How Pediatric Providers Care for Adult Patients During Pandemic

How Pediatric Providers Care for Adult Patients During Pandemic

In this first person account, a hospital leader recounts how during the pandemic, it's been all hands on deck.

As COVID-19 has not affected the pediatric population in the same way as it has affected the adult population, our pediatric services at Yale New Haven Children's Hospital have seen a steep decline in in-person clinic and emergency department visits. We have had the same ban on elective procedures as our adult counterparts, leading to a significantly decreased census in our inpatient and pediatric ICU units, except for the neonatal intensive care units, which have maintained their normal volume of patients.

Our nurses have contributed to assist our adult colleagues in managing the extraordinary COVID-19 patient volumes in the adult acute care medical units and intensive care units, either assisting with care, serving on a "proning team" or acting as a "dofficer," and also in other outpatient COVID-19 sites, like our health system's drive-through specimen collection sites.

Nurses from two of our medical and surgical units combined forces with our pediatric hospitalists and resident teams and agreed to take on staffing and medical management of a combination of COVID-19 positive young adults and also COVID-19 hospice patients on a 28-bed adult unit. These nurses and doctors have taken on care that was completely foreign to them pre-COVID and had to go through a rapid and steep learning curve.

As the manager of the two pediatric units said, "In 10 years, our nurses have experienced three deaths on our units, and over the last four weeks, we have helped more than three dozen adult patients pass with dignity, respect and perhaps most importantly, with the love that pediatric nurses bring to their patients."

The nurses have held hands with patients whose loved ones were too far away to visit and use technology to make sure family members are at the bedside virtually. Child life specialists created individualized bereavement boxes that allow for keepsakes to be saved for the loved ones of these patients. Our pediatric residents said they have learned so much about empathy, patient and family engagement and difficult conversations, and they will take back an even greater communication skillset when they return to the family-centered care of children in our children's hospital.

Our nurses working on that unit said that despite the heart-wrenching toll this work has taken on them emotionally, they believe this is exactly where they were meant to be during this highly unusual time. This group of nurses exemplifies what is so special about nurses in general—they can face and overcome any challenge or obstacle when there are patients who need care. It's what nurses do, and I'm humbled and proud to say we have some of the best of them here at Yale New Haven Children's Hospital. These nurses and doctors are my heroes.

Written By:
Marianne Hatfield, DNP, RN, CENP
Vice President, Yale New Haven Children's Hospital

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