Infusion nursing was not Jill Wall’s first career. “I had a primary nursing career. I have been involved in ob/gyn and the special care nursery. I ended up having a child with medical complexities. That’s how I came to know Pediatric Home Service,” she said.
She left nursing for a while and was “at a crossroads” when she decided to go back to work eight years ago. While she was looking at options, she learned that PHS was hiring an infusion nurse. “I had done infusion with previous jobs, but not to the extent I do now,” she said.
Infusion is defined as “the introduction of a solution into the body through a vein for therapeutic purposes.” Wall said an infusion nurse “manages anything from routine antibiotics to specialized infusions for enzyme replacement therapy” — a process that can take eight hours.
Infusion nursing at PHS has special challenges, Wall said. “Pediatric patients are not just miniature adults. They have different needs because of their size, dosages, potential side effects. It depends on underlying diagnoses and complexities.”
Among the range of conditions, Wall said, a healthy child might develop osteomyelitis, a bone marrow infection that requires long-term antibiotics through a peripherally inserted central catheter (PICC) line. Children born prematurely might need nutrition through a central line up to 24 hours a day. Children with muscular dystrophy or cystic fibrosis need infusions of enzymes their bodies don’t produce naturally.
“The technology is changing on a daily basis,” Wall said. “We have to be continuously educating and updating — who we teach, how we teach, what we teach.” In addition to working as an infusion nurse, Wall now handles training for PHS, not only for their own nurses but for hospitals and nursing services throughout the region.
What are the benefits of treating pediatric patients at home?
None of us want to spend time at a hospital if we can help it. It’s not only being at home as a family; these kids are going to school, going out in the community. We take care of chemo oncology patients. As soon as they can go home, they go home, with intravenous hydration therapies. One of the things they want to do is get back to school as soon as they can. Some of these kids as they get older are going out in the workforce.
What does it take to be successful as an infusion nurse?
You have to be driven and be very independent. You work with all types of demographic areas, all types of cultures. You have to be independent to do that. You’re not just looking at infusion. You do a complete assessment, troubleshoot, collaborate with the physician, the dietitian, the home-care nurse. I’ve been to the school to attend Individualized Education Plan (IEP) meetings, to make sure kids are going back to school safely. There’s also more responsibility. You don’t have someone to say, “Can you come take a look at this and tell me what you think?” If a patient may have a central line infection, that’s an urgent situation that has to be dealt with immediately.
What does it take to be successful?
Really what it comes down to is the love for home care — for being able to provide that in the home care setting. Most of the home care nurses I meet — infusion or extended hour — love to see patients at home, in community, in school, thriving as they should. □