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YON 2020 Day 289: Marisa Adams, MSN, RN

Serving as both a pain rehab nurse and comfort team member at Cleveland Clinic Children's Hospital Rehabilitation Center (CCCHR), Marisa Adams, MSN, RN, explains the importance of both roles. She is looking forward to moving into a new role as a pediatric nurse practitioner.

As a nurse at CCCHR, I have taken on many roles in my last 4 years. Starting on the rehab unit, I quickly became charge and a resource nurse while taking part in different quality projects. I have been in the pain rehab nursing role for almost two years and take pride in my dedication to such a specialized unit. Working with kids who have chronic pain can be challenging, but being an active member of the team and learning coping mechanisms/therapeutic ways to help kids manage pain has really benefited my nursing career. Seeing the interdisciplinary approach in this pain program has also taught me a lot about my role as a RN and helped me to gain increasing knowledge and experience with different diagnoses.

In addition, I am also a member of the comfort team at Cleveland Clinic Children’s. I had never heard of the term comfort measures except in a learning module prior to joining this comfort team. Rehab seemed to have a gap in education on comfort and it was nice to be a bridge between main campus and CCCHR. Working as a one-woman team with no child life specialist, there was some difficulty getting my team to adopt comfort measures. Although my colleagues were at first slow to adopt these interventions, with explanation and role modeling they saw the benefits that our patients received. I still continue to act as the only comfort member in nursing at CCCHR but am constantly educating as well as empowering caregivers to use their skills.

Once, I assisted a nurse with an infant’s immunizations. She had two to administer. Knowing I was perfectly capable of helping in this instance, I told her we would be giving the immunizations at the same time. She questioned why I had stepped in to help and I explained that it benefits the patient to give them at the same time rather than separately. The patient did very well with two quick pokes simultaneously and recovered faster than with two separate procedures in an increased time frame. I believe that I changed her mind set during that procedure and helped to advocate for our patient while educating in a productive manner.

Helping each other implement comfort measures is the best way to advocate for our patients during painful procedures. Having that little bit of extra support can go a long way for not only the patient but our fellow caregivers. Changing a culture is really difficult but empowering others can really break down those barriers! Being a member of both the pain and comfort team has truly shown me how far dedication can go. When you actively participate on a unit or within a committee, you have a greater appreciation for the work the team does. I just passed my pediatric nurse practitioner boards and these experiences have truly helped shape me into the nurse that I am today and the future pediatric nurse practitioner I will become!

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