Practice might make perfect, yet few nurses have had the opportunity to hone their skills in the delivery of quintuplets. That did not deter the team at Banner Desert Medical Center in Mesa, Ariz., which drilled to ensure good outcomes for two families.
“Preparation was key,” said Kathy Walker, RN, BSN, MS, senior nursing director of womens and infants services and neonatal intensive care at Banner Desert and Cardon Children’s Medical Center. “It was well-coordinated and a beautiful thing to watch.”
Soon after learning perinatologist and multiple-birth specialist John Elliott, MD, had joined the Banner Desert staff, nurses at the hospital and at Cardon Children’s began preparing for deliveries of multiples, and it has paid off with two sets of healthy quintuplets delivered within a few weeks of each other. The nurses mapped out the logistics and determined placement of equipment and staff required. Then they conducted a mock delivery and ran through multiple what-if scenarios to prepare for emergencies.
“We prepared for months,” said Juli Edge, RN, BSN, a NICU nurse at Cardon, who “caught” one of the babies in the second delivery. “Patient safety was first and foremost. We worked with labor and delivery and came up with a strategy of what would be smooth for the mom and babies.”John Ferraro watches as Marti Marnell, RN, a neonatal NP, cares for one of his quintuplets.
The circulating labor-and-delivery nurse cared for the mother. A NICU nurse handed the baby off to a nurse in the recovery room, where the hospital had set up radiant warmers for each infant. A NICU nurse was assigned to each baby and wore the corresponding letter — A, B, C, D or E — on his or her surgical cap. Each team also had a neonatologist and a respiratory therapist. A labor-and-delivery nurse handled patient identification for the babies. Once each baby was stable, the assigned nurse transferred the newborn via isolette to the NICU.
“All roles were outlined, so there was no question about who would do what,” said Katie Holtz, RN, BSN, a labor-and-delivery nurse at Banner Desert.
For the first set of quints, the hospital scheduled nurses who wanted to take part in the scheduled event. Those nurses practiced together and then debriefed after Carmen Milam Matthews, 33, delivered on Sept. 6, but they did not find much to change.
But the second patient, California resident Meryl Ferraro, 39, did not make it to her scheduled delivery. She had spent nine weeks on the antepartum unit on bed rest, occasionally getting up in a wheelchair.
“We became like a surrogate family,” said Barbara Islas, RN,C-OB, BSN, an antepartum nurse at Banner Desert. “We use a team approach. … We work with the families to provide holistic care.”
On the morning of Sept. 26, Ferraro announced her water broke, with the quints at 32 weeks gestation.Mike Bei, RN, puts a wristband on one of the quintuplets.
“From that point, we started making phone calls,” Holtz said. “When I came on shift that day, my main job was to make sure all the proper people were in place. Then my role started shifting to making things move quicker because she started actively laboring.”
“To see five babies born is a miracle,” Edge said. “[The parents] struggled to have children. To share that happiness and celebration with them is rewarding as a nurse.”
For updates on the babies progress, visit the parents blog at www.SoCalQuints.com.
For a photo gallery of the delivery, visit www.Nurse.com/Gallery/Quints.