The limb difference clinic takes loss — a missing limb detected on a prenatal scan, or an amputation needed after an accident or cancer diagnosis — and creates the chance for these children to do just what their peers are doing — and often so much more.

This is the factory floor where Paralympians are made. Walk the allied health therapy rooms at the Royal Children’s Hospital and you will see children, tongue-out in concentration, trying out their prosthetic device. From the look on their face, they can already imagine how their new leg or foot, a new device for them to hold a bike handle or riding reins, will help them do the things their friends are doing.​

A team of eight specialists work together to help each child, including two prosthetists and orthotists who design, fit and monitor each device.

A physiotherapist and occupational therapist help the children develop the physical skills needed to use each device, made by the prosthetic technician.

An orthopaedic surgeon performs amputations and revision surgeries, while a social worker helps the family with counselling and advocacy.

And given each child is different, there is no one off-the-shelf product that will be the perfect fit. It takes ingenuity, creativity and perseverance to get the right answer for each child at every age.

Sebastian, 4 yrs old

It was clear four-year-old Sebastian could already picture himself sitting in his future prep class room when prosthetist Phoebe Thomson showed him his latest prosthetic.

The four-year-old’s latest leg — his sixth — is the first he has had with a knee joint. It will allow him to sit on a chair with both feet on the floor when he starts school next year.

It has been a monumental technical challenge to develop a leg with enough stability. Sebastian has just 5cm of his right thigh bone remaining — the highest amputation the RCH prosthetics team has come across.

Born at 27 weeks and weighing just 890g, Sebastian had his leg amputated when he was two weeks old to save his life from an invading infection after the leg was injured during pregnancy.

“He’s just started asking questions about his leg, a bit earlier than I expected,” said his mum, Mel.

“He asks, ‘Will my leg grow back? Why can’t I have two legs? Why did you let them take my leg?’ “It breaks my heart, but with this new leg he will look like everyone else in the class — something that’s becoming more important to him.”

Zara, 6 yrs old

The limb difference clinic has helped Zara confirm that she belongs.

Her mother, Trina, remembers vividly the heartbreak of watching her daughter checking each doll she played with as a toddler, inspecting their hands. “She would slump down because they all had fingers. She was aware of it,” Mrs Bond said.

With nothing on the market and getting little help from doll restorers, she turned to the RCH. Prosthetist and orthotist Meleita Finnegan and prosthetic technician Leo Mouratidis took Tamika the doll to their workshop to make a series of alterations so she looked just like her owner.

“She could not stop hugging it,” Mrs Bond said. “They’ve said anything you can think of that she needs, we will come up with a way of creating it for you. It’s an amazing service.”

Zara has had a prosthetic device made so she can ride a bike or scooter, and the team will make a left-handed pick device so she can play guitar, further confirming that Zara can do anything other kids can do — an ethos that has firmly rubbed off on the grade one student.

When a classmate asked on the first day of school why Zara didn’t have any fingers on her left hand, she stood up confidently in front of the class. “She tells them: ‘That’s how I was born. When I was in my Mummy’s tummy, one hand grew fingers and one hand didn’t. But it doesn’t stop me doing anything. Watch me, I can do anything you can do’,” Mrs Bond said.

Our Emergency Department (ED) is often the first port of call for many who attend the hospital, providing urgent medical care to children and teens from across the state.

Last year, the department saw nearly 90,000 children ranging from newborns to teenagers.

A team of doctors, nurses, clerical and allied health staff (such as social work and mental health workers) ensure the department is able to see patients 24 hours a day, seven days a week, 365 days a year.

We caught up with Bec and Ashlea who told us what life is like as a nurse in the Emergency Department.

Can you tell us about the patients you care for?

Ashlea: These can range from the critically ill, including multi-trauma victims and severe asthma patients, through to minor lacerations and children with viral symptoms. Our patients range form newborns through to teenagers, and it can be their first presentation or a child with a complex medical history who has visited the ED on multiple previous occasions.

Bec: Emergency is a particularly unique environment in which we care for paediatric patients of all ages who can present with a range of illnesses and injuries. The diversity of patient presentations is vast and I feel like we see EVERYTHING!

How do you decide which patients get seen first?

Bec: Each patient who presents to Emergency is seen by a highly-skilled triage nurse. This nurse will rapidly assess each child and triage them as per the Australasian triage scale. This then determines how quickly a patient is seen with the sickest of our patients seen first.

Why did you get into nursing?

