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The “honor” of a nursing career David J. Kilarski Chief Executive Officer FirstHealth of the Carolinas
A few months ago, I had the privilege of attending a special event at FirstHealth Montgomery Memorial Hospital in Troy, a reception honoring Sandra Nall Davis, R.N. Mrs. Davis was retiring after 46 years as a registered nurse, 40 of them with Montgomery Memorial. On the day she retired, Mrs. Davis sent me a letter in which she very thoughtfully reminisced about her long career and what it had meant to her. Since this issue of FirstHealth’s magazine serves as our 2014 Nursing Annual Report, Mrs. Davis’s letter appears here, in the space usually reserved for the CEO’s message. I think you will find it as appropriate for this issue of our magazine as I do. And thank you, Mrs. Davis, for your devoted service to your patients and your community.
anuary 17, 2015: This is the day that I retire from being employed as a nurse of 46 years. In those 46 years, it has been my honor to have taken care of some five generations of families in Montgomery, Moore and Randolph counties. Those patients could have been your grandparents, your parents, you, your children and maybe your grandchildren. In those years, I have had the privilege of meeting and tending many U.S. veterans of World War I, World War II, the Korean War and the Vietnam War. Some of them shared their war experiences and stories that they might never have shared with their friends and families. What a privilege it has been to sit by Sandra Nall Davis, R.N. their bedside and listen to their stories. I have worked alongside so many wonderful nurses during my career, and you all know who you are. Nurses are resilient people. If you could walk in their shoes for a 12-hour shift, you would be amazed at the split-second decisions they have to make. Nurses give up their break times, their lunch times, their holidays and their days off, because they are dedicated to taking care of people. They work through ice and snow storms, hurricanes and tornadoes. They give up their Easters, Thanksgivings and Christmases to care for the sick. They miss their children’s special events. The next time you find yourself lying in a hospital bed and looking up at a nurse, smile at her/him. She/he will take great care of you. To you the patients: I take this opportunity to thank each of you for the trust you have placed into my hands by sharing your ailments, troubles and worries and secrets. To my own family: I thank you for your unending and untiring support and sacrifices that you made to allow me to work and serve as a nurse. I leave you all with this thought, my mantra for many years: “Cherish the sacrament of the present moment.” Take time to appreciate the people in your path daily, and enjoy the fact that you share this moment in time, and that your paths crossed for a reason.
Sandra Nall Davis, R.N.
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On the cover: On a late fall afternoon in 2014, the Operating Room at FirstHealth Moore Regional Hospital quickly became much busier than usual. For a story on how nurses and other FirstHealth professionals helped bring four Cesarean-section babies into the world in just 11 minutes, turn to page 12.
155 Memorial Drive P.O. Box 3000 Pinehurst, NC 28374 Editor, FirstHealth of the Carolinas. . . . . . . . . . . . . . . . Brenda Bouser Managing Editor . . . . . . . . . . . . . . . . . . . . . . . . . Jason Schneider Creative Director . . . . . . . . . . . . . . . . . . . . . . . . . . Jan McLean Production Director . . . . . . . . . . . . . . . . . . . . . . . . Traci Marsh
w ww. f i r s t heal t h .o rg Contributing Writers
Brenda Bouser, Ellen Cooper
Brenda Bouser, Ellen Cooper, John Gessner, Don McKenzie
Board of Directors FirstHealth of the Carolinas Mr. Hew Fulton, Chair Ms. Tracy A. Leinbach, Vice Chair/Secretary Mr. Sherwood Blackwood Mr. James H. Bulthuis David M. Cowherd, M.D. John N. Ellis, M.D. Mrs. Carolyn D. Helms Mrs. Anna G. Hollers, Treasurer Mr. David J. Kilarski
Mr. Julian W. King Mr. Don Padgett Bernard M. Stanfield, M.D. William L. Stewart, M.D. Mr. Robert E. Tweed Raymond Washington, M.D. Mrs. Rusti Welch
Corporate Officers Chief Executive Officer, FirstHealth of the Carolinas President, FirstHealth Moore Regional Hospital. . . . . Chief Financial Officer, FirstHealth of the Carolinas.
. . . Mr.
David J. Kilarski
. . . . Mrs.
Chief Medical Officer FirstHealth of the Carolinas .
. . . . . . . . . . . . . . . . . . . . . . . John
Chief Information Officer, FirstHealth of the Carolinas .
. . . . . . . . . . . . . . . . . . . . . . . Mr.
Lynn S. DeJaco F. Krahnert Jr., M.D.
David B. Dillehunt
Chief Operating Officer, FirstHealth Moore Regional Hospital. . . . . . . . . . . . . . . . Mr. Brian T. Canfield Chief Nursing Officer, FirstHealth Moore Regional Hospital. . . . . . . . . . . . . . . . Mrs. Karen Robeano, DNP, R.N. President, FirstHealth Physician Group . . . . . . . . . . . . . . Daniel R. Barnes, D.O. President, Moore Regional Hospital-Hoke Campus. . . .Mrs. Susan K. Beaty, R.N. President, FirstCarolinaCare Insurance Company. . . . . Mr. F. Craig Humphrey President, FirstHealth Richmond Memorial Hospital
. . . Mr.
John J. Jackson
President, Foundation of FirstHealth . . . . . . . . . . . . . . . . Mrs. Kathleen Stockham President, FirstHealth Montgomery Memorial Hospital. . . . Mrs. Beth Walker, R.N. Vice President, Human Resources, FirstHealth of the Carolinas . . . . . . .
. . . . . . . . . . . . . . . . . Mr.
Vice President, Strategy & Innovation, FirstHealth of the Carolinas . . . . . . . . . .
. . . . . . . . . . . . . . Mrs.
Vice President, Finance & Support Services, FirstHealth of the Carolinas . . . . . . . . . . . . . . Vice President, Quality, FirstHealth of the Carolinas .
Daniel F. Biediger
. . . . . . . . . . Mr.
Jeffrey A. Casey
. . . . . . . . . . . . . . . . . . . . . . . Mrs. Cindy McNeill-McDonald, R.N.
The not-for-profit FirstHealth of the Carolinas is headquartered in Pinehurst, N.C., and is composed of Moore Regional Hospital, Montgomery Memorial Hospital, Moore Regional Hospital-Hoke Campus, Richmond Memorial Hospital (a division of Moore Regional Hospital), the Foundation of FirstHealth, FirstCarolinaCare Insurance Company, and FirstHealth Physician Group. Comments on FirstHealth of the Carolinas magazine or changes of address should be directed to email@example.com or to (910) 715-4278.
FirstHealth of the Carolinas is published by StayWell 407 Norwalk St. Greensboro, NC 27407 (336) 547-8970 President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . William G. Moore Senior Staff Accountant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sharon Tesh © Copyright 2015 by StayWell, an operating company of StayWell/MediMedia USA, and FirstHealth of the Carolinas, Inc. No part of this publication may be reproduced or transmitted in any form or by any means without written permission from StayWell. Articles in this publication are written by professional journalists who strive to present reliable, up-to-date health information. However, personal decisions regarding health, finance, exercise and other matters should be made only after consultation with the reader’s physician or professional adviser. All editorial rights reserved. Opinions expressed herein are not necessarily those of StayWell or FirstHealth of the Carolinas. Models are used for illustrative purposes only.
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Departments 1 CEO message 22 New providers 23 Letters
Features 3 Stand Up 4 Nurses 4 Cancer Nursing 5 Neuroscience Nursing 6 Bariatric Nursing 7 Orthopaedic Nursing 8 Emergency Department Nursing 9 Women & Children’s Nursing 10 Cardiac Critical Care Nursing 11 Behavioral Nursing 12 Operating Room Nursing 14 Hospice Nursing 15 Case Management 16 Quality 17 Home Care Nursing 18 Clinic Nursing 19 Nursing Leadership For more information on any of the programs or services offered by FirstHealth of the Carolinas, please call (800) 213-3284 or visit www.firsthealth.org.
n 2011, when FirstHealth Moore Regional Hospital got word of its second Magnet Nursing Designation, Magnet Program Director Craig Luzinski had some very kind words for the nursing support provided by The Foundation of FirstHealth, calling it an “exemplar” program that had so impressed the Magnet survey team that it had contributed to the re-designation decision. Frontline cardiothoracic nurse Kim Ball, R.N., knows personally what Foundation support can mean to direct patient care. (See the accompanying letter below.) “I think it’s great The Foundation provides the equipment to make our patients’ quality of stay better,” she says. Financial support for FirstHealth’s nursing program dates from the early days of the original Moore County Hospital and the assistance of the Hospital Auxiliary, which raised $6,500 in 1939 to help build a nurses’ home.
