Recently, we had an emergency fetal EXIT procedure on a mom who went into labor early and unexpectedly. In an EXIT procedure, we partially deliver the baby (usually only the head outside of the uterus) and perform surgery on the baby while they are still on placental support. The fetus has severe Pierre Robin Syndrome and an EXIT procedure was required to safely deliver the baby. ENT planned to scope and intubate the baby with a backup plan for tracheostomy and potentially ECMO. At 1500 we got word that mom would be coming down as soon as the maternal-fetal medicine doctor was available. I looked at Yaya in near panic and asked if she would circulate this case with me. She jumped right in and made the whole experience amazing for the surgeons, and staff, as well as the mother and baby. Normally for these cases, there are multiple planning meetings to map out where everyone will be in the OR and how we will proceed, but because mom went into premature labor weeks ahead of her scheduled procedure date, none of this had occurred.
Yaya helped gather supplies and organize people in the room. Making sure our supply and instrument carts were available, the placement of the ENT scrubs and OB scrubs, as well as other special equipment including the NICU isolette and neonate resuscitation cart. She helped me go through my mental checklist to ensure we had all the necessary life-saving equipment and appropriate staff members. She helped label each person with their name and role. She worked closely with the ENT surgeons to discuss the game plan for the order of events, including what to do if an emergency tracheostomy was necessary. She prepared with them by also plugging in and setting up all necessary camera and light cords as well as bovies for both mom and baby.
When mom entered the room she was visibly upset, obviously feeling anxious and concerned that she was in labor early and that she and her baby were undergoing a risky procedure. The L&D nurse was busy and away from the mother, so Yaya immediately came to mom's bedside. She held her hand and spoke to her softly, immediately forming a bond with mom. She helped mom relax by sharing stories of their children and by utilizing therapeutic touch. After Yaya helped mom through the epidural and getting ready for anesthesia induction, I could tell mom was more relaxed and had stopped crying. Yaya was essential in helping mom feel relaxed and comfortable in the chaos of the operation room.
After mom was asleep Yaya made sure she was positioned safely. She participated in our surgical time out and assisted the maternal-fetal surgeons, general surgeons, and ENT surgeons as they began the procedure. Yaya was calm and gave clear responses to every question. She was attentive and the baby was successfully intubated, delivered, stabilized, and taken to the NICU. She stayed past her normal commitment to finish the case and help mom wake up.
Yay exemplified the qualities of a DAISY Nurse. She acted professionally on a moment's notice to provide outstanding patient-centered care to the mother and her baby. She went above and beyond recognizing where she was needed and helping mom cope when she was at her most vulnerable. Yaya made a difference in this critical emergency situation. She is well respected by her peers for her clinical expertise and calmness under pressure. She truly is an Extraordinary Nurse!