There are days, especially when I am with students, when I feel my life has been divinely led. Tonight was on of those evenings. My clinical setting is a SNF for medically fragile children- one of a handful in the country. Kids there have trachs, g tubes, j tubes and soon will start taking vents as well. The main diagnosis is Cerebral palsy, but there are also children with genetic disorders, severe TBI, and near drowning.
I got into my part time job as a clinical instructor by accident- one of my previous students told me that they needed an instructor for this setting, and knew that I would be a perfect fit. After all, I had 7 years of experience of working with special needs kids and adults.
I had never thought before of wanting to be a nursing instructor. Even though I always had students in my previous jobs, they were always fit into an already tight schedule and I would feel resentful- how would I do my own job, when I am making sure they were taken care of?
So, fast forward to the present time and my joy of being with students. I consider myself very fortunate to be with the students in this setting and tell them regularly it is my honor to be their instructor. I tell them that working with these children is a spiritual experience and they will never be the same.
I talk a lot to the students about the spiritual side of nursing- the part that leaves us so often when we are busy and stressed. I tell them my definition of spiritual care- which is bearing witness- just being there and not necessarily needing to provide anything except a smile, touch, or ear.
For anyone who has had the good fortune of working with special needs people, you may understand what I mean by the spiritual side of providing their care. These children do not communicate with their words, they use either use visual cues for choice; hand signs for yes and no; Dynavox which is a speaking computer; or the majority - communicate through touch and smiles.
It is always hard for the students when they start the rotation. They have to let go of their preconceived ideas of special needs children, and what it means to be there. That for the most part, the parents did love their child and deeply care about them, but were unable to provide their daily care- of lifting, moving, bathing, feeding ,medications, and transporting to medical providers. The students quickly realize that the staff is the child’s family, and these children are adored and loved for who they are.
The students are busy at the center- providing total care for their patients with the use of lifts, feedings and meds, but they also get a chance to make a difference in someone’s life for a few weeks, and wait for that precious smile that will warm their heart’s forever.
I have had a student sing to her 15 year old patient, while joking how she hopes that her best is enough. Another student took her patient outside to the wheelchair swing, letting her feel the cool breeze on her face and the sensation of movement. Another played hide and seek with this hands- and got an eruption of sweet peals of laughter.
Tonight I witnessed something that melted my heart- twice actually in the same shift. One of my students was rocking her patient in the soft rocker, and her patient snuggled into her breast and under her chin. I could sense that special sweet infant inside of her.
Another student told me that he has been teaching his patient a new song to hum. Her only communication is humming and she is always humming Three Blind Mice; he is now teaching her another easy song. He repeats the new song to her continually during his shift and she is starting to repeat it!
Yes- these are BSN students at a small private college. Most all of the students have at least one job to help with expenses, and many are intensely competitive. But bottom line is that this pediatric rotation will change them forever and help to dismiss the beliefs we carry about “the other”.
Wendy Votroubek, RN, MPH, CLNC
photo thanks to Wendy Votrubek, Out of the Blue Blog