By Matthew N. Skoufalos
Sarah Matney has always had an ability to relate to children and a passion for their care. As she grew up, she says she was always up for babysitting; always willing to volunteer to help with kids’ activities. But the one career that persisted unwaveringly in her heart was nursing.
“I can’t remember ever wanting to be anything else,” she said. “My grandma used to tease me because it was the only thing I ever wanted to be.”
So it seemed a natural fit when, in the early days of her rounds at the pediatric inpatient oncology unit of Rush University Medical Center in her hometown of Chicago, Matney took “hook, line, and sinker” when it came to pediatric nursing. Today, the mother of two directs the Center for Cancer and Blood Disorders at Connecticut Children’s Medical Center in Hartford. As challenging as it can be treating seriously ill patients, much less children, Matney said what’s least understood about her work is how the resilience of children lessens its emotional toll.
“Kids go on with life despite the treatment, and so you just get to help them do it,” she said.
Despite the high-stakes nature of the environment, Matney insists that “every day is not sad.” Rather, she said, it’s a combination of challenges to balance the medical and personal needs of young patients with those of the families who share in their struggles.
“When a child is diagnosed, a family is diagnosed,” Matney said. “Patients and families are going to be on this journey anyway, and the privilege you have as a nurse is to walk alongside them. You have the ability to bring joy and empathy to help them find joy in the little things, which they will.”
Simple activities such as crafts, toys, games, and books can all help establish a sense of normalcy that allows children — and, more importantly, their caretakers — to heal, she said.
“What you see happen is as these children start to adjust and be kids and have fun, the whole group takes a deep breath,” Matney said. “ ‘We’re going to do this together. We’re going to be a part of the community.’ That’s the most amazing thing about being part of a long-term care.”
Nonetheless, in Matney’s experience, “there are two very different kinds of stories” that emerge from long-term care: those that “are amazing and change you forever,” but in which the patient may succumb to illness, and those of recovery, in which life goes on and the trappings of the disease remain behind with other childhood memories. Obviously, health care workers prefer the latter; however, some of the stories of the former persist beyond the brief years of the patients themselves, she said.
“Kids are allowed to be kids, but they have this maturity about them,” Matney said.
“I took care of one kid for seven years. He was willing to continue treatment as long as he could make it to school. School was the last thing in his life that was normal; he did that right to the very end.”
There are also those patients who recover fully. Matney recalls caring for a child who was battling a rare leukemia in 2011; his mother emailed her recently to say that the boy is in college and studying abroad for a semester.
“Things went amazingly well,” she said. “It’s so rewarding to see kids move on and see life go on.”
Creating an atmosphere in which children are allowed to heal, and their families with them, is the job of the staff at Connecticut Children’s Medical Center, and it can be taxing. Although Matney believes the hospital, and the field of pediatric nursing in general, attracts people who are “generally empathetic and playful in nature,” the resilience and innocence of the children in their care “is so rewarding,” she said. To enhance their understanding of the needs of their patients and families, the better to elevate the standard of care delivered, the hospital works to engage its clients as stakeholders, too.
When Connecticut Children’s Medical Center built its new cancer center, it was done with the input of parents and family members who were invited to sit in with the architect and offer feedback on the design, Matney said. Their perspectives were considered in everything from the layout of waiting rooms to elements of the atmosphere in the building. From there, the hospital also invites families and patients to participate in its monthly quality and safety meetings, which helps providers to consider everything they do from the perspective of their audience.
“The way you talk about errors, near-misses; you have a parent’s feedback on that,” Matney said. “It’s been extraordinarily rewarding for us.”
As a nurse leader, Matney’s day-to-day experience is farther removed from the bedside than it used to be; however, she sets the tone for how the facility handles the treatment of patients suffering from cancers and blood disorders at a higher level of administration. Being tasked with improving the continuum of care at her facility is a departure from direct-care responsibilities, she said. Yet it allows her to elevate the overall quality of service delivered by influencing staff behaviors and policy decisions.
“You inspire staff to always improve,” Matney said. “We’ve done it structurally, where daily, we talk about where we were yesterday. We’ve established the standards, and what’s risen to the top are things that need more attention.
“My motivation has always been to do the right thing,” she said. “My moral compass was set at a very young age, and there is always, to me, a way to sit down in a situation, even if it’s a very difficult conversation, and have two people walk away at the end and know exactly what has to happen and have it not be hard.”
“Our one True North is the patient and family experience,” Matney said. “If your staff is happy, the patients are happy.”
In the earlier years of her career, Matney said she didn’t appreciate the broad nature whereby nurses can improve the patient experience. Now, as a veteran of the field, she said she is “100 percent away from the bedside” but still feel like she has “a major impact” on the patient experience.
“We think of it all as, we go to the bedside, we push the meds,” Matney said, “but nursing now is so much broader than that.”