Helping patients 'get a bit of their sparkle back'
Aidryan Reyes with registered nurse Priyanka Uthayarathinam
By Louise Kinross
A former patient at Holland Bloorview recently told me about her favourite nurse. The nurse brought in nail polish and helped her paint her nails. The girl had seen her friends on social media trying out new colours and felt left out. Her left hand didn’t work the same after a brain injury, so she couldn’t do it herself. This nurse was Priyanka Uthayarathinam. We spoke about her six years working on Holland Bloorview’s brain injury rehabilitation unit.
BLOOM: How did you get into this field?
Priyanka Uthayarathinam: I was doing my Bachelor of Science and in my third year I faced a small bit of illness. I had to go for a day procedure and I remember waking up from sedation and how kind the nurses were to me. They treated me with so much dignity and kindness. One nurse took me to the recovery room and wrapped me in a blanket and brought me juice and talked to me till I was ready to go.
I was so touched by the amount of kindness a stranger gave to me, and to this day I don’t know her name. The warmth I felt from her was so comforting. I hadn’t thought about nursing, but I decided to look at accelerated nursing programs then.
BLOOM: How did you end up working in pediatrics?
Priyanka Uthayarathinam: I had a placement here and ended up staying here. Jane Wong was my supervisor. It was the first time I was exposed to primary nursing, where you work with a patient every day, and develop deep relationships with your families. What kept me here was building connections with kids and families and helping make a difference in the long-term.
BLOOM: What is a typical day for you now?
Priyanka Uthayarathinam: I usually come about 15 minutes before my shift starts and get report from the night nurse to see how my patients were through the night. I look at their schedules to see what therapies they have that day, and plan their medications, procedures and feeding times around their therapy. There are bursts of busyness during the day. The major one is from 7 a.m., when I come in, till 9 a.m. We need to prep medications, assess patients, do their care and get them ready for the day, make sure they eat, and get them off to therapy at 9. I usually have three patients.
BLOOM: What are the greatest challenges of your role?
Priyanka Uthayarathinam: I think seeing how families may struggle outside of the hospital. A lot of the time families are grieving new functional changes in their child, in addition to having a whole other life outside of here.
Parents may be the only caregivers for other children or family members at home, or face housing or food insecurities. If a parent has to leave work to be at the bedside, that’s one income gone. Sometimes I feel a bit helpless when I hear about a family struggling from multiple angles.
We need to help families cope with the new changes in their child. They’re going through a grieving process. And children are confused as to why they were once able-bodied and now they’re not. A lot of heaviness comes from supporting families through this.
BLOOM: How do you cope with that?
Priyanka Uthayarathinam: It’s important to talk about how you feel. I’ve made some good friends with coworkers who understand what we see day to day. We’ve built a mutual friendship and understanding and feel comfortable relying on each other. I may talk to our clinical resource leader or other coworkers. We try to stay strong for our families, but I know my colleagues will always be there to support me.
BLOOM: What are the greatest joys?
Priyanka Uthayarathinam: Seeing the kids make progress. We see inpatients for so many months that we see them make quite good gains. When I see children and their families recognizing their improvements, it’s great to celebrate alongside them. We see a bit of their sparkle come back.
BLOOM: What emotions come with your job?
Priyanka Uthayarathinam: I feel a lot of joy when I’m at work. I’m so happy to see the kids and see how they’re progressing and what they’re up to. Sometimes I can feel nervous. You don’t know what’s going to go wrong and you need to be prepared to act on anything that comes through the door.
Sometimes there is sadness or grief if things don’t work in favour of the kids or families.
BLOOM: How do you manage stress?
Priyanka Uthayarathinam: I like to do fitness classes—to follow along and not think about what I’m doing. I turn my thinking brain off. I do yoga, which seems to help, and I hang out with my dog Jumper. He’s a mini poodle. We like to cuddle.
BLOOM: When a child acquires disability through trauma or illness it can cause a lot of emotional pain in families. How do you help them navigate that?
Priyanka Uthayarathinam: The best way to support families is to develop deep relationships with them, so they feel comfortable talking to me when something is bothering them. We need to build that connection first, and show up as being reliable, consistent and trustworthy. Once they’re comfortable talking to me, I can see if I’m the right person to help, or if a social worker, our family therapist, child life, or my manager or clinical resource leader can provide support.
BLOOM: What have you learned from families?
Priyanka Uthayarathinam: I’ve learned a lot about resilience. I see families who have gone through very traumatic situations, and they still treat people around them with so much grace and kindness. I’ve learned a lot about courage and perseverance.
BLOOM: I liked hearing about how you brought in nail polish to help a client paint their nails.
Priyanka Uthayarathinam: I try to understand their interests outside the hospital. Doing something fun takes away from the medicalization of being in the hospital.
BLOOM: If you could change one thing about how we support children with brain injury, what would it be?
Priyanka Uthayarathinam: I think the biggest complaint or concern I have from families is the rooming situation. Families struggle with a lack of privacy when sharing a room with another client and family. If I could change one thing it would be private rooms for everyone, so they have a safe and private space to cope, grieve and feel emotions. I know this won’t be an immediate fix.
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