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Children's Hospital Nurse Bridges Animal and Human Medicine

By: Louisa Shepard

Caring for foals is remarkably similar to caring for babies, if you are an operating room nurse. So Laura Ramspacher discovered when she became a “foal sitter” at New Bolton Center’s Neonatal Intensive Care Unit.

An operating room nurse at Children’s Hospital of Philadelphia for 32 years, Ramspacher brings a range of expertise and experience to New Bolton Center’s volunteer corps, and creates a bridge between the worlds of animal and human healthcare.

Laura Ramspacher brushes a mare.“I love being a foal sitter,” Ramspacher, a registered nurse, said in a recent interview. “I enjoy crossing over into a different kind of medicine. It’s really neat to see how the two worlds are similar, but also different.”

Dr. Jonathan Palmer, Chief of New Bolton Center’s NICU and Director of Perinatal/Neonatal Programs, values the skills that volunteers bring to their work with the mares and foals under his care. 

“No matter whether you’re a veterinary nurse or a registered nurse, part of being a good nurse is being able to seamlessly multitask, have great organizational skills, intuitively know the most efficient way to get things done, and most importantly, recognize the development of unexpected changes in the patient,” Dr. Palmer said. “I’m always delighted to have people with these skills join our care team as volunteers.   

What is Foal Sitting?

For nearly 30 years, New Bolton Center has invited volunteers to assist the NICU clinicians and staff during the busy foaling season.

“The foal sitters are very important,” Dr. Palmer said. “To deliver the level of intensive care that we do, we need help. Foal sitters are vital to our operation.”

The overnight crew tend to an expecting mare.New Bolton Center currently enlists over 90 foal-sitter volunteers, including about 50 who have participated in the past. Some foal sitters have participated for years, and include local horse owners and enthusiasts, as well as university and high school students. Second-year Penn Vet students also foal-sit for five shifts of six hours each as part of an elective course.

Two foal sitters are assigned to each of the three daily shifts: 7 am to 3 pm, 3 pm to 11 pm, and 11 pm to 7 am. Foal-sitting volunteer shifts start in February and go through June. Registration takes place in December, with an orientation to follow in January. Foal sitters must be at least 16 years old.

“Most mares foal between 11 at night and 6 in the morning,” Dr. Palmer said. “It is much more active at night. If you want to see the birth of foal, that’s when you want to be around.”

Possible duties for foal sitters include: holding foals upright when they are lying down, assisting staff as they stand and turn foals, milking mares and storing the milk, monitoring equipment for alarms, changing bedding, restocking treatment areas, and cleaning equipment and hospital areas.

From CHOP to the NICU

Ramspacher first heard about the foal-sitting program from her daughter, who wasn’t yet old enough to participate. Life was extra-busy then, with two off-the-track Thoroughbreds at home. When Ramspacher’s daughter graduated from high school, she took the horses with her to college in Kentucky.

Laura Ramspacher feeds a mare a treat.“I really missed the horses,” Ramspacher said. “It took away a lot of stress to watch the horses and groom them. I just liked being around them.”

A New Bolton Center Field Service vet mentioned foal sitting to Ramspacher, who didn’t realize the program was for adults as well as students. So she went to the orientation program before the 2012 foaling season. Looking around, she saw most of the other volunteers were students.

“I credit Dr. Palmer for encouraging me,” said Ramspacher, who is 54 years old. “I told him I didn’t think I could do this, that I was too old, and he said he thought I could. So I said, okay, I’ll give it a try.”

Dr. Palmer cautions that foal sitting can be a very physical activity, but added that some foal sitters have been well into their 70s. “No matter what your age, you need to know your physical limitations and not take on a foal- sitting job that is too much for you,” he said. “But no matter what your limitations are, there is always something you can do to help.”

Ramspacher realized that her experience as a nurse made her “a good fit” to be a foal sitter. During her three decades in the operating room at CHOP, she’s worked on traumas and emergency surgeries, as well as neurosurgery, orthopedic surgery, and other specialties.

Dr. Jonathan Palmer looks on as the night crew assembles.“Our volunteers come from all walks of life and bring with them insights into our program from their unique perspective. Laura is no exception,” Dr. Palmer said. “I always enjoy exchanging ideas with human healthcare workers who volunteer, highlighting the similarities and differences in our patients.”

Says Ramspacher, laughing, “I like how the people at New Bolton call us ‘the human nurses.’”

Even though the foal sitters often do routine jobs, like laundering the scrubs and cleaning the equipment, Dr. Palmer includes them in the education he constantly provides for New Bolton Center students and residents.

“I’m in awe every time I’m here with Dr. Palmer and I listen to how he teaches,” Ramspacher said. “He includes me in his questions sometimes. That’s very welcoming. He never gets tired of our questions.”

A Bridge to CHOP 

Ramspacher has formed a bridge between CHOP and New Bolton Center, setting up a donation program and sharing her experiences with her colleagues, finding new volunteers in the process.

“Everybody at work thinks it is so cool. My phone is full of photos –,not of my family, but of my New Bolton photos!” she said. “People with horse experience see the pictures and say they would love to do that. ”

That’s how her friend Denise Morton, also a nurse at CHOP, learned about the foal-sitting program and came to volunteer this year. The two colleagues often worked their shifts together. And they reconnected with another mutual friend, also a foal sitter.

Dr. Jonathan Palmer catches up on his notes during the overnight shift.Ramspacher started a recycling donation program, reclaiming items that can’t be used at CHOP, but are still useful, like tubing, drapes, instruments, bandage wrap, scissors, and towels, all in packages that were opened but not used. In the CHOP employee lounge there is a collection box with a picture of a foal on the front.

“Often these are small, inexpensive items, but Laura knows it’s the little things that often make a big difference in delivering care to our neonates.” Dr. Palmer said.

During the 2014 foaling season, New Bolton Center broadcast the birth of a foal live to the world through a Foal Cam. Ramspacher was part of the team that cared for the mare, My Special Girl, during the last month of pregnancy, on camera in the NICU. Ramspacher shared the Foal Cam with her colleagues at CHOP, and they would often check the live broadcast on Penn Vet’s website.

On March 29, the night My Special Girl gave birth to her colt, Ramspacher was working in the CHOP operating room and received a text from a foal-sitter friend, alerting her that My Special Girl was about to foal. She tuned into Foal Cam on her phone.

A patient came just at that time, an anxious boy who was going into surgery. Ramspacher showed him the Foal Cam on her phone, and they talked about their mutual love for horses. The boy started to relax. He continued to watch the Foal Cam on a big screen in the operating room as he went under anesthesia. 

“It was so wonderful to watch,” Ramspacher said. “The patient was so nervous, and watching My Special Girl calmed him down. We all thought the Foal Cam was awesome.”

Looking forward to the 2015 foaling season, Ramspacher thinks she will volunteer two nights a week, the 3 pm to 11 pm shift. And she may be bringing another operating room nurse and two recovery nurses as new volunteers. The CHOP foal sitters already have started texting each other, deciding which shifts to sign up for together.

“It’s just so nice to be there. It’s fun,” Ramspacher said. “We are happy to do whatever they need us to do.”

For more information about foal sitting, please email  foalsitters@nicuvet.com.

You can make a big difference in the care of our equine patients. Make a gift to the Friends of New Bolton Center Fund today!