November 22, 2021

Nanaimo Regional General Hospital Update- November 22, 2021

Perinatal Unit/ Intensive Care Unit/ Pediatric Unit- Support Person Guidelines

Perinatal and pediatric care units consider the partners and parents of patients as essential components of the care encounter. Recommendations for planning safe, family centered care on perinatal and pediatric units include the following:

Support persons are to come through NRGH main doors during daytime hours. All visitors must be Covid screened and wear a medical grade mask upon entry to unit. Temperature assessments are no longer required upon entry. Any visitor refusing to wear a mask will not be allowed on the unit.
Perinatal/NICU support persons may enter through the perinatal doors only after 11:00pm.
Two support people will be permitted at a time throughout the continuum of active labour/PP/post cesarean recovery (main support in OR and PNU PACU)/NICU/Pediatrics.
Only 1 support person in the PNU assessment room for acute assessments & and ECV procedures.
Antepartum patients may have 1 support person. Overnight stays are permitted if moved to a semi private room that is not occupied by another patient.
Off service patients may have one visitor, this person must provide vaccination status.
No support people for routine NST and iron infusions (exceptions can be made)
Support people will have visitor ID bands applied identifying 1st and 2nd support people.

A sibling is permitted to accompany an adult as the 2nd person support person.
We are encouraging to defer sibling visits with newborn until the baby is at home considering most siblings are not vaccinated. An adult must be the 2nd visitor with a sibling. (ie: sibling groups are not permitted simultaneously).
Mask wearing in the presence of staff or outside of patient rooms, remains a requirement. Any exemptions will be dealt with by leadership on an individual basis, to ensure mitigation of risk to staff.
Contact tracing is to be completed at the NUA desk for all visitors entering the unit.
We are no longer monitoring the number of times visitors come and go from the unit.
A pregnant patients’ identified primary support person (a partner, friend or family member) is exempt from the vaccine requirements for hospital visitation
There is now a requirement to prove vaccination status of the identified second support person.
Doulas will be required to be vaccinated and show proof of vaccine status. This is because either doulas are considered part of the care team and/or are acting as a labour support person who is not the partner of the laboring patient.
NRGH is not opening their waiting rooms.
Patients may bring in their own pillows, etc.
Patients are not to use the nutrition centers.

**These guidelines may change in the near future.

October 19, 2021

Nanaimo Regional General Hospital Update- Oct 15, 2021

Perinatal Unit/ Intensive Care Unit/ Pediatric Unit- Support Person Guidelines

Support persons can arrive through the NRGH main doors during daytime hours. Screening for COVID-19 will occur.
Support persons attending the Perinatal/NICU may enter through the perinatal doors during off hours.
Two support people will be permitted at a time throughout the continuum of your time in the hospital.

A sibling is permitted to accompany an adult as the 2nd person support person, however this is not recommended.

All visitors must be COVID screened and masked on entry to the Unit. Any visitor refusing to wear a mask will not be allowed on the unit.
Mask wearing in the presence of staff or outside of patient rooms, remains a requirement.
At this time there is no requirement to prove vaccination status of support people.
- Parents of pediatric patients are not required to show vaccine status (although, strongly encouraged to do so).
- Soon the additional support person can be asked about their vaccination status, and be denied entry similar to other visitors to the hospital.
- Soon, doulas will be required to be vaccinated and show proof of vaccine status. This is because either doulas are considered part of the care team or doulas are acting as the labour support person who is not the partner of the laboring patient.
NRGH is not opening their waiting rooms.
Patients may bring in their own pillows, etc.
Patients are not to use the nutrition centers.

**These guidelines may change in the near future.

July 7, 2021

With the new changes taking effect around mask wearing in public, we wanted to update everyone on our clinic policies. At this time we do not have new guidance from the BC CDC, therefore we will continue to have everyone wear a medical mask in clinic. This is to continue keeping all of the midwives, admin, clients and our families safe.

We are happy to welcome back partners and support persons in clinic. Every client can bring one support person with them to any appointment.

We will continue to ask that your children stay at home. As always, if childcare is a problem just advise us ahead of your appointment so we can make a plan.

We will continue using zoom for some of our appointments, as it is a system that we and many clients have grown to love.

We are looking forward to seeing you more in person!

