Preview

Atul Gawande

Good Essays
Open Document
Open Document
441 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Atul Gawande
AStandardization is good, it saves lives
Agpar score
Standardization resulted in good things such as neonatal intensive units, prenatal ultrasound, obstetrics package.
“And that package has produced dramatic results”.
Gawande highlights some flaws of Obstetrics such as their lack of double blind, controlled randomized trials (obstetrics uses the least double blind controlled trials in all of medicine), use of fetal heart rate monitoring device, forceps eliminated even though better for mothers
Gawande though absolves them of blame because they are so successful at saving lives.
Gawande even complements obstetrics for not relying on clinical trials, but trying things on the fly.
Even admits that it is unclear whether many aspects of the obstetrics package are beneficial.
Gawande seems to be satisfied that obstetrics is saving lives, not concerned that there are some alarming practices that could be improved.
Because Obstetrics still is concerned primarily with safety, “reliability [is chosen] over the possibility of occasional perfection”.
Gawande postulates whether medicine is a craft or industry, with craft being about perfection, and industry being about safety and reliability. Gawande’s view is black and white, should be a craft where if you can do forceps you do that and you perfect c-section if you can do that. Gawande’s view leads to a reliance in c-sections. A system could easily be developed in residency to deem wheter obstetricians are ready for forceps to allay Gawande’s concerns about inexperience.

Despite Gawande’s misguided desire for standardization and reliability, Gawande’s agpar for mothers after surgery is a step in the right direction because it will push doctor’s to achieve perfection and foster innovation.

Incrption devices. Fetal heart monitors are essentially inscription devices, but instead of producing diagrams and charts, it leads to unneccesaey c-sections.

Gawande constructing authority
Capturing other’s

You May Also Find These Documents Helpful

  • Good Essays

    This study should have also included a more clear identification of what exactly a CAM is, and account for the effect of the different types of CAM methods used with pregnant women, listing patterns, benefits and complications women experienced with…

    • 830 Words
    • 4 Pages
    Good Essays
  • Better Essays

    SWOT Analysis

    • 1273 Words
    • 6 Pages

    Indiana University (IU) Health Paoli Hospital is a Critical Access Hospital in southern Indiana. IU Health Paoli serves a rural population and offers obstetrical (OB) services. The OB department offers an individualized family centered birthing setting. The hospital delivers around 130 babies annually. The mission of the OB department is to offer a personalized compassionate delivery of care and provide a quality outcome for mother and newborn. The staff on OB is all registered nurses (RN), certified in in-patient obstetrics and electronic fetal monitoring. All 14 staff members are neonatal resuscitation and advanced cardiac life support providers. 2 of the 14 RN’s are internationally board certified lactation consultants and have an 83% breastfeeding rate at discharge. Labor support offered is hydrotherapy, birthing ball, epidural and they also offer vaginal birth after cesarean. Six family practice physicians offer obstetrical services at the hospital and three of the physicians offer cesarean section services. The 2012 Annual statistics for the OB department reflected a primary cesarean rate of only 13% and no early elective deliveries prior to 39 weeks gestation. All RN’s and physicians are focused on quality, compassionate care and outcomes. All standards of care and core measures for OB care of followed and implemented to the fullest degree. The OB Nurse Director is very passionate about quality outcomes and staying patient centered with the delivery of care, decisions and policies. A special quality that all nurse’s and physicians possess on this unit is each patient, birth is a miracle. The opportunity to be present at this memorable time in each patient’s life is an honor not a job. The patient satisfaction scores and comments from NRCPicker® reflect this passion and commitment.…

