Mental Health Nurse Manager Shares How Nursing is the Art of Caring for People

CHOC Children’s wants its patients and families to get to know its staff. Today, meet Lisa Schneider, nurse manager in CHOC’s new Mental Health Inpatient Center. Lisa has a degree in nursing from The Ohio State University, and is in the last semester of completing her master’s degree with a focus on Nursing Administration. She is also a board-certified psychiatric-mental health registered nurse.

mental health inpatient center nurse manager
Lisa Schneider, nurse manager in CHOC’s new Mental Health Inpatient Center

Q: What are your special clinical interests?
A: I am very passionate about pediatric mental health. I have a strong interest in trauma-related diagnoses and crisis prevention, as well as serving as an advocate to destigmatize mental health.

Q: How long have you been on staff at CHOC?
A: I am new to the organization and so excited to be here! I have been with CHOC since January 2018.

Q: What diagnoses are most common among the patients you care for?
A: As the community is beginning to recognize mental health disorders sooner, children and adolescents can present with a wide range of diagnoses such as depression, anxiety, eating disorders, psychosis, autism, PTSD, and ADHD, among others.

Q: What myths about mental health would you like to dispel?

A: Many people believe that talking to kids about suicide can put the idea into their heads. However extensive research has shown that this is not the case. Suicide is currently the second leading cause of death in children and young adults ages 10-24. Start the conversation now and talk to your kids about suicide – it could save their life.

Q: What excites you most about the Mental Health Inpatient Center?

A:  The opening of the Mental Health Inpatient Center is so exciting because we will be providing innovative care and services to children and their families. The unit will consist of private rooms, group activity rooms, an expansive outdoor play area, along with daily programming such as music therapy, art therapy, pet therapy, and classroom education. The Center is designed around aspects of nature to promote a holistic and healing environment. In addition, every child will receive a comprehensive treatment plan which will include individual and family therapy sessions while inpatient, and care continuation at discharge. I am so excited for the positive impact this Center will have on the kids in our community, especially since we will be the first to offer inpatient mental health services to children under the age of 12 in Orange County.

Q:  What inspires you most about the care being delivered here at CHOC?
A: I am inspired by the tremendous amount of dedication that CHOC Children’s has shown in our mission to provide quality healthcare to children. Specifically, we are taking a leadership role and setting a high standard through our commitment to de-stigmatizing mental health and expanding services. It is important to remember health does not solely rely on physical health, but strongly depends on mental health as well. In order to achieve overall health and well-being, mental health must be cared for with the same emphasis that is placed on physical health.

Q: Why did you decide to become a nurse?
A:  I chose to become a nurse based on the philosophy of nursing. Nursing is known not only as a science, but also as an art in caring for people. I have a passion for creating strong nurse-patient relationships, which can promote the healing process. I chose pediatrics because I’m inspired by the resiliency I see in children, and mental health specifically because I strongly believe in the concepts of prevention and early intervention.

Q: If you weren’t a nurse, what would you be and why?
A: If I wasn’t a nurse, I think I would probably be a police officer. I enjoy serving others and building strong relationships within the community.

Q: What are your hobbies/interests outside of work?
A: Outside of work, I love spending time with my husband and 4-year-old son. We are new to California so we have been spending a lot of time exploring this beautiful state!

Learn more about CHOC’s commitment to mental health

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The Power of Music Therapy: Darlyn’s Story

On a sunny day in the middle of spring, Darlyn was born at St. Joseph Hospital in Orange. She was immediately transferred across the street to the level IV neonatal intensive care unit at CHOC Children’s. As the spring turned to summer, and summer gave way to fall, the NICU remained Darlyn’s home as she battled with a myriad of health challenges.

Before she was born, prenatal ultrasounds showed that Darlyn had a congenital diaphragmatic hernia (CDH), a rare birth defect where a hole in her diaphragm allowed organs from the abdomen to move into the chest. After birth, she was diagnosed with bilateral CDH. Approximately one in every 2,500 babies born are diagnosed with CDH. Of those, only one percent have a bilateral CDH. Darlyn’s parents Mirian and Edgar understood the seriousness of this diagnosis and weren’t sure if their baby would survive the pregnancy, or pass away shortly after birth. In her first week of life, Darlyn underwent her first in a series of surgeries.

