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Health Care Professional Interview – Abby Fletcher

*I = interviewer, P = participant
I: I’m just going to ask some questions for this assignment in my anatomy class.
P: Will I know the answer to these questions?
I: I don’t know, I think they’re opinion based questions.
P: Oh, okay.
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I: First question, what does the phrase “Laughter is best medicine” mean to you? Do you agree or
disagree with this statement?
P: Uhm… I think it means being – I agree with it and I think if you just – from like working in
pediatrics I think you can accomplish like a ton more with trying to do something with a kid if
you can get on their level and make them comfortable and make them feel like whatever you’re
doing is a game, and not like I’m listening to your lungs or I’m feeling your pulse, like if you can
get them involved and make it fun for them. It makes things so much easier.
I: What kind of things do you do in pediatrics?
P: Like fun things or like nursing things?
I: Yeah, like fun things.
P: We so – we, I mean anything’s [sic] not off the table, I mean we’ve had kids we’ve let fill
syringes up with water and squirt people as they walk in the room, I mean we do tons of fun
things.
[Pause – recording one]
I: Second Question is, do you believe that spiritual healing is as important as or more important
than physical healing? Why or why not?
P: Well, I think I guess it depends on the person. Uhm… like, for me not being as religious of a
person, I would probably lean more towards physical, but I think that’s dependent on the person.
I: Oh, before I ask the next question, what is it exactly that you do?
P: So, currently I’m the clinical nurse specialist in the pediatric cardiac ICU, so I am responsible
for running like the orientation program for that unit. So making sure that all of the new nurses
that come into our unit, whether they’re brand new nurses or experienced nurses, get an
orientation that’s tailored to their needs so that they – after whatever time it’s determined they’re
going to be in orientation, come off confident to take care of and safe to take care of, uhm, you
know, a stable patient in our unit. In addition I also will, like, coordinate the ongoing education
for the nurses; so making sure that people are up to date on what are the new things we’re doing
on our unit, when there’s a change in practice, and then that’s sort of like at the unit level, uhm,
and then I help in the pediatric service level preceptor education, so making sure that people that
are preceptors, so those are the people that are responsible for training those new nurses sort of

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know how to do that and feel supported. And then I mean I can also jump into the bedside
anytime I need to, which is probably what I like the best.
I: The next question is, medicine itself is critically ill from an emotional void between doctors
and patients, the disappearance of the old-fashioned house call and the near industrialization of
the healing arts, how do you feel about that void between doctors and patients, do you think it’s
like valid and prevalent or do you think that’s not really a thing that happens and it depends?
P: [Sigh] I think it depends on the doctor, and I also think it depends on what area of nursing
you’re in. So I think PEDS, like the doctors are amazing and a lot of them can be like just as fun
and silly as any nurse or child life specialist, uhm… So I think it kind of depends on where you
go, like I don’t think you come into pediatrics wanting to be a person that’s not going to have to
like interact with families and patients in a different way than you would maybe like a normal
adult patient. Now that being said, are there definitely still doctors that you’re like could have a
better bedside manner, of course, but I think for the most part, like the doctors I interact with in
PEDS are like – I do not see that in them, like they are very invested in not only like the outcome
of the patient but making the family feel like they are important and like being just as funny and
silly anyone else.
I: So what do you think is the great sickness affecting medicine and the world? Greed. That is a
quotation that I just read as a question, but do you think that greed is afflicting medicine and the
world?
P: Uhm, it is, but I think – If I think how I’m interpreting what they’re trying to ask, like I’m
interpreting it more like with like reimbursement and health insurance type stuff.
I: That’s good, that’s the way it’s supposed to be interpreted.
P: Uhm, then yes, I think there’ so much of an emphasis on like meeting certain measures, like
we don’t want you to have any central line infections or we don’t want you to have any, you
know, catheter associated urinary tract infections and I think, you can – people can get focused
on those outcomes and not focus on like ‘Okay well what is actually in the best interest of this
patient’ or you know, people get so focused on the regulatory part of things that it’s like ‘You’re
making decisions that like affect people that are doing the work at the bedside that make
absolutely no sense for the people who do the work at the bedside. So, yeah I do, and it’s sad.
I: Well, that’s all the quotation questions I have, so I guess I’ll just ask regular questions. What
is, I guess the most interesting, I don’t want to say like case that you’ve ever had ‘cause [sic] I
don’t know if you call them cases but, like the most interesting, uhm, I guess patient that you’ve
ever had.
P: Oh God… Uhm… [sigh] ohoooooo, well I think for – probably, I think the most interesting –
I don’t know if I would call it interesting but I think one of the most like amazing thing I’ve ever
seen is when I worked and it was both the PICU and the cardiac ICU and I took care of a
teenager that ended up getting – ended up having toxic shock syndrome that turned into
throbopedic, oh my god, throbopedic leukocytic perper, or something like that, and he was
probably one of the sickest kids that I’ve ever taken care of and like just, like every organ in his
body was affected by this and he – like his kidneys shut down and he was on dialysis, he was just
super super super sick and ended up, like I don’t know how many times I took care of him and
would call his parents and say, “You know, things aren’t going well”, and he ended up being like

