By lunchtime Melissa Strickland has seen every child on Koala Ward, found beds for new patients and reassured a string of worried patients.
She is a ward sister at Great Ormond Street Hospital (GOSH) and since 7.30am, when she started her shift, she has been responsible for children being treated for epilepsy, complex craniofacial syndromes, neuromuscular disorders and spinal cord abnormalities.
“The resilience of children is spectacular. I never ever, ever get bored here. There is always a challenge and it sounds really mushy but it’s very healing working here,” she says.
“You see another side of life. When you go home you see people rushing to get on the Tube being grumpy about their bit of space, but there’s another side to life.”
The 48-year-old has worked at the hospital for 20 years and The Independent’s Give to GOSH campaign has been following her since November. Over Christmas, she told how she prepared Koala Ward and its patients for the festive period, adding: “The campaign makes a big difference with research and equipment. It also funds play specialists, and in a children’s hospital I cannot imagine what it would be like without them. We couldn’t manage without them.”
The Independent has followed Melissa’s working day to give an idea of what life is like on Koala Ward. Her day starts with a handover from the night team, when Melissa gets a briefing on each of the 24 children on the ward, which is currently operating at full capacity.
Meet the patients and doctors of GOSH
Meet the patients and doctors of GOSH
1/9 Elliott Livingstone
Two-year-old Elliott is a “cheeky” little boy who has a Thomas the Tank Engine sticker on his Berlin heart machine, which has kept him alive since his own heart failed eight months ago. Elliott has two tubes pumping blood around his tiny body. It keeps him alive but the machine has left him confined to the wards of Great Ormond Street Hospital until a new heart is found
2/9 Melissa Strickland
As the ward sister on Koala Ward, Melissa Strickland leads a nursing team with the challenging job of looking after children with craniofacial and neurological conditions. “You have to have all the skills and knowledge to do this job but personally for me you cannot do it unless you have passion but also compassion,” she said. “You don’t get used to the sad side of things but you do learn to manage it.”
3/9 Amy Willis
Amy Willis carries a discreet black medical bag everywhere she goes. It contains the cutting-edge HeartWare device that is keeping her alive. A smaller, more advanced version of the Berlin artificial heart, it was fitted in April after she was emergency airlifted to GOSH from Alder Hey hospital in Liverpool. The device means that 14-year-old Amy can be home in Flintshire this Christmas while remaining on the heart transplant waiting list. She is doing well but 15 per cent of patients with a HeartWare device or Berlin heart die while waiting for a new heart, so money raised by the appeal will also go to help researchers identify ways to keep children alive while they await transplant
4/9 Myra Bluebond-Langner
Professor Myra Bluebond-Langner represents the vital work of the Louis Dundas Centre for Children’s Palliative Care, GOSH’s world-class centre dedicated to research and care for children with life-limiting illnesses. The LDC is named in honour of Louis Dundas, a four-year-old boy who died in “unspeakable pain” after suffering a brain tumour in April 2008. Its aim is to ensure that no child suffers unnecessarily in their final days. Money raised from The Independent’s Give to GOSH appeal will go to fund the team’s work to manage pain, and also fund vital research into palliative care in children across the whole of the UK. Professor Bluebond-Langner, who heads the research, said: “Paediatric palliative care is a relatively new field where practice has outstripped research. We look to change that.”
5/9 Finella Craig
Together with with Professor Myra Bluebond-Langner, Dr Finella Craig represents the vital work of the Louis Dundas Centre for Children’s Palliative Care, GOSH’s world-class centre dedicated to research and care for children with life-limiting illnesses. The LDC is named in honour of Louis Dundas, a four-year-old boy who died in “unspeakable pain” after suffering a brain tumour in April 2008. Its aim is to ensure that no child suffers unnecessarily in their final days. “One of the worst experiences for a family is to witness their child in pain and discomfort, and for them to feel totally powerless to do anything about it,” said Dr Craig, a consultant in paediatric palliative medicine at GOSH since 2002. Money raised from The Independent’s Give to GOSH appeal will go to fund the team’s work to manage pain, and also fund vital research into palliative care in children across the whole of the UK.