January 21, 2021

As we are continually working to minimize interactions between clients and staff during this pandemic, we are implementing a "check-in" service as you arrive at the office. You can check-in via this link HERE, or from the link on our main home page. We are requiring this prior to all appointments; do not enter the office until you have been prompted to do so.

If you do not have a cell phone capable of text messaging, please ring the doorbell and wait for someone to come. Do not enter the office until you are prompted to do so.

We are still adhering to the previously posted policies - medical masks are still required in clinic. You, and all household members over the age of two, are required to wear medical masks for all home visits you have scheduled in your postpartum period.

NOTE: There have been no changes to how your appointments are booked - we are still conducting appointments virtually and will not be changing those to in-person appointments. For any/all appointments you currently have booked, they will remain the same.

November 20, 2020

In response to the directions given by the Province of British Columbia, we are updating our clinic policies with respect to COVID-19.

Effective immediately, all clients are required to wear a medical mask while in the presence of a health care worker. Home made/store purchased cloth masks are no longer an acceptable form of PPE. This policy is the same for all appointments you may have for ultrasounds/bloodwork/NSTs in other health care facilities.

NRGH has implemented the following policy for births:

1 support person in attendance for pre-booked cesarean sections
2 support people for all other births. This does not include your midwife, but does include doulas
Women in labour are not required to wear a mask at this time

For those clients who are in their postpartum period and are expecting home visits, please be prepared and have medical masks on for all persons (except children under 2) while you have a midwife in your home.

Hospital policy is the same at clinic and home.

All other clinic standards remain the same. We have not made any changes to appointment frequencies or virtual vs in-clinic appointments, and are still unable to accommodate any support persons in the 1st and 2nd trimesters. Please do not arrive more than 2-3 minutes before your scheduled appointment time.

As of November 4, 2020, wearing a MEDICAL mask is mandatory the entire time you are in the office; please ensure it is on before you walk in the door, and do not remove it until after you leave. The requirement for medical masks is set out by the Province of BC, and the communique can be found here.

You are now welcome to come into the clinic to wait instead of remaining outside or in your car; please continue to use the back door of the office for entry. Do not come into the office more than 2-3 minutes before your scheduled appointment time. Sit in the waiting room in the designated seats (marked with a green x on the floor).

If you require use of the bathroom, please ask if it is available. Be prepared that you may be required to wait if the area is occupied.

We are unable to accommodate support people attending 1st and 2nd trimester appointments; please arrive on your own. For any visits in your 3rd trimester (27+ weeks), one support person is welcome to join you for any/all appointments - this must be the same designated person for all visits (ie. please don't bring your partner to one visit, your mom to the next, and your close friend/doula to the next).

Lastly, if you are experiencing any illness (cold, flu, covid), please call ahead to reschedule your appointment or change to zoom/phone.

As always, we appreciate your understanding as we navigate keeping everyone safe.

October 6, 2020

Updated November 11, 2020

September 8, 2020

We are working hard to protect all of our clients and prevent exposure, and appreciate your understanding of the importance of also keeping your midwives safe in return. Therefore, effective immediately, all clients attending in-clinic appointments must wear a mask; we encourage you to bring your own.

Partners are still invited to join you for third trimester visits only (27 weeks+), and are also expected to wear a mask. We are unable to accommodate anyone in your extended family attending your appointments with you (ie. your parents, siblings, or friends).

When you arrive, wait outside of the back door or in your vehicle; please do not enter the office on your own through either entry as we cannot accommodate clients waiting in the office. Your midwife will come and get you when she is ready to begin your appointment and ask you to sanitize your hands upon entry.

If you are coming to the clinic at any time and you are not scheduled for an appointment, please call from the parking lot to ensure we can safely welcome you in. This will be necessary if you are returning loaned equipment (ie. infant scale) or you are needing to pick anything up. The best days for this are Tuesday/Wednesday/Thursday.

If you are experiencing symptoms of ANY illness (cold, flu, or COVID), do not attend your clinic visit; please call to reschedule. You should self-isolate for a minimum of 10 days after your symptoms begin, even if you have had a negative COVID swab.

Please note that we have not adjusted our appointment schedule to accommodate more in-person appointments. All currently booked appointments are remaining as you have previously been advised (ie. Zoom, telephone, or in-person). Should an appointment status change, you will be notified.

