See You In Grapevine!

by, Bree Fallon, BSN, RNC-OB, C-EFM

When I was told my administration would be sending three of us to the AWHONN Convention, my heart skipped a beat. Actually, I squealed like a child and jumped up and down. It was a dream come true! I couldn’t help but compare Convention to a labor and delivery nurse’s Disneyland. It’s funny to me now remembering that day, as I would have had no way of possibly knowing what a tremendous impact the trip to Convention would have, both on my own nursing career as well as my unit.

AWHONN 2015 provided so much great education, but it was the passion from the speakers that truly resonated with me.

Bern Melnyk inspired me to challenge the evidence. Since hearing her speak, every policy I review and protocol I update, I scrutinize each article and ask myself, “Are we doing this because this the way we’ve always done it?  What does the latest evidence tell us?” As a clinical educator, one of my duties is to help coordinate our Nurse Residency Program. I’ve allocated an entire day in the upcoming cohort to illustrate to our new frontline nurses that we are the essential piece for recognizing nurse sensitive indicators through understanding of evidence based practices. Our goal is for new nurses to have a comprehensive knowledge of the relevant evidence in every task they perform and an understanding of how that impacts their patients’ outcomes.

Suzanne McMurtry Baird spoke on the patho of preeclampsia. I felt like I already had a pretty good understanding of this complicated disease, but she blew my mind. Listening to Suzanne was poetry. She had such command of one of the most complicated disease processes of pregnancy, breaking it down with such clarity, as if explaining how to butter a piece of toast.  Questions that had constantly crossed my mind throughout my career were addressed in the short time allotted for her session. I feverishly took notes, hoping to retain every ounce of her wisdom. I loved Suzanne’s analogy of a balloon animal from the fair being similar to the vasculature of a preeclamptic patient.  When I now borrow the same metaphor (of course giving credit where credit is due!) I love seeing that light go on for other nurses, new and experienced alike.

Twelve years ago as a new nurse, I thought I knew how to take great care of my sickest patients with preeclampsia.  I knew what to do, but I didn’t understand why we did all the things we were trained to do. This past year in our facility, we had over 200 obstetric nurses go through hypertensive emergency education and eclampsia simulations. Each time a class or a simulation was in session, I was able to confidently and comprehensively address questions or comments. Our leadership team is identifying opportunities to further improve our preeclampsia related care, enrolling our facility in a preeclampsia immersion project with the state hospital association.  What a difference a 90 minute session can make!

I also attended a session on the Maternal Fetal Triage Index. It was brilliant. Shortly after the session that very day, I met a lovely and enthusiastic woman at the AWHONN Booth, Mitty Songer.  We struck up a conversation on the MFTI and how AWHONN was looking for pilot communities. I took her card and brought it to home to the rest of our leadership team, who agreed that being part of the pilot community was an amazing opportunity. Our hospital is currently working on integrating the MFTI into our electronic medical charting. Being part of the pilot community has been extremely beneficial. We are able to collaborate with other facilities who utilize the same EMR system, bouncing questions and ideas for best practices off each other.

Another memorable session was presented by Lisa Miller. I could listen to Lisa Miller talk for days on end!  She draws you in with the statistics of liability in obstetrics, hitting on the pitfalls that can lead to litigation using real world examples.  Comparing notes and putting our heads together on our plane ride home, my manger Eva and I felt we needed to raise awareness of these issues.  Since Convention, we have integrated an obstetric liability class into our 2016 curriculum. The class is complete with an expert panel consisting of hospital legal counsel, a legal nurse consultant, a representative from our risk management team, and a couple of nurses who have firsthand experience with litigation. I also incorporated one of the articles Lisa referenced, “Intrapartum Management of Category II Fetal Heart Rate Tracings: Towards Standardization of Care”, into our mandatory interdisciplinary education for 2016. Reviewing strips and utilizing the algorithm from the article helps to take the variability out of the management. From this, we have also developed a task force focusing on opportunities for improvement in C-sections resulting from non-reassuring heart tones.

Many other sessions sparked ideas for initiatives for consideration by our leadership team. For example, we held a discussion on the potential use of Nitrous Oxide for analgesia. Nitrous is not currently used on any labor units in Kansas City. Generating dialogue and interest is the first step, and we are currently working towards getting more information to our interested providers.  Another initiative, delayed bathing, has been discussed at length within our shared governance. Though I am so excited to incorporate many of these innovative practices, I have to remind myself that any successful change in practice takes time, born through discussion and development of a well laid plan.

The sheer magnitude of information crammed into my brain in that short four days in Long Beach was overwhelming but completely invigorating. Each session I came away smarter, which has translated to my nurses and especially my new grads becoming more knowledgeable through the experiences I took away from Convention.

Out of everything I learned, the most important was gaining an understanding of who AWHONN is.  Our Kansas City AWHONN Chapter is fairly young, so my idea of AWHONN was great webinars and fetal monitoring courses. Every person I met, the bedside nurses filling the sessions, the speakers, the editors of AWHONN’s journals, every person working the booths, each of us is united by the same common thread, to make a difference in the lives of women and newborns.

It was inspiring to be back at my desk surrounded by the same text books, journals and resources, now having heard and met many of the authors. To learn from the best of the best, I felt like I was at the Top Gun of OB Nursing!

The networking opportunities at Convention are endless. In addition to a selfie with Lisa Miller, I’ve also been the benefactor of continued guidance from her. I personally met Dr. Kathleen Rice Simpson in the lobby of our hotel. I had seen her speak earlier in the day and just had to tell her how much I loved her session, I also took the opportunity to ask her for her thoughts on my contemplated return to school. She was so kind, providing her email address and telling me she would be happy to discuss it with me at greater length. A month later she graciously spoke with me on the phone, sharing her wisdom, thoughts and opinions to help guide my decision.

Inspired with gratitude and pride for the leaders within AWHONN, I am motivated to become more involved and find out ways how I can contribute. This fall I applied for the AWHONN Emerging Leader Program and was selected! I will be beginning my journey and learning more about advocacy for health care in Washington DC in March! So pumped, a cow town girl on Capitol Hill!

Just a few days in Long Beach at the AWHONN Convention changed the trajectory of my career. I am counting the days down for Grapevine and hope to see you there!

Bree Fallon, BSN, RNC-OB, C-EFM
Bree Fallon is a Clinical Educator for Perinatal Services at Shawnee Mission Medical Center, the busiest delivering hospital in Kansas City. She graduated from nursing school in 2004 and started her career in a tertiary care facility, providing high risk intrapartum and antepartum care. In 2010, she moved to Children’s Mercy in Kansas City who was looking for experienced L&D nurses to help open the their new Fetal Health Center.