Selected Podcast
A Children’s Hospital’s Battle Against Gun Violence: Part 1
Theresa Drewry, Wanda Keath, and Dr. Kiersten Hawes make up the Le Bonheur Trauma team and discuss the work being done to mitigate the long term effects that gun violence has on children.
Featured Speaker:
Wanda Keath is a trauma social worker at Le Bonheur Children’s Hospital in Memphis, TN. Prior to her current position, Keath worked as a school social worker for Shelby County Schools. Keath is a licensed master social worker and she earned her Masters of Social Work from Union University. She completed her Bachelor of Arts degree with a concentration in social work at LeMoyne Owen College.
Theresa Drewry BSN, RN, PED-BC, CPEN, TCRN, is a Staff/Charge registered nurse at Le Bonheur Children’s Hospital in the Emergency Department. She also serves as chair of the Community Outreach Le Bonheur Nursing Professional Practice Council. Drewry has been an active member of the Emergency Nurses Association since 2005. Drewry is a graduate of the University of Tennessee Health Science Center.
Kiersten Hawes, PhD, LPC, NCC | Wanda Keath | Theresa Drewry, BSN, RN, PED-PC, CPEN, TCRN
Dr. Kiersten Hawes is the BRAIN CENTER Clinical Director of Trauma Services for Le Bonheur Children’s Hospital Trauma Center. Dr. Hawes is a recent graduate of the PhD Counselor Education and Supervision program in the Department of Counseling, Educational Psychology, and Research at the University of Memphis. She earned a master’s degree in Clinical Mental Health Counseling at the University of Memphis. She received a bachelor’s degree in Psychology at Spelman College.Wanda Keath is a trauma social worker at Le Bonheur Children’s Hospital in Memphis, TN. Prior to her current position, Keath worked as a school social worker for Shelby County Schools. Keath is a licensed master social worker and she earned her Masters of Social Work from Union University. She completed her Bachelor of Arts degree with a concentration in social work at LeMoyne Owen College.
Theresa Drewry BSN, RN, PED-BC, CPEN, TCRN, is a Staff/Charge registered nurse at Le Bonheur Children’s Hospital in the Emergency Department. She also serves as chair of the Community Outreach Le Bonheur Nursing Professional Practice Council. Drewry has been an active member of the Emergency Nurses Association since 2005. Drewry is a graduate of the University of Tennessee Health Science Center.
Transcription:
Bill Klaproth (Host): Gun violence has been identified by Le Bonheur Children's Hospital's Level One Trauma Center as a pandemic within a pandemic with catastrophic impacts on children. So, we are here with the Le Bonheur Trauma Team to discuss this issue and the work being done to mitigate the tragic long-term effects gun violence has on children. These experts not only treat children for their physical injuries, but they also help with the mental toll this takes on them and their families. With me is Theresa Drewry, Staff Charge Nurse at Le Bonheur Children's Hospital Emergency Department, Wanda Keith, Trauma Social Worker at Le Bonheur Children's Hospital.
And Dr. Kiersten Hawes Brain Center Clinical Director of Trauma Services for Le Bonheur Children's Hospital. This is the Peds Pod by Le Bonheur Children's Hospital. I'm Bill Klaproth. Theresa, Wanda and Dr. Hawes, thank you so much for your time. We really appreciate it. This is such an important topic, and I'm glad that we have an opportunity to talk about it. So, Theresa, let's start with you. Being an emergency department nurse, you have unfortunately seen more than your fair share of trauma cases as a result of firearm injuries. Can you tell us what happens when a trauma case enters?
Theresa Drewry, BSN, RN, PED-PC, CPEN, TCRN (Guest): So prior to the trauma getting there, whoever's the charge nurse, whether it's me or someone else, sends out a trauma page based on the resources we think we will need. And so we have a team assembled before the patient arrives. They will all be in the room waiting upon the child's arrival. Everyone in the room should be quiet. Everyone in the room should know their roles prior to the child rolling in. And again, we're there with our ER physician as the team leader, who will direct the care that is given.
Host: Right. So you're all there. You're standing by. You're quiet. You're ready for this patient to come to you. Can you take us through those first minutes of the process then? How do you evaluate each case?
Theresa: When the child arrives, prior to being moved over to the stretcher, the physician will do what's called a primary assessment. And that's where we determine if there are any life-threatening injuries that need to be immediately addressed. So, that will be things that affect the child's airway, their breathing, their circulation, any of those, we need to intervene immediately to save the life of that child. So, things can progress really quickly through that. If we don't identify a problem at the point they have done that, we move the child onto the strecher. And then people began doing their assigned roles. At that point, the physician gets report from whatever team has brought the child.
Host: So Theresa, I imagine this has gotta be an emotional moment. I know you're a professional and you're probably trying to keep the emotions out of it. But when you see a little child come in with a gunshot wound, that's gotta be tough. Can you describe the emotions that surround cases like these for both the Le Bonheur team and your interactions with families accompanying their child?
