PINEHURST – A shoulder dystocia complicates an otherwise uneventful delivery, putting both mother and baby at risk for more serious problems. Labor & Delivery nurses assist the obstetrician with a series of maneuvers that free the infant and then hand it off to a team from the Neonatal Intensive Care Unit for evaluation.
Nurse education liaison Bonney Barron, R.N., (standing center), leads a training program on shoulder dystocia for members of FirstHealth’s Labor & Delivery nursing team. Barron’s presentation was part of a recent shoulder dystocia drill that incorporated the use of a maternal simulator (at left) provided by the Moore Regional Hospital Foundation.
Although recently played out in a room at FirstHealth Moore Regional Hospital, this scenario was fortunately just a simulation. However, shoulder dystocia, in which the baby’s shoulder becomes obstructed by the mother’s pubic bone and is unable to follow the head through the pelvis, occurs in about 1 percent of deliveries.
The Labor & Delivery team has to be prepared, and there is no better preparation than practice. A Noelle birthing and maternal simulator from Gaumard Scientific is now a regular part of the obstetrical education plan for Moore Regional and its Rockingham division at Richmond Memorial Hospital.
The eerily lifelike mannequin and a Preemie Hal premature infant simulator were recently purchased with funds provided by the Moore Regional Hospital Foundation. Four years ago, the Foundation also provided funding for a full-term infant simulator.
“We are most fortunate to have the continued financial support of our ongoing perinatal education by the Moore Regional Hospital Foundation,” says Nicholas Lynn, M.D., medical director of Moore Regional’s Clarke Neonatal Intensive Care Unit (NICU). “First, with the neonatal simulator, back in 2008 and now with the maternal simulator, we are able to create realistic, high-risk scenarios to improve our staff’s preparation for real delivery room emergencies.”
According to nurse education liaison Bonney Barron, R.N., the Noelle simulator lends itself to a variety of Labor & Delivery situations. The mannequin can speak and breathe and has a heart beat and blood pressure. Its pulse strengths vary with blood pressure, and the pulses can be synchronized with an electrocardiogram. It even bleeds and responds to medications.
Because the mannequin is so lifelike, it can also be used to simulate breech deliveries, C-sections or episiotomy repairs in addition to such complications as postpartum hemorrhage and the previously noted shoulder dystocia.
“It’s very sophisticated,” says Barron.
The Preemie Hal simulator allows the team to practice the six assessment and care modules in the S.T.A.B.L.E. (sugar, temperature, airway, blood pressure, lab work and emotional support) program taught by Mary Ellen Lane and Matt Massero, neonatal nurse practitioners in the Clarke NICU.
A 45-year L&D veteran, Barron retired from full-time nursing three years ago and now devotes herself to continuing nurse education. She predicts that simulation scenarios like those being done for the Moore Regional and Richmond Memorial nurses will eventually “become the norm” since many Boards of Nursing already recommend them.
“It’s better to practice on a doll than practice on a person,” she says.
Like Dr. Lynn, Barron credits the Moore Regional Hospital Foundation for contributing to patient care excellence by providing educational tools – such as the three simulators and the 10-module Perinatal Orientation and Education Program (POEP) – that are usually available for nurse training only at teaching institutions.
“We’re very grateful to them,” she says. “They’re very generous.”