Bec: I often wonder the same thing. But one thing I do know is that I would not want to do anything else. You inevitably become a part of a person’s life during a time of need. To be able to help a child and their family the best you can, through what can be an extremely stressful situation and see the improvement, the smile, or see them go home is extremely satisfying. I am grateful for this opportunity.

Ashlea: I am not sure exactly why I chose to be a nurse, I just know from a young age I always wanted to work in a profession where I was able to make a difference in peoples lives. I think this likely stemmed from my grandparents, who have been in the the CFA for over 50 years and an ambulance officer for over 25 years.

What attracted you to working in Emergency?

Bec: The department is fast-paced, demanding and keeps me on my toes. It challenges me and there is never a day that I do not learn something new. I love that everyday is different. No day is ever the same as the last.

Ashlea:  As an undergraduate nursing student I knew I wanted to work in paediatrics and strived to get my grad year at RCH. Since then I have worked in multiple departments within RCH, but have found my passion in Emergency Nursing. I love the variety of patient presentations and the autonomy in patient care we have in Emergency.

How do you cope with working in such a high-pressured environment?

Bec: The department can at times be chaotic and extremely high pressured. It requires you to act promptly and think on your feet. But we are so fortunate to have an extremely supportive multidisciplinary Emergency team. We all look out for each other and make sure that patients are receiving the best care we can possibly deliver.

Ashlea: I enjoy working in a challenging environment, although I think this is greatly enhanced by the Emergency Department’s fantastic interdisciplinary supportive culture. Everyone is always happy to help one another and it is ultimately a team environment.

What’s the most rewarding thing about your roles?

Bec: The amazing team I work with. I work alongside incredibly intelligent, resilient and resourceful individuals who come together and work as an amazing team, even during the toughest of times.

Ashlea: Being able to assist both patients and their families during a significant time in their lives.

How do you relax after a long shift?

Bec: Relaxing usually involves a quiet walk in the sun or chilling on the couch with the pooch….in fact, it is anything where I can switch my brain off from noise. I also have an extremely supportive fiancé who is a great listener and makes sure I get some ME time.

Ashlea: I enjoy getting out in the sunshine, buying fresh flowers, planning our next holiday, and catching up for brunch with friends.

If you weren’t a nurse, what would you be doing instead?

Bec: I would love to volunteer in a third world country looking after disadvantaged children.

Ashlea: I actually have a bit of addiction to property, and would love to work in the property investment industry, but I don’t think I could ever give up nursing completely.

The Royal Children’s Hospital is the largest paediatric cardiac centre in Australia and performs over 16,000 cardiac procedures a year on patients from all over Victoria and Australia, as well as overseas.

On level three in the ‘treetops’ of the RCH, you’ll find Koala ward which provides specialist care to patients with both cardiac and renal conditions.

These patients are cared for by nurses like Justin and Chelsea, who told us what it’s like to work as a cardiac care nurse.

Can you tell us about the type of patients you care for? 

Chelsea: Koala ward looks after patients of all ages ranging from newborns through to adolescents. We provide specialist cardiac and renal treatment care including for patients who have had heart and kidney transplants.

Justin: These kids have come from all over the country to receive specialist cardiac and renal care. So we get to meet a variety of different people and their families from all over Australia, and even sometimes from overseas.

What makes Koala unique to other wards?

Chelsea: Koala is a critical care ward that cares for specialised patients all over Australia and overseas. It is the only paediatric cardiac ward in Australia that cares for patients on Paediatric Ventricular Assist Devices, including both Berlin Heart and Heartware.

Justin: On Koala we get a mix of surgical and medical patients, both of which can be of high acuity.

What attracted you to working at the RCH on Koala ward?

Chelsea: When I was 14 I had a sporting injury and was taken to the RCH. My brief experience as a patient in the Emergency Department encouraged my nursing interest and is the main reason for me entering the field – it was always a dream to work at the RCH! I have also always been interested in the way the heart works, it fascinates me because it is such an amazing organ, so Koala was the obvious choice for me.

Justin: I have always had an interest in paediatric medicine and cardiology, so working on Koala gives me experience in both of these areas. Also, Koala receives heart and kidney transplants, treats hypoplastic left heart syndromes, and manages patients paediatric ventricular assist devices. It’s pretty exciting to be a part of.

Why did you get into nursing?

Chelsea: I became a nurse because I wanted to help people and make a difference in the world. These differences can be small things like putting a smile on your patients face or making them laugh. And then you can be involved in bigger things like working with intelligent and dedicated staff to save someone’s life. Being a nurse is incredibly rewarding, challenging and enjoyable.

