CATHY TAYLOR AND Michelle Tracy had never met, but the two Marin moms had something in com- mon: they’d both suffered through upsetting hospital visits with their
children that inspired them to make emergency
room care work better for families.
Taylor, a sonographer at University of
California–San Francisco Medical Center who
lives in Greenbrae, brought her then-3-year-old
to Marin General in an ambulance with complications from croup. She was dismayed that when
her son cried for his daddy, he couldn’t see him,
because a flu-season one-visitor policy relegated
Dad to the waiting room.
Tracy, who lives in Corte Madera and manages Marin General’s emergency and trauma
departments, had an experience no parent
ever wants to face: after a car accident, she was
prevented from seeing her critically injured
4-year-old. “When your child is in a critical
accident and she may not make it through the
night, her mother should be by her side. And
that wasn’t allowed,” she says. Initially she
was even denied information about whether
her daughter had survived. “The physician told
me, ‘if you don’t calm down, I’m not telling you
anything about your daughter,’ ” she recalls.
Both children recovered, although Tracy’s
now-adult daughter faces lifelong challenges
due to traumatic brain injury. But neither
mother was prepared to merely complain to
management and move on.
Months before her distressing visit to Marin
General, Taylor had encountered a completely
different style of care when her son got hurt at
Disney World and received stitches at Orlando’s
Arnold Palmer Hospital for Children. A child
life specialist (a professional who helps kids and
parents cope with treatment) advised Taylor on
how to keep her son calm and offered an iPad to
distract him. A nurse applied a numbing gel so
the toddler didn’t have to have a shot.
“He lay there with his chin up, staring at
the iPad, with no sedation, and let that doctor
stitch him up,” Taylor says. “He was scared, but
he was calm.”
So when she had a bad experience at Marin
General — beyond the one-visitor policy, Taylor
was disturbed to hear staff yelling and failing to
provide a supportive environment for a scared
child — she wondered if she could convince
those in charge at Marin General to make it
more like Arnold Palmer.
The more Taylor looked into the issue, the
more she realized how high the stakes were.
One in five Marin residents is a child. How
would Marin General, the county’s only trauma
center, handle a flood of injured children
in an earthquake?
Taylor spent six months attending Marin
Healthcare District meetings and researching
what’s known as “ouchless emergency care”
for children — care that takes children’s needs
and fears into account, while minimizing pain.
When she finally spoke up, Marin General management connected her with Tracy, then the
assistant vice president of nursing, who had
long wanted to advance such an approach.
“We had always had other pressing initia-
tives here. But Cathy really helped make this a
priority,” Tracy says.
With Tracy working from within and Taylor
reaching out to patient communities, fire chiefs
and experts, the pair has achieved much. Now
Marin General’s ER is an ouchless emergency
department, using the same distraction techniques and kid-friendly equipment that Taylor
saw in Orlando.
Perhaps most important is the training
staff received, funded by a $30,000 donation
from the Schultz Family Foundation. Doctors,
“How traumatic the experience is can be
completely controlled by a little effort from
staff,” Taylor says.
Now that the Ouchless ER is up and running,
the two moms aren’t resting on their laurels.
Tracy is overseeing a new, more ambitious initia-
tive at Marin General: seeking certification as an
Emergency Department Approved for Pediatrics.
“What that means is that we are not just a
hospital that takes care of kids. We are a hospi-
tal that gives as good [a level] of care to children
as a children’s hospital would give, minus all
the [pediatric] specialists,” Tracy explains. As
part of that effort, the hospital has earmarked
$160,000 to have all nurses certified in pedi-
atrics and to hire a child life specialist. And
when it’s built, Marin General’s new emergency
department will cater to kids with private pedi-
atric rooms and a separate waiting area that
should shield kids from witnessing scary things
adult patients might be going through.
Meanwhile, Taylor is looking to help other
community hospitals throughout California fol-
low Marin General’s lead. Ouchless care tends to
be found in children’s hospitals, but, she learned,
90 percent of pediatric emergencies are treated in
community hospitals like Marin General.
“So by changing the atmosphere there, we
impact nine out of 10 kids,” she says.
Although Tracy has her hands full at Marin
General, she plans to continue the partnership
by supporting Taylor’s statewide mission. “We
want to bring this concept to other ERs,” she
says. “This is something we want to share.” m
How traumatic the experience is can be completely
controlled by a little effort from staff.