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this for over a month and like recovered from all of it, eventually. He was in the hospital I think
for like nine months total, uhm, and recovered from it and is like normal. Now he’s in his
twenties and a couple years ago, actually – he had a younger sister, and a couple years ago, I was
teaching at a pediatric service orientation class and I saw this girl that looked – that was a nurse
and looked really familiar and I finally said to her, “I know you from somewhere”, and she said,
“You took care of my brother in the ICU and because of the care he received there…” like she
went to become a nurse, and that was really cool. But I think the reason I like what I do is I never
know like, taking care of pediatric patients is – and like you never really know what’s going to
happen when you walk onto that floor.
[Pause]
P: But I think I like what I do because I never know like what’s going to happen, you never
know like how sick a patient is going to be, uhm, and a lot – like some of these kids that have
like really horrible heart defects, like their family actually becomes – like they think of us as
their family, you know, because they come back for multiple surgeries so you kind of get to –
some of these kids you get to see them grow up, which is neat.
I: So, did you choose to specialize in like the cardiac part of PEDS or did, or was that just
something that you did the best at?
P: No, so when I graduated from nursing school and was like applying for jobs, well, I only
applied to Strong and I knew I wanted – always knew I wanted to work in pediatrics and in all
honesty, I didn’t necessarily know I wanted to work in critical care. My last clinical that I did at
Syracuse was in pediatrics, in the PICU at the hospital in Syracuse and I really liked it and it just
so happened that the sur – our surgeon in Rochester, our cardiac surgeon in Rochester who lives
in Syracuse – and so one day a week he operated in Syracuse at that time, uhm, so I had kind of
seen the heart aspect of it and in all honesty like when I applied for jobs at Strong, I applied in
the PICU and that was the first unit that called me back and I was just like I want a job so
[laughing] I took it and just really liked it and then eventually the two units were going to split
into separate units. So one was going to be the cardiac ICU and one was going to be the regular
like medical, like other surgical ICU and I just really liked the cardiac population.
P: What other kind of things did you do during your clinicals?
I: It’s very different I feel than it is now. We pretty much did everything, like we started with
geriatrics, so like my first clinical was in a nursing home, uhm, but I went through one OB
rotation, uhm, the bulk of it was just like medical, surgical floor, so getting you like the basic
practice with adults, but I went through a psych rotation, I went through a community health
rotation, an OB rotation, I went through a whole semester PEDS rotation, which I think is the
part that’s very different now. Most of the programs that I know about, people actually probably
only get like two clinical days in PEDS, if that, and I think for some people if you’re trying to
like figure out like ‘what do I want to do’, or ‘what kind of nurse do I want to be’, like, being a
pediatric nurse, I think sounds great to a lot of people, but if you only spend like two days doing
something like it’s hard to know ‘like am I really gonna like this based off of two days’. A lot – I
tell people, like you should shadow as many different areas as possible because it’s really hard to
know like ‘what is my passion and what do I’ – unless you know, like I’ve always wanted to
work in pediatrics, uhm, but a lot of people will be like, “Oh yeah, I want to be a PEDS nurse”
and then you’ll ask them when they’re interviewing,” Well, do you have experience in PE – just

