Health Connect | Fall 2018 by Mary Greeley Medical Center

FALL 2018

CONNECT

MIND LIKE A CYCLONE Lyndsey Fennelly’s inspiring mental health journey. Plus: An exclusive look inside our Behavioral Health Unit.

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Why Men Become Nurses

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Our Lab Saves a Life

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A Room Filled with Gratitude

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Contents

On the cover: Lyndsey Fennelly with husband, Billy, and children, Will and Callie.

2 4 6 9 16 About this publication Health Connect is published three times a year for residents of central Iowa by Mary Greeley Medical Center. For more information about Health Connect, please contact the Mary Greeley Medical Center Community Relations Department at 515-239-2129. Visit us on the internet Learn more about Mary Greeley Medical Center’s programs and services at www.mgmc.org. Contact us Individuals are encouraged to contact Mary

FALL 2018

Q&A What you need to know about the differences between Admission and Admitted for Observation. Plus: Meet the new McFarland Clinic providers.

Steady as She Goes

Men in Blue

Loes Lessons

Here’s why vertigo sufferers turn to our “Dizzy Therapist.”

The Champion Lyndsey Fennelly candidly describes her journey from mental health patient to mental health care advocate.

Behavioral Health Unlocked Come inside one of Mary Greeley’s most important units and learn more about our role in providing mental health care in central Iowa.

Safe Haven Welcome to Mary Greeley’s new Crisis Stabilization-Transitional Living Center.

Greeley Medical Center if they have any concerns about patient care and safety in the hospital that have not been addressed. If the concern continues, individuals may contact The Joint Commission at One Renaissance Boulevard, Oakbrook Terrace, IL 60181. You may also call 800-994-6610 or e-mail complaint@jointcommission.org. Opportunity for support Your contributions can help us care for those who come to us at every stage of life. Charitable giving to support Mary Greeley Medical Center has played a signiﬁcant role in shaping your medical center. To learn

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Meet some of our male nurses and discover why more men are pursuing nursing careers.

In an entertaining and insightful interview, our chief nursing ofﬁcer reﬂects on more than three decades in healthcare.

Breath of Life A savvy lab tech’s nick-of-time discovery saves an Ames man’s life.

2018 I&E Awards Mary Greeley recognizes outstanding achievements.

Lasting Comfort Learn how cancer patients and families will beneﬁt from touching act of gratitude and remembrance.

Prime Time Alive & More Clinics & Classes

more, contact the Mary Greeley Medical Center Foundation at 515-239-2147 or visit www.mgmc.org/foundation. President and CEO Brian Dieter Director of Marketing and Community Relations Steve Sullivan

Medical Advisor Steven Hallberg, MD Design Scott Thornton Photography Justin Connor Paul Gates Tim Hoekstra

Editors Steve Sullivan Stephanie Marsau

HEALTH CONNECT | Fall 2018 | www.mgmc.org

PRESIDENT’S LETTER By Brian Dieter Mary Greeley President and CEO

Lori Frederick reviews a patient care plan on Mary Greeley’s Oncology inpatient floor.

Brains Behind the Scenes

s a patient at Mary Greeley, you will always know the names of your doctors and nurses. These front-line caregivers are supported by a talented and focused group of professionals who also play significant roles in your care. Two recent cases at Mary Greeley provide dramatic demonstrations of this. You can read about one featuring Kristen Veencamp on page 26. Here’s the other one. A few years ago, to better ensure our patients understood their medications, especially at discharge, we assigned pharmacists to inpatient units. Lori Frederick, PharmD, works on our Oncology floor and has a deep understanding of chemotherapy. Recently, a patient started chemotherapy treatment at Mary Greeley. The patient had originally been treated at another hospital and continued treatment closer to home. The patient was part of a clinical trial that involved a specialized chemo drug designed to fight a specific type of cancer. It was a drug that we rarely work with at the medical center. Lori, who is skilled at adapting to new challenges, was going through her usual

protocols for the patient’s treatment plan when she noticed that something didn’t seem right. This is a complicated process involving formulas using micrograms per metered-squared versus micrograms per kilogram. It involves a lot of double checking of math, as well. Essentially, though, Lori sensed that the dose recommended for this patient was too high based on the patient’s weight. She was right. Concerned, she tapped into Care Everywhere, a terrific system that enables caregivers at one facility to look at patient records from another facility. This revealed a discrepancy between the treatment the patient received at the other hospital and the treatment notes that were sent to Mary Greeley. After conferring with a McFarland Clinic oncologist and the oncologist who treated the patient at the other hospital, it was determined that the

dose had indeed been incorrectly described in the notes. Lori immediately corrected the dose for the patient’s treatment plan. Had the patient received the dose originally recommended, it could have resulted in serious side effects. Our physicians and nurses typically have the higher profile in patient care. Behind the scenes, though, Mary Greeley has some incredibly talented employees. Our patients can take great comfort in knowing they are here and ready to fulfill their vital roles in your care.

Thank you to our sponsors McFarland Clinic

The Mary Greeley Foundation would like to thank these sponsors who provide annual support for the William R. Bliss Cancer Center, Mary Greeley Hospice, Mary Greeley Mileage Club, and Grand Rounds. Presenting Sponsor McFarland Clinic Sustaining Sponsor NOW 105.1 & 1430 KASI Lifesaver Sponsors Ames National Corporation and afﬁliates Boone Bank & Trust Co., First National Bank, Reliance State Bank, State Bank & Trust Co.

Pacemaker Sponsors Ag Leader Technology NAI Electrical Contractors Caretaker Sponsors Banker’s Trust Great Western Bank Henkel Construction & Accord Architecture Co. Jester Insurance Services Sponsors Adams Funeral Home Alfred’s Carpet and Decorating, Inc. Ames Ford Lincoln Celebrations Party & Rental Dentistry at Somerset, Family & Cosmetic Dentistry

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Hanger Clinic Integrity Construction Services Kindred Healthcare Kevin & Yvonne Kinzler Knapp Tedesco Insurance Agency Kreg Tool Company MB Financial Bank Mittera Group (ColorFX) Nyemaster Goode, PC Steve & Randi Peters Shive-Hattery, Inc. Sigler Sign Pro US Bank Wandling Engineering Wells Fargo Austin Woodin – Edward Jones Financial Advisor

Mary Greeley Mileage Club Renewable Energy Group – Sustaining Sponsor 3M – Lifesaver Sponsor Danfoss – Pacemaker Sponsor Hy-Vee – Caretaker Sponsor Grand Rounds First American Bank – Lifesaver Sponsor Green Hills Health Care Center – Pacemaker Sponsor

Q&A

ADMITTED TO OBSERVATION A physician has ordered a patient “Admitted to Observation.” How is this different from being admitted as an inpatient? We follow strict guidelines in regard to determining the designation of a patient’s level of care when hospitalized. These guidelines are defined by your insurance and take into account your condition, expected length of stay, and tests/treatments ordered by your physician. Observation level of care is considered outpatient care. While you will be placed in a bed on a nursing unit, your level of care is observation. It is important to remember that there is no difference between observation and acute inpatient levels of care with respect to the care and attentiveness provided by the physicians and staff. However, being in the hospital as an outpatient, or observation level of care, may affect the amount you have to pay in terms of copayments and deductibles. A physician will order “admitted to observation,” but, if necessary, we have processes in place to review the order to ensure it is the most appropriate option for the patient.

So you’re in a hospital bed and listed as “admitted to observation.” What does that mean? A lot, actually. Don’t worry, though, because Darla Handsaker, BSN, RN, director of Quality Management and Case Management at Mary Greeley, is here to explain it all.

determined by your plan. Please check with your plan about coverage for observation services. • If you are a Qualified Medicare Beneficiary through your state Medicaid program, you cannot be billed for Part A or Part B deductibles, coinsurances, and copayments.

How is the amount you pay determined? It depends on your coverage. Here’s a rundown: • Medicare Part B covers outpatient hospital services, including observation services. Generally, if you have Medicare Part B, you may pay: – A copayment for each individual outpatient hospital service that you get; and – 20 percent of Medicare-approved amount for most doctor services, after the Part B deductible.

Medication coverage can vary. Some of the medications that are ordered by your physician, including “self-administered drugs,” are not covered by Medicare Part B when you are admitted to observation level of care. “Self-administered drugs” are drugs you take at home and would normally take on your own. If your physician has ordered for you to take your home medications, you may want to bring these medications to the hospital. All home medications brought into the hospital for usage must be checked and labeled by our pharmacy for patient safety. If the integrity or identification of your home medications is in question, you may not be allowed to take them.