6/9 Rowan Pethard
Like most little boys, Rowan Pethard loves playing football. At the start of 2015 the seven-year-old Spurs fan baffled his doctors in Hemel Hempstead with a string of coughs, colds, tummy bugs, aches, pains and rashes. It wasn’t until quite late on that doctors discovered he had leukaemia. He spent two days in intensive care while he had emergency chemo. He has two years of follow-up treatment ahead. “He’s amazing, a little superhero,” his mum said. “It makes it easier for his father and I and his brother to cope.”
7/9 Martin Elliott
Paediatric heart and lung surgeon Martin Elliott, 64, is one of the longest serving doctors at GOSH, leading groundbreaking research and treating thousands of patients over the past 30 years. His work has bridged the gap between surgery and research with skills ranging from heart-bypass surgery to correcting congenital lung disorders.
8/9 Ralph Frost
For Ralph the hardest thing about having to live at GOSH while he waits for a new kidney isn’t missing his toys. He has plenty of those and can terrorise the nurses by pushing his little red motorbike down the corridors of Eagle Ward. The hardest thing for the six-year-old is battling not to cry out during his nightly dialysis sessions. “It really hurts,” he said. “But the other kids are sleeping and I don’t want to wake them up.” Ralph suffers from nephrotic syndrome and is currently waiting for a kidney from his father, Nick. He’s called the kidney “Chase” and his parents, who have been trained to operate his dialysis machine, hope to be home by Christmas
9/9 Lynsey Steele
The strongest praise for Lynsey Steele, 33, comes from the parents of the children she helps. “The children here wouldn’t get by without Lynsey,” said Ralph’s mother Amie Frost. “If she wasn’t here then we’d have cracked up.” Lynsey’s role, which is funded by the Great Ormond Street Hospital Children’s Charity and will be supported by The Independent’s Give to GOSH appeal, is to help children play and relax, but also to have the difficult conversations explaining their treatment
The day starts with an emotional moment, when Melissa hears that the parents of a seriously ill child have spoken about their child’s shortened lifespan for the first time. Other updates are less challenging, such as a little girl who is “quite feisty this morning”, and is telling nurses to go away, which they take as a good sign.
After the meeting Melissa starts her ward round, but she’s already spoken to many of the patients. She turned up early this morning to meet her patients, some of whom are suffering from epilepsy and can have 100 seizures a day.
One such patient is 11-year-old Henry Green on the “telemetry” ward. He has had several seizures and will be in GOSH for a week being monitored to find out if he is eligible for surgery to improve his epilepsy. Across the corridor a team of neurophysiologists watch live footage of him as he sits on his bed, and they analyse his brain activity.
Speaking about the resilience nurses need to carry out their job, Melissa says: “You can’t stop yourself being upset. If you stop being upset that’s when you have to stop doing the job. But we are in control of our emotions and we don’t sob over people.
“Sometimes you show you have had tears in your eyes and that’s not a bad thing. You have to have empathy otherwise you shouldn’t do the job.”
Throughout the morning teams of doctors from the neurosurgery, neurology, craniofacial, telemetry and ophthalmology departments carry out ward rounds and check on their patients. The ward is full but there are four children waiting to be admitted from elsewhere at GOSH and from other hospitals. Melissa spends much of her time speaking to the hospital’s bed manager and other ward managers trying to juggle beds for patients.
It is already one of the busiest neurosurgery wards in the country and the biggest centre for epileptic neurosurgery in the country, as well as being the largest centre for children needing brain surgery, but it is set to grow next year with the addition of eight beds.
At midday she has a bed meeting – she often skips lunch – and by 4pm when it is time for her to leave the hospital the pedometer on her phone shows she has taken 20,000 steps. It’s the emotional toll that is more keenly felt, though.
She describes her work as dealing with “raw emotion” and says that children and parents trust the nursing team with their “deepest fears”. She says: “As a nurse it’s really important you have resilience for that.”