4 ms·

I wonder how much this correlates with socioeconomic status. When my kids were born, the hospital had this incredibly elaborate, incredibly detailed checklists

• ghostly_s 2y ago
  None of those checklist things are done out of an interest in care - it is about avoiding liability.
  • munificent 2y ago
    I don't understand the completely unnecessary cynicism in this comment. Do you really believe that everyone working in maternity wards in hospitals cares absolutely nothing about babies?
    • iamthepieman 2y ago
      But your not being taken care of by a person. Your being taken care of by the system. The nice nurse goes home in 3 hours, the nice doctor has 9 other patients. The secretary relies on the information in The computer. The people may very well care a lot. The system does not.
      • elgenie 2y ago
        Checklists have been demonstrated to improve care quality because when it's the not-so-nice nurse that's on shift, and the doctor's been awake for 60 hours straight, the stuff that's on the checklist still gets done.
        • deleted 2y ago
          [deleted]
    • cqqxo4zV46cp 2y ago
      “It’s the corporations, mahn!”
    • deleted 2y ago
      [deleted]
    • cwillu 2y ago
      One can be forced to mindlessly perform ridiculously constricting duties that have everything to do with limiting liability and nothing to do with outcomes, while also caring about babies.
    • lupusreal 2y ago
      Have you seen the itemized bills for giving birth in an American hospital? They'll even try to mutilate an infant boy and charge you for it unless you emphatically opt out.
      • Der_Einzige 2y ago
        I want to see the criminals in the medical ethics community who ever greenlit this nonsense to have justice served upon them. Europeans would jail American doctors for what they do to babies here.
        • prmoustache 2y ago
          are you talking about circumcision? Do they do that automatically to all newborns?
          • mensetmanusman 2y ago
            It is not automatic, but it is default behavior.
          • lupusreal 2y ago
            They'll schedule it by default and often argue with parents who try to cancel it. It's about money for the hospital and they don't care about the suffering it causes, nor the completely unnecessary financial burden it places on young families. For them to be so soulless when it concerns infants, you can be sure they aren't any better when they're just dealing with adults. Greedy psychopaths are overrepresented in the medical industry.
    • unbrice 2y ago
      Re: Understanding the cynicism: For example it is intriguing that they insisted on using a wheelchair to get in the car, but not to get out. But what's even more revealing is that the child had to be in a car seat while on his mother's lap.
      • CoastalCoder 2y ago
        There are some circumstances where people don't realize they can just say "no". I suspect this is one such case.
    • lolinder 2y ago
      They didn't say that, they said the checklist is there for liability reasons and not for genuine care reasons. The "won't let mom walk to the door" thing is a great microcosm of that—it's a blanket policy applied to all mothers regardless of need. My wife had our youngest at home but we had to take her to the hospital afterward because her lungs were a little sticky and she needed a respirator for ~4 hours. I took our daughter in and my wife followed a few hours later, walking all the way into the hospital. The NICU wouldn't discharge us for two days (which is a whole liability > care story of its own), but when they finally did they insisted that my wife—who had had the baby at home and driven to and walked into the hospital while mere hours postpartum—needed to be in a wheelchair to the curb. We liked that shift of nurses, they clearly cared, but no one in that room looked at my wife standing by the warmer and thought "she needs a wheelchair". They had a checklist and they were going to be darn sure they followed it.
      • beaglesss 2y ago
        You can always refuse. They can't kidnap you or the baby if for whatever reason you don't want a wheelchair, and it's almost always illegal to block the exits without a court order or documented altered mental status.
        • lolinder 2y ago
          After 48 hours of putting up with hospital rules in order to avoid an AMA discharge, we were just happy to be done. They certainly didn't frame it as optional, and it wasn't worth the fight.
        • secstate 2y ago
          I appreciate your willingness to push for your rights here. But the situation is surprisingly similar to refusing to let a cop search your trunk. You can say no, but that K-9 unit is going to take four hours to get there from the station 20 minutes away. They will make your life hell. I've definitely been in hospital situations with my children where I was honestly afraid (perceived or real threat, I still don't know) that they were going to report me for child abuse if I took my kids home and refused care. People with authority are kinda scary, and while I love for us to all choose rights over security, sometimes I just don't want to have to fight for everything. And this is where police states evolve from.
    • Flop7331 2y ago
      Everyone in maternity wards is underpaid and overworked, and the checklist is there and rigorously followed so we don't have mothers with c-sections tearing open on the way out because no one brought a wheelchair.
      • Dylan16807 2y ago
        I don't understand that one very much. If walking is going to tear them open, isn't it better to have that happen at the hospital instead of half an hour later at home? I don't think much healing is going to happen in between. Is the risk sufficiently on a per-step basis to make that worth it?
    • Der_Einzige 2y ago
      Is go further and say that all doctors who work in those wards and perform male genital mutilation must hate babies, otherwise I have no explanation for how they can ignore the fact that their European peers would throw most American doctors in jail for the things they do to newborns.
  • nostrademons 2y ago
    ...which might still be socioeconomically correlated. People who make half a million a year can afford lawyers. People who make $50K/year generally cannot. The interesting point here is about how so many institutions become so much sloppier when the legal system becomes unaffordable for a majority of residents. Unsurprising, but it has pretty far-flung consequences if you're trying to root-cause why so much of America seems like a 3rd-world country today.
    • brvsft 2y ago
      I get tired of the constant deferral to socioeconomics as an excuse. It's pretty simple, we don't allow people to be born with zero documentation in the US. This would be a massive fuckup, and it doesn't matter if the kid is poor, they still need a birth certificate to get a social security number. They've had a long time to put whatever systems in place prevent that from getting missed, even in the poorest zip codes. And as far as safety, it's not always legal liability. I'm sure a good portion is, but we're talking about newborn babies right now. Most people don't want to have any part in a newborn being harmed, so it's trivially easy to get employees to take that stuff seriously.
