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.

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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:

  • 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 pediatric pharmacy technician
    By Harumi Hope, emergency department pharmacy technician at CHOC Children’s A pharmacy technician works under the direct supervision of a licensed pharmacist and perform many pharmacy-related functions. At CHOC Children’s Hospital, pharmacy ...
  • From patient to administrative leader: Lucy’s story
    Dr. Lucy Morizio’s connection to orthopaedics began long before she joined CHOC Children’s as director of the Orthopaedic Institute. A self-described daredevil as a child, when Lucy was 5 years old, ...

A day in the life of a pediatric pharmacy technician

By Harumi Hope, emergency department pharmacy technician at CHOC Children’s

A pharmacy technician works under the direct supervision of a licensed pharmacist and perform many pharmacy-related functions.

At CHOC Children’s Hospital, pharmacy technicians prepare, dispense and deliver medications and make sure required administrative work is kept up to date. They take on these responsibilities so the pharmacists can focus on assisting patients and healthcare providers to ensure patient safety and satisfaction.

In addition to CHOC’s inpatient and outpatient pharmacies there are three satellite pharmacies—the operating room pharmacy, the emergency department (ED) pharmacy, and the intensive care unit pharmacy.

This is a typical day in my life as an ED pharmacy technician.

6:45 a.m. — My alarm goes off. I make breakfast, get my kids ready and choose colors for my scrubs (my favorite is maroon!), and drop kids off before work.

8:25 a.m. — Arriving at work a little bit early, I stop for a cold brew to jump start my day. My shift as an ED pharmacy technician starts at 8:45 a.m. Before heading to the ED pharmacy, I spend a few minutes catching up with my colleagues in the main pharmacy. Getting handoff from the morning crew helps me plan and prioritize my work.

8:45 a.m. — As soon as my shift starts, my first priority is to determine if there are any urgent medications to dispense. Keeping a watchful eye over the programs we use to manage these is essential to preventing delays in drug delivery. My first order to fill today is an IV antibiotic that is commonly used to treat infections.

As soon as the pharmacist verifies the order, I start preparing the medication in our sterile hood. Mixing ingredients together to prepare a medication is known as compounding. It is a specialized skill that requires clean technique, strong math skills and attention to detail. This is a very important task that can help to save the lives of sick or injured patients. I find this part of my job as a pharmacy technician especially rewarding and satisfying. After compounding this medication, I deliver it to the nurse who is taking care of the patient.

9:15 a.m. — I go to the MRI suite to replenish emergency medication trays and replenish them. Ensuring that emergency medications are available is an important function of my job.

10 a.m. — An emergency code is called, and I grab our emergency medication cart quickly and go to the patient room along with the ED pharmacist. A patient is seizing and needs a rescue medication immediately. After the pharmacist receives an order from the doctor, I draw up the dose have the pharmacist double-check prior to handing the medication to a nurse. Thankfully, the patient responds to the medication quickly. Once the patient is stable, we return to the ED pharmacy.

11 a.m. — Throughout the day, I check inventory and replenish medications stored in the two medication rooms and medical supply carts to ensure the medical team has the supplies they need to take care of patients.

Harumi_ED pharmacy
Harumi, a pharmacy technician, checks medications in the ED pharmacy.

12:15 p.m. — A patient in the ED who takes multiple medications at home is going to be admitted to the hospital, so I stop by her room for medication reconciliation. This is where we take a thorough medication history in order to make sure the appropriate medications and doses are continued while the patient is in the hospital. .   .

1 p.m. — I try to eat healthy, so I pack salad with homemade dressing, spaghetti and fruits. When there is not a lot of time for cooking, pasta is always the answer.

1:30 p.m. — When I return to the ED pharmacy, I continue with drug preparation, inventory replenishment and medication reconciliation.

4 p.m. — While my priority is ED patients, I try to help the main pharmacy whenever I can. This time is usually the busiest time in there as they have the biggest medication batch for the entire hospital.

5 p.m. — The ED pharmacy receives a page of an incoming trauma patient. The pharmacist and I go to the assigned room with our emergency medication cart and wait for the patient to arrive.

When the transport team arrives with the patient, a paramedic explains what happened, and I try to catch all the important information in case medications are needed. Although the patient has some wounds on his forehead, fortunately, he is stable and doesn’t seem to need any medications at the time.

6:30 p.m. — After several orders and a medication reconciliation, I start cleaning my work station, IV hood, and other areas in ED pharmacy.

7 p.m. — The night shift ED pharmacy technician comes in, and I update him on the day. After making sure everything is clean and stocked up, I head home.

7:50 p.m. — My kids have already eaten dinner, so I quickly eat when I get home. Before tucking the kids to bed, we spend some precious time reading together. They both like to read a lot, and I am very proud of them especially because I never liked to read as a kid. Although there isn’t much time with them around this schedule, I do my best to support them in different ways, and I really appreciate my family for understanding my work.

8:30 p.m. — After preparing lunch for tomorrow and giving the kids a shower, there is finally some time to myself. I enjoy unwinding with music. It is my favorite time of day.

