During my 22 years of being a pediatric nurse, there have been many ups and downs. This job takes a great deal of energy, compassion, and strength, and let’s face it—it is HARD. So, after 22 years, why do I keep coming back to work at a job that can be so physically and emotionally exhausting? One part of the role that doesn’t get much attention is the fulfillment that nurses receive from supporting their patients and the personal growth that occurs as a result. When I can change someone’s day for the better, it leaves me feeling satisfied. When I can educate a patient and help them understand their experience a little better, I feel powerful. When I can help a family member or caregiver to independently care for their children, my heart bursts with joy. 


When I would teach a mom, dad or other caregivers how to manage a central line with infusions at home for their medically complex child, there were times when families would need interpreters to understand necessary information. One day, the mother of a four-year-old patient was scheduled for an appointment with a Spanish interpreter. Upon further evaluation, we learned that this mother was from a tiny village and Spanish wasn’t her primary language. A tribal dialect was spoken in her village, and she only understood a small amount of Spanish. Her dialect was so unique that there were no interpreters available. To add another challenge, this language was only verbal with no written form of communication. Since this mom was illiterate, our typical methods of teaching in a primary language and giving written instructions were ineffective.


My teammate and I sat down to discuss multiple approaches to the situation. How could we best prepare this mother to care for her medically complex daughter, which required medications and infusions via an IV pump? How could we help her properly manage any alarm that the pump may have or other challenges that might occur? We decided on holding multiple teaching sessions with the interpreter and using a step-by-step photographic presentation of the information.


Creating this guide was a painstaking process! Together, my partner and I deconstructed each step of care to the smallest detail. We photographed every single piece of equipment needed (alcohol, caps, IV tubing, etc.), each step involved with setting up the IV infusion, and screen of the IV pump. We then had to repeat the same process for all complications that may occur. After this was complete, we compiled the information into a photographic display.


Typically, families received one to two teaching sessions before achieving competency. This mom was slated for four to six sessions to ensure that we could explain every nuanced detail, refer to the photographic information, and have her successfully repeat the steps. I have to confess that I was skeptical whether the process would work, as there were so many challenges to overcome. Complex medical care for a fragile child. A mom who only understood a small amount of Spanish and could not read. No available interpreter to communicate in the primary language. A pump that had screens using English. 


To my surprise and delight, this mom was an exceptional learner and I am proud to say that her daughter was successfully discharged from the hospital. Since her primary language had no written communication, I realized that her ability to retain verbal information was superior to most individuals I know. Her drive to care for her daughter, get her out of the hospital, and help her reunite with her siblings paved the way for her success. 


This experience taught me how to be flexible, think outside the box, and better manage individual learning styles. It also led me to challenge my assumptions about illiteracy by revealing how referring to written communication can hinder my ability to recall auditory information. My job keeps me engaged with complicated challenges and forces me to move forward. For that, I am grateful. 


I enjoy guiding families through difficult and complex situations. Experiences like these allow me to empower family caregivers with knowledge and help them reclaim their ability to independently care for their child. This provides me with the fulfillment to keep coming back shift after shift.


smiling photo of Sarah Villavicencio BSN, RNSarah Villavicencio BSN, RN is a freelance writer and owner of Sound Writing Solutions. She is based in Seattle with over 22 years of pediatric clinical nursing experience and a passion for education. When not at work, she enjoys family time, long walks and smelling the salty sea air.