I recently took care of a critical care patient with limited IV access. This patient had multiple drips infusing. I was unable to give the necessary blood products due to insufficient IV access. Multiple registered nurses and one of our physician assistants tried multiple times to establish a peripheral IV and were not able to. We could not place a central line due to some other complications with the patient. I called the Emergency Department and requested assistance from any R.N. who had time to help. Jessica Heyse, R.N, gladly and quickly came to the bedside and placed an IV with the guidance of a portable ultrasound machine provided by funding from The Foundation of FirstHealth. Kim Ball, R.N. CVT Moore Regional Hospital
The Foundation of FirstHealth Support for Nursing 2004 - 2014 Clinical Education
Support provides for annual nurse continuing education
Support provides for nursing retention/navigators and for support of the Magnet Designation (occurs every three years)
Technology Equipment needed for training and improved patient care
Simulation System Outpatient $ 30,660 Computerized Human Simulator—EMS 110,000 Neonatal Simulator—resuscitation 23,000 Neonatal Simulator—maternal simulator 55,998 Ultrasound Equipment—ED 37,499 Birthing Simulator 4,538 Total distributions—2004 to 2014
$ 261,695 $ 1,391,690
As one of the five pillars for its innovative model for health care, Nursing Enrichment now joins Cancer Care, Heart Care, Physician Leadership and the Clara McLean House as a strategic area required to sustain FirstHealth’s mission “to care for people.” A few weeks ago, during FirstHealth’s observation of National Nurses Week, The Foundation launched a new fundraising initiative in support of Nursing Enrichment. With the incentive of a $50,000 gift from an anonymous donor, the Stand Up 4 Nurses campaign seeks over the next three months to raise a matching $50,000 while creating a sustainable program that will continue to raise funds and awareness for nursing programs, equipment and education. Throughout this issue of FirstHealth magazine, you will read stories about some of FirstHealth’s outstanding nurses and the care they provide in a host of medical specialties. For them and for their many colleagues, nursing is not only a career, but also a calling. www.firsthealth.org/standup4nurses
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“They give us as much as we give them”
ach patient who completes a prescribed course of treatment at the FirstHealth Outpatient Cancer Center gets a certificate that includes a signed message of encouragement from every nurse in the department. The infusion nursing team at the FirstHealth Outpatient Cancer Center: “Most patients treasure that and keep it as a front—Barry Baber, R.N.; and Laura Farrell, R.N.; and back (from left)— keepsake,” says Laura Farrell, R.N. Jenny Fowler, R.N.; Cori Ray, R.N.; Sandy Auditore, R.N.; Lauren Clapper, R.N.; Alyssa Elchook, R.N.; Shannon Barber, R.N.; Evelyn Bruce-Ofosu, Sometimes patients reciprocate with cards of R.N.; Alexis Wise, R.N.; Kellie Bankos, R.N.; and Erica Piantone, R.N. their own. Sometimes they come back for a visit and with the encouraging news that a recent scan has come back clear or that their hair has begun to return under the cap or scarf they are wearing. Mildred Brown and breast cancer are old acquaintances. Farrell and the other infusion nurses at the They’ve known each other since 1980, when Outpatient Cancer Center celebrate each success and Brown was first diagnosed and had a mastectomy. They mourn every loss—but always with the knowledge reconnected 25 years later when the cancer recurred in that they have made a difference in the life of the Brown’s breastbone, a diagnosis that the second time— patient. They recognize the vulnerability of patients unlike the first—required chemotherapy. with cancer. Brown was “scared to death,” but only for a while. “Their world has been turned upside down,” says “I wouldn’t have made it without these wonderful Farrell. “They’re very vulnerable and scared. It takes nurses,” she says. compassion to be able to guide them through this One day a week, Brown comes to the Outpatient Cancer journey.” Center for a maintenance dosage of Herceptin to keep her As they carry out treatment plans ordered cancer under control. She’s been doing it for years; she will by FirstHealth’s team of board certified oncology do it for the rest of her life. It has become routine. specialists, the infusion nurses at the Outpatient “I’ve been here so long that I feel like these nurses are Cancer Center see a virtual alphabet of cancers— like family,” she says. “They’re all so nice.” from brain to uterine—in patients 18 years of age and www.nccancercare.org older. Each nurse is chemotherapy- and biotherapycertified, and some have earned the national oncology nurse certification. FirstHealth Cancer Services All share a commitment to their • FirstHealth of the Carolinas provides cancer care, treatment and therapy. patients and a determination to make the Services also include patient navigation, nutrition and dietary assistance, stress cancer journey as positive an experience management, massage therapy, clinical trials, financial assistance and more. as possible. “I think all of us are very good • Infusion services are provided at the FirstHealth Outpatient Cancer Center, advocates for our patients to help them 220 Page Road, Pinehurst; and FirstHealth Sanford Hematology Oncology, a get through this,” Farrell says. “I also think division of Moore Regional Hospital, Suite 201, 1212 Central Drive, Sanford. they give us as much as we give them.” • FirstHealth Cancer Services has been approved with commendation by the Commission on Cancer of the American College of Surgeons four times or every time for which it has been eligible. It is the only cancer program in North Carolina to attain this achievement to date.
“They’re about family”
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The challenges of brain and nervous system nursing
ome of the most challenging patients in a hospital can be those with diagnoses involving the brain, spinal cord, spinal column and peripheral nerves. Successful treatment of stroke, brain injury, degenerative back disease and a host of other conditions involves constant monitoring, the closely watched administration of medications and ongoing physician consultation. The work, which requires the skill and talent of specially trained nurses, is often very difficult, but also very rewarding. Marjorie Rivers, R.N., entered nursing Marjorie Rivers, R.N. (left), and Kim as an LPN and Stroke Fiscal Year Fiscal Year McNeill, R.N., are kept on their toes by became a registered the challenges of their jobs. Rivers works Statistics 2013-2014 2012-2013 nurse in 1989. in the Med/Neuro ICU at Moore Regional She has worked in Hospital, where McNeill cares for patients Total patients 591 635 on the 2 Neuro nursing unit. the Med/Neuro Hemorrhagic 43 47 Intensive Care Unit Ischemic 417 397 former Jackson Hall, a large medical at FirstHealth Moore TIA (mini-stroke) 128 190 unit, and staying on through its Regional Hospital, Other 3 1 conversion to the 14-bed Jackson where stroke is a Neuro. She has been with the common diagnosis, tPA Administration (clot-busting drug treatment) dedicated 2 Neuro neurology unit for 13 years. Moore Regional 30 22 since it opened in 1999 in the “Strokes can Richmond Campus 1 0 hospital’s new Patient Tower. change a life in an Montgomery 1 0 “It’s always exciting,” McNeill instant,” Rivers says, Administration Rate 7.2% 5.5% says of her work. “You never “and usually not in a Moore Regional know what you’re going to get. It good way.” keeps you on your toes and keeps In addition to www.firsthealth.org/neurosurgery your skills fresh.” stroke, Med/Neuro Nurses on 2 Neuro care for patients with MS, stroke, ICU nurses care for patients with subdural hematoma even severe migraines—“the whole gamut,” McNeill and brain lesions among other diagnoses. Many patients says, as well as those who have had back, neck and brain need a ventilator to help them breathe, and pain surgery. management can be an especially challenging issue. “I love it,” says McNeill. “It’s very challenging— “It’s a balancing act between trying to relieve pain physically and mentally challenging—but I really enjoy and not affect the patient’s neurological status,” says Rivers. “You really have to know your patients and know what I do. That’s what I’m here for.” what you’re giving them and watch them closely so you know which is which.” Kim McNeill, R.N., of the 2 Neuro nursing unit, has been with Moore Regional for 20 years, starting on the
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Nursing support of the weight-loss surgery patient
very patient enters FirstHealth’s surgical weight-loss program with a goal. Each has practical aspirations for improved health or reduced medication needs, but some also have very poignant hopes—like being able to play with their grandchildren or shopping for pretty clothes. Christi Embler, R.N., hears every goal. As the nurse education liaison for the FirstHealth Bariatric Center, she is a partner in a medical change that requires lifetime commitment. “It’s a lifelong process,” she says. Embler spent almost five years working with weight-loss surgery patients on the First Surgical nursing unit at Moore Regional Hospital, becoming “more and more interested in bariatric,” before taking her current position last summer. She meets the patients at the beginning of their weight-loss journey, often during an information session that introduces them to the program. Her liaison-patient connection continues through a period of pre-surgical medical and psychological clearances and a time of post-surgical hospitalization and into the continuing months of post-operative follow-up. “The value Christi brings to our team is her clinical experience in educating patients at the bedside, educating them on post-operative care, re-educating them on medication changes and when to seek medical attention, and calming their medical fears,” says patient navigator Melissa Herman, R.D. “She also assists with post-operative calls to ensure patients understand post-op instructions and to keep a close eye on their progress.” In addition to the staff education she provides, Embler also facilitates support group meetings that provide educational information as well as the opportunity to form bonds with people who share a common experience. “When you hear their stories, you learn how the surgery has opened up their life,” Embler says. “They really feel like they have this rebirth. It’s very powerful to them.”
