The American Association of Critical-Care Nurses (AACN) recently conferred a gold-level Beacon Award for Excellence in the pediatric intensive care unit (PICU) at CHOC Children’s Hospital. This is the third time CHOC has earned the gold-level distinction.
The Beacon Award for Excellence recognizes unit caregivers who successfully improve patient outcomes and align practices with AACN’s six Healthy Work Environment Standards. Units that achieve this three-year, three-level award with gold, silver or bronze designations meet national criteria consistent with Magnet Recognition, the Malcolm Baldrige National Quality Award and the National Quality Healthcare Award.
“The Beacon Award for Excellence recognizes caregivers in stellar units whose consistent and systematic approach to evidence-based care optimizes patient outcomes,” explains AACN President, Clareen Wiencek, RN, PhD, ACNP, ACHPN. “Units that receive this national recognition serve as role models to others on their journey to excellent patient and family care.”
CHOC’s PICU earned a gold award, the highest designation, by meeting the following evidence-based Beacon Award for Excellence criteria:
leadership structures and systems;
appropriate staffing and staff engagement;
effective communication, knowledge management, learning and development;
evidence-based practice and processes; and
“This award is further validation of our entire pediatric intensive care team’s dedication to the highest standards of patient safety and care,” says Melanie Patterson, RN, MHA, DNP, vice president, patient care services and chief nursing officer, CHOC Children’s Hospital. “We are entrusted with caring for some of the sickest and most medically fragile patients, and our goal is to deliver the best possible outcomes for them and their families.”
Years ago, when Nora Higa was settling on a career, her main interest was helping people. She found that and more as a critical care nurse in the pediatric intensive care unit at CHOC Children’s at Mission Hospital.
“I work with an amazing group of professionals,” Nora says. “We are small but mighty. Everyone pulls together with such teamwork, especially when we have particularly challenging cases. It enables us to give the best care to our patients and their families.”
Nora has served CHOC Mission’s patients and families since the hospital opened its doors on the fifth floor of Mission Hospital in 1993.
Celebrating 25 years of service this month, the 54-bed hospital is the only dedicated facility for pediatrics in south Orange County, surrounding coastal areas and north San Diego County.
“I’m very proud to be a part of the organization,” Nora says. “Families really appreciate the personal care they get. I met a family recently who has been in hospitals all over the place, but said they really felt the caring of the nurses and the quality of the care at CHOC Mission.”
Throughout her time with the organization, Nora has appreciated the changing technology at CHOC Mission, as well as the collaboration with Mission Hospital.
“We are privileged to continue collaborating with Mission Hospital and be part of the verified pediatric trauma team,” she says. “This has given us the opportunity to care for some challenging and interesting trauma patients which has resulted in some amazing and rewarding outcomes.”
As CHOC Mission begins its next quarter century of service, Nora looks forward to her role in ongoing efforts to advance pediatric healthcare in south Orange County and beyond.
“I hope that we will be able to continue to serve the families of south County with the highest level of care, compassion and expertise,” she says.
At just 6 years old, Madison Morrison has earned the nickname “Miracle Maddy” after recovering from life-saving surgery at CHOC Children’s. The spunky girl, who loves listening to music and drawing, defied the odds of survival when the flu caused encephalitis (viral meningitis with life-threatening brain swelling). Within 48 hours of being taken to the Julia and George Argyros Emergency Department at CHOC Children’s Hospital, Maddy underwent emergency brain surgery and was placed in a medically induced coma. For the next two months, her parents remained by her bedside in the pediatric intensive care unit (PICU).
Mike, Maddy’s dad, says February 4 marked the beginning of their journey. He and his wife Angel never imagined a trip to the emergency department for vomiting would end with their youngest child fighting for her life. On the evening of her admission, Maddy’s nurse immediately noticed when her patient became unresponsive and her pupils became fixed and dilated – grave findings suggestive of dangerous brain swelling. Maddy was intubated, placed in a coma and underwent surgery to have a device placed in her brain to measure and help reduce the pressure inside her skull. Given the fixed volume of the skull, there is little room to accommodate for brain swelling. As it does, the pressure in the skull increases. Seizures, strokes and even death can occur if the pressure rises significantly.