• If you have Medicare Advantage plans (for example, Humana, Coventry, AARP, etc.) or other Medicare health plans (Part C), your costs and coverage are

How do observation services affect coverage and payment of your care after you leave the hospital? If you need skilled nursing facility

(SNF) care after you leave the hospital, Medicare Part A will cover SNF with a qualifying inpatient hospital stay. A qualifying inpatient hospital stay means you’ve been a hospital inpatient—you’re admitted to the hospital as an inpatient after your doctor writes an “Inpatient Admission Order”—for a medically necessary stay of at least three midnights in a row. This refers to either a current inpatient stay or one that has occurred within the last 30 days. Your discharge day is not included in the count. Observation level of care does not count toward this requirement. Thus, Medicare will not cover your skilled nursing facility stay. If you have a Medicaid, Medicare Advantage, or other health plan, each plan may have different rules about qualifying for SNF services after you leave the hospital. Please check with your Medicaid, Medicare Advantage, or other health plans for covered services. Where can people turn if they have questions about this? We understand how complicated all of this can get. Our case managers are always ready to help. People can call Case Management at 515-239-2580, or our Business Office at 515-239-2111.

HEALTH CONNECT | Fall 2018 | www.mgmc.org

NEW Faces Nicholas Olson, MD

Lee Carlson, ARNP

Nicholas Olson, MD, joined the McFarland Clinic Radiation Oncology Department in 2018. Dr. Olson completed his radiation oncology residency and his medical degree from the University of Minnesota in Minneapolis. He received his B.S. degree from Trinity University in San Antonio. For more information, call 515-239-2411.

Lee Carlson, ARNP, joined the McFarland Clinic Emergency Medicine Department in 2018. Lee received his M.S. in nursing and family nurse practitioner degree from Clarkson College in Omaha, Nebraska. He received a B.S. in nursing from Mercy College of Health Sciences in Des Moines. For more information, call 515-239-2155.

Semira Ramic, DO Semira Ramic, DO, joined the McFarland Clinic Neurology Department in 2018. Dr. Ramic completed a neuromuscular medicine fellowship at the University of Minnesota. She completed her neurology residency at the University of Pittsburgh and her doctorate of osteopathic medicine at Des Moines University. For more information, call 515-239-4435.

Karissa Junior, NP

Ikigu Thuku, MD

Mary Jane Mills, PA-C

Ikigu Thuku, MD, joined McFarland Clinic in 2018. Dr. Thuku specializes in physical medicine and rehabilitation and pain medicine. He completed a physical medicine & rehabilitation residency and a pain management fellowship at the Virginia Commonwealth University Hospital System in Richmond. He completed his medical degree and M.S. in public health sciences at Pennsylvania State University in Hershey. Dr. Thuku completed his B.S. degree at Lincoln University in Oxford, Pennsylvania. For more information, call 515-956-4077.

Mary Jane Mills, PA-C, joined the McFarland Clinic Emergency Medicine Department in 2018. Mills received her M.S. in physician assistant studies from Des Moines University. She completed her M.A. and B.A. degrees at Southeast Missouri State University. For more information, call 515-239-2155.

Joshua Zwingelberg, MD Joshua Zwingelberg, MD, joined the McFarland Clinic Anesthesiology Department in 2018. Dr. Zwingelberg completed an anesthesiology residency at Washington University in St. Louis. He received his medical degree from Tulane University in New Orleans. For more information, call 515-239-2182.

www.mgmc.org | Fall 2018 | HEALTH CONNECT

Karissa Junior, ARNP, joined the McFarland Clinic Emergency Medicine Department in 2018. Junior received her M.S. in nursing and family nurse practitioner degree from Allen College in Waterloo. She received her B.S. in nursing from Grand View University in Des Moines. For more information, call 515-239-2155.

Nichole O’Brien, ARNP Nichole O’Brien, ARNP, joined the McFarland Clinic Occupational Medicine Department in 2018. Nichole received her family nurse practitioner degree and M.S. in nursing from Graceland University in Lamoni. For more information, contact 515-239-6992.

Usha Chhatlani, MD Usha Chhatlani, MD, joined Mary Greeley Medical Center’s Behavioral Health Unit in 2018. She earned her medical degree from NKP Salve Institute of Medicine Sciences and Research Center in India in 2002. She did her psychiatry residency at the University of Iowa Hospitals and Clinics. 3

STEADY AS SHE GOES Mary Greeley’s ‘Dizzy Therapist’ provides relief for patients suffering from a miserable condition. B Y S U S A N FL AN S B UR G

ana Barnard scanned the waiting room. An older woman was sitting very still, head straight ahead. The Mary Greeley physical therapist guessed this was her next patient and walked over to inquire. It was. This scenario plays out frequently for Barnard, who is known as “The Dizzy Therapist” in physicians’ offices around central Iowa. She’s certified as an American Physical Therapy Association neurologic clinical specialist and is recognized by peers throughout central Iowa for her skills in treating people with vertigo and balance issues. She can often spot her new patients in the crowded waiting room because of how they sit, stone still, staring straight ahead. Any movement at all can cause a spinning sensation that makes them feel sick. Teddy Beard smiled as Barnard’s face appeared in front of her. The 80-year-old Des Moines woman clutched Barnard’s and her daughter’s arms as she walked between them, swaying, back to the treatment room. Barnard worked with Beard for an hour, providing her the kind of help she had sought for so long.

Tough Diagnosis

Dizziness (vertigo) and balance problems are especially common in aging adults. Up to 30 percent of people over 60 years old—and as many as 50 percent of those over 85—will seek medical help for it. Most researchers agree that the condition is underestimated, but in spite of its prevalence, many providers don’t diagnose or treat it. “Research tells us it takes about 11 physician visits before a vertigo patient finds relief,” Barnard said. By then, the patient’s frustration level can be skyhigh and her muscles—often weakened from sitting still so much—can be unreliable. Teddy and her daughter can relate. “Mom started having episodes of vertigo about three years ago,” Joan Beard, herself a nurse, said. “Whenever it hit she was homebound, barely getting from bed to chair. She couldn’t eat. She just sat there, feeling miserable. It wasn’t my mom.” Indeed, sitting still was the opposite of what Teddy would normally do. An “extremely social” person, she is known for her love of travel, gardening, volunteering, cooking, and cribbage. Possibly her passion for activity may have triggered her vertigo—three years

Dana Barnard

ago, perched atop a ladder picking grapefruit in Arizona, she slipped, fell, and hit her head. The force may have knocked her vestibular system—the system of organs responsible for our ability to walk a straight line—for a loop. Balancing Act

The vestibular system runs from the canals of the inner ear along the vestibular nerve to the brainstem. When it’s working well, we don’t notice it. We can stand, walk, turn, and laugh without feeling a bit dizzy. When it’s damaged, on the other hand, any movement can make us feel like we’re spinning uncontrollably. A cause can’t always be determined, but head trauma like Teddy’s can dislodge the microscopic crystals that help keep the system in check, producing benign paroxysmal positional vertigo. The now-freed crystals tumble around the ear canal with the slightest movement, making the brain think the head is moving wildly. But dizziness is a symptom of many diseases and disorders. It’s no wonder it can take so long to find relief. “Cardiologists, neurologists, ENTs, and gastroenterologists all see patients with dizziness, nausea, fatigue, general

HEALTH CONNECT | Fall 2018 | www.mgmc.org

BRIDGE THE DISTANCE ADVICE FOR CARING FOR AGING PARENTS WHO LIVE FAR FROM YOU.