“For the first two or three weeks of her life, our main goal was survivorship,” recalls Edgar.

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Darlyn and her father Edgar in the NICU.

Darlyn also has underdeveloped lungs (a condition known as pulmonary hypoplasia), which makes it a struggle to breathe on her own. She lacks a fully formed esophagus, meaning she also can’t swallow or eat on her own either. During Mirian’s pregnancy there was a build-up of amniotic fluid due to Darlyn’s duodenal atresia (a blockage of her small intestine), so the baby was especially active and moved around constantly. The only thing that calmed her down was playing music ― everything from lullabies to classic rock did the trick. Knowing their baby loved music even before she was born, her parents gave her the middle name Melody.

“From day one she has been the melody of our lives,” Mirian says.

Darlyn and her mother in the NICU at CHOC Children's
Darlyn and her mother in the NICU at CHOC Children’s.

Music has continued to play a big role in the now seventh-month-old’s life. Daily music therapy sessions conducted in tandem with occupational therapy sessions have helped her make progress on clinical goals such as developing fine motor skills. Other goals she’s already accomplished include standing for longer periods of time, reaching for and grasping toys tightly, and visual tracking.

A music therapy session conducted in tandem with occupational therapy in the NICU.
A music therapy session conducted in tandem with occupational therapy in the NICU.

“Before starting music therapy, Darlyn wasn’t very active and she often lost oxygen very quickly,” Brie says. “This baby is a new baby since experiencing music therapy.”

Environmental music helps create a soothing space to teach patients to calm themselves in an over-stimulated environment, which can help them heal, even after they go home.

“From the outside, it may look simple, as if I am just serenading a baby in a soothing tone, but I’m working hand in hand with their developmental team to help them reach clinical milestones.”

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A music therapy session conducted in tandem with occupational therapy in the NICU.

Darlyn’s care team is vast. Her medical team at CHOC sees music therapy as a trusted partner in helping Darlyn achieve her clinical goals. Her support system includes: Dr. Irfan Ahmad, a neonatologist; Dr. Peter Yu, a pediatric general and thoracic surgeon; and pediatric specialists from gastroenterology pulmonology, cardiology, infectious disease, the NICU developmental team (made up of occupational, physical and speech therapists), and a dedicated team of NICU nurses.

“We love and appreciate our NICU nurses more than we can even put into words,” Mirian says. “Without them, this journey would be more difficult and more heartbreaking. They take care of Darlyn as if she was their own baby girl.”

Jamie, a NICU nurse, celebrates July 4th with Darlyn.
Jamie, a NICU nurse, celebrates July 4th with Darlyn.

“Music helps calm down infants,” says Dr. Ahmad. “During their fetal life, they are exposed to rhythmic sounds, such as their mother’s heartbeat. They get accustomed to these sounds, and after birth when they hear music with a similar rhythm, they like it. Older neonates become more interactive with rhythmic music, and they look forward to their sessions.”

Darlyn isn’t the only one who has been looking forward to her daily music therapy sessions― her mom does too. After each session, her developmental team calls Mirian to give a full report on her occupational therapy progress and disposition.

Her parent’s high level of engagement is deeply appreciated by her care team.

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Darlyn’s parents chose a Snow White theme for her first Halloween, which she celebrated in CHOC’s NICU.

“Darlyn’s parents are amazing. They ask good questions, and they trust us to take good care of their little girl. It would be hard to tackle this level of complexity without their trust,” says Dr. Yu. “We still have a long road ahead of us, and maybe more challenges too, but they are resilient, just like their daughter.”

Darlyn-private-room-decor-nicu
Darlyn’s parents have decorate her private room in the CHOC Children’s NICU to feel more like home.

A few months into her time in CHOC’s NICU, Darlyn moved into the brand new 36-room unit with all private rooms. Her family has loved having their own private space.

“In the old unit, it could get noisy and we didn’t feel like we had any privacy. Now, we get to decorate her room and make it feel more like a nursery,” says Mirian.

Darlyn's parents have decorate her private room in the CHOC Children's NICU to feel more like home.
Darlyn’s parents have decorate her private room in the CHOC Children’s NICU to feel more like home.