Number of bariatric surgeries in 2014:
In addition to the clinical and education support she provides patients, Christi Embler, R.N., standing, also conducts educational sessions for members of the FirstHealth nursing staff who care for weight-loss surgery patients while they are in the hospital. Here she discusses a weight-loss procedure with Annette Davis, R.N.
“Christi has compassion from her nursing background and a willingness to care for patients, but her personality is one that she can easily figure out how to interact with patients of different backgrounds.” Raymond Washington, M.D. Weight-Loss Surgeon Moore Regional Hospital www.NCWeightLossSurgery.org “Weight-loss surgery has been the best thing that I have done for myself. The new and healthier me has no regrets except that I should have done it sooner.” Jamie Chandler Waldschmidt Certified Surgical Technician and FirstHealth Weight-Loss Patient
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When the orthopaedic nurse becomes the orthopaedic patient
n May 2013, Evelyn DimpsWilliams, R.N., clinical director of the 2C nursing unit at FirstHealth Moore Regional Hospital, became Evelyn Dimps-Williams, patient in the 2C orthopaedics nursing unit at FirstHealth Moore Regional Hospital. It wasn’t an easy role change for the longtime orthopaedic nurse or for the nursing staff that she would have otherwise been supervising. “I wasn’t the best patient,” says Dimps-Williams, who had surgery to replace her right knee. “They were nervous about who was going to take care of me.” Everything turned out well, though, and with a better understanding for all concerned about what it’s like to be a joint replacement patient. The experience helped Dimps-Williams understand the frustrations of limited mobility and the struggle to be independent that every patient faces, and she shared that knowledge with her staff. She also developed a greater appreciation for her staff’s perception skills. “They know what your needs are,” she says, “and those needs are taken care of before you have to say anything.” Even though DimpsWilliams found it “strange to
be on the other side” of the nurse-patient relationship, she was confident that she would be well cared for. She had good reason for her confidence. In
Evelyn Dimps-Williams, R.N., is the clinical director of the Moore Regional Hospital nursing unit that cares for patients who have had joint replacement surgery. Two years ago, she herself was a patient there after surgery to replace her right knee.
www.firsthealth.org/ortho addition to being well-trained and experienced, many of the 2C nurses are nationally certified in orthopaedic, medical-surgical and pain management nursing. “I was pretty darned proud,” Dimps-Williams says. “I felt like this is what is provided to all the patients who come through here, and I was a recipient of it myself.”
Getting prepared for surgery Patients who have joint replacement surgery at FirstHealth Moore Regional Hospital come into the hospital prepared for the experience. Every Wednesday and Thursday of every week, the hospital holds a Joint Replacement Pre-Operative Class for people scheduled for joint replacement surgery. Attendance varies, but usually averages between 10 to 15 per class. Each person has been referred to the class by his/her orthopaedic surgeon. Carrie Harmon, R.N., an eightyear veteran of orthopaedic nursing, is the clinical nurse leader for the 2C orthopaedic floor at Moore Regional. She and five other nurses provide information for the class. So do physical therapists, occupational therapists, discharge planners and unit secretaries. “Everybody helps,” she says. The information the group presents in the class is evidence-based (i.e., based on clinical practice and research) and approved by the hospital’s orthopaedic surgeons. Topics include preparing for surgery, what to expect during the hospital stay, pain management, discharge and more. The purpose is to inform patients about what they will encounter. Family members are encouraged to participate in the class, too. “The class informs patients about what’s going to happen and what they can do ahead of time to prepare,” says Harmon. “It helps ease their anxiety about the whole process.”
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Hoke ED met the challenges of a very busy opening
hose who were present at the time and should know felt like someone had put one of those “Hot Now” signs that usually herald the availability of fresh doughnuts on the doors to the just-opened Emergency Department at Moore Regional Hospital-Hoke Campus. Hoke County had never had a hospital before, which meant that medical treatment—especially for emergencies—always involved out-of-county travel. That changed overnight with the opening of the new hospital in October 2013. “That first night, we were surprised,” says Vicky Jorgenson, R.N., day shift clinical nurse leader. “Every room in the place was full.”
FirstHealth Emergency Department Patient Registrations Calendar Year 2014 Moore Regional Richmond Memorial Hoke Campus Montgomery Memorial
60,010 30,947 28,648 14,382
As Jorgenson recalls, four EMS stretchers were lined up in the hall and so many patients were coming through the doors that some day-shift employees had to stay over to help out. According to Renee Sanders, R.N., ED day-shift charge nurse/house supervisor, several of those early patients were in critical condition. “Pretty much everything came through the door,” she says. Like Sanders, many of the Emergency Department employees are Hoke County residents who moved from critical care or emergency department jobs at FirstHealth’s flagship Moore Regional Hospital to open the hometown facility. The volumes were high from the beginning and increased incrementally almost from month to month through the first year.
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Many of the health care professionals who now staff the Emergency Department at Moore Regional Hospital-Hoke Campus are residents of Hoke County themselves. They include (from left) Kaylee Kopp, R.N.; Cedric Lee, R.N.; Christi WhiteLocklear, charge R.N.; Vicky Jorgensen, clinical R.N. leader; Amanda Lee, charge R.N.; Jenny Jefferson, CNA; Angela Monroe, R.N.; Marcus Williford, R.T.; Linda Threatt, R.T.; Renee Sanders, charge R.N.; and Crystalline Harris, charge R.N.
“It was challenging,” says Christi White-Locklear, R.N., day shift charge nurse/house supervisor. “We had to be flexible and learn to adapt.” Cedric Lee, R.N., transferred from the Critical Care Unit at Moore Regional to work in the Hoke Campus ED along with his wife Amanda, previously a registered nurse in Moore Regional’s ISU. He recalls a lot of excitement with the buildup to the hospital’s opening. “Everybody was hyped up, hyped up,” he says. “We were ready for anything.” Lee is especially proud of the department’s customer service and for the quality of care that helped earn MRH-Hoke Campus national recognition as a Professional Research Consultants Top Performer and Five-Star Facility during its very first quarter of operation. To be considered for the Excellence in Health Care Award, a hospital is judged against all other health care organizations in similar categories in the national PRC database. “You’re not going to beat our customer service,” says Lee. “Our customer service is No. 1. We treat people the way we want to be treated, and we’re sincere about the care we’re giving.” www.firsthealth.org/emergencycare
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NICU nursing is “what it’s all about”
f there can be a “Damascus road” experience involving career choice, Kelli Baker’s occurred after she accompanied a pregnant patient needing an emergency C-section to the Operating Room at FirstHealth Moore Regional Hospital. A “stork nurse” R.N. on the hospital’s 2A post-partum unit, Baker watched as the baby was delivered without a heartbeat. A team of specialists Pamela Garner, went to work, the baby R.N.-C, had four job survived, and Baker was offers after she applied sold on the idea of a career for a nursing job with as a Neonatal Intensive Care FirstHealth of the (NICU) nurse. Carolinas. “That just did it,” she She took the offer says, “to be a part of bringing from Labor & Delivery him back. This is what it’s all Pamela Garner, R.N.-C with the idea that she about.” could always move on if Baker, the “little mama” things didn’t work out. who even as a child loved That was 22 years ago. tending to children, has “Labor & Delivery is my absolute love,” found her dream job in Garner says. NICU nursing. Although her With occasional sad exceptions, Labor work focuses on her tiny & Delivery is the hospital’s happy place, patients, she also spends where patients are discharged with a whole a lot of time with families, new identity—“Mom”—and with the loving showing parents and other responsibility of a whole new life. Garner is caregivers how to provide always thrilled to be a part of the experience. the special care needed by “It’s an exciting time,” she says. sick or premature infants. As with many nursing positions, Baker, who will earn Garner’s job includes a lot of educating, her bachelor’s degree in especially with first-time mothers. The nursing later this year, likes department’s new Mother-Baby Couplet Care every aspect of her job— program, in which one nurse is assigned to the teaching as well as the three or four mom-baby pairs for an entire hands-on nursing. shift, helps with that. “I love it,” she says. As much as the mother feels up to it, “There’s nothing better than the baby stays in the room with her and her to take care of little babies nurse is available to assist as needed. who need you.”
