Care of High Risk Antepartum Moms

OBRN2004 · Jan 4, 2006

Our hospital provides "group therapy" for them as well as movie nights, family nights (most of our moms love showing off their children! ), games, crafts, etc. for those that wish to participate. One of our physicians wanted to hire a massage therapist for the pts, but I haven't too much about that lately, I'm sure it probably has to do with funding. It sure would be nice to offer that to the pts though.

Cienna2000 · Jan 4, 2006

I hope you don't mind me answering this from a patient perspective. I'm not even in nursing school yet--just starting pre-reqs. My drive to become a nurse is in part from my 14 days in the Family Birthing Center (Prison as one of my nurses called it) and my daughter's 7 weeks in the NICU. She was born 9 weeks early due to my severe pre-eclampsia that was turning into HELLP Syndrome. The hospital I was in has a 12 bed LDRP with a 9 bed NICU in the center of the FBC, so fairly small. The month my daughter was born there was a record number of births (167) so not nearly as most of you post about.

I was one of the unfortunate ones on mag (for 9 days) who wouldn't allow the tv to be on, the blinds to be open or the lights on. To tell the truth, while I was occassionally bored I wasn't interested in being entertained. If I was bored entertaining me would take 15 minutes tops before I wanted everyone to leave me alone. For the most part, I just wanted to lay there, I didn't feel well enough to do anything else. I wrote a lot of letters to friends and family for my husband to mail, but since I wrote in near dark with a horrible headache and vision issues, they weren't exactly the most legible!

I think the NICU consult is a great idea, but since my daughter's neonatologist is a little hard to talk to (and he is who did the consult) I would suggest having one of the NICU nurses come in also and let the mom know potentially what to expect (emergency crib, reasons why a baby can be rushed into a incubator, vented baby, tons of tubes, wires and alarms, etc). The doctor is incredible with a sick baby and I completely respect him, but preparing a mom for her baby being in "his" NICU and being one of "his" babies is not his strong suit. He is actually still her pediatrician and I get along with him quite well now and have ever since she was put on CPAP instead of a vent (turns out he's only hard to get along with when he is worried about "his" baby).

I also believe that having the same nurses would be really nice, especially if they are ones that are not against being in ante-land. Believe me as a patient you can tell when your nurse does not want to take care of you because you are on hospital bedrest. I had several of the same nurses over and over again. One of those nurses and I actually got along quite well. It was to the point when she would come on duty she would see if I was still there and if yes, she would request me (she also, I believe the term is, floated to NICU as necessary and cared for my daughter a few times).

I can see where having a good social worker would be a plus, but the one I was assigned was so "perky" and way too happy all the time. She drove me insane and I didn't like dealing with her.

I really hope you get a lot of good suggestions (and that they can be implemented). Let me know if it is ok, and I will post about this in my preemie parenting group to see what PTL moms would have liked in their stays.

SC RN, RN · Jan 4, 2006

Cienna,

I would love to have you ask other PTL moms on Mag what would've made the stay more bearable. Please ask them and then return here with your information to share ...

And I'd still love more input from others ... keep it coming!

Thanks!

wannabeL&D73 · Jan 4, 2006

Well, bed rest is one of the most difficult experiences I have ever had, and hospitalized bed rest for 6 weeks was even harder. I only had to be on mag at the beginning of my hospital stay for 48 hrs. After the original horribleness of it for the first few hours, my reaction wasn't as extreme as other people's. I could tolerate lights, sound etc.

What got me through was having a laptop--there are lots of online support groups of women in the exact same situation, and that really helped. Also a DVD player--this would help the time pass and keep my mind off of the situation. If patients or their family members are not familiar with netflix, this is a good time to sign up for it!

I personally found the neonatologist consult useless--he was cold--stood about 5 feet away from the bed the whole time, gave cold hard statistics and had absolutely NO bedside manner. I cried for a few hours after he left. Now, I can imagine that the neonatologists who took care of my son would have been more compassionate if I had met them in the same situation. But I totally agree that a NICU nurse might be the best one to talk to patients. The nurses who took care of my son were so kind and compassionate, and I can imagine that they would do a great job of letting HR moms know what to expect.

