N.
i
Duke University
Medical Center
Intercom
VOL. 24, NO. 49
DEC. 16, 1977
DURHAM, N.C.
They spare the needle, befriend the child
By David Williamson
Among the most common complaints
heard from patients and their families
about modern hospitals is that the care
seems cold, disjointed and impersonal.
Patients trade their names for
numbers, fill out a host of complicated
forms and swallow strange medications.
An ever-increasing number of white-
clad specialists swoop down on the
unsuspecting ill to perform an ever-
increasing number of tests, often without
explaining their purpose.
If there is a method to tile seeming
madness, patients and their families may
feel like they are the last to know.
A new kind of nurse
Over the past few years, however, a
new kind of nurse — known as the nurse
clinician — has joined the traditional
health care team in this country to try to
change all that.
Nurse clinicians say they see
themselves as advocates of patients and
their families. Their aim is to try to make
hospitalization a positive rather than a
negative experience by preventing undue
anxiety and discomfort for ail concerned.
Two nurse clinicians at Duke, Ceeya
Patton and Wendy Bullard in pediatric
cardiology, may typify the new breed.
The patients they treat range in age
from a few hours to 18 years and suffer
from a variety of congenital heart defects.
Some of the newborn weigh as little as
two pounds.
Each one is a person
“Every single child with a heart
problem who comes to Duke is known to
us as a person," Bullard said. "We meet
patients and parents as early as we can
and follow them through the entire
hospitalization, from initial diagnosis to
visits to the clinic after they've been
discharged."
"We're teachers as much as anything,"
Patton said, explaining how clinicians try
to add the skills of the social service
worker, the psychologist and the family
counselor to their nursing experience.
"Our doctors are very good about
drawing diagrams and explaining the
heart defects, but after families have had
time to think, frequently they'll have 27
questions that we help to answer," she
said.
"And if someone is needed to browbeat
the system, we won't hesitate to do that.
too," she added. "You know a child hates
needles more than anything else in the
hospital. If you can reduce the number of
times he gets stuck by better coordinating
the times when blood is drawn, you've
made a friend for life."
Mickey Mouse and Cookie Monster
Bullard said the clinicians take parents
and children on extended tours of the
catheterization laboratory where
diagnostic studies are made, the acute
care unit where they will awaken after
surgery, the wards, the playroom and any
other appropriate areas.
The children meet the people who work
there so they won't be strangers.
With Mickey Mouse, Cookie Monster
and Raggedy Ann dolls, the nurses
demonstrate how such medical
equipment as blood pressure cuffs,
intravenous feeding tubes and breathing
masks will be used.
Both wear colorful uniforms because
youngsters are frequently suspicious of
white hospital dress.
Chaplains particularly helpful
If a patient has to undergo heart
surgery, new friends Wendy or Ceeya
will stay with the child for reassurance
until he or she has been put to sleep.
The clinicians also give families
frequent progress reports during
operations. If a complex procedure is not
going well, the nurses try to prepare the
parents as gently as possible, sometimes
enlisting the services of a hospital
chaplain.
"We find chaplains particularly helpful
if a family is using religion for the wrong
reason," Bullard said. "Parents sometimes
blame themselves for having a child with
a heart defect, especially if that child dies.
They may say, 'It's God's way of
punishing us for not wanting him
enough.' "
Unusual strains on the family
Patton says that having a child in the
hospital can place unusual strains on the
best of marriages and the closest of
families. A concerned mother, for
example, may ignore her husband and
other children so that resentments build
up.
"Well make the families aware that this
is a potential problem to guard against,"
she said. "Brothers and sisters are often
included in the preoperative preparation
(Continued on page .3)
m.
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Ik
REMOVING FEAR FROM LITTLE MINUb—Vvhen childrei\.are being prepared tor heart surgery
here, they get acquainted ahead of time with the mysterious equipment and surgical garb they will
encounter when they go through preliminary heart catheterization and then the surgery itself.
Pediatric Nurse Clinicians Wendy Bullard (left) and Ceeya Patton even use prop* like, the Mickey
Mouse doll here to help their patients. One of them, six-year-old Sharon Smith of Fayetteville,
who already has had heart surgery once, checks out the surgical gknres. (Photo hy Jim WallactI