Joy Miller
November 2016
Children's APN Support
University of Virginia Health System
United States




Joy is the palliative care nurse practitioner for the Children's Hospital and has worked with hundreds of cases since she has been in her role. There are numerous examples of how she has created safe, calm, peaceful environment for careful decisions for patient management.
Joy Miller helps the entire provider team keep goals of care at the center of our treatment plan for the children in the PICU. Recently she came in from home on a weekend when she was off to help me with an infant. The baby was very ill with an abdominal cancer, and the care team was trying to decide if we should intensify her care or redirect. Joy arrived for a Saturday 7am family meeting and helped us meet the family's needs -- both with medical decision making as well as with formulating what her redirected care looked like. During the conversation, she offered to have the baby's home pets come into the hospital for a last visit with the baby. I watched this baby's mother's face when Joy offered this; her face transformed, and I saw grace enter our plan for the care of this sweet baby. Joy is a gentle, tireless advocate for families before, during and after end of life care.
We also currently have a baby who was born with multiple defects and his long-term prognosis is undetermined. Since birth, it was clear that this family was faced with making multiple decisions during their child's hospital stay. Joy met this family at the beginning of the hospitalization, has gotten to know the family members and has helped be a consistent voice for the patient and family members. When multiple care teams have been involved in the management of the patient, information can be confusing. Joy is an advocate for the patient and his parents.
What is remarkable is how thoughtful Joy is about caring for the providers in the PICU. After the emotional family meeting, she texted with each member of the physician team to check in on our well-being. She was in constant contact with the bedside nurses over the weekend, checking that they were supported, that the family's needs were met and that the nurses felt emotionally supported. Again, this was all over a weekend when she was not scheduled to work.
She has also found that staff members struggled mentally and emotionally during unfortunate situations where medical therapy is no longer effective to support life. She is currently working on a project for a cart that would house resources for all staff members, that coaches them in conversation tips, how to talk to siblings, and how to support others. Joy was also instrumental in the development of the staff only resiliency room- a calming, peaceful and quiet space for staff to take a few moments and step away from the bedside for personal time.
She walks into your unit during the most stressful cases and you immediately feel calm. I'm so grateful that Joy is my colleague and friend at UVA. We're lucky to have her.
It has been an honor to work these past years with Joy. Her compassion, professionalism and support for family and staff truly go above and beyond. I can't say enough good things about her but in all confidence, can say that our lives and the lives of the patients and their families are enriched with her presence.