By Patricia Cicerone, BSN, RN, HNB-BC
When I became a nurse, I never realized how important finding original solutions could be when taking care of patients. After 20 years of caring for mothers and babies in a hospital setting, I took this philosophy and started my own business helping new parents in their homes. I attended a postpartum doula class given by the Childbirth and Postpartum Professional Association, whose mission statement includes “to give families the tools needed to move forward confidently into parenthood.”
A postpartum doula offers support and education to the new family, which may include newborn care, breast-feeding support, care of the mother, family support and even light housework. Having taught childbirth and breast-feeding classes for the past 10 years, I also could offer those skills. Through education and support, I help new parents prepare for their child, the birth, breast-feeding and the popular question, “Am I doing this right?”
One of my first clients was partially deaf. Angela could read lips, and her husband, Mike, knew some sign language.
After years of infertility, Angela became pregnant. It was not the easiest pregnancy. Angela’s gallbladder became inflamed. An ultrasound revealed that it had many stones and would need to be removed. The surgeon felt the procedure could wait until a month after delivery.
During the time prior to the baby’s birth, we met for childbirth, newborn care and breast-feeding classes at Angela’s home. We realized that with Angela having a scheduled cesarean section, she would not be able to read lips because everyone would be wearing masks. She was terrified.
The Americans with Disabilities Act of 1990 requires healthcare settings to provide effective communication for those who are deaf or hard of hearing. A sign language interpreter was offered to Angela, but she preferred to read lips.
Mike suggested a white board to write down answers to Angela’s questions. I cleared this with her physician and the nursing staff. It seems that some physicians are more open to discussing a potential problem when a solution is offered. We all want the patient to experience as little stress as possible.
The Monmouth Medical Center L&D staff and I came up with phrases — such as time out, name and date of birth, lie down, lots of pressure and here comes the baby — that a patient might hear during a C-section, so I could familiarize Angela and Mike with them. I printed them out on a clipboard for the circulating nurse. The circulating nurse would point to a phrase, and Angela would respond when appropriate.
I also received permission to be a support person for Angela in the OR. I was at her side from the moment she walked into labor and delivery until she was comfortably settled in her postpartum room.
Logan was born with no difficulties and bonded skin to skin with Mike in the recovery room while Angela’s operation continued. Due to some complications, the procedure lasted longer than planned, but with the white board I could easily answer Angela’s questions and pass on updates from her physician.
The white board followed Angela to postpartum and became a valuable tool for all her caretakers. And she used it again during her cholecystectomy two weeks later.
What I learned from this experience is that every patient has his or her own needs. It’s up to us to figure out the best way to make a scary procedure less frightening and assist the patient in meeting those needs. And it is absolutely OK to be creative.
Pat Cicerone, BSN, RN, HNB-BC, opened Pat the Darling Doula in June 2014. She is pursuing a master’s degree so she can teach nursing education.
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