For the past year, the pediatric unit has provided care for a 5-year-old patient who comes for an infusion once a week. The infusion requires portacath access followed by an infusion that lasts approximately 5 hours. From the first day on our unit, this patient was terrified of the port access and de-access. She would scream, cry, hide, hit, and squirm in such a way that it made it very difficult to successfully access her port. Four people were needed to restrain her during the access. This happened week after week after week, for months. It was extremely traumatic for the patient, her mother, and the staff.
Katie took on the role of the primary nurse for this patient and began a lengthy process of trying to make the access less traumatic for the patient. She has spent many, many hours engaging in therapeutic and medical play with the child. She has encouraged the patient to play with syringes and other equipment used for access/de-access, she has had her "access" a port on her bear (many times); she has shown pictures and videos and used the educational mannequin for demonstration and to decrease fear. She has shown the patient the port in the mirror and explained what is there and why. She allows her as much control as she can, from removing the tape to pushing in a saline flush. She even connected with the Child Life Specialist department at Seattle Children's Hospital for additional ideas on how to make this weekly event less traumatic for the child and implemented every suggestion (distraction with videos, sticker charts, special toys, etc).
Katie has communicated extensively with the pediatrician and the patient's mother and was steadfast in her advocacy for the need to help this patient. For all of the nurses involved in this patient's care, this has been a frustrating and challenging situation. For Katie, it has always been about decreasing the fear and trauma for this patient. It has now been a year of this weekly infusion, and progress has been made, in large part due to Katie's significant effort. It took 10+ months of work and therapeutic intervention, but this patient can now lie still during insertion, with only one additional helper. She no longer cries or hides. This is a huge difference, and it is because of Katie's dedication and determined efforts in working with this patient.
Katie demonstrated creativity, patience, persistence, and the ability to think outside the box even when her initial efforts seemed like they weren't working. She continued to give the patient time to adjust while working to increase her ability to cope with this weekly occurrence. Katie strengthened this patient's confidence with her steady approach and constant effort, and she built trust with the patient and her mother through her consistent use of therapeutic and developmentally appropriate communication.
Katie demonstrates extraordinary commitment, knowledge of pediatric nursing and most importantly, deeply compassionate care.