Helen Alexander

Helen Alexander - Work Sample April 2017 Mobi content developed for nurses in the public health care system to supplement regular clinical and motivational SMSs. SMS: Try to see all first antenatal visits on the day the patient arrives. Early antenatal care picks up problems - like hypertension and HIV. Early antenatal visits save lives See each patient when they first come to the clinic Never turn a woman away when she first comes in. The sooner she gets antenatal care the better her chance of a trouble-free pregnancy. Early booking can prevent complications and pick up problems like hypertension or HIV. Book patients early to: ● pick up problems and risk factors, ● decide what level of care is needed for pregnancy and delivery, and ● plan further management. The best time for the first antenatal care visit is at 8 weeks when the woman has missed her second period. At this visit, you will: ● confirm the pregnancy, ● take a full history, ● do a general exam. ● work out how far along she is, ● find out her blood group and haemoglobin, ● do a PAP smear (if indicated), and ● screen for hypertension, proteinuria, glycosuria, over or underweight, HIV and syphilis. At the end of the first visit, you will grade the woman’s maternity risk as low, intermediate or high and enter all details entered into her hand-held record. Have you found ways to encourage women to come to the clinic earlier in their pregnancy? Helen Alexander - Work Sample April 2017 SMS: All babies are special, but some need extra care. If born preterm (less than 37 wks) keep warm and check for breathing & feeding problems. Premmies need extra care Check warmth, breathing and feeding It’s important to know whether a baby is born full term or preterm. Prem babies are at higher risk and need to be carefully observed and cared for. During ANC visits, you need to work out the gestational age of all pregnancies. Most babies are born between 37 and 42 weeks (258 to 293 days) after the first day of the mother’s last normal menstrual period, and are considered ‘at term’. They are at low risk of problems after delivery and usually only need routine care. On the other hand, preterm babies are born too soon (before 37 weeks) and often need extra care, because they may: ● be at higher risk for problems after delivery due to immature organs. ● become injured during delivery (eg severe bruising). ● suffer from the medical condition which caused the preterm delivery (eg congenital syphilis). Common complications amongst prem babies include: ● poor breathing at birth, ● recurrent apnoea (stopping breathing), ● respiratory distress syndrome (lung disease), ● periventricular (brain) haemorrhages, ● hypothermia (low body temperature), ● hypoglycaemia (low blood sugar), ● jaundice, and ● poor feeding. Preterm babies need special care and should be delivered at a facility that can provide this. Helen Alexander - Work Sample April 2017 SMS: Remember to check your patient’s blood pressure at every ANC visit. A raised blood pressure means mom will need close follow-up or referral. Checking for Hypertension in pregnancy Make sure to measure blood pressure properly It is very important to check a woman’s blood pressure at every antenatal visit to screen for hypertension which could indicate pre-eclampsia. Hypertension in pregnancy is a systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher. Make sure to measure the blood pressure correctly: ● The woman should sit in a chair or lie on her right side but not on her back. ● Let her relax for a few minutes. ● Physical effort and anxiety can raise blood pressure, so don’t rush the procedure. ● Choose the correct size cuff and put it firmly around her right arm. ● Pump the cuff up until the brachial pulse can no longer be felt. ● Place the diaphragm of the stethoscope over her brachial artery and slowly let the air out of the cuff. ● Record the systolic pressure when the pulse is first heard. ● Record the diastolic pressure when the pulse disappears. Do not record the diastolic pressure when the sound gets softer. Try taking turns observing each other and giving each other feedback. Helen Alexander - Work Sample April 2017 SMS 2: Midwives often work long hours, lose sleep and deal with stressful situations. Remember to take breaks & find ways to de-stress after work. Being a nurse is hard Are you taking care of yourself? Twelve-hour shifts, switching from day to night, standing for hours, feeling overworked – a nurse has a lot to deal with. These challenging conditions can harm your health. Watch out and take action to stay healthy. Here are some signs that you need to de-stress. Are you: ● ● ● ● ● ● Tired and worn out? Getting sick often? Eating more or less than usual? Sleeping too much or too little? Biting your nails or grinding your teeth? Suffering from constant head or stomach aches? Support from colleagues can work wonders. If you share how you’re doing, you can lean on each other. Also make sure that you eat sensibly and regularly (at work and home), and that you get enough sleep. Regular and fun exercise can also help – take a walk with friends, or dance around the house with your kids to de-stress and keep fit. Breaks are really important. Don’t skip your tea breaks; even 5 minutes helps. And do take your leave days! When so many people need your help, it’s easy to ignore your own needs. Look after yourself! Helen Alexander - Work Sample April 2017 SMS 3: A kind or encouraging word from you can go a long way! It gives a woman confidence in herself. Let her know you're there to listen and help Talking from the heart Communicate in a caring and effective way An encouraging word from you can mean so much to a new mother. Here are some ideas for building an open, trusting relationship with the women under your care. ● ● ● ● ● ● Take an interest in each mother as a person. Be friendly and warm, listen, and respect her dignity. Give information that is clear, accurate and free from confusing medical terms. Show that you are there to listen and help -- not to look down on or judge her because of her age, religion, race or any other reason. Remember that people look up to you, so follow your own advice and set the example. Always respect your patient’s right to privacy and confidentiality. Promise her that you won’t share her story. Make eye contact - if you see you’ve lost her, stop and go back. Remember that non-verbal communication (body language, facial expression etc) is also important. Try not to come across as too busy – focus on the person in front of you. You can also use touch where useful to reassure, comfort and make a connection. Helen Alexander - Work Sample April 2017 SMS 15: De-stress Tip: Working with children and families can be challenging. Remember to look after yourself! Find ways to manage stress each day How do you switch off after a shift? Do you switch off after a shift? While some nurses are able to switch off pretty easily, others find it really hard to leave work at work. They worry about patients and about whether things have been done. But experts say that you will wake up more relaxed and motivated if you can switch off from work. Here are a few tips from other nurses: ● As you leave, in your mind switch off the light and say "Good Night!" ● Come home and chat to your husband or family member about your shift - then it’s finished for the day and you can move on. ● After work, spend half an hour doing something fun – sport, music, a hobby. Focussing on an activity gets your mind off work. ● Relax. Do nothing. Or use stretching or breathing exercises to help you unwind. ● Spend more time with your family and friends. ● Music is a great way to change your mood. ● Make specific plans after work, so you have to leave and can’t work overtime. ● Sleep. Put in place plans to keep work at work. This helps you recharge mentally and emotionally. How do you relax after work?