Veteran Nurse to Help Lead CHOC Mental Health Inpatient Center

After spending time with a relative with a mental illness, Dani Milliken knew as early as age 6 that she wanted to help people who struggle with mental illness when she grew up.

“From that point on, I dreamed of working as a psychiatric nurse,” Dani says. “I am so fortunate that I get to come to work every day and love what I do. My passion in life is psychiatric nursing; it always has been and it always will be.”

mental health nurse
Dani Milliken. clinical director of CHOC’s inpatient mental health center

Dani will put that passion – as well as a wealth of experience in establishing a pediatric inpatient mental health unit – to good use as clinical director of the CHOC Children’s Mental Health Inpatient Center, set to open next spring.

Before joining CHOC in June, Dani helped design and operationalize a pediatric inpatient mental health unit at Nationwide Children’s Hospital in Columbus, Ohio. Previously, she spent four years at Twin Valley Behavioral Healthcare, a state-owned and -operated inpatient psychiatric hospital in Ohio. There for four years, she served in a variety of roles, most recently as assistant director of nursing.

Dani hopes her work at CHOC will set the standard of care for psychiatric nursing across the country, as well as help remove a stigma that persists around patients with mental illness and the clinicians who treat them.

“Unfortunately, there can be incredible amounts of stigma surrounding not only the patients on an inpatient psychiatric unit, but also the staff that works there,” she says. “I look forward to teaching everyone about quality psychiatric treatment, and what it means to be a real psychiatric nurse.”

Dani earned her bachelor’s degree in nursing from Mount Carmel College of Nursing, and went on to receive her master’s degree in nursing administration. She is currently working toward a doctorate in health care administration.

Though much of her free time is spent getting settled in Orange County after a cross-country move, Dani looks forward to hiking and biking with her husband and dog, as well as quilting and sewing.

In her short time at CHOC, Dani already has been impressed with the culture of collaboration, accountability and respect.

“I am inspired at the amount of teamwork, collaboration and respect that I have encountered during meetings with various disciplines,” she says. “All of these things speak loudly about the level of quality care being delivered to patients here at CHOC. I am thrilled to be a part of this amazing team!”

Upon its opening, CHOC Children’s Mental Health Inpatient Center will be the first pediatric inpatient mental health center in Orange County to accommodate children younger than 12.

With 18 private rooms in a secure and healing environment, the center will provide a safe, nurturing place for children ages 3 to 18, and specialty programming for children younger than 12.

The center is the cornerstone of CHOC’s efforts to create a pediatric system of care for children, teens and young adults in Orange County with mental illness. One in five children – about 150,000 in Orange County – will experience a diagnosable mental health problem.

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.

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Surgical Team Gives Back Through CHOC Walk

Known as CHOC’s most anticipated event, the CHOC Walk in the Park presented by Disneyland Resort is set for August 27 this year. Many of our employees — among the more than 15,000 people expected to attend — will be proudly walking for CHOC in support of our patients and their families.

We spoke to Christina Portugal, unit assistant, surgical unit, and team captain of CHOC Walk’s team 3E Suture Heroes, who shared what inspires her to participate in this beloved tradition.

choc walk
Team Suture Heroes at last year’s CHOC Walk in the Park

Q: What inspired you to become part of CHOC Walk? How long have you been participating?

A: I was inspired to participate in the CHOC Walk in the Park when I was a volunteer, before I joined the staff. I was inspired to be a volunteer after losing my dad to cancer eight years ago. I was moved by all the health care professionals who treated my dad with such kindness and compassion. Through my dad’s illness I gained a profound passion for the healthcare industry and wanted to find a way to give back so I chose to volunteer at CHOC. As my volunteer journey began, little did I know this would be the place where I would give to others and in turn heal from my loss. Volunteering I meet so many brave children fighting through the most difficult times and still standing strong heroically, our true super heroes of this world, teaching me that I could also be strong. I decided after a few years of volunteering that I would make a career move into the healthcare industry and joined the 3E surgical unit. I am grateful to be amongst a team of hardworking, warm kindhearted people who care about helping others. When I started walking in the CHOC Walk in the Park as a volunteer it was another way to say thank you and now I continue to say thank you to CHOC for giving me more than I can possibly put into words. Team Suture Heroes of 3E has grown and last year we were 38 members strong and raised over $4,000!

Q: There are many ways that associates can support CHOC. Why do you participate in CHOC Walk every year?

A: I participate every year because it affords me an opportunity to raise funds that make an immediate impact on families at CHOC Children’s. I walk for HOPE and get to do so alongside my coworkers and community. It is a privilege.

Q: What is your favorite memory from a previous CHOC Walk?