Dana Barnard sees many aging adults at her Mary Greeley physical therapy practice. Often, their loved ones live out of town, meaning no one may be immediately available to help manage medical needs. Over the years, Barnard has developed a few suggestions for family members. 1. Grant permission for release of your loved one’s medical information to a few trusted friends or relatives in the area, so if a problem arises medical providers can speak with them. 2. Identify a primary physical therapist— like a primary care physician—to evaluate your loved one’s baseline level of mobility, tolerance to activity, and adherence to exercise activity. As a medical care provider, a PT can provide helpful insight into your loved one’s overall health.

yuckiness,” Barnard said. “But if symptoms are causing a movement problem, the patient should see a PT.” Solution

Watching Teddy keep her head still was the first clue Barnard noted. Another was her unsteady gait. She also asked some questions she poses to all her dizzy patients. “I ask the following questions: If you were sitting at a train crossing, could you count the train cars as they went past, or would that give you a sick feeling?” she said. “If you go to the grocery store and have to look for something like toothpicks—you can never find toothpicks—can you scan the shelves while moving without feeling sick? When they say that either of these scenarios would make them feel sick, it’s another good clue.” Finally, Barnard directs her patients to perform a series of particular maneuvers to see if their eyes move in coordination with their heads. If their eyes continue to move rapidly once they are still, it confirms both the diagnosis and the location of the problem. Barnard had Teddy do a roll test maneuver, which involved her laying on her back while moving her head from side to side. When Teddy reacted

strongly to the maneuver, it indicated that the loose crystals were in her horizontal ear canals. The treatment— a maneuver completed that day in a matter of seconds—was successful. “For 75 percent of patients with benign paroxysmal positional vertigo, one treatment is all they’ll need,” Barnard says. “It can come back, though, over time. So I teach them how to treat themselves at home.” “Mom felt better immediately,” Joan said. “Dana was so kind and compassionate. She taught mom exercises she could do at home. We were very happy.” Ongoing Treatment

Many aging adults will need further physical therapy to rehabilitate the muscles that were weakened by sitting still due to their vertigo. They may also need therapy to restore their balance. “Many will need vestibular— balance—therapy,” Barnard says. “This isn’t just balancing on one foot, but retraining their eye movements. They have to relearn how to keep their eye focused while their head and body are moving. The idea is to get the entire system—brain, inner ears, muscle, and bones—back in shape.” Teddy continues her own therapy

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3. If your loved one has a neurological diagnosis, consider scheduling PT checkups to look for possible changes in movement capacity and fall risk. This proactive step is particularly useful for Parkinson’s and MS patients, although anyone coping with movement challenges would beneﬁt from it.

close to home in Des Moines. Recurring vertigo has kept her grounded the past couple of months, but because of Dana’s initial diagnosis and treatment, Teddy is once again on the mend. “Vertigo is particularly challenging when it happens to an aging parent,” Barnard said. “They want to be independent but need help with transportation and care coordination. I’m glad I was able to help get Teddy on the path to complete recovery.” Joan is, too. “Dana lived up to the praise I heard about her,” Joan said. “When you can’t see the symptoms, it’s hard to explain. You’re afraid people won’t understand. Dana not only understood, she was able to help.”

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For more information about Mary Greeley’s vestibular rehabilitation program, contact Dana Barnard, PT, CNS, at 515-239-6770. 5

THE CHAMPION Meet Lyndsey Fennelly: Mom, wife, businesswoman, athlete, media personality, volunteer, … and mental health patient. B Y S T E V E S U L L I VA N

hen she got out of the hospital, the first person Lyndsey Fennelly called was Georges Niang. They hadn’t spoken in weeks, which was unusual for these close friends. “Where the heck you been?” asked Niang, former Iowa State basketball star turned NBA player. Fennelly explained she’d been in the hospital. More specifically, she’d been at Mary Greeley, being treated in the Behavioral Health Unit. “It was a freeing moment,” Fennelly said. “I planned all along not to hide behind the reality of what I had because I have nothing to hide. Mental illness is like any other disease or disorder. We talk openly about cancer and diabetes and leukemia. We should be able to talk openly about mental illness.” Fennelly is doing just that, using her high-profile voice to reduce the stigma of mental illness and raise awareness of the services available at Mary Greeley Medical Center’s Behavioral Health Unit. “I love that hospital, and to have that quality of mental health care available in central Iowa is incredible. That’s why I want to share my voice and my story to encourage others facing mental health issues to step back and take care of these problems,” she said. “Mental health involves a variety of conditions—anxiety, depression, substance abuse; none are more important than the other. Recognizing the symptoms is what’s important.”

A Full Life

On the surface, Fennelly would seem to have it all. As a college student, she was a standout on the Iowa State women’s basketball team and was drafted into the WNBA in 2007. She married Billy Fennelly, assistant coach for the ISU women’s team and son of Bill (longtime women’s head coach) and Deb Fennelly. They have two children— Will, 4, and Callie, 1. She does radio commentary for the women’s games, runs sports camps, and is an enthusiastic volunteer. Two years ago, she and her business partner opened CampusCycle, a spin studio in Ames and Ankeny. Fennelly is smart, quick witted, and high energy. She also has a mental illness, which presents itself through intensely manic behavior. With Fennelly’s permission, Dr. Kasey Strosahl, a psychiatrist with Mary Greeley’s Behavioral Health Unit, offered insights into her condition. “Mania is one of the most difficult diagnoses to convince someone of because they feel so good, so on top of the world. They don’t see it as a problem,” she said. Mania is marked by impulsivity, disorganization, irritability, and a feeling of grandiosity, as if the person has special powers, said Strosahl. Catching the symptoms early so a person can enter a high level of treatment is vital. “There is a decreased need for sleep, which Lyndsey displayed. Someone may sleep zero to two hours a night for days or weeks,” she said. “It can include,

as it did for Lyndsey, delusional ideas.” Fennelly fit the profile. She was a multitasker extraordinaire. “I’m making dinner, texting my husband, tweeting about the women’s team, … trying to do as much as I can in a short amount of time. You can’t truly be present in anything when you’re doing that,” she said. When planning her business, she impulsively cranked out a 17-page outline on how to build a gym. She compared the experience to Tom Cruise’s title character in “Jerry Maguire” writing his manifesto. In some ways, this was who she was—lively and always on the move. She’d respond to email and texts within seconds after receiving them, no matter the time of day. Her creative juices flooded her brain with one idea after another. None of this, ultimately, was healthy. The highs always turn into lows. Despite what she thought she was accomplishing, Fennelly wasn’t sleeping. She really couldn’t focus. She couldn’t distinguish reality anymore. This led to her hospitalization in April, but it wasn’t her first time in the Behavioral Health Unit. Her problems originally presented themselves five years ago. “I didn’t eat, sleep, or drink for four straight days. I went to the Emergency Department and was admitted to the Behavioral Health Unit for 16 days. I remember it was January 29, and I got out on Valentine’s Day,” she said. She admits she did a poor job of taking care of herself after getting out of the hospital that time. She didn’t

HEALTH CONNECT | Fall 2018 | www.mgmc.org

Lyndsey Fennelly got the help she needed at Mary Greeley’s Behavioral Health unit. Since treatment, she is pursuing a new goal to be a vocal advocate for mental health care.

fully recognize that she was sick, that she had a serious illness. She ignored follow-up treatments and her medications. And why not? She had everything going for her. She was loving life and living it fully … or so she thought. In April 2018 she was in California,

on a trip with a close friend, when “I snapped, lost control.” She had so much going on and ultimately just couldn’t keep juggling so many proverbial balls. The trip was cut short, and her friend got her on a plane home. “Two plane flights with a very manic individual is not easy,” she

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remembered. “I had pushed myself so fast, so hard to the point of completely losing control.” She doesn’t remember much about the ensuing days except that at one point, she looked at her husband, Billy, and said, “You have to take me to the hospital.” 7

“While we would like to pass things off as life circumstances, most mental health problems are lifelong conditions,” said Strosahl. “They are in our genetics. They aren’t something you can have-agood-life your way out of.”

with her therapist. “I wrote a letter to myself before I left the hospital. It was my commitment to taking medication, continuing ongoing treatment and therapy,” she said. “And I added a P.S. that I am going to become a strong voice for mental health.”

On the Unit

The first few days on the Lyndsey Fennelly with Behavioral Health Unit Georges Niang, former are foggy. Fennelly at Iowa State Cyclone and first didn’t recognize— now NBA player, and Brian Dieter, president or maybe refused to and CEO of Mary Greeley. recognize—the level of The three are at the her illness. With theraGeorges Niang Golf py she eventually came Tournament, which raised money for mental health around to the painful care at Mary Greeley. truth, said Strosahl. “It’s much easier on the provider’s part when someone gains I was having a heart attack,” she said. insight into their illness and recognizes Her husband, Billy—“my rock”— they have it,” she said. “You need mental visited her every day. Fennelly’s fourhealth professionals to help manage a year-old son visited one day, too. They mental illness.” met outside of the unit and Will gave Treating a condition like Fennelly’s his mom a note “that kept me going involves medications to stabilize moods those last few days.” and specialized therapies to help with Being away from her kids was the sleep regulation. Being an athlete is in most difficult part of being in the hosFennelly’s favor. She’s competitive and pital. Getting better and getting home likes to win. to see them was her goal, and “if that “She sets goals for herself and meant a doctor saying that I’m going looks for small victories, like sleeping to take medicine for the rest of my life, through the night,” Strosahl said. then that’s what I’m going to do.” Lindsey kept to herself a lot, only As with most Behavioral Health occasionally interacting with other Unit patients, getting better takes time patients. and treatment. Fennelly was discharged “We’d strike up conversations about in late April. It was June before she felt what we did for a living, whether we stable enough to interact with people were Cyclone or Hawkeye fans,” she outside her family and closest friends. said. “But I was personally untrusting She went weeks without that everof myself. I was still recovering.” present phone, fighting the urge to She felt safe though. She had three check messages and respond ASAP. meals a day, which wasn’t typical for her. Fennelly knows she’s doing well “The staff would ask me what I wanted “when I can wake up after a great to do for the next hour,” she rememnight’s sleep and just be present. Not bered. “I’d take a shower. Have breakfast. everything is an emergency. I don’t I took it slow, which, like most moms, have to respond to an email within 60 I never did much. I’d do crafts, which seconds after receiving it. I can be a I’m awful at, but I made stuff for my mom and a business owner, but I don’t kids. I had group therapy. I paced the have to do everything at the same time. halls. I’ve never paced like that.” I’m learning to be okay with silence.” “Being in a manic state, I was She’s taking her medications, meeting so confused. I had scary thoughts. with her psychiatric nurse practitioner, I thought I was pregnant. I thought and talking while taking long walks 8

