How being an athlete prepared me to be a nurse

elyse-shelger-rn-choc-childrens

By Elyse Shelger, registered nurse at CHOC Children’s

In my life before nursing, I was a soccer player. I started playing the game when I was 4 years old. It shaped my childhood and taught me more than I realized at the time. In high school, I learned from incredible coaches and teammates, and then had the honor of playing for one of the top college programs in the country, Santa Clara University. When you practice something day after day, those movements, patterns, principles and lessons eventually become ingrained in your mind, body and soul. You don’t always notice they are there since they become part of you gradually, until you are forever changed.

As an adult, I often am reminded of certain guidance my coaches imparted and recognize why I do certain things the way I do. A large part of my mentality, behavior and beliefs have been shaped by the game of soccer, my life-long teammates and my undeniably great coaches. These are a few lessons that have shaped me as a person and as a nurse, and how I apply them in my world today.

In my new life, I am a nurse. I am not just a nurse when I am working a shift at the hospital. I am a nurse every day, always, at all times. I grew up learning that success comes when you commit yourself fully, on and off the field. I was also taught a great deal about accountability and personal responsibility. Why blame teammates or others when things get tough? We all must do what we can to make a difference. We each have to do our part. When I began working at CHOC Children’s Hospital, I took an oath to defend childhood. As an athlete, the word defense runs deep. Every team needs goal scorers— we need people to take action and move things forward, innovate, be creative, solve problems and think outside the box. This is what medical professionals do every shift, and some say a good offense is the best defense.

“Off the field,” I am still a nurse.

In team sports, you learn about selflessness. It becomes second nature to do what’s best for the team as a whole, to give 100% for each other, to have each other’s backs, and to fight selflessly until the last whistle. As a nurse, when I clock out after a long shift and I’m driving home, I relive each play in my mind, whether I won or lost that game, knowing I gave it my all. Sometimes no matter how well the team prepares, and how well you perform together, you can be defeated by a really strong opponent.

Currently we are in the middle of a big game. Our opponent is COVID-19. In our communities, some people are so terrified of losing that they are paralyzed with fear. Others have heard the opponent isn’t as formidable as people claim, so they grossly underestimate it as a threat. This is where risk lies. We must prepare properly. We must come to the game ready to play hard. We must give 100%. We must not lose focus.

What we do off the field matters. I will wear my mask to do my part to contribute to our team’s defense. I will speak responsibly and not spread misconceptions. I will encourage those around me to be safe as well because we are all in this together. If some team members decide they don’t really need to train for this game because it will be an easy one that can hurt all of us.

We don’t yet know what the rest of the COVID-19 pandemic will bring. Maybe this is half-time, or maybe we’re at another point in the game. But we know the game is not over yet. Do not let up now — not if you feel tired, and not if you feel like we are already winning. The game isn’t over.

Please don’t confuse my care for fear. I believe and have confidence we can win the game if we all come out to play our best, with and for each other.

Get more information on Coronavirus (COVID-19)

Related posts:

One nurse’s thank you letter to a former patient

By Amanda Paragas, registered nurse, CHOC Children’s cardiovascular intensive care unit

The CHOC Children’s RN Residency Program is a 17-week program that is specifically customized to meet the requirements of the new nursing graduate to be successfully transitioned to becoming a professional pediatric nurse. Here, a recent RN Residency Program graduate pens a thank you letter to a patient she had the privilege of caring for during the RN Residency Program — one who impacted her as a nurse.

To you, my sweet girl, I owe many thanks.

Thank you for showing me humility and grace.

Thank you for showing me what compassion and love looks like from your perspective. Thank you for letting me watch you grow and develop your wonderful personality.

Thank you for showing me, and everyone else, that you are capable of so much more than anyone ever gave you credit for.

Thank you for showing me how strong and resilient such a young patient can be, without even knowing it.

Thank you for always being mighty and always fighting for what you wanted.

Thank you for never giving up despite being faced with unthinkable circumstances.

Thank you for reminding me that life should not be taken for granted and that all of our time is limited here on Earth.

Thank you for challenging me to be a better nurse and to always strive for excellence when caring for others.

And most importantly, thank you for letting me defend your childhood.

The August RN Residency/Fellowship Program is scheduled to begin on August 17, 2020. Applications will be accepted: May 15, 2020 through May 19, 2020.

