AT HOME WITH MY FRIENDS
By Candy Goulette
Published Monday, December 1, 2003

RN Susan Rolin holds Paige, 2, on her lap while she interacts with Hunter, 2, who has just gotten up from a nap. The two toddlers attend My Friends Pediatric Day Healthcare Center in Orangevale. Photo by Charr Crail

There was a time when Nancy Giachino worked a shift along side her fellow nurses. Like others, she began her career on a med floor in a hospital. After seeing that path wasn't for her, she earned a public health credential and transitioned to home care, working for an agency. She spent time with patients, assessing and tending, watching changes take place over which she had no control.

In 1991, that changed with the opening of Giachino's own home care business, Always Home Nursing Services in Fair Oaks. For 12 years, Giachino and her staff brought loving care to home-bound seniors, AIDS patients, post-cardiac rehab patients and those with terminal illness, and provided respite to caregivers. But it was the medically fragile children her nurses cared for that really moved Giachino, and the idea for My Friends Pediatric Day Healthcare Center was conceived.

Working with the state department of health, Giachino drew up plans for a combination preschool, daycare center and pediatric healthcare facility.

"The My Friends facility meets or exceeds the numerous stringent facility and personnel requirements as specified by the State of California's Department of Health," Giachino said, "and we are a fully licensed Pediatric Day Health and Respite Care Facility."

Licensed staffers, either registered nurses or licensed vocational nurses, are on hand at all times to administer medications or perform treatments. Certified Nurse Aides, called Personal Care Attendants at the center, are there to assist the nurses in giving every child personal attention.

"All of our staff have pediatric experience and enjoy the rewards of working with special children," Giachino said. "And for children who receive private tutoring or therapy, there is space set aside for these professionals as well."

After nearly a year in the planning stages, the center was "born" in 2002. Like many of the children it cares for, its birth was a little premature.

"We were all licensed, had been inspected and were all set to go, and our official opening day was a few weeks away," Giachino said. "But our little Johnnie needed a place to go, so we opened up just for him."

Johnnie is now the unofficial "king" of the center. He's spent half his short life there, his weekdays under the watchful eye of Giachino and her staff. Registered nurse Susan Rolin is the nursing manager for both Always Home and My Friends. She admits the managerial side of her job keeps her from spending as much time as she'd like on the floor with her little charges - literally. On a recent visit to the Orangevale center, Rolin rollicked on the floor with Johnnie, helped little Paige find a toy to play with and checked Hunter's respirations while checking out the spider decorating the tummy of his play suit.

"Because of the nursing shortage, it's sometimes difficult to find nurses who want to work at home care, "Rolin said. "My Friends gives parents another option that they didn't have before for care for their medically fragile children."

Rolin notes that chronically ill children who are cared for at home miss out on the social interaction their well-bodied counterparts get from day care, preschool or gymnastics lessons. It's something most parents take for granted, she said.

"Kids here learn socialization, sharing and the same things other kids learn in regular day care," she said. "At the same time, they receive physical therapy, speech therapy, vent care, tube feeding - whatever is medically necessary for them. It's a complete day."

Rolin said children who are approved for home care can receive the same care at My Friends. And if the care is covered at home by insurance, it will be at My Friends as well.

"Any condition that would warrant a licensed need qualifies," Rolin said.

Not all children come every day like Johnnie does. Some come a few days a week to give their parents a break while others come just for after school care. Students in the San Juan district are bused to the center while those in other districts are picked up by the center's van.

And while it looks like learning fun and games for the kids, there is plenty of nursing care taking place. Each child is given a hospital-type ID tag when they arrive, and vitals are taken. Meds are checked in and nursing notes are recorded. Except for the setting, it could be a peds unit in a hospital. PCAs keep their charges entertained, on task and working smoothly with the other children.

Simone Giachino, Nancy's son, has been working at the center on and off since it opened. After earning a Bachelor of Science degree in business, Simone worked for Ernst and Young in San Francisco before coming home to be part of the business he had been surrounded with since childhood. He manages the financial end of the business for his mom, but says he enjoys his time as a PCA with the My Friends kids the most.

Kim Mays has been working for Nancy Giachino for nearly 3 years, first at Always Home, now at My Friends. Her son, Gregory, helped her choose working with medically fragile children. A former Bank of America employee, Mays said her son was born with some problems, and she took him home trac-dependent. She had to quit her job, and learned first-hand how difficult it is to parent a child that really needs 24-hour care. As Gregory out-grew his problems, Mays started looking at ways she could use her new knowledge for other parents.

"You do what you have to do," she said. "And when he got better, I said I would provide respite care for other moms. Then when My Friends opened, it was a perfect fit. I'm not much of a morning person, but the thought that the kids need me gets me out of the bed."

Mays enjoys her work so much that she often clocks out and stays around to visit with the "big kids" who come in after school.

"I just love being with them," she said with a smile. "I love the babies during the day and the big kids after school. It's really a lot of fun!"

Mays lives in Elk Grove and could transfer to the newly opened My Friends there, but says she'd miss the babies she tends in Orangevale. It's a sure bet they'd miss her, too, if the delight in their little faces at the sight of her is any indication.

	Hunter sits through his daily nebulizer treatment for asthma. Photos by Charr Crail

	15-year postal service employee Brad Simmons greets Hunter, left, and Johnnie on his rounds. The boys enjoy being part of his daily routine. Simmons, father of a young daughter, also enjoys the interaction, noting his "heart goes out to them."

	PCA Kim Mays snuggles baby Naomi as she has a bottle. Born with a cleft palate and development disabilities, Naomi, now 9 months, has difficulty with sucking. Mays uses a specially adapted bottle to help the baby get nourishment.

	Nancy Giachino, RN, PHN
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