Perspective: Where have all the visitors gone?

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In another article in the At the Nurses Station with OBIX series where our clinicians share thoughts and views, Diana Sturlis reflects how some of her experiences in a labor & delivery hospital have changed in the past year, and how the rule of unintended consequences doesn’t always bring bad news. In fact, some of these enforced changes have brought about benefits for expectant Mothers and their babies, and the nursing staff, and may be worth keeping as we move into a COVID-recovery world.

Diana has years of experience in the nursing world, both as a labor and delivery nurse in a community hospital since 1986, but also as a New Product Implementation Manager and Clinical Specialist since 2001. At a reasonable approximation Diana estimates being directly involved with hundreds of births across the years and has a highly relevant experience to bring to views on life in an L&D environment.

As Diana states from the outset, “One of the things that has become abundantly clear is that nothing related to this virus is clear! Things are in a constant state of change. One of those significant changes is the change in hospital visiting policies.”

“In my hospital, pre-COVID, we had a very open policy where we allowed any three visitors at a given time during the labor period and unlimited visitors during set hours in the postpartum period. While this allowed patients an abundant amount of support and drove excitement and happiness in welcoming the newest family member, it also brought on some significant challenges.

“One of those challenges was that staff spent more time tending to the door of the locked unit than we did on patient care. Hospital volunteers would be our saving grace as we would put them to work by ‘manning the door’.”

She continues “Also challenging were the well-meaning family members who became medical experts by what they learned from Dr. Google. Informed decision is what we strive for but debating ‘facts’ found on the internet can often be futile.

“Often times there were family dynamics that put the patient in the middle of making other people happy which brought tension to the joyous occasion. Nothing like an unsupportive boyfriend to bring out the momma bear in grandma to be!

She says another routine scenario would be a room full of visitors playing pass the baby from one to another like a game of hot potato. The visitor who got caught with the crying baby would then hand the baby over to the mother and say “I think he’s hungry” yet continue to just sit in her room simply unaware and failing to consider that the patient may not want an audience while breast feeding.

“You can imagine the anxiety of a new mother as she considered asking her visitors to leave or opt to nurse in their presence. With our adjusted visiting policy for COVID safety, patients are aware and understand that they are allowed one visitor who is to remain with them for the duration of their stay. Once they leave, they aren’t allowed to come back. While there is an occasional abandonment from a father to be who thinks it’s more important to get a good night’s rest in his own bed rather than see the birth of his child, most patients choose their support person carefully and wisely. While this may sound limiting, I have noticed some definite advantages to these restrictions.

“There is a sense of calmness on the unit. Staff can focus on patients rather than distractions caused by an abundance of visitors. The actual birth seems to be more intimate and relaxed with the focus on the nucleus of this family of three. I am seeing more connectedness in the bond between the couples. The ability for them to just take in their new baby without having to compose themselves to receive the grandparents who are patiently waiting in the waiting room chomping at the bit to see their new grand baby.

“I am seeing patients focusing on their own needs rather than entertaining visitors. Exhausted mothers can actually act on the sage advice of ‘sleep when the baby is sleeping’ since they don’t have to consider additional visitors.

“I am seeing the coming together of a family unit as the new parents get acquainted with their baby. They’re able to take advantage of this special time where they can just focus and bond with their newborn and each other. Their stay is short and in no time, they find themselves heading home where the business of life takes over once again.

Diana concludes this does not mean families and friends are completely left out of the picture.

“During this time of social distancing we have all found creative ways to maintain some semblance of normalcy while still being responsible for keeping each other safe. Extended family and friends have learned alternative ways of showing their support and excitement in welcoming their new baby. Car parades in the hospital parking lot with decorations and welcome signs are becoming a common occurrence. The ability to facetime and video chat can give a glimpse to family and friends. Short zoom meetings with family gathered on screen to toast and celebrate their precious addition is yet another way to stay connected and involved.

“Conversation at the nurse’s station often leads to lamenting over the good ol’ days when life was ‘normal’, yet we all seem to have a few silver linings to share.

“While this virus has affected our lives in many ways, one of the lessons learned may be for us to slow down and get back to basics. That, in my opinion, is my silver lining. Perspective.”