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Year of the Nurse: The Guardian Angels

Brianna Mishler, Pediatric Nurse, and Kathy Perko, Director of Palliative Care Education & Pediatric Nurse Practitioner, OHSU Doernbecher Children’s Hospital

Presented by Regence BlueCross BlueShield of Oregon By Ben McBee September 17, 2020

As the battle against Covid-19 rages on, it’s vital to recognize the brave men and women who, every single day, risk their health to protect ours. That’s why Regence BlueCross BlueShield of Oregon is dedicating this special series of articles to eight local and regional nurses who, through their compassion and humanity, have made the difference for thousands of lives.

It’s hard to imagine the pain that parents feel seeing their child hurt from a chronic illness, and not being able to be at their side due to the Covid-19 pandemic must make it nearly unbearable. Hopefully, they can rest a bit easier knowing that the pediatric nurses at OHSU Doernbecher Children’s Hospital are some of the best in their field.

Brianna Mishler (left) and Kathy Perko at Doernbecher Children's Hospital

Image: Ben McBee

Brianna Mishler has worked at Doernbecher for two and a half years, but not a day goes by that she doesn’t learn something new—personal and professional growth is one of her favorite aspects of the job. Each shift, however, starts the same way: “First step, mask on,” she says. “The next 12 hours are generally a whirlwind of patient care, conversations with the medical team, addressing family concerns, giving meds, and balancing admissions and discharges.”

Although Covid does not seem to affect children as much as adults, the virus’s impact goes beyond health. Rigid yet necessary guidelines limit most visits to the hospital. Coping with that separation is difficult for all involved. Nurses are under pressure too, so it’s important that they have their own support system. Kathy Perko, Doernbecher’s recently appointed Director of Palliative Care Education, provides valuable perspective through her teaching role, drawing on extensive clinical experience gained over 36 years.

“Kathy has been so thoughtful in recognizing the roller coaster of emotions a new nurse experiences during the beginning of their career,” explains Mishler. “When Covid-19 hit, she put together a care package full of chocolate and notes of encouragement. It's so valuable and appreciated to have a mentor who recognizes the joys and challenges of being a bedside nurse.”

In 2003, Perko founded the Bridges Palliative Care Program, inspired by feedback from families on how care workers can do a better job supporting them through serious illness and end-of-life treatment. The resulting approach emphasizes their physical, emotional, social, and spiritual needs, and it offers resources regarding bereavement, counseling, decision making, and communication technology. Though she now works less directly with patients, her influence is strongly felt at DCH and beyond.

“Modifying my teaching plans and having the patience to wait until the time is right to introduce this new education has been difficult,” says Perko, who had a presentation on perinatal palliative care in Singapore, as well as a number of national meetings and conferences, canceled due to Covid-related travel restrictions. Like many others, she’s taken it in stride and moved her arrangements online; still, learning to engage virtually, for instruction or telehealth, is demanding.

These types of obstacles seem minor, though, in the face of the palliative care nurses’ ultimate mission to optimize their patients’ quality of life and alleviate suffering—an honorable feat by any measure.

“A few months into the pandemic, a 14-month-old little boy, who had spent the bulk of his life being treated for leukemia in the hospital, was admitted for pain management and end-of-life care,” recalls Perko. “In that time, kind, thoughtful, and compassionate staff worked together to allow both of his parents to be with Cypress. On his best days, he was able to go out to the garden at Doernbecher to smell flowers and be in the sunshine. He played and giggled and smiled and continued to charm everyone he met. The medical team and nurses were able to provide the family with excellent, loving care and a space of quiet and privacy to spend with their son as he left this earth.”

Through times of grief, Perko remains optimistic that lessons learned from cooperation will be essential to beating Covid. Nevertheless, she implores people not to give in to “pandemic fatigue” and to continue to wear masks to protect those who can’t protect themselves.

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