While COVID-19 has spurred an extensive series of changes in Yuma Regional Medical Center’s everyday policies and practices, staff in the labor and delivery unit are striving to keep things running as close to normal as possible.
According to Dorie Rush, administrative director of labor and delivery, one way of doing this is by continuing to allow mothers to bring their one “support person” to remain with them through the duration of their stay — as long as that person isn’t sick or showing any symptoms of being sick.
“The woman also has her own health issues, obviously, when they’re delivering (and) it’s challenging to take care of the baby immediately by themselves, so having that support there to assist in taking care of the baby is really, really important,” Rush said. “So we really strive to ensure that we can maintain an environment (that is) as safe as possible and still allow the husband to come in.”
While near-normalcy remains a priority, there are a few things that have inevitably changed in the labor and delivery unit as the hospital responds to COVID-19.
According to Rush, all patients are screened for COVID-19 upon arrival and given a mask, which they’re encouraged to wear throughout their stay. Rather than walking the halls as laboring mothers often do, patients at this time are being asked to remain in their rooms as much as possible to eliminate any potential exposure.
“It’s a little different in that aspect,” Rush said. “Sometimes in early labor we would have them walk the hallways for long periods of time, but we don’t allow that anymore. We have very large rooms, so we do have them walking around in their rooms.”
As YRMC continues to uphold its no visitor policy, family and friends have to wait until the patients are discharged to meet their newborn loved ones; but even then, the parents are encouraged to take precautions.
“On the other side, we’re very much educational in making sure they are taking care to protect their baby and their family once they get home, because babies are very vulnerable in their early stages,” Rush said. “We really encourage them to practice social distancing when having their newborn around other people.”
Another thing Rush and her team have had to contend with is determining how to proceed when encountering a patient who is positive or symptomatic for COVID-19. The staff created a plan and simulated scenarios to train and prepare for such an event, and according to Rush, all of this was recently put to the test as the unit treated its first COVID-19 patient.
“We had developed a very strict protocol and had worked through simulations of that kind of a delivery, and also a cesarean section multiple times, so when the patient came in, everything was very smooth,” said Rush.
To ensure the wellness and safety of other patients, five rooms in the labor and delivery unit have been sanctioned for mothers who are positive or “under investigation” for COVID-19. This hallway has a separate entrance from the outside, which allows patients to enter the hospital without having to go through the registration area and the rest of the unit. For cesarean sections, a separate operating room has been set aside specifically for these patients as well.
Another unique change that’s been “very challenging” to make for COVID-19 births is the aftercare.
“The one big issue that we do have with a mother and a baby is that obviously we have two patients to take care of,” Rush said. “Once the baby is born, they are separated and the baby is treated as a positive COVID as well even if they’re not, because initially we don’t know that. So we have to be safe and screen them and they are isolated in a separate room from Mom. Either the father of the baby or a separate family member who is not sick can come in and be with the baby — one separate person with the baby, one separate person with the mom. It is a very big change in the department to have to work that way.”
These changes in protocol, according to Rush, continue to be evaluated on a regular basis.
“There are a lot of different touch points that have been reevaluated and reworked,” Rush said. “Everything is very highly vigilant, between the handwashing and making sure that all surfaces are clean at all times. Things that you...take for granted every single day are very, very much on the forefront of everything that we do right now.”
For the foreseeable future, staff continue wearing masks at all times, “from the moment they get out of their car” to head into their shift.
“That is really our new norm, and something that I think we’re probably going to be getting used to even after we get through this initial pandemic,” Rush said. “That is very different.”
According to Rush, in such a time of uncertainty and unprecedented alterations to plans and normalcy, it’s important to the healthcare providers in the labor and delivery unit to stick to routine as much as possible when dealing with routine deliveries, “switching gears” as necessity and unique scenarios dictate.
“There’s a great group of nurses and providers that work here; we know how to do our job and we’ve done it for so long the same way that putting a mask on our face and going into a delivery is just one piece of it,” Rush said. “But the care that we provide to these patients, we really try to keep it as best as we can and as normal as we can. Keeping Mom and baby together when they don’t have symptoms, still allowing all of that bonding and communication, still allowing the dad in the room with them — that’s all very essential right now.”