Kaitlyn Campbell, BSN, RN has been a part of the Pediatric Dialysis Unit since early 2016. During her time, she has worked diligently to understand the impact dialysis has on the pediatric patient’s life. She has taken ownership of her primary patients and has been committed to providing them the education needed for their success. Our chronic patients lose a lot of control when they enter our unit. We are in control of their schedule as they must receive dialysis three times a week. These three unit visits last anywhere from three to five hours each time. This limits their time to attend school and do things that their counterparts are able to do (go to football games in the fall, attend vacations without having to find a dialysis center near the vacation spot, go to the fair and not worry about how much fluid they are drinking, etc.) We limit their fluid intake to prevent volume overload and educate them on taking phosphate binders with every meal to prevent phosphorous build up and we discuss the harmful things that occur if this regimen is not followed. Kaitlyn has gone out of her way to help her primary patients acclimate to this new way of life.
One patient, in particular, was struggling with medication management due to short-term memory loss with her disease. The patient had a seizure due to not taking medications as prescribed and Kaitlyn was committed to helping the patient the best way she knew how. Kaitlyn had the patient bring her medication bottles in and they loaded up her weekly pill pack together. Kaitlyn has continued this process with this patient to ensure medication safety, which in turn has likely helped prevent medical emergencies for this patient. Additionally, it helped the patient be more confident in getting the right medications and also gave Kaitlyn the opportunity to educate the patient as needed about her medications
In the PDU, we have had pediatric patients on dialysis for as long as eight years before receiving a kidney transplant and we have had several patients on dialysis who would never receive a transplant due to their co-morbidities. No one likes to think of children dying and certainly not dying when there is a perceived “cure”. The harsh reality is that not all adult patients nor all pediatric patients receive the organ transplants that we would like them to.
One patient, who had many co-morbidities and was total care became Kaitlyn’s primary patient. This patient was the first we had taken in the PDU who required care far beyond that of the chronic outpatient nature. Due to his illness and tenuous stability, he was cared for as a one on one patient. Kaitlyn routinely cared for him and learned quickly how to help him cope to the best of his abilities. She provided therapeutic care in the form of genuine care, compassion, and conversation. When he was having a rough day, she knew his love for Batman was something to help him focus on to get through the long and tough dialysis treatments. Due to his rare illness, dialysis was more of a struggle for him than most. He was wheelchair bound, required the need to be lifted into the dialysis chair (which was incredibly uncomfortable for him) by the Hoyer Lift. He had incredible anxiety about everything and was pretty unsure of our team when he started coming to dialysis. He quickly gained trust in Kaitlyn and they formed a therapeutic relationship which saw him through until he passed away. He looked forward to seeing Kaitlyn and she looked forward to taking care of him. Kaitlyn was able to ease his fears and concerns by talking with him, remaining calm, and helping him understand what was happening to him at any given moment. There were a few times the patient was PERTed in our unit. This was incredibly scary for him, you could see it in his eyes. He had a trach and was mostly non-verbal, but his eyes told you everything. Kaitlyn would be pushing IVFs and looking at him to talk him through the situation while everything around him was moving faster than he could stand. Kaitlyn’s calm demeanor and understanding spirit of what her patients need, allowed her to be exactly what this patient needed in some of his scariest times.
The patient loved his brother fiercely and really liked him to be with him in the dialysis unit after school. During one of the episodes where the patient was not doing well, he wanted his brother to be present and even though it may not have been the right time due to the unit activity, it was right for the patient and Kaitlyn advocated for this. She intuitively knows how to advocate for her patients and support their needs to the fullest of her ability as a nurse. When it came time to withdraw dialysis care on this patient, Kaitlyn wanted to be present to support him and his family. His family was really having a hard time with this and I know Kaitlyn’s presence and support made a difference to them. While this was hard for Kaitlyn due to the bond she had developed, she knew it was the right thing ethically for the patient as he had expressed his wishes to her. He shared many times he was tired and wanted to stop; because he was not 18 years old, he could not decide this and it was left up to his family to decide.
One of the things we do well in the PDU is support each other, our patients and their families. After this patient passed away, Kaitlyn went to work trying to figure out something to get the family to remember him by. She gathered donations from the unit and had flowers delivered to them. A great while later, the mother returned to the unit to thank Kaitlyn and the PDU team for the exceptional care that was provided to her son and her family during one of the toughest times of their life. She shared that her husband just couldn’t understand how she could come back (it was far too painful for him yet), but she countered with telling her husband she needed to say thank you and let the team know they made a difference. These may not have been her exact words; however, this was the intent in her message. This is what we all live for as healthcare providers; to make a difference. Sometimes it may feel like we are not in the business of our days and the struggles to find balance with patient safety and productivity. Making a difference doesn’t have to be grand in any fashion. This is a story of a nurse who cared, showed compassion, and was committed to helping her primary patient and family through a scary time in their life. Being present, astute, and in tune with their needs was what made a difference in this child’s and this family’s life.
The Starfish story (by Loren Eiseley) is one that shares a child’s vision of making a difference by throwing starfish back into the ocean to save them because the tide is going out and they will die if he doesn’t. He is challenged by an adult who shares he cannot make a difference that there are miles and miles of beach and thousands of Starfish. As the child leans down to pick up another Starfish to through into the ocean he simply replies, “it made a difference to that one”. Kaitlyn challenges us to make a difference in at least one! Kaitlyn is a true DAISY Nurse. She provides extraordinary, individualized, compassionate care to her patients and makes a difference in the lives of others.