Low Prevalence of Designated Lactation Spaces at Hospitals and Ambulatory Surgery Centers in Iowa: An Educational Tool for Graduates' Job Selection

Survey of Lactating Anesthesiologists Using Wearable Breast Milk Pumps While Working in Operating Rooms and Other Clinical Settings

We performed a prospective Internet survey study of anesthesiologists lactating in 2022 or 2023. Approximately half (48%, 75 of 156) lacked convenient dedicated lactation space and approximately half (55%, 86 of 155) used a wearable breast pump. The vast majority using a wearable pump did so in clinical settings, including operating rooms (88%, 76 of 86). When using during cases, approximately half reported that milk production was sufficient to substitute for lactation pumping sessions (52%, 39 of 75). Based on probability distributions of surgical times, future research can evaluate the usefulness of wearable pumps based on the objective of reducing anesthesiologists' durations of lactation sessions to <15 minutes.

Lactating nurses' experiences of return to work after lifting COVID-19 lockdown: A qualitative study

Aim

To explore the lactating nurses' experiences of return to work after lifting COVID-19 lockdown.

Background

Return to work is a key reason for the low rates of breastfeeding. Especially after lifting COVID-19 lockdown, case counts reached recorded highs. So lactating nurses face more challenges when they return to work.

Method

The empirical phenomenology method was used to conduct a qualitative study. Lactating nurses were recruited in a tertiary hospital through purposive and snowball sampling, and participated in semi-structured video interviews. Colaizzi's method was used to analyze the data.

Results

Three themes and 10 sub-themes emerged from the interview data of 15 participants. The first theme was "preparation for return to work", which helped lactating nurses adapt to return to work quickly. The second was "experiences of return to work". The inconvenience of pumping was mentioned repeatedly. In addition, the flexible work schedule was highlighted. The third was "experiences of infection". The attitudes toward breastfeeding differed due to different perceptions of COVID-19.

Conclusions

Lactation nurses easily interrupted or stopped breastfeeding when they returned to work after lifting COVID-19 lockdown. Recommendations include the further provision of longer periods of leave, flexible working arrangements, separate facilities for breast pumping, and breastfeeding strategies for epidemics.

General Surgery Faculty Knowledge and Perceptions of Breast Pumping Amongst Postpartum Surgical Residents

BACKGROUND

There is a lack of data regarding the knowledge and perceptions teaching faculty possess about breast pumping among general surgery residents despite breast pumping becoming more common during training. This study aimed to examine faculty knowledge and perceptions of breast pumping amongst general surgery residents.

METHODS

A 29-question survey measuring knowledge and perceptions about breast pumping was administered online to United States teaching faculty from March-April 2022. Descriptive statistics were used to characterize responses, Fisher's exact test was used to report differences in responses by surgeon sex and age, and qualitative analysis identified recurrent themes.

RESULTS

156 responses were analyzed; 58.6% were male and 41.4% were female, and the majority (63.5%) were less than 50 years old. Nearly all (97.7%) women with children breast pumped, while 75.3% of men with children had partners who pumped. Men more often than women indicated "I don't know" when asked about frequency (24.7 vs. 7.9%, p = 0.041) and duration (25.0 vs. 9.5%, p = 0.007) of pumping. Nearly all surgeons are comfortable (97.4%) discussing lactation needs and support (98.1%) breast pumping, yet only two-thirds feel their institutions are supportive. Almost half (41.0%) of surgeons agreed that breast pumping does not impact operating room workflow. Recurring themes included normalizing breast pumping, creating change to better support residents, and communicating needs between all parties.

CONCLUSIONS

Teaching faculty may have supportive perceptions about breast pumping, but knowledge gaps may hinder greater levels of support. Opportunities exist for increased faculty education, communication, and policies to better support breast pumping residents.

Feasibility of Anesthesiologists Giving Nurse Anesthetists 30-Minute Lunch Breaks and 15-Minute Morning Breaks at a University’s Facilities

Background

Managers of an anesthesia department sought an estimation of how often each anesthesiologist can give lunch breaks and morning breaks to nurse anesthetists to plan staff scheduling. When an anesthesiologist supervising the nurse anesthetists can give a break, it would be preferred because fewer extra nurse anesthetists would be scheduled to facilitate breaks.

Methodology

Our methodological development used retrospective cohort data from the three surgical suites of a single anesthesia department. Surgical times were estimated using three years of data from October 2016 through September 2019, with 95,146 cases. Comparison was made with the next year from October 2019 through September 2020, with 30,987 cases. The 5% lower prediction bounds for surgical time were estimated based on two-parameter, log-normal distributions. The times when two and three sequential rooms had overlapping lower prediction limits were calculated. Sequential rooms were used because that was how anesthesiologists’ assignments were made at the studied department, when feasible given constraints. Percentages of cases were reported with 15 minutes available starting sometime between 9:00 and 10:30 and 30 minutes starting sometime between 11:15 and 12:45, times characteristic for the studied department. At the studied university’s facilities, the nurse anesthetists were independent practitioners (e.g., an anesthesiologist supervising two nurse anesthetists each with a long case could give a break to one of the two rooms).

Results

The percentage of days for which an anesthesiologist could give a lunch break (11:15-12:45) was close to the percentage of cases when an anesthesiologist could give the same-length break anytime throughout the workday. In other words, the length of the break was important, not the time of the day of the break. The absolute percentages also depended on how many rooms the anesthesiologist supervised, the duration of cases, and facility. For example, among anesthesiologists at the adult surgical suite supervising three nurse anesthetists, a lunch break could be given by the anesthesiologist on at most one-third of the days without affecting workflow.

Conclusions

Our results show that the feasibility of an anesthesiologist clinically supervising one, two, or three rooms to give lunch breaks to the nurse anesthetists in the rooms depends principally on how many rooms are supervised, the duration of the break, and the facility’s percentage of cases with surgical times longer than that duration. The specific numerical results will differ among departments. Our methodology would be useful to other departments where anesthesiologists are clinically supervising independent practitioners, sometimes during cases long enough for a break, and there is anesthesiologist backup help. Such departments can use our methodology to plan their staff scheduling for additional nurse anesthetists to give the remaining breaks.