by, Melissa Strunc, RN
This was my first AWHONN Convention!
The first class I attended was on dealing with neonatal abstinence. My hospital has a center for addiction and pregnancy and I deal with these babies almost on a daily basis, so when I saw that AWHONN offered a pre-convention seminar on shortening the length of stay for these newborns, I knew I just had to go!
The presentation by Maureen Shogan, MN, RNC, dealt with the newest changes in caring for these infants, and the latest research concerning shortening their length of stay. The first thing that stood out to me was when the Maureen said “Babies are not born addicted!” She proceeded to explain the definition of addiction, which included a pattern of compulsive behavior, impairment and behavioral control, and problems with interpersonal relationships. This certainly doesn’t sound like a newborn!
She clarified that these babies are dependent on the drugs their mothers are taking while pregnant, but are not “addicted”. The word addiction puts a negative stigma on these babies so early in their lives. The second thing that stood out to me was that these mothers, these patients who are doing this to their babies, are someone’s mother, sister, daughter, cousin. Their dysfunction is how they kept alive.
Maureen also presented information on cigarette addiction among these women who are taking other drugs and how this affects the babies’ withdrawal symptoms. She shared the latest research concerning this out of Dartmouth, where they were able to shorten the entire length of stay for these newborns when they factored in the nicotine dependence of these newborns among other slight changes to their approach.
She went on to discuss in depth the scoring system, and how to train nurses to become reliable, instruct parents prenatally and postpartum on what to expect from their babies during the hospital stay. She highlighted the importance of team training for staff in conjunction with psychiatry and finally the importance of the timing of scoring these babies so that we are not giving them unnecessary high scores when they may just be hungry.
Coming into this, I felt that my department was very good at scoring NAS babies, although I do see disparities myself from nurse to nurse. However, in this class I picked up on one specific category that we were scoring these babies higher than we should have, when one point should not have even been included in the scoring system.
I am so glad that I came to this pre-convention workshop, and I will be sharing everything that I learned with my colleagues when I return.
The second workshop I attended involved the rapidly deteriorating OB patient and how to pick up on warning signs, and follow through with the appropriate treatments, all the way through CPR (if necessary), and emergent delivery of the baby. One key point that stood out to me is to never ignore changing vital signs as these will be the earliest indicator that something is going wrong (as well as the fetal heart tracing).
I also had never heard about the importance of displacing the gravid uterus to the left during CPR! This seems so obvious after hearing it, but we do regular simulations on my unit (including the doctors), and I have never heard anyone bring this up!
My take-away quote from this workshop was “I can only control what I do”. I can’t control the doctors and other nurses, but I can take responsibility for my actions and reactions; and this will improve my patients’ safety.
The first general session had so many “ah-ha” moments for me, I don’t even know where to start. Not only was the presenter knowledgeable, but her words touched my heart and soul. It was uplifting and encouraging, at the same time challenging and convicting. As I sat there, I found myself wishing she could do the entire conference – and she’s not even an OB nurse! I left with tears in my eyes, and her presentation wasn’t even sad!! THANK YOU, Captain Beeson! I will definitely be hunting down these slides and sharing her words with my colleagues and managers concerning resilience!
One of the many quotes that stood out to me was, “Getting upset & complaining over silly, stupid things saps your energy from things that are important.” This can be translated into work, personal life, family, etc.
My favorite story she told was concerning crisis, and how there is so little complaining and negative attitudes in time of crisis. She shared a story about the time period after 9/11 when her military hospital sent a large number of their nurses to man a hospital ship off the coast of New York. She immediately started receiving calls, and was able to fill those spots in her hospital with nurses all over the area. It was such a touching story, and it really hit a chord when she said that this is the kind of nursing we need – crisis nursing without the crisis.
I know that I will start being more diligent in staying positive, speaking encouragement and positivity rather than feeding into the negativity. And, again, take responsibility for my actions in my area as well as never taking the “not my problem” attitude after attending this session.
I have already learned so much from this convention, and can’t wait to see what the next few days hold!