- Kayce Morton
1. You helped start the pediatric sedation program at CoxHealth—what were the biggest challenges, and how did you overcome them?
I started at CoxHealth with my mentor, he had been sedating kids occasionally but once I was able to start we decided we wanted to make it a service for our patients. Patients would wait 4-6 weeks to get needed MRI’s or procedures. So we went to administration and asked for some additional training, starting with a sedation course, researched other programs. I had known I was going in to hospital medicine so I had done some training end of residency but I additionally did some anesthesia time to get on better terms with our anesthesia department. We easily got buy in from our administrators, as anesthesia didn’t want to do them. The biggest challenge in developing a process that works was figuring out who this truly belonged to, once we had proven our need we had to get combine our pediatric department with our radiology department as although we are doing the sedation the radiology department makes money on the actual procedure/test a process was born. So it only made sense to have our pediatric sedation nurses to switch from our department to radiology which was a big adjustment, but it has been a good transition. We have had several moves but we have actually found our own space within the hospital, and we now have dedicated nurses, a separate shift for scheduled and emergent sedations. We do the scheduled sedations on Monday and Wednesday and have swing coverage for emergent sedations through the week and other outpatient procedures. We utilize the radiology sedation nurse but also cross train our floor nurses for back up and for when the peds sedation nurse isn’t available. It is a great opportunity for our community kids and helps keeping kids from driving 3 hours to get a sedated procedure or test.
2. Through your church, you participate in a program called “Cents of Pride.” Can you tell us more about this program?
I have in the past been involved in our previous church program Cents of Pride, it is a non-profit organization that has different sponsors such as our church that sponsor schools. It is basically positive behavior program that our church donates to a “store” which is made up of food, clothing, hygiene products, toys, books and many other items. Some donated by people and some stores that would give. If the child had a good day or did something kind or out of the ordinary they got behavior bucks, 1$ and some golden 5$, the child would have allotted time each week to browse and decide if they wanted something. It helped them learn how to earn and manage their money. What struck me in this is how many kids chose food over toys or gadgets. Some kids also got socks or mittens because they didn’t have any, one year it was heart-breaking to see a kindergarten student in the middle of a very cold winter, pick up mittens and ask what they were, she had never had any or even knew they could help keep her hand warm. Volunteers would organize store, run it and help run the kids around. I have since moved to working at our local crisis nursery Isabel’s House, I am a board member and we fund raise and help families in the community that just can’t take care of their families due to many different circumstances whether it is substance abuse, homelessness or illness and keep their kids from going into the system. I am honored and blessed to live in a such an amazing community with so many great options for our community to develop resilience amongst adversity.
3. Having met with government officials and lobbied for children, what advice do you have for hospitalists who want to get more involved with advocating for children?
I encourage hospitalists to find a local group and start learning who their local legislators are, network and develop relationships. I am fortunate to be involved with our MO AAP chapter , they sent me to the national AAP legislative conference in Washington D.C., which was very eye opening as well as inspiring. It helped me to learn how to find out what the issues are easily, learn what the opposition is and how to talk about it with people that mattered. I still have the jitters and get all nervous talking to politicians but I think that’s because I know how important the issues are to our patients. Other than AAP there are other local medical groups that network and work with local legislators. I joined our county medical society which has given me so many opportunities to talk with legislators, give them my time to answer their questions on medical issues as well as made myself a reliable resource to them when needed as well.
4. You are also very interested in trauma informed care and spreading trauma awareness. Please share more with us about one of your passions.
As a pediatrician we innately know and learn that preventative care is key in producing healthy adults, but I don’t think I got how much our childhood truly impacted our health. When I joined Isabel’s house as a board member one of the first events I went to was the a film debut of Resilience during Child Abuse Awareness Month. It was life changing for me. I was flabbergasted that there was this research and that it was well known about Adverse Childhood Events and the effects of toxic stress or trauma on our lifelong health. I think as we go through med school and residency and although we learn so much, and we still want to be doctors the one thing I also learned was judgement and lack of sympathy for patients or their parents. What I learned from that movie and my own further research, is there is so much more to a patients families story and I became a physician, particularly a pediatrician to play a part of that journey. Sometimes that journey involves helping families that are victims of toxic stress and are repeating a cycle but helping them understand how toxic stress has affected them as a person and a parent. We have to start with changing the relationships for our patients to change the cycle. I personally came from a traumatic childhood, my ACE score is elevated and I overcame this but it took a step up and support, and now it has shifted my personal and professional goals, to help my patients find that.
5. As a member of the Board of Directors for the Missouri Chapter of the AAP, tell us how you got involved, and what advice you have for young hospitalists that want to get more involved with their state AAP chapter.
