Author Archives: Robin Deal

Most Memorable Mentor: Nurses Week

Robin DealRobin Deal, BSN, RN, CCE is the Perinatal Services Manager at UNC REX Healthcare and has over 37 years of nursing experience in Women’s Health. She is the proud “Nana” of two little girls and expecting a grandson in September.

Happy Nurses Week!

Several years ago, ADVANCE for Nurses encouraged their readers to write about their most memorable mentor. “Mentors play an important role in the lives of nurses. Whether they inspire you to choose this profession or provide you with advice and guidance along the way, they are the ones who make a difference in our lives. More than 250 submitted their stories telling about that special person that made a difference in their career. These stories made it clear the nursing profession is full of compassionate and caring individuals that not only care about patients but each other as well.

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During Nurses Week, it is nice to reflect on the individuals who have influenced and supported us in our profession. Here is the story of the individual they chose as their Most Memorable Mentor.

“Louise” has been an outstanding mentor. Not only has she been my mother but a shining example of what a nurse should be and my inspiration to dedicate my life to nursing. As a little girl I remember the care and concern she showed to the patients of Dr. Bob. She took care of babies, kids, and adults with compassion and care. She retired in 1992 but families still see her in the community and say “I remember when you took care of me as a child” or “you took care of my mother when she was sick.” Her dedication to her profession, her passion to do a good job, and her understanding and care for people not only was present in the hospital and office where she worked, but she took it into the community into her church and her family. In 1973 when I was diagnosed with Hodgkin’s disease, she wore her “mom” hat but dedicated herself to care for me while in the hospital and through radiation therapy. She coached me through nursing school and was always willing to talk “shop” and encourage me. Even when she retired she worked in the local Medical Ministries organization to assist physicians in providing free medical care to indigent patients in the community. Then in 2003, she took on her most difficult nursing job ever. She put her excellent nursing skills and sent her compassion into overdrive all over again when she cared for my sister who had been diagnosed with a very aggressive glioblastoma. She and my dad spent 7 months in Texas (they live in NC) as primary care givers for my sister until she died. In a truly very difficult personal situation, she advocated, cared for, and grieved for her oldest daughter with dignity, compassion and love that she has shown to thousands of people over the years. Her dedication and inspiration to her profession truly served as a mentor for me and every day I try to live my career in the same way I have witnessed such an outstanding nurse over 54 years. Louise is truly a shining star for Nursing and always will be.

This week, take time to remember those who have influenced you as a nurse. Be proud of the nurse you are and the wonderful care and compassion you provide to your patients, their families and to each other. Thank you for all that you do and the influence you have on others as mentors.

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Child Safety Seats: Are They Used Correctly?

Robin DealRobin Deal, BSN, RN, CCE is the Perinatal Services Manager for Rex Healthcare. She has been a Child Passenger Safety Technician for over 15 years.

September 13-19 is National Child Passenger Safety Week. Safe Kids coalitions and other organizations are holding child safety seat inspections to emphasize the importance of proper car seat installation and use.

Do most parents and caregivers use child safety seats correctly?

091615_carseat2According to researchers at the Oregon Health and Science University Hospital led by Dr. Benjamin Hoffman, the answer is no!  In an ongoing study, new mothers who were asked to install a child safety seat in their vehicle and position their newborn in the seat under the supervision of a certified child passenger safety technician (CPST) did not do it correctly. 93% made at least one critical error in positioning their child in the car seat or installing the seat in their vehicle.*

Additionally, the study showed 68% made a harness error, 33% positioned the retainer clip too low, 28% used the incorrect harness slot, and 14% did not know how to adjust the harness.  The most common installation errors were a seat that was too loose (43%), incorrect angle (36%), and an unlocked safety belt (23%), There was an average of 2.3 positioning errors per family and an average of 1.9 installation errors per family.

