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Mount Sinai Beth Israel

With meticulous planning, adapting to the challenges, skillful teamwork and enthusiasm, this team helped a family unit stay together

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EXCEPTIONAL CARE: The Mother/Baby Unit goes above and beyond for not only mothers and babies, but also their families. photo by Jeff Leeser

Mount Sinai Beth Israel, New York
Team: Mother/Baby Unit
Category: Adaptability
Entry submitted by Elena Lobatch, RNC, MSN, NE-BC, nurse manager mother/baby unit
Judge's notes: A special circumstance took this L&D team well out of their comfort zone. But the experience brought them together as a team.

A fitting nickname for our unit is "Baby University." Our unit is privileged to share in the joy of a mom and family getting to know their precious brand new baby. We help moms as well as families learn how to take care of these new treasures. It is often a joyous time for all; albeit a little stressful as babies don't come with an instruction manual. There is so much to learn, but we have the passion, expertise, ability and creativity to ensure a successful learning experience and we are proud of our graduates from "Baby U."

Every once in a while Mother Nature throws a curveball, but we at Baby U were ready for the challenge. In early April 2013, a patient presented to L&D in preterm labor. The prospective mother had many severe neurological conditions that left her unable to take care of herself, to speak clearly, walk or even sit up without assistance. It became evident that although she was unable to perform any of the above activities, she understood everything that was going on in her surroundings and indeed had a specific goal of being able to take care of her baby in whatever way she could.

After spending a few days in L&D, the patient was transferred to our unit, still undelivered, as she needed further clinical management. Our team understood that it would take more than just purposeful rounding to meet her needs and ensure her safety. Careful planning at the beginning of each shift was geared toward dividing patient care activities between nurses and ancillary staff to provide the ultimate in care. The team coordinated her care so that a member of staff would be able to physically check on the patient every 30 minutes. Her needs were addressed promptly. This soon-to-be mom's needs were seemingly endless. She needed moving, turning, toileting, feeding and transferring to the chair and bed. We devised a schedule of visits to her room so that she would know that she was not alone, because it was important to provide human contact. Every staff member on the unit would make a special effort to stop by, have a seat and spend a few minutes with her. After spending a week on the unit, the patient was discharged, with plans to return to have her baby.

The patient returned to us a few months later and spent six weeks on our floor following the delivery of a beautiful baby boy. She had communicated her desires and we were armed with a plan to assist her to meet her goals. We knew she wanted to be involved in her baby's care and that she wanted to keep her baby with her with help from the baby's father, who although he had no physical limitations was mentally delayed. The team rose to the occasion meeting the need for her extended stay while addressing the unique needs and limitations of this family unit.

It was an exceptional challenge to have a patient with these special needs on the OB service, for this length of time. Our patients are usually healthy and are physically able to care for themselves and their newborns. Although some patients might be ill, this was usually related to the pregnancy and there is an expectation they will fully recover and participate in their self-care. This was not the situation in this case, but our team was convinced that we were the best caregivers for her at this particular time and that mother and baby were in the safest place.

It took meticulous planning, adapting to the challenges, skillful teamwork and enthusiasm of our multidisciplinary team to make this mom's experience at our hospital safe, enjoyable and very successful. Our enthusiasm was contagious and the mom was able to accomplish much. Despite her physical limitations, the mom learned to use the breast pump, and hold it independently (to the amazement of even our lactation consultants). Our patient also was able to hold and breastfeed her baby with some assistance from staff, skin to skin worked and it was truly gratifying to see that babies do find their way to the breast if given time and encouragement. The joy on this mother's face was truly rewarding and strengthened our commitment.

Looking back at the challenges we faced, we learned to truly appreciate each other in our motivation to make this a successful experience for this special needs mom. There were times when it appeared daunting and various members felt that we had reached a breaking point and success was elusive. The team was buoyed and regained confidence by a visit from the chief nursing officer who helped us realize just how much we had accomplished with our patient, by changing our mindset about what we perceived to be the normal family unit. We became re-energized and our commitment to helping our patient realize her dream was again the main focus of our attention. We did not lose sight of the shared goal of keeping mother and baby together. Advocating for her plan became our main priority.

Needless to say the excellent care that was provided by the team allowed the patient to develop the confidence to be able to participate in caring for her infant as we believed she could. She began to believe in herself and that made all the difference. After tremendous efforts on the part of all team members, she was finally discharged to kinship foster care where both mom and baby stayed together. This was a life-changing event for us all and made the team stronger in our convictions and passion for our role in the lives of our patients. At Baby University, learning took place for baby, for family and also for the staff.


 

Great article, excellent work of professional and enthusiastic team with a great and knowledgeable leader!

Your hospital has to be proud of you!

Mila Teslya,  Database Administrator,  GLOBAL Reinsurance CorpMay 02, 2014
New York, NY



An extraordinary team work. It takes team work to get the best results.

Claudetth  ,  RNApril 30, 2014




     

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