Ever since college I have enjoyed being involved in groups that help make things better. In residency I was lucky to get invited and participated in AAP residency committees, so when I started practicing, I needed a break to find my groove, take my boards so I stepped away from a lot of outside activities. One of my local colleagues was still involved in MOAAP invited me to a dinner and I learned that the chapter had a lot of resources to help and connect people. I then applied for opportunity to go to the legislative conference with the chapter and my love and enjoyment of the advocacy part I had participated in previous to practicing was re-ignited. Within a year or so I joined the communications committee and thereafter was nominated to become the communication chair. I helped with social media and the newsletter, and it has led to my activity and a lot of open doors that have not only helped me but my patients and colleagues. The best thing to know as a young hospitalist is you don’t have to do everything but when you give a little time you may find that it isn’t as much of a commitment as it is a connection that help you develop into a better physician. I feel so fortunate to be in a field and have the AAP that have led the way on how to advocate for our patients and ourselves.
6. You are also the president of the Greene County Medical Society. What is your role with them, and how do you manage your time with your many responsibilities in addition to practicing medicine and having a family?
I joined GCMS because I was asked to, I didn’t really know if I would like it or what it would entail. I just knew that it was an hour a month early morning and worked with my schedule. I joined right after I had returned from the AAP training on tobacco, which I had done for one of my upcoming VIP projects. I learned about Tobacco 21 at that conference and came back on a mission. After joining GCMS, I found support and leverage with my local physicians as well with my local health department. All the health department had really needed was a physician champion, and about a year in a half later we got it to pass and I had all the physicians from GCMS when the city council passed Tobacco 21. I was then nominated as president and saw why local medical societies were impactful. MO AAP and AAP are as well but it is very different when you are trying to get something done in your own area. It also has helped me connect with those outside of my hospital system and feel more like part of a complete medical community. My responsibility as president is to connect physicians and continue to advocate for our medical community. Currently I am working with for medicaid expansion and have been involved in the COVID19 planning with our health department. I have had to say no, like stepping down as our hospitals pediatric section, and that was honestly really hard but it was important to move forward. I make sure that what I am involved with benefits me and currently my different positions and groups intermix which is beneficial to my job and my community. My family understand and actively participate in some of my functions/activities. I still am able to keep up with my family and kid activities and it can be a juggling act but it keeps me motivated and I truly enjoy it.
7. Jack Percelay often ends his list-serve commentary with the phrase “that’s just my 2 pennies.” What are your two cents?
That is quite a lot to live up to as I don’t truly have “phrase” so here is my recurring theme that I feel is always relevant.
In my passion for trauma, it is important in recognizing the importance that small changes can make a big difference. So I like to approach teaching on toxic stress and trauma to our residents, patients and staff that we can help patients by simply asking one question, what is your greatest concern? Now apply that question to yourself, your staff and your colleagues. It’s a simple question that can lead to life-transforming care and personal wellness.
I started at CoxHealth with my mentor, he had been sedating kids occasionally but once I was able to start we decided we wanted to make it a service for our patients. Patients would wait 4-6 weeks to get needed MRI’s or procedures. So we went to administration and asked for some additional training, starting with a sedation course, researched other programs. I had known I was going in to hospital medicine so I had done some training end of residency but I additionally did some anesthesia time to get on better terms with our anesthesia department. We easily got buy in from our administrators, as anesthesia didn’t want to do them. The biggest challenge in developing a process that works was figuring out who this truly belonged to, once we had proven our need we had to get combine our pediatric department with our radiology department as although we are doing the sedation the radiology department makes money on the actual procedure/test a process was born. So it only made sense to have our pediatric sedation nurses to switch from our department to radiology which was a big adjustment, but it has been a good transition. We have had several moves but we have actually found our own space within the hospital, and we now have dedicated nurses, a separate shift for scheduled and emergent sedations. We do the scheduled sedations on Monday and Wednesday and have swing coverage for emergent sedations through the week and other outpatient procedures. We utilize the radiology sedation nurse but also cross train our floor nurses for back up and for when the peds sedation nurse isn’t available. It is a great opportunity for our community kids and helps keeping kids from driving 3 hours to get a sedated procedure or test.
2. Through your church, you participate in a program called “Cents of Pride.” Can you tell us more about this program?
I have in the past been involved in our previous church program Cents of Pride, it is a non-profit organization that has different sponsors such as our church that sponsor schools. It is basically positive behavior program that our church donates to a “store” which is made up of food, clothing, hygiene products, toys, books and many other items. Some donated by people and some stores that would give. If the child had a good day or did something kind or out of the ordinary they got behavior bucks, 1$ and some golden 5$, the child would have allotted time each week to browse and decide if they wanted something. It helped them learn how to earn and manage their money. What struck me in this is how many kids chose food over toys or gadgets. Some kids also got socks or mittens because they didn’t have any, one year it was heart-breaking to see a kindergarten student in the middle of a very cold winter, pick up mittens and ask what they were, she had never had any or even knew they could help keep her hand warm. Volunteers would organize store, run it and help run the kids around. I have since moved to working at our local crisis nursery Isabel’s House, I am a board member and we fund raise and help families in the community that just can’t take care of their families due to many different circumstances whether it is substance abuse, homelessness or illness and keep their kids from going into the system. I am honored and blessed to live in a such an amazing community with so many great options for our community to develop resilience amongst adversity.