The National Highway Safety Administration (NHTSA) reports that child safety seats reduce the risk of death in passenger cars by 71% for infants and by 54% for toddlers ages 1 to 4 years.  Proper usage of a child safety seat requires a combination of reading and following the car seat manufacturer’s instructions along with the vehicle owner’s manual that includes a section child seat safety.

Here are a few tips to help you install and use your child safety seat correctly.

  • 091615_carseat4Read all directions carefully in both manuals – vehicle owner’s and car seat
  • Know and understand the locking system of your seat belt.
  • Install the seat with less than one inch of movement – it does not have to be immoveable!
  • For a rear-facing seat, use the correct angle as noted by the indicator on the seat.
  • Position the harness retainer clip at armpit level.
  • Choose the harness slots that are at or below the child’s shoulders for a rear-facing seat.
  • Snug the harness so you are not able to “pinch up” the material.
  • Know how the LATCH system works if you have it in your vehicle (hint: owner’s manual!).
  • Avoid the use of products that did not come with your child safety seat.

There is no substitution for reading all instructions thoroughly before installing and using your seat.  Additional assurance that you are correctly using your child seat can be provided by having your seat inspected by a certified Child Passenger Safety Technician (CPST).

091615_carseat5If your baby is premature, make sure you choose a seat appropriate for the weight and length of your baby.  Select a seat that has a lower weight limit of 4 pounds and low harness slots.  Most premature babies are tested in their seat before discharge from the NICU to make sure they can ride safely in their seat.

Rex is proud to offer car seat inspections and classes for caregivers.  A certified CPST is available from 8:30 AM- 12:30 PM Monday, Wednesday, Thursday and Friday to inspect your car seat installation for free.  Please note:  We ask that you have read your instructions and installed your seat prior to coming to the inspection area in front of the Rex Women’s Center.  You may contact our technician, Chris Morris, at 919-784-1802 or Robin Deal at 919-784-3340.

 

*Hoffman B. Abstract #25919.  Presented at the 2014 AAP National Conference and Exhibition, “Majority of Parents with Newborns Misused Car Safety Seats.”

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Nurses Appreciation Week: The Heart of Nursing

Robin DealRobin Deal, BSN, RN, CCE is the Perinatal Services Manager for Lactation Services at Rex and has over 36 years of nursing experience in women’s health.

For the last eight years, I have served as an online mentor where middle or high school students can submit questions about nursing careers.  Most often they want to know about courses to take, degrees required, hours, salary, and many other aspects of the job itself.  My goal is to answer their questions but also provide encouragement to pursue their dreams whatever they are.  So I found it reflective this “Nurses Week” to receive a question that I think gets to the heart of nursing “What is it like to care for people?”

What a great question!  This question was one no student had asked before so it got me to thinking about what one quality nurses possess that identifies the “heart of nursing.”  While there are many wonderful characteristics that help define nursing, I think the one quality that reaches far above any other is caring.

042714_Robin_baby3There have been some wonderful nurse mentors in my career that have demonstrated this quality beyond measure.  My own mother, now retired, has demonstrated that attribute.  Today at 84-years-old, people frequently come up to her and thank her for the many years she “cared for them” or their family as patients of the family doctor where she worked for over 36 years.  They use the word “care” or some form of it to define what she meant to them. Even in retirement she worked in the local Medical Ministries organization to assist physicians in providing free medical care to indigent patients in the community.  She truly has a “caring heart.”

So what is it like to care for people?  Webster defines caring as “to be interested in or concerned.”  But is there more to this word than just Webster’s definition?  Absolutely!

Dr. Kristen Swanson has described caring in five basic processes:

  • Maintaining Belief is sustaining faith in a person’s ability to get through an event or life transition.  Nurses recognize there is personal meaning for each individual as they face daily challenges.
  • Knowing is the second caring process and is a true understanding of the effect the event has in their patient’s life.  It helps the nurse to identify the needs of their patient.
  • Being with is a process that includes both the physical and emotional presence that allows the nurse to share meaning and be attentive.
  • The fourth process, and I believe the key to caring, involves doing for others as they would do for themselves if it were possible.  This includes safety and actions in the best interest of the patient and anticipating their needs.
  • Finally, enabling is helping the patient and their family through events and life transitions.  It is the nurse who connects all of these processes together in providing quality care for patients and their families.

