hello
I work in a unit which is formed by the merging of two maternity units. At the Jessop Hospital until a couple of years ago the physios ran a TENS hire service, charging for use of machines and teaching couples individually to use them. At the Northern General, machines were owned by labour ward, we (physios) trained the midwives to apply them and left them to it. Occasionally we would be asked to teach a woman or a couple how to apply it.

Both systems were fraught with insoluble problems.
1) charging for hire - does the hospital charge for epidurals or entonox? Why for TENS? Outrageous! (I wouldn't be surprised if it were unlawful, if anyone ever tested the law). The system was given up after some years because of the workload - it's quite labour intensive (in terms of physio hours) and no extra staff were allocated for it. So it took time that should have been for other patients.

2) At the Northern we could never get the midwives to come to the training sessions (overworked, no time - like us), the machines went missing at an amazing rate and the women had to send someone in to labour ward to fetch the machine when they were in labour - or else wait till they were admitted, which is usually too late for it to be effective. In the end we washed our hands of it. At present, as far as I know, there are a few machines used on labour ward by midwives and most women hire machines from Boots. We have a small supply of our own which we use for the occasional patient in special circumstances.

If anyone has an idea for a system which works, I'd love to hear about it.

My suggestion would be for physios to train the midwives and let them run the system. TENS is needed when it's needed, and we aren't available for labour ward day and night (unfortunately) - or even at weekends. So the skills should be in midwives' hands. I'd like to see community midwives applying TENS at home in early labour. And I would NEVER want to be involved in the business of keeping track of machines - it's a mug's game.

Best wishes. Would love to hear what others think, and have done

Bardy McNair
Women's Health, Sheffield
-----Original Message-----
From: Gregory Angela (RJC) PHYSIOTHERAPY - SwarkHosp-TR
[mailto:[log in to unmask]]
Sent: 04 March 2002 11:26
To: [log in to unmask]
Subject: Re: Provision ot TENS for use in labour

Dear All
We are reveiwing our procedure for the loan of TENS machines for use in
labour. I would be interested to hear from other departments if they loan
TENS machines . If so do you make a charge , who runs the system, and how do
you organise the instruction for use eg is this done in a group,
individually , during a routine antenatal class. Do the women have the
opportunity to experience the sensation during the class? Is the service run
by midwives in any hospitals? If so is there any involvement from physios.
Thank you in advance.
Angie Gregory

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