In bed, I think about what I can improve the next day for a better patient care. Sometimes, I dream about making medications.

Although the days can be hectic, I enjoy being a mom and working as a pharmacy technician. There is so much to learn every day and so many opportunities for growth in the pharmacy. It can be stressful, but I work with a passionate group of people who like what they do for our patients, and I am proud to be part of the team.

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From patient to administrative leader: Lucy’s story

Dr. Lucy Morizio’s connection to orthopaedics began long before she joined CHOC Children’s as director of the Orthopaedic Institute.

A self-described daredevil as a child, when Lucy was 5 years old, she fell off her swing set and broke her fibula – a bone in the lower leg. She didn’t know it at the time, but this experience would ultimately impact her career path.

Lucy_childhood image
Lucy, around the time she suffered a broken bone.

Lucy’s parents brought her to a local emergency department for an X-ray, where doctors noticed her bone was indeed broken, and put a cast on her leg.

However, a few weeks later her dad noticed the cast looked crooked, so they went back to the emergency department. Another X-ray showed that her bones were not properly aligned, so she needed to be re-casted.

She wore a new cast from her groin to her toe for a few more weeks. Her total time spent in the casts was around eight weeks — which felt like an eternity in the midst of summer vacation.

When her cast was removed, she began physical therapy and aqua-therapy to regain the strength and coordination she had lost.

“My therapists were amazing; they would make paper dolls with me after sessions—there were no iPads for kids like there are now,” Lucy said.

Then an almost-Kindergartener, Lucy had already developed an interest in healthcare at a young age. Her mom volunteered at a hospital, and her uncle was a gastroenterologist.

“I had an amazing experience with my therapists, which propelled me into the healthcare field. I already had a passion for it, and my experience piqued my interest.”

Lucy eventually became a podiatrist, then transitioned into the newborn screening program and later to the administrative side of healthcare. Today, she is responsible for the strategic planning and growth of CHOC’s Orthopaedic Institute.

Lucy.Morizio
Lucy Morizio, director of the CHOC Children’s Orthopaedic Institute

“My experience in breaking my leg steered me towards pediatrics because the doctors and physical therapists made it a good experience,” Lucy said. “They had a certain charisma in dealing with kids. They had a different – and unique – approach to patient care. I’ve tried to take that with me.”

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 ...
  • 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 ...
  • A day in the life of a pediatric pharmacy technician
    By Harumi Hope, emergency department pharmacy technician at CHOC Children’s A pharmacy technician works under the direct supervision of a licensed pharmacist and perform many pharmacy-related functions. At CHOC Children’s Hospital, pharmacy ...

What we’re thankful for this year: 2019

The  physicians, nurses, staff and patients that make up the CHOC Children’s healthcare community have much to be thankful for this year. In addition to celebrating our 55th anniversary, expanding our Primary Care Network and preparing to open the Thompson Autism Center, we’re grateful to be able to offer best-in-class care to kids in Orange County and beyond. A few members of the CHOC community share what they are most thankful for this year.

KimberlyChavalasCripe
Kimberly Chavalas Cripe, president and CEO, CHOC Children’s

Kimberly Chavalas Cripe, president and CEO, CHOC Children’s

“I have the privilege of experiencing the magic of the holidays through the eyes of our patients.  Their courage, strength, and optimism inspire our team year-round, and drive us to push the limits of what is possible to ensure the very best outcomes for our community’s children.  From bringing preventive care closer to home, to expanding access to mental health services, CHOC’s mighty brigade is dedicated to keeping kids happy and healthy. And for that, I am especially grateful.”

chris-furman
Chris Furman, chairman, CHOC Children’s Board of Directors

Chris Furman, chairman, CHOC Children’s Board of Directors

“I am grateful for serving as chairman of CHOC’s board of directors.  It’s incredibly heartwarming for me and the entire board to help CHOC’s physicians, staff, volunteers and donors preserve the magic of childhood for thousands of children in Orange County and beyond.”

Emma_Sandhu
Emma Sandhu, vice president, administrator and chief nursing officer, CHOC Children’s at Mission Hospital

Emma Sandhu, vice president, administrator and chief nursing officer, CHOC Children’s at Mission Hospital

“I make an effort to live each day with gratitude. I am especially thankful for my family and for having the opportunity to be together this Thanksgiving. I am grateful for the things that I learn each day that help me to be the leader that this amazing organization deserves. Anyone that knows me knows how much I love CCMH and how blessed I feel to be a part of CHOC Children’s. A mighty brigade of passionate associates working side by side each day to serve our most precious gifts, our children.”

Isabella Valdovinos
Isabella, age 10

Isabella Valdovinos, age 10, CHOC Children’s patient

“I’m thankful for my mom, and the nurses and doctors at CHOC who took out my appendix and took such good care of me. I’m looking forward to a healthy and happy Thanksgiving with my family – especially the mashed potatoes and gravy.”

