Understanding Evelyn

Joy Ryan, President/CEO

I have deep respect for the nurses who choose to work at Dakota Boys and Girls Ranch.

I respect nurses in general. My late sister was a nurse. Three of my husband’s five sisters are nurses. My mom wanted to be a nurse until the realities of her poverty ended her educational journey. I honestly cannot think of a bad interaction I have had with a nurse. I’m not sure I could say that about any other profession.

The nurses at the Ranch, in my opinion, are even more special amidst all those in this noble profession.

Yes, they fix owies. With so many children around, there are always scrapes and bruises and pink eye, twisted ankles, sore throats, cramps… you get the idea. But, Ranch nurses are also Designated Mental Health Professionals. They are able to work with a child who has suicidal thoughts, who has developed a coping skill of self-harming, who is learning how to treat their mental illness. Their nursing “tool bags” are pretty full.

Sometimes they are the first person a guardian, or a child in care themselves, decides to trust with their whole story. At the Ranch, the mantra of “Don’t ask what is wrong with the child, ask what happened to the child?” is a guide to care. The more we know about what a child has experienced, the more we can personalize their healing. Sometimes, that whole story is pretty hard to hear.

One of our RN’s recently sent this email to the treatment team on one of our campuses.

“I’ve been asked to share some background information about Evelyn to help everyone better understand her history and the behaviors we’ve been seeing recently. Evelyn experienced significant medical complications early in life. She spent the first two months after birth in the neonatal intensive care unit on a ventilator and receiving multiple supports. At eight months old, she suffered a traumatic brain injury (TBI) that required another three-month stay in a pediatric intensive care unit. Following this, specialists indicated she would likely face long-term challenges with learning, emotional regulation, and interpersonal relationships.

In addition to her medical history, Evelyn endured extensive childhood trauma—physical, sexual, and emotional. Because of this, she often dissociates during periods of heightened anxiety or aggression.

Evelyn’s TBI adds complexity to her PTSD and anxiety symptoms. When she becomes dysregulated, please keep the following strategies in mind:

Use short, simple sentences.
Avoid telling her to “calm down.”
Avoid pressing for details during the moment of crisis.
Reduce environmental stimulation when possible.
Offer simple, safe choices to restore a sense of control.
Be patient and prepared to repeat information if needed.

I hope this information supports us as we continue learning how to best help Evelyn during her time here. We need to be supportive and prioritize safety, while also understanding her neurocognitive disorder. If there are any questions, please reach out!”

These are real kids who have endured so much, being helped by the best professionals. Your kindness, prayers, and support make it possible for them to come together to provide help and create hope.

Thank you.