Caring for critical COVID-19 patients who are pregnant requires tremendous teamwork among many specialties, roles and departments. While COVID-19 comes with a new set of challenges, collaboration among Labor and Delivery and critical care is familiar ground to Brigham nurses.
“We have wonderful relationships with intensive care units that care for obstetrics patients who are too sick to be on a labor floor,” said Kelly Anne Morgan, RN, nurse-in charge, of the Center for Labor and Birth. “We highly respect these nurses and staff and the care they provide. Our goal is always to to work together with all teams involved to maintain the pregnancy for as long as it is safe for mom and baby.”
When a patient is receiving intensive care, Labor and Delivery nurses regularly visit the ICU to monitor the baby and work with the care teams involved to plan for the delivery.
Gisvel Pena, BSN, RN, a critical care nurse who has current certifications in both critical care and obstetrics nursing, has been able to play a crucial role in the care of COVID-19 patients receiving intensive care while also pregnant.
“I’m able to assist my former Labor and Delivery team by helping to monitor the babies while also caring for these mothers in the ICU,” said Pena, who transferred to Braunwald Tower 11C recently after beginning her career in the Center for Labor and Birth. “I can page them to give a quick update and let them know the baby’s OK so they don’t need to come to the ICU as frequently.”
Emergency caesarean sections for patients on ventilators come with their own set of challenges. “An emergency procedure is especially difficult under the circumstances,” said Morgan. “But we work as fast as we can while keeping the mother, baby and all staff involved safe. We’ve all had to step out of our comfort zone with COVID-19, but we do everything we can to support the patients and have a good outcome.”
Such cases require intense coordination by interprofessional teams, including Obstetrics, Anesthesiology, Critical Care, Respiratory Care, the NICU, Central Transport, Environmental Services and many others.
“There is great collegiality between different specialties and roles,” said Nora Scharf, MSN, RN, nursing director of the Center for Labor and Birth. “It’s so impressive and a real testament to what a great team of expert clinicians we have that we are able to provide this kind of care under difficult circumstances.”
Pena agreed, noting that the Special Pathogens Units, where COVID-19 patients receive care, are made up of staff from units and areas throughout the hospital working together. “It’s really nice to work with nurses from other units,” she said. “We all help each other out. We’re also fortunate to also have a group of nurses who serve as extenders to support us. Everyone’s coming together to really make a difference during this challenging time.”