Children’s Memorial Hospital, Chicago, Illinois

After the Great Chicago Fire in 1871, Chicago became one of the fastest growing cities in the world. But in this time of prosperity and growth, the prognosis for children born in the city was grim. A child had only a 50% chance of surviving to the age of 5 years, and those who survived were likely to be exposed to a host of diseases. In 1882, Julia Foster Porter, a young widow who also lost a child to disease, took bold steps to transform the future of children’s health in Chicago. Ms Porter renovated a modest home at the corner of Belden and Halsted Streets for $13,000 and established first—and still its only—hospital dedicated exclusively to caring for children. From these modest roots, with the support of many community partners, Julia’s cottage would eventually become Children’s Memorial Hospital.

One hundred twenty-nine years later, Children’s Memorial Hospital is guided by the belief that all children need to grow up in a protective and nurturing environment in which each child is given the opportunity to reach his or her potential. Its vision is inspired by the courageous children and families it serves and is sustained by the extraordinary contributions of compassionate, knowledgeable, and dedicated staff and volunteers.

Jacqueline Marie Toia, RN, MS, DNP, a pediatric hematology/oncology nurse practitioner, graciously answered our questions about her experiences working at Children’s Memorial Hospital.

Children’s Memorial is consistently ranked among the top children’s hospitals in the country by U.S. News & World Report. In 2010, Children’s Memorial placed in the top 10 for children’s cancer centers. How have these honors impacted your career?

Jacqueline Marie Toia (JMT): Children’s Memorial has such a rich background, and this legacy is just one of our treasures. We are especially proud to be recognized as one of the 30 best children’s hospitals in the United States in 9 pediatric specialties. The hospital ranked among the top 10 in 5 pediatric specialties. We scored particularly well on carerelated measures assessed for each specialty, ranking No. 5 in urology and No. 10 in oncology, gastroenterology, kidney diseases, and neurology/neurosurgery. We are the largest pediatric hospital in Illinois, providing specialists in every pediatric specialty, and we are the pediatric educational facility for Northwestern University Feinberg School of Medicine. Last year we served more than 140,000 children.

As a nurse at Children’s Memorial, I am especially proud of the specialty care we provide. Of the 1200 nurses who work at the hospital, 128 are advanced practice nurses. In January 2009, the American Nurses Association recognized the hospital as the first pediatric hospital in the nation, and the first hospital in the state, to receive its prestigious Magnet Award for Nursing Excellence. Children’s Memorial has now received Magnet designation for the third time. These awards and acknowledgments foster pride among us. Our pride in practice creates new benchmarks in excellence and encourages collaboration both internally and within the broader nursing community. Nurses are at the heart and core of our patient care. And because our nursing practice is open to endless possibilities, we attract and retain talented and caring practitioners.

How does your parental advisory committee translate to better patient care?

JMT: Not only do we have a Family Advisory Board (FAB; the parents’ committee), we also have a Kids Advisory Board (KAB). Both of these boards serve to create a true partnership and are pivotal to the care we provide. We rely on families’ unique experiences and perspectives to help us make decisions about the hospital’s programming and policies.

The FAB was founded in 1992 to formalize the partnership between parents and hospital leadership and to seek parents’ consultation on an ongoing basis. The board is made up of parents of children who have had extensive inpatient and outpatient experiences at Children’s Memorial; the FAB advises administration and medical leadership on patient needs and hospital priorities from a family perspective.

The purpose of the KAB is to give a voice to kids who are treated here and to share with staff what is important to children, teens, and siblings during healthcare experiences. The current KAB is made up of 10 members who range in age from 11 to 17 years. Its mission is to recommend change that positively affects patient care and contributes greatly to making the hospital an even better place for kids.

What is your role on the treatment team, and how has that role changed over the years?

JMT: I have had the unique and privileged experience to practice as a nurse in various roles at Children’s Memorial for the past 24 years. I started as a staff nurse on the oncology unit in 1986. It was, and is, a fabulous unit in which to begin a nursing career. I had so many amazing mentors who taught and encouraged me to grow and question the art and science of pediatric oncology nursing. From the inpatient unit I went on to practice as a registered nurse in the outpatient oncology clinic. During this period of my career I continued to expand my knowledge base, participated in care provisions governed by clinical trials, served on hospital-wide committees, and became a nursing member of the national Children’s Oncology Group, all while attending graduate school, which was completely financed by the hospital.

After I completed my first master’s degree, I worked as a clinical nurse specialist in oncology and helped develop the pediatric Survivors Taking Action & Responsibility (STAR) Program, which provides long-term follow-up for survivors of pediatric cancer. That was an exciting time and a great opportunity to participate in program development in an emerging field within oncology. As I completed my second master’s degree and my Doctorate of Nursing Practice, I began to practice as a pediatric nurse practitioner, which I continue to do today.

Our team has evolved over time to include many disciplines. We are truly a multidisciplinary team. In addition to the primary medical team, comprised of attending physicians, fellows, advanced practice nurses, and registered nurses, our families receive support from social work, pastoral care, child life, art therapy, parent support team, as well as a caring mix of ancillary support staff and volunteers.

Do you have a patient success story to share?
JMT: I love this question. There are so many wonderful success stories. Today in the field of oncology, it is estimated that 80% of children will survive their disease. I have had the pleasure to care for so many beautiful children throughout my career. Many of them have gone on to great success. I have cared for children who have gone on to become doctors, nurses, lawyers, teachers, moms and Chicago’s dads, and everything in between. I have even had the pleasure to watch a few of them go on to become oncologists.

I have a few success stories that are so very special. One in particular is a patient, IB, who was diagnosed with high-risk leukemia when he was a junior in high school. He was a quiet young man with so much depth of character; he was funny, insightful, and loving. He would come to clinic with his mother and always managed a smile even in the worst of times. His dad would call me after each visit for an explanation of the day. This became our routine with every visit. Clinically IB went on to do well; he progressed through 3 years of therapy and maintained a clinical remission.

I have always been a huge supporter of our oncology camp, One Step at a Time. I have to admit that on occasion I have been known to “push” a little when it comes to recruiting kids who I think will enjoy camp life. During the course of IB’s therapy, when I employed my tactics to get him interested in going to camp, I was always met with a polite “I don’t think so, Jacquie.” We rehearsed this interaction for years until IB reached an age where he was old enough to participate in camp as a counselor. I convinced him it was time for him to come and work with the children. He finally agreed. And the rest, as they say, is history. IB went on to take over the camp program designed for the youngest kids who I managed for 20 years. It was one of the most special moments of my career to be able to pass this program into IB’s management. IB went on to marry his high school sweetheart, and they now have a 1-year-old daughter. He graduated from law school and has a successful private practice, and to this day he continues to run the program each summer at camp One Step at a Time. Not only does he manage the program for the youngest campers, he also serves as legal counsel for the camp. I would call that a great success.

What is in the future for Children’s Memorial?

JMT: Children’s Memorial will soon take on a new name at a new location. The Ann & Robert H. Lurie Children’s Hospital of Chicago, named in recognition of Ann Lurie who pledged a $100- million gift, is especially meaningful as Ms Lurie once worked at Children’s Memorial as a critical care nurse. We will be moving to the heart of downtown Chicago in 2012, to the medical campus of Northwestern University Feinberg School of Medicine. The new hospital will be a 23-story, state-of-the-art children’s hospital. This collaborative effort involvies skilled architects, our FAB and KAB, community and cultural organizations, and more than 800 Children’s Memorial employees and physicians.