“Kids that go on ECMO are sick, and they need very high-level care and a big care team because these cases are complex,” explains Mickell Schmeling, RN, a PICU nurse at Rady Children’s who specializes in ECMO. “Right now, we have four patients on ECMO. Sometimes there’s none, sometimes there’s one—it kind of comes in waves.” A PICU nurse since 2015, Schmeling applied to the ECMO team to further her professional development. It’s an elite crew trained to manage the ECMO circuit for critically ill patients. ECMO nurses work 12-hour shifts to keep a keen eye on vitals, medications, lab results, device settings and the patient’s and their family’s needs. “It’s challenging working with kids, but it’s also really, really rewarding,” Schmeling says. “I’ve been doing it for a while, but I still learn something every day I’m at work.” Though she admits it can be stressful at times, Schmeling says there’s nowhere she’d rather be. “I love working with children. I knew when I started nursing school that I wanted to work with the pediatric population,” she says. “I was living in San Diego and Rady Children’s is one of ŹĠăŹŎŨĠŎŰŨĤŹØĺŰĤŅŹĠăõŎƀŅŹŬƛ̐ ŰŎRƱęƀŬăûĤŹ was the place to be.” Pediatric nurse Stephanie Hope, RN, has been working in the CTICU since it opened in 2013, and also sought on-the-job training to work with complex medical devices like ECMO. “It’s been a journey watching these kids over time and how medicine has evolved and how the technologies evolved,” Hope says. “The things ƕăõØŅŎƫăŬĠØƔăõĠØŅęăûŰŎŬØŨĤûĺƛ̖̲ The CTICU cares for children from infancy to adolescence. Some children were born with cardiovascular health problems; others experienced a triggering event. Hope says she feels privileged to care for families in their worst and best moments. “Even if it’s just as simple as handing a kid to ŹĠăĤŬłŎłėŎŬŹĠăƱŬŰŹŹĤłă̐ ĠăŬòØòƛŹĠØŹ she hasn’t been able to hold because they’ve been so sick, all the way to kids coming in who we really honestly didn’t know if they were going to survive,” she says. “Seeing those kids come back and then eventually getting their Christmas cards, or they come running down the hallway screaming your name. You’re like,
‘Wait, there’s no way that’s the same kid.’” Schmeling’s recent highs included simultaneously caring for both an infant and a teenager with failing hearts in need of ECMO support. “They got heart transplants, and they went home with their parents,” Schmeling says. “It was just so cool to see those patients walk out of the hospital.” Both Schmeling and Hope say
that Rady Children’s has provided them with an array of professional growth opportunities and a supportive workplace culture. The positive work environment helps ŎƫŰ㏏Ġă long hours and stress intrinsic to the nursing profession as it experiences nationwide ŰŹØƬŅę shortages. Hope says she’s inspired by the dedication and caring of the ECMO
SEEING THOSE KIDS COME BACK AND THEN EVENTUALLY GETTING THEIR CHRISTMAS CARDS, OR THEY COME RUNNING DOWN THE HALLWAY SCREAMING YOUR NAME. YOU’RE, LIKE, ‘WAIT, THERE’S NO WAY THAT’S THE SAME KID.’” MICKELL SCHMELING, RN
team, who work together to give patients and their families the best outcomes possible. “It is stressful, but at the same time, you see so many beautiful moments that you would never be able to see anywhere else,” Hope says. “We always talk about how it’s like this protected little world, that if you’re in it, you get it and understand it. You’re in the trenches with your coworkers and the physicians and the patients and the families.”
WINTER 2024 HEALTHY KIDS MAGAZINE 27
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