May 2024
Pediatric Team
PICU
Virginia Commonwealth University
Richmond
,
VA
United States
Donna Chisholm, RN; Kelsey Clay, Nurse Educator; Brooke Dahoney, RN; Mikaela DePonte, RN; Lexi Ellis, RN; Kendall Gunderson, RN; Kayla Hathaway, RN; Brooke Heath, RN; Jennifer Johnson, RN; Ellie McLean, RN; Haley Mire, RN; Erica Nickels, RN; Elizabeth Overstreet, RN; Carter Petsos, RN; Danny Phillips, RN; Abby Pugh, RN; Haley Silva, RN; Shayla Simms, RN; Peyton Spivey, RN; Alex Suhr, RN; Stephen Turner, RN; Lins Aiken, RN; Bailey Bair, RN; Gabrielle Barton, RN; Caitlyn Burch, RN; Emma Burch, RN; Jenny Deavor, RN; Brittany Fontana, RN; Sam Garcia, RN; Mary Howell, RN; Autumn Marshall, RN; Megan Mawby, RN; Cynthia McClain, RN; Natalie Morrison, RN; Peter Rossbach, RN; Elizabeth Uvanni, RN; Katie Shearon, RN; Colleen Wisniewski, RN; PICU Nursing Leadership; Daniel Cannone, Physician; Amanda Gideon, Pediatric Nursing Administration; Kelley Lastrapes, Physician; Heather Rossi, Child Life Specialist; Joe Roberts, Clinical Social Worker; Paige Lockamon, Child Life Specialist; Amy Mercurio, RN Care Coordinator; PICU Attendings; Laura Meija-Connoly, Housestaff; Carlos Carmona, Housestaff; Ashley Nyitray, Housestaff; Tamara Neiderer, Occupational Therapist; Hanna Lee, Occupational Therapist; Megan Stratton, Occupational Therapist; Caitlin Giovannini, Occupational Therapist; Ashley Daniels, Occupational Therapist; Melissa Caldwell, Occupational Therapist; Abby Comeau, Occupational Therapist; Allison O'Donnell, Occupational Therapist; Lindsey McIntyre, Occupational Therapist; Julia Perkins, Occupational Therapist; Julie Seabury, Physical Therapist; Carly Robinson, Nurse Practitioner; Lindsey Shah, Nurse Practitioner; Josh Moore, Nurse Practitioner; Sarah Hutchison, Physician Assistant; Dale Purrington, Nurse Practitioner; Natalie Lovern, Speech-Language Pathologist; Cathy Van Drew, Physical Therapist; Clare Simasek, Physical Therapist; Brittany Wynn, Physical Therapist; Jenny Reseta, Physical Therapist; Chelsey Blizzard, PCT; Dwight Baldwin Jr., PCT; Neisha Shelton, PCT; Melissa Owens, Music Therapist; Michael Feldman, Physician; Burn Advanced Practice Providers; Pediatric Respiratory Therapy; Teachers; Kelly Smith, RN, Nurse Manager

 

 

 

Our unit has weathered winds, but what we experienced last year was unprecedented. Our unit provides specialized care in the setting of complex illnesses, symptom management, acute changes, and sacred transitions. Our acuity fluctuates and it is not uncommon for a patient to become 1:1 depending on their symptoms. Some examples include acute bleeding, respiratory distress, breakthrough pain, delirium, anxiety, intractable nausea, or during final breaths. Families require continuous education and support throughout the care continuum as interventions evolve, values are honored, and, at times, existential crises emerge.

On one occasion, we had an experience where the patient and family required an interdisciplinary approach to manage multifaceted symptoms, psychosocial complexities, and unique relational dynamics. Beyond our typical interdisciplinary team, a strategic team was formed to include members from legal, patient relations, divisional and medical directors. The weight of care and advocacy placed the bedside nurses in a demanding position. Burnout and moral distress began developing within the team – Kelly Smith remained accessible and acted. She advocated for our needs and as a result an intervention was implemented that ensured patient care was not compromised and the unit was equipped with additional resources. During this time, she often worked past regular hours to meet with the patient, family, team, and more specifically to be a hands-on guide for the unit. She went above and beyond to cover. It is a sacrifice that is not easily measured. Her attention to detail provided space for leaders across the healthcare system to have increased knowledge on the specialized care that we provide on our unit. Moreover, in crisis, Kelly provided a way forward that has become a blueprint for advocacy, action, and escalation.

On another and more somber occasion, our unit experienced a tragic event over a weekend. Immediately, Kelly left her family and came into the hospital to be with the team. She managed increased team members and assisted with flow of patient care as the unit still needed to run and was a real time resource to all team members. She did not delay holding an emergent staff meeting to ensure that all team members, present and absent, had a chance to be updated and provided space to debrief. If you were unable to attend the emergency meeting, Kelly met with you one on one. The ripple effects of this experience were palpable, and our Nurse Clinician, Naomi, raised awareness about Second Victim Syndrome. Kelly coordinated a specific training with the Employee Assistance Program on second victim syndrome and held space for us. The trainings accommodated schedules and learning needs both in person and virtual—it was powerful. It gave language for the work done on our unit both within the context of customary and unprecedented occurrences. Kelly’s compassion continues to create greater retention and well-being for our team.