Nurses ’n Kids | Pediatric Medical Day Care Centers in Delaware
Dedicated to Caring For Children with Special Needs
by: Tricia K. Hedinger, MS, CCC-SLP
When parents first discover their child has special needs, they are flooded with intense emotions. They must cope with the reality that is dreaded by every expectant parent: something is wrong with my baby. “You are on an emotional rollercoaster when you first find out your child has special needs,” says Mandy, mother of Jennifer, a preschooler. “You’re scared & sad, but most of all, you are nervous about the future.”
Parents are forced to wrestle with painful thoughts of the past and what lies ahead. If they had done something differently, would their baby be okay? What will the years ahead bring for their child? for them? “We became overwhelmed when we realized just how much her condition was going to affect our daily lives,” says Linda, mother of baby Sara. “There was oxygen, feeding tubes, central lines, a totally different diet and the realization that Sara was developmentally behind her peers.” Their fears of the past and the future, however, are quickly overridden by the pressing issue of what do they do now?
“I always wanted my children to have the best daycare and education possible,” says Shana, mother of Kevin, a toddler. “My first option was my older daughter’s daycare, but they do not accept children with special needs.” Quitting work is not an option for most parents. Mandy states, “No other daycare provider would consider taking Jennifer because she was g-tube dependent and on an apnea monitor 24/7… Nurses ’n Kids was my only option.”
Nurses ’n Kids is a Medical Day Care, also known as Prescribed Pediatric Extended Care (PPEC), that has cared for children with special needs since 1988. They provide daytime childcare to children who have skilled nursing needs and are unable to attend a typical daycare. The staff at Nurses ’n Kids is comprised of registered nurses (RNs), certified nursing assistants (CNAs), early childhood educators, therapists - PTs, OTs, SLPs, and registered dietitians (RDs), all of whom participate in the daily care of each child.
Nurses ’n Kids - Medical Day Care has 2 Pediatric Centers in Delaware – New Castle & Milford. Each center is designed with children in mind, including brightly painted walls, shelves full of toys, little tables and chairs, carpeted floors, and toddler-friendly playgrounds. They also provide appropriate equipment for children with special needs.
Nurses ’n Kids accepts children with a variety of disabilities, including (but not limited to) children who receive tube feedings, have juvenile diabetes, use central lines, require apnea monitors, experience seizures, need oxygen and/or have a tracheostomy/ventilator. Rather than being cared for in a typical daycare, these children are cared for by a team of health professionals who consider their medical and developmental goals. Therapy and nursing staff work together to best meet the needs of every child.
It takes a village to raise a child. When you have a child with special needs, it really helps to have a village full of nurses and therapists. That is what a parent can expect from Nurses ’n Kids - a team full of knowledgeable people who have cared for children similar to theirs for many years. The interdisciplinary model of therapy accompanied by a closely-knit nursing staff offers an unparalleled level of care and education.
Very often, a child of working parents who requires skilled nursing care is restricted to staying in his/her home with a nurse. Physical, occupational and/or speech therapists may come and go throughout the week. Interaction with other children is often limited to siblings and other family members. Parents endure the chaos of scheduling appropriate coverage and often miss work whenever a call-off occurs. Additionally, parents must tolerate having other people in their home daily when they are not. “We are so confident when dropping Sara off at Nurses ’n Kids that she is in the best possible care,” says Linda, “and we almost never miss work.”
Nurses ’n Kids offers an alternative to families who bear the weight of providing optimal care for their child with special needs. “Parents of typical children are given a variety of options for child care when they are working. The parents of a child with special needs should also be given options,” states Katherine Daniello, a physical therapist at
Nurses ’n Kids. “At Nurses ’n Kids, children get the social interaction they would have at a typical daycare or preschool program.” While a child’s medical needs may be cared for adequately when they are home with a nurse, their developmental skills may suffer from limited socialization with peers. The Medical Day Care / PPEC program eliminates the isolation factor and permits children to interact with peers their own age to advance their gross motor, fine motor, speech/language and social skills. They go on field trips, have special guests and participate in holiday excitement just like they would at a typical daycare.
Additionally, in a home health care situation, the child with special needs may receive individual therapy sessions, however, minimal opportunities are present for the therapists to speak with one another. At Nurses ’n Kids, therapists plan and conduct interdisciplinary groups together, provide co-treatments, participate in weekly rounds to review a child’s goals, and converse about a child’s performance on a daily basis. Nurses are also informed of a child’s progress and work jointly with therapy to problem-solve and improve a child’s abilities. “Teamwork and communication are the foundations for fostering progress in a child’s development,” states Stephanie Smith, an early childhood educator at Nurses ’n Kids of Milford, who visits with every child daily. Parents are invited to observe therapy sessions and provide feedback whenever they can. Handouts, daily communication logs, phone calls and one-on-one demonstrations help to keep the parent actively involved in their child’s therapy and improve carryover into the home environment. Semi-annual parent meetings gather together all of the child’s nursing and therapy staff into one room with the child’s family to review progress updates and reevaluations. Goals are revised and activities are provided to conduct at home. Family members have the opportunity to voice their concerns, report their own findings and participate in their child’s plan of care while all of their health care providers are present. “The information shared by the staff at Nurses ’n Kids made the transition from Kevin’s hospital stay to home a smooth one,” reported Shana, “they are so informative and make you feel comfortable about asking questions…. they have shown nothing but compassion.”
“Children are given opportunities to experiment with a lot of different equipment and communication devices,” reports Amy Hudson, a registered nurse. Nurses ’n Kids centers have a number of different seating options, standers, gait trainers and communication devices for children to trial. The therapists can spend several sessions testing different equipment, making adaptations and choosing the perfect piece to meet the child’s needs. After trying out a new piece of equipment or device for a while, a parent may decide if it would be beneficial to have a similar one at home. And, to make life just a little bit easier for parents, Nurses ’n Kids also offers transportation. Vans are available to pick-up and drop-off children at their home everyday. The vans are wheelchair accessible and are fitted with car seats by a certified car seat specialist. As a child transitions to school, school buses take some children to and from Nurses ’n Kids for Before & After School care.
She used to have a feeling of “helplessness”. But, now, “I just take it day by day,” says Shana. “I rejoice in every milestone he meets and hurdle he crosses.” Having a place to go where there are people you trust is the greatest peace of mind one can offer to anxious and overwhelmed moms and dads. There could not be a nicer village full of loving and knowledgeable people than the one you find at Nurses ’n Kids.
“Nurses ’n Kids has been everything to my husband and I,” says Mandy affectionately. “They are always there to help us out… every single therapist and nurse truly cares about your child. It was the best place for our daughter once she got out of the NICU. I cannot say enough nice things about Nurses ’n Kids. The staff goes above and beyond. It’s a very special place for your very special child.”
Tricia Hedinger, MS, CCC-SLP has been a pediatric speech-language pathologist for 10 years. She has worked for Nurses ’n Kids at both their New Castle and Milford sites for 6 of those years. Additionally, she has conducted home care visits and worked in the school district.
Some names in this article have been changed to protect their privacy.