percent of the midwives and two-thirds of the doctors believed that the behavior they saw constituted a risk to patient safety, had actually harmed patients or led them to consider changing jobs. As if that weren't disturbing enough, this wasn't about events over the course of their career in the delivery room but about circumstances which occurred over the last year.

However, very few of the study participants approached the errant party stating it was out of concern that the person would become even harder to work with, or because they didn't want to have conflict in front of a patient.

A number of the participants did state that they spoke to a manager about the problem or incident later, but knew in many cases that nothing was done afterwards to address or correct the problem.

Audrey Lyndon, a study researcher and associate professor at the University of California, San Francisco School of Nursing, said, "We need to take these kinds of problems seriously, and put energy behind ensuring that we have a psychologically safe, healthy work environment," where people feel comfortable speaking up."

One problem may be the traditional hierarchy in the medical field in general where doctors will not be called into question by other staffers seen as subordinates to them, such as nurses or midwives. Some participants in the study referred to a disrespect and unwillingness to listen to or consider the concerns of nurses or midwives even though they were the ones actually witnessing the problems or providing the hands-on care.

Another issue is the perpetual time crunch facing health care professionals like nurses. It's also hard to confront or question a colleague in front of a patient, but it can be difficult to find face time later with a doctor.

One of the study researchers was VitalSmarts LC, a company that makes training material for improving corporate culture and interpersonal communication. The study was done via survey, which researchers believed would make participants more likely to be open about such matters.

What does this mean for the patient? According to RID, a committee to Reduce Infection Deaths, you need to be proactive to protect yourself and of course in the case of an expectant mom, the baby.

- Ask any doctor, nurse or midwife to wash their hands before beginning any examination.

- Ask the physician to wipe down the stethoscope diaphragm with alcohol.

- Request that should surgery be required the surgery site not be shaved, since tiny nicks in the skin are prime locations for infection to get in.

- Always ask questions and don't settle for a complicated answer that is over your head as a layman. Get clarification until you understand what is happening.

- Don't be afraid to get a second opinion.

- Be an informed patient. Have intelligent questions about procedures being considered by reading up ahead of time.

- Know your own medical history and make sure every health care provider knows it. Never assume your history is shared amongst professionals.

- Always keep a list of your current medications and allergies. Tell everyone who treats you to read the list before treating you.

- If anything concerns you, stop the action and get a handle on things. You have a right to know what is happening to you and your child.

- It's not rude to speak up for yourself. It's your life and your child's.

- Expect professionals to treat you professionally, never allow curt replies or condescending attitudes to cower you. Having a medical degree is not a license to be abusive or unprofessional ever.

Katlyn Joy is a mother to 7 children, and a freelance writer. She earned her Master of Arts in Creative Writing and Poetry, and a Bachelor of Arts in English and was previously an adviser to new mothers on breastfeeding through a maternity home program. She currently resides in Colorado with her family.

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