Bow Valley PCN’s Baby Team Deliver Pre- and Post-natal Care

The PCN’s Leslee Nickerson (l) and Sarah Hassall support expectant and new moms and their babies

Two of Bow Valley Primary Care Network’s Inter-Professional Team members, Registered Nurses Sarah Hassall and Leslee Nickerson, work together to provide wholistic care for expectant and new mothers and their babies in the Bow Valley. Sarah, who is also a Charge Nurse at Canmore General Hospital with responsibility for Obstetrical Liaison, is an International Board Certified Lactation Consultant, with more than 1200 hours of practical and teaching experience. Leslee specializes in pre- and post-natal care for patients through the Three Sisters Obstetrics and Family Medicine clinic at Dyrgas Gate in Canmore.

Low-risk obstetric patients contact the Three Sisters clinic direct or are referred through their family doctors. At the clinic they receive multi-disciplinary care, if they plan to deliver locally. Meanwhile, higher risk patients (for example mothers expecting twins, or who have diabetes or hypertension as well as those who have had previous delivery difficulties) can opt for shared care if they want to be followed in Canmore prior to delivery in Calgary.

Pre-natal screening and liaison

Leslee Nickerson says that an important part of her role is to act as a liaison between patients, the hospitals and the referring clinics.However, most of her time is spent providing pre-natal screening and patient education. That way, she says, “Patients know what to expect, what they are entitled to in Alberta and guidelines for pre-natal appointments.”“As well as the scheduled appointments,” Leslee continues, “some patients just come in to talk about labour and labour support. Building a relationship with the patient is most important. She might call up and say she thinks she’s having contractions and we can ask her to come in to the clinic, rather than going to the hospital”.

Leslee does the routine checks herself, only calling on a doctor if she needs higher level input. “Each morning the team has a get-together, where we go over the schedule and decide who will do what, which patients I’ll see myself and who we’ll see jointly,” she explains. Another new skill for Leslee is learning how to do PAP tests – a procedure that is increasingly being undertaken by RNs in the Bow Valley Primary Care Network.

Of course care from the team at the clinic doesn’t end with delivery. After the birth mothers return to the clinic for post-partum check-ups and advice on breastfeeding and contraception. At the same time, the baby gets a head-to-toe physical where checks are done for weight, development, jaundice and other newborn health concerns.

Advice and education

Meanwhile, Sarah Hassall also connects with mothers (referred by their physician, Three Sisters clinic or hospital staff) prior to the birth, to provide advice and education and then follows up with a personal visit with mothers requiring breastfeeding support 24 to 72 hours after the baby is born. She stays in touch by phone, email or by appointment, typically for another two weeks. However, if the new mom still wants support, she stays in contact for as long as is necessary to establish and maintain successful breastfeeding, keeping the patients actively on file for a year.

Sarah helps new mothers, who may be feeling uncertain about breastfeeding in the early days with concerns about how to increase milk supply, helping the baby latch properly, fighting infections and generally answering the mothers’ questions. Her approach includes natural or complementary remedies directed at treating low milk supply, thrush and other infections, as well as simple tried and tested practices like more frequent feeding to encourage milk flow. She also supports mothers with breast injuries or previous surgery, and those whose babies are jaundiced, premature, who have mouth deformities, or who simply fail to gain weight as expected.

“Stress can be an issue,” says Sarah. “Mothers are in a new environment, they are lacking sleep, maybe they are in some pain, feel embarrassed or anxious, or lack confidence.” She explains that many mothers in the Bow Valley are healthy, athletic women who find the transition to life with a new baby may bring about uncertainty or self-doubt, feelings that they may not previously have experienced. Sarah’s role here is to provide practical suggestions as well as emotional support.

Support group and volunteer role

Sarah is also establishing a support group for expectant mothers, where they can meet with moms already successfully breastfeeding. As well, she is working with Bow Valley hospitals providing breastfeeding education for staff and developing a role where experienced volunteers pair with new moms to provide extra support.

“This whole job is rewarding,” Sarah comments, “especially when I can give a new mom who thought she couldn’t breastfeed confidence and watch the baby gain weight.”

Leslee also finds her work fulfilling, and especially appreciates the team approach to care.“The scope of nursing here [at Three Sisters] is very broad: I’m learning so fast, working side-by-side with the physicians, learning new skills and increasing the scope of what I can do.”

Spring into Health – 12 weeks of focusing on your fruits and veggies intake, minutes of daily exercise and setting wellness aims set the pace for positive lifestyle changes for Bow Valley residents.

Bow Valley residents, volunteer Lifestyle Ambassadors, sponsors and donors contributed to the positive outcome and benefits of Bow Valley Primary Care Network’s Spring into Health twelve-week self- directed wellness program. The PCN would like to congratulate all participants!