What is it like to care for people?  Every nurse I know will tell you that it is wonderful!  We gain so much from our patients and their families and each time we become a better nurse and even more caring.

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National Hospital Week: Why I Love Rex

Robin DealRobin Deal, BSN, RN, CCE is the Perinatal Services Manager for Lactation Services at Rex and has over 36 years of nursing experience in women’s health.

As I think back over my thirty six years in nursing, twenty-eight have been at Rex and I can’t imagine working anywhere else.  Rex is like family and I love it!  From the co-workers who care for patients and the facility, to those who assist staff, volunteer and especially those who lead Rex, the atmosphere  is always supportive and caring, much like a family.

Robin with a brand new Rex patient

Robin with a brand new Rex patient

Quite often I talk about my “Rex Family” and how we daily encourage and support each other and our patients.  Working in Women’s and Children’s Services,  I continually see nurses, doctors, and other hospital co-workers provide excellent care and services to patients and their families.  From the smallest patients in the Special Care Nursery to the most critical in the units, the Emergency Department or in the towers, patients receive the very best from the Rex co-workers.

They go beyond providing for patients and families; they provide for each other!  Whether celebrating a wedding, new baby, college graduation or lifting up someone through difficult times, Rex Co-workers care for each other.  They donate time off to a staff member in need.  They provide needed items for someone who loses everything in a disaster.  They mourn the loss of co-workers and celebrate the new life of children and grandchildren.  They donate their time to organizations such as Safe Kids of Wake County, Open Door Clinic, and Hospice.  They run, bike, swim or walk in marathons to support the work of organizations like the March of Dimes, Angels Among Us, and the Susan Komen Race for the Cure.

042714_Robin_baby3For over 120 years, Rex has been an integral part of the community and has reached out beyond the Wake County borders to be the hospital of choice for many North Carolinians.  And just like most families, Rex has experienced a “marriage” with the UNC Health System, the “birth” of many new programs, services and facilities, and continues to grow in direction and opportunities to provide our community and surrounding areas with compassion and care.

The Rex Family has cared for several of my family members and me over the last 30 years.   It is the best place in the Triangle to work and when needed, to be cared for by wonderful people.   If you have been touched by Rex Co-workers, I hope you will share your story with us on our Facebook page in celebration of Hospital Week.   From all of us at Rex, thank you for making us your family hospital!

Robin and the birth  center management team

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SIDS Awareness Month: Sleep Safe and Sound

Robin Deal, BSN, RN, CCE is the Perinatal Services Manager for Rex Healthcare. She is a registered nurse and childbirth educator and has over 34 years of experience in caring for mothers and babies.

What a beautiful sight to see a little baby, quietly sleeping in his or her crib! Are they at risk by sleeping under a hand-made blanket by a grandmother, or surrounded by bumper pads that match the nursery decor? What about a stuffed bear sitting in the corner of the crib?

It is important to make sure that the environment your baby sleeps in is a safe one. October is National Sudden Infant Death Syndrome (SIDS) Awareness month. In 2011, the number of deaths in North Carolina attributed to Sudden Infant Death Syndrome (SIDS) was the lowest in our history. While SIDS is not preventable, there are specific recommendations that can reduce the risks of SIDS.

In 2011 the American Academy of Pediatrics (AAP) expanded their recommendations for a “Safe Infant Sleeping Environment.” (PEDIATRICS Volume 128, Number 5, November 2011). There has been a major decrease in the incidence of SIDS since 1992 when the AAP released their recommendation that infants not be placed on their tummy to sleep. However, the decline has reached a plateau in recent years as other causes of sudden unexpected infant death have increased.

