Nursing student by morning, tourist by afternoon

            Mission Children’s Hospital located in Ashville, North Carolina, is a children’s hospital that holds 130 beds (approximately 3,000 children) (Mission Children's Hospital, 2016).  Our tour included visiting the Newborn Intensive Care Unit (NICU), Pediatric Intensive Care Unit (PICU), and the Pediatric General Floor.  Mission Children's Hospital also has an outpatient pediatric center that provides all outpatient procedures for all body systems. This outpatient center has features that treat endocrine, respiratory, orthopedic, and many more injuries presented. The outpatient center allows the family and the pediatric client to receive all care within one visit.  

            There were several actions or interventions the Mission hospital staff provided for the families that struck me.  One intervention is the Mission staff providing a pull out couch for two parents of the child to sleep on and stay overnight in the child’s room.  This helps promote comfort and a calming sense for both the parents and the child.  A child admitted to the hospital forces the nurses to treat them, but also take care of the parents.  Parents are forced to create time in their lives that allow them to visit and comfort their hospitalized child.  This may force them to skip work and not earn the financial income needed. 

Another stressful event that may occur in the hospital setting is regression of the child’s milestones.  A toddler may begin using “baby-talk” after being able to speak two to three word sentences clearly.  The sense of insecurity found within the hospital setting causes the child to feel unsafe and regress back to previous milestones.  To help prevent this, it is recommended to not perform any procedures on the child’s bed.  The bed is commonly referred to as the child’s “safe zone” at school. At Methodist Hospital in Peoria, Illinois, I have only observed staff members prepare oral medications for the children. However, the nurse I observed did inform me and give me suggestions on how to prepare equipment such as urinary catheter or IV site. Mission Children’s Hospital had a designated room entitled “Treatment Room” where all treatments (IV insertion, shots) are performed to ensure the child’s security and sense of safety.  The treatment room can also promote trust and loyalty within the nurse-client relationship among the child and their family.Unfortuantely, Methodist does not have a treatment room, the nurse I observed gave me ideas on preparing equipment that may often be seen as frightening to children.  She suggested preparing them outside the room, or having your back turned towards the client so they cannot see the equipment.

            A pediatric nurse is not only responsible for the pediatric clients, they are also responsible for educating the parents and demonstrating treatment interventions if needed.  Rounding is often described as the process of the residents, physician, nurse, and client giving a report at bedside or within a common gathering area.  Mission Children’s Hospital allows the parents to sit in on rounding with the physician, nurse, dietician, resident, and nurse manager.  This allows the parents to receive feedback regarding their child’s prognosis as well as share their concerns regarding treatment.  Miscommunication can be found within healthcare as many health care team members have more than one client to care for.  These rounding sessions help apply family-centered client care to ensure the parents understand the child’s condition, as well as being competent enough to care for the child once discharged.

            Mission Children’s Hospital is located in Ashville, which means it is not on the Cherokee Qualla Boundary.  This allows the hospital to have different policies or regulations than the Cherokee Indian Hospital.  One difference between the two is the presence of an ethics committee, used if needed.  Both hospitals provided family-centered care and allowed the clients to have nature-themed rooms.  The rooms have one wall full of windows that outlook the mountains and a gorgeous view.  Both staffs have interdisciplinary report that prevents miscommunication or confusion regarding the client’s treatment program.  The use of the interdisciplinary report (witnessed at Cherokee Indian Hospital) is one observation that has stuck with me this entire week.  I hope our hospital systems are able to inquire this type of report session in the near future. 

About us. (2016).  Mission children’s hospital. Retrieved from http://www.missionchildrens.org/about-mission-childrens.php