Loving Labor & Delivery
Kelli Baker, R.N., is living her professional dream as a registered nurse in the Clarke Neonatal Intensive Care Unit at FirstHealth Moore Regional Hospital.
Moore Regional Hospital Number of Deliveries in Calendar Year 2014:
Percentage of Breastfeeding Moms in 2014:
72% Breastfeeding remains an area of focus for FirstHealth as the state average is 77.2 percent, and the national rate is 79.2 percent. The current number of FirstHealth mothers who breastfeed only is 47 percent, up from 44 percent in 2013.
“It’s part of my job, to make it a good experience,” Garner says. “It’s just the best feeling in the world.”
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An open heart for open-heart nursing
I Sheryl Loehr, R.N., has worked in FirstHealth’s open-heart surgery program from the beginning. Her son, Josh, is now a registered nurse in the electrophysiology lab at Moore Regional Hospital.
"More than a nurse" My mom was at the Reid Heart Center recently, and I just want to express my gratitude. Karen Helms, on the fourth floor (CSU), was the most caring, positive and “real” nurse I have ever met. I have Karen Helms, R.N. always stayed with my mom while she was in any hospital, but the two nights Karen was with her, I felt safe enough to drive 30 minutes home. Karen is more than a nurse at the Reid Heart Center; she is an angel and anyone who gets to have her as their nurse is blessed. Debbie Williams Newport, North Carolina www.firsthealth.org/heart
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n 1990, John Krahnert, M.D., hand-picked 10 nurses for the open-heart surgery program he was starting at FirstHealth Moore Regional Hospital. One of them was Sheryl Loehr, R.N. Twenty-five years and nearly 7,500 surgeries later, Loehr is still on the job, providing bedside post-surgical care to open-heart surgery patients in the hospital’s Cardiac Care Unit (Cardiovascular Thoracic Surgical Unit in the early days). She wouldn’t have it any other way. “I love doing bedside nursing,” she says. “It’s a passion of mine to help both the patients and their families through the intensive care experience.” She’s also good at it. Dr. Krahnert calls her “awesome.” The two have known each other since Loehr was a CCU nurse at the University of Kentucky, where Dr. Krahnert did his residency. “When I learned she was down here and interested (in the open-heart team), I put her at the top of the list,” he says. “It was one of the best decisions I ever made. Sheryl is a great nurse. She possesses that rare combination of compassion, knowledge of complex physiology and the ability to multi-task—all crucial talents for a post-op cardiac surgical critical care nurse.” Loehr is also a role model
for other nurses, especially the young ones who call her “Mama Sheryl.” “I try to take them under my wing to help them learn to be the best nurse they can be in the sometimes difficult technical world of critical care nursing,” she says. Loehr’s own two children are also nurses. Daughter Ashley, formerly a CCU R.N. with FirstHealth, joined the CCU nursing staff at Novant Health Presbyterian Medical Center after marrying and moving to Cornelius. Son Josh is a registered nurse in the electrophysiology lab at Moore Regional. Since his job involves heart rhythm studies, he and his mother sometimes care for the same patients. He had originally planned on a career in pharmacy, but eventually decided to follow his mother into nursing. “She’s been a great resource,” he says. Loehr is a resource for patients, too. Cardiac care nursing can be very difficult, but also very satisfying, and Loehr is devoted to it. “It’s a tough job, but then I turn around and look at the patient in the bed—they need you,” she says. “That’s what keeps me here.”
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N U R S I N G
Making the mind-body connection
ornings usually find Catherine Major, FNP-BC, PMHNP-BC, making her way through the nursing units at FirstHealth Moore Regional Hospital. As a certified psychiatric nurse practitioner for FirstHealth Behavioral Services, she goes wherever she is needed to evaluate patients suspected by the medical team of having a psychiatric issue that could affect their recovery. She also sees patients who present with psychiatric symptoms that are caused by a medical condition. Working jointly can help speed up the recovery. “Nurse practitioners look What is a nurse practitioner? at the entire person as opposed to the Nurse practitioners bring a complaint of today,” comprehensive perspective to health care. Major says. Each must complete a master’s or doctoral According to degree program and have advanced clinical administrative director training beyond their initial professional Mary Silverman, registered nurse preparation. LCSW, adding Major Clinical courses give them the specialized to the FirstHealth knowledge and clinical competency to practice Behavioral Services in primary care, acute care and long-term staff came from an health care settings. attempt to “look From the American Association of outside the box” Nurse Practitioners in the treatment of patients throughout the hospital, not just on the inpatient psychiatric unit. “We hired Catherine who had the skill, experience and willingness to help us develop that role,” Silverman says. “Because our psychiatrists see behavioral patients on both the psychiatric unit and in the outpatient setting, Catherine's services assure that patients on the floors are seen in a timely manner.” In addition to the evaluations and consults she provides, Major spends a lot of time educating patients about the mental health aspect of their illness. Given the age-old stigma surrounding mental illness, that’s not an easy job. “The stigma of mental illness needs to disappear,” she says “Mental illness is really no different than any disease process. They can all be debilitating and very costly when not treated properly.”
In her role as a nurse practitioner with FirstHealth Behavioral Services, Catherine Major, FNP-BC, does inpatient consultations that help determine if patients have mental health issues that are complicating their medical problems.
