October 2014
Kim
Hiatt
,
RN
Hemodialysis
Wake Forest Baptist Health
Winston-Salem
,
NC
United States
Three months ago we began hemodialysis treatments on a lovely 8 year old young lady. This child was on vacation visiting her grandmother when she became ill and was found to be in renal failure. Mom was in Pennsylvania where the family had just moved. She had to quickly return to NC, leaving behind family, friends and a new job.
Our unit fell totally in love with Miss K. and her mom. Everyone went well out of their way to support them in this traumatic life change. Although this child was tremendously brave and courageous throughout, dressing changes for both her perm catheter and PD catheter became a dreaded procedure. She had allergic reactions to the adhesive. The Tegaderm, plastic tape, and even paper tape would stick like a second skin and was damaging to her tissue. Use of adhesive remover, alcohol, and easing off the dressing did nothing to help. This charming child would cry hysterically if dressing changes were even mentioned, they were so painful and frightening for her. Her mom was near tears on many occasions. It was heartbreaking for all of us to see this child who had gone through so much, terrified over dressings. No one had a solution.
Kim took it upon herself to go to Brenner's and investigated various dressing options in the peds community. She brought several back for Miss K. to try. To ease her fear, Kim would put the dressing on her own arm then let Miss K. pull it off; she next put it on Miss K's arm and let her remove it. When our young patient was comfortable with this, Kim then tried it on her perm cath site and PD cath. To the relief of all, one of the dressings, Mepilex, worked. Kim followed up with getting the approval of the unit manager and nephrologists for this variance in our dressing policy.
Miss K. also had many setbacks in transitioning from hemodialysis to peritoneal dialysis. She experienced great discomfort with her fill for PD (fluid instilled into the abdominal cavity for peritoneal dialysis) and became afraid of this treatment method. Finding a way for PD to work for this child was crucial to letting her lead a "normal" life style that hemodialysis would not allow. With time and patience, Kim worked with her filling a small amount of volume at a time and let Miss K. control stopping the fill when it became uncomfortable. The young lady would then indicate when she was ready for a little more fluid to be instilled. They went on this way starting and stopping with Miss K. in control until the necessary volume was in without pain.
The most recent report is that Miss K. is doing well on PD and running around like a child again. Her courage exceeds that of many adults. She and her family will be able to return to Pennsylvania soon to resume their lives there but this disease has changed them forever. I am so proud to see how our unit came together and contributed in making this difficult time easier for this child and her mom, but Kim Hiatt went above and beyond to help remove traumatic barriers and add to the successful outcome for this family during a life changing event. She truly deserves this recognition.
Our unit fell totally in love with Miss K. and her mom. Everyone went well out of their way to support them in this traumatic life change. Although this child was tremendously brave and courageous throughout, dressing changes for both her perm catheter and PD catheter became a dreaded procedure. She had allergic reactions to the adhesive. The Tegaderm, plastic tape, and even paper tape would stick like a second skin and was damaging to her tissue. Use of adhesive remover, alcohol, and easing off the dressing did nothing to help. This charming child would cry hysterically if dressing changes were even mentioned, they were so painful and frightening for her. Her mom was near tears on many occasions. It was heartbreaking for all of us to see this child who had gone through so much, terrified over dressings. No one had a solution.
Kim took it upon herself to go to Brenner's and investigated various dressing options in the peds community. She brought several back for Miss K. to try. To ease her fear, Kim would put the dressing on her own arm then let Miss K. pull it off; she next put it on Miss K's arm and let her remove it. When our young patient was comfortable with this, Kim then tried it on her perm cath site and PD cath. To the relief of all, one of the dressings, Mepilex, worked. Kim followed up with getting the approval of the unit manager and nephrologists for this variance in our dressing policy.
Miss K. also had many setbacks in transitioning from hemodialysis to peritoneal dialysis. She experienced great discomfort with her fill for PD (fluid instilled into the abdominal cavity for peritoneal dialysis) and became afraid of this treatment method. Finding a way for PD to work for this child was crucial to letting her lead a "normal" life style that hemodialysis would not allow. With time and patience, Kim worked with her filling a small amount of volume at a time and let Miss K. control stopping the fill when it became uncomfortable. The young lady would then indicate when she was ready for a little more fluid to be instilled. They went on this way starting and stopping with Miss K. in control until the necessary volume was in without pain.
The most recent report is that Miss K. is doing well on PD and running around like a child again. Her courage exceeds that of many adults. She and her family will be able to return to Pennsylvania soon to resume their lives there but this disease has changed them forever. I am so proud to see how our unit came together and contributed in making this difficult time easier for this child and her mom, but Kim Hiatt went above and beyond to help remove traumatic barriers and add to the successful outcome for this family during a life changing event. She truly deserves this recognition.