Going Public

One of her first public events was the annual Georges Niang Golf Tournament. At Fennelly’s urging, the tournament raised money for mental health treatment at Mary Greeley, eventually pulling in more than $30,000. Two days before the golf event, Fennelly asked Niang to tour the Behavioral Health Unit with her. “I wanted it to be personal to him,” she said. “It was the first time I’d been back to the unit. We toured the same halls I had paced. It was as powerful a moment as I’ve had in my life. But I was at peace.” Jody Kapustka, psychiatric nurse practitioner with the Behavioral Health Unit, provides outpatient care for Fennelly through her private practice. She met Fennelly on that first visit to Mary Greeley five years ago. “I was familiar to her when she came up there,” Kapustka said. “There was an immediate comfort level, a feeling of safety.” Being public about her condition, being an advocate, can be beneficial to Fennelly. Those activities, however, need to be managed as much as the illness itself, said Kapustka. Fennelly has already had to pull back on some of her public events. “She wants to be public about it and help other people. That’s what she does. She’s a coach and wants to be there for other people,” Kapustka said. “I think she can be a great spokesperson for mental health. She’s experienced it, gone through a lot, and is being successful. That gives other people hope.”

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HEALTH CONNECT | Fall 2018 | www.mgmc.org

BEHAVIORAL HEALTH UNLOCKED It’s one of Mary Greeley’s most complex and necessary services, and it’s growing. Here’s why. B Y S T E V E S U L L I VA N

elanie was brought in by a friend, but she’s been here before. Jennifer is ready to do “whatever she needs to do to get home.” Matthew is paranoid and delusional and hearing voices. He’s “nowhere near ready to go.” And so begins another intensely focused day on Mary Greeley’s Behavioral Health Unit, where each morning a team of therapists, social workers, psychiatric nurses, nurse practitioners, and psychiatrists gather to review each patient being treated on the sixth floor of the medical center. One patient has reportedly expressed a desire to overdose, while another isn’t sleeping or eating and “wishes someone would just shoot her.” One young woman denies being

suicidal. Another hasn’t eaten in days and comes from a family with a history of eating disorders. One man is going through drug withdrawal, and the good news is that his sores are drying up. The questions are many, and the conversation is lively. How much sleep did each patient get? What’s the next step, the next place for them? Will they go home or to another facility? What kind of support do they have? What community resources are available? Are their families a help or a hindrance? Who has Medicare? Medicaid? Private insurance? Which facility will take military insurance? The review of these fragile lives by these experienced professionals is open, honest, and occasionally touched with gentle humor. What permeates everything, though, is a commitment to help each of these patients get better.

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“It’s very much a brainstorming session,” said Jody Kapustka, MSN, RN, PMHNP, a psychiatric nurse practitioner. “The goal is to come up with the best plans for our patients. We want to get their needs met outside of the hospital in a timely manner, as well as understand what needs to be done while they are here with us.” Behavioral Health is one of Mary Greeley’s busiest and most complex departments. Access to mental health care in Iowa is a significant issue and with one of the few inpatient units in central Iowa, Mary Greeley is right in the middle of it. In this article, we will take you behind the scenes to help you understand the place, what happens there, and the people who provide care. We also offer a look at what the future of mental health care at Mary Greeley might be.

THE PLACE

Mary Greeley’s Behavioral Health Unit is behind a locked door, which can make it intimidating. If you are a visitor, for example, you will need to pick up a phone so someone can let you in. Lockers in an anteroom are available for valuables and anything that could be a weapon. There are no guns allowed, even when law enforcement comes to the unit. Once inside, though, you enter a space that is comfortable and quiet. There are two separate units: a 4-bed high-acuity unit and a 14-bed general unit. The area is decorated in calming 10

beige tones and is sparsely furnished. Everything is designed for safety. You won’t find any thumb tacks in bulletin boards or glass in picture frames. “High-acuity patients are incredibly ill and can’t tolerate the general unit. There’s too much stimulation, which can lead to undesired behaviors escalating,” said Christine Krause, director of Behavioral Health Services. “Treating these patients in a separate area creates a much safer environment for them. We are learning a lot from this environment and continue to make changes to enhance safety and quality of care.”

It is possible that someone in the high-acuity area can stabilize to the point of being shifted to the general unit, and vice versa. The general unit bedrooms are doubles. The bathroom doors in each room have partial doors that can easily be torn from Velcro hinges in case of an emergency. A multipurpose room provides a gathering space for patients, where they can play games, have a snack, and interact with each other and staff. Regardless of whether they are in high acuity or the general unit, behavioral health patients have opportunities to

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Behind the locked door of Mary Greeley’s Behavioral Health Unit is an environment designed to be calm and safe for the patients being treated there.

engage with others coping with mental illness. “This can be very therapeutic,” said Krause. “Others can say, ‘Hey, I’ve been where you’re at; it gets better.’ They support and encourage each other. It helps reduce the stigma of mental illness.” Though a locked unit, the area has the same services as other inpatient areas. Dietary staff brings meals. Guest Services staff clean rooms. ADMISSION AND TREATMENT

Mary Greeley’s Behavioral Health inpatient unit treats nearly 800 adults each

year. This translates to more than 4,200 patient days (the number of days those 800 patients spend in the inpatient unit). Both these statistics are trending up because mental illness does not discriminate on the basis of gender, age, or socio-economic status. “You never know what you are going to walk into. Every day is different, every patient is different,” said Dr. Kasey Strosahl. On any given day, patients in Mary Greeley’s Behavioral Health Unit represent a diverse mix in terms of age, gender, socio-economic background, and, of course, condition. They are highly educated and intellectually disabled. They are bipolar, manic, or schizophrenic. They have anxiety disorders. Sometimes these maladies are coupled with addiction issues. What all these people have in common is that in their current state, they are considered at risk. “Their mental illness has decompensated to a point where they are a risk to themselves or others, either actively or passively,” she said. “Actively means they are making threats, for example. Passively means they just can’t manage their own self-care. They are not eating. Not sleeping. Not able to function. They are engaging in activities that are incredibly unsafe, like walking down the middle of the highway.” These patients can take many paths to Mary Greeley’s inpatient unit. Some are brought by friends or family members, whereas others are transferred from other facilities. They are brought by law enforcement after being court ordered to mental health treatment. Others are admitted after first being evaluated in Mary Greeley’s Emergency Department. Because they are brought to a locked unit, the admissions process can be overwhelming. “We purposefully limit contact with the outside world,” Krause said. “You have to keep in mind that in a lot of cases what brought people here is the inability to cope with the outside world and the stresses that it brings with their illnesses. We keep them on the unit

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and limit visiting hours. We have to ask family to take a deep breath and let us get their loved one in a better place.” Ultimately, the process is designed to be as calm and safety focused as possible, said Krause. “When a patient arrives, we greet them and explain what the immediate process is. We take their belongings and they change into a hospital gown. We do a noninvasive body search to ensure their safety. We search belongings for contraband,” said Krause. “The biggest thing I try to enforce with my staff is to make sure that when patients are coming onto the unit you greet them with a smile. Make sure they know who you are and what you are doing,” said Christina Mayfield, BSN, RN, unit supervisor. “New patients don’t know what to expect and it can be scary. We need to make them feel welcome and at ease with no surprises.” Emergency Department