A: Being amongst the thousands of people in our community all affected by and or supporting our families of CHOC is surreal. Walking alongside patients, families and teams supporting one another is what makes this event so memorable. Seeing the hundreds of banners, cheering crowds and smiling faces all walking with grateful happy hearts is an experience like no other.

Q: As a veteran of past CHOC Walks and leader of an experienced CHOC Walk team, what “insider tips” would you offer to someone participating in their first CHOC Walk this year?

A: When you register, you will be given your own CHOC Walk personal page. I would encourage everyone to post this right away on all their social media sites. With a click of a button your friends and family can donate toward your fundraising efforts. Another helpful tool is the CHOC Walk FUNdraiser app which makes it easy and fun to track your progress in real time. For the morning of the CHOC Walk in the Park I would suggest you come extra early and give yourself enough time to walk to the entrance of the park since there are no trams running that morning. The parking can get quite congested and crowded and can delay your arrival to the CHOC Walk and you don’t want to miss out on the opening festivities.

Q: What would you say to a community member or fellow CHOC associate to encourage them to participate in their first CHOC Walk?

A: There is something very special about coming together to benefit others.  You gain a sense of hope in humanity. The quote that inspired me to not only participate in the CHOC Walk but to also begin my journey as an employee at CHOC was, “The best way to find yourself is to lose yourself in the service of others.” – Mahatma Gandhi

Q: What inspires you most about the care being delivered at CHOC?

A: I am continually amazed by the medical teams at CHOC and the outstanding care they provide our families. When I walk across the bridge from the parking structure into the hospital, I have a grateful heart that I can be a part of a loving, giving and supportive community. I am thankful for what CHOC has taught me― how to be a better human and to appreciate what you have in this world.

Register Now!

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My Journey to Becoming a NICU Nurse: April’s Story

By April Bell, registered nurse at CHOC Children’s and mother of CHOC NICU graduates Mikayla and Emma

I’ve been a nurse at CHOC for 15 years. I started working here as a nurse aide while I was in nursing school and after graduation, I entered the RN Residency program as a nurse in the medical/surgical unit. I learned a lot about time management and honed my nursing skills starting IVs, inserting feeding tubes and catheters, and giving medications. I enjoyed the time I spent on that unit, but after about five years I was looking for another challenge. The new pediatric intensive care unit (PICU) and new cardiovascular intensive care unit (CVICU) had just opened on the sixth floor, and I was considering a nurse fellowship in the PICU. However, before I could start that process, I found out I was pregnant with twins.

Not only twins, but very high-risk twins called monoamniotic-monochorionic, or “MoMo.” These types of twins share one amniotic sac and the risk is that their umbilical cords could become tangled and/or compressed. These rare twins have a 50 percent survival rate. I knew they would most likely be delivered early; my OB-GYN did not want to deliver past 32 weeks gestation. We ended up making it only to 28 weeks, as their cords were knotted together twice and wrapped around my daughter, Mikayla’s neck, twice.

Mikayla weighed only one pound, 13 ounces when she was born. Emma was two pounds, six ounces.

nicu nurse
April was a registered nurse in the medical/surgical unit at CHOC Children’s when her twins were born premature. Their family’s experience in the neonatal intensive care unit (NICU) inspired her to become a NICU nurse.

From the moment the twins were delivered, the neonatal intensive care unit (NICU) team that was in my delivery room made a huge impression on me including the neonatologist who was present at the delivery, Dr. Daryoush Bassiri. I met Dr. Bassiri the week before my twins were born, when I was admitted to St. Joseph’s Hospital, next door to CHOC. He told me what I could expect if they were born at 27, 28, 29, 30 weeks, etc. The nurses who were at the delivery were also very supportive and kept me informed about what the plan was for the babies.

Both of my daughters need to be intubated right after delivery, but the nurses made sure I could see them briefly before they left for the NICU. The next few days were quite a roller-coaster, starting when Emma became very sick. Because her lungs were not fully developed, she was placed on a ventilator to help her breathe. The pressure of the ventilator caused her lungs to collapse. She needed two chest tubes to resolve her collapsed lungs. Her lungs also developed pulmonary hypertension (a type of high blood pressure) and pulmonary interstitial emphysema (where air collects outside the normal air space). All of Emma’s lung problems are common conditions in premature babies, but it was still a very scary time. I wasn’t sure if she was going to make it. She was given nitric oxide, a medication to treat breathing problems in premature babies, and finally she started to slowly improve. She took a turn for the better, only to face another setback: she was diagnosed with a heart defect called patent ductus arteriosus (PDA). In some premature babies, the opening between the aorta and the pulmonary artery does not close, as it does in most children.