The goals of Spring into Health were to promote a healthy lifestyle through education about national activity and dietary guidelines and to set and support achievable wellness goals on a weekly basis. While there were no mandatory exercise classes or rigid diet requirements, the program was free and participants benefited from weekly email tips, used simple tracking tools and were entered to win weekly prizes.

In February, 25 volunteer Lifestyle Ambassadors generated enthusiasm and recruited family, friends and co-workers …then they helped keep the momentum going as the program progressed.

In the end more than 500 residents from Canmore, Exshaw, Banff, Lake Louise, Morley, Kananaskis, Lac des Arcs and Harvie Heights registered for Spring into Health, either individually or in groups. All participants received a resource kit with educational materials and fun gifts to set them off on their wellness journey.

Weekly tips and practical recommendations were provided and registrants had the opportunity to complete surveys reporting on their progress. Participants said they enjoyed the practical insights, which sparked plenty of discussion and commentary. They also mentioned heightened awareness around their health behaviours.

Daily or weekly tracking of how many servings of fruits and vegetables they ate, minutes of activity they completed and working towards personal wellness aims helped build awareness of overall health and wellbeing.

Prizes – 35 in all – rewarded individual participation, thanks to the generous donations of eight local businesses.

Back in March snow was on the ground, but this didn’t slow down Adrienne from strapping on her snowshoes as a way of getting in the nationally recommended minutes of physical activity!

 

Volunteer Lifestyle Ambassadors keep motivation levels High

Volunteer Lifestyle Ambassadors have played an important part in Bow Valley PCN’s self-directed wellness program, Spring into Health, by engaging people from communities all along the Bow Valley - from Lake Louise to Kananaskis. The Ambassadors have displayed energy and enthusiasm, recruiting participants from workplaces, clubs, and among groups of friends and neighbours. They have continued to give support, promoting health choices, physical activity and well-being, distributing resource materials and keeping motivation levels high.

Bow Valley PCN would like to thank all Lifestyle Volunteers for their commitment and generosity in helping promote this initiative. Click on the Spring into Health link for an interview with Paula Remple, a volunteer Lifestyle Ambassador.

Lifestyle Ambassador Paula Remple says, “Spring into Health seemed to be a no-nonsense approach that brought people together towards a common goal.”

Taking a Pro-Active Approach to Active Living Delivers Increased Mobility and Weight Loss

Angioplasty, two knee replacements and hip replacement surgery aren’t holding Ken Ritchie back – in fact they were likely the catalysts for his increased activity levels and an impressive 25lbs. weight loss. Following his angioplasty at the end of May 2011, Ken was slated for a cardiac rehabilitation program at the Talisman Centre in Calgary, which would have meant a 100 km trek several times a week from Canmore to Calgary. Fortunately, the Bow Valley Primary Care Network’s (PCN) Active Living Program was able to deliver the support and exercise facilities Ken needed locally.

Ken enrolled in the twelve-week Active Living Program offered at the Canmore General Hospital, under the supervision of the PCN’s Physical Therapist, Todd Wolansky. His four days per week exercise included increasing levels of walking speed up to a brisk 3.5km an hour, resistance exercises and other physical activities aimed at improving flexibility and overall fitness. “Todd and the nurses were excellent,” says Ken. “I’m getting around so much better – when you take 25 lbs. off your back it’s bound to show.”

A few surprises

Ken’s wife, Pat, was already knowledgeable about dietary matters even before Ken’s procedures and has never been a fan of processed foods. Nevertheless, she chose to attend the PCN’s Cholesterol and Label Reading workshop, led by Dietitian Lesley Arnsdorf. Pat comments that there were a few surprises, especially concerning the sugar and sodium content of some foods. “We’ve cut right back, I’m using more low fat recipes and we’re eating smaller portions.” As Ken trimmed his weight, Pat, too, has dropped pounds and is feeling the benefits.

A former hockey player, Ken still curls regularly. Today he enjoys his increased level of activity and trimmer silhouette and is managing the effects of osteoarthritis better. He says, when it comes to health, “You have to be proactive”, adding (regarding the angina that signalled his need for angioplasty), “You don’t know what’s going on – when you get that funny feeling, get yourself in for tests!” Now Ken has completed the initial program, he’s exploring different options with Active Living Consultant, Randi Lynn Rinaldi, to ensure that he keeps up his activity level and his new fitness standard.

For more information about the Bow Valley Primary Care Network’s healthy eating and active living workshops, click on News and Events.

Coming soon – watch for our Spring into Health self-directed program aimed at healthy lifestyle changes.