Related posts:

How one surgery inspired a career in nursing

By Lisa Turni, surgical unit nurse manager, CHOC Children’s

lisa-turni-rn-choc-childrens

I’ve been a nurse for 18 years, but the seeds of my career were planted long before I put on my first pair of scrubs. Although I didn’t know it at the time, having surgery as a teenager would ultimately inspire my career path.

Growing up, I was an athlete and especially loved playing basketball. Although I was in good shape, I was always out of breath and would hyperventilate often. I felt insecure because I thought I was giving my best at practice.

When I was 14 years old, my mom took me to the pediatrician who initially assumed I had asthma. But when my doctor lifted my shirt to listen to my breathing, she noticed a depression in my chest. I had always known it was there, but I thought that’s just how my chest looked. He diagnosed me with pectus excavatum, commonly referred to as “sunken chest.” This is when the breastbone, or sternum, and some of the ribs grow abnormally and cause a depression in the middle of the chest. Pectus excavatum is the most common congenital chest wall abnormality in children. Many cases of pectus excavatum are found in the early teenage years because growth spurts during puberty can exacerbate the chest depression.

I was referred to a surgeon, who explained that the depression in my chest was pushing down on my heart and lungs, which make it harder for them to work properly, and harder for me to breathe properly. He told me that I would need surgery to correct the deformity in my chest wall. I hadn’t realized there was anything I could do to fix it. He explained that during surgery, he would make an incision across my chest and reshape my rib cartilage which would keep my breastbone in the correct position.

As my surgery date got closer, I became more aware of the depression in my chest, and the way I thought about and saw myself started to change.

At that age, kids at school can be harsh. Sometimes they would unknowingly ask hurtful questions like, “Oh, why does your chest look like that?”

I started to realize I was different. Not necessarily all of the kids and comments were mean, but I was aware that I stood out. I changed the types of bathing suits and clothing I wore to hide the depression in my chest, a behavior I now know is common among pectus excavatum patients.

A physical abnormality is an emotional thing to shoulder as a child. It can be hard for others to understand how much it can affect a child emotionally. When I became a nurse, I used that understanding to inform the care I provided to my patients.

My surgery went well, and although that occurred in the days before the minimally-invasive Nuss procedure was invented, my surgeon was able to “hide” my scar near my bra line so it wouldn’t show in bathing suits or other clothing. The scar became a badge of honor. It was a sign of my courage.

My hospital stay after surgery is what led me to pursue nursing. I knew from that hospital stay that I wanted to help other kids. Some of my providers during that time got frustrated with me because I couldn’t take a deep breath or cough due to pain. Even though pain management has improved tenfold in the years since, the way my care team acted toward me has made me want to always treat patients better than they did.

After eventually getting my bachelor’s degree in nursing, I came to CHOC Children’s Hospital as a travel nurse. As soon as I stepped foot inside CHOC, I knew it was my forever home because of the people and culture.

I worked my way up to nurse manager of the combined medical/surgical unit. Later, when we created separate medical and surgical units, I chose to stay in the surgical unit. Giving back and taking care of patients undergoing surgery is my way of making a difference. I have a special connection with patients undergoing pectus excavatum surgery.

Even though my surgery was over 20 years ago, I’ve found that many pectus patients have similar journeys. When I share my story with my patients, I let them know they are not alone. When I was younger, I didn’t know anyone else who had this condition or understood what my surgery felt like.

Now, I do my best to connect my pectus excavatum patients with one another for peer-to-peer support. In fact, at CHOC, we’re developing a mentor program where former pectus excavatum patients, along with scoliosis patients, are trained to meet with new patients prior to surgery, and help answer their questions and be part of their support system alongside clinical staff.

I also make sure to be there for my patients’ parents as well. Parents often feel guilty for not noticing how deep the chest depression had gotten – but how could they have known? By the time their kids are becoming teenagers, the period during which pectus excavatum becomes most pronounced, they’re no longer in charge of bathing them and they’re not often seeing them without a shirt. I can comfort them in a unique way because my mom had similar feelings.

They are also understandably worried about their child’s surgery and recovery, and they seem grateful to talk to someone who is so many years post-surgery without any major complications. Parents usually have a lot more questions for someone who has been through it, and I spend as much time with them as they need. Thanks to our new mentor program, it has been amazing to see connections made between our parents and patients, and what a huge support that has been for them.