“We realized yesterday’s way of providing the services did not work efficiently with today’s volume of requests. Having an inpatient nurse practitioner role helps us do a better job of practicing what we believe, a change for the better to support our mission ‘to care for people.’” Mary Silverman, LCSW Administrative Director FirstHealth Behavioral Services
(800) 213-3284 • www.firsthealth.org 11
O P E R A T I N G
R O O M
N U R S I N G
FirstHealth teams deliver four
hursday, Oct. 30, 2014, started Matt Dunn, Biomedical Services out much like any other day for the nurses and other Gretchen Oldham, CST members of the surgical team in the Operating Room at FirstHealth Moore Regional Hospital. The caseload was busy, but not unusually so, and included one Ashley Ellington, R.N. scheduled Cesarean section. Around 1:30 p.m., however, as the scheduled C-section was about Whitney Walker, R.N. to begin, the tempo picked up—very quickly and very unexpectedly. Judy Hunsucker, CST “OR nursing is never a cookiecutter role,” says Ashley Ellington, R.N., OR clinical director. The C-Section Teams “Our lives change in OR Room 5—Emergency Delivery split seconds from Male baby delivered at 1:51 p.m. ordinary to amazing, Lori Cameron, R.N. and Oct. 30 turned into Shannon Keller, R.N. Debbie Sawyer, R.N. an amazing day.” Gretchen Oldham, CST The scheduled Asucena Miles, CST OR Room 3—Scheduled Delivery C-section patient Melissa Lung, CST Male baby delivered at 1:56 p.m. was rolled into the Brad Morgan, CRNA Sharron Purvis, R.N. Mary Beth Yow, CRNA Operating Room Whitney Walker, CST Joanna Cartwright, NNP as planned, and the Judy Hunsucker, CST Audrey Ring, RCP Dana Chavis, R.T. anesthesia team Jill Rogers, X-ray technician Tricia Lerma, R.N. Jane Claire Dawson, R.N. started the surgical Liz Richman, CRNA Ann Giancola, R.N. process with her spinal anesthetic. Then, the phone rang. Eleven members of the three teams that delivered the Caesarean section The call—from the hospital’s Labor babies at FirstHealth Moore Regional Hospital the afternoon of Oct. 30, 2014, & Delivery unit—alerted the OR team to returned to Operating Room 3 for a reunion photograph. the fact that another C-section patient, one having twins who needed urgent delivery, would soon be on her way department responsible for mom with a baby in fetal distress, down. Since OR 3, the only operating medical equipment) assisting with needed a C-section, too. room that stays prepped 24/7 for setup,” Ellington says. That’s when the tempo went C-sections was taken, a second room had Then the OR charge nurse— from urgent to emergent. Fetal to be prepared quickly. who had gone to Labor & Delivery distress can mean harm, or even “We went into action to help transport the second death, to a baby. transforming OR 8 into a C-section patient to the operating room—got The team kicked into even room with the help of Biomed (the the word that a third patient, a higher gear to open a third OR
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C-section babies in 11 minutes Jamie Waldschmidt, CST
1:51 p.m.; Baby 2 at 1:56 p.m.; and the twins, Baby 3 at 2 p.m. and Baby 4 at 2:02 p.m. Their mothers were doing well, too, although one very anxious dad needed a pep talk from orthopaedic surgeon David Casey, M.D., who had seen that help was needed and pitched in.
Jane Claire Dawkins, R.N.
Brad Morgan, CRNA Stefanie Dean, CST Lori Cameron, R.N.
“The teams went into action, and amazing team work saved lives that day.”
Debbie Sawyer, R.N.
OR Room 8—Urgent delivery Male twins delivered at 2 p.m. and 2:02 p.m. Nancy Gorba, R.N. Ashley Hennings, CRNA Audrey Ring, RCP Joanna Cartwright, NNP Jamie Waldschmidt, CST Stefanie Dean, CST
room for the STAT surgery. Members of the Respiratory Therapy and Imaging staff had been called in to assist, and the clinical directors of Women & Children’s Services, the Newborn Nursery and the Clarke Neonatal Intensive Care Unit (NICU) were
added to the mix. “The teams went into action,” says Ellington, “and amazing team work saved lives that day.” Within 11 minutes, four tiny boys—two singles and a set of twins, all healthy—had been helped into the world: Baby 1 at
The 27 professionals actually in the ORs included eight registered nurses (R.N., including one nurse from the hospital’s Heart Team), four certified registered nurse anesthetists (CRNA), one neonatal nurse practitioner (NNP), one X-ray technician, one respiratory therapist (RT), one respiratory care practitioner (RCP) and seven certified scrub technicians (CST) along with attending obstetricians Stephen Szabo, M.D.; Lissette Machin, M.D.; and Kendall Zmiewsky, M.D.; and NICU medical director Nicholas Lynn, M.D. “With fast thinking and employee commitment to patient safety and to uphold our mission at FirstHealth ‘to care for people,’ the entire health care team performed at its peak of commitment,” says Ellington.
(800) 213-3284 • www.firsthealth.org 13
H O S P I C E
N U R S I N G
Nursing care at the end of life
hose who are hospice through the process for nurses would be the first to as long as it takes or as say that hospice nursing is short as it takes,” says not for everyone. Pessagno. They would also say that those “We lead people who are in the work love it and through the hardest wouldn’t want to do anything else. point in their life,” says “It’s the hardest work I’ve Myrick. ever done as an R.N.,” says Becky Hospice care Myrick, R.N., “but it’s the most also requires a gratifying.” “I really love this job,” “How people die remains in the says Lacy Pessagno, R.N. memory of those who live on.” Words of Pessagno and Myrick Dame Cicely Saunders, founder of the are nurses with the not-formodern hospice movement. profit FirstHealth Hospice This past January and February, & Palliative Care. Pessagno those words became a noble reality is a field nurse who cares to me as my husband began his final for patients in their home or journey. The hospice team, first at in long-term care facilities. Hospice House and later in our home, Myrick’s patients have come was kind, loving, faithful, professional to the FirstHealth Hospice and understanding. They took our fear House for pain and/or away. They became our friends in a symptom control. very sad time. They aren’t just angels in Although both have disguise—they are earthly angels. I truly worked in various other thank God for them. specialties, both are committed to hospice care. Talmage Bandy “I’ve done a lot of Whispering Pines, North Carolina different nursing over the years,” says Myrick, “but my dream job came open and team—doctors, nursing assistants, that’s where I went.” chaplains, social workers, grief In addition to the actual handscounselors, housekeepers, food on patient care, hospice nursing and nutrition staff, secretaries and involves an educational component volunteers as well as nurses. about the end-of-life process and “We all work together to meet a family commitment that can myriad needs,” says Pessagno. continue well after the patient’s journey ends. “We work with the family
Hospice nurses Lacy Pessagno, R.N., (left), and Becky Myrick, R.N., share a rare moment of relaxation in the woodland garden at FirstHealth Hospice & Palliative Care campus.
FirstHealth Hospice Fiscal Year 2014
(serving Moore and Montgomery counties) Home Hospice: 472 new admissions 47,047 days of care provided 614 patients served Hospice House: 398 new admissions 2,656 days of care provided 406 patients served Thirteen registered nurses are certified in Hospice & Palliative Nursing, and the staff includes three Certified Hospice & Palliative Nursing Assistants. Because these certifications demonstrate specialized skill sets and experience in end-of-life care, those who are certified must pass certification and recertification exams that assure required expertise.
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C A S E
M A N A G E M E N T
Preparing for discharge starts at admission
ime was that a patient was discharged from the hospital with no more than a prescription or two and orders to see the doctor within a few days for follow-up. No more. Nowadays, what is known as discharge planning begins with the patient’s admission to the hospital and focuses on the successful transition back into the community after he/ she is discharged. As a FirstHealth case manager for both Moore Regional and Richmond Memorial hospitals, Cathy Millson, R.N., helps determine where the patient will go and under what circumstances after a hospital discharge. The many options range from home to long-term-care to hospice. As much as possible, the patient is always involved in the process. So are relatives or other caregivers. “Each case is so patient-centered,” Millson says. “The patient must be an integral part of the plan for it to be successful.” At FirstHealth of the Carolinas, discharge planning is a branch of the broader domain of case management, which also includes utilization review (the evaluation of services to monitor quality health care and control costs). According to the Commission for Case Manager Certification—case management is “characterized by advocacy, communication and resource management (to promote) quality and cost-effective interventions and outcomes.” Much of the work is government regulated “to meet concerns regarding timeliness and completeness,” says Case Management Director Jennifer Gripp, R.N. “We have goals we have to meet,” she says. “We have processes we have to follow.” For Millson, the work is also up front and personal. Communication is key and begins within 24 to 48 hours of admission with an
interview of the patient and/or family about what can involve very sensitive matters. “You are dealing with families when they are at their most vulnerable,” she says. “You have to be aware of that.” In her role as a discharge planner with FirstHealth’s Case Management department, Knowledge about the patient’s condition Cathy Millson, R.N., helps patients prepare for life after a hospital stay. and status comes from the entire health care team, but nurses and aides can provide some of the most valuable information. “They are at the bedside more than you are,” says Millson. “You “We are kind of the gatekeeper to try to find out who the make sure patients get the care they need key people are.” after they leave.” It’s also Millson’s job to know about the Jennifer Gripp, R.N. various health careDirector related resources that FirstHealth Case Management are available in the community. Because these resources can differ greatly from county to county, especially for patients who are uninsured, she is an expert in networking with various agencies and using the Internet to expand her searches. She finds the work challenging, but also very fulfilling. “I do love it,” Millson says. “You begin again every day, are never bored and meet lots of people. We’re in a position to make a difference in people’s lives.”