To help make sure your infant is in a safe sleep environment, follow these expanded recommendations from the American Academy of Pediatrics:

  • Place your baby on his or her back to sleep for naptime and bedtime
  • If your baby falls asleep in a car seat, swing, or carrier, move them to their crib as soon as possible
  • Infants should sleep alone in their own bed. Sleeping in the same room with a parent can be convenient and reassuring but they need their own space
  • Use a crib or bassinet that meets all current safety standards (cribs manufactured after 6/2011)
  • The mattress should be a well-fitting, firm, flat one covered with a tight-fitting sheet
  • Leave soft objects, toys, bumper pads and loose bedding, and pillows out of the crib
  • When using portable cribs, play yards, bassinets, etc., make sure they have a sturdy bottom, wide base, smooth surfaces, and legs that lock to prevent folding while in use
  • Keep your home a smoke-free environment. Even second-hand smoke increases the risk
  • Breastfeed your baby 
  • Use a pacifier at nap and bedtime. If you are nursing, wait until breastfeeding is well established (usually 3-4 weeks) before giving a pacifier
  • Make sure all childhood immunizations are up to date
  • Avoid using devices such as wedges, pillows, or supports that keep babies on their back
  • Dress your baby in layers and avoid over-heating. Consider using a sleep sack with only a t-shirt underneath for sleeping instead of a blanket
  • Provide supervised “tummy time” at least one or more times a day for your baby when he or she is awake. When sleeping on their back, you can turn their head to one side or the other to help prevent the back of the baby’s head from getting flat

Talk with your pediatrician about any concerns you may have about your baby’s health and safety. For more information about SIDS, check out the following websites:

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Make the First Ride a Safe One

Robin Deal, BSN, RN, CPST is the Perinatal Services Manager for Rex Healthcare. She has been a Child Passenger Safety Technician for over 13 years.

Baby Car seatsDid you know that car crashes are the leading cause of death for children ages 1 to 13?  Many times injuries or death may be prevented by the proper use of child safety seats, booster seats, and seat belts.   The National Highway Safety Administration (NHTSA) reports that child safety seats reduce the risk of death in passenger cars by 71% for infants and by 54% for toddlers ages 1 to 4 years.  Research studies have shown as many as 70-80% of child seats are misused.

Parents want to know “What is the best car seat for my child?”  The best car seat is the one that fits your car, fits your child and one you will use correctly every time.  Because there are so many types and brands on the market, parents have trouble deciding which one to buy.  More expensive does not necessarily mean safer.  All child safety seats have to meet minimum safety standards.  Check the labels and seat instruction manual to make sure the seat meets federal requirements.

To find the seat that fits your car, start by checking your car’s manual to determine the seating positions you can use to install a seat in your vehicle.  Vehicle features such as width, depth and angle of the seating position and types of seat belt systems may limit the positions you can use.  Cars with 2-doors or “bucket” seats are often difficult to get into and install a seat.  In general, the safest place to install a seat is in the middle position of the back seat (for sedan models).  You may have to try out several seats before you find the right fit.  Your child’s weight and length (height) will help you decide on a seat that fits your child.  For newborns, an infant only rear-facing seat is the best recommendation.  The American Academy of Pediatrics  recommends that all infants and toddlers should ride in a rear-facing car safety seat until they are 2 years of age or until they reach the highest weight or height allowed by their car safety seat’s manufacturer.  Make sure you select a seat you will use correctly every time.  You should be able to properly install the safety seat into your vehicle with less than 1 inch of movement and at the correct angle or position according to the seat instructions.  Remember to read both your car owner manual AND your child safety seat manual before installing your seat.