Mary Greeley’s Emergency Department (ED) is a safety net for behavioral health patients, said Krause. It’s often the only option for people who can’t otherwise access mental health care. “What we really do there is determine whether someone is at risk to harm themselves or others. They clearly may not need the level of help that would require admission as a patient. In these cases, we will provide resources to seek in the community,” she said. About two-thirds of the people who come to the ED for behavioral health-related issues are assessed and discharged with recommendations for care in the community. For the other third, admission to a mental health facility may be required. If there is space, a patient might be admitted to Mary Greeley’s unit. Otherwise, another facility will have to be located. Mary Greeley’s ED has two rooms specially designed for mental health patients. These are staffed by psychiatric nurses. This is a big advantage, Krause said, because many hospitals don’t have trained psychiatric nurses in the ED, assessing patients and providing input to the ED physician. 11

If an ED physician feels it necessary, a patient can be placed on a 48-hour hold to be fully evaluated. (Mary Greeley’s Behavioral Health Unit is for adult patients. Adult and adolescent patients are treated and evaluated in the ED.) Assessment

When a patient arrives at the inpatient unit, nursing staff will do an assessment. They will review general and mental health, including medications the patient is taking and treatment history. They will review why the patient has been brought to the unit. The patient will be given a tour of the unit and introduced to peers. The information gathered during the first 24 hours is critical because it will help staff formulate a treatment plan. The patient is the first source of information but not always reliable. With proper authorization, family members can help fill in gaps. Staff will try to find other records based on what the patient shares. “You need to glean the story. One

of the huge challenges for psychiatric patients is continuity and consistency of care,” said Krause. “We want to establish what their care environment has and hasn’t been. We really try to be diligent to figure out where they’ve been, what’s been going on, and what we can do to do what’s right for them. Maybe something hasn’t been working. Maybe they haven’t been compliant. So do we need to change something or start more intensive case management? It’s so important to create that patient’s story.” Treatment

People can sometimes have antiquated ideas of mental health treatment. “One of my patients told me, ‘I am so thankful for what you did for me. This is not what I expected. I thought you’d have me in a straitjacket,’” said Strosahl. The treatment plans vary from patient to patient. For some, medication is the answer; for others, maybe not. The best treatment could be a combination of medication and therapy.

The key is finding the best approach to stabilize a patient’s mental health crisis and working toward a discharge plan. Depression patients, for example, typically receive the fullest range of treatment. On Mary Greeley’s inpatient unit, that means daily meetings with a psychiatrist or nurse practitioner to discuss symptoms and do therapeutic work. It can also mean group therapy sessions and recreational therapy. In some cases, treatment for depression or other conditions involves electroconvulsive therapy (ECT). This procedure is done at major hospitals, such as Mayo Clinic. Mary Greeley is one of a handful of hospitals in Iowa that offers it. Done under general anesthesia, ECT involves small electric currents passing through the brain, causing a brief seizure, which helps reset the brain’s chemicals. “For severe depression, it can reset chemicals in the brain. It really does help some people,” said Strosahl. Some patients’ behavior put them at such a high risk that they require 24hour supervision. Often these patients

Furniture in the unit’s highacuity area is designed for safety. It is surprisingly heavy, making it difficult to lift.

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VIDEO TOUR Get a look inside our Behavioral Health Unit and discover how we create a safe, comfortable, healing environment for our patients: mgmc.org/mentalhealth

RN, PMHNP, a psychiatric nurse practitioner. “Their world has just crashed and they might be glad to see me, but it’s a tough situation.” Adds Kapustka: “When a patient is discharged, we always tell them, ‘if you get to a point where you are not safe and cannot care for yourself, please come back to the hospital.’ We would rather see them here, where we can provide the care and oversight they need.”

bilization-Transitional Living Center in Ames (see separate article). Mary Greeley is part of the Central Iowa Community Services mental health region, which includes 11 counties: Story, Boone, Greene, Marshall, Jasper, Hardin, Hamilton, Franklin, Poweshiek, Madison, and Warren. “With the regional system, a patient shouldn’t need to be sent to Mary Greeley, and then Dubuque, and then Sioux City,” said Krause. “We should be able to work with resources within the region to help our high-acuity and general-care patients.”

Regional Approach

STAFF

Iowa has recently established regional mental health systems to help ensure community-based continuums of care. “Compared to 99 counties having their own system, a logical person can see the value in this approach,” said Brian Dieter, president and CEO of Mary Greeley. “There were big gaps between those that provided robust services and those that provided the least. The whole promise of regionalization is greater consistency.” This should mean more community facilities, such as the new Crisis Sta-

Behavioral Health has more than 40 staff members, including nurses, social workers, therapists, and psychiatric assistants. The majority of the nursing staff are certified in psychiatric and mental health nursing. “Our staff all want to work in behavioral health. They have a desire to be here and have pursued additional coursework and internships,” said Krause. “Some have a personal connection.” Krause had a background in occupational therapy before transitioning

Dr. Usha Chhatlani, a psychiatrist, recently joined the unit’s staff. She also serves as medical director of Mary Greeley’s new Crisis StabilizationTransitional Living Center.

have a history of incarceration and violent behavior. No surprise, it is difficult to find long-term facilities for these patients. Two of the state’s four mental health hospitals were closed in 2015, making placements of these patients even more challenging. As a result, these patients may stay longer at Mary Greeley. The average length of stay is five to six days. Some get out sooner; some stay much longer. Mostly, patients return to their communities with recommendations for follow-up with a community service. A patient without a residence may be referred to a group home, for example. Rehospitalization

“There’s always a sense of hope when a patient significantly improves and is discharged from the hospital,” said Strosahl. “You always have a sense of concern too, wondering how effective the outpatient services will be and if it will be enough.” It can be disappointing and frustrating for caregivers, but sometimes a patient’s treatment plan does not work. Their resources aren’t sufficient or the patient isn’t compliant. This can result in rehospitalization. “You do get to know these folks very well, and some patients can start to feel like family. You see them again and you greet them with, ‘Oh my gosh, how are you?’” said Shannon Lindley, MSN, www.mgmc.org | Fall 2018 | HEALTH CONNECT

Christy Krause, director of the unit, confers with Christina Mayfield, unit supervisor.

Psychiatric nurse practitioners Shannon Lindley and Jody Kapustka review a case.

The staff discusses each patient’s status during a meeting every morning.

to mental health care. “In rehabilitation, your whole focus is on recovery and rehabbing the patient. Behavioral Health is no different,” she said. “We have to believe these patients can recover and go back to their lives, contributing to their communities and living independently. That is our goal.” Nurse practitioners Lindley and Kapustka both opted for psychiatric nursing over typical medical inpatient care. The specialty provides Lindley opportunities to use her skills at oneon-one listening and forming connections with patients. It is continually challenging and satisfying work, she said. “I remember once I was working with someone with limited cognitive 14

ability who had been damaged by 18 years in the foster system. After finishing, I was immediately waylaid by another patient; this one had a PhD. I had to quickly change how I was communicating. Every patient is different and you have to learn how to manage that,” she said. Kapustka studied criminal justice and psychology and had hopes of being a probation officer. She opted instead for nursing school and pursued psychiatric nursing. In addition to working for Mary Greeley, she has a private practice. This can be beneficial for Mary Greeley patients who become clients outside of the hospital because they already have a familiarity and comfort level with her. Strosahl became interested in

psychiatric medicine during her rotations as a medical student. She realized “what an impact you can have in all aspects of a person’s life in dealing with mental health issues and directing them through the difficulties they have.” “I’m doing a job I love and I wish there were more resources. Sometimes in an inpatient setting we are getting someone in a healthy place and once they are ready to leave, you ideally want them to have all the necessary resources, like a psychiatrist, a well-trained therapist, and assertive community treatment,” she said. “It can be discouraging because they came for help and have to wait two to three weeks before a program can take them. It’s tough, but you have to keep at it.”

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“There’s a need. We don’t shy away from taking on physical health issues, and we shouldn’t shy away from taking on mental health issues. We can help. We should help. Patients and families need and deserve our help.” – Brian Dieter

Dr. Kasey Strosahl, one of two psychiatrists on the unit.

A meeting and exercise room on the unit.

