ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, April 28, 1996 TAG: 9604300031
SECTION: NURSES PAGE: 2 EDITION: METRO
SOURCE: SARAH COX
People wave at Lewis-Gale Hospital's Baby Express van as it travels down neighborhood streets. Bystanders point to the pictures of the babies painted on its side. It's become recognizable around town.
Inside, in addition to bringing one of two OB nurses to homes after mother and baby leave the hospital, the van carries educational material, gifts of sunshades and electric socket covers, and a lot of experienced, solid advice for new mothers.
``A lot of people just don't realize just how much their lives will be changed with a baby - particularly the professional people whose lives are in order," said Rosemary Winslow, the department director for Lewis-Gale's Maternity Care Center.
The idea behind the Baby Express home-visit van was to reinforce teaching, answer family questions that may crop up once mother and baby are home, and make sure the baby and mother are doing well, said Kereen Mullenbach, vice president of Patient Care Services.
The shortness of the 24-hour stay probably is physically adequate, she said, but it doesn't allow for teaching and education. Winslow said that in comparison to the five-day stay of years ago, the one to two nights in the hospital often leave new mothers to their own devices.
To compound the problem, she said, Roanoke is a relatively transient population; there are less family ties than there used to be, with ``no mother or sister to pop in during the day."
The home-visit program is included in the entire delivery package, said Winslow, and about 90 percent of the mothers who deliver at Lewis-Gale take advantage of it.
In addition to the baby van, Lewis-Gale has a 24-hour-a-day, seven day-a-week phone line that connects directly to the nursery.
Sue Cundiff, one of the Baby Express van nurses who works in the obstetrical unit, said she thinks it's the best job she's ever had.
``I love labor and delivery, and there isn't anything like being in there, but it's different being outside, being with them in their own territory. I have the perfect mix - being in the hospital and having the freedom to be out,'` she said.
Cundiff and Sandy Adam's routine, when they visit mothers and babies at home, is to give about an hour's worth of practical advice, field questions and conduct a general check of baby and mother.
They can give bath demos and check the safety features of the home, specifically the nursery. They can weigh the baby and discuss any feeding problems. The pair also ask the mother how she's eating and sleeping, and what kind of support system she has.
Cundiff and Adams make sure the mother isn't in pain, has fever or is bothered by her stitches.
``We're devising a new, three-page check list," said Cundiff, who said questions will lead to more questions. They've also been able to treat minor problems that could have blown into major ones.
Cundiff said post-partum blues is a very common occurrence - 80 to 90 percent of all women who deliver should expect to experience it. In some cases, these blues can progress to ``more than teariness. I usually have them call the doctor while I'm there and then we always follow up with another call. I know a few who've been put on medications for depression," she said.
Adams, who has been a maternity nurse for 17 years, said couples had expressed a need for follow-up education after leaving the hospital. Mothers are more relaxed in their own environment, and once they get home, they realize they have other questions they've forgotten to ask, she said.
``We see mothers distraught because of sleep deprivation, with feeding and formula questions," she said. Adams said they'll do small things like show them the best place to bath the baby in their home, or at what temperature to keep the house.
Alison Sledd, whose son is 3 years old, delivered a daughter at Lewis-Gale in February. Sledd said the Baby Express program made a great deal of difference with her second child, because she didn't get to stay in the hospital nearly as long as the first time.
``They didn't have time to go over enough information, both for the baby and for me. It takes time to come up with questions. By the time the nurse came, problems had come up and I had time for those new-mom type questions. She knew exactly what I was going through," said Sledd.
Sledd said the nurse surprised her by asking questions about her health.
``I had a new outlook on things after she was here. It reassured me that Anna was doing all right. I'm just afraid people are going home too early and problems arise with the baby. If there is a problem, the nurse might spot it. Otherwise, it could go undetected until the first-month visit to the pediatrician," said Sledd.
To Cundiff and Adams, the greatest reward is seeing the joy on the faces of the mothers and fathers, they said.
LENGTH: Medium: 90 lines ILLUSTRATION: PHOTO: TIM TREVILIAN. OB nurse Sandy Adams (above), who teamsby CNBwith Sue Cundiff, takes her expertise to mother and baby at home via
Lewis-Gale's Baby Express.