On the fourth floor of the only freestanding children’s hospital in Kentucky is the Intensive Care Unit (ICU). There are two ICUs made especially for children. One is the PICU (pediatric) which cares for children with any type of critical illness. The other is the CICU (cardiac) which cares for children with congenital heart disease, an illness affecting one in a hundred children. The ICU team at Norton Children’s Hospital in downtown Louisville treats children from all over Kentucky and Southern Indiana.
“If it’s an illness that has a reasonable chance of leading to major sickness, death, things of that nature, it falls under our jurisdiction,” said Dr. Aaron Calhoun, the division chief of the ICU.
On a typical day, the unit’s team consists of intensivists, nurse practitioners and usually a fellow (someone in training). These core assets to the ICU work closely with surgeons, cardiologists, neurologists and more to provide the best care possible to their patients.
To do a difficult job such as this one, collaboration is key. When dealing with difficulties in their job, the specialists reached a unanimous and simple solution. The group functions well as a team, and as a family.
“And that’s the other aspect of our unique ability is that we are all such good friends inside and outside of work, and I think that kind of helps lead to that relationship that we carry onto our patient care. Personally, I think it helps patient care and outcomes if you have such a collaborative team working for your child,” Nurse Practitioner (NP), Jessica Storch said.
“I would say we’re on par — in terms of the care we give — with any of the big centers, and I think what we do that’s different is I think we do it while maintaining that collaborative atmosphere within our team that, frankly, a lot of centers don’t seem to have,” Dr. Calhoun said.
This collaborative environment present within the ICU allows for the team to focus on their main goal: giving the best care possible to their patients.
“We provide access to care and we provide our ability to make sure that no child is left without the care that they deserve and that they need,” Dr. Jamie Furlong-Dillard, an intensivist, said.
It takes a specific type of person to want to pursue a career such as this. ICU specialists face things that other doctors don’t. However, at the end of the day the team stresses that they understand what they signed up for, and it’s always rewarding to see their hard work pay off.
“We need the excitement of the high-stress situations, but everybody in those roles is a similar type of personality,” said Dr. Kevin Havlin, another intensivist in the ICU.
In dealing with the sickest children, there are bound to be some setbacks and even deaths. These losses can greatly affect those caring for them. Oftentimes, specialists write accounts of their careers, including both the ups and downs. One book, “Stories from ICU Doctors,” details first-hand accounts of specialist-patient interactions.
“ICU clinicians gain great satisfaction in utilizing their skills to care for those critically ill. However, the high acuity of patient illness, numerous pressures on decision-making, the complex and frequently confronting interactions with other medical specialties, and isolation effects of after-hours and on-call patterns of work all combine to create an exceedingly challenging vocational environment,” reads “Stories from ICU Doctors.”
“You only have so much emotional currency to spend in a day, and so spend it well, and understand that some days when you’re in the ICU, you’re going to have to overspend and go into debt,” Dr. Calhoun said.
“And that’s okay as long as you know you’re doing it, you’re choosing to do it for a good reason, and you recognize that it’s going to hurt you, and you have a plan in place to deal with that damage later, and to recognize that you’ve allowed yourself to become hurt for the sake of somebody else.”
When dealing with these mental health effects, a collaborative environment is important.
“Our group is so supportive that even in those difficult situations, there are always discussions and people reaching out saying, what else can I do to help, so I think the supportive nature of our group really helps battle some of what would lead to burnout,” Dr. Havlin said.
In the ICU’s long-term care, patients and families are often stationed in the ICU for months, if not years. This transforms the hospital room to their bedrooms, and the specialists to family.
Getting these patients out of situations where life is not a guarantee, and sending them home safely, is the primary goal of the ICU, and when patients are around for such long periods of time, these wins become extremely personal. These specialists get to know their patients beyond the illness. They realize that they’re more than just a disease, they’re a part of someone’s family.
“A lot of times, we’ve seen [patients and families] through a lot of really bad days, dark times, a lot of uncertainty with these families that they don’t know if they’re going to get to take their child home. And so being able to work through that and getting them to a discharge day feels like such a win, and we do like to celebrate and remember those wins that we also get,” Storch said.
One intensivist, Dr. Furlong-Dillard, detailed an interaction she had with a patient’s mother, completely unrelated to medicine, that she later learned (via a Facebook post) had a large impact on the parent’s life. She asked the mother if she wanted to hold her baby.
“All you want to do is take care of your child,” she said. “And when they’re in the hospital, you kind of lose all of it. You can’t do any of it. You’re just standing there hoping that somebody else is doing a good enough job and hoping all you can really do is show them love. But if they’re sedated, they don’t even know that. And so the fact that she was able to feel like a mom in that moment, I think was impactful to her.”
Outside of their busy work schedule, these specialists try to balance their own personal lives with their career. This group makes time for each other outside of work as well. They are friends, and they have each other’s backs. They not only rely on one another, but on other integral aspects of their own communities such as their faith communities.
This group consists of mothers, fathers, husbands, and wives. They are not just doctors and nurses. They are a team and a family, and what they do is like nothing else. The care they provide to their patients is unique and necessary to treat the sick children of Kentucky, and they work tirelessly, day and night shifts, to make this care possible.