Her sister, Mikayla, although smaller, was doing much better. She only needed to be intubated for about a day and a half and was on bubble CPAP (continuous positive airway pressure), non-invasive ventilation support for newborns. Mikayla had the same PDA diagnosis as her sister, and received medication to close her PDA. Emma could not get the medication because the doctors were worried about her kidneys, after how sick she had been. So the doctors decided that a surgical repair know as PDA ligation was the way to go. Once again, we were worried about her. She had an excellent surgeon, Dr. Brian Palafox, who explained everything to me and Emma’s dad. Although he told us what possible complications could come from the surgery, everything went very smoothly.

The next few months were filled with more ups and downs, but nothing quite as scary as the first few days. After they mastered breathing on their own, working on feedings was another struggle. They had an amazing team of developmental therapists, lactation consultants and of course, their bedside nurses. I learned so much from everyone that took care of my twins. As a medical/surgical nurse, I had floated to the NICU before, but I had no idea what each preemie went through.

Emma spent 75 days and Mikayla spent 77 days in the NICU. Towards the end of my twins’ NICU stay, I realized that the NICU was where I wanted to be as a nurse. I spoke with one of the NICU managers and told her I was interested in transferring to the NICU. I was surprised to learn that they were, in fact, just starting a nurse fellowship program. When I started my NICU fellowship, I went with the RN Residents to a special NICU consortium taught by the NICU educator at the University of California Irvine. We were there with nurses from NICUs all over Southern California. I finished the NICU fellowship when my daughters were just about 1 year old. I feel like the classes really helped me understand so much more about the development of the neonate and how to care for them.

During the last seven years in the NICU, I have taken care of a variety of babies, from small micro-preemies to babies who have undergone surgery, and babies with heart defects. I helped open the CHOC Children’s NICU at St. Joseph’s Hospital. I have also had the privilege to care for babies in our Small Baby Unit.

After having two micro preemies of my own, I feel I can really relate to a lot of the parents. I have been on the other side of it and know how frustrating and worrisome it can feel.

I enjoy sharing my story with my patient’s families. I have seen firsthand how strong and resilient these babies can be.

I was working the night that we opened the new, all private room NICU. At the end of my night shift, I helped transfer my patients upstairs and get them settled into their new rooms. It was amazing to see how smoothly everything went that morning. It was also exciting to see the babies in their own rooms. My twins were always with other babies in a pod, and it would have been so nice to have a private room. I would’ve loved to have been able to stay overnight and sleep right next to my babies when they were in the NICU, like the parents can do now in our new NICU. It was hard to leave the NICU when my daughters were there. The noise in the pods could get loud at times, and occasionally a baby would be sick and need sterile procedures which meant all non-clinical staff had to leave the unit. The patients did not always have privacy. I am excited for the patients and families that will benefit from our new private room NICU.

Looking at my daughters today, you would never know what they have been through. They are almost 8 years old and they are just about to start second grade. They’re very smart and are excelling in school. They started reading in pre-kindergarten and have been reading at an advanced level ever since; they almost read better than their older brother, Joey. The only long-term effect from being born so premature and facing a mountain of health challenges has been with Emma, who has a raspy voice from left vocal cord paralysis, a common complication from the surgery. I am so grateful to have two healthy girls.

I am also very grateful for the way the CHOC NICU cared for my own children, and I am extremely proud to be part of it as a caregiver.

Take a virtual tour of our new NICU

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Meet Dr. Seth Brindis

In addition to providing high-quality medical care, physicians and staff at the Julia and George Argyros Emergency Department at CHOC Children’s Hospital strive to make the experience less stressful for children and families. One physician has a few tricks to ease his patients’ fear and anxiety. Dr. Seth Brindis, a board-certified pediatric emergency medicine specialist and medical director of informatics, performs magic for his patients.

choc emergency department
Physicians in the CHOC emergency department strive to make the experience less stressful for children. Dr. Seth Brindis often performs magic tricks for his patients.

“For me, magic makes my job easier, instantly transforming what can be a scary experience for children to something fun. I incorporate magic into my physical exam as it makes the exam easier and more reliable when patients are comfortable with me and distracted. I tend to use coin tricks because they appeal to a wider range of ages, with the added benefit that the coins can be disinfected between patient contacts.”

Luckily, it doesn’t have to be an emergency in order to see Dr. Brindis’ magic. With help from child life, he occasionally puts on impromptu magic shows in the CHOC theater for inpatients, their siblings and parents.

Dabbling in magic since childhood, Dr. Brindis’ interest in magic was revitalized while in residency at Harbor-UCLA Medical Center, where he realized that simple tricks with cards and coins could help make connections with patients and staff. Since then, he has continued to study magic, even taking courses tailored for magic in medicine. Seeing thousands of patients each year, Dr. Brindis gets ample time to try out new tricks and help patients and their families leave with positive experiences and smiles on their faces.