    • 1273 Words
    • 6 Pages
    Better Essays
  • Good Essays

    Margaret Sanger

    • 437 Words
    • 2 Pages

    My mother died at the age of 50 due to the strain of 18 pregnancies, consisting of 11 births and 7 miscarriages. I was the sixth out of those 11 children. In 1900, I began training as a nurse; I wanted to aid pregnant women. Since then, I’ve seen many poor young mothers become extremely ill and die of the strain from frequent pregnancies. During a house visit, I met a 28 year old mother of 3 with another child on the way, who died of self induced abortion. I remember seeing her body, I remember earlier visits, and I remember how desperate she was to get out of her situation. After witnessing these terrible tragedies I quit nursing in 1902 and devoted my life to helping women before they were driven to dangerous and extreme measures. I then got the idea of a “magic pill” that women could take to help prevent pregnancy.…

    • 437 Words
    • 2 Pages
    Good Essays
  • Powerful Essays

    To generate more money, hospitals have placed focus on efficiency, taking a woman through childbirth as quickly as possible. As a result, standard, predictable procedures are necessary. Technology is being used at an increasing rate, acting as a control over the natural process of childbirth. Overall, it seems that selling the idea of care is more important than the care itself.…

    • 1657 Words
    • 7 Pages
    Powerful Essays
  • Better Essays

    Other models of care including obstetric models place less emphasis on continuity of care and therefore marginalize the mother’s holistic health. For example public obstetric care still provides the mother with antenatal care but the mother could see a different obstetrician each time she has a check up. This results in no form of relationship with the team who will deliver her baby, which affects the mothers social and emotional health determinants. Birthing centers contrast this model by providing the same team of midwives throughout the entire pregnancy. This method therefore heightens the mother’s confidence in her team and all members of the team have an understanding of the mother choices rather than duplicating information as seen in shared maternity care.…

    • 1570 Words
    • 7 Pages
    Better Essays
  • Good Essays

    Business of Being Born

    • 693 Words
    • 3 Pages

    There’s this idea since hospitals are a business that once they “facilitate” an intervention has been started and it becomes a domino effect after that. When these interventions have started, the questions: “what’s best for the baby?” “Is the baby going to benefit from this or not?” need to be well thought out. According to Overview of Maternity, “medical evidence shows that the routine use of unnecessary interventions put mothers and babies at risk.” In the film Marsden Wagner M.D., stated that there is no history of worthy obstetrical practices and careful studies of the long-term effects of the interventions.…

    • 693 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Examination of the Newborn

    • 5919 Words
    • 24 Pages

    The purpose of this assignment is to explore the issue surrounding screening and examination of the new born from birth. The article will look at why we perform this examination following birth and will pay particular attention to the examination of the eye. It is documented that the purpose of the first examination of the new born is to confirm normality and to provide reassurance to the parents (MacKeith, 1995, Hall, 1999) and also to identify any apparent physical abnormality (Buston and Durward 2001). However the question that we may wish to consider is ‘what is normal in a neonatal who is undergoing major physiological adaptations to extra uterine life (Blackburn and Loper, 1993) ? How as midwives can we fulfil this expectation of norm, when there is, as Hall (1999) suggests no confirmation of normality available ? Nevertheless a thorough search of the literature suggests that the neonatal examination is universally accepted as ‘good practice’, and any deviation from this practice could perhaps, potentiate negligence when subjected to the Bolam test (Sherratt, A, 2001). This test is often used as a benchmark to measure any negligence by, and examines if another professional of same standing would act in the same manner.…

    • 5919 Words
    • 24 Pages
    Good Essays
  • Good Essays

    One of the most positive experiences is bringing a child into this world. There are two ways that a baby can be delivered, vaginally and a cesarean section. Since the 1990s, cesarean sections have become the most common procedure in the United States. This procedure is necessary for certain circumstances, such as a breech baby or placental abruption. Some women are now preferring elective cesarean sections due to personal preference. There are nearly 1.4 million babies born surgically in the United States every year. This trend is due to an increase in elective cesarean sections that are not medically necessary. As with any surgery, there are always risks and complications involved. In this case, it's to both the mother and the baby. The cost…