(800) 213-3284 • www.firsthealth.org 15
Q U A L I T Y
Quality: more than a health care buzzword
ebster’s defines quality as “the degree of excellence a thing possesses … excellence, superiority.” Lori Lefler, R.N., Christy Land, R.N., and Michelle Yarboro, R.N., define it more specifically in terms of patient satisfaction, patient safety and excellent patient care. All are registered nurses whose careers have taken them from bedside nursing to their current supervisory roles ensuring quality QualityFirst throughout FirstHealth of FirstHealth’s definition of quality the Carolinas. health care focuses on six aims: As director of FirstHealth’s Quality • Safety: Patients should not Department, Lefler be harmed by the care that reports to the vice is intended to help them and president of Quality and delivered in an environment oversees a staff of 17 (all where professionals learn from but two of them registered errors. nurses) whose job is to • Patient-Centered: Respectful and ensure that patients at based on individual needs. Moore Regional Hospital, Richmond Memorial • Timely: Reducing waits and Hospital, Montgomery harmful delays. Memorial Hospital and • Effective: Evidence-based (based MRH-Hoke Campus get on scientific knowledge in a the best care possible. combination on best research, Much of their work expertise and patient values). involves “chart mining,” combing through • Efficient: Avoiding waste in individual patient records equipment, supplies, ideas and for information and then energy. communicating with • Equitable: Equal and excellent for frontline caregivers in everyone no matter what their “real time” to assure that race, gender, religion, location or patients are indeed getting income. the best possible care. “We have a direct line of communication with the doctors and nurses who are caring for the patients,” Lefler says. “We collaborate with Christy and Michelle, often on a daily basis, to address
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It’s the job of Michelle Yarboro, R.N., Lori Lefler, R.N., and Christy Land, R.N., (from left) to ensure that FirstHealth patients get the quality care they need and deserve.
quality and safety priorities to ensure that quality is consistently maintained throughout the organization.” Land and Yarboro’s work is especially focused on the facility-based care at Richmond Memorial, where Land is director of Clinical Performance, and Montgomery Memorial, where Yarboro is Quality coordinator. “Quality is patient-centered care that makes sure each patient gets the best care every time in the safest, most efficient way, using the most up-to-date evidenced-based guidelines.” Cindy McDonald Vice President, Quality FirstHealth of the Carolinas Lefler, Land and Yarboro have the same goal: “zero”—zero defects, zero errors, zero misses. Patients expect this; the government and other payers demand it; and FirstHealth insists on it for its patients. “It’s my job to assure we’re doing the best we can every day for our patients and we’re following evidence-based guidelines,” says Lefler. “We are committed to improving the quality of care we deliver every day by implementing patient safety interventions and evidence-based care,” says Land. “Quality is simply providing the right treatment to the right patient at the right time and doing it the right way the first time with excellent customer service,” says Yarboro. www.firsthealth.org/quality
H O M E
C A R E
N U R S I N G
Nursing that keeps patients in the home
Barbara Harbeck, R.N., has been a nurse with FirstHealth Home Care for 15 years. It’s her job to see that patients with chronic illnesses get the care they need to avoid repeat hospitalizations or emergency department visits.
arbara Harbeck, R.N., can walk into a patient’s home and know right away that something is wrong. This “sixth sense” comes from 18 years as a home health nurse—15 with FirstHealth Home Care. “You see patients so regularly, and you form such a bond, that you can tell right away the patient’s not feeling well,” she says. This level of nursing intuition comes from the longtime experience of working with the chronically ill. Harbeck’s patients are dealing with COPD, diabetes, congestive heart failure, non-healing wounds and other equally serious diagnoses—often in combination.
Out of Africa and into Home Care Jillian Terry, R.N., grew up on a farm with brothers, which may account for the adventurous streak that sent her to Africa for work with a safari company for the better part of two years. She has since found an outlet for her adventurous spirit as a nurse with FirstHealth Home Care, where she travels Jillian Terry, R.N. from patient to patient each day, where no two days are alike and where you never know what you might face. Working on your own requires considerable confidence in your clinical skills as you are often required to make on-the-spot decisions. That makes this kind of nursing practice special. “In home health, you get to know the people,” Terry says. “You see some of them for weeks, and they become like your family.” Although headquartered in Richmond County, Terry sees patients in neighboring Scotland County, driving many miles to accommodate a daily caseload of five or six patients. The modern technology of laptops and smart phones assures communication with physician offices and other locations while she’s in the field, and the gratitude of “sweet little patients” makes all the driving and necessary paperwork worthwhile. “Your patients are so grateful for everything you’ve done for them,” Terry says. “It makes you feel like you’re making a difference. It makes you feel like you’re actually doing something.” www.firsthealth.org/homecare
“All the nurses were wonderful. They showed me compassion, and they cared. Their kindness showed me that they treated me as a ‘person.’ We laughed and cried together, mostly laughed. When they were through with their care, I was sad to see them go, but the sweet memories will last a lifetime.” FirstHealth Home Care patient
Because they are so sick, Harbeck measures their progress in achievable goals—getting dressed, walking outside, living independently in their own home. “To see the progress they make with our help, that makes me happy,” she says. The goal is to improve the patient’s quality of life and avoid repeat hospitalizations. Technology helps. The telehealth program FirstHealth introduced in 2005 with help from The Foundation of FirstHealth allows patients to send vital medical information electronically to the nurse between home visits, allowing her to provide more comprehensive care. Because of strict Medicare and other regulatory guidelines, documentation is extensive. Harbeck sees that as a necessary part of the job. Company-provided smart phones, laptops and an electronic patient record are big time-savers. Company-provided cars are an added bonus. “It’s a lot of work,” says Harbeck, “but I still love it.”
About FirstHealth Home Care FirstHealth Home Care’s two Medicare-certified, ACHC-accredited offices cover six counties. The staff completes nearly 35,000 visits annually, driving more than 500,000 miles and serving more than 2,500 patients. More than 1,000 patients with chronic disease receive state-of-the-art remote telehealth monitoring that has demonstrated a significant reduction in unnecessary hospitalization and emergency care. FirstHealth Home Care has achieved 4.5 out of 5 stars in the soon-to-be-published Home Health Compare Star Ratings, which reflects the high quality of care it delivers.
(800) 213-3284 • www.firsthealth.org 17
C L I N I C
N U R S I N G
Clinic nursing, where patients become like family
side from your provider, the most familiar face at your primary care medical practice is probably the employee who escorts you to the exam room, takes your temperature and blood pressure, records your height and weight, and enters notes about the reason for your visit on a laptop. Depending on the location, that person could be a registered nurse (R.N.), a licensed practical nurse (LPN) or a certified medical assistant (CMA). If you’re a patient at FirstHealth Family MedicineSeven Lakes, it might be Lisa Tedder, an LPN. At the FirstHealth Family Medicine office on Teal Drive in Raeford, it’s probably Sharon Sampson, CMA. Their job titles may be different, but their regard for their work—and their patients—is very similar. “I love it,” says Tedder. “This is my niche.” “I just love helping people, caring for people,” Sampson says. An LPN since 1987, Tedder has seen a lot of changes in the past 28 years. She remembers when electrocardiograms (EKGs) had to be transmitted Sharon Sampson, CMA by telephone line to a company in California for interpretation. The process could take up to 90 minutes. With the availability of modern, in-house technology, it now takes five. As a certified medical assistant, Sampson can do everything Tedder does except start an IV. Both triage patients, assist with procedures, see that lab work is processed and give injections—among a long list of responsibilities. In family medicine, that also means seeing patients of all ages with all of the accompanying joys and sorrows. One of Tedder’s patients just turned 100, Sampson’s eldest is 104, but it’s not all that unusual for a proud mom to bring in her newborn for its first checkup either. Obviously, relationships develop over time. “They’re just like family when you see them this many years,” says Tedder. “You’ve got to have compassion and the concern for other people to be able to come in every day and help them,” says Sampson. www.firsthealth.org/primarycare
Lisa Tedder, LPN, is a licensed practical nurse with FirstHealth Family Medicine in Seven Lakes, where the providers include (in background) James Liffrig, M.D.; and Dan Matthews, PA-C.
