A Teaching Hospital – For Patients, Too

Every parent knows how a child’s illness can get in the way of schoolwork. A cold or flu may mean a few missed days of classes and homework to catch up on. But when a serious or long-term illness keeps kids away from all or many of their classes—sometimes for weeks or months at a time—it can be an academic catastrophe.

For inpatients and their siblings at Packard Children’s, there’s our hospital school—part of the Palo Alto Unified School District. Teachers from the hospital school even make visits to a child’s bedside when they aren’t able to come to the classroom. But for patients in our Dialysis Center, there was a unique challenge: hemodialysis patients, who come to the hospital several times a week for outpatient treatment, aren’t eligible for the inpatient school. Instead, their treatment had them seated, sometimes bored and restless, in a chair for 3 to 4 hours during their dialysis treatment. Oftentimes their teachers at school didn’t fully understand their medical situation and absences, resulting in low or failing grades.

In 2011, Packard Children’s hired Katie Fennimore to work exclusively with children in the dialysis unit. Katie—a former elementary school teacher trained as an instructor for children with special needs, such as chronic illness—works to ensure that each patient’s educational needs are met in the medical setting, and that medical needs are met in the educational setting.

Katie helps kids ranging in age from 3 to 19—preschool to high school—undergoing dialysis treatment to set goals, stay motivated and keep up to date with class work, or prepare to enter school for the first time. She also bridges the gap between school and hospital, to make sure that everyone involved in the child’s life—parents, school teachers, administrators, doctors and nurses—are in step with the patient’s medical status and needs, as well as his or her academic development.

“It’s especially hard in high school when kids have multiple teachers who see hundreds of kids,” says Fennimore. “We give them support to help them understand dialysis and what needs it may present for the child in the classroom.” For children who have an Individualized Education Plan (IEPs) or 504 education plan, Fennimore works with teachers to help ensure that students are on the right track while they’re at Packard Children’s.

Lori Vargas is mother to 15-year-old dialysis patient Taylor Simpson, who was diagnosed with Goodpasture syndrome just over a year ago. Vargas said, “Katie is a huge help for us. She helps bridge the communication between us and the school when we need that extra support.”

In Fennimore’s role, knowing her dialysis students individually is key to helping their progress. Vargas added, “Katie knows, off the top of her head, everything that is currently going on in Taylor’s classes. She will also be attending Taylor’s IEP meeting via conference call to help us communicate with Taylor’s teachers and explain the importance of Taylor staying in school even though she has this illness.”

Keeping kids engaged requires a good mix of skill and talent. “It can be hard to do schoolwork when there’s a TV in front of you,” says Fennimore, stating another truth that parents know well. To help kids on dialysis make the most of their time, Fennimore uses the no-TV “power hour”—the first hour of treatment when kids are still high-energy.

Screens aren’t always a distraction, though. “We have iPads and computers that have been donated to the Dialysis Center,” Fennimore adds. “We put educational materials on those for the kids to use, such as learning games and Apps. Teachers can recommend specific lessons as well.”

In addition to working directly with patients, Fennimore is also working on research with nephrologist Cynthia Wong, MD, medical director of the Packard Children’s Dialysis Center, to measure how a dedicated teacher has influenced patients in the dialysis unit. For example, the number of children who engage in educational activities during dialysis goes up from 14 percent to 79 percent when a teacher is present. Methods to achieve this include assessment of educational needs, assistance with focusing on tasks, setting goals (one goal per month instead of a vast set of goals), bridging gaps between parents, students and school, and working one-on-one and in group settings with specific California-based standards.

An added benefit to Fennimore’s role is helping kids to build confidence. She understands that kids enjoy making progress when they’re engaged in learning. “All kids lose focus,” said Fennimore, “but if someone’s there to encourage and help them, it makes a huge difference.”

“Katie is a great motivator for Taylor while she’s here in dialysis to stay focused on her homework and grades,” said Vargas. “She rocks! We are grateful for all her help.”

The dialysis teacher position is supported by a generous grant from the Bank of America Foundation. Corporate partners provide important funding for many community outreach and clinical care programs at Packard Children’s. For more information, please visit supportlpch.org/ways-give/corporate-giving.