The Bloomberg 10 North Team
December 2023
The Bloomberg 10 North Team
The Johns Hopkins Hospital
Baltimore
,
MD
United States
The entire Bloomberg 10 North Team
I have waited three hundred and forty-four days to make this nomination. J was admitted to Bloomberg 10 North. He is an autistic, non-verbal child who has developed a significant and severe rumination disorder, leaving him malnourished. He also had aggressive behaviors, requiring multiple resources to keep both himself and the staff safe.
At the time of his admission, the plan was to get him nourished and onto the next step for neurobehavioral rehabilitation in an NBU. That never happened. For three hundred and forty-four days, the 10 North nurses provided incredible, compassionate, culturally competent nursing care.
They became this patient’s fiercest advocates. They showed amazing teamwork. They were creative and innovative in their ideas and approaches. And they fought the good fight for a young man who could not speak for himself. They knew him better than any providers or other members of the multidisciplinary team and were not afraid to speak to that in every forum, from daily rounds to weekly team and family meetings. When all of the other names and faces changed, they were his constant.
The love that they showed this child was immeasurable, despite enduring long shifts where they were repeatedly spat on and sometimes hit and scratched. You see, these are trained pediatric medical/surgical nurses, not trained NBU or psychiatric nurses. They cared for a patient not suited for our environment for the better part of a year and not once did they utter the words “we can’t”. They knew we were not equipped from a training or environment/setting perspective, but that never stopped them from getting it done.
They worked to create a safe environment, partnering with our Life Safety colleagues to advocate for locks to be placed on sinks and doors (to prevent access to water, his main rumination “vehicle”), padding to be placed on walls to prevent physical harm from his head-banging, and numerous other necessary physical space modifications. They partnered with our behavioral psychology colleagues, engaging in daily activities and routines, including a strict bathroom/water/feeding schedule and keeping copious “logs” and documentation (most aside from their standard nursing flowsheets in order to be thorough and capture anything and everything that might be important to the plan), always giving input and suggestions on how we could make the process better and more beneficial for J.
They coached and supported our security and PSA colleagues who were assigned to J’s detail, helping them know the boy inside that body and quell their fears based on the stories that were being told about him in every corner of the Johns Hopkins Children’s Center (and some corners of JHH-at large). They supported one another when the shifts were especially hard when JA was having a really bad day, and when they had to restrain him in 10-point restraints each night and place an NG tube to provide for his daily caloric needs.
They partnered with the hospitalist and psychiatry provider teams, researching and making suggestions for medication changes that may benefit J. They never held back in sharing their ideas and thoughts on how we could be doing this better. When they were not advocating and trying to figure out creative approaches to care, they took the time to dance, sit, play, practice words and writing, and go for walks with J so that he could feel the warmth of sunshine on his face.
When we learned that an applied behavioral analysis (ABA) therapist could benefit him and that the Children’s Center lacked this resource, we found one outside of JHCC. We got permission to contract with them to bring the necessary therapy here to J, turning our treatment room into his own personal feeding therapy space.
Even something seemingly small, like going to the Great Room for safe play, was a huge undertaking. Still, they articulated the importance of trying, developed a plan to prepare him for the visuals along the way, and held extensive “practice runs.”
As a team, they poured every ounce of energy they could into creating an environment and providing care that was so out of our “norm.” I don’t know that any unit has rallied as many resources for a patient as 10 North did for JA.
10 North was never the right place for him, but this team of incredible nurses made it work. This was never the setting that could benefit him the most, but when everyone else literally said “no”, the 10 North nurses did what needed to be done.
JA was discharged home from 10 North. I could go on for days about the incredible ways this group of medical/surgical nurses created a safe, therapeutic environment for JA, but I will wrap it up.
While they cannot control what happens next for this patient, they literally moved mountains for three hundred and forty-four days to provide him with the absolute best care possible. I am so incredibly proud of this team.
At the time of his admission, the plan was to get him nourished and onto the next step for neurobehavioral rehabilitation in an NBU. That never happened. For three hundred and forty-four days, the 10 North nurses provided incredible, compassionate, culturally competent nursing care.
They became this patient’s fiercest advocates. They showed amazing teamwork. They were creative and innovative in their ideas and approaches. And they fought the good fight for a young man who could not speak for himself. They knew him better than any providers or other members of the multidisciplinary team and were not afraid to speak to that in every forum, from daily rounds to weekly team and family meetings. When all of the other names and faces changed, they were his constant.
The love that they showed this child was immeasurable, despite enduring long shifts where they were repeatedly spat on and sometimes hit and scratched. You see, these are trained pediatric medical/surgical nurses, not trained NBU or psychiatric nurses. They cared for a patient not suited for our environment for the better part of a year and not once did they utter the words “we can’t”. They knew we were not equipped from a training or environment/setting perspective, but that never stopped them from getting it done.
They worked to create a safe environment, partnering with our Life Safety colleagues to advocate for locks to be placed on sinks and doors (to prevent access to water, his main rumination “vehicle”), padding to be placed on walls to prevent physical harm from his head-banging, and numerous other necessary physical space modifications. They partnered with our behavioral psychology colleagues, engaging in daily activities and routines, including a strict bathroom/water/feeding schedule and keeping copious “logs” and documentation (most aside from their standard nursing flowsheets in order to be thorough and capture anything and everything that might be important to the plan), always giving input and suggestions on how we could make the process better and more beneficial for J.
They coached and supported our security and PSA colleagues who were assigned to J’s detail, helping them know the boy inside that body and quell their fears based on the stories that were being told about him in every corner of the Johns Hopkins Children’s Center (and some corners of JHH-at large). They supported one another when the shifts were especially hard when JA was having a really bad day, and when they had to restrain him in 10-point restraints each night and place an NG tube to provide for his daily caloric needs.
They partnered with the hospitalist and psychiatry provider teams, researching and making suggestions for medication changes that may benefit J. They never held back in sharing their ideas and thoughts on how we could be doing this better. When they were not advocating and trying to figure out creative approaches to care, they took the time to dance, sit, play, practice words and writing, and go for walks with J so that he could feel the warmth of sunshine on his face.
When we learned that an applied behavioral analysis (ABA) therapist could benefit him and that the Children’s Center lacked this resource, we found one outside of JHCC. We got permission to contract with them to bring the necessary therapy here to J, turning our treatment room into his own personal feeding therapy space.
Even something seemingly small, like going to the Great Room for safe play, was a huge undertaking. Still, they articulated the importance of trying, developed a plan to prepare him for the visuals along the way, and held extensive “practice runs.”
As a team, they poured every ounce of energy they could into creating an environment and providing care that was so out of our “norm.” I don’t know that any unit has rallied as many resources for a patient as 10 North did for JA.
10 North was never the right place for him, but this team of incredible nurses made it work. This was never the setting that could benefit him the most, but when everyone else literally said “no”, the 10 North nurses did what needed to be done.
JA was discharged home from 10 North. I could go on for days about the incredible ways this group of medical/surgical nurses created a safe, therapeutic environment for JA, but I will wrap it up.
While they cannot control what happens next for this patient, they literally moved mountains for three hundred and forty-four days to provide him with the absolute best care possible. I am so incredibly proud of this team.