August 3, 2020

Happy Summer! Here's a quick update.

If you are planning a home birth, please speak with your midwife about further changes in that department.

1. Partners are invited to clinic for third trimester visits (27 weeks+). Partners must wear a mask. Of course, we will have some masks available, but we would sincerely appreciate it if you could try to bring your own. Please do not bring older children unless you have no childcare.

2. Wait outside the back door or in your car for appointments - please do not use the waiting room. The midwife will come get you when she is ready to begin your appointment. Hand sanitizer will be available as you enter the building and everyone will be required to sanitize their hands as they enter and leave the building.

3. Visit schedule - we have significantly increased the visit frequency and the number of in-person visits. Your appointments will be changed as needed starting next week. Of course, if you prefer to continue with more zoom visits, just let us know.

June 27, 2020

As the province moves forward in BC’s Restart Plan, we are hopeful that in the coming months we will be able to see you in face to face clinic appointments more often. However, we also recognize that some of you may not feel safe coming into the clinic and are comfortable with continued teleconference or videoconference prenatal appointments. Others may have discovered that videoconferencing some of their prenatal appointments is more convenient. That is OK! We will continue to offer videoconference and phone appointments in lieu of some clinic appointments if that is what you prefer.

At this time, we have not received any communication from the Provincial Health Officer that we can relax our pandemic precautions and so we are still adhering to the reduced prenatal visit schedule as mandated by the Health Officer. Also we are still asking that you come into the clinic unaccompanied by friends or family. You can feel free to FaceTime/Zoom or teleconference them into the appointment if you wish. If you arrive early for your appointment, please wait in your car or outside the clinic until your scheduled appointment time. This allows us to keep a minimum of contact between people in the clinic and preserves the physical distancing that is so important in this pandemic.

Before you come in for your appointment, please go through the Covid symptom checklist to be sure you are free of symptoms. We also are doing this each day before we come to work. https://bc.thrive.health/covid19/en

When you arrive, please head into the bathroom to wash your hands. Hand sanitizer is also available at the door for when you leave.

VIHA policy is that all healthcare providers wear a face mask when providing direct client care, so we will continue to wear a face mask when we see you in clinic, in hospital, and at your home visits. You may also choose to wear a mask, or not. There is no directive for clients or patients to wear a mask while receiving care in the community.

In our clinic, we are sanitizing all direct touch surfaces (chairs, exam table, etc.) between each appointment. We also sanitize each piece of medical equipment we use between clients (BP cuff, fetal doppler, etc.). General cleaning and disinfecting of other surfaces such as doorknobs, light switches, keyboards, pens, etc. is occurring at least twice per day.

Our MOA, Jacqueline, is working in the clinic most days as we are able to maintain safe distancing for her. Please respect this if you are speaking with her. You will see a taped marker on the floor in front of her desk, simply ensure you are standing behind that marker for everyone’s safety.

We are following the same guidelines for home births and home visits as for hospital births and hospital visitors, which is a maximum of 2 support people at the birth and during our postpartum visits. Remember these support people must also have gone through the Covid checklist and not be on self isolation or quarantine, and must be free from symptoms of Covid-19.

We have been receiving questions from our clients about the safety of returning to work and unfortunately, we cannot give a blanket answer for each individual workplace and situation. However the general guideline is that if your workplace is open, then it is safe for you to return to work (or to continue to work). If you have questions about the safety of your workplace, it is recommended that you contact WorkSafe BC and discuss your concerns with their representatives. We are unable to provide letters for clients to be off work for concerns related to Covid-19 without a directive from WorkSafe BC.

April 8, 2020

The BC government, BCCDC, and the College of Midwives of BC have given Registered Midwives a clear mandate to further reduce the number of prenatal visits in order to reduce the risk of COVID-19 transmission. See: http://www.bccdc.ca/Health-Professionals-Site/Documents/COVID19_AntenatalVisitsDuringPandemic.pdf.

We will be offering a few more Telehealth visits than this recommendation, but otherwise will be sticking to this schedule. This means that a number of your already scheduled visits will now be Telehealth/phone visits, rather than in-person. We are reviewing the clinic schedule each week and will contact you by the Friday before your visit if your visit is changing.