The pressure inside Maddy’s skull remained very high. Her physicians feared she would not survive. After all medical interventions failed to control the brain swelling and lower the pressure in her skull, and after a scan revealed Maddy was at imminent risk of death, CHOC neurosurgeon Dr. William Loudon presented Mike and Angel with one final measure: a decompressive craniectomy, a surgery in which part of the skull is removed to allow a swelling brain to expand beyond the normal confines of the closed skull.
“Dr. Loudon patiently explained everything, including the risks, and assured us he’d care for Maddy as though she was his own daughter,” recalls Mike. “We were naturally frightened, but we had confidence in him and trusted he would do everything in his control to save her.”
Mike adds, “He kept his word. We will forever be grateful to him.”
Maddy remained in a coma as she continued to heal. Her PICU care team became, in her parents’ words, “the protectors.”
“Without ever hearing her voice or experiencing her outgoing personality, the team stood by Maddy’s side to not only protect her and save her life, but to love her. The people in CHOC’s PICU are special. There’s no way to understand the emotion and bonds created in that unit unless you’ve been there and experienced the passion within the entire team and the love they have for their jobs, their patients and their parents,” shares Mike.
The PICU team rallied with Mike and Angel when Maddy came out of the coma. She still had a tough recovery ahead, but with the help of CHOC’s speech, physical and occupational therapists, she relearned to walk, talk and eat.
The day Maddy was discharged from the PICU was bittersweet. Her parents were thrilled to be taking her home but sad to say goodbye to the staff who had become part of their family.
Angel explains, “Not only did the people in the PICU save Madison’s life, they were smiling faces to us day in and day out. They were a big part of our encouragement, while sharing in our hope and our worry. I was grateful to leave the PICU but sad to leave so many amazing people.”
Shortly after arriving home, Maddy was living up to her nickname. Walking laps around her home, dancing to her favorite songs and enjoying some Snapchat fun, she was putting her hospital stay behind her and focusing on the joys of childhood. And her CHOC family wouldn’t want it any other way for their “Miracle Maddy.”
Growing up, Tony often heard his mom Sam talk about her job at CHOC Children’s Hospital. As a respiratory therapist, he knew that she played an important part in helping to make critically ill patients better.
When he was in fourth grade, Tony was tasked with writing a paper about what he wanted to be when he grew up. He told his mom he wanted to either join the military and be a sniper, or become a registered nurse (RN).
“I told him he was too tall to be a sniper and that he should definitely become a pediatric RN. He never wavered after that,” Sam recalls.
Fast forward to his high school biology class, when he connected with his mom over his coursework on different body systems, and some of the diseases she had seen in her 30-year career at CHOC.
“When I was younger, I would see my mom come home after work exhausted, but always with a smile on her face. She was doing what she loved and was proud that she was a CHOC employee,” Tony says. “As I got older, I saw friends’ parents stop enjoying their jobs, while my mom was still coming home happy.”
While pursuing his nursing degree, Tony was hired at CHOC as a unit assistant in the neonatal intensive care unit (NICU). On the 3:00 p.m.-11:00 p.m. shift, he interacted with day shift and night shift nurses and physicians, and occasionally floated to other units. He felt a strong pull towards the pediatric intensive care unit (PICU) for the complex and diverse patients they care for on a regular basis.
“Initially I did feel bad for Tony because the majority of his coworkers knew him as my son, and had heard stories about him when he was growing up,” Sam recalls. “I work the day shift, and I remember the day a nurse who had just switched from the night shift asked me, ‘Are you Tony’s mom?’ I said, ‘No, Tony is my son!’ I had worked here for over 25 years at the time and he had only worked here for six months! Since then, everyone on night shift has called me Tony’s mom.”
Clinical rotations in nursing school reaffirmed Tony’s commitment to pursuing a career at CHOC.
“When I was at other hospitals, I noticed a difference in both the care team and the way they interacted with patients,” Tony says. “Later, when I was halfway through the nursing residency program at CHOC, I had a sense of pride as I bragged to my old classmates from nursing school about how amazing CHOC was and how great PICU was. I knew I had found my home.”
