October 2021
A5/Pediatric Intensive Care Unit
Pediatric Intensive Care Unit
King Fahad Specialist Hospital Dammam
Eastern Province
Saudi Arabia
Eyad Mohammad Nasser, RN
Alice Brabante, RN
Alphonsa Jose,RN
Amani Mqdad Hassan Al Hakeem,RN
Amara Sankara Reddy RN
Ashjan Ali Alshammari RN
Bini JosephRN
Daniya Pullat Abraham RN
Edmanuel R Macaraeg RN
Esraa Sadiq Abdrabereda RN
Gladys Mae Castillo Cena RN
Hayat Hussain Khan RN
Jacklyn Gestiada Musa RN
Jennelyn Nanasca Lahaman RN
Jomol Puchukanadathil Thomas RN
Juliat George RN
Kavitha Krishnan RN
Ma Leonora Bernardo RN
Ma. Cristina Sandan Marcelo RN
Maria Ahmed AlBagshi RN
Mini Mathew RN
Nisha Mathew RN
Nishy Isaac RN
Norah yehya alkhaldi RN
Princy Puthiyathu Samuel RN
Rawan Al Harthi RN
Rawan Fawzi Aujan RN
Remelyn Eclarino RN
Renzi Rajan RN
Rosenda Grajo Tuti RN
Rosse Anne V. Lasala RN
Ruth Pappiah RN
Sarah Jane Galindo Angeles RN
Senead Belino RN
Sinitha Abraham RN
Smitha Piues RN
Sujatha Thoppil Thankappan RN
Susan Varkey RN
Zilda Magtangob Emejas RN




Patient H was a one-year-old boy, who for a very young age, suffered from Chronic Liver Disease. He underwent a Liver Transplant and was admitted to the PICU. After his liver transplant, he faced life-threatening complications and battled on life support. The PICU team pushed and utilized the best possible plan of treatment for him. His frail body received numerous blood products, multiple Inotropic support, nourishments, and aggressive antibiotic treatments. A high dose of sedatives, analgesics, and paralytes were required to keep him fully sedated to help his small lungs breathe with a conventional ventilator then eventually with a high-frequency oscillating ventilator. He had a tough battle.

Until he became bedbound, fed through a tube, tracheostomized, and ventilator dependent. His weak immune system increased his susceptibility to hospital ir tons. He acquired nosocomial infection and deteriorated. Later on, PICU had to close the unit and transfer him temporarily to the ICU to protect him from unwanted infections. Attempts were made to transfer him to the wards as a transition for his hospital discharge but oftentimes he would get sick and need PIC care. H's PIC care was then focused on his rehabilitation in a holistic or multidisciplinary approach. But on top of that, his human connection encouraged him to full recovery. The speech therapist performed a swallowing test and the Dietary Department helped to improve his nutritional intake. Respiratory Therapists trained his lungs to breathe without ventilator support. Dr. Z (Pharmacist) guided his medication regimen. Infectious Diseases monitored him closely to prevent him from getting any infections. Pediatric Gl focused on keeping his liver at its best function. Nurses cuddle and play with him. He was treated more with love and encouraged to take orally, he endured his months of PIC stay away from his family. His mother cannot visit him often because of family issues and work schedule, she was provided with an open visit pass and used it whenever possible.

Qurans are kept on the bedside so that the mother can read them to him during her visits. This absence is compensated by his PIC family. Nurses turned to be his "Mama* or a "big sister*, and a friend to his mother. The Nurse Manager (Eman) brought a sitting chair and toys for him which he is excited to use all the time. There are times that he will be groomed with ordinary clothes which are gifts from the nurses.

PICU team stood beside him as his family throushout his stay. And PIC started to play with H. He was introduced to a routine. During mornings, he will be put on a chair with safety straps and play with him. He enjoys Nursery Rhymes and Prayers from the computer provided to him. Nurses open the windows for him to see the sun. Doctors would greet him more often. Because of this increased human interaction, H became more interactive and looks brightly. He finds joy in cuddles and small walks outside his room. H's PICU stay became enjoyable. We always see his wide smile and bright eyes excited to play and be cuddled. He was then shifted to oral feeds and his tracheostomy was closed.

From a helpless child with multiple complications, he was able to walk out of the hospital in a healthier condition without any tubes. He was a happy child upon discharge. He stayed in the hospital most of it in PICU. Right now, he regularly follows up in the OPD for PT and further rehabilitation. Patient H's narrative is strong evidence of an exemplary practice that improved a patient's outcome. H's condition improved when the team joined hands to make a holistic and multidisciplinary approach. The team not only treated the disease but moreover, took care of H's overall well-being by giving him play therapy, liberating him from medical support, and nursed him with love. H's journey has inspired the PIC nurses to initiate à project for Play Therapy which now helps the team and the patient have a better relationship and achieve a better PIC experience PICU Team went over and beyond on improving this child's life. I have a firm belief that this group of extraordinary people deserves a commendation.