3 East Surgical

Sept. 9, 2019 – Today I met with a team whose job it is to get kids up and walking again. The staff on this 42-bed unit in the Acute Care Pavilion, called 3 East Surgical, provides comprehensive surgical and rehabilitation care to infants, children and young adults.

The unit is unique in that it has its own gym that allows patients to have physical and occupational therapies on the same floor where they are recovering. Patients here generally have a longer stay, from two weeks to five or six months, to recover from significant surgeries or major traumatic injuries.

One of the first stops on my tour was the room behind the nurses’ station. This is the nerve center of the unit, where information about each patient is kept and continually updated, both on computers and on white boards. The unit is divided into “uptown,” “midtown” and “downtown” based on the geographic location of the rooms (rooms at the south end are downtown). The charge nurse also keeps track of the number of post-ops, discharges and at-risk patients, as well as important unit updates.

In the treatment room

We then headed to a treatment room where a baby doll equipped with a gastrostomy tube (also called a G-tube) was positioned on the bed. G-tubes, inserted through the patient’s belly, deliver nutrition directly to the stomach. They’re one way children who have trouble eating can get the fluid and calories they need. Caregivers who are ready to go home with their child can practice with the doll. They also receive a detailed checklist and an emergency kit in case they run into any difficulties. All of the information is provided in English and Spanish.

We also talked about the plan of care for children who have a spinal fusion. A whiteboard in the treatment room details exactly what parents can expect over the three days (on average) their child is in the hospital and what they need to do to help with a speedy recovery.  This team has done a great job of reducing patients’ length of stay and the use of narcotics for pain.

Getting an introduction to Rover

While I was in the room, I learned more about Rover, which is getting a big thumbs-up from this crew! Rover is EPIC’s mobile application that allows nurses and respiratory therapists to review clinical information, complete documentation and carry out key workflows on the go on a Hospital-issued iPhone. Now multiple devices; such as phone, pager and barcode scanner; are consolidated on one device, improving efficiency. This team was the first to pilot the device, which will be rolled out to all the other inpatient units and the emergency department by the end of the calendar year.

Members of this team also piloted a research project to study the effects of aromatherapy on anxiety and pain levels in post-op patients. These children would rate their pain before and after smelling orange oil on a cotton ball. A larger sample size is needed, but so far, the aromatherapy appears to be having a positive effect.

Taking a break in the relaxation room

To my pleasant surprise, our next stop on the tour was the relaxation room. Staff can take breaks in here, spend some time in the remote-controlled massage chair, listen to soothing music, drink some hot tea and de-stress with calming lights. It has been a big hit with the team, and was even the subject of a research study that asked staff, “In the past month, how often have you felt nervous or stressed?” The six-month survey found that staff who answered “very often” dropped 11 percent from the pre-survey. The research will be presented at the 2019 American Nurses Credentialing Center National Magnet Conference in Orlando in October, along with a study on ostomy care video education for nurses. This study sought to find whether providing pediatric bedside nurses with video education on ostomy care increased their knowledge and comfort in caring for patients, compared to current education formats. The results suggest that incorporating various methods into education, including videos, helps to accommodate different learning styles and aids in information retention.

Enjoying churros and chips and getting my own bottle of orange oil!

While I was treated to churros, chips and guacamole from local favorite California Burritos, I also learned about a new practice that matches preceptors and new graduates for orientation based on their teaching, learning and personality styles; a comprehensive booklet that tracks RN competencies over 18 weeks; and a badge card that was developed to give tips on preventing lateral violence.

This group had one last surprise in store for me. As I exited the conference room door, I was serenaded in the hallway by about 20 team members! They sang the same song patients hear when they have completed their recovery and are sent home. Check it out here on the Team Rady Instagram page (scroll through the photos; the video is at the end).

This team is truly a dedicated group. It’s clear they are committed not only to improving the experience for their patients, but for themselves, so they can deliver the best care possible. Thanks for the fun and informative visit!