October 31, 2014
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The Power of Caring: Inside the ICU at Golisano Children's Hospital

Inside the Pediatric ICU at the Golisano Children's Hospital, where a dedicated medical team delivers professional and emotional support to kids in crisis.

Elizabeth Jimenez-Guzman keeps nurse Joy  Mones, and the rest of the staff, wrapped around her finger with her engaging personality.

Elizabeth Jimenez-Guzman keeps nurse Joy Mones, and the rest of the staff, wrapped around her finger with her engaging personality.

Photography by Alex Stafford

Elizabeth Jimenez-Guzman was born 14 weeks premature. she weighed less than 2 pounds. Cerebral palsy and chronic lung and gastrointestinal complications have continued to give her fi ght after fi ght; any inkling of illness, and she ends up in the Pediatric Intensive Care Unit at Golisano Children’s Hospital of Southwest Florida. In and out of the PICU since birth, the 3-year-old has come to prefer a seat in the highchair by her door, where she can monitor the comings and goings of the nurses’ station. On a typical day, she might see one patient admitted, another released—a steady emptying and fi lling of the unit’s 12 beds. Her mother is unable to visit much, but still Elizabeth has a smile for anyone who passes: critical care nurses and nurse practitioners, pediatric intensive care physicians and respiratory therapists, dietitians and pharmacists, child life specialists, social workers and case managers. From her favorite perch, Elizabeth watches the constant consultations of this dedicated team Photographer Alex Staff ord spent a day in the life of the PICU, where he captured the joys and sorrows of the patients and caregivers.

--Cayla Stanley

Nurse Holli Spencer takes the temperature of 6-year-old Helmer Ramirez, whose complex medical history includes a significant neurologic disorder that causes seizures. Helmer was admitted with pneumonia, but recovered nicely and returned home to join his family.

Nurse practitioner Lilian Barroso converses with a PICU staff member at the nurses' station. Barroso has been a member of the hospital's health care team for close to 15 years.

Pharmacist Glen Kelton, left, confers with pediatric intensivist Dr. Jose Diaz about medication orders. Rounds are generally the biggest event of the day: The entire interdisciplinary team convenes with families to offer input on each patient, summing up the previous 24 hours and planning care for the next 24.

Spencer updates charts in the electronic medical record. Much of a nurse or doctor's daily routine consists of data entry; the task is incredibly important in an ICU, where professionals must constantly communicate care decisions, change medications or tretment plans, and document every aspect of delivered services.

Beneath a case of supplies, a patient's crib is brightened by a note from the nurses that reads, "Smile you're being thought of!"

Nurse Andrea Kubarek cares for 15-year-old Noah Johnson, who was critically ill with an exacerbation of asthma brought on by an Influenza/H1N1 infection. He since was discharged and is doing well. Like Noah, many PICU patients are kept sedated so they don't experience discomfort; though they respond to questions from staff members, often they will have no memory of their stay.

Music therapist Julie Avirett, above, uses music to help children physically, emotionally and developmentally. The enrichment can make a world of difference in the experience of patients like Nantasia Johnson, below, a 5-year-old with sickle cell disease and related acute chest syndrome.

Mone gives Elizabeth a cuff to cover her medical lines so she can't pull them out. Irresistible, Elizabeth already receives visits beyond scheduled baths, movement and medication, but she wins extra one-on-one attention by toying with her heart monitor, which sounds an alarm at the nurses' station.

Spencer takes a break in the unit's dictation area. Visitors will never find a coffee cup, paper plate or other contaminative object on any work surface in the PICU, not even a personal desk.

 

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