Liz_Hawkins
Liz Hawkins, volunteer, Mental Health Inpatient Center

Liz Hawkins, volunteer, Mental Health Inpatient Center

“As the first volunteer in CHOC’s Mental Health Inpatient Center, I’m humbled to be of service in the simplest of ways, be it a warm smile, a cup of juice, a compassionate ear or a shared laugh with our patients, families and staff. I’m grateful for all of the little things that I experience with our patients; from painting nails, to working on a puzzle, to learning a new game and even just acting silly by rolling around in the grass in our outdoor play area. I’m honored to be embraced so warmly by our patients and incredible staff as a part of the MHIC “Dream Team.” My husband Ryan and I are thankful for our entire MHIC’s dedication to treating our patients with dignity and respect every day and resetting the standard of care for pediatric mental health in this country. We are making history every day at CHOC. Lastly, I am grateful for all of the lessons our MHIC patients teach me: to face challenges head-on, to develop resiliency and self-awareness, to remember that you are never alone and most importantly, that the little things are always the big things. ”

Sterns
Ralph and Sue Stern, CHOC Children’s supporters

Sue and Ralph Stern, CHOC Children’s supporters

“As the grandparents of 10 grandchildren ages 5 – 17 years and all residing in Orange County, we are so grateful to have CHOC in our backyard. To us CHOC is not just a children’s hospital, it’s a healthcare system staffed by superb physicians, along with caring and attentive nurses, technicians and administrative staff. Each time one of our grandchildren has been admitted to CHOC Children’s Hospital as a patient, he or she has been discharged in much better condition. Our gratitude to Kim Cripe, CHOC’s president and CEO, for providing outstanding leadership and to Kara Kipp , CHOC Foundation assistant vice president, and Brianne Ortiz, manager of the Cherese Mari Laulhere Child Life Department, and the rest of the child life team for the impact of their work.”

Liam Katz
Liam, age 5

Liam Katz, age 5, CHOC Children’s patient
“I am thankful for CHOC, child life, the playroom, the treasure chests, all the doctors and nurses, and the wonderful families and friends we have met.”

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Dr. Tom Megerian, pediatric neurologist and medical director, Thompson Autism Center at CHOC Children’s

Dr. Tom Megerian, pediatric neurologist and medical director, Thompson Autism Center at CHOC Children’s

“I am so grateful for the opportunity that the CHOC executive leadership team and the Thompson Family Foundation have given us to open a state-of-the-art autism center. This will allow us to provide a medical home for families and children suffering from Autism Spectrum Disorders. My team and I are thankful that we will be able to promote early diagnosis, treatment of co-occurring disorders, education and research for families suffering from ASD.

I am especially appreciative for the gift and privilege of working with colleagues across the CHOC healthcare system in helping make the Thompson Autism Center a reality. Everyone from rehabilitation services, CHOC Children’s Specialists, neurology, psychology, information services, project management, the CHOC Foundation, marketing, and my newfound family within the Thompson Autism Center who have been so supportive and single-minded in their dedication to our patients. Finally, I am grateful to the families who, every day, put their faith and trust in us to care for their children. Thank you for enriching our lives by helping us aspire to be better clinicians, caregivers and citizens.”

Kimberly Burks
Kimberly Burks, charge nurse, neonatal intensive care unit (NICU), CHOC Children’s at Mission Hospital

Kimberly Burks, charge nurse, neonatal intensive care unit (NICU), CHOC Children’s at Mission Hospital

“As we near the end of 2019, I feel so thankful for my CHOC Children’s at Mission Hospital family. Each member of the team — from our volunteers to our managers — is an integral part of our goal to provide excellent patient care. When things get busy, our team pulls together and works hard to get the job done. I am thankful to work in a neonatal intensive care unit (NICU) that values patient- centered care and infant developmental care so much.”

chief residents
2019-2020 chief residents

Dr. Timothy Hicks, Dr. Stephanie Lee, Dr. Majid Husain, Dr. Amanda Schafenacker, chief residents

“For the past three years we have had the honor and privilege of learning from the incredible patients, physicians and medical staff at CHOC Children’s as part of the UC Irvine-CHOC Pediatric Residency Program. This year, we are thankful to be serving as the Pediatric Chief Residents. We are especially thankful for our 90+ residents who serve as the frontline providers taking care of the children of Orange County and beyond, our attending physicians and administrative staff for their commitment to education and teaching, and CHOC leadership for their unyielding support and dedication to our training program. Lastly, as pediatricians, we are grateful have the opportunity to partake in CHOC’s mission to nurture, advance and protect the health and well-being of our children.”

Jessica Ochoa, emergency department admitting representative

“I am thankful for the opportunity to work here at CHOC. I am thankful for all of my coworkers and all of the nurses because without them we would not be able to make a difference in these families’ lives. I am thankful for all the wonderful families that I have been able to meet while working here and last but not least, I am thankful for all the children that come in and continue to brighten our day with all of their little personalities. Happy Thanksgiving to all CHOC employees and CHOC families.”

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