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Post by Admin on Feb 13, 2018 18:14:52 GMT -4
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jose
New Member
Posts: 4
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Post by jose on Feb 13, 2018 19:54:37 GMT -4
A very sad and depilating condition that often have serious complications if not treated. I believe that there should be a screening for postpartum depression within 1-2 months after birth. Just how there is depression screening in adolescences and adult that early detection results earlier treatment, same can be true here also. However, passing a piece of Legislation may not be the best approach to address awareness since it usually requires taxpayers to fund the measure. The idea for this is to establish well-being for the patient(s) and safety from and to themselves is a certainly a public health concern. As long early detection is in place, it will be vital to do early interventions can be made immediately so the problem/issue/condition does not prolong and not only will be a struggle but much difficult to treat if adult/late-onset of these sx.
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Post by samthanms4 on Feb 14, 2018 10:26:17 GMT -4
There absolutely should be mandatory depression screening for new mothers. I’m in support of a law that would require a quick screening. I am glad that California is in the process of moving a bill, because leaving it to the provider is clearly not working. A screening should not add too much time and money to the process. Especially when comparing the cost of a screen to an involuntary hold in the Emergency Room. The screening does not necessarily have to be done with a nurse, it could possibly be done on a paper form while in the waiting room to be reviewed later in the appointment by the provider or the nurse. A protocol should be put in place that will fairly delineate when to have an involuntary hold or to simply treat with medication or therapy.
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Post by AngelaKoulms4 on Feb 14, 2018 12:04:00 GMT -4
Isn't it frustrating that in order to enforce medical protocol and in this case mental health, we need to rely on the legal system? I guess that is the only way for medical providers to do their job and be reliable of their actions. Women's mental health, especially postpartum depression has become more and more diagnosed among mothers today because the diagnosis is being understood. We have started to educate ourselves in spotting symptoms, asking the right questions to get a good history and offering the appropriate medication and therapy for these women when needed. The key word is "education." That is what medicine needs and will always need and that is being educated and aware of conditions such as postpartum depression. So, if the legal system is the only way of getting things done and protecting woman's mental health, then yes to the bill for requiring a screening on all mothers and yes to federal funding for postpartum programs and awareness campaigns.
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Post by Krista on Feb 14, 2018 16:04:52 GMT -4
I found this article to be very informative and eye-opening to health care providers coming from the patient's perspective. I can empathize with both sides, the nurse possibly not understanding postpartum depression and trying to protect the baby, and the patient feeling completely ostracized by the way the situation was handled. Healthcare providers in general are not well educated when it comes to this very common illness. Mandatory screening needs to be performed for any mother who recently gave birth, even up to a year after. I would assume the nurse was imagining the worst case scenario occurring and the action she took was in her mind appropriate. We as a society have all heard of the most severe cases of "postpartum" where the mother drowns her child in the bathtub or tortures the child in some unimaginable way. A lot of these mothers had pre-existing disease that contributed to their psychosis. The whole situation could have been handled much better. Treating a mother suffering from postpartum like this will only discourage mothers from seeking help in general. Ideally there should be services available to these mothers staffed with providers who can educate the mother and treat them if needed. Additionally, education during the pregnancy and while in the hospital could make postpartum easier to detect and enable the patient to receive treatment expeditiously.
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Post by brette on Feb 14, 2018 17:02:15 GMT -4
It is really unfortunately of how the police were called for the mother who actually came to seek help. However, in a situation like this you have to take into consideration that the nurse at the clinic probably didn’t know a better way of conducting the interview or that she didn’t know “ proper protocol”. Yet still, in the position that the nurse was most likely in in her thoughts was to protect the baby ie calling the police. This clearly shows that some sort of protocol or screening should be made compulsory for all mothers; whether first time or second time. The mother demonstrated great awareness with respect to the greater picture when she decided not to sue because of what repercussions would follow for everyone who needs the medical help in that area. Advocating for post partum depression could help bring attention to the issue at hand but only the government can make a greater impact if or when a law is passed or funding is allocated to support the notion of screening / protocol for post partum mothers.
