Karen Miller, B.S.N., R.N., C.E.N., (pictured in the birthday hat with some of her neuro-oncology teammates), has been a nursing pro for the past 12 years, and has been overseeing all aspects of brain tumor cases at Rady Children’s Peckham Center for Cancer and Blood Disorders since June 2018. We chatted with the San Diego newcomer to learn more about her role as neuro-oncology case manager, her penchant for a certain red-haired crooner and what local staple she’s obsessed with snacking on.
As a nurse case manager, what’s your day-to-day like?
I like to think of myself as the filter for all things that are brain tumor-related in the world of pediatric neuro-oncology. I help coordinate scheduling for doctor’s appointments, radiology, labs, referrals, etc. I answer all calls that come in from neuro-oncology patients and families during the week and help triage their needs and concerns. Unfortunately, sometimes, that means bringing them into the oncology clinic or Emergency Department. However, my hope is always to do my best to help patients and families obtain the resources and information they need to stay out of the hospital. Although I don’t get to see a lot of patients and families in person, I get to know them very well over the phone and sometimes speak to them daily. This position is truly a culmination of the various nursing positions I’ve had over the last 12 years and has been the most challenging.
How many cases do you typically handle at one time?
The neuro-oncology team has served more than 700 patients and their families since the inception of the program by [pediatric neuro-oncology Director] Dr. John Crawford; Lani Yeh-Nayre, N.P.; and my predecessor, Gail Garcellano. The team now consists primarily of Dr. Crawford; [Pediatric Proton Therapy Program Director] Dr. Jennifer Elster; Lani; Liz Torok, N.P.; and myself. We are the point of contact for all patients and families, whether they are currently in treatment, being followed post-treatment, or have even transferred to other facilities.
The team is closely tied to the palliative care, social work and research teams, as well as other specialty teams including endocrinology, ophthalmology, neurology, pediatric neurosurgery, radiation and rehabilitation medicine. Brain tumors are very different from other pediatric oncology diagnoses in that they are more of a chronic than an acute diagnosis. It’s tough to give a number for cases that we handle at once. It is unquestionably a group effort and the team is juggling many cases simultaneously.
What is your favorite part of your job?
My favorite part of the job is unquestionably the team I work with on a daily basis. They are all so passionate about the care they give and providing a source of support for our patients and families any time of day, any day of the year.
What brought you to this career, and to focus on neuro-oncology?
I started in pediatric hematology/oncology as a new graduate nurse over 12 years ago after reading a book written by kids with cancer in the 1980s. I was so moved by how the children and teenagers wrote and viewed their disease, even at such young ages. I spent the next few years working and traveling in pediatric hematology/oncology and worked in inpatient, outpatient, bone marrow transplant, radiation oncology and hematology/oncology urgent care. When I was thinking about going to graduate school, I thought it would be a good idea to expand my clinical experience and worked in the pediatric emergency room. There, I rekindled a dream to become a flight nurse and obtained required neonatal intensive care unit experience to get hired as a flight nurse a few years later. I flew patients of all ages but specialized in neonatal transports.
I was a workaholic and always had two jobs, so I’ve also worked per diem jobs. I worked in the blood bank, as well as postpartum and inpatient pediatric nursing. I was also a sexual assault nurse examiner, which involves collecting evidence and treating adults and children after suffering from trauma and/or sexual assault. I continue to serve as an expert witness in depositions or trials, should any of my cases require that service.
I loved flight nursing but always missed oncology. I missed the consistency and the relationships I had with patients and families. When my family and I decided to move permanently to San Diego, I decided to re-pursue hematology/oncology, and wanted to find a position that I could carry hopefully through retirement and challenge me throughout. Neuro-oncology is extraordinarily challenging, dynamic and rewarding. After I interviewed with Dr. Crawford, Dr. Elster and Lani, I prayed to be offered this position, and was thrilled when it became my permanent home.
What advice would you give to aspiring neuro-oncology medical professionals?
You will never be bored and you will always be rewarded when you least expect it. It is an ever-changing, ever-growing field of pediatric oncology that is a beast you will fight with and grow to love. It takes a certain strength and patience, and most importantly, it takes a village.
What do you think makes Rady Children’s special?
Most jobs I’ve had start out really exciting and kind of simmer out over a few months. It is during those few months that you get a really good feel for the team, hospital and what the job is really about. This job started out as the greatest challenge in my career. The last few months have been the opposite of a simmer-down for me. They have fueled me to enjoy [the role] more and more, and that is almost entirely due to the team I work with and the patients and families I serve. The case management, research and neuro-oncology teams have dedicated themselves to helping me become and remain successful. This type of support for one’s colleague is unique. They say when it doesn’t feel like work, you’re in the right place. For me, more importantly, when work family feels like actual family, then you truly have found home.
On an average day off, where would we find you?
I am a full-time stepmother to four young children and my husband and I just bought a new home in North County. Lately, you can pretty much find me keeping up with these little future Kardashians or at Home Depot or the grocery store. Six mouths = constant need for milk and cookies. I love to run and hike, so am super excited to hit the trails once we’re settled in. My first visit to this area was my first ultra distance run in Lake Hodges, so I know how beautiful this area is and can’t wait to explore.
If you could hang out with one person, real or imaginary, alive or dead, who would it be and why?
Moses. I think he would have a lot to help me understand about Judaism. Plus I’ve always been curious what those tablets of the Ten Commandments were really made out of…
You can have absolutely anything in one meal. What do you pick?
Easy. A hardcore, hole-in-the-wall San Diego drive-through bean-and-cheese burrito and red velvet-flavored fro-yo. It used to be cheese pizza and fro-yo, but now that I’ve had San Diego’s Mexican food, I’m sold on that for good.
What is your favorite place in the world and why?
Currently, it’s at home with my husband and stepkids on a night with no obligations nor early wake-up time in the morning. Corny, but true. They will only be young for so long and I’m a pretty big fan of our new home, at least once all the appliances start working. Though I won’t lie, if we could relocate to Hawaii for a few nights with no early wake-up, that would be my new favorite place.
What are a few of your favorite bands/musical artists, movies/TV shows, and books?
Ed Sheeran is my current non-romantic love. His music and lyrics are so beautiful, and my stepdaughter even tried to see if my husband could hire him to propose to me. Turns out that was a bit fiscally prohibitive, but I still appreciated the thought. I love historical fiction movies. “Sergeant Stubby” nailed it for people of all ages. However, romantic comedy is my favorite, and no one beats “Juno” — best movie lines of all time. Even my stepkids know the line, “Thundercats are go!!” I consider that one of my primary accomplishments as a stepmother. I enjoy lots of different types of books, but have currently been on a celebrity autobiography kick. Naya Rivera’s Sorry, Not Sorry is one of my favorites. Work and life are too serious to spend much downtime on anything that’s not a bit free-spirited and comical.
What else should people know about you?
I am a twin. I am an Ironman. I am a 50-mile ultra-distance runner. I was the salutatorian of my high school and valedictorian of my nursing school. However, I am most proud to be a stepmother, wife and neuro-oncology nurse.