This week we got a chance to talk to Jessica Bimm from Northwestern Memorial Hospital in Chicago. Jessica works in labor and delivery as well as triage. If you’re pregnant, check this out! If you already have had kids, let us know what you think or if you have any more questions!
Ok enough messing around, on to the interview!
What is your favorite thing about working in triage?
Your least favorite?
My least favorite things about triage are its fast pace and not getting to spend a whole lot of time with the patients. With the triage census being what it is, I sometimes don’t have the same opportunity to get to know the patients as I would if I were their primary nurse in L&D.
What symptoms might a pregnant mom-to-be experience that would prompt her to go immediately to the E.R.?
Symptoms to be aware of during the duration of pregnancy that warrant further attention include (but aren’t limited to): vaginal bleeding, leaking of fluid, shortness of breath, headache, blurry or spotted vision, severe nausea and vomiting, and decreased fetal movement. I believe that every hospital may have their own protocol about ER vs. L&D. At Prentice, all patients over 16 weeks are generally seen in L&D if they have a pregnancy related sickness. Patients should always call their primary OB physician with any questions and to be given further hospital-specific instructions. As always though, in the case of an emergency, if no specific instructions are given, head into the ER. Patients are often transferred from the ER to L&D once non-pregnancy related emergencies are treated or ruled out.
What can a Mom expect when they arrive in triage?
Moms can expect to have their vital signs and complete health history taken by their admitting nurse. Generally, monitors are then placed on the patient to monitor the baby’s (or babies) heart rate(s) and to monitor the frequency and duration of any contractions. Depending on the reason for being in triage, patients can expect to have a sterile vaginal exam (for assessing cervical dilation), a sterile speculum exam (for ruling in or out rupture of membranes), and sometimes a blood draw (for rule out preeclampsia or those patients who may have fallen or had minimal trauma to the belly). Depending on the results of the exams and/or lab work, patients are admitted to L&D or remain in triage for continued monitoring before being discharged home.
What are common mistakes moms to be make when they come to the hospital?
The only “mistake” that I can specify is not calling their physicians before their departure for or arrival to the hospital. It may be different in other hospitals but at Prentice, our physicians call ahead to triage or directly to L&D to allow the nursing staff to prepare for specific patients. Obviously in the case of an obstetric emergency, this point is completely void.
Any tips on how to make it a more pleasant experience for everyone involved, including the nurses and doctors?
Communication! Always be honest and vocal about your expectations and concerns with your nurses and doctors. Labor and delivery has a tendency to run smoother when everyone is on the same page. Don’t be afraid to ask questions and let us know how you are feeling.
When I went during my pregnancy I expected to wait a long time, but I was surprised to learn that I skipped most of the line due to the fact that I had multiples: is this usually the case?
In general, multiple pregnancies are viewed as higher risk but it does also depend on what you were presenting with (labor vs bleeding vs rupture of membranes). If two people were waiting, both presenting with labor, the multiple pregnancy would more often then not be seen before a singleton pregnancy. However, if there were singleton pregnancy patients who were more acute (vaginal bleeding, imminent delivery, etc.) they would be seen first.
Do you meet a lot of moms-to-be in your job that are expecting multiples?
What are the most common reasons they are coming in (ie Braxton Hicks, Pre-eclampsia, early delivery)?
Prentice sees a fair share of moms expecting multiples. We have lots of twins and a decent amount of triplets. As you know moms of multiples can expect more trips to the hospital then the average singleton pregnancy. Many times they are seen for abdominal pain, Braxton Hicks, or rule out preterm labor as we unfortunately know that these women are at a higher risk for early delivery. We also see many patients (multiple and singleton pregnancies) being ruled out for Pre-eclampsia. Prentice physicians also begin scheduling non stress tests near the end of multiple pregnancies to monitor the well being of the babies.
Time to be honest, what are your biggest pet peeves with Moms to be? What do you wish everyone would know before they came in, or wish that you could tell them?
My biggest pet peeve has to do with patient nurse communication and expectations. We have many patients that come into the hospital with specific down to the minute birth plans to guide their labors. Anyone who has had a baby or has worked in L&D knows that labors change on a minute to minute basis. Expecting to follow a detailed birth plan is unrealistic. I will say however, birth plans do serve as great guide to labor. Being flexible and open with your nurses and physicians will always make for a better labor and delivery experience for all involved. I hope that all expecting moms know that their L&D nurse is always in their corner. We do what we do because we love it. Ensuring a happy and safe outcome for both mom and baby(ies) is always our number one goal!A big thank you to Jessica for sharing all this information with us! Be sure to visit your fellow MoMs and let us know what you think!