Nursing in a high-tech clinic The relationship of Kimberly LeGrand, R.N., with her patients will sometimes last for a year or more. As coordinator of the FirstHealth Valve Clinic at Reid Heart Center, she serves as the liaison between patients and Valve Clinic physicians, assuring that patients get the pre-op studies they need before Kimberly LeGrand, R.N. a procedure as well as the follow-up care they require afterward. “I see them through the entire process,” she says. LeGrand entered cardiology nursing as a new nurse just out of Sandhills Community College, starting out on Moore Regional Hospital’s Hiatt nursing floor (later CSU) and then moving to a FirstHealth cardiology practice. She joined the Valve Clinic staff last summer. She enjoys the challenges of cardiology as well as the opportunity to be involved with new procedures and technology—such as the TAVR (transcatheter aortic valve replacement) procedure that has offered renewed quality of life to formerly very sick patients. “It’s a really gratifying job,” LeGrand says.
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N U R S I N G
L E A D E R S H I P
MMH President Beth Walker grew up in the hospital she now leads
ention FirstHealth Montgomery Memorial Hospital to any Montgomery County resident and he (or she) will probably know Beth Walker, R.N. Most people in that community
Beth Walker, R.N., was born in and grew up around Montgomery Memorial Hospital. She has been the hospital’s president since 2011.
should—and do—since Walker has lived in Montgomery County practically her entire life and is now the hospital’s president. Her story began in Montgomery Memorial, where her mother, then a nurse in the hospital’s operating room, fell in love with one of her patients. Her supervisor made sure the two got together, and the rest is history. Daughter Beth was born at Montgomery Memorial and grew up in the hospital’s lobbies. “I would go over to the hospital after school and the ladies in the business office would take care of
me until my mom’s shift ended,” Walker says. “It was like my second home. Being there, around all those amazing hospital employees, inspired me. By the time I was in high school, I knew I wanted to work in health care.” During high school and college, Walker worked in the hospital’s pharmacy. After graduating from the Presbyterian Hospital School of Nursing in Charlotte, she returned to Montgomery County and took a job in the hospital’s MedicalSurgical Unit. Later, she worked in intensive care. “I had met so many of the hospital employees, nurses and physicians when I was growing up,” she says. “I remember coming back thinking, ‘Now I get to work with them,’ and I felt so incredibly lucky, and honored, to be working with and learning from the best of the best.” Walker’s nursing resume is extensive—from working with cardiac patients to riding in ambulances to helping transport patients. “I was always busy, and the hospital was extremely busy,” she says. “I loved doing what I was doing.” Walker’s children were born at Montgomery Memorial, and her professional life continued to focus on the hospital. She moved into the Quality and Risk Management department and worked in Quality until 1992, when she became director of Nursing.
Advice from nurse leaders: Learn, set goals, do your best for your patients Every member of FirstHealth’s nursing leadership team began her career “caring for people.” Here, they offer words of experience, and wisdom, to young people who are starting out or considering a career in the nursing profession. “Get in as much experience as you can. Be prepared to step out of your comfort zone by helping out with other departments. Get involved in nursing councils and committees within the hospital. Continuously set new goals for yourself, always striving to achieve more. Volunteer and participate in your hospital.” Karen C. Robeano, R.N., DNP, NEA-BC Chief Nursing Officer/Vice President Patient Care Services Moore Regional Hospital “Learn as much as you can. Do the best for your patients every day. Always work as a team and help others. Remember your job is about the patient and what is best for the patient and family. Never stop learning. Further your education. Learn to work well with your coworkers and always be a team player. We are here for the patient; that is our first priority. Love what you do and you can grow.” Cindy McDonald, R.N., MSN, FACHE Vice President, Quality FirstHealth of the Carolinas
(800) 213-3284 • www.firsthealth.org 19
N U R S I N G
“Always keep learning: pursue continuing education courses, certifications and higher education. Participate in activities and committees in your hospital and become involved. Become part of a team. Make suggestions, let your voice be heard when you think you can help improve your work environment. And always stay passionate—remember why you became a nurse in the first place.” Allison Duckworth, R.N., BSN, MBA, CENP, FACHE Chief Operating Officer Richmond Memorial Hospital
“Have confidence in yourself. You made it through nursing school! Always remember that, even on those toughest days. Be proud of your job, the organization you work for and the opportunities you have to make a difference in the lives of the patients and families you care for. Being a nurse is a special gift.” Susan Beaty, R.N., MSN President Moore Regional Hospital-Hoke Campus
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L E A D E R S H I P
In 1995, when Moore Regional Hospital merged with Montgomery Memorial to create FirstHealth of the Carolinas, she
Walker also believes her nursing experience has helped her make a difference in her community. Having known
“Actually, all aspects of nursing help me as an administrator—caring for people, being concerned and attentive, knowing how to react quickly—being a nurse taught me those skills.” Beth Walker, R.N. President FirstHealth Montgomery Memorial Hospital returned to her management role in Quality. Several years later, she became chief nursing officer and chief operating officer. In 2011, hospital President Kerry Hensley retired and Walker was approached about replacing her. “It was a full circle experience,” Walker says. “I felt like it was the right opportunity at the right time.” Walker credits Hensley for teaching her all she knows about the business side of health care. Walker credits her nursing background for helping her become the best leader she can be. “My bedside experience has taught me how to communicate, and I have transitioned those communication skills into talking and listening to my staff,” she says. “Actually, all aspects of nursing help me as an administrator—caring for people, being concerned and attentive, knowing how to react quickly— being a nurse taught me those skills.”
the hospital and Montgomery County her entire life helps, too. “I love being able to take care of people I know,” she says. “And, fortunately, we have a wonderful team here that also enjoys taking care of their family, friends and neighbors. We are lucky to be able to provide services that are critical to the residents of our county.” That, she says, is what makes Montgomery Memorial Hospital unique. “We are a special place, and I feel like the luckiest person to have grown up here, to have learned from nurses and physicians here, and to now be in the position I am,” she says.
N U R S I N G
L E A D E R S H I P Tammy Smith, R.N., (center in red uniform), is the most recent FirstHealth DAISY nursing award recipient. A FirstHealth nurse for seven years, Smith is surrounded by her co-workers on the 3 Medical nursing unit at FirstHealth Moore Regional Hospital. Also pictured are Deana Kearns, R.N., (far left), of FirstHealth Patient Care Services; and Karen Robeano, R.N., (second from left), chief nursing officer and vice president of Patient Care Services at Moore Regional Hospital.
