I have a followup clinic where dyads come back to our hospital Women's
Center, where OB, Postpartum, and Nursery are located. They return in 1-3
days after hospital discharge and they are usually 3-6 days old. I allow 1
hr for the visit. Some visits take less time, usually not less than 30 min,
and some run overtime, like 1.25-1.5 hrs. In the mornings, later afternoons,
and in between, I am helping the inpatients.
We have a form that we use on the inpatients, so we have a good amt of info
on the dyad when they come in, and then I have my handy little followup form
so I can get info quickly and write it down while talking and interacting
with the family. I often observe a feeding but not always. I very rarely do
a pre/post weight. I always weigh the baby, and about 95% of the time do a
transcutaneous bilirubin measurement. I do a quick assessment with vital
signs and listen briefly to heart and lungs. Parents always have questions
about the umbilical area, rashes, sneezing, hiccoughs, etc.
I am usually writing things down, briefly, during the visit, but I try very
hard to be aware of being very engaging and face to face with mom, and not
just writing. When the visit is over I take a minute to complete my notes.
If the visit is getting lengthy, we develop a plan and schedule a f/u visit.
I have alot of handouts, some that I developed, to give mom info like
reinforcing hand expression, or pumping info and pump rental info, if that
is needed. Also one about smoking, very prevalent in our population, one
about exclusive bf "What's the big deal about exclusive bf" I think is what
i called it, and an easy "discharge instruction" page, all these i
developed, including one about pumping and rentals, to streamline the visit
and reinforce what I say verbally. Keep everything within arms reach.
You could have a form that mom fills out prior to her consultation, and you
could have a flowsheet, f/u form, or checklist where you can put info down
quickly. And you could have a form letter where you can write a brief
report, or check what you did and what you are recommending, to send to the
primary providers. Good luck, it's hard work, being as organized as possible
will help.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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