Tuesday, August 21, 2018

'Emotionally, it's a lot to see sometimes:' Rehab nurse

By Louise Kinross

Michael Maschmann is a registered practical nurse at Holland Bloorview who works with children who are hospitalized following painful bone surgeries or life-changing trauma. He came to the hospital a year ago as a Seneca College student, and was hired full-time in February. He’s recently received a number of Spotlight awards from families, like this one that starts: “Michael is a very gentle, caring nurse.” We talked about how Michael got into nursing, and how he picked up a passion for running here.

BLOOM: How did you get into this field?

Michael Maschmann:
It was an experience I had when I was 12 years old. I went to SickKids to have a small operation on my kidney. My kidneys are upside down—they’re called horseshoe kidneys. But they didn’t discover that till I had a hockey injury and they gave me an ultrasound. There was a little blockage, so they wanted to put a stent in to open it up. I was in hospital for a week after the surgery, and I had two male nurses who were incredible. I was terrified to have the surgery and didn’t want to go. But by the end of the week, I didn’t want to leave the hospital.

BLOOM: What was it about these nurses that made an impact?

Michael Maschmann:
They made me and my mom, who was at bedside, very comfortable. It was during the hockey playoffs, and I was a Detroit Red Wings fan and they noticed I was wearing my jersey. So they made a point to turn on the Detroit Red Wings game one night. I was shy, but they got me out of my comfort zone. I was a lot more comfortable having a male nurse.

BLOOM: Was there anything they did that helped with recovery or pain?

Michael Maschmann:
I don’t even recall the medical part—which is good on their part. It was such a happy environment, and there was a lot of distraction, too. There was a place called Marnie’s Lounge for teenagers with a pool table and computers. I was probably there every day. They gave me my first introduction to nursing.

BLOOM: What is a typical day here?

Michael Maschmann:
I come on shift and I’ll review a child’s care plan and get a report from the previous nurse and go introduce myself. A lot of the children are here for a while, so I already have a relationship with them.

During the day I may be providing personal care to children with spinal-cord injuries, or doing wound care and range of motion exercises with a child who had an orthopedic surgery. Our physiotherapists will update on the child’s status board if we can help with stretches. I also give medications. I mostly work evenings and one of the things I like about that is that many tasks have already been done, so there’s a lot more time to sit down with children and provide emotional support. 

Last week I was here when we introduced white boards in the patient rooms. This is a great way for us to get to know what’s important to a child. They can write what they like and talk about their goals for the week and long-term. The kids were really into filling it out. For example, if I was a patient at SickKids, I would put the hockey thing on the white board. It helps us to find common ground with children who are often here for a long time.

BLOOM: What’s the greatest joy of the job?

Michael Maschmann:
Seeing a kid come in after surgery with big zimmers and wedges on, looking pretty miserable. And weeks or months later, seeing them walk out of here. I love working with kids. I get a lot of joy from some of the younger ones. They might not be able to walk like you or I, but they’re naturally happy, and that’s nice to see. It puts things in perspective.

BLOOM: What’s the greatest challenge?

Michael Maschmann:
I think emotionally, it’s a lot to see sometimes. For children who were in a car accident and have a spinal-cord injury, it’s so sudden for that family. It’s different from families whose children have had cerebral palsy since birth. Sometimes the families have really high hopes. Or they’ve gone from both parents working every single day, to being here 24 hours a day, and knowing this is a life-long journey. It’s very difficult because it’s all of a sudden. And it’s not just the client, it’s the emotions of the mom and dad.

BLOOM: How do you cope with the emotions?

Michael Maschmann:
When I was first introduced to this setting I think I took work home with me. I’d be thinking about the fact that I could go home, and I was upset that the kids I worked with were stuck here. Eventually I adjusted to it. I tell myself that when I walk through these doors I’ll do everything I can to help. I’ll give it 100 per cent. But then I have to leave.

BLOOM: Is there anything you do to manage stress?

Michael Maschmann:
I love running. When I first came here there were a few people on the unit who were into running, and they got me into it. I’m now running 50K a week, and was at 100K, in advance of the Scotiabank Waterfront Marathon in October.

BLOOM: You never ran, and now you’re running a marathon?

Michael Maschmann:
Yes. A bunch of us did a 15K. I find running helps with mental health a lot.

BLOOM: What was your experience as a student like here?

Michael Maschmann:
I was very lucky that I had Lisa Drumonde as a preceptor. What I love about Holland Bloorview is it’s very small. So Lisa had me follow around physiotherapists to learn about what they did, and build relationships with other disciplines that my work depends on. I also got experience working on the other units so it was very holistic.

BLOOM: What are the most important qualities in a nurse?

Michael Maschmann:
I think my teacher on my first day of nursing class did a good job explaining it when she said it’s both a science and an art. The medical side of it—understanding how the surgeries affect children—is important, but I stress the value of building relationships with families.

The caring aspect of it is where we can try to make even a little difference every single shift. It’s recognizing that it’s not just emotional for the client, but for the whole family. When we do build relationships, families start to open up, and that makes it easier for them. Sometimes just letting mom or dad know that nursing is here for their kid, if they want to go home for a night to be with their other kids, helps. They're dealing with a lot.

BLOOM: If you could change one thing in children’s rehab, what would it be?

Michael Maschmann:
I think Holland Bloorview does a great job with family-centred, holistic care. But what I hear from families is how hard it is for them when their children transition to adult rehab. I know that at age 19, the services are not there. I wish we could make it a bit more smooth for them.