NRGH updates:

Please ensure you have read the updates below.
You and your support person will have your temperature taken when you arrive at the hospital.
Your support person can leave the hospital one time per day, so please bring all your things in when you arrive. There are to be no food deliveries to hospital, but patients can bring their own food from home, or use their ONE “out” to meet a driver outside. We will also order a hospital meal tray for your support person.

March 30, 2020

Our new clinic, Sage Community Midwives, is now up and running! The address is 1000 Terminal Avenue - parking and entrance are around the back.

We are reminding everyone to go through the usual COVID-19 self-screening before coming into clinic.

Do not come into clinic if you are feeling unwell, if you have been around people who are unwell or who have recently travelled outside of BC.
Please call ahead to let us know if you have any concerns about coming into clinic and we can arrange a phone or video appointment for you.

We’ve had to put away many of the home-y touches you are used to allow for proper disinfection of all surfaces and equipment but we tried to make up for it with MANY plants :).

Home visits:

We are asking that there only be the parents and the new baby present at any home visits.
You must let us know if you have people in your home who are sick or have been travelling recently.
Please have soap and paper towels available. If possible, try to have the room we will be visiting in free of extra clutter or objects that can transmit the virus (throw pillows, etc.).
We may enter your home only briefly to do our hands-on work and then finish the rest of the visit over the phone/video-chat.

ZOOM videoconferencing:

As the government has requested we reduce the frequency of face-to-face clinical appointments, we have moved to either telephone appointments or videoconference appointments for some of your prenatal care. Our videoconferencing platform is Zoom. If you are booked for a phone appointment, you will receive an email prior to your visit with a link to the meeting. You can use your phone or a computer. If you would rather not use videoconferencing or are having technical difficulties, please call our office.

Check out this quick video on joining your meeting: https://www.youtube.com/watch?v=UNxhkq9jjVo

NRGH updates:

Personal protective equipment (PPE) is now mandated for ALL births once you are pushing or in the operating room. This means that any care providers at your bedside during the time of your birth (midwife, nurses, etc.) will be wearing a full gown, face mask, and clear plastic face shield or goggles. You will still be able to see our eyes and hear our voices as we encourage you to bring your baby out into the world - that will be our connection during that incredible time.
Please note that Entonox (laughing gas or nitrous oxide) is no longer available.
Everyone will require an IV to be placed shortly after they arrive at the hospital. This is to make it safer for nurses to do their job if a sudden emergency happens. We request your support of our colleagues as they are doing a difficult job during a stressful time.
Please enter the hospital via Dufferin Crescent :
- Days: The Main hospital entrance is open from 7:30 am-7:30 pm
- Nights: The Sliding Glass door entrance with the sign for 'Perinatal Unit' is open from 7:30 pm-07:30 am.
- DO NOT enter the hospital via the Emergency Room.
- You will be greeted at the door and reminded about hand hygiene, mask use, and social distancing rules.

As we continue to figure out this new way of being with and amongst each other, there are bound to be bumps along the way. Our wonderful provincial health officer Dr. Bonnie Henry has encouraging news that our collective efforts seem to be paying off and we are "flattening the curve”. That is something to celebrate! We ask for your patience with all these changes and in turn promise you that we will continue to offer you and your family skilled, caring, and compassionate midwifery care. Stay healthy and in good humour :)

Check us out of Facebook! We are posting little self care discussion, handy disinfecting tips, etc.

March 23, 2020

We recognize these are unpredictable and uncertain times and everyone is feeling the stress and strain of the current pandemic. Please know that your midwives are committed to keeping you and your family safe, while also keeping the joy and wonder of your pregnancy and birth in the forefront of your care. We are so honoured and excited to walk alongside you as you grow your baby and get ready to welcome them into the world and continue the amazing adventure that is being a parent!
Please follow our Facebook page for updates and (soon) to connect with other families in our care.
Our new clinic at 1000 Terminal Ave opens in one week! We are working tirelessly to get it ready to welcome you.
Like many other healthcare providers, we are working with limited supplies and quickly-changing information. We are spending our own time and money finding and buying things like clothing, masks, and extra gloves to protect you, ourselves, and our own families. If we are visiting your home, please have hand soap and disposable paper towels available where we will be washing our hands.
We are planning to wear masks with eye covering at every birth for everyone's protection, so please don't be surprised! The recommendations are changing every day, but we may soon be wearing masks during your clinic visits, too.
Nitrous oxide (laugh gas, entonox) is no longer available at NRGH.

