OB Nurse Consulting

05/07/2026

People do not always realize how many roles an OB nurse can play in one shift.

We are monitoring, educating, reassuring, advocating, communicating, and constantly adjusting based on what is happening in front of us. Sometimes we are the calm in the room. Sometimes we are the coach. Sometimes we are the one picking up on the subtle change that needs further assessment. That matters not only in the moment, but sometimes long after.

When cases are reviewed later, people often focus on the big outcome. But so much of the story is in everything leading up to it - what was recognized, how things were communicated, whether concerns were escalated, and how clearly it was all documented.

That is part of what makes OB nursing such a layered job. It is never just one role, and the impact of it is often bigger than people realize.

04/29/2026

A lot of people picture the delivery. They picture the baby, the excitement, the happy ending.

What they do not picture is everything it can take to get there.

So much of OB nursing happens quietly in the background…watching closely, thinking ahead, and recognizing when something needs a second look.
Especially for first-time moms, labor is not always quick or straightforward. Sometimes it is a multiple-day induction. It’s a lot of repositioning, turning from side to side, trying different positions, doing everything possible to help labor progress. And when it is finally time to push, that can mean hours more work too…sometimes in multiple positions, sometimes literally playing tug-of-war with the nurse to help bring that baby down.

People do not always see how much of this job is anticipation, advocacy, critical thinking, and staying calm when things can change quickly. That is part of what has always stood out to me about OB nursing. From the outside, people often see the joyful side of it. We see that, too. But from the inside, you also see how much responsibility, trust, and judgment it really takes.

People see the delivery, but we see everything it took to get there. I never take for granted the trust patients place in me to help guide them through some of the most vulnerable moments of their lives. That is part of what makes OB nursing so meaningful to me.

*AI-generated image used to protect patient privacy*

04/22/2026

One of the most important reminders in patient safety is that serious outcomes are not always the result of one dramatic mistake. More often, they come from smaller breakdowns that build over time - missed communication, incomplete handoffs, unclear follow-up, or assumptions that someone else is handling it.

That is part of what makes chart review so important. The story is often in the gaps just as much as in the documented events.

Clear handoffs are not just a workflow issue. They are a patient safety issue.

What do you think contributes most to communication breakdowns in healthcare: time pressure, culture, or inconsistent systems?

Transitioning care between health care professionals during hospitalization — known as handoffs and signouts — are often a time where medical errors and adverse events can take place.

05/14/2025

🧠 China's AI Hospital: A Glimpse into the Future of Healthcare

On April 26, 2025, Tsinghua University held an inauguration ceremony for "Agent Hospital," the world's first fully AI-powered medical facility. This virtual hospital is staffed entirely by virtual doctors and nurses and can treat tens of thousands of simulated patients in just days—what would take human clinicians years. These AI doctors scored a 93.06% accuracy rate on the MedQA dataset, demonstrating their ability to replicate the full continuum of care, from diagnosis to follow-up.

This groundbreaking development raises several critical questions for our profession.

Legal Accountability:
- Who is responsible when an AI doctor makes a misdiagnosis?
- How do existing malpractice laws apply?

Regulatory Oversight:
- What frameworks are in place to ensure patient safety and data privacy in AI-driven healthcare?

Ethical Considerations:
- Can AI truly replicate the empathy and nuanced judgment of human healthcare providers?

Impact on Medical Training:
- How will AI integration affect the education and roles of future medical professionals?

This is no longer just sci-fi. How do you think AI will shape our practices and the legal landscape moving forward?

Leading insights and solutions in AI.

05/03/2025

Case Spotlight: Hospital Declines Care, Infant Dies Days After Birth

A recent news report highlights the tragic case of Hanna Goldsmith, who was 6 months pregnant when she sought care for intense pain at a California hospital. Staff reportedly told her they can’t care for babies at 6 months of gestation and advised her to go elsewhere. Hanna unknowingly gave birth in her car in the parking lot of the hospital before being put in a wheelchair with a baby in her pants—her baby died five days later.

While the full clinical picture is unknown, this story raises serious questions about how triage decisions were made and whether federal emergency care obligations were met. EMTALA is a Federal law that requires that all patients presenting to the ED be evaluated for emergency medical conditions. In obstetric cases, this includes assessing whether a woman is in active labor and determining the need for stabilization or transfer. When these steps are skipped, the legal and clinical consequences can be significant.

Let’s look at EMTALA.

EMTALA (Emergency Medical Treatment and Labor Act):
* Passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA).
* Purpose: To ensure public access to emergency services regardless of ability to pay.
* Applies to all hospitals that participate in Medicare and have an emergency department.
* Key requirement: Hospitals must provide a medical screening examination (MSE) to anyone seeking treatment for a medical condition.
* Stabilizing treatment: If the patient has an emergency medical condition (EMC), the hospital must either treat and stabilize the condition or transfer the patient appropriately.
* Appropriate transfer: If the hospital lacks the capacity or capability to treat the EMC, it must transfer the patient to a facility that can, under strict conditions.
* No patient dumping: EMTALA prohibits transferring or turning away patients based on insurance status or ability to pay.
* Labor and delivery: Special protections are included for women in active labor, ensuring care until delivery is complete or a safe transfer is made.
* Penalties for violations can include fines (up to $100,000 per violation) and exclusion from Medicare/Medicaid programs.
* Enforced by: Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG).

This case invites close review of triage protocols, staff education, and EMTALA compliance—particularly when a facility has both labor services and neonatal capabilities. For legal and clinical professionals, it underscores the stakes of failing to conduct even a basic medical screening in emergency situations.

Nurses at Sharp Grossmont told 29-year-old Hannah Michaelis she needed to go to another hospital. She gave birth to her baby in her car.