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Pediatric Oncology Nurse
Transformation of Jorge

(Excerpt from the Journal of Healthcare Design, Volume X, proceedings from the Tenth Symposium on Healthcare Design)

"When I first came to Children's Hospital and Health Center, I worked mostly with hematology oncology patients--kids with blood disorders, cancer, and leukemia. Our patients were on the medical unit in the Nelson Pavilion, which is the older original building. The unit had a very traditional design, with single rooms (some doubles), a door, and, in those days, a high window...

After the new pavilion was built, we moved in with a patient named Jorge who had been with us in the Nelson Pavilion for nearly two months. During that whole period of time, he had been in isolation. Jorge's father works in El Centro and the family could visit only one day a week, on Sunday. Those of us who were his nurses were very aware of his isolation, growing depression, and sadness of being taken from this loving Hispanic family. We worked hard at spending time with him. Our child life specialist and social workers worked with him. We had volunteers who spent very many hours with him keeping him amused and occupied.

About a week after moving into the new pavilion, we noticed that very early in the morning, as soon as he was up and washed, Jorge pulled his curtains back so he could see everything that was going on. Even though we were the same people taking care of him spending the same amount of time, Jorge started smiling and waving, and people would pass by and wave. He actually had more interaction because more people were aware of his being there. They could see him, whereas previously, he had such a little tiny window and high door and couldn't be seen. Also, when we entered his room previously, we were wearing masks. Now he could see our faces.

Within 10 days, this child changed from being a very quiet, depressed, withdrawn child to a smiling interactive human being. It wasn't his leukemia that kept him in isolation; it was because he had underlying infections that hadn't been treated when he was so sick. Finally, he came out of isolation and we had a big celebration. To see the change in him in 10 days was reason enough to have built the new pavilion."

Ayesha Marion, R.N.
Children's Hospital and Health Center
San Diego, CA