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like, you know, experience with kids in general?” and they’ll be like, “No.” and I think it’s – like
kids are not easy things, it’s hard enough to like interact with regular kids let alone like kids that
are sick that you’re now going to have to do things that they’re not necessarily going to like and
how do you convince them, ‘you have to do this’. So shadow lots of places.
I: What is, since you’ve been in PEDS, what is the hardest, like case that you’ve ever had, or like
I guess the saddest case you’ve ever had?
P: Oh, well there’s a lot of them… I think probably the hardest case I’ve ever had, and I don’t
know that it would’ve – it kind of – but it was a case that kind of like shaped how I realized that I
had to like deal with this, this sometimes the sadness of working in a critical – pediatric critical
care environment was a little girl named Morgan Green, your mom probably had heard me talk
about her before…
I: Yeah, she’s getting ready to cry right now [laughing].
P: That had cancer, who was just the sweetest little girl and, but was like a stubborn little girl and
only liked certain people to take care of her and for some reason, her and I hit it off and so I took
care of her for a long, long time and I used to bring her Wegmans Water, which was like cheap
Wegmans Water [laughing] that at the time was in a blue water bottle and she used to call it
“Mindy Blue Water” and eventually she died, uhm, and that was.. That was really hard for me,
like I – and she had a dog and on the day she died they brought her dog in and it was just, it was
just... it was really, that was really hard. That was the first patient that I had really gotten
attached to that then passed away and that was really hard, uhm, and I think that was when I
realized you can’t – like you have to have some kind of like separation, because otherwise it just
like consumes you and in the end I realized like that was the best thing for her, like she was
suffering and I think like, if you look at it in that, and what it the best thing like for this kid. We
also have a little kid on our unit now that is six that I’m taking – and he’s been in and out of the
hospital since he was a baby, so for any of us that have been there more than six years we’ve sort
of seen him grow up and he’s never, like he’s just never gotten like a break anytime he’s ever
been in the hospital and he’s been with us now for like two or three months and Santa came to
visit at the hospital on Friday and he’s just – he really – he’s really just sick and like, it just is
really sad to even like go in his room and he whispered what he wanted for Christmas to Santa
and like everybody was crying like already, and then after he whispered what he wanted, even
Santa started crying and so that makes me sad because we all realized that he probably asked like
to just want to go home and those are things that are sad, like when you can’t help a kid that just
really deserves a break. There are many aspects that are really great, because I feel like those
were two really sad things, but Morgan was probably my saddest, ‘cause I really liked her, I
loved her, she was a good little girl.
I: Is it cool, because you said you get to train the other nurses, is it cool to watch them take on
cases and then do really really well?
P: It is, because I can remember, uhm, I had probably been a nurse in the ICU for like 18 months
and I can remember there was like – all of a sudden it was like a lightbulb, like somebody hit a
switch and everything just started to make sense. I think when you’re going into a critical care
environment, it’s… just when you’re a new nurse, everything is so overwhelming, like
everything is so different, like when you’re an actual nurse, it’s not like it is when you’re in
clinical, it’s just so different so I really felt like I can remember the first day on my unit thinking

