Behind the Badge: Managing Pediatric Capacity Challenges During the Recent RSV Surge

Kim Whalen, RN, nursing director at Mass General for Children (MGfC), has worked at the MGH in various roles and departments since 1996. This year, as respiratory syncytial virus (RSV) cases surge in pediatric patients, she’s using those decades of experience – and calling on others to do the same – to address capacity challenges and support her staff.

“When the RSV surge first began this fall, there was very little movement between floors,” Whalen says. “There were children who needed to move to the pediatric intensive care unit (PICU), but with limited beds available, nurses had to stay with them until they could be moved.”

Because beds weren’t available in the PICU, RSV patients began moving to other pediatric floors, the neonatal intensive care unit (NICU), the adult ICU and community hospitals. This led nurses to begin “caring for much sicker patients than they were used to” and looking to leadership for support and education.

To address these needs, Whalen proposed the implementation of a PICU consult nurse pilot – a program that would invite senior-level nurses experienced in caring for PICU-level-of-care RSV patients to pick up extra shifts, providing hands-on support and education to nurses who needed it.

“I really wanted to find a way for us to manage our own busy, full unit, but also provide expertise to everyone who needed it,” Whalen says. “So, I drafted the proposal and sent it to our senior-level staff.”

Whalen quickly received an overwhelming response to her request, and PICU consult nurses are now incorporated into the MGfC staffing plan to provide support during the RSV surge. Cheryl Holman, RN, is one of those nurses who stepped up to help during the surge.

“Working as a PICU consult nurse has been a great experience,” Holman says. “I have really enjoyed working with the nurses and respiratory therapists on Ellison 17 and 18. They have embraced this RSV surge and are eager to learn. I feel so appreciated when I’m on the floors helping and answering questions.”

Whalen says that as a PICU nurse herself, she is proud of the creative collaboration happening between teams and departments across the MGH. She felt similarly when the PICU transitioned into an adult ICU during the height of the COVID-19 pandemic and says the idea for the PICU consult nurse program came from the teamwork she witnessed during that time.

“Capacity challenges like this are not new to us,” Whalen says. “But, when we work together and when staff really step up to help their colleagues and patients, we’re able to successfully meet those challenges.”