Are used car seats safe?  Before buying or borrowing a used car seat, find out the answers to these questions.  Has the seat been involved in a crash?  The National Highway Traffic Safety Administration has guidelines to help you decide if the seat is safe to use if it has been involved in a crash.  Does the seat have an instruction manual?  If not, you can call the manufacturer to get one.  Has the seat been recalled?  This question can be answered by looking at a recall list.  You can find a current list on the NHTSA website http://www.nhtsa.gov/Safety/CPS or on the North Carolina Buckle Up website at http://www.buckleupnc.org/using_recalls.cfm.  Has the seat expired?  All current models of child safety seats have an expiration date imprinted on the bottom or on the car seat label.  Finally, make sure that the seat has all the pieces and parts specified in the car seat manual.

At Rex, we want to make sure that first ride is a safe one.  We offer a monthly Child Passenger Safety Class to educate parents on proper installation.  In addition, a Certified Child Passenger Safety Technician is on duty Monday, Wednesday, Thursday and Friday from 8:30 a.m. to 12:30 p.m. to inspect your child safety seat installation.  In observance of national Child Passenger Safety Week, September 15-21, Rex will host its annual “I LOVE YOU BABY DAY” inspection clinic on Saturday, September 14 from 10 a.m. to 1 p.m. on the second level of the Women’s Center parking deck.

For more information about car seats, check out the resources listed below.  You may also reach our technician at 919-784-1802.  Don’t forget, children learn by example so buckle up every time you get in your vehicle and make sure all passengers do the same.

Car Safety Seats – Information for Families

safekids.org – car seat tips

nhtsa.gov/Safety/CPS

buckleupnc.org/using_recalls.cfm

Subscribe to the Rex Pregnancy Newsletter today if you are expecting or have a family member who is expecting!

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Breastfeeding Month: Power to the Pump

Robin Deal, BSN, RN, CCE is the Perinatal Services Manager for Lactation Services at Rex and has over 34 years of nursing experience in women’s health.

There are many questions about breast pumps, insurance and the Affordable Care Act. Unfortunately, there are no clear answers. Each insurance company is different, as companies grandfathered in under specific regulations are not required to provide one.

Since August of 2012, insurance companies have developed policies to be compliant in providing breast pumps for new mothers. Each company has taken this to mean something a little different. Here are some tips to help you ask the right questions when you talk to your insurance company about your specific benefits.

Use these guidelines to help you decide about a breast pump purchase or rental:

  • Each insurance company is different in the type of pump they provide, and you may or may not have a choice in the type or brand of pump you want
  • Most companies only pay for a hospital grade pump (rental) if the baby is separated from mom
  • Some companies only allow a mother to order a pump after delivery, which means you may not have it at home before you deliver
  • Certain companies require you purchase a pump from a specific provider of medical equipment
  • Generally, pumps purchased at retail stores are not covered under insurance plans
  • If you buy a particular type of pump, your company may not fully reimburse you
  • Check to see if there is a deductible to meet or if it has been met
  • You may be able to upgrade but your cost may be more and reimbursement less
  • Most companies require a prescription for the pump, a diagnosis code, and procedure code in order to file your claim with your insurance carrier. Diagnosis codes and prescriptions can only be provided by your doctor or primary care giver.
  • Ask if prior authorization is required and what the steps are
  • Insurance companies may provide you with a list of places providing durable medical equipment (DME) but not all of them sell breast pumps. Ask them for only the ones who sell breast pumps
  • Pump replacement parts and accessories are not usually a covered benefit
  • Outpatient consultations may only be covered by a certified lactation consultant if they practice under the direction of a physician or within the hospital
  • Always check with your insurance company about benefits related to breast pumps and lactation consultations once you leave the hospital

Before purchasing a pump, review your policy to know what your benefits are. Then call your insurance company and ask detailed questions about the purchase process. Use the tips above as a guide to forming your questions. The Rex Lactation Station staff can be reached at 919-784-3224. We are happy to answer your questions!

Subscribe to the Rex Pregnancy Newsletter today if you are expecting or have a family member who is expecting!

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