Recognize a nurse: Pick a DAISY DAISY Award honorees personify FirstHealth’s remarkable patient experience. These nurses, who consistently demonstrate excellence through their clinical expertise and compassionate care, are recognized as role models for their nursing community. The DAISY Award is a national program that rewards and celebrates the clinical skills and compassionate care provided by nurses every day. As a DAISY Award Hospital Partner, FirstHealth of the Carolinas recognizes a nurse with this special honor every month. To nominate a deserving FirstHealth nurse for the DAISY Award, visit www.firsthealth.org/caretoshare. Winners as of April 2015 are listed as follows:
Nursing Statistics 2014 Total number of Registered Nurses 1,173 R.N. turnover 11.38%, a drop from the previous year of 13.62% Nurse Education BSN or higher throughout FirstHealth 45.2% Certifications throughout FirstHealth 23.5% BSN or higher among nurse leaders 100% Certifications among nurse leaders 52%
2013 May—Aubrey Parker, Richmond Memorial ICU June—Sheryl Loehr, Moore Regional CVT July—Ann Whittaker, Moore Regional Outpatient August—Pam Tyler, Richmond Memorial ICU September—Sandra Davis, Montgomery Memorial October—Maribel Matochik, Moore Regional 3 Medical November—Jessica Rakes, Moore Regional ED December—David Dunker, Moore Regional CVT
August—Skyler Winkler, Outpatient Cath Lab September—Tammy Hussey, Richmond Memorial October—Pam Garner, Moore Regional Women & Children’s Services November—Marvel Koury, Moore Regional Med/Neuro ICU December—Belinda Pope, Moore Regional Recovery
January—Farrah Kader, Moore Regional 3 Medical February—Toby Williams, Moore Regional 4 Medical March—Sharon Davis, Moore Regional ED April—Tammy Smith, Moore Regional 3 Medical
January—Lenore Rittenhouse, Moore Regional Inpatient Rehab February—Carol Lighthall, Moore Regional 2 Neuro March—Colleen Parr, Moore Regional 2 Neuro April—Shannon Smith, Moore Regional 4 Medical May—Allison Thomas, Richmond Memorial ED June—Tamara Spivey, Moore Regional 4 Medical July—Kelly Adelman, Moore Regional ED
(800) 213-3284 • www.firsthealth.org 21
N E W Anesthesiology & Pain
Aaron Seller, D.O. Pinehurst Anesthesia Associates PA Moore Regional, MRH-Hoke Campus
Katie C. Imhof, M.D. Sandhills Emergency Physicians Moore Regional, Richmond Memorial, MRH-Hoke Campus
Samuel A. Ralston, D.O. Sandhills Emergency Physicians Moore Regional, Richmond Memorial, MRH-Hoke Campus
James R. Liffrig, M.D. FirstHealth Family Medicine-Seven Lakes Outpatient Only
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P R O V I D E R S Family Medicine
Gleybis Sanchez Lobaina, M.D. FirstHealth Family MedicineRockingham Richmond Memorial
Kathleen Prussian, FNP FirstHealth Family Medicine-Vass Outpatient Only
Carol H. Pillsbury, ANP Pinehurst Medical Clinic Moore Regional
Lindsay M. Fairfax, M.D. Pinehurst Surgical Moore Regional
Warren Thomas Day, FNP FirstHealth Hospitalists MRH-Hoke Campus, Moore Regional, Richmond Memorial, Montgomery Memorial
Johnny Dias, D.O. FirstHealth Hospitalists Moore Regional
James W. John, M.D. FirstHealth Hospitalists Moore Regional, Richmond Memorial, Montgomery Memorial
Ejaz Khalid, M.D. FirstHealth Hospitalists Moore Regional, MRH-Hoke Campus, Richmond Memorial, Montgomery Memorial
Rhonda Wright, N.P. FirstHealth Hospitalists Moore Regional, Richmond Memorial, MRH-Hoke Campus
Chad A. Frazer, PA-C FirstHealth Neurosurgery Moore Regional
Obstetrics & Gynecology
Shayna Jones, M.D. Pinehurst Surgical-Womenâ€™s Care Center Moore Regional
Winston J. Garris, M.D. Carolina Eye Associates Moore Regional
Keith Jackson, M.D. Pinehurst Surgical-Orthopedic & Joint Replacement Center Moore Regional
James T. Marino, M.D. Pinehurst Orthopedic Group Moore Regional
Mary E. Lunde, D.O. FirstHealth Behavioral Moore Regional, Richmond Memorial, MRH-Hoke Campus, Montgomery Memorial
Catherine R. Major, FNP-PMHNP FirstHealth Behavioral Moore Regional, Richmond Memorial, MRH-Hoke Campus, Montgomery Memorial
“I couldn’t ask for better quality” Since March 2014, I have received three medical procedures at FirstHealth in Moore County. It began with Dr. David Casey conducting double knee replacement. While recovering from the knee surgery, I had a routine checkup with Dr. Christy Eller. An abnormal test turned out to be cancer. I was referred to Dr. Barry Buchele and Dr. Michael Sundborg. During the past months, I have experienced the most professional medical treatment anyone could receive. All the abovenamed physicians provided caring and professional service. I could not ask for Double knee replacement patient Ruth Morris (seated on exercise better quality. bike) is shown with her physical therapy “team” in Montgomery My physical therapy was Memorial Hospital’s Outpatient Rehabilitation Center. Pictured (from conducted at FirstHealth left) are Michael Shutt, P.T.; Beverly Buie, department secretary; Tim Murphy, P.T.; Morris; Andy Gillis, physical therapy assistant; and Paula Outpatient Rehabilitation in Troy. The rehab center consists Covington, physical therapy assistant. of five therapists. There is not a more knowledgeable and caring group of individuals. I appreciate the sincere efforts made by therapists to help each patient. The therapists assigned to me were Mike Shutt, physical therapist, and Andy Gillis, physical therapy assistant. I call Andy “magic fingers,” because his hands are truly miracle workers. Both were committed to improving my flexibility and extension. Because of their efforts, we believe I achieved more than Dr. Casey expected. During my visits, I became familiar with Tim Murphy, physical therapist; Paula Covington, physical therapy assistant; and Nancy Hancock, physical therapist. These therapists are also very knowledgeable and are genuinely interested in each and every patient. I do not want to fail to mention Beverly Buie, department secretary, and her commitment to making schedules as easy as possible. The entire department has enthusiasm about helping others. Their ability to motivate patients results in a significant increase in productivity. They all work together as a team. The physical therapy department is a reflection on the management at FirstHealth Montgomery. Mrs. Beth Walker, the hospital’s president, is a personal friend of mine. She has an undying, second-to-none commitment to FirstHealth. I admire her ingenuity, professionalism and passion. The FirstHealth families at Moore and Montgomery have demonstrated their commitment to delivering quality services to their patients. Thank you. Ruth Bruton Morris Troy, North Carolina
(800) 213-3284 • www.firsthealth.org 23
A job well done I finished the adult swim class at FirstHealth Fitness-Pinehurst with Amanda Himmelberger as the instructor. She did an excellent job. Her instructions on techniques were very clear, and she has a knack for motivating her students. She knows her subject well and is the ultimate encourager. She constantly praised everyone in the class. She said numerous times that she enjoys teaching swim classes, and it shows. She’s a real asset to the fitness center in general and the swim program in particular. A job well done. Amanda Himmelberger teaches swim classes at FirstHealth Fitness-Pinehurst where she is known as an “ultimate encourager” who consistently praises everyone in her classes.
Blair Hall staff was “great” I want to thank the staff of Blair Hall at FirstHealth Montgomery Memorial Hospital. Everyone who treated me was so great. The whole staff on every shift was great. Thanks again for all your help. Shirley Webb Troy, North Carolina
Hoke County fortunate to have Hoke Campus The residents of Hoke County are extremely fortunate to have FirstHealth Hoke Campus available for their health care needs. My mother was hospitalized on the medical unit for a four-night stay. She received excellent care from the doctors, nursing staff and the ancillary staff, both on the acute-care unit and in the Emergency Department. The staff was well-trained, supportive and attentive, and the security and cleanliness of the facility made her stay comfortable. My family and I would like to extend our gratitude to FirstHealth for being close by in a time of need.
Paul Williams Cheraw, South Carolina
No need for fear I was a patient in FirstHealth Moore Regional Hospital from Jan. 8, 2015, to Jan. 11, 2015. Dr. David Casey performed total knee replacement on my right knee. Since I had not had surgery since I was 5 years old, and I am now 72 years old, I was very apprehensive about the whole process, including staying in the hospital. I needn’t have been. From check-in to check-out, I never encountered an unpleasant person. Everyone was very kind, caring, concerned and willing to help me any way they could. They allayed my fears, encouraged me in Physical Therapy and made sure I realized I was going to be OK. My husband, Mallory, and I cannot say enough good things about the staff on 2C (orthopaedic nursing unit). They are welltrained, competent and patient. 2C is aptly named the “gold floor,” because I was attended by a top-notch team. Thanks again to all for making my hospital experience positive. Catharine Sloan Evans Cheraw, South Carolina
Thanks to Reid Heart Center staff
Mary Maxwell Barnett Eastaboga, Alabama
I want to give thanks to the staff at Reid Heart Center, where my father had a pacemaker put in. To the staff on third-floor ICU Observation, y’all are amazing. Thank you for everything you have done and will continue to do. I want to personally thank you from the bottom of my heart. Anita M. Napier Trinity, North Carolina
24 Spring/Summer 2015
SUCCESS STORY Meet Mark Rhyne, success story. A few months ago, the Ellerbe resident and longtime Pee Dee Electric employee was taking seven medicines for the various health problems caused by his excessive weight. Now he weighs 85 pounds less, and he doesn’t need any medicine. Start YOUR success story by attending one of our FREE weight-loss surgery information sessions. For more information, visit www.NCWeightLossSurgery.org or call (800) 213-3284.
(800) 213-3284 • www.firsthealth.org 3
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Published on Jun 1, 2015
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Nurses make a difference; careers in nursing. FirstHealth Magazine published by FirstHealth of the Carolinas health care system.