HAWAII AT WORK
DENNIS ODA / DODA@STARBULLETIN.COM
Rodney Aquino is a registered nurse who has been working at the Queen's Family Treatment Center since it opened in 1998. Above, Aquino showed off one of the center's "sensory rooms," where patients are taken sometimes to help them calm down. Aside from the stunning illustrations on the wall, things in the room include an aquarium and toys.
A different perspective
Rodney Aquino tries to get troubled youth to look at the world more positively
Title: Clinical nurse IV
Job: Works with patients and supervises staff at the Queen's Family Treatment Center
Rodney Aquino almost selected a career in business but, he said last week, he liked the idea of helping people and nursing seemed to him a better way to do it.
So Aquino started taking nursing courses at Kapiolani Community College, during which time he also worked as a unit clerk at Kapiolani Medical Center for Women & Children. After obtaining his LPN (licensed practical nurse) degree, Aquino joined the Rehabilitation Hospital of the Pacific, where he worked part time helping head-injured patients. He also continued in college, attending University of Hawaii, where he earned a bachelor's degree in nursing and then a master's degree in public health.
Aquino continued working part time at the rehab hospital through 2002, even after joining the Queen's Medical Center, in 1993, initially in its adult behavioral health unit. In 1988 he joined the newly opened Queen's Family Treatment Center, where he started as a staff nurse, then two years later was made a charge nurse, or supervisor, of its day-shift staff of about 10.
A Queen's spokeswoman said last week that the center is a 28-bed inpatient facility established 10 years ago to "better care for and meet the short- and long-term behavioral health needs of youth under the age of 20.
Because of his close work with youth, Aquino also for the past two years has been a member of the state Suicide Prevention Task Force, headed by Art Tani of the state Department of Health.
Aquino moved to Hawaii in 1988 after living in Virginia for two years with his sister, Vickie Aquino-Jackson, who coincidentally now also lives in Hawaii and also works in the Queen's health system, as a surgical technician. Both are originally from Guam, where he graduated from Simon Sanchez High School in Yigo. They also both attended Old Dominion University in Virginia, before moving to Hawaii.
Rodney is 39 and with his wife, Gloria, has two children -- a daughter whose fourth birthday is today, and a 10-month-old son. They reside in Mililani.
DENNIS ODA / DODA@STARBULLETIN.COM
Rodney Aquino is a charge nurse at the Queen's Family Treatment Center, a 28-bed inpatient facility that provides care for youths with behavioral health needs. Above, Aquino confers about the progress of a patient with colleagues Cathy Bell, left, medical director of the center; clinical social worker Anna-Maria Beck; and psychiatrist Barry S. Carlton.
What is your title?
Rodney Aquino: My title is actually the charge nurse.
Q: What's that?
A: Basically, each shift has a charge nurse, and they run the milieu, ... the environment.
Q: And what would be the environment?
A: It would be like the unit, the personnel, the clients ... the day-to-day operations.
Q: Are the people at the Family Treatment Center considered patients or clients?
A: We use them interchangeably. One person may use them as a client versus a patient, but it is an inpatient unit.
Q: Which means what?
A: It's where the patient gets admitted to our unit from various sources -- from the ER (the emergency room), from the community ... Sometimes we do get direct admits, like someone is having trouble on the outside at the doctors' office, and the doctors would call our doctors and then we make arrangements for them to come over.
Q: So are they really sick or was it their behavior that got them committed?
A: Yeah, a lot of time there could be stressors that the youth is experiencing and he or she needs assistance. They could overwhelmed. Their families could be overwhelmed as well. They could need a break from one another sometimes.
Q: What's the average age of the clients?
A: We have a child and an adolescent program. So a child would be anyone 11 and below, and adolescents would be 12 and above.
Q: Up to what age?
A: Eighteen. It gets tricky sometimes. If they're still in the DOE (state Department of Education) system, we can take them, if they're still in school.
Our unit is an acute program, which is more for stabilization.
Q: What -- like some kid's freaking out?
A: Yeah, or they come in with, like, suicidality.
Q: Suicidality? They're threatening to kill themselves?
A: Yeah, They're threatening to kill themselves, they're depressed, they're engaging in disruptive behaviors at home; it could be substance-induced behavior -- they're not really perceiving the same thing that we're perceiving.
Q: How long is the average stay of these kids?
A: The average stay for acute is anywhere from three or four days to seven days.
Q: And what about generally?
A: The average stay for those people is about one to three months. They're here, for example, because of what's happening in school -- they're not doing too well, or they're fighting, skipping school, whatever it may be, they're referred here, and we're one of the highest levels of care in the state when it comes to this type of care, because it's hospital-based.
