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.”

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  • 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 ...
  • Honoring the Veterans Among our Mighty Brigade
    This Veterans Day, CHOC Children’s wants to acknowledge the military veterans among our mighty brigade of clinicians and staff, and extend our heartfelt thanks for their service to our country. We ...

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.”

dr-tom-megerian-choc-childrens
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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Honoring the Veterans Among our Mighty Brigade

This Veterans Day, CHOC Children’s wants to acknowledge the military veterans among our mighty brigade of clinicians and staff, and extend our heartfelt thanks for their service to our country.

We asked our veterans to share how their history of service impacts their work at CHOC, and how it contributes to our mission to nurture, advance and protect the health and well-being of children.

Here are a few of their responses.

Bill Rohde

  • Sergeant (E4), U.S. Air Force
  • Vice president, finance, CHOC Children’s

“Veterans understand what it truly means to defend and protect, making them well qualified to be defenders of childhood and protectors of the health and well-being of children.”

Bill_Rhonde_CHOC

Teela Hernandez

  • Hospital corpsman, pediatric unit, U.S. Navy
  • Registered nurse, multispecialty unit, CHOC Children’s

“Because of my service, I know how to multi-task and roll with the punches. I work well under pressure.”

Teela Hernandez

Daniel Holloway

  • Petty Officer, U.S. Coast Guard
  • Marketing project manager, CHOC Children’s

“I joined the Coast Guard and served active duty for six years because I aligned with the mission to protect lives and the environment, provide life-saving care to those in distress and promote safety through law enforcement. Military service taught me teamwork and discipline to see things through. Transitioning to CHOC was a great fit for me as its mission and values are in alignment with protecting the health and well-being of children and everyone who comes through our doors. I am grateful to work in partnership with the most wonderful people doing incredible, life-saving work within our community. I am a proud veteran and CHOC employee.”

Daniel Holloway

Cortney McKinney

  • Medic, U.S. Army
  • Registered nurse, outpatient infusion center, CHOC Children’s

“While I was a medic in the Army, I found my love for medicine and helping people. I knew I wanted to be a nurse. The Army helped me realize that God gave me the heart of a servant. I now continue my service as a nurse caring for my patients here at CHOC.”

Courtney McKinney

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From CHOC mom to CHOC employee

“You look like you could use a good cup of coffee,” Maria would say from time to time to a tired parent at CHOC Children’s at Mission Hospital. “Oh yes!” they’d reply as she’d make them a cup.

Maria understands that a warm cup of coffee doesn’t just help sustain a parent who’s running low on sleep, but also gives them back a small sense of normalcy while their child is hospitalized.

Maria, a former department assistant in the administrative offices of CHOC at Mission who recently transferred to the laboratory at CHOC Children’s Hospital in Orange, knows this all too well. Her son Nehemiah, who is now a happy and healthy 11-year-old boy, was born with a heart condition and spent the first four months of his life at CHOC.

“If I see a mom struggling, I would try to do my best to be there for them because I understood what they were going through” she says. “They’re comforted knowing that someone understands.”

Delivering next door to CHOC

Thanks to a prenatal ultrasound, Maria and her husband Juan knew there was a problem with their son’s heart. But doctors told them they wouldn’t know the extent of the problem until he was born. Maria chose to deliver her son at St. Joseph Hospital in Orange so that they’d be next door to CHOC, and he would have close access to any specialized care he might need.

Shortly after Nehemiah was born, doctors performed an echocardiogram, a common and safe procedure that helps doctors look at how the heart is working. Dr. Anthony Chang, a pediatric cardiologist who is today CHOC’s chief intelligence and innovation officer, was present at Nehemiah’s birth.

“I was so scared for my son, but I felt like he was in good hands,” recalls Maria. “Dr. Chang explained Nehemiah’s condition and that he needed to be transported to CHOC for emergency surgery. He said it was a race against time.”

Nehemiah was born with interrupted aortic arch and ventricular septal defect, a condition with a large hole in the heart and blockage of the main artery feeding the body. Normally a hole in the heart would be considered bad news, but that hole helped him live because it allowed blood to circulate until corrective surgery could be done.

When Nehemiah was two days old, he underwent his first in what would become a series of heart surgeries, performed by Dr. Richard Gates, CHOC’s medical director of cardiothoracic surgery and co-medical director of CHOC’s Heart Institute.

After Nehemiah recovered from surgery in the cardiovascular intensive care unit (CVICU), he was transferred to CHOC’s neonatal intensive care unit (NICU). He had a feeding tube to help him eat, but as a step towards going home, he needed to work on eating on his own.

Nehemiah spent his first Christmas in the hospital, and his parents weren’t sure when they would be able to bring their baby home.

The day after Christmas, Nehemiah’s condition worsened when he contracted a blood infection called septicemia. Babies under 3 months can contract this because their immune systems haven’t developed enough to fight off overwhelming infections that originate elsewhere in their body. Once he was stabilized, his care team opened his chest so they could administer a vacuum-assisted closure (VAC) to help soak up the infection. A suction pump device connected to a tube with a foam sponge on the end, which was placed into Nehemiah’s chest to soak up the infection. His dressings were changed regularly for several weeks until the infection was gone. Once he recovered, his care team closed his wound and he was transferred back to the CVICU.

It takes a village

It would be another few months before Nehemiah would be able to go home. During that time, CHOC became home for his family. Juan would shuffle back and forth between hospital and the family’s home, bringing Nehemiah’s siblings Ethan and Giovanni, who were 3 years old and 10 years old at the time, to visit their baby brother. Maria’s mom would help the family and visit as well. During Nehemiah’s months-long hospitalization, Maria stayed by his side and never went home.

“It took a village to get my little guy through this ordeal,” Maria said.

A four-month hospital stay

Before Nehemiah was discharged after more than four months in the hospital, his parents received education and training from his doctors and nurses, so they would be able to care for him at home. He was discharged with a feeding tube, oxygen tank and medication.

“We were so excited to finally bring him home. In a sense, it was like we all got to finally go home,” Maria recalls. “My other two kids had essentially been living with their grandma, I had been at the hospital, and my husband had been going back and forth. We were finally together under one roof.”

Nehemiah’s heart was fragile, so as he grew up he would sometimes get sick more easily, and more severely, than his brothers and friends.

“If he would get sick with just a little cold, he would go from zero to 10,” Maria says.

Sometimes that would include seizures, which lead to two hospitalizations.

A second heart surgery

Nehemiah has undergone one additional surgery to repair a blockage that developed between his heart and great aortic artery, called a subaortic membrane.

“After his last heart surgery, his seizures stopped, and he started becoming normal,” Maria said.

These days, Nehemiah, who loves sports and music, visits CHOC every six months for check-ups with Dr. Chang to see how his heart and arteries are progressing as he gets older.

“His team always wants to know as he is growing, are the arteries growing with him? Eventually, he’ll need another procedure someday,” Maria said.

Despite semi-frequent trips to CHOC, Nehemiah is not afraid of doctors because for him, doctor appointments are second nature, according to Maria. Nehemiah has spent so much of his life in and out of CHOC that he refers to it as “My CHOC.”

A few years ago, when Maria was looking for a new job, her personal connection to CHOC was a big factor in her search, she says.

“I felt like CHOC was somewhere I’d want to work because I had so many positive experiences here as a mom. Everybody was very friendly. The nurses were good with all my kids, and with me too,” she said. “I remember that little things went a long way, and I try to bring that to my work here now.”

Learn more about the Heart Institute at CHOC Children's

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