How being an athlete prepared me to be a nurse

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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.

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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

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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.

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  • 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 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 ...

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.

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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.

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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.

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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:

  • 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 ...