Physicians
The physicians that care for your child during the bone marrow transplant have had specialized training in the care of children and also the bone marrow transplant process. The physicians provide coverage on the pediatric bone marrow transplant area and the pediatric hematology oncology unit. The physicians rotate coverage so while your child is an inpatient, you will meet all the physicians. When your child is discharged, your primary physician will provide follow-up care.

Physician Assistant
Physician Assistants care for patients in both the inpatient and outpatient setting. The PA first becomes involved with the transplant patient when they arrive at the UIHC for their pre-transplant work-up. The PA is then responsible for gathering information about the patient (history and physical), review all the tests performed, write orders, and participate in the marrow harvest in the operating room. While hospitalized, the PA will perform the patient's bone marrow aspirates and lumbar punctures along with participating in daily rounds and assessments. The PA will continue to follow the patient closely in the clinic once they become an outpatient. The relationship between patient, family, and PA will continue for months and even years as patients return for check-ups at the UIHC.

Nurse Manager (NM)
The Nurse Manager is responsible for the supervision of all nursing staff on the unit, and assumes general administrative responsibility for the unit. This includes consultation on clinical issues, assuring appropriate supplies and equipment are available, evaluation of nursing staff performance, infection control, quality assurance and improvement, and management of the unit budget. The Nurse Manager is available and willing to meet with patients and families regarding questions and concerns at any time.

Assistant Nurse Manager (ANM)
The Assistant Nurse Manager serves as charge nurse on the day shift and provides clinical expertise for the unit. The ANM works closely with members of the multidisciplinary team to coordinate your child's care while in the hospital and assists with discharge planning. The ANM works with the NM to assist with unit decisions and to serve as a role model for the nursing staff.

Primary Nurses
The purpose of primary nursing is to provide consistency for your child, you and the nursing staff. Your child will have a primary nurse and 2-3 co-primary nurses. Generally, these staff members will care for your child whenever they are working. Along with care, the primary nurses will also do much of the teaching, work with you and your child on developing a daily routine and schedule if needed. Your primary nurses are also here for patient and parental support -- they are good listeners and may help you with problem solving and coping techniques. Our nursing staff is small, so you will probably get to know many of the staff. Always feel free to express any questions or concerns you may have with your primary nurses or any staff member, or with the Nurse Manager or Assistant Nurse Manager.

Nursing Assistant
Under direct supervision, the nursing assistant assists the nursing team in providing many types of patient care. Nursing assistants help feed, bathe, weigh, change diapers and linens, transport patients, take vitals, and provide play activities with your child. Nursing Assistants may be available on day, evening and night shifts.

Nursing Unit Clerk
The Nursing Unit Clerk performs clerical, reception and related activities to nursing care and service to patients. They are available to help you when needing information or assistance.

Clinic Staff Nurse
The Clinic Staff Nurse generally becomes involved with your child's care prior to admission. When you come for consultation and outpatient work-up, the Clinic Staff Nurse will coordinate your child's consults. After your child's admission to the BMT unit, the Clinic Staff Nurse will work with the inpatient health care team and continue to follow your child's progress.

When your child is discharged, the Clinic Staff Nurse will coordinate your child's clinic visits, including blood draws and infusions. The Clinic Staff Nurse serves as a resource for you, your home health care company, and other health care professionals. When you are ready to return home, the Clinic Staff Nurse will help to facilitate your child's care with your local physician and nurse. Also, the Clinic Staff Nurse will help coordinate any home health care needs which you may have.

Transplant Coordinator
The Transplant Coordinator does just that, coordinate the different things that must come together in order for your child to get ready for transplant. The coordinator will work with the Business Office to obtain insurance approval before your child's admission to the unit. The coordinator, along with the Social Worker, can help you in addressing any financial concerns that you may have. The coordinator will organize any needed donor searching and tissue typing. If your child has a transplant from an unrelated donor the coordinator will be the intermediary for any anonymous correspondence you might have with the donor. The coordinator will schedule your child's pre-BMT work-up evaluations. The coordinator's office can also provide you with general information about the bone marrow transplant process and about the University of Iowa Hospitals and Clinics. This office is set-up to provide you with a central place where any concerns that you may have pre-transplant may be addressed.

