Quality of Life and Pediatric Healing

Author: Sophia Hart, Pediatric Critical Care RN

At Nursing Evolutions, we understand the profound impact that patient quality of life has on their overall health, recovery, and resilience. With this understanding as a guiding principle, we are dedicated to providing as many enriching experiences as possible to enhance the lives of our patients. 

From regular walks to the park, visits to the pumpkin patch, to zoo days with families, these are just a few examples of the diverse experiences we offer to enrich the lives of our patients. We believe that these activities not only bring joy and happiness but also contribute positively to their physical, cognitive, and psychosocial development. 

While hospitals are remarkable places to receive care from many providers and specialties, they often struggle to provide the “normal” childhood experiences essential for holistic development. This challenge is particularly pronounced during long-term stay in units like the Neonatal Intensive Care Unit and Pediatric Intensive Care Units, where the environment can interrupt children’s development on multiple levels. 

In our facilities, we prioritize creating an environment that prioritizes both the safety and growth of our patients in all areas of life. Our progressive critical care facility goes beyond traditional nursing care to provide a nurturing environment where children with complex health conditions can truly be kids. Whether it’s crawling in the grass, playing with other children, or doing regular kid things like trick-or-treating on Halloween, we strive to offer experiences that are difficult to replicate in a hospital setting. 

Central to our approach is the belief that pediatric care should revolve around play. We recognize the profound impact that play can have on reducing anxiety and mitigating healthcare-related trauma. As such, we ensure that our nursing interventions are as enjoyable as possible, engaging our patients in activities that cater to their developmental needs, whether participating in pretend play, hide-and-seek, stacking blocks, or participating in matching games. We tailor our play to support each individual patient’s growth, following recommendations from their interdisciplinary team 

In addition to traditional medical care, we integrate complementary therapies into daily life at our facilities. Music therapy is beneficial in improving patient quality of life. Our patients have dance parties and the kids get excited to learn simple songs to on play pianos. These moments of joy and connection help ensure that our houses are rarely quiet, filled instead with the sounds of laughter and play. 

At Nursing Evolutions, improving quality of life permeates care practice, from our daily routines to our exciting outings, ensuring that our patients receive the comprehensive support they need to thrive. 

Nursing Job Fair at Bellingham Technical College

Join us!

Nursing Evolutions on the Road!

Our HR team has been hosting booths at healthcare-oriented job fairs. Most recently, we traveled to Spokane for Washington State University’s School of Nursing Job Fair, and to the Bellingham Technical College School of Nursing Job Fair. We are currently hiring for Registered Nurse positions and Pediatric Care Technician positions (PCT – nursing students, NARs, or CNAs). But how is it that we can sometimes hire new nursing school grads for such a niche patient specialty?

Training for CNA / Pediatric Care Technicians

Nursing Evolutions patients consistently exceed the expectations of their hospital-based care teams due to the expertise and professionalism of every member of the care team. Pediatric Care Technicians are essential members of the team, and as such, complete rigorous technical training. This includes detailed knowledge of activities that PCTs would only perform in extreme and highly unlikely emergencies; Nursing Evolutions follows emergency preparedness similar to the multiple layers of clinical back-up in a hospital.

Depending on the experience level of the new PCT and their familiarity with tracheostomy care and pediatrics, the training process can take anywhere between four and twelve weeks of full-time shift work. There are many milestones along the way as the new PCT becomes proficient in each patient care activity and passes the associated Nursing Evolutions quiz. At the end of a PCT’s training, we issue their Pediatric Care Technician Certificate with sign-off from the PCT Manager, Nursing Supervisor, Clinical Director, and CEO.

Comprehensive RN Mentorship Program

We believe that providing the best care for our patients requires a commitment to continual learning and skill development.

Hands-On Experience with Expert Guidance
New RNs receive hands-on experience under the direct supervision of experienced RNs. The length of the mentorship period varies based on the complexity of the patient’s case and the experience level of the RN. Mentorship continues until the nurse is confident and prepared to provide care independently.

Even experienced RNs participate in the mentorship program when encountering new patient cases.

Residency Program
Once the mentorship period is complete, nurses can then enroll in our two-year Residency Program which includes a $5,000 retention bonus. The program combines on-the-job training with formal off-site courses to expose RNs to a wide range of situations and decisions that must be made in the field.

At a minimum, all mentees and residents become proficient in the following nursing care responsibilities:

  • Head-to-toe physical assessments
  • Tracheostomy care
  • Managing mechanical ventilation, including pressure and volume ventilation, intensive pulmonary treatments, and cough assist devices
  • Administering fluids and medications through various lines and tubes
  • Nutrition and hydration management
  • Medication administration, both scheduled and as needed
  • Effective communication with patients, family, and healthcare professionals

We currently have open positions! Come visit us at a job fair or reach out to us at hr@nursingevolutions.com!

Creating a Strong Team Across Medical Specialties

Critical care units are high-stakes environments where patients require round-the-clock care and monitoring. The success of this care depends mainly on the teamwork and collaboration of medical professionals from different specialties. This post will discuss creating a robust and cross-disciplinary team in a critical care setting.

