NURSING MATTERS - Miami Children's Hospital

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From the Desk of Jackie GonzalezDear Nursing Team:The nursing team at Miami Children’s has much to celebratelooking back and much to anticipate in the year underway.As always, our nursing team was at the forefront of 2011hospital initiatives to advance care practice and experience.For many families, we are the heart, soul and smiling face ofMCH care and our impact is immeasurable.We recently went live with our PEDS electronic medicalrecord system. I want to thank those nurses who serve asSubject Matter Experts last year and in 2012 to supportdevelopment of the new system and as well as theircolleagues. Their hard work and guidance ensures that ournew system will be optimal in its ability to support childrenand families and care here at MCH.Some of our nurses were trained as “super users” who teachothers how to utilize the new system. The go-live in April,marked a huge step forward for the children we serve. Theinterconnectivity of our systems through PEDS optimizescare practice, facilitating access to comprehensive patientrecords and enhancing care.We continue to pursue our Magnet renewal process and areadvancing documentation that demonstrates how the MCHnursing team lives and breathes Magnet components. Thesite visit is expected to follow in late fall. This is a busy timefor us as we prepare to showcase ourselves and “Magnify ourExcellence.” The delivery of care at Miami Children’s Hospitalis guided by the principles of family-centered care. The NursingDepartment is dedicated to the belief that each child is uniqueand an integral part of a family unit. Families are involvedthroughout the course of their child’s care and are consideredvalued partners in care delivery. At all times, the deliveryof care ensures respect for the dignity, values, religious andcultural beliefs of children and families. You will be hearingmore about our new Professional Practice Model in months tocome, developed especially by and for MCH nurses, that willserve to guide us into the future.Thank you one and all for a dynamic 2011 and for embarkingwith me on PEDS and Magnet projects. As always, our nursingteam is truly a force to be reckoned with. It is genuinely aprivilege to serve with all of you.Sincerely,Jackie Gonzalez, ARNP, MSN, NEA-BC, FAANSenior Vice President / Chief Nursing Officer / Patient Safety OfficerState Nursing VisionMiami Children’sHospital’sLeadershipCollaborativeRelationshipsPatients, Families,& GlobalCommunityNursingProfessionalism& ValuesProfessionalPractice ModelCare Delivery& OutcomesRecognition& RewardsState Nursing Mission2
Child Life in Our MCH Emergency DepartmentBy Brittany Brown, Miriam Damvar, Lauren Falduti, Danielle Furio and Kim MoralesFrom a child’s eye view, a hospitalis a blur of white coats, strangevoices and sharp needles. And whenyour medical vocabulary is limitedto “boo-boo” and “ouchy,” it’s hard forcaregivers to figure out what’s going onor why it hurts. This is where a Child LifeSpecialist, such as Miriam Damvar, canhelp. Miriam assists patients and familymembers in understanding what’s going onin an age-appropriate manner. She mightuse bubbles to distract a toddler during anIV Start or use an iPad with a school-agechild during a laceration repair. Miriamis one of five Child Life Specialists whowork in our Emergency Department here atMiami Children’s Hospital.Miami Children’s Hospital employs fiveChild Life Specialists and one Child Lifeassistant in our Emergency Department. Tobecome a Child Life Specialist, you mustearn a minimum bachelor’s or master’sdegree, with an educational emphasison human growth and development,education, psychology, or a related field ofstudy. All of our ED Child Life specialistsare certified, which requires them tocomplete a supervised 480-hour clinicalinternship, pass an examination, and adhereto a minimum standard for continuedprofessional development in order tomaintain certification. Our Certified ChildLife Specialists in the ED help childrenand families cope with stressful situationsby finding out about any misconceptionsor fears they have about the ED and helpthem work through anxieties. Kim Morales,the outpatient Child Life Supervisor, said,“Much of the distress that is associatedwith an emergency room visit is due to thechild’s fear and the parent’s uncertaintyaround how to manage all of that. If we canreduce those fears, what is left over is notso horrible.” The truth is an IV start, blooddraw or laceration repair is going to hurt.And you can’t save a child from all thepain and indignity that comes with a visitto the Emergency Department but there aremany things that a Child Life Specialist cando to help ease the pain and distress of ourpatients and families.Child Life utilizes play to establishquick rapport with a patient in order tocreate a trusting relationship that aids inthe child’s comfort with the healthcareteam. We prepare the patient for upcomingprocedures using visuals and medicalequipment in order to decrease anxietyand fear, and encourage confidence andcontrol by giving them choices, whenpossible, such as allowing a child to choosewhat hand the nurse first looks at for anIV start. Child Life is also present duringthe procedure to facilitate distraction fromanxiety, and to provide emotional supportand coping techniques to help the childmaster the experience. The methods appliedby Child Life help to increase the child’scooperation, which can result in fewermedical staff members needed to “hold” aswell as less time spent during procedures.There is also a significantly lower amountof sedation and pain medication needed,due to the focus Child Life places ondecreasing the child’s anxiety as wellas utilizing non-pharmacological paintechniques such as distraction, guidedimagery and comfort positioning.3The following is an email is from aparent of a patient who was in our ED inDecember. Child Life Specialist BrittanyBrown (BB) was providing support anddistraction with this patient using an iPadand the patient was playing a game calledFruit Ninja, which involves swiping ascreen. “This e-mail is to let you know thatyou guys are..!!!!..AMAZING..!!!..My son(you can’t stop the swipe) the best fruitninja of the emergency room was very sickand you guys helped us to pass througheasily. BB was a very special person tous and Chris. They did a bunch of tests tomy boy. (Blood work, x-ray, etc.)....butwe didn’t feel it because somebody tookthe time to explain to us the whole thingwith detail. That person was BB. .So, toBB and the Child Life Department....a bigTHANK YOU! Thanks for all the thingsyou did for us to make us comfortable atMiami Children’s Hospital. With peoplelike that... (BB)...we just want to be sickall the time. Thanks to Miami Children’sHospital, to the emergency room and theChild Life Department. A big thank you toBB for being there for my son.....thank youso much......and remember.....“You can’tstop the swipe.”
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