There is a place at Penn State Health Children’s Hospital that remains unseen by many. This special place is familiar only to the brave children and their families who have undergone in-patient cancer treatment, along with a devoted team of care professionals. The children and their families interact with a comprehensive care team that includes oncologists, nutritionists, music and art therapists, Child Life team members, chaplains and social workers.

Providing round-the-clock care, the nursing staff forms the strong foundation of this team. These nurses take immense pride in their work and are deeply grateful for the opportunity to provide such vital care. This place is the third floor of Penn State Health Children’s Hospital – where in-patient care is provided to our Four Diamonds children battling childhood cancer.

Nursing staff with teenage patient showing special connection they have developed.

The Admissions Process

New families often arrive fearful and worried. The unknown of the situation can be overwhelming, and they may struggle to navigate the uncertainty. It is a fragile time for each family and their emotional state resonates deeply with the staff within the unit, creating a shared sense of concern.

Despite the challenging circumstances, the team offers their expertise and compassion to help bring each family comfort, particularly during periods of waiting. This team often serves as the glue holding everyone together while awaiting further information.

As soon as a newly diagnosed patient and their family is scheduled to arrive, the nursing team immediately begins working. They diligently set up a room for the family, ensuring that each child being admitted has a special pillowcase on the bed. While waiting for the patient to arrive, the team collects data to prepare thoroughly for the new patient. This data may come from within the health system, a pediatrician’s office or another hospital.

Caring for Scheduled Visits

The third floor nursing staff plans uniquely for children scheduled for in-patient treatment. Forming strong bonds, the nurses prepare the rooms to meet the preferences of each patient. They anticipate personal items the kids might bring, such as guitars or 3D printers. The nurses quickly rearrange the furniture and, in some cases, order the patient's favorite food to be waiting when they arrive.

Combining Comfort and Care

Every patient room on the third floor is equipped with a private bathroom, shower, refrigerator and a convertible couch that transforms into a bed. The staff encourages children to decorate their rooms as they like, which fosters a sense of comfort and familiarity. We provide each child with a notebook and pen to facilitate communication, ensuring that patients and their families can jot down any questions that arise.

A unique feature of these rooms is the “All About Me” board. This board displays information about the child’s preferences, spanning their favorite things, preferred name and coping mechanisms, painting a holistic picture of the child for their care professionals. This information plays a pivotal role in developing meaningful relationships between the children undergoing treatment and their nursing team.

Nursing staff holding up an "all about me" board.

A Day in the Life of our Nurses

The day shift for these remarkable nurses commences at around 7:00 A.M. They assemble around the huddle board where the charge nurse from the night shift provides an overview of the situation, sharing crucial changes and identifying patients who may require closer attention. Each nurse then meets individually with the night nurse who cared for their assigned patient to receive a detailed handover.

Patient care begins at 7:30 A.M. After reviewing their charts, the nurses dedicate the next twelve hours to fulfilling orders, attending rounds, conducting tests, responding to calls, advocating for patients and providing emotional support. Amidst the flurry of procedures, physician visits, tests and therapy sessions, the nursing team advocates that patients also get ample time to rest.

Nursing staff and music therapists spend time with a younger childhood cancer patient.

The night shift begins around 6:40 P.M. Given the limited time they have with their patients before bedtime, they understand the need to be efficient. The pace tends to slow down overnight. Teen patients often enjoy spending time with the nurses, engaging in activities like painting nails, making bracelets or playing video games — while excellent patient care remains priority.

Nurses schedule lab time between 3:00 and 4:00 A.M., striving to be as discreet as possible to avoid disturbing their resting patients, most of whom have central lines. This approach allows them to receive results in a timely manner and address any needs, thereby setting up the next shift of nurses for success.

The Overnight Hours

On the third floor, the night nurses serve as the linchpin for all nursing duties, promptly addressing any tasks left incomplete during the day. They are often the team members engaging in the most heartfelt conversations with patients.

Teenage patients, who process emotions differently than younger children, can sometimes find themselves in a negative headspace during the late-night hours. The night nurses are present for all these moments, providing much-needed support. At times, the most crucial part of their shift is simply sitting with these patients and helping them navigate their emotions. This team approaches their role with compassionate care, ensuring patients have the support they need during their in-patient stay.

Bringing Joy and Celebration

Celebrations and holidays hold a special place on the third floor. Banners adorn patients’ doors to celebrate the completion of their chemotherapy treatments. In-patient families celebrate the conclusion of their in-patient treatment by ringing the bell – a moment filled with emotion and tears as the staff reflect on the children’s journey towards recovery and their role that led to this achievement. Nursing staff also joyously celebrates the birthdays of patients and their families.

During a prolonged hospital stay, you may think holidays could be overlooked. This is not the case on the third floor. The Child Life Team excels at creating memorable holiday experiences for the children. Additionally, Mara, a registered nurse on the third floor, decorates the floor festively for all holidays, making patients feel included and comfortable. From Hanukkah to Halloween and everything in between, Mara goes above and beyond to infuse a festive spirit into the floor.

Support Through Grief and Loss

Often, a nurse possesses the heart-wrenching knowledge of when a child might be nearing the end of their journey. The grieving process sometimes begins even before the patient passes, a testament to the deep bonds formed. The nursing team has a strong desire to make this time as peaceful as possible for the families, aiming to protect them during this delicate time.

The hospital therapy teams craft legacy gifts, a tangible symbol of remembrance, and our chaplain support team offers unparalleled spiritual comfort. The team leans on each other, united in the belief that these children have won their battles, regardless of the outcome. They take pride in knowing they’ve given their all in care and support of these children.

The “Butterfly Board” serves as a beautiful reminder of these brave little warriors. Adorned with butterfly cut-outs bearing the children’s names and their dates of passing, it stands as a symbol of remembrance. Even long after those dark days, families continue to write letters and pay visits, a testament to the lasting bonds formed. Guided by the mantra of ‘family first’, our staff remains steadfast in their commitment.

A Labor of Love

The work of these dedicated nurses is unceasing. Their commitment spans 365 days a year, 24 hours a day, 7 days a week. The world of nursing knows no pause. These individuals are consistently present for their patients, day in and day out, repeating the cycle with unwavering dedication.

They embrace this responsibility with gratitude, taking pride in their daily care routines. These nurses hold immense pride in their work and the care they provide. They serve not just as care providers, but also as advocates, friends and the primary pillar of support for these families.