by Being a chronic patient is not always easy. And even less so when you start as a child, you reach adolescence, and that implies certain conditions. But, if the same health hand that grabbed you during childhood accompanies you at this stage and does not let go until I have prepared you to move on to the adult consultation, everything is kinder. he ABC Salud 2023 Nursing Award has been for the project “Overcoming the challenges of pediatric transplantation: strategy for a successful transition to adult life” of the La Paz Hospital in Madrid.
This initiative began its journey in January 2022 with a specific follow-up and transition consultation that aims to ensure that the change of adolescents to adult medicine “is not just a folder step”, in the words of María Jesús Pascau and Paloma . Martínez Campos, coordinator and nurse, respectively, of the pediatric transplant transition consultation. “Before it was an exclusively medical transition, now, from this consultation a complete Nursing report is made,” adds Mercedes Hermosilla, supervisor of the Pediatric Transplant Unit and in charge of the Family School, a care training to which Parents of recently transplanted children must attend before leaving the hospital.
There are currently 19 admitted, the smallest, only 2 months old. The most common transplant in childhood is the liver transplant due to bile duct atresia. Supported by the Unit, where 19 nurses and 10 assistants work, María Jesús and Paloma do not let any of their patients go to the adult consultation until they are sure that the young people are prepared and have personally spoken with the doctor who is going to receive them. Sometimes they get it the first time and other times it takes them a few calls before someone answers on the other end of the phone or email. Things sometimes get complicated if the patient is from another autonomous community, a circumstance that is not exceptional, since La Paz is a national reference hospital for children’s liver transplants.
They currently have a 33 young people of transfer age, but in almost a dozen cases they have not yet been able to contact the adult consultation. Age (18 years) is not the only criterion to take the leap. «They must have passed 70% of the transition questionnaires, have clinical stability and psychological maturity enough to move on to adult status,” explains Paloma, who is in charge of organizing the workshops so that adolescents, from 12 years old, understand their condition as transplant recipients, take responsibility for their medication and avoid risky behavior in the future, such as drink alcohol, giving them alternatives. «The teenager does not see the disease nor remember when he had a transplant. They look healthy in the time of risk and they may be tempted to stop medication», points out María Jesús.
In the workshops, they create a climate of trust so that the message reaches. «Our commitment is to give you quality information without misleading you. And they tell you a lot of things. That is success,” says María Jesús.
In this sense, Erika Guijarro, a psychologist at the Unit, who also plays a very important role in this stage, reminds patients and their parents that “there are no limitations but conditions” and that we must avoid overprotection or the subway fear children and adolescents with their health so that they comply with the guidelines. Contact continues with those who are already away, at least for a year, although they know that they will be there whenever they need them.