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Post by DevinneD on Feb 14, 2018 19:00:38 GMT -4
I interpreted this article in both a narrow scope and a broad scope. In the narrow scope, it's about a patient who had an unsatisfactory experience with her healthcare treatment. I applaud this patient for seeking professional help and being forthcoming with her issues. However, I take issue with her dispute. Inferring from the article, she wasn't an established patient at this clinic, so where did she receive her prenatal care, if any? And if she did, why did she choose to switch clinics? Had she returned to her previous provider, I would think it's safe to assume her situation wouldn't have escalated into hospitalization since she would have had a prior established relationship with a healthcare provider and charted documentation regarding her prior visits. But since she sought care as an unestablished patient and admitted to having thoughts of self harm and harming her child, how could any provider at this clinic also believe her when she said she had no intention of harming herself or her child? I believe the nurse acted in an appropriate manner to prevent harm to both patient and child. Now in the broad scope, this article is provoking a discussion about government's role in healthcare. I personally feel that government should have an extremely limited role in any and every aspect of healthcare. I strongly believe that healthcare providers as a whole can make better decisions regarding healthcare rather than government because healthcare providers are advocating for patients while government is ultimately advocating for cost-saving. Mandating postpartum depression screenings is an unnecessary waste of federal tax dollars. What kind of oversight would be necessary to enforce such legislation? Is a government official (without any background in healthcare) going to determine if a healthcare provider properly assessed for postpartum depression? And what would the repercussions be if the screening was deemed unsatisfactory? A fine? Loss of license? Imprisonment? The ACOG has already published guidelines regarding screening for depression in women, and from personal experience with past OB/GYN preceptors, inquiring about mood in the perinatal period was discussed within minutes of walking into the patient's room. As far as funding awareness for postpartum depression, I can advocate for that. But we as future healthcare providers don't need a law mandating how to do our job. We live in an era where mental health issues and drug addiction are rampant; so whatever field you decide to specialize in, always keep mental health screening in the back of your mind. As far as I'm concerned, the system saved this patient and child, so don't fix what isn't broken.
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matt
New Member
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Post by matt on Feb 15, 2018 9:45:13 GMT -4
This article presents good arguments for both sides. For one, I don’t believe that the nurse who called the police should be reprimanded or viewed in a negative light as the article says. The nurse was doing what she thought best to keep the baby safe. I do understand the mother’s issues as it became a situation that could have been handled differently. This is why I think that the screening for post-partum depression should be implemented and the nurses and providers involved should be trained to better deal with these type of circumstances. Screening for post-partum depression could be as easy as a questionnaire and a few questions from the providers whether it be at the at post-partum pediatric appointments or OB-GYN. Nurses and physicians should be trained to deal with mothers dealing with post-partum depression and understand the illness more to not embarrass mothers or put them in unnecessary positions. I believe that the safety of the child and mother are the most important issue in this circumstance so although this situation causes some stress that may have been avoided, ultimately a child was protected.
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Post by sarakhan on Feb 15, 2018 16:08:01 GMT -4
Although I sympathize with what this patient went through, I understand that the nurse was obligated to report the patient. The ER needed to thoroughly examine the patient before she could safely be released into the community with her child. Post-partum depression screening should be implemented for all new mothers. The problem that this patient faced was not because she was screened but because she was not informed about what was going on. Patient education would be the best way to inform pregnant patients of postpartum depression and ways that it can be dealt with. Discussions about mental illness is still a topic in our society that is not talked about openly, more conversation is needed so people are not ashamed about seeking help.
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Post by AjaH on Feb 15, 2018 16:38:30 GMT -4
This article is a good representation of the kind of difficulties that physicians face when it comes to evaluating the patients current mental health state and determining the safety of other parties involved. I believe it is important to perform postpartum depression screenings for new mothers. From a financial and legal perspective, it does not cost a lot or take up a significant amount of resources to administer a simple screening test. The article attacked the nurse and made it seem that the nurse was in the wrong. I believe that she was just trying to follow protocol since she was concerned about the safety of the child. By implementing a mandatory postpartum screening for depression, it would allow physicians to catch it early on before it manifested into a dangerous level. Also, the earlier you screened for depression and the new mother was made aware of her diagnosis, it would provide her with more insight into her diagnosis. This would allow her to work with her physician to both educate her on ways to manage her symptoms in order to prevent it from escalating to dangerous levels for both the mother and child.
