Becky Dean joined MUSC in April 2015 as the RN coordinator for the Advanced Fetal Care Center. Serving as a patient navigator for pregnant women carrying babies with complex congenital anomalies, Becky helps provide integrated and patient-focused care throughout their pregnancy and delivery. Becky recently answered a few questions about the Advanced Fetal Care Center.
Who would be assigned a nurse navigator?
Any family whose pregnancy is complicated by a diagnosis in their unborn child that requires care outside of normal postnatal care. This can be as simple as a baby who will need a diagnostic ultrasound after delivery to rule out a minor abnormality with their kidney, to a family who requires coordination of multiple teams, sometimes with as many as about 30 healthcare team members, to be present at delivery.
What is your role in caring for those families?
Most days, in some aspect or another, I interact with families who are facing one of the most difficult times in their life: finding out that their unborn baby’s health is in jeopardy. These families are emotional and scared, and, while I cannot take away their baby’s diagnosis, I can make this process easier for them.
This starts when a baby has been identified as high-risk or complex. I usually start by helping them understand their baby’s diagnosis. Additionally, I am present for patient consults with the multidisciplinary teams here to help with coordinating complex care plans. At those consults we finalize diagnosis, review expectations, outcomes, complete complex delivery planning, hospital tours, and global management of pregnancy. I then take the information from these consults and make sure that it is communicated to the teams who will be caring for these families throughout their pregnancy. That involves labor & delivery, antepartum, and postpartum staff here at MUSC, the neonatal ICU team, the pediatric cardiac ICU teams, and nursery teams. It also involves teaming up with their local OB/GYN and referring maternal fetal medicine teams to ensure that we are all on the same page for a patient’s plan of care.
If a patient requires a complex delivery with multiple teams present at the time of delivery, I am responsible for making sure that happens. If we need special equipment for management of a baby at the time of delivery, I communicate with the appropriate teams to make sure that it is available. For babies who will need specialized testing and/or care at or after delivery, my job is to help make that a streamlined and seamless process from before birth through the newborn period.
What might a typical day look like for you?
Every day is different for me. Some are very busy days in which I am working directly with our Advanced Fetal Care Center families in clinic, or contacting families throughout the state to manage their high-risk pregnancy remotely. Some days involve preparation and participation in healthcare team meetings in which we discuss our highest risk patient cases and decide on plans for best outcomes and delivery. Other days involve participating in practice runs in the operating room for our highest risk deliveries or reviewing prior cases in which we strive to learn from the experiences of past patients, and strive to improve the care that we provide. Then there are the days that involve staff education and outreach to understand the purpose of this new program, working on updates to patient education materials and preparing for our transition to our unit in the new MUSC Shawn Jenkins Children’s Hospital.
What are our patients saying about the program?
Since opening, we have maintained 100 percent patient satisfaction with the care we provide, even though these families are meeting us under such adverse conditions and have every reason to not be enthusiastic about their care. Our patient surveys have been overwhelmingly positive.
How will nurse navigators shape a family’s experience at the new MUSC Shawn Jenkins Children’s Hospital?
While our location is changing to a beautiful new facility that we are very excited about, our practice will be similar to what it is now with some exciting new additions. We hope to continue to grow this wonderful program and look forward to being able to offer families amenities like couplet care, private ICU rooms, state-of-the-art diagnostic imaging and partnering with the Ronald McDonald House to hopefully provide housing and peace of mind for many of our highest risk families prior to their deliveries. With the expansion to the new hospital, we will be able to offer more fetal intervention therapies such as treatment for Twin-to-Twin Transfusion Syndrome; that is an exciting part of our medium term plans.