3. Having met with government officials and lobbied for children, what advice do you have for hospitalists who want to get more involved with advocating for children?
I encourage hospitalists to find a local group and start learning who their local legislators are, network and develop relationships. I am fortunate to be involved with our MO AAP chapter , they sent me to the national AAP legislative conference in Washington D.C., which was very eye opening as well as inspiring. It helped me to learn how to find out what the issues are easily, learn what the opposition is and how to talk about it with people that mattered. I still have the jitters and get all nervous talking to politicians but I think that’s because I know how important the issues are to our patients. Other than AAP there are other local medical groups that network and work with local legislators. I joined our county medical society which has given me so many opportunities to talk with legislators, give them my time to answer their questions on medical issues as well as made myself a reliable resource to them when needed as well.
4. You are also very interested in trauma informed care and spreading trauma awareness. Please share more with us about one of your passions.
As a pediatrician we innately know and learn that preventative care is key in producing healthy adults, but I don’t think I got how much our childhood truly impacted our health. When I joined Isabel’s house as a board member one of the first events I went to was the a film debut of Resilience during Child Abuse Awareness Month. It was life changing for me. I was flabbergasted that there was this research and that it was well known about Adverse Childhood Events and the effects of toxic stress or trauma on our lifelong health. I think as we go through med school and residency and although we learn so much, and we still want to be doctors the one thing I also learned was judgement and lack of sympathy for patients or their parents. What I learned from that movie and my own further research, is there is so much more to a patients families story and I became a physician, particularly a pediatrician to play a part of that journey. Sometimes that journey involves helping families that are victims of toxic stress and are repeating a cycle but helping them understand how toxic stress has affected them as a person and a parent. We have to start with changing the relationships for our patients to change the cycle. I personally came from a traumatic childhood, my ACE score is elevated and I overcame this but it took a step up and support, and now it has shifted my personal and professional goals, to help my patients find that.
5. As a member of the Board of Directors for the Missouri Chapter of the AAP, tell us how you got involved, and what advice you have for young hospitalists that want to get more involved with their state AAP chapter.
Ever since college I have enjoyed being involved in groups that help make things better. In residency I was lucky to get invited and participated in AAP residency committees, so when I started practicing, I needed a break to find my groove, take my boards so I stepped away from a lot of outside activities. One of my local colleagues was still involved in MOAAP invited me to a dinner and I learned that the chapter had a lot of resources to help and connect people. I then applied for opportunity to go to the legislative conference with the chapter and my love and enjoyment of the advocacy part I had participated in previous to practicing was re-ignited. Within a year or so I joined the communications committee and thereafter was nominated to become the communication chair. I helped with social media and the newsletter, and it has led to my activity and a lot of open doors that have not only helped me but my patients and colleagues. The best thing to know as a young hospitalist is you don’t have to do everything but when you give a little time you may find that it isn’t as much of a commitment as it is a connection that help you develop into a better physician. I feel so fortunate to be in a field and have the AAP that have led the way on how to advocate for our patients and ourselves.
6. You are also the president of the Greene County Medical Society. What is your role with them, and how do you manage your time with your many responsibilities in addition to practicing medicine and having a family?
I joined GCMS because I was asked to, I didn’t really know if I would like it or what it would entail. I just knew that it was an hour a month early morning and worked with my schedule. I joined right after I had returned from the AAP training on tobacco, which I had done for one of my upcoming VIP projects. I learned about Tobacco 21 at that conference and came back on a mission. After joining GCMS, I found support and leverage with my local physicians as well with my local health department. All the health department had really needed was a physician champion, and about a year in a half later we got it to pass and I had all the physicians from GCMS when the city council passed Tobacco 21. I was then nominated as president and saw why local medical societies were impactful. MO AAP and AAP are as well but it is very different when you are trying to get something done in your own area. It also has helped me connect with those outside of my hospital system and feel more like part of a complete medical community. My responsibility as president is to connect physicians and continue to advocate for our medical community. Currently I am working with for medicaid expansion and have been involved in the COVID19 planning with our health department. I have had to say no, like stepping down as our hospitals pediatric section, and that was honestly really hard but it was important to move forward. I make sure that what I am involved with benefits me and currently my different positions and groups intermix which is beneficial to my job and my community. My family understand and actively participate in some of my functions/activities. I still am able to keep up with my family and kid activities and it can be a juggling act but it keeps me motivated and I truly enjoy it.
7. Jack Percelay often ends his list-serve commentary with the phrase “that’s just my 2 pennies.” What are your two cents?
That is quite a lot to live up to as I don’t truly have “phrase” so here is my recurring theme that I feel is always relevant.
In my passion for trauma, it is important in recognizing the importance that small changes can make a big difference. So I like to approach teaching on toxic stress and trauma to our residents, patients and staff that we can help patients by simply asking one question, what is your greatest concern? Now apply that question to yourself, your staff and your colleagues. It’s a simple question that can lead to life-transforming care and personal wellness.