Mission Children's Hospital

       Greetings! Today our group toured the Mission Hospital in Ashville, North Carolina. We got the opportunity to see their pediatric unit, pediatric intensive care unit (PICU), and their newborn intensive care unit (NICU). We were not able to go into the pediatric oncology unit, but it was a unit present as well. We also went to an outpatient center that had a wide variety of pediatric specialist in one central location. During my clinical rotation in pediatrics, I never had a day on Methodist’s pediatric floor due to low volume of patients, so this was my first clinical experience in a pediatric unit (excluding the nursery). I was impressed with Mission’s hospitals units. What was really interesting to me was the focus of care. One of the nurses shared that she isn’t just caring for the child, but the immediate family, but also the extended such as grandparents. This is a focus of care that I’ve learned about in pediatrics lecture, so it was helpful to see it in the practice setting. Another thing that stood out today was just how the hospital was structured. There were specific treatment rooms that children were taken into anytime there was going to be an unpleasant or frightening procedure (ex. Foley catheter insertion, IV sticks, ect.). Our tour nurse shared that the idea behind this was that children would associate their own rooms as safe place. This also applied to the children’s play rooms, where nurses are not allowed to even give medicine to the children while they’re in them. Because hospitalization throws off a child’s routine and can be stressful, I think these pushes to give children a safe space is a great idea. Another impressive part was that the nurses were doing a pilot study where they wore a “medication sash’ while passing medications, so other nurses or care providers knew not to interrupt them. The nurse shared that the idea behind this was to reduce medication errors and help nurses focus.

            A child’s hospitalization can be incredibly stressful on a family. There are many dynamics to this disruption, such as family support system, ability to take off work, child care for other siblings, and socioeconomic income. There is also the possibility of commute time. On our tour, our nurse discussed a couple different way that this organization is trying to apply family-centered care. One of those ways was doing interdisciplinary rounding for patients, and including the parent in these rounding’s. The nurse explained that this keeps the parent in the loop and enables the parent to ask questions or correct the care providers if misinformation is given. This environment of interdisciplinary rounding on patients was similar to what Cherokee Indian Hospital does for their rounding report on inpatients. This was a practice in both Cherokee and Mission hospitals that I would like to see applied more at hospitals at home. The patient’s rooms have a pull out bed so family members can stay with the child. The nurse reported that one meal is provided for a family member at every meal. Housing can also be provided for families at other rooms in the hospital. The nurse reported that housing is also available to families for a set number of days at a resident similar to the Ronald McDonald houses, so that caregivers can be within thirty-minutes of their children. Something that was different from what I’ve seen in Cherokee Hospital is the amount of family members or visitors allowed for the children, which only two visitors at a time. The nurse said exceptions to this case may be in palliative situations. In previous clinical days at Cherokee, we have learned that family is important to this culture, and hospital rooms are constructed to allow for large family or community groups to visit.

            My favorite part of the day was visiting the hospitals NICU. We were able to see a variety of patients, and the nurse discussed the issue of becoming attached to these patients, and needing to take care of themselves emotionally and mentally. The nurse stressed the importance of using her resources. She said that she frequently finds support through debriefing with the hospital Chaplin. It’s important for nurses to take care of themselves so that they do not become burnt-out or hard-hearted. In working in any unit this is important, and something we as new nurse may need to utilize. I had a great day!

            Following our tour in Ashville Mission Hospital, we stopped by the Biltmore Estate. The home and grounds were beautiful. It was fun to learn more about the area, and a good bonding experience for our clinical group. Tomorrow we have clinical at Cherokee Indian Hospital. We will also be going through donation’s tonight as part of our service project. Looking forward to tomorrow!

                                         A photo I snapped of the Biltmore today. It was beautiful.