Stories about: Practice

Notes from a nurse on the stem cell transplant unit

Stem cell transplant nurse with patient
Colleen caring for a child on 6W

I have worked at Boston Children’s Hospital for the last 10 years, the first two as a co-op and the last eight as a staff nurse — all on 6W. I just love this floor. We’re a small, 14-bed unit that provides longer-term care for children undergoing bone marrow transplants. We see different types of leukemia and other cancer and blood disorders such as neuroblastoma, aplastic anemia and myelodysplastic syndrome. We also see other genetic, metabolic and hematologic diagnoses like CVID, Wiskott-Aldrich syndrome, SCID, adrenoleukodystrophy and sickle cell disease, some of which we treat with gene therapy. …Read More

Hypertension in kids: When to refer

high blood presssure
(Illustration: Fawn Gracey)

We typically associate hypertension with older people, but elevated blood pressure isn’t an uncommon finding in children and adolescents. According to the American Academy of Pediatrics (AAP), pediatric hypertension occurs in 2 to 5 percent of kids and is one of the top five chronic diseases in children.

Despite those numbers, the diagnosis is missed in up to 75 percent of pediatric patients in primary care settings. “We should be checking blood pressure at every routine well-child visit for kids age 3 and older, and more often in kids with cardiometabolic risk factors, such as obesity and diabetes,” says Corinna Rea, MD, MPH, a pediatrician in Boston Children’s Primary Care at Longwood. …Read More

Breaking down language barriers: Strategies for working with LEP families

Doctor sitting down to explain something to a patient with limited English proficiency

Caring for patients with limited English proficiency (LEP) is a complex process that challenges clinicians in any setting. Being able to effectively communicate is crucial to ensuring the patient’s well-being and safety. But when this process is hindered by a patient or family’s language barrier, quality of care and patient outcomes could be compromised. Even with the assistance of an interpreter, how can we ensure that LEP patients and families truly understand their education? How much health knowledge and health literacy do they need in order to effectively synthesize and apply everything they learned during an encounter? There are a number of factors to consider. …Read More

Expert’s Corner: A guide to managing knee injuries in athletes

knee-pain

Knee pain and injuries are common among young athletes. Although some parents may think to bring their child to the emergency department (ED) when a knee injury occurs, there are many cases when the injury is better managed by either a primary care provider (PCP) or an orthopedic specialist.

The following guide will help you manage knee pain in athletes and provide guidance on when to refer your patient to an orthopedic specialist. …Read More