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Post by kiragaleano on Feb 15, 2018 16:53:11 GMT -4
The high prevalence of postpartum depression coupled with societal stigmas against it warrant widespread screening for this condition in new mothers. However, there is also a need to train providers and staff on proper protocol for interacting with patients in an effort to maintain rapport that will ultimately allow the patient to consent to treatment. In the article, I do believe the nurse should have consulted with the patient’s OBGYN physician or hospital psychiatrist to appropriately assess the risk of harm instead of immediately calling the police and thus creating a scenario that will likely cause the patient to never seek out future help for potential postpartum depression. I understand the nurse’s concern with comments such as “squeezing my baby too tight” but I believe the response to this should have been different to create the best outcome for the patient and treatment team. No system is perfect, and I do believe that postpartum depression screening should be mandatory in new mothers since it is often under treated. I would also just assert that in addition the mandatory screening, there should be mandatory training for clinic/hospital staff on the next step when patients present with these symptoms as to encourage them to seek help instead of creating the scenario that occurred in the article.
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Post by psychforlife (JAMESEUNMS) on Feb 15, 2018 16:58:55 GMT -4
Medicine, unfortunately, is an imperfect science. Doctors and other health-care professionals have less freedom these days to act solely on clinical judgement. Many psychiatric conditions are diagnosed via clinical judgement and once that diagnosis is in place, there are certain protocols that are followed to protect both the physician and the patient. The patient stated she was having violent thoughts, "hitting myself or squeezing the baby too tightly" which prompts the nurse to follow post-partum depression/psychosis protocols. Perhaps the the nurse could have used better clinical judgement, but she also could've been hit with a lawsuit if the authorities were not notified of harmful ideations to others. It is understandable that the patient is upset with the situation, but the OB/GYN group is not at fault. The ultimate solution is to find an objective way to screen for suicidal/homicidal ideations, but until then we must all work to together to improve both the protocols and the health-care professional to patient relations. The patient did right by being an advocate to legislature change rather than suing the practice.
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Post by Tanuj on Feb 15, 2018 17:03:24 GMT -4
The perinatal period is one of increased connection with the healthcare system for most women and does provide an opportune time to screen for the symptoms of depression. However, I do not think mandating a postpartum depression screen is necessary as new mothers are queried about changes in mood and behavior during their follow up OB/GYN visits. I firmly believe that federal money can be better spent on educating patients on postpartum depression and increasing access to mental health services for Medicaid/ low income patients through existing programs such as Early Head Start. I firmly believe that the nurse acted in the child’s best interest when calling the police as she erred on the side of caution; though, she could have been more delicate and sensitive towards Ms Porten.
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Post by clarissadr on Feb 16, 2018 12:07:54 GMT -4
This article helps to illuminate the complexity of providing adequate care for patients with mental health issues, while trying to ensure the safety of all involved. Historically, mental health treatment also meant legal interventions, which does not always translate to the best care for patients. More specific to the article is the issue of postpartum mental healthcare. According to the CDC 1 in 9 women suffer from symptoms of postpartum depression (PPD). It is important to note that the study included only voluntary responses, so it does not account for woman who were embarrassed or ashamed to admit to symptoms of depression. Of the women who reported symptoms, only 15% received medical treatment. This means most women don’t get the help that they need. While PPD is common, there is a negative view on seeking treatment which makes is difficult to identify, and treat those patients who need it most. The proposed California legislature will help to reconcile both medical and legal protocols, removing some of the ambiguities and providing patients with the earliest and safest care. As our society still struggle to accept, and effectively treat mental health issues, it is important that we continue to learn from incidents as the one described in the aforementioned article. www.cdc.gov/reproductivehealth/depression/index.htmwww.apa.org/pi/women/resources/reports/postpartum-depression.aspx
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ebube
New Member
Posts: 4
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Post by ebube on Feb 19, 2018 2:35:56 GMT -4
In this case there is valid argument on both sides. I understand the nurse being concerned for the safety of the child and mother, calling the cops. Considering how unclear what constitutes immediate danger as it relates to postpartum depression is, and the information she recieved from the mother. But it is also very easy to see why a mother who willingly came in to the clinic with concerns for her mental health would be less than satisfied by the treatment she recieved and made to feel like their actions were not centered on her getting the help she needed but on the clinic trying to protect itself from the law. [“It was all legality,” Porten said. “Everybody was protecting their own liability instead of thinking of me.”] In the healthcare industry we need to find a balance between legality and empathy. “The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head...” - Sir William Osler
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