Theresa: There is a lot of emotion concerning this. In particular, when the child has life-threatening injuries and we're doing everything we can to save that child. The families, as you can understand are very distraught. There's a lot of emotions going on. And for that reason in our room, we have social worker who will be present. We have a chaplain, hopefully, we have a Child Life people who can sit there with the parent or caregiver while we're doing our life threatening interventions. But it is very emotional for everyone. You have to focus first on the clinical needs of the child and deal with our emotions surrounding it afterwards.
Host: Right. I imagine that's gotta be very, very tough for you, the team at Le Bonheur and the families involved. So, you mentioned having a social worker ready to go. So Wanda, being a social worker who provides support for gunshot wound victims and their families, can you tell us then how do trauma social workers at Le Bonheur provide immediate assistance to families?
Wanda Keath (Guest): As has been stated, that social worker will respond when the page is received to the appropriate location, awaiting the patient and family to present. At that time, the social worker's job is to help that family become as comfortable within that space as possible under the circumstances. As the medical team work to support and provide medical care to the patient, it is the social worker's responsibility to ensure that the family is getting what he or she needs to be in that room to hear what's going on, but also have the support from the social worker and or spiritual care and the Child Life Specialists.
Host: So you are there to provide immediate assistance. So then does Le Bonheur also offer counseling services too?
Wanda: Yeah. Yes. Le Bonheur offers counseling services to our patients, to our trauma patients. We work in collaboration with the University of Memphis through the Brain Center. And we also have Carlos Torres, who is a psychologist that is employed by Le Bonheur Children's Hospital.
Host: So then I think I know the answer, but I could be wrong. And this is social work care for the patient different from social work care of the patient's family. Is there a difference there?
Wanda: Not necessarily different yet individualized. You're going to provide care for the patient and family in the way that meets the need of that patient and family. You meet them where they are. Everyone will not require the same need of support, but whatever that need is that is what the social worker will work to accomplish.
Host: Yeah, such an important role. We think about the physical needs of a gunshot wound victim, but that mental health, the mental support is really important as well. So thank you for that Wanda. And Dr. Hawes, so you are the Brain Center Clinical Director of Trauma Services for Le Bonheur, but you also help families with counseling services. So, can you tell us about your job and your role in the support services offered to children and families?
Kiersten Hawes, PhD, LPC, NCC (Guest): Sure. As the clinical director, I conduct counseling sessions with our trauma patients and also caregivers in the inpatient and outpatient facility. I also supervise and train our amazing University of Memphis graduate counseling students. They're trained in different trauma informed interventions. And so essentially the counseling team, we just really hope to address those emotional wounds and mental health symptoms that accompany the physical effects of trauma at their greatest point of need, which is at the bedside while they are healing.
Host: And then I know there's a new counseling services available as well. Can you talk about those new counseling services offered to every child who comes to Le Bonheur suffering from a gunshot wound?
Dr. Hawes: Sure. First the mental health counselors, we screen for traumatic stress symptoms in children by administering the child stress disorders checklist. Oftentimes children who are recovering from a traumatic event, such as a gunshot wound, they might have an acute stress reactions such as difficulty concentrating, angry outbursts. They may experience loss of appetite. They may appear on edge. They might experience some changes in mood. Oftentimes they also experience flashbacks or nightmares of the event. And so if the child has a high score, we discuss what that score means with the patient and the caregiver. And then we recommend ongoing mental health counseling to process those emotions and also to learn healthy coping skills to manage stress.
But I mean, even regardless of their score, we still offer ongoing unlimited mental health counseling services, both inpatient and outpatient or teletherapy at no cost to all children and families who are being treated for a gunshot wound at Le Bonheur.
Host: Well, I imagine the ongoing mental health support is a really important component of this. So what is the followup like for these families?
Dr. Hawes: Families have been so receptive to receiving therapy especially, while being cared for inpatient. I mean, honestly, like they welcome back the counselors and they request services daily. Oftentimes they even ask if the counselors can circle back and see them twice a day, if they have time in their schedule. And it's just so awesome to see how many families are being more open to counseling, because it's offered in a setting where it's what I like to call in to their medical care. You know? So even patients who are being treated in outpatient, come in for what we like to call a mental health check-in.
Host: So, that's really important that this mental health support is built right in. So, we certainly have learned a lot through this discussion. I know that it is a very complex and it does take an entire community coming together to create solutions to such complex problems like gun violence and firearm injuries. So, what kind of progress are you hoping for through the collaboration's like the one, the Brain Center has with Le Bonheur Children's Hospital, Dr. Hawes?