      • guerrilla 2y ago
        Nobody's excusing anything. It's an explanation. You're comparing apples to oranges: things that are free and done by the state compared to things that cost done by for-profit corporations.
      • mensetmanusman 2y ago
        We do let millions of people in without documentation, and they are nearly all poor. The underclass somehow manages while the upper class ducks everything up.
      • mrguyorama 2y ago
        >Most people don't want to have any part in a newborn being harmed And nobody is ever the bad guy in their own story. During my sister's birth, she got stuck, and the doctor, instead of doing the normal and accepted and standard fix of breaking one bone, broke a different one instead. This damaged nerves in her arm and permanently disabled her. Turns out, he did the exact same thing to another kid in town a few years later. ALSO turns out, he had to stop practicing medicine in a different state because he kept doing that to a bunch of babies, so instead of retiring or retraining because he obviously did not know what he was doing, he moved to bumb-fuck nowhere so he could keep doing it. I bet he even thought he was a good doctor. It is never trivially easy to get someone to do something they don't want to do, like admitting they fuck up, or that they are careless about something they don't think is important. We only got $10k in the malpractice suit, which doesn't even cover like a year of physical therapy, for a lifelong and entirely avoidable disability of her dominant arm. She had to learn to be left handed. If our family didn't have state employee insurance, we would have never seen a doctor, like most people in poverty.
  • cowsandmilk 2y ago
    Going to disagree hard here, numerous studies have shown checklists improve patient outcome. Similarly, they improve safety in numerous industries. And requiring two person sign off on dangerous actions in the hospital also improves outcomes. Sure, following these practices is helpful in a lawsuit, but primarily because they are best practices.
    • opello 2y ago
      I'm pretty sure that the person you're replying to isn't making a claim about the utility of checklists but the content of the enumerated checklist items.
      • prmoustache 2y ago
        Only in the USA will you see people being rolled in a wheelchair at the door. The only reason is people love to sue for anything in this country. This is unrelated to best practices.
        • mrguyorama 2y ago
          >The only reason is people love to sue for anything in this country People "love to sue" in this country because the court system was designed to be THE place where problems are solved. Can't have a federal agency who's job it is to make sure hospitals don't kill people, that would be tyranny, better make everyone sue them instead. This affects everything in the US. It only affects hospitals worse because the US cost of healthcare is so stupidly artificially inflated that you have to sue for very minor things so you can pay the $40k it takes for some basic physical therapy.
• pyuser583 2y ago
  Those checklists have done a good job preventing infant kidnapping.
• monetus 2y ago
  > They actually wouldn't let my wife walk herself down - they had to call Transport, and she had to be wheeled down in a wheelchair with the baby's carseat on her lap, and I had to be waiting at the designated curbside to pick her up. She was perfectly capable of walking herself down, and we were both capable of putting the carseat into the car in a normal parking spot, but everything had to be done in the presence of an orderly. I have tonic-clonic seizures; at least 4 hospitals have wheeled me out that way, suffering no argument otherwise. I guess it is common.
• mlinhares 2y ago
  A lot. A friend worked for years in a well known hospital in PHL (that closed somewhat recently), and they were pushed to get people with no insurance out as fast as they could. If they know you won't be paying, they will try to kick you out as fast as they can and consequences be damned, if you don't have insurance you likely don't know/understand your rights and wouldn't sue them.
• protocolture 2y ago
  We had the opposite. They tried on multiple occasions to evict my wife after a C section while she was in an incredible amount of pain. They kept giving her an oxy in the morning, then after it set in, asking her to rate her pain level, and recording it. Which is backwards. Then they blamed her for not asking for more pain meds, which she had. Then they told her to just ask for more pain meds, which we did. Then the nurse told her that shes not allowed to have any more pain meds. At which point I went full Karen, got our stay extended by 2 nights. Apparently the midwives expected her to be walking up and down the corridor, which was not a requirement and not part of the treatment, just to demonstrate her pain levels.
  • RoyalHenOil 2y ago
    Oh god, I hate nurses you make you prove your pain level. When I was a university student, my tonsils suddenly swelled up so much that I was unable to speak and I was having difficulty just breathing. I went to the university urgent care, and the nurse showed me a pain scale and asked me what my pain level was. I pointed at the '7', and she told me I needed to actually say the number to her. I kept trying (it was extremely painful to try, more like a 9!) but I physically could not make the sound — which just pissed her off even more. At long last, she got so frustrated that she stormed out and finally got the doctor. When the doctor examined me, he told me that I had the biggest tonsils he had ever seen in his career. He diagnosed me with mono and put me on steroid treatment, and my tonsils were back to normal by that evening.
• vegardx 2y ago
  Having a low child mortality is important, and we've done so many good things in the last couple of decades, but I'm starting to think we're at the point now where the money you have to spend to make a meaningful difference is better spent in other areas of health care. A classical example of this is in Norway. There's nothing that gives you access to more resources than being pregnant or being in care of a newborn. You can suffer from all kinds of mental health issues for your entire life, struggle to be a productive member of society and be in and out of temporary treatment and be on social benefits. But the moment someone is pregnant they get will be top priority for anything that is even remotely connected with child mortality, almost regardless of how benign something is. I personally know several people that finally got the help they had been so desperately been begging for, just because they got pregnant. We could have saved them from literal decades of suffering by just providing good treatment early. I'm willing to bet that we'd even be in a position to spend even more money on reducing child mortality, because when you start doing the math of how much they ended up costing society it really adds up.