Doctors performing surgery on patient

Nurse Helps Make Cancer Surgery Less Stressful

Longtime nurse Michelle Johann’s empathy helps her imagine and anticipate her patients’ needs, desires and concerns — and find simple solutions
City of Hope nurse, Michelle Johann
Michelle Johann, D.N.P., R.N.

If you ever need to have surgery at City of Hope®, you can thank a nurse — Michelle Johann, D.N.P., R.N. — for making the entire process a little less scary.

That’s because Johann, a clinical practice education specialist and 25-year City of Hope veteran, devised a program that enables patients and their families to tour the pre-op, operating and post-op facilities and meet the people who will care for them each step of the way. It creates an important familiarity, so when the time for surgery arrives, patients aren’t wheeled into strange rooms, surrounded by people they’ve never seen before.

“They can see everything in their own time,” explained Johann, “not just when they’re stressed out at the time of their surgery.”

About the Hope Tours Program

The program, called Hope Tours, took a pause during the pandemic but was reconstituted on video (and is now being reimagined). It’s the kind of common-sense innovation that typifies Johann’s approach to her job, and it’s a big reason she is one of a select handful of City of Hope nurses to be chosen to receive this year’s Off the Chart recognition from the Simms/Mann Family Foundation, celebrating nurses who display “a bias towards action, a capacity for self-direction, originality and creative instincts, courageous and bold thinking and the potential to achieve even more.”

Add to that a “never give up” attitude and an enormous capacity for kindness, and you pretty much have a perfect description.

“From the minute I met Michelle, I knew she was a highly skilled individual, with compassion and integrity,” said longtime colleague Peter Hirsch, clinical nurse manager for perioperative services. “She is genuine and kind, and there’s nothing she wouldn’t do for her colleagues or her patients.”

Indeed, Johann is all about making things better, an instinct she recalls having long before she began thinking about a career in nursing.

“I was 5 years old,” she recalled, “and I’m in the supermarket with my mom, strolling down the aisles, and I see elderly people dropping things, and they can’t pick them back up. So, I picked them up for them.”

She remembers a “wonderful childhood” growing up in Los Angeles as part of a big family — she has two brothers and three sisters — and especially admiring her mother, a department store logistics manager. “She was the go-to lady, the multitasker, very big on safety,” she said. “She drove me to always want to make improvements. She was always working on some kind of improvement project, and I remember thinking, ‘Wow, that’s cool!’”

A Calling Toward Nursing

She was always fascinated by the human body, wondering as a child, “How can we be so perfect, run so smoothly?” But she didn’t see herself as a nurse. Not right away. Not until the teachers at her all-girls Catholic school encouraged her to take on student leadership roles and be more assertive. Her physical education instructor, who also taught general science, noticed her passion for the subject and told her she belonged in the medical field. “Could I?” she asked herself.

Then, in high school during Career Day, something clicked.

“I saw this OB-GYN nurse, all in white, with that cap on,” she said. “She was cradling an imaginary baby in her arms as she talked about her day as an OB-GYN nurse. That’s when I knew I wanted to do that. Every part of me wanted to live that life.”

But self-doubt haunted her, and when she entered Pasadena City College, she did study science but put her nursing dream on hold, taking a job as a financial manager to pay the bills. Until one night, when a dream shook her out of her hesitation.

“I was asking myself, ‘Is this what I really want to do? Isn’t there something else I should do?’”

She began taking nursing classes. And she didn’t stop, earning her R.N. certification, a master’s degree and most recently her D.N.P. — Doctor of Nursing Practice.

“I always seem to need that one person to say to me, ‘Of course you can!’” she said. “Now I want to be that person for others.”

Her longtime study partner and booster saw potential in Johann from the start.

“We both had the same goals, the same focus on continuing to learn and improve ourselves,” recalled Carolina Uranga, a clinical nurse specialist in geriatric oncology and a quality improvement specialist. “We encouraged each other — because nursing school is hard! She’d come over to my house to study.”

Johann remembers their first meeting, in Pasadena. She’d spotted a “very pregnant” Uranga and marveled at her new friend’s ability to balance family and school so well. When Uranga got her first job at City of Hope, she encouraged Johann to apply as well. “‘You would like City of Hope,’” she told me. ‘There’s zero turnover. Nurses have been there 15 years or more.’ So, I applied. Carolina was right. I love the collegiality, the collaboration and respect at City of Hope and, above all, the patients we care for.”

Speaking of respect, Johann is the kind of leader that others look to for guidance. Like her mom, she’s proud to be the go-to person, the problem-solver. Her typical day is a nonstop quest to ensure that her nurses in the pre-op and post-op units have everything they need. But Johann takes it a step further.

“I ask them every day, ‘How did you connect with your patients today?’” she says. Making those connections is paramount to Johann, and she rarely passes up an opportunity to try a new idea to improve the patient experience.

For example, the simple concept of “being present.” Johann saw that patients scheduled for surgery typically arrive around 5:30 a.m. And typically, at that early hour, there is limited staff around to greet them. Not OK, she thought. So Johann proposed a program to train volunteers to staff the waiting area to be there for patients at their most vulnerable time. It makes a difference, she says.

'Grab Every Opportunity'

Johann and her family
Johann with her family on vacation in Big Bear.

And when she gets an idea, she runs with it. Johann thought aromatherapy would ease post-op nausea for some patients. She pushed the idea in a unique way. Seeing a surgeon about to enter the OR, she pressed an aromatherapy sample into his hand. It got his attention. Long story short: A pilot program grew into an institution-wide practice. “Grab every opportunity,” she says. “Keep knocking on doors because eventually one will open.”

Colleagues describe Johann as an ever-smiling, look-on-the-bright-side presence. “We shared office space for five years,” recalled Hirsch. “And we never had a disagreement.” When push comes to shove — like when the patient load is unusually heavy, the unit is understaffed and time is short, they have their own secret way of coping together. “Michelle really loves musicals, and we’d often put on show tunes and whistle them to get through stressful times.”

And just in case, there are other favorite stress-busters, too, useful at work and at home. Johann, a wife and mother of three, has a black belt in karate. And a season pass to Disneyland.

Working in the surgical unit of a cancer institution can take an emotional toll, but Johann loves coming to work every day. “I love being part of something bigger than myself, and being a positive influence for everyone,” she said.

She encourages her nurses to pursue “a continued spirit of inquiry” aimed at making things better. As for the patients, her message is simple: “I want them to know that this is your home. You are accepted. You are embraced. You are loved. And you are a priority.”