Dr. Hawes: I'm really hoping that this partnership serves as a future model for other hospital settings in the city because providing counseling interventions at the bedside, children and families have easier access to mental health counseling and more patients are actually more receptive because it's integrated within their medical care. It's confidential. And it's very non-threatening. And truly the trauma team, such as the physician, the social worker, counselor, and nurse practitioners, physical therapists, and the nutritionists; we really do work as one unit to treat the whole patient and family. And so I just really hope that more settings adapt this integrated model in the future.
Host: Well, it's easy to see how the child and the family are both traumatized and you are there not only for the physical help, but also the mental support during and after as well. So, my thanks to each of you for your time today. We're very happy people like you at Le Bonheur are there trying to help tackle these problems. So Theresa, Wanda and Dr. Hawes, thank you so much for your time today. We appreciate it.
Dr. Hawes: Thank you.
Wanda: Thank you.
Theresa: Thank you.
Host: And to learn more, please visit Le Bonheur.org/podcast. And be sure to subscribe to the Peds Pod on Apple podcasts, Google podcasts or wherever you listen to your podcasts. You can also check out Le Bonheur.org/podcast to view our full podcast library. And if you found this podcast helpful, please share it on your social channels. This is the Peds Pod by Le Bonheur Children's Hospital. Thanks for listening.
Bill Klaproth (Host): Gun violence has been identified by Le Bonheur Children's Hospital's Level One Trauma Center as a pandemic within a pandemic with catastrophic impacts on children. So, we are here with the Le Bonheur Trauma Team to discuss this issue and the work being done to mitigate the tragic long-term effects gun violence has on children. These experts not only treat children for their physical injuries, but they also help with the mental toll this takes on them and their families. With me is Theresa Drewry, Staff Charge Nurse at Le Bonheur Children's Hospital Emergency Department, Wanda Keith, Trauma Social Worker at Le Bonheur Children's Hospital.
And Dr. Kiersten Hawes Brain Center Clinical Director of Trauma Services for Le Bonheur Children's Hospital. This is the Peds Pod by Le Bonheur Children's Hospital. I'm Bill Klaproth. Theresa, Wanda and Dr. Hawes, thank you so much for your time. We really appreciate it. This is such an important topic, and I'm glad that we have an opportunity to talk about it. So, Theresa, let's start with you. Being an emergency department nurse, you have unfortunately seen more than your fair share of trauma cases as a result of firearm injuries. Can you tell us what happens when a trauma case enters?
Theresa Drewry, BSN, RN, PED-PC, CPEN, TCRN (Guest): So prior to the trauma getting there, whoever's the charge nurse, whether it's me or someone else, sends out a trauma page based on the resources we think we will need. And so we have a team assembled before the patient arrives. They will all be in the room waiting upon the child's arrival. Everyone in the room should be quiet. Everyone in the room should know their roles prior to the child rolling in. And again, we're there with our ER physician as the team leader, who will direct the care that is given.
Host: Right. So you're all there. You're standing by. You're quiet. You're ready for this patient to come to you. Can you take us through those first minutes of the process then? How do you evaluate each case?
Theresa: When the child arrives, prior to being moved over to the stretcher, the physician will do what's called a primary assessment. And that's where we determine if there are any life-threatening injuries that need to be immediately addressed. So, that will be things that affect the child's airway, their breathing, their circulation, any of those, we need to intervene immediately to save the life of that child. So, things can progress really quickly through that. If we don't identify a problem at the point they have done that, we move the child onto the strecher. And then people began doing their assigned roles. At that point, the physician gets report from whatever team has brought the child.
Host: So Theresa, I imagine this has gotta be an emotional moment. I know you're a professional and you're probably trying to keep the emotions out of it. But when you see a little child come in with a gunshot wound, that's gotta be tough. Can you describe the emotions that surround cases like these for both the Le Bonheur team and your interactions with families accompanying their child?
Theresa: There is a lot of emotion concerning this. In particular, when the child has life-threatening injuries and we're doing everything we can to save that child. The families, as you can understand are very distraught. There's a lot of emotions going on. And for that reason in our room, we have social worker who will be present. We have a chaplain, hopefully, we have a Child Life people who can sit there with the parent or caregiver while we're doing our life threatening interventions. But it is very emotional for everyone. You have to focus first on the clinical needs of the child and deal with our emotions surrounding it afterwards.
Host: Right. I imagine that's gotta be very, very tough for you, the team at Le Bonheur and the families involved. So, you mentioned having a social worker ready to go. So Wanda, being a social worker who provides support for gunshot wound victims and their families, can you tell us then how do trauma social workers at Le Bonheur provide immediate assistance to families?
Wanda Keath (Guest): As has been stated, that social worker will respond when the page is received to the appropriate location, awaiting the patient and family to present. At that time, the social worker's job is to help that family become as comfortable within that space as possible under the circumstances. As the medical team work to support and provide medical care to the patient, it is the social worker's responsibility to ensure that the family is getting what he or she needs to be in that room to hear what's going on, but also have the support from the social worker and or spiritual care and the Child Life Specialists.