Dr. Usha Chhatlani recently joined the Behavioral Health Unit. She will treat patients at the unit, as well as being medical director for the new Crisis Stabilization-Transitional Living Center in Ames. (See separate story.) “I had always been in primary care, but whether I was doing internal medicine, family medicine, cancer care, I was always seeing psychiatric issues come up,” she said. “I gravitated toward this kind of care because it is so needed.” Mayfield brings personal experience to her job. She had a brother who spent most of his life in a state hospital for the developmentally disabled. Another brother committed suicide when he was 22. “He had attempted suicide once and was hospitalized. The feeling was

that he did it for attention. He was discharged without seeking behavioral health care because they didn’t think it was a serious attempt,” she remembered. Mayfield had worked as an assistant in an adolescent behavioral health facility. After losing her brother, she started applying to nursing schools to be a psychiatric nurse. “We need more people to stand up for these people,” she said. “I need to be an advocate for them. We treat so many people here. The homeless, drug addicts—you have to be able to look past that and see a person, a person who needs our help. I want to make sure our staff are in this for the right reason, that they want to be advocates too. I believe all my staff are there.” FUTURE

So what would happen if Mary Greeley did not have an inpatient Behavioral Health Unit? “You’d have a lot more individuals

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lost in the system,” predicted Lisa Heddens, director of National Alliance on Mental Illness Central Iowa. “If someone is in a crisis situation and needs evaluation … I don’t know how many people would have the means or support to find it elsewhere.” Mental health is a “huge gap in the healthcare system,” said Heddens. Because of this, Mary Greeley is looking to expand its inpatient unit within the next few years. This will provide more general unit beds and, more importantly, more high-acuity beds. “We have four now and it simply is not enough. The unit is always full,” said Krause. A lack of providers and facilities has made it more challenging to provide intensive psychiatric care. A longtime psychiatrist who was also medical director for Mary Greeley’s Behavioral Health Unit has retired. Mary Greeley is exploring how one or more of its psychiatrists can provide more outpatient care, including being a resource for McFarland physicians who may be treating patients who have mental health issues. “There’s a need,” said Dieter. “We don’t shy away from taking on physical health issues, and we shouldn’t shy away from taking on mental health issues. We can help. We should help. Patients and families need and deserve our help.”

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SAFE HAVEN A new Mary Greeley-managed facility expands community mental health services. B Y S T E V E S U L L I VA N

arrell Robinson planned to work for Mary Greeley Medical Center’s Behavioral Health program for five years and then move south. That was 35 years ago. He’s still here and has been a psychiatric assistant at Mary Greeley’s Transitional Living Program (TLP) facility since it opened near the hospital in 1995. Robinson finally made a move in October, but not far. He’s now at Mary Greeley’s new Crisis Stabilization-Transitional Living Center (CS-TLC), which opened a few blocks away from the hospital. “The value of this program is priceless,” said Robinson, who has helped countless people move on with their lives after facing significant mental health challenges. “This is what the

community needs to help those with mental health issues and those who are not capable of advocating for themselves.” Mary Greeley’s TLP was the first program of its kind in Iowa. All of the experience and expertise gained through TLP now shifts to a more significant program at the CS-TLC. “TLP has been the model for similar programs in Iowa. Providers from throughout the state have toured this program to see how it works,” Robinson said. New Facility

The CS-TLC is a cooperative effort of Mary Greeley, Story County, and the Central Iowa Community Services mental health region, which covers 11 counties. It is located at 124 S. Hazel

Street in Ames. Mary Greeley oversees the program. The CS-TLC provides care and support services to persons who have a diagnosis of mental illness or cooccurring diagnosis with mental illness and substance abuse. The CS-TLC fits into the continuum of mental health services by providing crisis or transitioning care for adults in a less restrictive setting at a lower cost, said Jen Barber, CS-TLC coordinator. Dr. Usha Chhatlani, a psychiatrist with Mary Greeley’s Behavioral Health Unit, is the center’s medical director. The center is staffed with psychiatric assistants from Mary Greeley, including Robinson, who are trained in working with adults with mental illness in a supervised, community-based setting. It will be for people 18 and older

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One of the center’s bathrooms was designed to accommodate clients who are in wheelchairs or who have mobility issues.

The center has eight bedrooms.

The Crisis Stabilization-Transitional Living Center is a new cooperative effort of Mary Greeley Medical Center, Story County and the Central Iowa Community Services mental health region.

a place for people in crisis, it frees up inpatient beds for patients who might be facing more extreme mental health issues. “We are very fortunate to have this facility, given the increased need for psychiatric care we see in the community right now,” she said. “There are different degrees of crisis in mental health and sometimes people in crisis don’t always need to be in the Emergency Department or an inpatient unit. This facility will provide a safe place for people who can stabilize in a few days in a less restrictive setting.” Individuals needing this level of care will typically be in the facility for up to five days, during which time a safety stabilization plan will be established.

who are referred to the CS-TLC by a provider from Mary Greeley, or from other medical and mental health provider locations. Levels of Care

The CS-TLC has eight beds and provides two levels of care: crisis stabilization and transitional living. Two beds are designated for crisis clients, and up to six are available for transitional living. Crisis stabilization care is for clients who are experiencing a mental health emergency such as increased mental health symptoms or emotional distress. Although these clients are in crisis, it is not so severe that they need to be in an inpatient setting, said Barber. This is one of the biggest benefits of the center, said Chhatlani. By having www.mgmc.org | Fall 2018 | HEALTH CONNECT

Darrell Robinson has been part of Mary Greeley’s Transitional Living Program for more than 20 years.

Individuals will meet with a licensed mental health provider each day to review their plan and connect with resources. Transitional living care is intended for individuals who have been in crisis and are now stabilized but need more time to get supportive resources in place, such as housing, employment, and ongoing counseling services. The goal is for individuals who have been hospitalized for mental health treatment to have services in place to successfully transition them back to their communities and avoid rehospitalization. The length of stay at this level of care is up to three months. Referral Required

The CS-TLC is not an intake center. A provider’s referral is necessary. Someone in a mental health crisis should first go to their provider or to the nearest Emergency Department. Referrals are coordinated by contacting Mary Greeley’s Behavioral Health inpatient unit at 515-239-2682. While other agencies can refer a client to the CS-TLC, a medical screening will be required before they can be admitted. The state’s mental health regions can provide payment for either level of care. The CS-TLP is seeking accreditation through the Department of Human Services. Once received, payment will be sought through Medicaid for crisis care. Payment for crisis care by private insurance is not widely established at this time. Private insurance does not pay for transitional living. Only the mental health regions fund this level of care.

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HEALTH CONNECT | Fall 2018 | www.mgmc.org

More men are getting into nursing. Male nurses at Mary Greeley explain why the profession is so attractive, and the challenges they face. BY STEPHANIE MARSAU

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“People are coming to the realization that nursing is rapidly changing and more men are joining the profession now than ever before.” – Luke Stalzer, BSN, RN, CEN, Emergency Department

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POST-SURGERY CARE One of Mary Greeley’s male nurses, Kevin Krausman, recently helped educate patients on how to care for themselves after surgery. This is especially important in the prevention of surgical site infections (SSIs). To watch Kevin in action, please visit: mgmc.org/ preventssi

Men account for just 13% of the nearly 3 million nurses nationwide. In the 1960s, men accounted for just 2%. Out of its 500+ nurses, Mary Greeley employs 31 male nurses.

ever let them see you cry.” That was the advice Neal Loes’ supervisor gave him during his orientation as a nurse at Mary Greeley Medical Center 38 years ago. The supervisor offered this advice to all her nurses. On this occasion, however, it was the first time she was offering it to a male nurse—the only one at the time on Mary Greeley’s staff. Loes assured her that he had no intentions of crying. He went on to become vice president for nursing at Mary Greeley and has seen the population of male nurses grow at the medical center. (See “Loes Lessons” story on page 24.) “Nursing is as personally and professionally satisfying a profession for men as it is for women,” said Loes. “The career has always come with some stigmas for guys, but that hasn’t deterred men from becoming nurses. It’s a real opportunity. Research has shown that if we simply double the number of men in nursing there would not be a nursing shortage across the country.” Nurses typically are the largest employee group at any hospital. Of Mary Greeley’s 1,300-plus employees, more than 500 are nurses. Of those, only 31 are males. According to a working paper from the Washington Center for Equitable Growth, men account for about 13% of the nearly 3 million nurses nationwide. That may not sound like many, but in the 1960s that number hovered around 2%.

So why did some of the other male nurses at Mary Greeley choose to enter a profession that, even in 2018, still employs nearly six times as many women as men? “I chose to be a nurse because when I was going to Iowa State my dad had a second heart attack that required quadruple bypass surgery,” said Kevin Krausman, RN, CMSRN. Krausman’s nursing role is unique in that he is part of Mary Greeley’s Nursing Support Team, which means he doesn’t work on just one unit—but instead floats to other units that may be short-staffed. Ian Halliday, RN, who works on Mary Greeley’s Medical Telemetry Unit, shares, “Helping people is my favorite thing about nursing. There’s something about seeing the reactions on a patient’s face, or on the faces of their family members, after you’ve helped them that is truly amazing.” “I have been around nursing all my life because my mother is a nurse. I’ve been able to see firsthand the impact nurses can have on people,” said Jake Keller, RN, Home Health Services. A Gender Shift Why are more men choosing a career path that has traditionally been dominated by women? The answers are many, but one of them is the fact that traditional gender roles are going by the wayside. According to Patricia D’Antonio, a nursing historian at the University of Pennsylvania, nursing has traditionally been considered a women’s field

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because women were perceived as natural caregivers. Nursing was such a gendered profession, males were not allowed to serve in the Army Nurse Corps in either of the world wars. Attitudes are changing toward gender roles though, and as we become more and more progressive, more and more males are entering the nursing profession. In fact, the American Assembly for Men in Nursing is currently running a campaign in the hopes of seeing a 20% increase in male nurses in the United States by the year 2020.