The family has displayed notes of encouragement from loved ones and her favorite nurses- including nurse Jamie, who taught Darlyn how to stick out her tongue. They’ve even hung up the outfit she’ll wear when she finally gets to go home.

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Darlyn’s parents have hung up the outfit she’ll wear when she finally gets to go home from the NICU.
Learn more about music therapy at CHOC

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CHOC Emergency Department Honored for Exceptional Practice and Innovative Performance

The Julia and George Argyros Emergency Department at CHOC Children’s Hospital is one of only three emergency departments in California — and 22 in the country — to be named a 2017 Lantern Award recipient from the Emergency Nurses Association.

The honor recognizes emergency departments across the nation for demonstrating excellence and innovation in leadership, practice, education, advocacy and research.

Recipients of the award went through a rigorous application process, during which they had to provide outcome metrics, as well as descriptive examples that highlighted the following:

  • Practice – qualities that foster professional pride, confidence and a community of support for emergency nurses
  • Leadership – operational improvement initiatives, including new systems and processes that positively impact department operations
  • Education – quality and accessible education that instills knowledge and enhances competencies
  • Advocacy – efforts that enhance the emergency nursing profession and quality patient care
  • Research – quality improvement research and the evaluation of clinical outcomes

“Our team is dedicated to providing safe, quality care based on evidence-based practices.  We are honored to have our commitment recognized by the Emergency Nurses Association, and will continue to push ourselves to provide the best possible emergency medicine and trauma services to the children and families who depend on us,” says Frank Maas, RN, BSN, MBA, director of the CHOC ED.

The 22,000-square-foot, full-service CHOC ED is exclusively dedicated to the treatment of pediatric patients.  It features 31 treatment rooms, including several rapid evaluation and discharge rooms and three triage suites.

The department will be presented with its Lantern Award at the Emergency Nursing Conference 2017 in St. Louis, Missouri this month.

The Lantern Award honors the legacy of Florence Nightingale, referred to as the “Lady of the Lamp” for her actions during the Crimean War.  Working throughout the night, she would bring a lantern to help her see and tend to the wounded soldiers.  She is credited with changing nursing from an untrained job to a skilled, science-based profession.

Learn more about emergency services at CHOC Children's

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CHOC Nurse Following in her Mother’s Footsteps

Spending her lunchtime with her young daughter Monica was something Maria Arreola always enjoyed when working her shift at CHOC Children’s Hospital. Proud of both, she looked forward to the times when Monica could join her at the hospital. And Monica enjoyed it, as well. Little did the two know then just how much of an impact those times together would have on their futures.

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Maria Arreola joined CHOC in 1981 – a dream come true. Eager to get a foot in the door, she accepted a position with the environmental services department in hopes she’d eventually land a spot as a clinical assistant (CA). Six months later, she was working as a CA in oncology.

She loved her job, and particularly enjoyed when her daughter Monica would visit her for lunch. Maria’s co-workers would frequently ask Monica what she wanted to be when she grew up. Her reply was always the same: “a nurse.”

“I saw something very special in Monica, something that told me she would be a wonderful nurse,” says Maria.

Though she didn’t tell her mom. Monica wasn’t always so sure. What she did know, however, is that CHOC was unique.

“Even at a young age, I knew CHOC was different, and I thought it was so special because it was just for kids,” recalls Monica.

The kids are what drew her mom to CHOC.

“I love working with children and their families; it’s my passion. And being at CHOC means I get to care for patients, as well as provide support to their parents. It’s wonderful to be able to make such a difference,” explains Maria.

That desire to make a difference lured Monica to follow in her mom’s footsteps. She joined CHOC in 2007 as a CA in the neurosurgical unit. At the time, Maria was working in that same unit.

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Monica grew up visiting her mom, a registered nurse at CHOC Children’s Hospital, on lunch breaks. Inspired by her mom’s work ethic and compassion for patients, she grew up to be a registered nurse at CHOC.

“Whenever we had the same shifts, I admired my mom’s work ethic and was inspired by her passion and her ability to connect with families,” says Monica.

And like her mom, Monica enjoys practicing patient-and-family-centered care.

“I love being an advocate for my patients, and a voice for those who perhaps can’t verbalize. As care providers, we need to partner with our patients and their families to really understand and meet their needs,” explains Monica.