Since graduating from the residency program last year, Tony has already made a lasting impression on patients in the PICU and their families.
“Patient and family-centered care means a lot to me. I chose pediatrics to work closely with the patient as well as the family during their scary time,” Tony says. “I tell every parent as I take care of their child, that if they feel something is wrong to tell me and we’ll explore every avenue together. I always encourage them to participate as physicians are making rounds so they feel a part of the team. Working night shift, it’s important to me that my patients’ parents trust me enough to rest and take care of themselves, as I watch over their child.”
Even though Sam knew that Tony would be a great registered nurse from the time he was young, seeing him in action has filled her with an even greater sense of pride.
“Tony has always demonstrated a strong sense of compassion and a willingness to take care of others. He has a strong work ethic and an outstanding moral compass,” she says. “When I am approached by people who have just learned he is my son and they tell me how much they love working with him, it makes my heart sing.”
In their family, the admiration goes both ways.
“Knowing that my mom is a hard worker and well-respected at CHOC makes me want to live up to her standard,” Tony says. “There have been a couple of instances where we’ve worked together and it’s exciting because I’ve long heard how amazing she is as a respiratory therapist, but I’ve gotten to see it firsthand.”
Although Sam works days and Tony is just arriving for his shift as she is heading home for the night, she takes loves whenever she has a chance to see her son in action.
“I see him at change of shift receiving reports and my smile is instantaneous. He is a delightful young man and I am proud to be his mom, thrilled to work with him and honored that he chose a profession that helps others.”
I honestly don’t remember the exact moment that I decided to pursue a career in critical care nursing. I almost feel like it’s been forever. When I was younger, I do remember spending time at my older cousin’s house, and looking through all of her human anatomy books. I was fascinated with her nursing text books. My favorite aunt in Mexico is also a registered nurse. She is intelligent, kind and was been a major support through my mother’s illness and after she passed away.
I was a troubled teen and young adult and although I was in college, I couldn’t focus. At the age of 21, I found myself in an abusive relationship and by 23 I was a single mother. I found the courage, with the support of my mother, to leave my unhealthy relationship and start a new life with my daughter. As part of this new chapter, I took a short course towards becoming a medical assistant, which piqued my interest in medicine. Once I started working full-time I went back to community college and started to take more classes with the hope that one day I’d get my nursing degree. My daughter was two years old when I started working towards that goal.
In 1993, my mom had a heart attack and then surgery, and shortly after that we moved to California to be near family. With the support of my mom and family I worked full time and continued taking courses towards my nursing degree. During this time, I worked and saved up money to buy a small condo, while maintaining a full course load and making strides towards my dream of becoming a nurse. I’m not going to lie; this wasn’t an easy time. There were semesters that I only took one class. There were semesters that I couldn’t take any, but I kept trying. I was a mom with a mission. I had my daughter to raise and I wanted to be a good example for. When people ask me what was my driving force was, I tell them that it was Alexis, my daughter. I wanted to be an example of success to her. I wanted to show her that anything was possible. Hard work, dedication and commitment mixed with a lot of faith in God makes anything possible.
Finally graduating from nursing school has been my biggest accomplishment. As a medical assistant I worked in pediatric clinics for many years and it was always my goal to stay in pediatrics. My favorite rotation during nursing school was the pediatric intensive care unit (PICU). I loved the rush of the intensive care setting. After my first rotation in the PICU I knew that was where I wanted to be and I knew that CHOC was the hospital that I wanted to be in.
Taking care of very sick, often medically unstable, pediatric patients has been my passion, especially families who have a language barrier. There are many moms, dads, grandmas and grandpas whose loved one is critically ill, but they can’t express themselves or their hearts to nurses or doctors due to the language barrier. That was and has been my heart’s mission, to help those families feel safe, supported and care for, just as much as we are caring for their loved one.
I am grateful and honored to be a critical care nurse at CHOC. I have cared for many patients during my time as a CHOC nurse, and I’ve developed many wonderful relationships with many of their families. I have laughed with my patients and I have shed many tears. I’ve held the hands of parents as they have said goodbye to their child when we had done all we could do.
Nursing is what I love. Nursing is what I do best. It’s where I see miracles take place.