    • 1670 Words
    • 7 Pages
    Good Essays
  • Good Essays

    The birthing center is a department that involves various different teams. There are the labor and delivery nurses, the postpartum nurses, and the NICU nurses. Alongside the nurses are the doctors which include the anesthesiologist and the OB GYN. In such a big department with various different roles, the communication and teaming skills are essential. The labor and delivery nurses must be in contact with the patient in order to give them their best treatment possible. They must communicate the the NICU if there is any complications that could lead to problems with the baby’s health. They should also keep the postpartum nurses uptodate with the mother’s health status. Specifically, the nurses have to communicate between the patient and the doctor in order to assure all the information if correct. For safety procedures, the nurses must gel in and gel out as well as wearing gloves. They must also make sure all the equipment in the room is clean and available incase of any emergencies. She will also make sure that each equipment if properly cleaned before and after each examination. Some diagnostic procedures I observed include temperature check, physical examination, and cervical dilation check. The nurses go into a patient’s room and tell them they will be checking for far they are into labor by doing a…

    • 669 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Sometime ago, women face childbirth with fear and anxieties. They knew that childbirth could be a difficult and sometimes extremely dangerous experience for women and babies. “During the seventeenth and eighteenth centuries, between 1 percent and 1.5 percent of all births ended in the mother’s death. A mother’s lifetime chances of dying in childbirth ran as high as 1 in 8…

    • 548 Words
    • 3 Pages
    Good Essays
  • Satisfactory Essays

    Cesarean Section

    • 442 Words
    • 2 Pages

    Cesarean section is sometimes a medical necessity, or even an emergency. But it is increasingly a choice made in cooler…

    • 442 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Surgical Birth Summary

    • 179 Words
    • 1 Page

    Carolyn Sargent and Nancy Stark in their article Surgical birth: Interpretations of cesarean delivery among private hospital patients and nursing staff explained the biomedical process of childbirth in the context of United States. Cesarean delivery, although classified by medical practitioners as major surgery, is simultaneously defined as childbirth by both specialists and laypeople. It is related with the cultural norms and practices. Women experiencing cesarean delivery, therefore, confront a contradiction which affects postpartum treatment by nursing staff and expectations by family and the post-cesarean patient regarding appropriate responses to delivery. The decisions of the delivery are also depended on the family and medical practitioners.…

    • 179 Words
    • 1 Page
    Satisfactory Essays
  • Good Essays

    Midwife Vs Midwives

    • 742 Words
    • 3 Pages

    Every year, more than three million infants are born in the United States. For the mother, one of the most important things is bringing the baby out from the womb safely into the world. The majority of women choose to birth their children in hospitals with doctors, mainly because it is believed that hospitals are the safest environment to birth a child. Others, decide to stick to what they consider a more natural option: at home births with midwives. Whatever the situation may be, the mothers have their child’s best interest at hand. The fact of the matter is, no matter how well one plans, and no matter how excellent a medical professional may be, sometimes complications are inevitable. Historically midwives did not have to be doctors, because…

    • 742 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Homebirth Versus Hospital birth: A Compare and Contrast Essay Women have been delivering babies at home since the beginning of time. The option to deliver a baby in a hospital is only a few generations old. Society tends to view hospitals as a safer place to deliver babies and has frowned upon women who choose to have planned homebirths as irresponsible and uneducated. Current research does not support this common belief or show evidence that hospital birth is safer than planned homebirth for low-risk, healthy women delivering full-term babies.…

    • 651 Words
    • 3 Pages
    Good Essays
  • Best Essays

    The NMC code (2008) states that “you must deliver care based on the best available evidence or best practice.” Which suggests that midwife’s need to find a balance in using the best available evidence as well reflective learning to gain the best possible outcome for the women (Raynor D., Marshall E. & Sullivan A. 2005). Schon (1991, p.12) uses a metaphor to describe how professionals take into account professional issues: “High ground” uses manageable issues which can be solved by applying evidence based research and theory. For example when administering an injection, a midwife could read the most up to date evidence on what different areas are available on the body for administration for that individual women. “Swampy…

    • 4779 Words
    • 20 Pages
    Best Essays

Related Topics