Perks of Nursing Job security may be another attraction to the nursing profession for men. Nurses are in high demand, and the profession offers a level of security higher than many other fields. “I had worked in an iron foundry and in a few production line type jobs prior to becoming a nurse,” said Eric Adelmund, BSN, RN, clinical supervisor on Mary Greeley’s Medical Telemetry Unit. “I had been laid off three separate times in 10 years and the fear of not knowing if I was going to have a job to support my family scared me.” According to the Bureau of Labor Statistics (BLS), employment of registered nurses is projected to grow 15 percent between now and 2026, much faster than the average for all other occupations. This is due to a number of reasons, including an increased emphasis on preventive care, growing rates of chronic conditions, and demand for healthcare services from the baby boomer population as they 21

“I know that being in the hospital can be stressful for a patient. Having a calm, caring nurse can help alleviate some of their stress.” – Kevin Krausman, RN, CMSRN, Nursing Support Team

live longer and more active lives. Luke Stalzer, BSN, RN, CEN, a nurse in Mary Greeley’s Emergency Department, had always been interested in healthcare and medicine. He started volunteering as an EMT when he turned 18. “I felt like it was a natural transition to go from prehospital care to nursing care, and the job outlook was definitely in my favor,” said Stalzer. “Nursing also allows for advancement in many different areas whether that be education, leadership or advanced practice.” The pay certainly doesn’t hurt either. The BLS reports the median salary for a registered nurse in Iowa was $57,930 in 2017. According to Penny Bellville, Mary Greeley’s Human Resources director, the median at Mary Greeley is higher than the average. Greg Seward, RN, CMSRN, a nurse on the Medical Telemetry Unit, found himself needing to make a change in the early 80s. “In 1983, the company I worked for declared bankruptcy and I went from making $11.69 an hour on Friday to making $6.50 an hour on Monday,” recalled Seward. “After a strike, our pay rate was raised to $8.50 an hour. That was when I realized I needed a degree in a field where I could go anywhere and get a decent job.”

Helping Others While job security, salary and career advancement certainly all play important roles in the choosing of a profession— the male nurses at Mary Greeley all offered up another, more important, reason for choosing the career path they did. “I became a nurse because I have always had a desire to help people,” said Keller. “Being a Home Health nurse and taking care of clients in their home is a completely different atmosphere than taking care of them in the hospital. I love being able to help them in their own environment.” “I like knowing that every day I come to work I can make a patient’s day,” said Krausman. “As a nurse, I

HEALTH CONNECT | Fall 2018 | www.mgmc.org

MAKE A CAREER Are you interested in a career in nursing? We are always looking for compassionate care providers with a dedication to quality and service to join our team. Visit www.mgmc.org/ careers to see our current openings.

Employment of registered nurses is projected to grow 15% between now and 2026. Mary Greeley’s median salary for a registered nurse is higher than the state average of $57,930.

mused Davis. “When I correct them I tell them that it was probably my gray hair that had them confused.” Adds Adelmund, “There are definitely times that I’ve had patients think that I’m a doctor. I make sure to let them know that I am indeed not their doctor and that if I were, I would have a much nicer car.” “It’s funny because in spite of all nurses at Mary Greeley wearing the same color scrubs (navy), I am frequently mistaken for an Emergency Department physician when entering a treatment room,’ said Stalzer.

“I became a nurse because I have always had a desire to help people. I love being able to help them in their own environment.” – JAKE KELLER, RN, HOME HEALTH

know that being in the hospital can be stressful for a patient and they can feel very vulnerable. Having a calm, caring nurse can help alleviate some of their stress.” Adelmund echoes those sentiments. “When I first started college, I wanted to be a cop because I could help people. Now that’s the very thing I like most about nursing. I guess that need to make a difference in someone else’s life has always been a part of who I am.” Helping others inside the hospital may be their job, but many of these guys are helping others outside of the hospital as well. Several volunteer in their own communities as coaches and a few have been volunteer EMTs.

The Stigma The fact remains that while male nurses are becoming more and more common,

there are still far more women in the profession than men. So when a male employee enters a patient’s hospital room, it is not always readily assumed they are a nurse. “I have been called doctor more times than I can count, and also get asked frequently if I am a paramedic,” recalls Steven Gelder, MSN, RN, CEN, nurse on Mary Greeley’s Surgical Unit. “I have had some patients who do not want to change in front of me, but most patients don’t seem to have a problem with it. I have learned that if I seem uncomfortable, the patient will be as well.” Tim Davis, BSN, RN, Cardiac Cath Lab, and Adelmund tend to use humor with patients who mistake them for a doctor. “I seem to always be correcting people who think I’m the doctor,”

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Prognosis The Mary Greeley male nurses interviewed for this story all agree that the outlook for males in nursing is strong. “The stigma is there nearly every day,” explained Krausman. “But after I explain my role in the care they’re going to receive, patients are usually very understanding about having a male nurse on their care team.” “People are coming to the realization that nursing is rapidly changing and more men are joining the profession now than ever before,” added Stalzer. Male or female, a nurse plays a crucial role in providing patientcentered care. As one nurse put it, “Because of the knowledge I have, I could save a person’s life every day I come to work.”

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ary Greeley has provided central Iowans with highquality healthcare for more than 100 years, and there are few people in this organization’s history that have helped shaped that care as much as Neal Loes, vice president and chief nursing officer (CNO). He started at Mary Greeley in 1981 as a staff nurse. He left in 1985 and worked in different arenas and returned in 1989. He became CNO in 1994. Loes has spearheaded the medical center’s RN to BSN program (more than half of our nurses have earned their BSNs). He’s also been a leader in nursing education across the state, and most recently played a key role in establishing the new nursing program at Iowa State University. As he approaches retirement, we asked Loes to share some of his most memorable experiences and lessons he’s learned during his long career. I decided to look into healthcare when I was 16. I had to appeal to get into a CNA program as they had no experience with men and were unsure if adding males to the program would work. My mom was a Registered Nurse and I always was prideful of how she cared for her patients and her community. I really enjoyed taking care of people and decided I would go into nursing. When I went to my high school counselor and told him I needed help finding a nursing school, he looked at me and said, “I can’t help you.” I said, “You just helped Maureen (a friend of mine). Why can’t you help me?” He looked me straight in the eye and said, “I can’t help people like you.” I think we all know what he meant. In the late 70s and early 80s, I was called many things when people learned what I did or saw me in my white uniform. It just added to my resolve that I need to make a difference.

LOESLESSONS An insightful and entertaining look at our chief nursing ofﬁcer’s experiences from a three-decades-plus career.

(Clockwise) Neal Loes, vice president and chief nursing officer, makes a point; laughs (his laugh is instantly recognizable); struts in a breast cancer awareness video; runs in Hope Run in memory of a close friend; kisses a pig for charity; and graduates from nursing school in 1980.

