The kids recovering from serious illness or injury in Children’s Wisconsin’s Pediatric Intensive Care Unit might not be able to see nurse Tim Coenen’s usual smile hidden behind his protective mask, but he hopes they sense it in his eyes. With visitation restricted to only one parent at a time, he knows his young patients need a comforting smile more than ever.
Meanwhile, primary care triage nurse Jessica Ackley now assesses cases exclusively over the phone — and sorely misses seeing the patients and families who usually brighten Franklin Pediatrics. “I hope they can feel me smiling over the phone, hugging them with my voice and my words,” she said.
Although COVID-19 doesn’t typically affect children as seriously as adults, the pandemic has certainly changed day-to-day life at Children’s Wisconsin, the only 100-percent kid-focused health care system in the state. To help “flatten the curve” and protect patients, families and staff, Children’s Wisconsin temporarily halted non-urgent appointments and procedures at its 40 locations across Wisconsin (and is now slowly and safely rescheduling those appointments). Nurses who usually staff clinics or schools have jumped into other assignments, from checking colleagues for fevers as they arrive to work to assisting Children’s Wisconsin employee wellness program. Personal protective gear is carefully conserved, supplemented by handmade masks donated by the community — sometimes with prayers tucked into the filter pockets.
While these are extraordinary times, the more than 1,800 Children’s Wisconsin nurses bring the same exceptional dedication to their work every day.
“COVID-19 changed health care overnight,” said Nancy Korom, MSN, RN, vice president and chief nursing officer at Children’s Wisconsin. “I’m really proud of how everyone has responded. What hasn’t changed is our purpose. We’re here to give the best and safest care to the children and families we serve. The way we do our work has changed, but not the why.”
In March, the American Nurses Credentialing Center awarded Children’s Wisconsin the highly coveted Magnet Recognition Program® status for the fourth consecutive time. Magnet designation needs to be confirmed every four years and is considered the gold standard for nursing excellence. Less than 1 percent of U.S. hospitals have achieved the honor four or more times. The rigorous application process considers a number of factors, including a demonstrated commitment to evidence-based practice, providing new knowledge and innovation, and transformational leadership.
Nurses at Children’s Wisconsin are well prepared to deliver outstanding care: 82 percent have a bachelor’s degree in nursing and many have advanced degrees and specialized professional certifications. That includes 175 advanced practice nurses, who are specially trained to directly diagnose, treat and manage patients’ conditions.
Not only do Children’s Wisconsin nurses embrace best practices — they also develop them. A dozen PhD nurse scientists lead research studies and mentor other nurse-led research and quality improvement projects throughout the health system, on topics ranging from improving discharge education to the best infant feeding practices to new ways to support kids with complex conditions. Nurse researchers have published hundreds of articles in research journals and are recognized for their leadership and expertise at the state, regional and national level.
“We are so fortunate to have the workforce we do,” Korom said. “Children’s Wisconsin nurses act with purpose. They are here because they want to do what’s best for our patients and their families. It’s a passion, not a job.”
That shared passion inspired Coenen to follow in the footsteps of his mom and dad, who are both nurses. “I always joke that it’s like the family business,” said Coenen, whose sister, aunt, uncle and cousins also work in health care.
The trauma/surgical ICU can be a stressful environment under even normal circumstances. Coenen’s patients include infants to 20-somethings who are recovering from organ transplants and other surgeries, brain injuries, car accidents, gun shot wounds, and “any kind of injury or illness that you could possibly imagine,” he said. Not only does he care for the kids in his unit, but he also comforts families during an incredibly trying time.
“We are always giving them 110 percent of everything we have,” he said.
But the rewards are incalculable. He especially loves when families send the ICU team updates via holiday cards or thank-you notes. “I always enjoy the little things, like when you take care of a patient for a really long time and you get to see them heal, grow, go home and get back to their regular routine,” Coenen said. “That’s always the great part of the job.”
Ackley, who worked in the Cardiac ICU before transitioning to primary care, also cherishes the connections with families. “I love to take a moment where they’re scared, sad, stressed or happy, and be a part of that with them and hopefully make a difference, whether by making them feel more confident and calm or by sharing in their joy,” she said. “And it’s not just the kids; it’s the parents and siblings, too.”
She’ll never forget the time a mother learned that her newborn, who was struggling to gain weight, needed to be admitted to the hospital as an inpatient. “The momma was scared, and I asked, ‘Can I hug you?’ And we hugged and cried together. Just knowing that she felt cared for in that moment and we were a team together was great,” Ackley said. “You get to walk families through these journeys. There are happy moments, but there are scary moments, too, and we’re going to be there at the beginning and the end. And we’re rooting for them every step of the way.”
There are no hugs in the social distancing era. But until the pandemic subsides, Coenen, Ackley and their colleagues have quickly adapted to the necessary changes.
“It’s affected us a lot,” Coenen said. “We’re monitoring our temperatures at home and wearing our appropriate PPE (personal protective equipment) to prevent the spread of infection. Sometimes it’s harder to hear a nurse or doctor talking under the mask, and I always feel bad for the little ones who can’t see us smile or see our mouths move when we talk. But it’s necessary. It’s not only about keeping our staff members healthy, but also keeping our children and families healthy because you never know who is a carrier.”
As a triage nurse, Ackley is used to working with families over the phone, but she also relished her in-person connections during well child checks and other visits. “That’s the part that I’m really missing,” she said. “It’s the buzz of the job. That light that they bring to the clinic is not here right now, and you don’t realize how much that means until it’s not there. During this pandemic our patients have expressed a lot of gratitude for what we’re doing, and it’s made me realize how very grateful I am for them and what they bring to my life. They enrich our lives as nurses."
But despite the challenges, spirits are still high amongst Children’s Wisconsin staff, she noted. “We’re a resilient bunch,” she said. “Things are changing daily in our practice, and it’s definitely required a lot of flexibility and teamwork. That’s the thing that’s shining through here: the teamwork. It’s not just the nurses, but the physicians, the medical assistants, the front desk. We really are all about our kids, and we’re committed to providing the best pediatric care in the state and the nation.”