PICU Nurses Build Relationships in Families’ Toughest Times
Kneeling down and leaning in close, Amanda Devine brings herself eye level with the object of her affection.
“Come on, Desi!” she coos. “Just one smile?”
The 7-month-old returns a sour look.
“I told you,” says Dawana Bridges, the boy’s mother, seated nearby. “He’s angry today.”
But not for long. Devine reaches down and starts playing with Desmond’s toes. She pauses to adjust the wires that are monitoring his oxygen and heart rates, then tiptoes her fingers up to his belly for a tickle.
Finally, a crack emerges in his stoic façade. And, just for a second, Desmond’s eyes brighten and his lips curl.
It’s a smile. Indisputably.
“Aww, I knew you were going to win,” says Jill Pol, who is looking on after trying — and failing — to coax a grin out of the youngster.
It’s not the first time the nurses have competed for Desmond’s attention. Since he was just two weeks old — when his mother noticed he was having trouble breathing — he’s spent almost every hour of every day in Golisano Children’s Hospital Pediatric Intensive Care Unit (PICU).
With his tenure at the hospital nearing seven months, the nurses in the PICU have grown fond of him. Devine and Pol, in particular, enjoy doting on the curly-haired youngster.
“We love Desi,” says Pol. “We’re going to be sad to see him go.”
‘I could never do that’
Away from work, when social introductions lead to the inevitable discussion of one’s profession, Devine always gets the same reaction when she reveals what she does.
“Everyone says ‘How do you do that? I could never do that,’” said Devine, who has worked at Golisano Children’s Hospital since 2012.
She understands why it seems daunting. Devine and her colleagues are specialists within a field that’s already pretty self-selecting. It takes a certain type of person to want to be a nurse and it takes a special kind of nurse to want to spend their days in a PICU.
“You definitely take it home with you,” said Devine. “It changes you. Part of nursing is bonding, and giving a part of yourself to your patients and your families. So when you see these kids, and some of them get taken so early…”
She pauses, searching for the right words.
“It just makes you appreciate everything more.”
As a PICU nurse, it’s impossible to shield yourself entirely from the pain that comes from seeing a child pass away, said Devine. But there are two sides to that coin, as those occasional sorrows are matched by the joy they get to share in when a family is able to take a child home.
Those relationships are part of what drew Devine to the PICU. With many patients having medical challenges that require weeks or months of care, there’s plenty of time to establish a rapport with a family and to spend down time playing games with a child. From a professional perspective, it keeps her challenged, as well.
“You really get to see the whole spectrum in the PICU. You’re thinking critically about medical issues and needs, but you also get to have fun and color with a kid,” said Devine. “That’s why I liked it when I was training — you get to help kids be kids.”
In virtually every part of the children’s hospital, nurses are the engines that keep clinical operations running. And in a care setting as sensitive as the PICU, their importance cannot be overstated.
“The nurses are the minute-to-minute point of contact for the patients and the families. It’s really the most crucial role that there can be in a PICU,” said Jeff Rubenstein, M.D., chief of the PICU. “They have to be compassionate enough to care for both the kids and for the families, and they also have to be medically sophisticated enough to recognize problems before they escalate.”
Though the job can be demanding, patients like Desmond are what make it all worthwhile.
A short time after he was born, he began struggling to breathe. The blood vessels in his lungs were too small and weren't allowing enough blood to reach his heart.
As a last resort, he was placed on a lung- and heart-bypass machine called ECMO (extra-corporeal membrane oxygenation). The outlook was bleak.
“I didn’t leave here for a couple months,” said Bridges. “I slept here, got up at 5:00 to go home and get my four-year-old ready for school, then came back to be with Desi.”
The infant stayed on ECMO for two months until finally he had stabilized to the point where he could be removed from the device. He was then transferred to St. Louis in the hopes of getting lung transplants, and though an organ never became available, he was able to undergo a surgery that improved his heart function.
“After we came back, I really got comfortable with the nurses here,” said Bridges. “Heather, Melissa, Sarah, Dan, Catherine, Amanda, Dave, Dani, Jill… there are too many to name. We love them all. They’re really good with him.”
After seven months, Desmond was ready to leave the friendly confines of the PICU. He’ll be taking some equipment with him, but he was finally able to go home.
“He’s beginning to thrive,” said Rubenstein. “He’s going to need some support, but we’re getting ready to send him home, which is pretty great given what he was facing when he arrived.”
Jessica O'Leary |