After a few years, and with encouragement from her mom, manager and co-workers, Monica decided to become a registered nurse. She continued to work part-time as a CA while completing her education. The support from everyone was amazing, says Monica.

Most recently, she completed CHOC’s RN Residency Program.  And, to the delight of her mom and her co-workers, of whom many watched her grow up, she was hired as a registered nurse in the neurosurgical unit. Monica’s mom still works at CHOC, in the neurosurgery clinic. So, while one Arreola works with CHOC Children’s Neuroscience Institute patients on the inpatient side, the other gets to interact with them as outpatients.

“I am so proud of my daughter, of the human being and of the nurse she became. I also still love working at CHOC,” says Maria, who recently celebrated her 25th year. “Having my daughter part of my CHOC family, as well, is amazing.”

When Maria and Monica aren’t working, they enjoy spending time with their family, going on hikes and enjoying Maria’s cooking.

Have you been inspired by a nurse at CHOC? Nominate them for the Daisy Award

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Inspiring the Next Generation of Nurses

In honor of National Nurses Week, and as part of CHOC’s week-long celebration of our incredibly skilled and caring nursing staff, we asked several members of our nursing leadership team what advice they would offer to the next generation of nurses.

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Melanie Patterson, vice president of patient care services and chief nursing officer

Melanie Patterson, senior vice president and chief nursing officer

Q: What advice do  you have for those pursuing their professional aspirations?

A: Recognize your strengths and spend time building on them. Don’t waste time focusing on your flaws; instead, strut your strengths! Know who you are and be that person always. Don’t beat yourself up when something doesn’t go perfectly. Sometimes, what we consider our biggest “mistakes” can make the biggest wake. Realize you make a wake, whether rough waters or not, so make that wake count. Showing your humility in the face of adversity is many times the best gift you can give another person or group.

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Nancy Kraus, service line director of critical care, director of clinical education

Nancy Kraus, service line director of critical care, director of clinical education

Q: What advice do you have for aspiring nurses?

A: In any profession there are a variety of roles and responsibilities you can have throughout your career. Typically you choose “A” and think you might progress to “B” or “C.” Don’t rule out “D thru Z.” Sometimes you find what you are most passionate about by stepping outside your comfort zone. Take every opportunity that is offered to you large and small – all will become growth experiences that help you progress personally and professionally. As a young nurse just starting my career I never would have imagined I would have had the opportunity to be a bedside care provider, a college professor, a national public speaker at conferences, a global health volunteer, a peer leader with my physician partners, assist in research, lead an organization to a Magnet award of excellence, mentor others, be “the neighborhood nurse,” and now a director over critical care. All of these opportunities came because early on I decide to say “yes” when opportunities were offered to me to try something new, when someone asked for help, when I joined a group project or chose to be engaged and participate outside of my primary position.

nurses
Alisa McCormick, nurse manager, pediatric intensive care unit

Alisa McCormick, nurse manager, pediatric intensive care unit

Q: What is something you wish you would have known when you began your career?

A: I wish I would have had the advice that a friend gave me recently. The advice was to always have someone behind me that I am helping to grow and develop, and someone ahead of me that is a mentor, helping me to grow and develop. Embracing such a simple concept of balance as a new nurse would have helped me focus and develop my career much sooner. I waited over 20 years to return to school mostly out of fear. Returning to school allowed me to gain the skill and confidence to step out of my comfort zone, become a manager, participate in evidenced-based projects, lead hospital-wide initiatives, mentor and develop my staff, and most importantly support the development of a unit-based mentor program for new nurses in the PICU.

Susan See, nurse manager, neuroscience unit

Q: What advice do you have for aspiring nurses?

A: Everyone has their own unique story. It is up to you to determine what your story looks like. Whether you are early in your career or you have been in healthcare for years, there is no better time than right now to keep your passion alive and active by embracing opportunities and striving to reach new goals. Decide what is most important to you, make deliberate choices, and run full force to attain your goals. There is something magically satisfying about doing what you love. It makes you better at what you do, and best of all, you will shine that satisfaction. Thoreau said, “Never look back unless you are planning to go that way”. Be uniquely you and continue to create what you want your story to look like!

Have you been inspired by a nurse at CHOC? Nominate them for the Daisy Award

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