Host: So you are there to provide immediate assistance. So then does Le Bonheur also offer counseling services too?
Wanda: Yeah. Yes. Le Bonheur offers counseling services to our patients, to our trauma patients. We work in collaboration with the University of Memphis through the Brain Center. And we also have Carlos Torres, who is a psychologist that is employed by Le Bonheur Children's Hospital.
Host: So then I think I know the answer, but I could be wrong. And this is social work care for the patient different from social work care of the patient's family. Is there a difference there?
Wanda: Not necessarily different yet individualized. You're going to provide care for the patient and family in the way that meets the need of that patient and family. You meet them where they are. Everyone will not require the same need of support, but whatever that need is that is what the social worker will work to accomplish.
Host: Yeah, such an important role. We think about the physical needs of a gunshot wound victim, but that mental health, the mental support is really important as well. So thank you for that Wanda. And Dr. Hawes, so you are the Brain Center Clinical Director of Trauma Services for Le Bonheur, but you also help families with counseling services. So, can you tell us about your job and your role in the support services offered to children and families?
Kiersten Hawes, PhD, LPC, NCC (Guest): Sure. As the clinical director, I conduct counseling sessions with our trauma patients and also caregivers in the inpatient and outpatient facility. I also supervise and train our amazing University of Memphis graduate counseling students. They're trained in different trauma informed interventions. And so essentially the counseling team, we just really hope to address those emotional wounds and mental health symptoms that accompany the physical effects of trauma at their greatest point of need, which is at the bedside while they are healing.
Host: And then I know there's a new counseling services available as well. Can you talk about those new counseling services offered to every child who comes to Le Bonheur suffering from a gunshot wound?
Dr. Hawes: Sure. First the mental health counselors, we screen for traumatic stress symptoms in children by administering the child stress disorders checklist. Oftentimes children who are recovering from a traumatic event, such as a gunshot wound, they might have an acute stress reactions such as difficulty concentrating, angry outbursts. They may experience loss of appetite. They may appear on edge. They might experience some changes in mood. Oftentimes they also experience flashbacks or nightmares of the event. And so if the child has a high score, we discuss what that score means with the patient and the caregiver. And then we recommend ongoing mental health counseling to process those emotions and also to learn healthy coping skills to manage stress.
But I mean, even regardless of their score, we still offer ongoing unlimited mental health counseling services, both inpatient and outpatient or teletherapy at no cost to all children and families who are being treated for a gunshot wound at Le Bonheur.
Host: Well, I imagine the ongoing mental health support is a really important component of this. So what is the followup like for these families?
Dr. Hawes: Families have been so receptive to receiving therapy especially, while being cared for inpatient. I mean, honestly, like they welcome back the counselors and they request services daily. Oftentimes they even ask if the counselors can circle back and see them twice a day, if they have time in their schedule. And it's just so awesome to see how many families are being more open to counseling, because it's offered in a setting where it's what I like to call in to their medical care. You know? So even patients who are being treated in outpatient, come in for what we like to call a mental health check-in.
Host: So, that's really important that this mental health support is built right in. So, we certainly have learned a lot through this discussion. I know that it is a very complex and it does take an entire community coming together to create solutions to such complex problems like gun violence and firearm injuries. So, what kind of progress are you hoping for through the collaboration's like the one, the Brain Center has with Le Bonheur Children's Hospital, Dr. Hawes?
Dr. Hawes: I'm really hoping that this partnership serves as a future model for other hospital settings in the city because providing counseling interventions at the bedside, children and families have easier access to mental health counseling and more patients are actually more receptive because it's integrated within their medical care. It's confidential. And it's very non-threatening. And truly the trauma team, such as the physician, the social worker, counselor, and nurse practitioners, physical therapists, and the nutritionists; we really do work as one unit to treat the whole patient and family. And so I just really hope that more settings adapt this integrated model in the future.
Host: Well, it's easy to see how the child and the family are both traumatized and you are there not only for the physical help, but also the mental support during and after as well. So, my thanks to each of you for your time today. We're very happy people like you at Le Bonheur are there trying to help tackle these problems. So Theresa, Wanda and Dr. Hawes, thank you so much for your time today. We appreciate it.
Dr. Hawes: Thank you.
Wanda: Thank you.
Theresa: Thank you.
Host: And to learn more, please visit Le Bonheur.org/podcast. And be sure to subscribe to the Peds Pod on Apple podcasts, Google podcasts or wherever you listen to your podcasts. You can also check out Le Bonheur.org/podcast to view our full podcast library. And if you found this podcast helpful, please share it on your social channels. This is the Peds Pod by Le Bonheur Children's Hospital. Thanks for listening.