Exclusively dedicated to the treatment of pediatric patients, CHOC’s ED features 31 exam rooms, including two trauma bays, and three triage suites. The ED is staffed with doctors who are board-certified in emergency medicine and specially trained nurses who provide the very best patient- and family-centered care. Child life specialists work with patients to help them feel safe and secure, and make the process a lot less stressful for the entire family.

“The ED is often the gateway for many families who are coming to our organization for the first time. We’re working together to deliver the best care to those who need it most. My job is to understand what is distressing to a parent in the middle of the night and either educate and reassure the family or intervene when called for.”

As the only trauma center in Orange County dedicated exclusively for kids, CHOC is ready to treat injuries 24 hours a day. The trauma team is trained to care for children and their unique physiological, anatomical and emotional needs, and CHOC’s protocols and equipment are specially designed for pediatrics.

The ED saw over 49,000 patients in the first year it opened. This year, it’s on pace to see more than 85,000 patients – an incredible rate of growth, which Dr. Brindis credits to the coordination and cooperation between the ED physicians, EMSOC leadership, and nursing, as well as CHOC administration.

“I love being a part of this team. I feel like we provide exemplary care to every person who enters our doors. Often, I feel like the conductor of an orchestra of care. There is no way I could do my job without the incredible people I work with. It really is impressive to watch our team working in concert to stabilize a really sick child.”

Dr. Brindis received his medical degree from Vanderbilt University. He completed his pediatric residency and pediatric emergency medicine fellowship training at Harbor-UCLA Medical Center in Torrance. In addition to caring for patients in the ED, he is actively involved with the training and teaching of pediatric and emergency medicine residents as well as fellows.

In his spare time, Dr. Brindis enjoys spending time with his wife, son and daughter. He also enjoys cooking, painting and, of course, working on his magic.

Learn more about emergency services at CHOC Children's

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Meet Dr. Alyssa Saiz

CHOC wants its patients and families to get to know its specialists. Today, meet Dr. Alyssa Saiz, a postdoctoral fellow in pediatric psychology and neuropsychology.

Q: What is your education and training?
A: I attended Pepperdine University to complete my doctorate in clinical psychology. My clinical internship was at the University of Health Science Center San Antonio. I am currently near the completion of my two-year postdoctoral fellowship in pediatric psychology and neuropsychology.

Q: What are your special clinical interests?
A: My clinical interests are working with children and teens with depression and self-harming behaviors, as well as somatic symptom and related disorders. I also am developing my specialty in pediatric neuropsychology. I love being able to help people during the most confused and vulnerable time in their life, and hope to give them a future they can thrive in.

Q: How long have you been on staff at CHOC?
A: Three years.

Q: What are some new programs or developments within your specialty?
A: CHOC is in the process of building both an intensive outpatient program and Mental Health Inpatient Center for children and teenagers through the Mental Health Initiative. This is very exciting because the services provided by both of these programs are greatly needed in our community and will help us provide even better comprehensive and intensive mental health care.

Q: What are your most common diagnoses?
A:  Somatic symptom disorders, depression, and anxiety.

Q: What would you most like community/referring providers to know about you or your division at CHOC?
A:  As a department, we are growing and evolving with the community, working on research developments and supporting CHOC’s mental health initiative – all for the happiness of the population here. We are here to serve them, and working hard with them in mind each day. For me personally, I would love for people know how much of a passion this is for me – I’m here doing this work because I truly love it, and admire the courage of my patients and coworkers.

Q:  What inspires you most about the care being delivered here at CHOC?
A:  The aspiration to always give more and provide better services to the children and families we work with, as well as the commitment to training the future generations of medical and mental health professionals.

Q: Why did you decide to become a doctor?
A: I am insatiably curious and always wondering how to improve a situation. I also love to connect emotionally with people and understand their journey. So naturally, I was always drawn to psychology as an area of study and found myself looking for opportunities to work with children and teenagers who were experiencing hardship or mental health concerns.

Q: If you weren’t a physician, what would you be and why?
A: I would be a florist or have a ranch for rescued animals. Both very different paths, but in the end they’re creating beauty to enhance someone else’s life and provide joy.

Q: What are your hobbies/interests outside of work?
A: I love to cook (usually anything pasta or cheese-filled) and be outside (hiking, walking my family’s dog, and being in the sun). I am also currently learning Spanish, which I am very excited about!

Q: What is the funniest thing a patient has ever told you?
A: When I told a young patient I was going to get her mom from the waiting room, she replied, “Well, she’s probably getting coffee. She can’t live without coffee!” I can relate. Kids hear and take in everything!

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.

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