Wondering if you should be tested for COVID-19? Check here for the latest info: https://covid19.thrive.health/

COVID-19

March 18, 2020

Changes to clinic schedule

The Midwives Association of BC has recommended we commit to social distancing
- We will now be offering the WHO (World Health Organization) recommended number of prenatal visits - many of your previously booked appointments will be changed/cancelled.
- Intake visits will be completed over the phone or virtually - updates to come. If you do not have enough minutes on your phone plan for a 30-60 minute call, please let us know in advance and we will ensure a wifi-only option is available to you.
As per our last update (see below), please do not bring anyone with you to your appointments and try to wait outside/in your car if you arrive early
Please wash your hands as soon as you arrive

Changes to postpartum visits

It is our priority to ensure that you and your baby are healthy and that feeding is going well. Once your baby is regularly gaining weight, we will follow-up with you mostly by phone/virtual platform.
Everyone will receive a discharge visit at 4-6 weeks for a final weight and physical exam.
Paps will only be offered if >1 year overdue.
If you or anyone in your home is in self-isolation: at this time it is not clear whether we will have access to appropriate safety equipment (e.g. masks and gowns) to provide care in your home. The situation is changing daily and we will update you if you are self-isolating and require care.

Hospital Updates

You will be allowed to bring one labour support person to your birth - we are advocating professional birth doulas to be exempted from this rule but at this time, they will not be allowed. Your support person will receive a wristband and it is not transferable.
Nitrous oxide (Entonox, or laughing gas) is available at NRGH.

Birth at home

Home birth requires planning, discussion, and supplies. If you are now considering a home birth, it is important that you discuss this at a scheduled visit before you page us in labour.

General COVID-19 Info

BC CDC: http://covid-19.bccdc.ca/ - includes a great tool for deciding if you need to be swabbed or self-isolate
You do not require a doctor/midwife note for your employer if you are self-isolating
Pregnant people in the third trimester are eligible for swabs IF SYMPTOMATIC or exposed. Call 8-1-1 if you think you require testing.

COVID-19

March 16, 2020

Dear valued clients,

You may be wondering how coronavirus could affect you, particularly in pregnancy. Fortunately, the rate of infection and illness on Vancouver Island is still very low, but our teams are working together proactively to ensure that you and your family are safe at home, in clinic, and in the hospital.

IF YOU SUSPECT YOU HAVE COVID-19 please call 8-1-1 and follow the directions you are given. We are not able to provide COVID-19 testing.

The good news is that COVID-19 does not seem to be more serious for pregnant women or babies than for the general population. There is evidence that COVID-19 infection in third trimester does not impact the baby, and COVID-19 does not pass into breastmilk. It is still too early to know if there are any impacts in first or second trimester.

Changes we are making to clinic this week to keep everyone safe:

Appointments will be slightly shorter than usual to give us time to clean more thoroughly between clients and to reduce the number of people in the waiting room. Thank you for understanding.
Please call us to reschedule your appointment if you are sick (cough, sore throat, aches, fever, sneezing or runny nose). Even regular cold and flu viruses can make young babies very sick, so we want to do everything possible to keep our tiniest clients healthy.
Please leave your family members at home. If you are unable to organize childcare (we appreciate this is a huge inconvenience), we can do your appointment over the phone this week and will make alternate plans for other upcoming appointments. You can call ahead to let us know if you would like a phone appointment.
We are taking usual precautions for all clinic appointments. We are wiping down door knobs regularly and disinfecting all of our medical equipment between clients.
Soap, water, and paper towels are available in the washroom and ‘kitchen’, please wash your hands when you arrive in the clinic.
We have removed all of our children's toys and the lending library to prevent virus transmission.

NRGH: Please note that our hospital is allowing ONLY ONE support person during labour and NO visitors at any point during your hospital stay.

A Note about Care Providers: In the unlikely event that a member of your care team is sick or quarantined, you may receive care from an alternative midwife, family physician, or obstetrician. We will ensure that qualified providers are always available.

Sincerely,

The Sage Team

Jessa, Tamara, Yvanne, and Leah