Establish clear communication protocols: Clear and consistent communication is one of the essential elements of effective ICU teamwork. Establishing protocols for handoff reports, shift reports, and critical event notifications will help ensure that all team members are on the same page.

Encourage interdisciplinary rounds: Regular interdisciplinary rounds, where all care team members meet to discuss patients and plan care, are an excellent way to foster collaboration and improve patient outcomes. These rounds allow team members from different specialties to share their expertise and perspective.

Foster a culture of respect and collaboration: Encouraging a culture of respect and cooperation can help build trust and teamwork within the unit. Team members should feel comfortable sharing their thoughts and ideas and be willing to listen and learn from each other.

Provide opportunities for education and training: Providing opportunities for continuing education and training can help build a strong, knowledgeable team. Encourage all members to attend conferences, workshops, and other educational events, and provide in-house training regularly

Preventing Infection in Toddlers with Tracheostomies

As a parent or caregiver of a toddler with a tracheostomy, it’s normal to have concerns about keeping your little one safeand healthy. One of the biggest concerns for children with tracheostomies is the risk of infection.

A tracheostomy is an opening in the neck that provides a direct airway to the trachea and lungs. Tracheostomies are often necessary for children with breathing difficulties. They also leave them vulnerable to bacterial and viral infections that can cause serious health problems.

However, there are steps you can take to minimize the risk of infection in your toddler with a tracheostomy. Here are some tips to keep in mind:

  1. Keep the tracheostomy site clean and dry. Regularly clean the skin around the tracheostomy and make sure it stays dry. Use a clean, damp cloth to wipe away secretions, and allow the area to air dry.
  2. Change the tracheostomy ties and dress regularly. Tracheostomy ties hold the tube in place, and the dressing protects the skin around the opening. Be sure to change these regularly as directed by your healthcare provider. At Nursing Evolutions, we attend to these every day.
  3. Avoid exposing your toddler to infections. Keep your toddler away from people who are sick andwash your hands frequently to prevent the spread of germs.
  4. Use sterile equipment. Always use sterile equipment when changing your toddler’s tracheostomy ties and dressing and cleaningthe tracheostomy site.
  5. Monitor for signs of infection. Look for any symptoms of infection, such as increased secretions, redness or swelling around the tracheostomy site, or a fever. If you notice any of these signs, contact your healthcare provider immediately.

In conclusion, preventing infection in toddlers with tracheostomies requires regular care and vigilance. Following these tips and working closely with your healthcare provider can help keep your toddler healthy and safe

A Case Study for Nursing Students! Meet Peter, A Typical Nursing Evolutions Patient

Are you a nursing student or working to become a nursing student? Curious about pediatric critical care? Here is a case study of the type of patient you might serve in the future! What kinds of patients do we help? Here’s an example!

Case Study

Peter is an 11-month-old male patient who came to our services after an 11-month hospitalization. He was born 26 weeks premature and had bronchopulmonary dysplasia, severe gastroesophageal reflux, tracheal malasia, and developmental delay. Peter requires 16 hours of critical field care daily, seven days a week, with his parents providing care for the remaining hours.

He is on a Trilogy ventilator receiving Intermittent Mandatory Ventilation at 25 breaths per minute with a tidal volume of 90ccs. When awake, Peter takes additional breaths with a respiratory rate of 27 to 35 breaths per minute but does not take extra breaths while sleeping. He receives a set supplemental oxygen dose of 2 liters per minute with a SpO2 range of 95-97%.

Airway suctioning is necessary approximately every 10 minutes while awake and every 30 minutes while asleep. There are no plans for weaning from mechanical ventilation or decannulating the tracheostomy. Peter is on a strict NPO status due to his aspiration risk and severe GERD.

We’ve shared this snapshot of the comprehensive care and attention we give to every one of our precious patients.

Exciting news! You have appointments later today with some of the top healthcare specialists in the field, including the Pulmonary, Otolaryngology (ENT), Gastroenterologist (GI), Physical and Occupational Therapists, and Dietitian teams.

The medical team currently has no plans for “taste” trials for the patient. However, we will focus on the patient’s strength, balance, and mobility. The patient is fully innervated but has limited upper extremity movement, with lower extremity movement only occurring with stimulation. While the upper and lower extremities are relatively weak, the patient’s torso muscles are nearly flaccid, and neck musclesare notably weak. At this time, the patient cannot hold up their head or sit up without full support.

Despite this, the patient does follow movements and actions with their eyes. However, they may be unable to move their head to keep up with the effort if it exceeds what they can see with their eyes. The back of the patient’s head is also flat and bald.

We want to make the most of these appointments and gain as much valuable information as possible.Here are some questions to consider:

  • What information are you hoping to obtain from each Specialty Care Provider team?
  • What are your expectations and concerns for each appointment?
  • What is your advocacy plan for the patient with each of these SCP teams?

We also want to coordinate our efforts to address critical issues, such as:

  • Advancing from continuous G-and G-J-tube feedings
  • Progressive mobilization
  • The plan for supplemental oxygen administration
  • Reducing dependence on mechanical ventilation
  • The eventual plan for tracheostomy decannulation.