Q: Are they there as a form of legal punishment?
A: No, no. I would say no. It's not a legal punishment. We pride ourselves on being a treatment facility. It's best practices, it's a collaborative effort, with the team. Trying to link them up with resources. All of our approaches are strength-based.
Q: So who's the team?
A: The doctors, the social workers. ... We have recreational therapists, occupational therapists, we have nurses, we have psychiatric assistants, and then also we have our teachers.
Q: Why do you need a nursing background to work at the Family Treatment Center?
A: Again, this is the highest level of care and they do need nurses around the clock.
Q: What kinds of things do you do each day as a nurse at the center?
A: Shoots, I have many hats here. For a lot of these kids, my main challenge is trying to get their trust and reliance, so we can deal with some of the core issues that they're having to deal with. It may be tossing the ball with them, just to talk story, just to get them comfortable. It could be music; it could be watching TV. Or just talking about their favorite foods, how they make this and that, and just getting their reliance and trust. We try to develop that over time, and we look at things they've been doing that are less optimal and got them in trouble at times.
Q: So this is somewhat psychological.
A: Yeah, that would be a major portion -- trying to get their trust and build rapport.
Q: Did you take a lot of psychology classes?
A: I took the basics, but every day is learning for me. I learn from patients, I learn from peers, the doctors, the team.
Q: Do you ever have to administer drugs?
A: Yeah, that's another hat I wear. I have to educate them about their medication, or their illness. They might say, "Why am I taking these pills?" Or "Why do I feel like this?" "Why do I think like this?"
Q: Your title is nurse. But it sounds more like coaching.
A: That's another hat you wear. You try to be their mentor.
Q: So where does the medical come in?
A: The medical would be like education stuff. Our first intervention is to gain the rapport, then the second is educational -- to get them to look at their coping skills and see if they can utilize something more positive.
Then we do have kids that come with medical issues, like diabetics, or they got into a car accident, or the brain changes after they used ice too much.
Q: Do you ever have to help clean or bathe any of the patients?
A: A lot of times we stress the importance of hygiene, and if they need assistance, we help them. But mostly these guys are quite independent. It's just a matter of emphasizing their priorities. But there are some, on occasion, where they need complete assistance because either they're too psychotic or they're too delusional and they can't take care of their hygiene at this point.
Q: What kinds of hours do you keep for the job?
A: Mostly day shifts; eight-hour shifts.
Q: Monday through Friday?
A: No. We do some weekends. Every other weekend.
Q: As charge nurse, how many people are you in charge of?
A: On a particular day, I'd say about 10 staff members.
Q: Do you have a lot of paperwork everyday?
A: (Laughter) Yeah, there's a lot of paperwork. There's tons of paperwork.
Q: Like about what?
A: Documenting their behaviors. We are a medical facility, so in order to get reimbursed sometimes we need proper documentation. Also it's for better communication between the two shifts, so the night shift knows what's going on.
Q: What do you like best about the job?
A: I think the best part of my job is you can make a difference in a person's life. You're outside doing things that you used to do, like throwing the ball, or you're cooking. It's a great job, trying to get their trust in life. And hopefully you can steer them the right way. You know, instead of doing it this way, why don't we do it this way.
Q: So are you basically trying to help them avoid getting arrested?
A: There's a lot of things. It can be legal issues, their psychological state. They can be unstable psychologically. There can be a lot of turmoil at home. So I just try to give them more choices.
Growing up isn't what it used to be. I'm sure when I was growing up it was totally different from what these kids are experiencing. I'm on this suicide-prevention task force with the state, and Hawaii's youth rank pretty high in suicide compared with other states.
Q: Why do you think that is?
A: Just the dynamics here in Hawaii. It's not like you can just jump in a car and drive off. It's a high cost of living, less resources. Back when I was growing up, the neighbors would help out, but now people have two or three jobs and the communities just aren't the same.
Q: Anything you don't like about your job?
A: You know, I tell my wife that this is a selfless and yet selfish job. When I come to work, you try to give it all you got, 110 percent. But then when you go home, you gotta take care of yourself. It's that old adage that to take care of someone else, you have take care of yourself. I've seen too many nurses get burned out because they take their work home, or they pound their heads saying "I don't know why this guy is doing this," or whatever. But there's only so much we can do for these kids. All we can do is give them choices.
Q: Have you formed any long-term friendships with any of them?
A: The greatest gift that can happen is you see them outside. You're with them here for only a brief moment of time. But sometimes they remember you.
I saw one former patient at McDonald's the other day and she told me she wanted to become a nurse. And you get those postcards or notes saying they've graduated from high school or college, and they're thanking you for what you've done. It's great.