Pediatric Emergency Nurse, Baystate Medical Center
Her Passion for Behavioral Health Has Enhanced Care Across an Entire ER
Ellen Ingraham-Shaw just couldn’t get away from children — even when she thought she wanted to.
And thanks to her leadership and innovative thinking, a lot of kids are better for it today.
“I actually started my career as a kindergarten teacher,” she said, before jumping back in time a little to when her interest in working with children really began.
“Growing up, I was a horseback rider, and I got into teaching younger kids how to horseback ride; that’s how I started working with children and adolescents, including working summer camps when I was in college,” she recalled.
Then she studied early childhood education and psychology at Mount Holyoke College before spending the first five years of her career as a kindergarten teacher.
There, Ingraham-Shaw saw needs that can’t always be addressed in the classroom.
“I worked in Chicopee, and in my classroom, I had a lot of homeless students,” she said. “So I started getting really interested in the socioeconomic status of kids and all the barriers that can really get in the way of how kids learn.
“I was happy, but I didn’t see myself doing it forever,” she continued, “so I went back to school for a second bachelor’s in nursing at UMass Amherst. After that program, I started working at Baystate Medical Center on one of the adult floors. And I just thought I didn’t want to work with kids anymore after feeling kind of burnt out.”
“Especially during the pandemic, the behavioral-health population just kind exploded in our ER. And I just got really passionate about it.”
So when friends asked her whether she wanted to enter pediatrics, she said no — but that feeling eventually thawed, and she applied for a position in Baystate’s pediatric ER. And she fell in love with it, calling it a well-run unit that, she realized early on, had an openness to new ideas and a focus on behavioral health that she would eventually expand in a number of ways.
“Especially during the pandemic, the behavioral-health population just kind exploded in our ER. And I just got really passionate about it,” she said. “And I’m lucky that my managers and my educators on my unit really support us working toward the things we’re interested in. If you want to seek out opportunities to do your own education, they give you opportunity to research.”
Thus began a fruitful career in pediatric emergency care with a focus creating more education and resources around behavioral health.
“I’ve been able to do education on de-escalating patients, just helping with the safety of the staff and the patients. And I think our physical restraint numbers have decreased; we have seen a decrease in having to resort to a restrictive environment with the kids.”
Ingraham-Shaw also worked closely with Pediatric ER Manager Jenn Do Carmo on Narcan take-home kits for the Pediatric Emergency Department. They were talking one day about how Baystate’s adult ED provides take-home kits to their substance-misuse population, but the Pediatric ED had no such process. So they decided to change that. Ingraham-Shaw created an education flier for nurses and doctors, made sure the kits were stocked, and educated every nurse on how to educate patients and families in their use.
“I did some education with our staff on how to identify patients that might be at higher risk,” she explained. “These are patients who come in with an overdose or, unfortunately, we’re seeing a lot of adolescents these days with suicide attempts and self-harm; sometimes they could be opioid-related, sometimes not. But if someone has a past overdose attempt, they’re at a higher risk of potentially overdosing on opioids in the future.
“So we’re making sure we have Narcan out in the community,” she added. “The nursing job is to help identify the patients that could be at risk, then working with the providers to make sure Narcan gets prescribed.”
Do Carmo, who nominated Ingraham-Shaw, said this program has the potential to save the lives of pediatric patients who overdose on opioids in the community. “Ellen is also going into the community and teaching local schools about the process of administering Narcan,” she wrote. “Ellen is a strong advocate for her patients and is a Healthcare Hero.”
Knowledge Is Power
As another example of thinking — and leading — outside the box, Do Carmo noted that Ingraham-Shaw noticed a gap in education on the care of LGBTQ and transgender patients, and took it upon herself to create educational materials and a PowerPoint presentation on how to care for and support these individuals.
“The entire Emergency Department now provides her representation on transgender education in nursing orientation,” Do Carmo wrote. “This presentation provides a clear understanding of a population in dire need of support and words and ways that help support the care of this population.”
Ingraham-Shaw told BusinessWest that she developed that education on LGBTQ and transgender health for a staff meeting, and the educators in the ED now utilize it as a required part of onboarding training for all emergency-medicine staff at Baystate, not just in the Pediatric ED. “So all of our staff has some level of training in how to be respectful and understanding of patients in our community.”