I think mainly some kindness and compassion goes a long way in these circumstances.

Shannon

judyblueeyes · Jan 5, 2006

We have over 30 (maybe 40 now) beds for Antepartums and it is not unusual for some to stay for 4 months. I stayed myself for 6 weeks in trendelenburg with no bathroom priveledges!

We have loaner laptops with wireless internet, books, magazines and videos, and VCRS (some rooms upgraded to CD players) in every room. We have PT consults that can include massage if ordered. The PTs teach bed exercises using therabands and pelvic rest. The patients are automatically referred to SS, education (pregnancy, L&D, CS, breastfeeding, etc- all topics), and dietary, and get NICU consults periodically. They have optional group sessions every week. If a bed rester wants to go, we will take her in the bed. Some docs allow extra WC rides if the situation permits. We have rooms for baby showers if needed. Most rooms are private rooms and we have very liberal visitation policies. We are undergoing a remodel right now so most of the SO beds have been converted to couches for the time being.

What else?

It's hard for me to ID what we do that is different (since it is normal for us).

Many (not all fo course) of our pts are magged for weeks and tolerate it very well once the get over the initial discomforts. Personally, it made me very ill, but my mag level was 7.9.

judyblueeyes · Jan 5, 2006

Oh- food. Room service, every take out menu in the area and a shared, pt-only fridge and microwave.

Cienna2000 · Jan 6, 2006

I waited a couple of days for preemie parents to respond. Everyone who was on mag said that they just wanted to be left alone.

One of the Dads is undergoing chemo and at his hospital the PTL moms are on the same floor as the inpatient chemo, he says they have movie nights and arts/crafts together a few nights a week. He is in Europe and have people that speak a variety of languages and lately they have been teaching each other a variety of languages.

I hope that helps!

SunshineBaby · Jan 6, 2006

Hi All:

Just wanted to say that I was high risk with my daughter's pregnancy. Woke up one night at about 24 weeks with lots of pain and nausea. I tried to go back to sleep but the pain soon became unbearable and I decided I had to go to the hospital. I was immediately sent to the L&D floor and examined. I was 1 cm dilated, cervix was soft. I was given a shot of Turb and then checked again. I was still progressing so I had to be put on the Mag. It was terribly frightening. They were able to stop the contractions and I was kept for about 4 days and then sent home with orders to stop working and take it easy. A month passed by with no incident. And then again the same thing. Awoke in the middle of the night with pain that I now recognized as contractions. Went to the hospital, same procedure as before. However, this time I was about 3 cm dilated and they decided I needed to go by ambulance to a bigger hospital about 45 min. away that specialized in high risk pregnancy. I had many tests while there, including a fetal fibronectin which I "failed." So, I was kept there for a month on complete bed rest. It was terrible, 45 min away from my family who couldn't visit me everyday. After all, someone had to work. I cried almost everyday. I tried to keep busy with reading and cross stitch but there were times when I thought the loneliness would consume me.

However, the nurses were fantastic. Some would even come and just chat with me when they weren't busy. I think I was one of their favorite patients because as long as I had water, I never asked for anything *LOL* I think just being compassionate to these ladies goes a long way. An extra smile or 5 min conversation made my day. I was never allowed to leave my room, except to go for ultrasounds, which they had a machine set up on the floor. It was hard for me being so isolated. I wish they would have let us talk to other ladies in the same boat. I wish I could have been wheeled outside once in a while.

Good did come from the whole experience, though. I decided I wanted to be a nurse and do the same thing these ladies did for me. I felt like God was speaking to me through my pregnancy. Telling me what I was intended to do with my life. I'm currently a nursing student. I graduate in April 2007 with my BSN.

In the end, I was released from the hospital after a month, only to be induced due to pre-eclampsia. My daughter was born healthy. She's now a normal craze inducing three year old and I love her to death :)