Multidisciplinary Orthopedic Care

Melanie Cole (Host): The pediatric orthopedic surgery service at Shriners Hospital for Children – Chicago includes a multidisciplinary team dedicated to the needs of your child through innovative pediatric care instilling confidence and teaching patients that there are no limits to what they can do. My guest today is Molly Grant. She’s a certified nurse practitioner at Shriners Hospitals for Children – Chicago. Welcome to the show Molly. So, give us a little overview of the Pediatric Orthopedic Department at Shriners Hospital.

Molly J. Grant, MSN, APN, CPNP (Guest): Well Shriners Hospital has quite a few orthopedic surgeons with different areas of expertise. We take care of all chronic orthopedic needs that a child with a special diagnosis might need. We also have people, specialists in our plastics department and children that are born with craniofacial differences are cared for by the specialists in our plastics department. We have a third branch that specializes in care of children with spinal cord injury and specialty care that those families and children require.

Melanie: So, among these subspecialties, they are not all really orthopedic in nature, but they can have orthopedic as a sort of a side along issue to whatever it is they have got, yes?

Molly: Correct. For example, a child that is born with osteogenesis imperfecta which is a skeletal dysplasia, one that can cause frequent fractures in childhood and is a specialty that we work with quite a bit at Shriners Hospital. How Shriners is unique is that when a child with osteogenesis imperfecta comes to Shriners, they come to see Dr. Smith and myself who have hundreds of patients with that diagnosis. We are familiar with it. We can anticipate some of the questions they may have and answer those, but if the child also has some craniofacial differences associated with that disease; they can be referred right down the hall to see people that are specialists in craniofacial management.

Melanie: So, tell us about some of the several clinic teams that you work with and your team approach.

Molly: Sure. Well one team that I work with that I think is unique and very important, is the muscular dystrophy team. On muscular dystrophy day, a family comes to Shriners and they would be evaluated by orthopedic surgery, neurology, physical medicine and rehabilitation, physical therapy, occupational therapy, nutrition and also on that day see a team member from our muscular dystrophy association to give them support that they may need outside of medical support but more navigating things, challenges within the home, or within the school or offering extra opportunities designed specifically for kids with muscular dystrophy such as offering sign ups for summer camp, etc. They also get to see a psychologist and a social worker and if there are other needs, such as having their wheelchair tuned; we can help work on that the day of the muscular dystrophy appointment as well. So, it’s a helpful day for families and I think it’s efficient. It’s an efficient use of time.

Melanie: Tell us about nurse practitioners at your hospital. What is the background of a nurse practitioner and what do they do in clinic for families who may see a nurse practitioner or a certified nurse practitioner?

Molly: Well, we have – nurse practitioners have received their Bachelor’s in nursing and then earned a Master’s degree in nursing after that, as part of the Master’s degree, we have worked in clinicals doing specialty care, honing our skills, honing our assessments, honing our understanding of the latest research and then we take a certification exam and obtain that certification and then we have to maintain that certification by keeping up with continuing education and making sure we are applying the most recent research that is out there for families. So, at Shriners, we have quite a few nurse practitioners working with the orthopedic surgeons. I think something that as a nurse practitioner we provide is a more holistic view. I work with orthopedic surgeons and their job is to focus on the orthopedics and making sure that we are optimizing a child’s orthopedic health which I appreciate and agree that is very important. I offer perhaps a little bit broader view and help with cross referrals. An example might be a child with cerebral palsy who is coming in to see the orthopedic surgeon for scoliosis and hip dysplasia, however, I notice on my exam that the child is drooling. I can cross refer to our plastics department because drooling is actually a very big challenge for families. It’s messy and uncomfortable and helps set that child apart from their peers and so if we can also address some of the more simple problems such as drooling; that family has a better life and I think that’s what nurse practitioners are able to do is see beyond just the orthopedic part.

Melanie: What a lovely description of the role of a nurse practitioner Molly. You are also the mom of a patient. Why did you choose Shriners for your care? Please tell us your story.

Molly: Sure, well my son Conrad, he’s the second child of my three children. He’s our biological child. He has a very visible skeletal dysplasia. He has achondroplasia dwarfism and, so he is very small, and his proportions are different than a typically developing child. So, why I chose Shriners is because not is to receive the expert advice and screenings and interventions if necessary from our orthopedic surgery, also all of the fantastic therapies that our team at Shriners offers such as physical therapy, my family has benefited from both physical therapy, occupational therapy and actually from the speech therapists as well. So, because of how accessible Shriners is and because the care is top notch; that is why I chose Shriners Hospital for my child. How I see it impacting my practice is I am able to share with families sometimes strategies on dealing with challenges within society. Let’s say a family member does look very different from their peers and that is a struggle. I can help give advice or suggestions on ways that my family has handled that, and families really appreciate that I have some real-life experience with mobility issues, physical differences and actually living a very full life with a family that has a child with differences like I’m talking about.

Melanie: So, wrap it up for us with what you want people to know about the orthopedics department and specialty orthopedics at Shriners Hospitals for Children - Chicago and your patient experience.

Molly: Well, I am impressed myself with the world class care that the surgeons are able to offer families that require orthopedic surgery. I definitely trust our doctors. I also am very impressed and thankful for all of the ancillary support that patients and my own family has received such as the therapies that I have discussed. When I have been to other specialty hospitals or worked in other specialty hospitals, the wrap around care that families receive at Shriners is not offered the way that it is- to the degree that is offered at Shriners Hospital and it makes a really big difference in how families can function. I think people are very satisfied and I see families returning with smiles on their faces and doing a lot more than they thought they could.

Melanie: Thank you so much Molly, for being with us today and for telling your story to the listeners. This is Pediatric Specialty Care Spotlight with Shriners Hospitals for Children – Chicago. For more information please visit www.shrinerschicago.org, that’s www.shrinerschicago.org. This is Melanie Cole. Thanks so much for listening.