Justin: I didn’t always want to do nursing, so I was a bit late onto the nursing scene. As I got older I realised I needed a career that was fulfilling, involved working with an awesome team, and making a difference in peoples lives, and nursing ticked all of those boxes for me.

What’s the most rewarding thing about your role?

Chelsea: When patients arrive on Koala they are usually quite unwell. After they’ve had surgery or other medical interventions we see them get a little bit better everyday. It’s amazing to watch their bodies recover and their personalities come back to life. I love seeing patients walk out the door and knowing we helped them get better.

Justin: Being able to work together in a team to provide care and support for not only the patients but their families and friends as well.

How do you relax after a long shift?

Chelsea: By sitting on the couch and watching a movie or having a cat nap! I also like walking my dog or catching up with friends and family for a chat over some delicious food.

Justin: To relax after a long shift I either go to the gym, walk my dog, or sit on the couch and binge watch TV. Any activity that doesn’t require much brain activity!

Can you tell me about the patients you care for on Cockatoo?

Nicole: On Cockatoo we have quite a few specialties that we look after. Our major specialties are neurosurgery, neurology, gastroenterology, endocrinology and metabolics. This includes caring for kids with major traumatic brain injuries, surgeries to remove brain tumours, seizure management and diagnosis, all kinds of gastroenterological conditions such as Crohn’s disease and short-gut babies, kids pre and post liver transplant and newly diagnosed Type 1 diabetics.

What makes Cockatoo unique from other wards?

Nicole: We are both a medical and surgical ward, making us very versatile nurses. One of the many things that makes Cockatoo unique is that we provide the statewide service for paediatric liver transplants and care for international and interstate kids pre and post liver transplant.
Bronte: Cockatoo ward is also equipped to preform Video EEG monitoring (VEM). This video monitoring is performed to help diagnose seizures by recording the child’s behaviour and brain electrical activity.

What attracted you to working at the RCH?

Nicole:  Growing up I personally experienced the amazing care from staff at the RCH. I always knew that I wanted to return in some way to work in such a fantastic hospital, I just didn’t know in what role. I was attracted to Cockatoo to work with the endocrine and diabetes patients as I, myself have Type 1 diabetes. However I have learnt that I love every other specialty that Cockatoo has had to offer me.
Bronte: In my final year of university, I completed a nursing placement at Bendigo Health on their paediatric ward and really enjoyed working with children. It was then that I decided to apply to do my grad year at the RCH. I didn’t preference a ward when I applied as I was happy to work anywhere in the hospital, looking back now though I’m so grateful that I was employed by Cockatoo.

Why did you get into nursing?

Nicole: During university, before studying nursing, I volunteered on a camp for children with Type 1 diabetes as a leader. I realised I wanted to use my own personal experience and knowledge to help kids like myself.

What’s the most rewarding thing about your role?

Nicole: Being able to care for patient and their families immediately post surgery or through a difficult diagnosis and watching the child improve and recover each day and then to see them begin to smile, play and be cheeky again is amazing to see and be a part of.
Bronte: For me the most rewarding part of my job is seeing our long term patients and families go home, especially if they were on the Butterfly ward as infants before coming to us and have never been home . Watching the growth and development that a child with liver disease makes following a liver transplant is pretty special as is seeing a child rehabilitate after a traumatic brain injury.

Is there a particular patient you’ve cared for who stands out for you?

Nicole: There are too many! I love our long-term gastro bubs and their families who can be with us on Cockatoo, sometimes upwards of a year. There are many memories and laughs shared with these patients and families that you will always remember and cherish.
Bronte: Several patients come to mind, I am inspired daily by the strength and resilience of the children that we care for. This job certainly keeps me grounded!

How do you relax after a long shift?

Bronte: I have a 30 minute drive home so I love turning up the music and having a little karaoke session, I find it’s a really good way to unwind and clear my head before I get home. Some old school 90’s is usually at the top of my playlist!
Nicole: A combination of rest and relaxation, rest and recuperation, rest and recreation and rest and retail therapy!

If you weren’t a nurse, what would you be doing instead?

Nicole: I always wanted to do something in the health science industry. It changed a lot from physiotherapy, to exercise science to medicine to dietetics. I’m very happy I landed on – and stuck with – nursing.
Bronte: I think I would still be working in the health industry, I always thought orthotics and prosthetics would be a pretty cool job!

To find out more about Cockatoo ward, download My RCH App from the App Store or Google Play.