A Day in the Life

Kayla Huey, BSN, RN, SANE, is the first nurse hired to work in the Madlyn K. Abramson Emergency Department (ED) at the Middleman Family Pavilion, CHOP’s new hospital in King of Prussia. This is a day in her life.

By Zan Hale

5:30 a.m.

The alarm goes off and, after a quick breakfast, drives from her home in Douglasville, Berks County, to King of Prussia. At 25 minutes, it’s a much shorter drive than when she worked at the Philadelphia Campus ED during her training.

6:50 a.m.

Arrives for her 7 a.m. to 3 p.m. shift. She is responsible for four rooms that are across the hall from each other.

7:05 a.m.

At the morning huddle, learns that after a busy night with 97 patients, there is only one child currently being treated.

7:08 a.m.

Makes sure each of her rooms is fully stocked. “I like how the rooms have natural light,” she says. “And I love the murals. If a patient is having a scary procedure, you can use the mural for guided imagery to calm them.”

7:21 a.m.

Her first patient is a 4-year-old boy with a croupy cough and a history of asthma. “A large percentage of our patients have some sort of respiratory problem.” The doctor prescribes ibuprofen and a steroid that opens inflamed upper airways. Heads to the medication room and scans each medicine, which automatically cross-checks it with the doctor’s orders in the patient’s medical chart.

7:27 a.m.

Alarm on her phone squawks. The child’s monitor registers an abnormal heartbeat. She races in to find the pulse oximeter had fallen off and the child is fine.

7:37 a.m.

Crushes the steroid pill and puts it in apple juice for the child to take. Dad is thrilled to be able to bring his son to King of Prussia, a 20-minute drive from their home in Royersford. “With three boys, we were in the Philadelphia ED frequently. This is so much more convenient.”

8:08 a.m.

Second patient is a 14-month-old boy who’s having trouble breathing and is being treated for a double ear infection. After the doctor’s exam, suctions mucus out of the child’s nose, which is not popular with the boy. To help soothe him, goes to a Child Life cabinet to retrieve a toy for him to play with.

8:55 a.m.

After the doctor orders a breathing treatment for the 14-month-old, calls child life to help out. “Given how upset he was with the suctioning, I think a distraction during the breathing treatment will help him a lot. Child life specialists are my favorite people in the whole hospital.”

9:25 a.m.

An 11-year-old boy comes in with stomach pain. Doctor orders an X-ray, and he is whisked off to Radiology, which is adjacent to the ED. He’s back in five minutes. Diagnosis is constipation.

10:20 a.m.

A 5-month-old boy with shortness of breath is placed in one of her rooms. His mother reports a fever and coughing since yesterday. As if on cue, the baby has a coughing fit.

10:30 a.m.

Back to see the 14-month-old. The breathing treatment is done, and he’s calmer. Lowers the lights so he can sleep while the medicine kicks in.

10:43 a.m.

A patient requires a rapid test for COVID-19, flu and RSV. Luckily, one nasal swab can be used for all three tests. Carefully explains what she is going to do before swabbing and has the child count along with her: “1, 2, 3, 4, 5.” Sends the swab in a green “rapid test” bag to the lab on the third floor via a pneumatic tube.

10:50 a.m.

Prepares to hand off her patients to the next nurse covering those four rooms. Quickly summarizes status of each patient and family — “mom in room 24 is pretty nervous” — before moving to the position of triage nurse for the final four hours.

11:05 a.m.

At the front desk, she’s the second stop for patient families, right after they register. Triage nurses assess the severity of each child’s illness.

11:23 a.m.

Two families enter: one with a boy who fell off his bike, the other with a 3-month-old girl who is wheezing. They are followed by an 8-year-old girl with asthma, who arrives after CHOP Allergy sent her to the ED because her usual medication is not easing her asthma flare. “I’m so glad this hospital opened,” says her mom. “The Philadelphia hospital is actually about 5 miles closer, but this is a much easier drive.”

11:50 a.m.

A teen girl with a persistent migraine arrives, followed over the next hour by a teen boy who has trouble urinating, a 2-year-old with a stomach bug, a 5-week-old with nasal congestion and a 7-year-old with a sore throat that has lasted four days.

1:03 p.m.

With all treatment rooms occupied, brings an 8-week-old girl who has been vomiting into Triage Room A, one of three right behind the front desk.

1:33 p.m.

For a Spanish-speaking family whose 14-month-old son has fever, uses an iPad linked to a live Spanish language interpreter.

1:50 p.m.

Next patient is a 5-year-old boy who fell face-first on the playground. In Triage Room A, his mom explains he has ADHD and sensory issues. Takes extra care to ask each time before touching the child to take his temperature and blood pressure. Time for ibuprofen to help with his pain and swelling left cheek: “This will help you feel better, buddy.”

2:32 p.m.

A teen girl being treated for brain cancer comes in with a severe headache and vision problems. As a Level 2, the second-highest priority, she is immediately taken back to the one open treatment room as her mother, in a practiced, calm voice, recites the symptoms and recent CHOP Cancer Center visits.

2:45 p.m.

\Chats with her fellow nurses during a breather in the steady flow of patients. “I like the community hospital feel of King of Prussia. The core staff gets to know each other.” Shift ends. Clocks out and heads home.

4 p.m.

Arrives home and works on an assignment for the Master of Science in Nursing class she’s taking at Alvernia University.

6:30 p.m.

Dinner with her husband and a couple hours of reading before bedtime at 10 p.m.