Carole Branch, a pediatric nurse practitioner (PNP) with Washington University School of Medicine and St. Louis Children’s Hospital, grew up in St. Louis. She first came to work at Children’s in 1979, and has held a number of jobs since. She has served in her current positions – as the inpatient PNP for the lung transplant program and the PNP coordinator for the SLCH pulmonary hypertension program – since 1999. In her years caring for extremely sick children, Carole has learned many important lessons. She outlines her top 11 for From the Bedside.
When I was thinking about this, the thing I thought the most about was what I have learned from all of my patients. I have had the privilege of working with some real characters and some very special patients. I’ve learned something from each of them. These are the lessons I carry with me to work every day, and the lessons I hope each and every new clinician has the opportunity to learn over the course of a career.
1. Recognize bravery.
These kids are the bravest people I’ve ever met. No exception. To think they go into the operating room to have their lungs removed from their body and have someone else’s put in – they surrender control when they’re wheeled into the operating room. That requires unimaginable trust and bravery, the likes of which I can’t imagine.
2. Mom knows best.
If a mother tells you her child doesn’t feel well and she thinks something is not right, believe her. In my experience, she’s usually right.
3. There’s nothing stronger than a parent’s love.
Parental love and family can be fierce, amazing and all-encompassing. The support I’ve seen families give these kids who have been sick for so long—that is humbling to watch.
4. Support a family the way they need to be supported.
I have had one family where the child unexpectedly took a turn for the worse, and the mom asked me to read the bible to her. I was like, “I don’t read the bible!” But there I was, sitting, reading it, and they were asking me what I thought. I learned religion from them.
5. Sometimes, it’s okay to just sit there.
Sometimes I may not have the answers, but I can find the time. Just sitting at the bedside is all you need to do. If you have time to watch a favorite TV show with a child or a stressed parent, it can mean the world.
6. You can make dreams come true.
We’ve had weddings. One of the respiratory therapists donated a dress. The nurses made a cake and provided food and snacks. They were married in the garden with close family members and staff as witnesses.
One adolescent who had a lung transplant wasn’t able to go to her high school prom. So the nurses on the floor decided to create a prom. Our house staff assistant, who runs a charity that provides prom dresses at a minimum to no cost, brought in several dresses for this girl to choose “the one.” The nurses arranged lights, balloons and music. That night, we got to see our girl dance with her father. I still get goosebumps.
7. Nurses are the best.
Respect the nurses and don’t ever underestimate their value to the care of the patient and family, their opinion and expertise. They are the heart and soul of the hospital, experiencing each moment with the patient and family. While the MDs may give the bad news, the nurses are the ones left behind to provide support, hug the parents, or just to listen.
8. You can’t be positive all the time.
A positive attitude can be hard to maintain. I did some work on compassion fatigue, and I learned a lot about self-care and separating yourself. On my off days, I’m off. And when I’m here, I’m here. I do things to help me and support me when I am outside the hospital so that I can take better care of my patients when I’m at the hospital.
9. The good days will pull you through the bad.
Some stories are incredibly uplifting; others, not so much. But when you see a patient come in that is so sick and pull through, it makes you feel so good. Let those moments reinvigorate you, and keep you going for the next patient
10. Appreciate the sass.
One patient we have followed for a long time is particularly sassy. She can push my buttons pretty easily, and I can feel like wringing her neck – but then I take a step back, and realize, “Wow. She’s amazing.” The things this girl has been through, and she keeps going. Her Make-a-Wish is coming up, to go on a Disney cruise. She says, “I want this done so I can swim on my cruise.” She has had a lot of badness in her life, but her sass and determination get her through.
11. Allow yourself to be inspired.
You learn something every day from these kids and their families. Every day with they will teach you about life and love and getting through the bad stuff. The will to live is amazing. Allow them to inspire you.