That aspect of education can be lacking in the training and college programs medical professionals experience entering their careers, she added. “So I think our people are definitely able to support those patients a lot better.”
Providing care that’s not sensitive to that population typically isn’t a problem of malice, but ignorance, she was quick to add. “It’s just people not knowing. And now my unit especially has at least a little baseline of how to be more respectful and understanding of patients.”
Of course, sensitivity to what patients are experiencing comes naturally in a pediatric ER, where the days can be challenging and the situations dire.
“I did some education with our staff on how to identify patients that might be at higher risk. These are patients who come in with an overdose or, unfortunately, we’re seeing a lot of adolescents these days with suicide attempts and self-harm; sometimes they could be opioid-related, sometimes not.”
“One thing I do like about it is that every day is completely different. I think it’s gotten a little bit harder now that I just had my own baby; I’m still adjusting to that,” she said of the toughest cases. “But the majority of what we see is more urgent care, or things likely to be seen in a primary-care setting. Those usually have a happy ending — you help educate the family, you make sure the child is safe, is eating, drinking, breathing, and then they usually get discharged home.”
At the same time, “unfortunately, we do see some really devastating new cancer diagnoses, we see some car accidents, so it’s definitely emotional. I think my co-workers do a really good job of supporting each other through those difficult times. Healthcare can be sad, and I think it’s especially sad when you know something bad happens to a child. And we do a lot of compassion with the families as well; we take care of the whole family, not just the child.”
Again, she comes back to the education aspect of her work, even for things families don’t specifically bring in their kids for, like properly installing car seats.
“When we’re at the triage desk, we first bring the kid in, we make sure they’re safe, and then that’s another point where we can just educate them and do that community health and make sure everyone’s safe by teaching families simple things like car seats.”
Going beyond the basics is how Ingraham-Shaw has really made a difference, though, implementing new ideas in an organization she says is very interested in hearing them.
“My management team is just really open. We have a lot of freedom to do things,” she said, before giving another example in the behavioral-health realm.
“One of my co-workers and I, a few years ago, started a behavioral-health committee. We try to meet monthly, just to talk about what’s going on with the unit, trying to work on different projects,” she explained. “One thing we did was make an informational pamphlet for the families and the patients that come in for behavioral-health issues because the way we treat them is much different than other patients. And sometimes they’re there for a really long time. So we want to do what we can just to support the families a little bit more.”
Do Carmo praised Ingraham-Shaw for identifying barriers in communication and creating a tool that has improved communication between nurses and patients. “Ellen works very closely with the behavioral-health team to ensure the behavioral-health population receives the needed care plans and treatments.”
Ingraham-Shaw’s interest in mental health was clear when she first studied psychology in college, but at the time, she couldn’t have predicted how it would become an important aspect of her career.
“When I was looking for jobs, if I didn’t find a teaching job, I was looking for other psychology-related jobs,” she said, adding that she’s in graduate school now, working on her doctor of nursing practice degree (DNP) to be a psychiatric nurse practitioner.
“I always thought that was a possibility, but I didn’t think this was the route I’d take,” she said. “For nurse practitioners, at least, the education track is different. So you’re a nurse first, so you get that compassionate care and bedside manner down first. And then you start learning the more advanced things.”
Once she has her DNP, she said she’d like to stay in the pediatric arena, although she’s hoping to gain a wide range of experience through her clinical rotations.
“Baystate in general is very supportive of education,” she added, noting the system’s tuition-reimbursement and loan-forgiveness programs, in addition to its affiliation with UMass Medical School’s Springfield campus, which is where she’s taking her graduate track.
“One of the reasons why I chose that school is because they have a focus on diversity and behavioral health,” she noted. “So I’ve been working hard, but I have also been lucky to find myself in places, and around people, that are supportive and inspirational, and I’ve been given a lot of opportunities to focus on the things that I want to do.”
As part of her graduate education, Ingraham-Shaw is hoping to focus on opioid and overdose education in her scholarly project. “It’s something I’m passionate about, and I’ve done a lot of my own learning. So I’m hoping to do some more research and actually implement some projects with that.”
For her work creating and cultivating a handful of truly impactful projects at Baystate already, but especially for the promise of what she and her colleagues have yet to come up with, Ingraham-Shaw is certainly an emerging leader in her field, and a Healthcare Hero. n