While pediatric cancer survival rates have improved significantly, approximately 1,600 children and adolescents still die of cancer each year in the United States, according to the National Cancer Institute. This reality is one that the care providers face daily in their work.
Kimberly M. Williams, DNP, MSN, RN, NE-BC, serves as the director of Nursing Operations in the Bass Center for Childhood Cancer and Blood Diseases at Stanford Medicine Children’s Health. She describes how the team at Stanford Children’s provides support for one another.
How have you fostered a culture of providing space for reflection to counter the emotionally heavy work environment that can be in pediatric oncology?
Reflecting on over 25 years in health care, I recognize the profound intentionality we place on prioritizing the health and well-being of our teams, who are dedicated to care for children with pediatric cancer. In the emotionally intense realm of pediatric oncology, fostering a culture that offers room for reflection is essential to nurturing our team’s well-being. At Stanford Children’s, and particularly within the Bass Center, we emphasize impactful leadership, humility, and grace to support our dedicated staff.
Leadership here involves more than directives. It embodies creating an environment where everyone feels valued and heard. As leaders in the Bass Center, we encourage open conversations about grief and coping, validating the staff’s emotions and fostering trust within the team. I am intentional about providing a safe space for reflection, allowing team members to process their emotions and challenges collaboratively. This can be done during leader rounding, huddles, or by just being present on the unit. Our team approach is grounded in humility and grace. Grace provides a space to be “OK with not being OK.” Lastly, recognizing that everyone—from physicians to support staff—brings unique experiences and perspectives is crucial.
What sort of system have you set up to help your team reflect on and manage their own emotions?
Stanford Children’s offers a multitude of resources to support emotional health. Access to counseling services, the Employee Assistance Program (EAP), and wellness resources ensures that staff have the necessary support. Our nursing leadership team has shown extraordinary commitment and expertise in creating an escalation process that can be activated instantly. This process empowers our staff to manage the profound challenges of death and dying with grace and professionalism, ensuring that necessary support is available precisely when it’s needed and beyond.
One of the first things we do is get our resilience team involved immediately. Resilience teams are essential in cultivating an environment where the emotional and mental health of staff is prioritized, allowing for effective and compassionate care for not just our pediatric cancer patients, but for all patients, families, and staff. They often provide small, quick exercises that promote calm and relaxation as well as a listening ear to guide and support:
- Emotional processing: Provides a safe space for staff to express and process their grief and emotions, reducing the risk of emotional burnout and compassion fatigue. Validation of feelings allows staff to share their experiences and ensures that they don’t feel isolated in their emotions.
- Peer support: By discussing their experiences, staff can bond over shared challenges, fostering a stronger sense of community and mutual respect. Engaging in debriefing sessions also enables the sharing of coping strategies, enhancing collective resilience among staff members.
- Professional development and insight: Reflective learning during debriefing sessions allows staff to reflect on their experiences, learning from both emotional and clinical aspects of caring for terminal patients. Insights gained from these sessions also can improve caregiving approaches and emotional intelligence, benefiting future patient care.
- Stress reduction guidance: Debriefing sessions not only provide a structured setting to process emotions, but also promote self-care by highlighting the importance of self-care and encouraging staff to proactively manage their mental health.
Bass Center staff also created their own initiatives to support patients, families, and staff:
- Starfish Award: Inspired by the Bass Center’s emphasis on acknowledging staff contributions amid emotionally taxing environments, the Starfish Award celebrates staff who embody excellence and compassion in caring for our pediatric cancer patients.
- Heart Cart: A cart provided for staff to promote relaxation, respite, and a moment to step away. The cart houses chocolates, teas, essential oils, arts and crafts, and treats to enjoy away from the bedside.
- Wellness events: Annual social events put on by the Bass Center Wellness Committee are typically held at casual restaurants or venues that provide a relaxed atmosphere in which to connect.
- Annual Palliative Care/End of Life Workshop: Our nursesfacilitate workshops to provide education, awareness, and support for staff taking care of end-of-life patients. The workshop focuses on topics like what are the most important things to know when taking care of end-of-life patients? What does it sound like and look like, and what to expect? How can you advocate for your patients? A panel of subject matter experts, including a parent of a child lost to cancer, a palliative care team member, and a few frontline providers, are invited to speak.
- Bass Center Family Advisory Council: The multidisciplinary council provides a space to partner with families to work together on quality projects, partnerships, education, and daily standard work from the family perspective. There is shared decision-making, collaboration, and communication on every aspect of patient care to deliver the highest level of quality care.
- Serenity Room: We have a special room to accommodate our patients during end of life. The room was designed to provide a tranquil space for families and loved ones to be at the bedside. The Serenity Room in the Bass Center is carefully equipped with various elements designed to support emotional and spiritual needs of patients, families, and staff navigating end-of-life circumstances. There are materials to make keepsakes, like memory boxes or molds to make handprints of loved ones. Staff are also provided with resources to understand cultural sensitivities, ensuring inclusivity and understanding.
How has this culture permeated through other departments at Stanford Medicine Children’s Health?
At the Bass Center, the culture is defined by an unwavering commitment to excellence and a collaborative spirit that permeates every aspect of care. This dedication is exemplified through seamless communication with palliative care, spiritual care, case management, social work, the Family Advisory Council, pharmacy, and many other departments, ensuring comprehensive support for both patients and families during challenging times. The Bass Center prides itself on developing robust policies and procedures that shape clinical practice across the health care system, focusing on delivering compassionate, holistic care. The commitment not only fosters an environment of healing and support, but also drives continuous improvement in clinical outcomes and overall patient experience.
