The Power of Processes

I thought the next blog post I would write would be in relation to submitting my PhD thesis. I would reflect upon what I’ve learned through the many hours of keyboard bashing, excel jockeying and the fact that my PhD is about the same age as my relationship with my wife. This is not that blog post. This blog post is dedicated to the power of processes…let me tell you why…

Last Friday at approximately 12:00pm, I was about to go into a meeting. I received a phone call from my wife who had just had a growth scan to determine the position of our baby. This was upon recommendation of our midwife, whom earlier in the week had had difficulty in identifying how he was growing because of his position. This was process number one – if in doubt refer, and refer to someone who can measure better.

Our baby was found to be back to back and breech. Neither of these are good. The scan’s doppler also indicated Alice’s placenta was not delivering sufficient oxygen to our son. Worse. So we headed to hospital as quickly as possible. Again, a referral to someone who can make better measurements, and more informed decisions.

We were rushed into hospital and our baby’s heart rate was monitored via a sort of belly-mounted ECG that looked like a combination of a heart rate monitor and one of those ridiculous ab workout things that are sold on channels such as QVC. By now we had some suspicions we would be having a baby that day. This was confirmed when the ECG revealed three large decelerations in the electrical activity of our baby’s heart. Again, not normal. Alice was rushed to a bed, prepped for surgery and we prepared for an emergency Caesarean. This involved very cordial introductions to every member of the surgical and nursing team. Every member. Roles were clearly explained and procedures plainly outlined. That’s not to say there was no warmth or urgency, quite the opposite. Alice was made to feel a priority, but was very much guided through and involved in every step of this discussion. Sports scientists can learn a lot from this – even in a situation with ever-mounting pressure, everyone was personable, calm and collected. They knew their role and communicated it brilliantly. We anticipated a positive outcome because of how confidently and soundly ‘things’ were explained to us.

The delivery was not without complication. Our son was lifted out feet first, but Alice’s body wanted to hold onto him a little longer – forceps were used to assist, and he was swiftly lifted to safety for examination. Alice had received a spinal block prior to and pain relief throughout the procedure – these had been expertly delivered and personalised to some pre-existing back issues. Know thy patient and make them feel safe and valued.

Following birth and Alice’s abdominal reparations we had some further complications – despite our best efforts Jackson Best was not quite warm enough, weighed only 2.4kg, and his oxygen levels were not saturating as expected. At the point of birth Jackson resembled an individual from the famous 1924 Boston Marathon paper (see here) – extremely low blood glucose, high lactate values, low sodium, low bicarbonate, high red blood cell damage and no reserves. He was an anaerobic baby who had been through a lot. I thank the doctors for communicating this with me on my level, and supporting my communication of Jackson’s condition to my wife who does not come from a science background. To be treated as an equal and not a victim at such a stressful time was so empowering, I had every faith my little boy was in the best possible hands.

Jackson was moved to NICU (neonatal intensive care unit) where he has since been receiving one on one care and has been treated by a range of practices, from CPAT, intravenous and gastric tube feeding, phototherapy and some other support. He is recovering well, but is closely monitored and cared for by an excellent staff – in the short time since we’ve known him, he is nearly breathing on his own now! Our story does not end here, but this blog post does. My pride as a newborn father is immeasurable, but I cannot thank each and every health care professional we have had the pleasure of interacting with this week enough for their efforts.

I hope you get something from this post. I hope you see how processes saved our baby’s life. Don’t be afraid to not have all the answers. Don’t be afraid to refer to someone who can do a better job; whatever that looks like, you will be rewarded for doing so. Develop and refine powerful processes in your field of practice and across your team – you never know, it might save someone’s life someday.

If you wish to support Waikato NICU please consider donating via this link: https://www.neonataltrust.org.nz/waikato . They do a stunning job and babies in much more challenging situations than our own are given the love and support they need by these wonderful people.

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