I’m grateful that I had pectus excavatum because it shaped who I am as a person. When I was younger, I didn’t realize how powerful nursing could be. I’m grateful this has been my journey because it feels right to be able to give back and to help patients and their families.

Related posts:

  • An innovative internship approach during COVID-19
    A year ago, Jenae Vancura joined an elite group of college and high school students for a unique and innovative summer internship program at CHOC Children’s. The interns shadowed physicians, ...
  • How being an athlete prepared me to be a nurse
    By Elyse Shelger, registered nurse at CHOC Children’s In my life before nursing, I was a soccer player. I started playing the game when I was 4 years old. It shaped ...
  • One nurse’s thank you letter to a former patient
    By Amanda Paragas, registered nurse, CHOC Children’s cardiovascular intensive care unit The CHOC Children’s RN Residency Program is a 17-week program that is specifically customized to meet the requirements of the ...

A day in the life of a mental health nurse

The CHOC Children’s Mental Health Inpatient Center is an inpatient psychiatric center exclusively dedicated to the treatment of children ages 3-17 with mental illness who are in immediate risk of hurting themselves or others. It is the only inpatient facility in Orange County that can treat patients younger than 12. Our doctors and care team are all specially trained to treat children and provide the very best patient- and family-centered care 24 hours a day, seven days a week.

During a child’s stay, he or she engages in daily multidisciplinary therapeutic groups and receives individual therapy, family therapy, brief psychological testing and psychiatric care.

In observance of Mental Health Month, follow along for a day in the life of Madeline, a clinical nurse in CHOC’s Mental Health Inpatient Center.

5:15 a.m. – After fighting my snooze button, I wake up, shower, and drink some much-needed coffee.

6:30 a.m. – My cat yells his goodbyes to me as I give him a treat and leave for work. On the way, I vibe out to music to get pumped up for the day. I’ve worked at CHOC for over a year now. Last year, I was accepted into CHOC’s Registered Nurse Residency program. As a new nurse, I felt called to work in a mental health setting. I am beyond proud to stand alongside the brilliant CHOC team on the frontlines of mental healthcare.  

7:00 a.m. – I join my team in our conference room for a daily briefing report. Together, we review any newly admitted patients, our current population of patients, and any safety concerns. One of the ways we keep kids safe is through trauma-informed care. Upon admission, we work with patients and their families to determine any triggering situations or actions the patients may have, and then learn how strong emotions may manifest outwardly; such as pacing, shaking, or becoming very quiet. This information helps us to rapidly identify when patients are struggling and may need extra support or encouragement to utilize their coping skills. One of my favorite environmental adaptations we can provide for patients is our sensory room. It helps stimulate a few of our five senses to help kids cope and be more present in the moment. Sometimes, just hearing the rhythmic movements of the bubbles can be soothing and have a great calming effect.

7:30 a.m. – Once I have an understanding of our environment, I walk the unit to check on the patients. Most are still asleep, so I then look up my patient’s medications, while verifying medication consents. All pediatric psychiatric medications need parental consent obtained by the patient’s psychiatrist.

8:15 a.m. — Our medication room has a barn door, so I can efficiently and safely administer patients’ morning medications, preform a quick mental status check-in, and obtain vitals.

9:30 a.m. — One of my patients is currently taking a new medication. In order to better understand her body’s acceptance and tolerance of the drug, we need to run labs. Before drawing her blood, I numb a small area of her skin using a J-Tip®. During the blood draw, a child life specialist and I help the patient cope by offering her modeling clay and a hide-and-seek activity book.

10:00 a.m. — Throughout the day, our patients are divided into groups based on age to attend group sessions. This creates a structured environment that promotes the development of coping and social skills they can utilize when they go home. The sessions focus on our various themes of the day that can range from problem solving or emotional regulation to nutrition and wellness. These sessions are led by our team of nurses, social workers, child life specialists, plus and art and music therapists. This morning’s group session is focused on gross motor skills. Our group leaders soak up some sunshine in our beautiful outdoor area while supervising patients socializing and joining in on a game of handball.

11:00 a.m. — I sit down with one of my patients to discuss their day so far and check in on any thoughts of self-harm that we can work through together. Afterwards, as part of the patient care team, I meet with that patient’s psychiatrist Dr. Lavanya Wusirika, and social worker Gaby, to discuss the patient’s care plan.

