Transplant Nurse Adopts Patient

[okarol]

Transplant Nurse Adopts Patient

By Debra Wood, RN, contributor

Good outcomes sometimes require a nurse to listen to her heart and to ignore warnings not to cross professional boundaries and become too involved with a patient.

Two-year-old Ashley Echols-Dobbs is thriving today, because Children’s Healthcare of Atlanta at Egleston transplant nurse Camille Echols, RN, BSN, took the time to reach out and earn the baby’s trust and eventually become her parent.

“I just felt that taking her into our home was something we should do, because she was so needy,” Echols said. “She was severely malnourished and suffering from overall neglect and medical neglect and signs of physical abuse, like cigarette burns. She never had anyone here with her.”

Doctors admitted Ashley, who was born with congenital dysplastic kidneys, time and again to administer IV antibiotics. Due to poor hygiene, she frequently developed line infections.

“No one ever stayed with her,” Echols said.

The baby would scream whenever anyone came into her room. She did not want to be looked at, talked to or touched. As her primary nurse, Echols would spend a few minutes at a time with the little girl, gradually earning her trust. Echols would come in on her day off to interact with Ashley and rock her to sleep. The birth mother rarely visited and could not properly care for the child.

Suspecting the Georgia Division of Family and Children Services (DFCS) might take custody of Ashley, Echols and her partner, Julie Dobbs, began taking foster parent classes, so they could be considered for placement. They completed the classes in November and the state agency removed Ashley from her birth mother in January 2008.

“Her biological mom approached me when she found out DFCS was going to remove her and asked if we would take her,” Echols said. “We went to court with the mom to ask to be granted custody of Ashley.”

Ashley received a transplant evaluation while in Echols and Dobbs foster care, but the physicians decided not to recommend her for a transplant unless there was no chance of Ashley being returned the birth mom, who would likely not provide the necessary long-term care and medication. The father is unknown. DFCS aimed to reunite Ashley with her biological mother within a year.

“The [doctors] said, ‘then you will be reuniting a dead child, because she will be dead in a year,’” Echols said. At that point the birth mother decided to give up her parental rights. “She saved her daughter’s life.”

Echols said she weighed concerns about professional boundaries and legal liabilities if the birth mom accused the hospital of falsely documenting Ashley’s condition, but she thought it was a risk she had to take.

“As a pediatric nurse, it is always challenging because you do not want your emotions to overshadow the professional care you provide your patients. But we are all human, and sometimes you cannot help it,” said Amy Hauser, director of transplant services, Children’s Healthcare of Atlanta.

Echols did not talk about the adoption or Ashley while at work, yet co-workers and physicians seemed supportive.

“You have to do what you think is right,” said Echols, who added that it now seems as if Ashley has always been her child. “People become nurses because they have huge hearts and care about people more than the average person. And that is what makes our profession beautiful.”

The adoption was finalized in May and Ashley received a kidney in August 2008. Five months later, she shows no signs of rejection and is thriving. She receives speech, physical and occupational therapy at day care and returns to the hospital regularly for care.

Now two years old, Ashley has started eating, has gained weight and begun talking and walking.

“She has so much energy,” Echols said. “We’re exhausted, because all Ashley wants to do is play.”

Echols recently became a peritoneal dialysis coordinator at Children’s of Atlanta, so her schedule more easily accommodates Ashley’s needs.

“I think the outcome is fantastic and Ashley has flourished and is doing wonderfully because of the love and care she has received from Camille and Julie,” Hauser said. “Everyone in the Children’s transplant department was absolutely thrilled for all involved when the adoption was finalized.”

http://www.nursezone.com/Nursing-News-Events/more-news.aspx?ID=18713

PHOTO: Two-year-old Ashley Echols-Dobbs is thriving today, because Children’s Healthcare of Atlanta at Egleston transplant nurse Camille Echols, RN, BSN, took the time to reach out and earn the baby’s trust and eventually become her parent.
Ashley Echols-Dobbs