February 2024
Kelsi
Dudzik
,
BSN, RN, CPHON
Hematology Oncology
Children's Mercy Kansas City
Kansas City
,
MO
United States

 

 

 

Kelsi was resourcing the weekend before this medication was starting, so she went down to the PICU to round with the PICU and BMT teams to come up with a game plan.
Kelsi is a great nurse and often just works quietly in the background without anyone knowing. She is attentive to detail and works hard to provide patient-centered care every shift. One particular weekend, she was resourcing, and we had a patient in the PICU who was receiving a special chemotherapy called Thiotepa. Typically, this medication is only given on 4 Henson Hall to our bone marrow transplant patients as a conditioning regimen for their transplant. We have not given this medication in the PICU before because usually, our patients are stable enough during the conditioning process and do not get transferred until later on in the transplant journey. This particular patient was different because he came to the transplant sick, but the transplant was the only thing that would help him. Thiotepa is excreted through the skin, requiring meticulous bathing every 6 hours and no adhesive or lotions on the skin. The patient's bedding and clothing have to be changed every 6 hours. This can be a daunting task for any patient on 4 Henson, but for an intubated patient with multiple central lines and a peripheral IV, it took a lot of collaboration and thought.

Kelsi was resourcing the weekend before this medication was starting, so she went down to the PICU to round with the PICU and BMT teams to come up with a game plan. She printed out the Thiotepa skin care policy and job aids for how to do the special dressings after the bath. The different teams got respiratory involved to see if there was a different securement device for the ET tube since the traditional way of securement included adhesive. RT was able to come up with something that did not have adhesive, and they were able to change it every 6 hours with each bath. She put in a lot of work prior to the patient getting the drug to make it run as smoothly as possible.

On Monday, Kelsi was back again and went down to the PICU to help with all of the baths and dressing changes. She had ordered all of the supplies needed for each dressing change and organized it all on a side table. She was sure to answer any questions for the PICU nurses and guided them on how to give the baths and change the dressings. This patient received 48 hours of baths every 6 hours without major complications from the medication. It was amazing to see the teamwork from everyone, but especially the planning and attention to detail from Kelsi. She put not only the nurses but also the family at ease. I'm so thankful to have Kelsi on our floor.