Oncology nurses bring so much to the care of their patients to try to help them through their journey. When the patients are pediatric, the type of dedication and commitment that oncology nurses display is often even more elevated. This is particularly true of one of our pediatric anesthesia nurses, Hollyn, at the PARC. Even before we started to treat patients, Hollyn began to work to ensure we were prepared to care for pediatric patients. She started researching ways she could make the very technical environment more kid and family friendly. These patients (and often their siblings) come daily for weeks at a time. Even though the decor was pediatric, there were not a lot of pediatric items to help the kids through the process. The daily treatments can be grueling for kids and their families as the kids are NPO and often must come in very early daily. Hollyn wanted to create a space where the kids looked forward to coming each day. First, Hollyn researched items that she felt would keep kids entertained and engaged. She created a list and worked with leadership to purchase the items. Hollyn then made art kits that patients (and their siblings) would each receive during treatment. Once treatments were over, the kids get to take the contents home. Hollyn also organized a toy drive for the pediatric patients. She gathered a list of toys that were appropriate for our space and different age groups for our pediatric patients. After collecting the toys, Hollyn purchased and decorated a toy box for the department to house them in. Hollyn also put together an “all about me form” for each patient to fill out at the start of their treatment. This form asks things like their favorite toy and favorite color so the treatment team can get to know the patient better and make interactions more personal. On a similar note, she created “all about me” forms for the nursing team to hang in the pediatric space. These forms have childhood photos of the nurses and include things like their favorite childhood toy in an attempt to connect with the pediatric patients and help them feel more comfortable in the space. All of these “little things” have created an environment of comfort and hope for our littlest patients.  

As we have begun to treat patients and get busier in the space, Hollyn has paid close attention to our workflows and is constantly thinking of different ways to make the space even better for the patients not only from a nursing perspective but as a department. As this is a new department, Hollyn has been instrumental in ensuring the care of the patients has been top-notch. The patients are under anesthesia alone inside a proton vault, which requires an enormous amount of coordination and attention to detail to ensure safety. Hollyn has worked closely with the anesthesia team to ensure patients are safe during induction, treatment, and wake-up. Her pediatric experience and knowledge have been invaluable as we have set up this service in a building outside the hospital.  

Hollyn has taken on leading the pediatric task force monthly, where interdisciplinary members of the department come together to discuss areas of opportunity, new ideas, and how to implement them. Hollyn has helped the department establish connections and foster closer relationships with patients’ clinic teams and navigators. Communication has improved between our teams regarding matters such as prescription refills, tube feed management, appointment times, and side effects, enabling a more holistic and seamless treatment approach for the patient. Hollyn also helped us align our practice with the pediatric inpatient team practices for more streamlined, consistent care. We have been able to take some of these ideas and processes and implement them in our other oncology department that occasionally has pediatric patients as well. Patient education is an integral part of good patient outcomes, setting patients and their families up for success. Hollyn is also currently helping in the creation of pediatric proton specific education documents regarding anesthesia, side effects, and an overall idea of what to expect throughout their child’s treatment. 

Not only has Hollyn been instrumental in developing the peds program, she has gone above and beyond in providing exceptional care. One example came with one of our first pediatric patients under anesthesia. He was 3 years old with nephroblastoma. The first day he came, he was crying hysterically, to the point he was throwing up. His parents were visibly upset and frustrated as we worked through the logistics of day 1 of providing anesthesia in the space. The stress of having a child with cancer is very difficult for the parents. He had to be NPO every day and go through anesthesia. Hollyn worked tirelessly to build rapport and trust with both the child and the family. She figured out what his favorite toy was and made sure it was waiting for him daily. Slowly but surely, he bonded with Hollyn. The tears faded and were replaced with excitement to play in our department each morning. 

Unfortunately, the patient developed a fever one evening and had to go to the emergency room, and was subsequently admitted to the hospital. He was scheduled for treatment the next morning. Hollyn worked with the interprofessional team to determine that if they could get him to the PARC, he could receive treatment. There was not time to arrange transportation, or he would miss his spot on the schedule. Hollyn volunteered to go to the hospital and transport the patient herself. When she arrived in the room, his parents were exhausted after being up all night in the ED. They had gained such trust with her that when she offered for them to stay and rest, they felt comfortable enough sending their child with her alone while they slept in the hospital room. They knew they could trust her and their child would be safe, taken care of, and feel comfortable. Because of this, the patient was able to stay on schedule and not have an interruption in their cancer treatment. 

As we have been underway with treatments for a few months now, we have had many patient completions, a celebratory moment with the patient, their parents, and the team. Typically, a moment filled with many emotions for the patients and their families, including happiness, but also many have expressed sadness that they will miss the team.  By the end of treatment, many of the kids look forward to coming to treatment and express sadness that they won’t be coming in each morning. A true testament to how much thought and love were put into building the program. Hollyn is living out our mission of helping our pediatric oncology patients find hope during such a difficult time.