12:30 p.m. – It’s time for the patients to have lunch. Our patients eat together, so I assist with passing out lunch trays and pouring drinks. One of our licensed vocational nurses, Brenda, has become our unofficial DJ, and she plays music during lunch to help create a fun, therapeutic environment.

1:00 p.m. – I receive a call from a patient’s parent. After addressing their questions, I update them on their child’s plan of care, medications and current temperament.

2:00 p.m. – I use my own lunch break to catch up with my coworkers. We spend a lot of time together, and I’m lucky to have such an amazing work family.

3:00 p.m. – It’s time for one of our patients to head home. Upon admission to the unit, our team begins organizing outside resources and planning ways to increase safety and support at home. This information is built upon throughout their stay and is incorporated into an individualized safety and coping plan. After our social workers discuss the plan for home with the patient and their parent, I review current medication information and additional discharge instructions. Staff members and fellow patients send off their peer with warm wishes and words of encouragement.

4:30 p.m. –As a nurse, it’s my turn to lead one of our nursing groups. After the patients participate in a discussion about favorite coping skills and we do a check-in of their current emotions, we follow a painting tutorial to practice our theme of the day, mindfulness.

6:00 p.m. – I spend time updating my patients’ charts, including their mental status assessments and treatment plans. This way our whole team can see the patient’s progress and any concerns.

6:45 p.m. – During daily community meetings, all of our patients join together, and our staff leads a check-in to summarize what has been learned from our theme of the day. Patients take turns sharing their high and low of the day and how we can build on these experiences for tomorrow.

7:00 p.m. – As our night shift nurses arrive, we take turns giving a report of their patient’s day and mental status. We share new triggers that we have learned from the patients as well as new coping skills that were helpful. Knowing how we can best care for patients before, during and after a crisis or stressful situation is fundamental for trauma-informed care. By caring for every patient as a whole, not as a diagnosis or as someone defined by their trauma or maladaptive behaviors, we are able to better understand and care for them.

8:00 p.m. ― Get home and share a delicious meal with my husband. A long hug and many kisses are bestowed unto my cat Boots. The three of us will cuddle up and watch a show before we head to sleep and start again.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative and to receive tips and education from mental health experts.

Related posts:

What one NICU nurse learned from her patients

By Marina Birch, registered nurse, neonatal intensive care unit, and graduate of CHOC Children’s RN Residency in Pediatrics program

Marina Birch, NICU nurse and graduate of the CHOC Children’s RN Residency program.

Nursing school taught me many things, but nothing compares to what I have learned during the CHOC Children’s RN Residency program. Experiencing uplifting days and watching your patients heal helps you see the difference you make in patients’ lives. I hadn’t realized how one amazing day will inspire you to come back to work after you have a rough day.

My patients and their families have taught me lessons I would never have learned by myself. During one shift, I had the privilege of caring for a sweet baby girl who was admitted to the NICU a few hours after she was born. Her mother had barely been able to hold her before the baby began having trouble breathing and was intubated. During my day with her we were able to pull out her umbilical vessel catheter, something that allows blood to be drawn for the baby without repeated needle sticks. In addition to this making the baby more comfortable, this allowed her parents to dress her in a onesie for the very first time. I still remember the pastel onesie that read “Little Miss Sunshine.” We then were able to allow her loving parents to hold her without an IV pole attached to her or a machine breathing on her behalf. Her parents had been waiting for this moment for a long time.

That is one of my all-time favorite days at work because the look on her parents’ faces is something I will always remember. They had wide eyes and massive smiles while holding and looking down at their little one. Something so simple as holding and dressing their child was a huge event they had been waiting for since she was born. Giving parents opportunities to hold their child and emphasizing these moments are what they will remember about their time at CHOC.

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

Related posts:

  • How being an athlete prepared me to be a nurse
    By Elyse Shelger, registered nurse at CHOC Children’s In my life before nursing, I was a soccer player. I started playing the game when I was 4 years old. It shaped ...
  • One nurse’s thank you letter to a former patient
    By Amanda Paragas, registered nurse, CHOC Children’s cardiovascular intensive care unit The CHOC Children’s RN Residency Program is a 17-week program that is specifically customized to meet the requirements of the ...
  • How one surgery inspired a career in nursing
    By Lisa Turni, surgical unit nurse manager, CHOC Children’s I’ve been a nurse for 18 years, but the seeds of my career were planted long before I put on my first ...