June 5, 1980, I graduated from nursing school in Rochester, Minnesota. I initially worked at a 50-bed hospital in northeast Iowa. Back then you received a Graduate Nurse temporary license until you completed your state board exams. There was a nursing shortage, so I worked as a charge nurse on the 24

HEALTH CONNECT | Fall 2018 | www.mgmc.org

3 to 11 shift while I was still under my temporary license. If I remember right, I had a one day orientation and then worked my shift. The state board exams were only offered twice a year in a central location within the state. It was two days of paper and pencil exams. Seven in total. There were not many men in the auditorium so the women confiscated all bathrooms, much to my dismay. I walked through a barricade of women to go to the men’s room and was told there were women in there. I opened the door and warned them to all stay in their stalls and no one will see anything they don’t want to. Then I proceeded to go in and use the restroom. When done, I hollered, ‘All Clear!’ and exited. There was a lot of giggling. January 5, 1981, was my first day at Mary Greeley. I was the only male nurse in the hospital. Frequently I was called upon to help with lifting on other floors and to insert male catheters. I finally set new expectations that the female nurses did all those tasks before I arrived and they can continue to do so. I worked one year on 3 South and then went to the Emergency Department. I worked a day-night rotation. The hospital was always full and mostly with surgical patients. We would frequently have surgical patients in hallway beds—yes, literally in the hallway. We had three separate floors for surgical patients: 2 East, 3 South and 5 South. As technology and evidence changed practice, we reduced surgical beds and redefined spaces to add oncology, skilled nursing and acute rehab. Outpatient surgery continued to expand. The ED only saw about 7,500 patients a year back then. We usually did not have a physician in house at night except for weekends. Night

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staffing was frequently one nurse and one tech/secretary except on Thursday through Sunday because they were busy nights. Though we have an amazing facility and equipment to work in, I think the thing that I am most proud of is our commitment to the professional development and practice of nurses. I am very proud that our leadership supports the professional development of nurses. Fifty-one percent of our nurses are BSN prepared and 34 percent are board certified. This level of support does not happen in most organizations. This effort has led to a higher level of collegiality among nurses, other clinical and nonclinical team members, and physicians. Ultimately this leads to better patient outcomes and we have data that proves this. I am excited about the future of healthcare and nursing. We now have data and systems in place to guide our practice of patient care. Transparency of outcomes has improved our healthcare delivery system. People interested in a challenging career that makes a difference have flooded the education system and forced expansion of programs to bring more nurses to the bedside. Advances in technology and changes in payment structure will create new thinking and new opportunities. Mary Greeley is very much part of who I am and I have been blessed to work the bulk of my career here. It is part of my family. In fact, I met my wife of 35 years here and two of our three children were born here as well as five of our nine grandchildren. I brag on the care and services of Mary Greeley and the people that serve its mission.

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BREATH OF LIFE

Robert Flint is surrounded by members of the Mary Greeley Laboratory’s microbiology team, (from left) Cindy Hansen, Carol Byriel, Gina Baker, Sherri Olson and Kristin Veencamp.

An Ames man faced almost certain death, and then a sharp-eyed Laboratory technician made an amazing discovery. Robert Flint was dying. In August, he and a close friend were visiting Flint’s family in Chicago. He fell ill and had to cut the visit short, returning to Ames with what he thought was just a bad cold. A bad cold would have been so much easier. Not long after getting back home, Flint ended up in Mary Greeley’s Emergency Department. His lungs were failing. A CT scan done on his chest indicated metastatic cancer. Dr. Tamim Mahayni, a pulmonologist with McFarland Clinic, wasn’t convinced, though and wanted to be more certain of what Flint was facing. A bronchoscopy was done and specimens were sent to Mary Greeley’s Laboratory. Meanwhile, Flint was becoming too sick to support even with a ventilator. Setback and Discovery Flint’s best hope was to be transferred to a Des Moines facility for an advanced lifesupport procedure called an extracorporeal membrane oxygenation (ECMO). Basically a lung bypass machine, an ECMO uses a pump to circulate blood through an 26

artificial lung back into the bloodstream. It is an invasive, risky procedure that is typically reserved for patients who are considered stable enough for treatment. Flint’s CT scan looked like cancer, though, and the Des Moines facility did not feel he was a good ECMO candidate. As Mahayni was getting bad news, Kristen Veencamp, a Mary Greeley Laboratory technician, was analyzing the speciman from Flint’s bronchoscopy. Something unusual caught her eye. She discussed her finding with her microbiology colleagues. The team then met with Dr. Daniel Fulton, a McFarland Clinic infectious disease specialist, and Dr. Trisha Anderson, a McFarland Clinic pathologist. Veencamp had seen a broad-based budding organism in the specimen. Imagine a figure 8 with an enlarged bottom half. This suggested that Flint had a fungal infection called blastomycosis, which is highly unusual given that it is not typical for this region of the country. “The slides and the fluid showed a small amount of this unusual fungus, which, although life threatening, is treatable with

antifungal medications,” said Fulton. “With this information, Dr. Mahayni was then able to call the Des Moines facility back and they accepted the patient for transfer for ECMO. We started him on antifungal therapy before he left and talked with the team at the other hospital regularly after he transferred. The conﬁrmation fungus testing came back positive about 48 hours later, but if the Lab had not caught this, Robert would have died.” Recovery After two months in Des Moines, Flint returned to Mary Greeley to continue his recovery in the Acute Rehabilitation Unit. He is gradually regaining strength and the ability to stand and walk on his own. He’s feeling much better, though, and praises the thoughtful, focused care he’s received at Mary Greeley. Veencamp, he said, is “my little guardian angel.” "I’ve got a whole different perspective on life now," he said. “I want to be healthier, go to church more often. This has changed everything.”

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HEALTH CONNECT | Fall 2018 | www.mgmc.org

2018 Innovation & Excellence Award Winners Each year Mary Greeley Medical Center present Innovation & Excellence Awards to recognize achievements in medical practice, leadership, nursing and service. The recipients are nominated by peers and selected by a committee of previous winners. This year’s winners explain why they love what they do and what this honor means to them. Innovation & Excellence in Nursing Practice

Amy Schweers, RN Lead Nurse, Acute Rehab I like that Mary Greeley always puts the patient in the center. On Acute Rehab, we keep patients longer than the other floors in the hospital. So some of our patients stay up to threeand-a-half weeks. We really get to know our patients and our families. I came to Mary Greeley not really sure what I wanted to do, or what kind of nurse I wanted to be. There was an opening on Acute Rehab, so I went ahead and applied. We’re a smaller unit and so we have a smaller nursing staff than some of the other units. We get to know each other personally, and that makes coming to work a lot more fun and easy when you enjoy the people that you work with. Being the I&E recipient this year is a huge honor. There’s so many great nurses that I work with just on my unit, but also on all the units in the hospital, that do great things every day. It was a huge deal to be recognized by someone, and then to have the whole committee read through all those nominations and think that I would be the best recipient this year, I’m very proud of that. Innovation & Excellence in Leadership

Christy Krause Director, Behavioral Health Unit I have been at Mary Greeley Medical Center for 26 1/2 years. My work in Behavioral Health is challenging. I like to look at a system, determine

where the roadblocks are, and try to eliminate them. It matters to me that patients get really good care. And for persons with mental illness, they deserve that. The day that they came to my office to present me with this award, I was really taken by surprise. I never in my mind anticipated that I would be chosen. I was almost speechless at first, because I just never expected that. I don’t think about those things I guess I do every day and the impact that they have on patients’ lives. It kind of hit me that other people acknowledge the work that I do here and that there’s something special about that. It’s very humbling. Innovation & Excellence in Service Delivery

Tara Box Walker Unit Secretary, Diagnostic Radiology I started as a CNA here and so it’s very important to me to do the patient care side of things. When patients come to Radiology, I’m the first person they see, and I want them to feel relaxed, welcome, and that I will help them with the best care possible. When I’m providing a service, sometimes I don’t realize the impact I might have on someone, because it’s just a part of my daily tasks. It means a lot when you have people that acknowledge the service you provide every day. Doing what’s right should be a part

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of what we do on a daily basis, and so to receive this award is pretty amazing to me. I already feel that I try to provide the best service and winning this award just reinforces that. Innovation & Excellence in Medical Practice

Jennifer Killion, MD Adult Medicine, McFarland Clinic My greatest satisfaction as a physician comes from learning about the lives of the people I care for, from connecting with them. Establishing connections is vital to providing the level of care people expect and deserve. I also am consistently energized by the diagnostic mysteries that present themselves to me. In healthcare, we often find ourselves trying to solve puzzles. It makes this a fun and challenging profession. I’ve been asked to serve in a number of leadership positions, including chief of the medical staff. I am mystified as to how I ended up in all these leadership roles. My nurse, Duanna (Thompson, CMA), says it is because I don’t know how to say ‘No’ when someone asks me to do something. She might be right. However, all of these leadership opportunities have taught me quite a lot, and my hunger to learn new things makes this part of the job enjoyable. It allows me to serve McFarland Clinic, Mary Greeley, and ultimately the communities we all serve.

Lasting Comfort

Close friends Chris Hunziker and Neal Loes, vice president and chief nursing officer, in the family comfort center on Mary Greeley’s Oncology floor. The room was remodeled in memory of Gary Hunziker, Chris’ husband.

An Ames family’s act of gratitude and remembrance beneﬁts oncology patients and their loved ones. BY DEB GIBSON

ary Hunziker and his family spent many hours on the fifth floor of Mary Greeley’s west tower. It’s home to the oncology unit, where patients brave cancer and its often devastating toll. Now, thanks to the generosity of the Hunziker family and countless friends, the fifth floor has an oasis for patients and families—a comforting space inspired by love, hope, and gratitude. