It may be one of the most intimate experiences in life but now moms-to-be must gaze at their newborns with a face mask before they are whisked away to check for respiratory infections. Welcome to labor and delivery during COVID-19. Three nurses from the St. Louis area, all Chamberlain alumnae—Kristen Lynch, MSN, MBA, RN-BC; Sarah Calhoun, BSN; and Amy Von Hall, BSN—have been instrumental in ensuring these moms and babies retain some normalcy in a world that has been anything but.
“There’s usually a feeling of closeness with patients during this time but now it’s so different because we have on all this astronaut gear. We can’t social distance while we’re helping a mom breathe through contractions. We have strengthened the bond between nurses and patients because of this virus—it’s made us focus even more on the patient.
“And there’s more compassion because of the empty room—there’s not 20 family members huddling outside waiting to hear the chime for the new addition. The atmosphere is so quiet when we’re used to grandparents, young siblings wearing big sister or big brother shirts, and aunts and uncles coming in and out of the room during labor,” said Kristen, an alumna from the Licensed Practical Nurse to Registered Nurse (LPN to RN) program with Deaconess College of Nursing in St. Louis, which changed its name to Chamberlain College of Nursing (now Chamberlain University) just a few months before graduation.
Healing Power of Nurses
Starting in a hospital housekeeping role in her late teens, Kristen wasn’t sure exactly what nurses did. “I assumed doctors did everything and nurses were their minions. But I quickly learned that’s not the case. I saw how hands on nurses were and I changed my focus from business to nursing because I loved how close and involved they were in healing people.”
As an RN, Kristen enrolled in Chamberlain’s RN to BSN online option followed by Chamberlain’s Master of Science in Nursing (MSN) degree program while working at the University’s SIMCARE CENTER in St. Louis. She then followed her parents to Texas where she still resides with her husband and two daughters who love to go to the park and ride bikes. First working on a medical-surgery floor, Kristen moved to labor and delivery and, after a few back surgeries, decided to split time between bedside and becoming an educator, what she calls “the best of both worlds.”
Kristen’s role as a nurse educator has dramatically shifted since COVID-19—she teaches on a smaller scale but dedicates more time to ensure everyone is up to speed. She has also taken over daily huddles to relay updates from the Centers for Disease Control and Prevention (CDC) and explain new department processes. Sending frequent communications and developing reference binders have also become routine. “It’s eye opening. I don’t like that COVID-19 is here and people are suffering through it. But what a time to be a nurse—I’m fascinated by the science behind it.”
Life in the delivery room is different as well. The number of nurses in each room has been cut in half to keep the team small and avoid reentry and re-gowning. The rarity of a pregnant patient being sent to the intensive care unit (ICU) is now the new normal, and complications during pregnancy are now magnified because of potential respiratory symptoms or infection. The nursing team is also ready to move delivery equipment to the ICU at a moment’s notice. And they immediately transfer all babies to the neonatal ICU (NICU), assuming the baby is COVID-19 positive until proven otherwise.
That’s forced Kristen to think outside the box because new moms aren’t allowed to hold or spend time with their newborns. She first suggested placing a baby in the room next to mom so she could hear sounds. Still not satisfied, Kristen proposed sealing mom’s phone inside a bag so the nurses could take photos and even livestream video. “One mom burst into tears because she had no pictures. She just wanted to see her baby. We have to remember that despite this virus, these are new moms with new babies and we have to find a way to give as much normalcy as we can.”
Also having to think innovatively on the job is Sarah, an alumna of Chamberlain’s Bachelor of Science in Nursing (BSN) degree program. New to the labor and delivery recovery and post-partum area, she said she enjoys the fast pace of the floor and utilizing her skillset. She also likes circulating through the operating room for caesarian-section births.
“Things change so fast in labor. You start out watching the fetal monitor, the heart tones and the contractions, and things are calm—everything is going well. And then the baby’s heart rate goes down and you have to move quickly. As a nurse, being there with moms at that moment is so incredibly special. You connect with the patient on a different level. But now it’s so sad because moms can’t share this special moment with the rest of their family and the I’m wearing a mask, which breaks the barrier of connection because they can’t see me smile.”
Patients are tested upon arrival. If positive, they deliver in the triage room; otherwise, they head to the delivery floor. Sarah said all pregnant patients must now receive an epidural and catheter in case the mom-to-be needs to be intubated. “We need to be prepared if they crash.” And nursing a baby after delivery has changed too. “Moms have to wear a mask and once the baby is done, the mom has to be moved six feet away. We’re taking away the whole bonding experience—they don’t get that time and connection.”
While Sarah fears bringing the virus home to her child, she is cautious and takes extra time to care for herself. She enjoys cooking, outdoor activities and has even gotten into the rhythm of home schooling.
Inspired by her mom who’s also a nurse, Sarah said this has been her dream job since she was a child. “I was really excited to listen to her stories and the connections she made with people. When I started my nursing career, I couldn’t see myself anywhere else and when I got to the obstetrics rotation, there was something in me that said this is where I’m supposed to be.”
Amy Von Hall
Amy, a NICU nurse, mom of two and a fellow Chamberlain BSN graduate, also knew nursing was her calling. “It’s a very weird time to be a mom and a nurse. I am pulled in so many directions—I feel compelled to work and help but the parent part of me feels like I should be home protecting my kids. I’m in a position where neither choice is right by itself. This is a calling, not just a job. I don’t go to work for the paycheck. Nursing is how I live my life.”
With one year of nursing under her belt, Amy admits the virus has created new chaos but has also strengthened the team bond. “The barriers between different job titles and positions have been broken. Right now, that doesn’t matter. It’s all hands-on deck.” Working in the NICU has been a challenge but one that intrigued Amy when her daughter was born at 34 weeks old. “I wanted to research what it means when a child is born early. The NICU can be intimidating and scary—when you have a child who’s intubated and have to flip them on their stomach— but at the same time, it’s amazing and a miracle. I absolutely love being bedside and interacting with the babies and parents.”
New NICU Rules
Since the COVID-19 influx, the entire dynamic of her children’s hospital has flipped. “Babies are so vulnerable already and now they are even more susceptible.” Hospital officials have instituted strict precautions and only allow one parent in the NICU, the same parent for the entire duration. “A lot of our moms have pretty traumatic births and have complications. Mom sometimes isn’t physically able to go to the NICU so then only dad can visit the baby.”
One NICU amenity—pre-COVID—are cameras over each baby so parents and extended family can watch them at any time. “It helps but parents are frustrated and scared right now. They are going through so much so I always reassure them that I am here for their baby. The least I can do is give them a detailed update and discuss our plan for care. And for the really little ones, I share the milestones like getting out of the incubator.” Some nurses voluntarily sew holiday outfits and then take pictures of the babies to send parents or find creative ways to share footprints.
Luckily, none of Amy’s patients have tested positive so far. “I don’t know what would happen because you can’t put a 20-week baby on the floor with COVID patients. We are not in the direct line of fire by any means but we still feel the stress of the whole situation and every day feels like a weekend because it’s so empty; it can be eerie. At times I can’t handle it anymore and I just cry a lot. I leave work, give air hugs to my kids and go in the shower. Sometimes I stay in the shower over an hour just to wash off the day mentally and physically. I don’t realize how much I did in a day until I get home and my feet and ankles are swollen and throbbing.”
Following in her mom’s footsteps, Amy started her career as a certified nursing assistant in a nursing home and provided pediatric home care at night. She became close with one 11-year-old patient who had a gene mutation and unexpectedly passed away. Coincidentally Amy was registering for nursing school when she received the fatal call. “That was a sign that this is what I was supposed to do.”
Merging Public Health and Nursing
Intrigued with rare disorders since that devastating event, Amy is now enrolled in Chamberlain’s Master of Public Health degree program. “The health process has made me more aware of my practice in the clinical setting and is helping shape me as a nurse. Instead of being very task oriented, I’m asking, ‘why aren’t we doing this?’ It’s made me really sit back and think deeper about different situations and how public health affects nursing as a whole.”
Amy is now considering broader career options, perhaps the union of clinical research with bedside patient care. For now, she brings her lunch daily and rides a shuttle to and from work. She’s also fortunate to have parents who have helped with childcare, keeping Amy’s kids for days or weeks at a time because they both have compromised immune systems. “They tell me I am on the front lines and am one of the most needed people in America right now.”
Bursting with pride for all fellow nurses, Amy encourages those in nursing school. “I tell them not to quit because this is why we became nurses—to help. This is what Florence Nightingale did way back when. People are starting to have a greater respect for nurses now. There will be a greater understanding of what we do. We are going to look back on this one day and think—wow, I can’t believe we went through that. To be a nurse—now more than ever—is a privilege.”
Appreciative and Thankful
We appreciate your commitment to the continued well-being of our Chamberlain community and support during this unprecedented time. Please visit the Chamberlain University website for the latest updates regarding COVID-19.
By Heather L Hurtado
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