Nurse Recalls 40 Years of Kids' Care at UCSF Children's Hospital

"Do you remember me?" After 40 years as a pediatric surgical nurse and administrator at UCSF Children's Hospital, Inez Wieging has memories to spare. But it is these searching moments -- literally questioned by an adult stranger who clearly recalls her with affection -- that both test her memory and sharpen her sense of worth. "I've probably taken care of a thousand kids during my UCSF career, and every time one of them returns years later to thank me, I'm reminded of the bonds that keep us connected." In four decades, surgical techniques, technology, medications, length of stays and the practice of nursing itself have all changed. Emotions, rooted in a medical crisis, have not. "I took care of our first kidney transplant child in the late 1960s, back when these kids had to stay in the hospital for months. Now they're home in a week. It doesn't matter though. Kids are the same little fun creatures as always," Wieging laughs. Learn more about what else has changed by watching a video clip of Inez Wieging. Expectations of nursing standards remain high as well, Wieging adds. "Pediatric surgical nurses still need to be the eyes and ears of the doctors, who are busy in the operating rooms. That is a given." One other distinction is the relationship with families, which both enriches and complicates care in a Children's Hospital. Caring for a child, after all, puts nurses into a role normally occupied by parents or other family members, who, while welcoming the expert help, can still feel displaced. There is a healing chemistry in most families that the best nurses catalyze easily, Wieging explains. Call it a loose atomic bond, the kind that encourages a close affinity but not a rigid connection. "We help families cope with terrible situations. And when you do bond with a child, you still have to acknowledge that the child is not yours. As hard as it is sometimes, you must learn to keep a certain distance." Keeping your distance does not mean keeping still when your instincts tell you that something is wrong. "We all keep a close eye on the child's vital signs and check how a wound is healing, but there is something else that sometimes happens, a sense that something is not right," says Wieging. You can see it the moment you walk into a child's hospital room, she adds. "These kids have a look in their eye and a particular kind of listlessness." Is this sixth sense usually accurate? "Usually," Wieging responds with little prompting. A neglected child - mysteriously more common these days than earlier in Wieging's career - also triggers a protective response; Nurses are often the first to alert social workers to a family's disengagement and disinterest. The sad truth, of course, is that sick children, no matter how well cared for, sometimes die. Length of service at UCSF does not soften that blow, Wieging admits, as she pulls out a photograph of a four-year-old Saudi boy -"my special boy," she calls him -- who died in 2005. "He always used to say to me when I would arrive in the morning, 'Mama nurse, you come back.'" Mama Nurse truly has been a fixture at UCSF's Children's Hospital, serving as a staff nurse from 1966 to 1980 before moving into the administrative ranks. She now is the pediatric medical surgery patient care manager, a position from which she will retire in the fall of 2006. Soft spoken as she is - and as proud as she is of the high quality of care provided by the 45 nurses she supervises at UCSF Children's Hospital -- Wieging makes no apologies about what needs to improve. "We need a separate Children's Hospital building so that when a nurse says 'I need this,' everyone on staff - from top to bottom -- will know that it is for sick kids." While the current hospital-within-a-hospital setup on Parnassus Heights has its advantages, Wieging believes that the large medical center culture inevitably treats children as "little adults." "We always go the extra mile for our kids," says Wieging. "But the truth is that children have special needs, everything from kid-sized scales and carts to equipment cuffs and calibrated nutrition. And they need lots and lots of wagons." Nurse-to-patient ratios should also differ, Wieging insists, from one nurse per four patients to one nurse per three patients on pediatric wards. More support for families is also on her new Children's Hospital wish list. And what happens to this wish list when her voice goes silent in September? "'I'm planning to leave my phone number behind."