Emma Carrick in the North Tower at Victoria General Hospital, where she’s the clinical nurse educator for pediatrics.                                Travis Paterson/News Staff

Emma Carrick in the North Tower at Victoria General Hospital, where she’s the clinical nurse educator for pediatrics. Travis Paterson/News Staff

As patients get sicker, technolgy keeps advancing, says nurse of 35 years

VGH pediatric nurse educator talks for National Nursing Week

When she entered nursing there was no way Emma Carrick could have foreseen the workload she’d handle as the clinical nurse educator for pediatrics at Victoria General Hospital.

Carrick, a Metchosin resident, has been at the hospital in View Royal since 1999, and has been a registered nurse caring for sick children since she started practising in Scotland in 1982. It’s four days a week, two nights, two days, at 12 hours a shift.

Though people are often unaware, VGH has B.C.’s only pediatric intensive care unit outside of the B.C. Children’s Hospital in Vancouver, and it bears a heavy load with five beds, three pediatric intensivists and about 100 nurses in total.

“Nurses just go, and they go, and they go, and they go… I refer to us as the energizer bunny,” she said.

They have to, because a lot has changed. The children in care at VGH’s pediatric ward (and all patients, for that matter) are sicker than ever. The technologies have advanced and so has the culture of care, said Carrick, ahead of National Nursing Week, May 7 to 13.

“We just keep going because we care about our patients, we will always care, we do it for the patients and their families.”

Eighty per cent of Carrick’s title as educator is to keep the staff in VGH’s pediatric ward updated on the latest technologies, the likes of which change fast.

“No one taught me to use a computer when I trained and now everything is about technology,” Carrick said. “You don’t just run IV, it has pumps run by a computer, everything is measured, and everything you put on to a patient is now associated to a piece of technology.”

There are benefits, she said. The intravenous pumps are automated, nurses no longer count drip rates but do have to program the machine. Medications all-around are delivered more safely through drug libraries and pumps, and other monitoring devices such as breathing machines (ventilators).

Even charting is moving to a electronic model as are simple devices such as beds, scales, breast milk warmers and phototherapy measurement devices.

Some say it creates a new challenge in assessing patient to nurse ratios, as the care associated with each patient intensifies.

But it’s not just electronic or software technologies that are advancing in pediatric care, it’s the culture of care, which is a technology in itself.

Family-centred care in Canada has come leaps and bounds in the last two decades. Jeneece Place, which runs at nearly full capacity year-round to keep parents and siblings on the grounds at VGH, is a testament to that.

“It means families are here and they are part of the process,” Carrick said. “The doors are open to them 24-7, they are partners in care, they are part of the team and the decision making.”

The children too, are part of the decision making, if they’re able to be, Carrick said. Not only that, family’s are present for certain procedures, including resuscitations.

“When the physicians and nurses make the rounds the family input is part of that, their opinion is respected and valued, and we invite feedback on how we’re doing,” she said.

Physicians and nurses working together is yet another example of the changing culture in pediatrics.

If you go back to Carrick’s start in 1983 and look ahead, it’s almost unthinkable that Carrick, a nurse by training, would play such a key role in the development of resident physicians at VGH. Then again we’re talking about Carrick, the nurse educator for pediatrics, the pediatric ICU, pediatric daycare, pediatric ambulatory services, and more.

“We have a great relationship with the Island Medical Program and have very successful Pediatric Residency Program about to enter its fourth year,” said Carrick,who supports the medical students on a daily basis. “I orientate them to the unit, suport their day-to-day questions and learning, and troubleshoot. It’s a very unique relationship, integrating a nurse [Carrick] into a medical program for resident physicians.”