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to myself ‘What the heck did I just spend four years doing, they taught me not a darn thing, that
was like [laughing] useful for what I was doing, which was true because like they’re not teaching
you to be like a pediatric critical care nurse in nursing school, they’re teaching you to be like a
nurse like for general medical surgical floor. So I felt like I learned everything, like once I started
working on the unit, but you’re still like very task-focused so like you’re not, like when you’re
new, you’re not able to see like the bigger picture and understand like why I’m doing something,
but I think around 15 or 18 months, like all of a sudden, you’re like ‘Oh yeah’ this makes sense
and so it’s really neat to be able to see that happen to other people, like you tell them that and
then all of a sudden when they get to that point they’re like ‘Yeah, it really – everything does
make sense’, you just have to be really selective in like who you’re picking to come to your unit.
I: Do you get to help interview people?
P: I do, yeah. So usually me and the nurse manager interview, uhm, all of the nurses that are
going to – that apply for the unit. So, uhm, and generally we are on the same page, but, uhm, I
think I’ve interviewed so many people now, I can usually tell if I’m a ‘yes’ or a ‘no’ within the
first five minutes.
I: So in like four years, do you want to give me a job? [Laughing]
P: Well, I would say yes, however they would never allow it, well, they would never allow you
to work on the same unit that I work.
I: Why?
P: They would, because we’re related.
I: They won’t let you work on the same one if you’re related?
P: If there is a structural hierarchy then, like if we were both bedside nurses, they probably
wouldn’t care, but because I would be – because I run the orientation. So, like, I would have
input into whether it was successful or not successful, they look at that as nepotism.
I: Okay, that makes sense.
P: Brittany asked the same thing. Although interestingly, Brittany is great with kids, but I think
Brittany would be an amazing geriatric nurse.
I: Is that what she wants to do?
P: I don’t know.
I: She just passed that nursing final.
P: I know.
I: I was like, “Go Brittany!”
P: I know. That’s the other thing, like I don’t think it’s, uhm, like obviously you have to pass all
the finals but, like to me, that’s – just because somebody is super book smart, that’s not
necessarily what makes a good nurse, like I can remember telling Billy when he was talking
about ‘I just don’t understand’ and I said, “Like some people just aren’t good test-takers, like,
that doesn’t mean – I go, “Brittany is gonna be an amazing nurse because it’s not, like, it’s not all

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about, like you have to be smart, but it’s not all about getting the best grades on a test, like you
just have to be able to pick up on like – I always tell people that you have to have that sixth sense
of like I walk into a room and I can tell like ‘Oh yeah, this is a patient that looks fine’ versus like
when you walk into a room and you’re like ‘Oh, this kid is not okay’. In addition to just being – I
mean, Brittany is going to be a great nurse because she is caring and she’s empathetic and
compassionate and, just because you’re the smartest person in a nursing class is not necessarily
the person that’s going to be the best nurse.
I: So along those guideline, is that your philosophy on being a nurse? I know some universities
or college have you go into a program and they say ‘This is our philosophy on nursing, this is
what we’re going to teach you to’, but what it your individual philosophy, that makes the best
nurse?
P: I think it’s somebody that is smart, but I think it’s those like softer skills, like being
empathetic, and compassionate, and being able to know like, like being able to pick up on like
the subtle changes, uhm, of something, and that’s not necessarily related to like how smart you
are. I’ve had nurses that have come in that have been super smart, but then you’re like ‘ Well,
how are you so book smart, but have no idea how to translate that book knowledge to the bedside
– they become like deer in the headlights. So you kind of have to be a person that can say like
‘Okay, I am ready to like crap my pants right now, but I am going to like put that aside and just
make this family feel like I know what the heck I’m doing’ because if they see you – if they see
that you’re nervous then that makes them nervous, and that just perpetuates this whole cycle, but
I also think you have to be like compassionate and empathetic and, uhm, kind of be able to put
yourself in somebody else’s shoes and, I don’t know, like there have been many days where I’ve
been like ‘Oh God, I’m having the suckiest day’, but then when I walk out onto my unit I’m like
‘ Well, you know what, I don’t have a kid that has a horrible heart defect, so – and I haven’t
spent the last three months sitting at a hospital bed, so’, I really don’t have that bad of a life.
I: That is very true. Okay, that was my last question.
P: Glad I could help!

Melinda Zalewski – Clinical Nurse Specialist in Pediatric Cardiac ICU