Friday, February 22, 2013

Ill Newborns Can Stay Close to Home with New Nursery Designation

Giving birth is a stressful situation even when all goes smoothly. Add to that an early arrival or medical complication, and the worry quotient is compounded many times.

Ellen Bejger, RN, Fauquier Health’s Family Birthing Center director, said that Fauquier Health is prepared to care for newborns, even when a health care emergency may arise. In December 2012, the hospital was approved for an intermediate care nursery by Virginia’s Department of Health.

The designation means that Fauquier Hospital’s Mars Family Special Care Nursery is able to provide a higher level of care for babies who are born prematurely or with health issues, Bejger explained, “It also means that instead of sending ill newborns to another facility far away from their families, babies can often remain at Fauquier Hospital and receive the care they need.”

The nursery’s medical director and three neonatal nurse practitioners together provide 24/7 oversight for any newborns requiring special care. Additional bedside nurses provide the minute-to-minute care and monitoring.

Neonatal nurse practitioner Helena Brady says, “The monitoring is so important. We have state-of-the-art technology to register babies’ cardiac and respiratory health. And our nurses are able to notice even the most subtle changes immediately.”

Teaming Up with UVA
Fauquier Hospital has a cooperative arrangement with the University of Virginia (UVA) Medical Center, which operates a Neonatal Intensive Care Unit. UVA physicians are consulted in any cases involving premature newborns or those with any kind of medical issues. Instead of automatically being transferred to UVA, many babies are cleared to stay in the Mars Special Care Nursery, under the watchful eyes of the unit’s medical director, pediatrician Maria Juanpere, M.D., the nurse practitioners and the bedside nurses.

A healthy baby born at 35 weeks, for instance, may be able to stay in the Mars Nursery for an extra week to gain some weight, rather than having to travel to VA. Other issues that can keep a newborn in the nursery include respiratory issues or an infection acquired during pregnancy.

Dr. Maria Juanpere, medical director of the Mars Family Special Care Nursery

OB/GYN Thomas Myers, M.D., says he is delighted with the new designation and what it means for his patients. “Take the example of a mother whose newborn needs to stay in the hospital for a few extra days. If she’s got three other kids at home, she can be at Fauquier Hospital in the morning, leave to get her other kids off the school bus, and come back later. If, on the other hand, the baby is sent to another hospital somewhere in Northern Virginia, she has to travel in traffic at 7 a.m. and not be there for her other kids.

“This is great for the siblings too. It’s not as scary for them if they can come and see the new baby. We are glad to be able to keep families together.”

NNP Tina Rindele helped to care for little Adriana Glinka when she stayed in the
Mars Family Special Care Nursery for a few weeks.
Tiny Adriana Brightens Mars Family Special Care Nursery
Michelle Glinka admitted she was scared. At 23, she was scheduled for a cesarean section on December 20 to have her first baby. When 6-pound, 12-ounce Adriana was given to her to hold, her relief was immense. Glinka grinned, remembering, “My mom was up from Florida to be in the delivery room with me, and I heard my mom’s voice and Adriana’s cry at the same time."

But the relief soon turned to worry as Adriana’s breathing became labored. Amniotic fluid in the baby’s lungs caused respiratory difficulties that required oxygen therapy. Toward the end of January, Adriana was still in the Mars Family Special Care Nursery growing and getting stronger, but in need of around-the-clock attention. Glinka said, “The cardiologist said that she has a heart murmur, but it should go away on its own.”

Glinka spent her days, and many nights too, in the nursery with her baby. “Everyone here has been wonderful. They have helped me to feel so comfortable; I was even able to bring in things to make her room here feel more like home.”

Spending so much time with Adriana has allowed Glinka to discover her baby’s emerging personality. She said, “When she wants her food, she wants it now! When she hears someone walk by, she perks up to see if they are going to come in and talk to her. And whenever I leave the room, she knows it.”

The new mom talked about the attentive and caring nurses in the Mars Nursery. “Tina
[neonatal nurse practitioner Tina Rinderle] has been so great about explaining everything carefully and answering all my questions. If Adriana is crying, they all know what to
do. She is getting so much attention.”

Adriana has reached 7 pounds, 10 ounces and is eating and sleeping well. Glinka was happy to bring her home, but parting with the nursery nurses was bittersweet. “I am happy that I have been able to tell my story, to talk about the wonderful nurses here who work so hard and made me feel so comfortable.”
Neonatal Nurse Practitioners: The Key to Exceptional Care When Fauquier Hospital’s Family Birthing Center began developing its intermediate
care nursery, one of the first steps was to find experienced, caring neonatal nurse
practitioners (NNPs) to provide advanced care. The Family Birthing Center now
Meredith Shaw, NNP
employs three fulltime NNPs to care for premature or sick newborns.

NNPs are advanced practice nurses who work with physicians and nursing staff to
provide comprehensive critical care to premature and ill newborns. NNPs also
provide educational programs and support to both nursing and medical staff to assure
that care is up-to-date and based on the best available evidence.

NNPs attend all cesarean section births and any high-risk deliveries. They provide
support to the birthing center nurses, as well as to the families of newborns.NNPs examine patients daily, discuss RN concerns and recommendations related to
the newborns and help develop the plan of care in collaboration with the pediatrician.

Helena Brady, NNP
NNPs also perform procedures to treat and diagnose newborns. NNPs are licensed to
perform umbilical catheterization, lumbar puncture and arterial blood sampling.
It is important for parents to bond with their infants during the first few days and weeks,
but this contact can be more complicated when a child is ill. Fauquier Hospital NNPs
do everything possible to encourage parents to spend time with their babies anytime of
the day or night. Siblings may also visit their baby brother or sister in the nursery.
Tina Rinderle, NNP

NNP Tina Rinderle explained, “We love taking care of our tiny patients, but we care for the families as well. We understand the stress and worry parents go through when their newborn is ill, so we do our best to help ease that concern however we can. Whether it’s answering questions, explaining treatments or just listening, we are here to make this difficult time easier for our parents.”

What’s in a Name?
The Mars Family Special Care Nursery is named in grateful recognition of the donors who have done so much to make it a reality. The Mars Family was among the first to recognize and meet the challenge of providing advanced neonatal care in the community. Their support helped Fauquier Health transform care for our most vulnerable patients.

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