Social Worker
Before, during, and after your child's transplant, the PBMT social worker is available to assist you with a variety of services. The social worker can help you become oriented to the UIHC and Iowa City community prior to your arrival. Written and verbal information can be relayed to you about a variety of resources, including air travel options, financial support organizations, maps, housing options, etc. While many of our families stay at the Ronald McDonald House, there are others who prefer an apartment setting. Your social worker can assist you with either of these options. If you are relocating your entire family to this area, your social worker can also assist with registering your other children in local schools or day cares, as well as help with other family needs and/or concerns.

During your child's hospitalization, you may be faced with any number of difficult or stressful situations. At these times, your social worker is available to provide emotional support as well as provide individual/family counseling as desired.

If at any time during or after your child's transplant hospitalization, you are experiencing financial or emotional problems, please feel free to contact your social worker. He/she may be able to help on your behalf, help you creatively problem-solve, or identify appropriate resources to help you resolve your difficulty.

Hospital Tutoring Program
During the school year, approximately September to June, school-age patients are tutored on the bone marrow unit in a classroom. Class is held from 1:00-3:00 p.m. daily, Monday through Friday. Each student is tutored with schoolwork from his/her home school. Volunteers are usually in attendance to assist the certified teacher with the students. Students continue to attend tutoring sessions, even as outpatients, until they are discharged to their hometown.

The hospital teacher is responsible for contacting home schools, writing weekly lesson plans during your child's stay, periodically returning completed assignments and/or scores to the home school, supporting the student emotionally as well as academically, and writing letters to the home school when the student leaves the Iowa City area.

Preschool is also available if there are younger children on the unit.

The tutoring program:

1. Encourages the student to focus on the future.
2. Aids the student in continuing his/her education.
3. Stimulates mental activity.
4. Serves as one part of a multidisciplinary recovery plan.

Child Life Therapy
A Child Life Therapist is available on the unit, usually in the playroom from 10:30 a.m. - 12:30 p.m., Monday through Friday. The Child Life Theapist provides developmentally appropriate play activities for children. Examples of some daily activities include arts and crafts, baking cookies, board games, bingo, listening to music, and story time. Child Life also coordinates parties on patient's birthdays and discharge dates, along with off-unit activities such as bowling and supervised gymnasium visits. Along with fun activities, Child Life is available for psychological support during treatment room procedures. Distraction techniques along with relaxation and imagery methods are utilized to assist your child.

Music Therapy
Through the University of Iowa Children's Hospital, the music therapy program provides services to children throughout the hospital. Group services are currently offered to toddlers and school age patients. Individualized care is provided on a referral basis.

Dietary
The Dietary Department provides nutritious meals and snacks to help the growth and development of your child undergoing a bone marrow transplant. Upon admission, the dietitian completes a nutrition assessment and calculates energy and protein needs for your child. We will ask you to record what your child has to eat and drink throughout the day so the dietitian can complete a daily calorie count. If your child is unable to eat enough calories and protein, CVN (central venous nutrition) and lipids (an intravenous fat solution), or enteral feedings (formula through a nasogastric tube) may be started. Your child's nutritional needs will be evaluated by the nutritionist and medical staff frequently. A small kitchen is available on the unit so that you may prepare special foods for your child if you wish.

Physical Therapy
During a lengthy hospitalization, it is important to remain as active as possible. The goal of physical therapy is to help your child maintain their strength and physical abilities throughout treatment.

Before transplant, a physical therapist will evaluate your child for strength, flexibility, and endurance. Then, the therapist will teach exercises to do while hospitalized to help prevent weakness and maintain strength and flexibility.

If during the transplant process, it is observed that your child is having changes in their physical abilities, a physical therapist will come to the unit and work with them individually. The staff always encourages exercise, at least three times a day, and the physical therapist can help design activities and exercises that will make exercise fun.

Volunteers
Volunteers may be available throughout the week on the PBMT unit. Through play, activities, or just spending time together, your child can develop a special relationship with a volunteer. This time also allows parents to make a new friend or take a break from the unit if they wish. If you or your child is interested in meeting a volunteer, please let your nurse know.

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