Transitional Care Unit

Miffy Ward is a five-bed Transitional Care Unit at Great Ormond Street Hospital (GOSH) for children of all ages and their families needing long-term respiratory support.

There are a variety of reasons why a child might need this type of care.

Most children will stay on the unit for three to six months while their care in the community is being planned with local authorities. The majority will have come from the intensive care area both internal and external to the Trust.

Key ongoing work is to engage the family and the child (if possible) in long-term ventilation support and training - the final goal is setting them up to discharge them home and back into the community.

There is a small team who work closely with allied health professional input, with emphasis on play, schooling and getting life back to as normal as possible for the child and their family.

Many of these families will be expert in the day-to-day care of their child and the aim is to provide a home-from-home environment in which to nurture the child's best potential.

Jo Bustard, Band 6 senior staff nurse, Transitional Care Unit

Jo has worked at GOSH for five years.

Why did you choose to come and work at GOSH on the transitional care unit?

I trained at GOSH, and now work on Miffy Ward , following an 18-month rotation between here and Badger Ward. I enjoy the nature of the work here - building relationships and a rapport with our families.

Our patients are long-term - they can be on the ward for anything from six months to a number of years so it can be a stressful time. We aim to create a therapeutic and calming environment for them by providing good nursing care and psychosocial support.

What do you enjoy most about working on the transitional care unit?

I enjoy facilitating the progression for children between hospital and home, and helping to show parents there is light at the end of the tunnel (even though at times it doesn't feel like it). I like being able to work out in the community, demonstrating to parents how care can be given in the home and contributing to the training and support of community carers.

We take children out for the day where possible. Most of our patients are reasonably stable, although trachea ventilated, and it is great to see them doing normal activities like playing in the park on the swings. Lots of the babies we care for who were born prematurely have never been home so, when they do return, seeing them in their home environment gives me great job satisfaction.

What types of skills do you need to be a nurse on the transitional care unit?

You've got to be alert as we are always monitoring the safety, wellbeing and development of our patients. We need expert knowledge in respiratory and ventilator care to identify problems at the outset. The ability to persevere and remain encouraging when things get difficult is crucial - having a child who is hospitalised for any length of time is emotionally draining for the family. We need to be able to empathise and appreciate how difficult circumstances might be for them. Sometimes it's just about reaching a happy medium.

Tell us something people might not know about the transitional care unit.

There is a lot of work behind the scenes into discharge planning and the co-ordination of a child's home care package. The ward is more nurse-led than medical, so we have an autonomous role in decision making and liaising in patient care. Play therapy is also an important part of our work here - not many nurses get to spend time assessing and aiding the development of their patients, which can be delayed in a hospital environment.

Did you ever think twice about applying for a role at GOSH?

I'm just like anyone else, I wanted to work here due to GOSH's reputation. I've gained a lot of specialised experience here and would recommend it to any one who wants to go into a specialist nursing role.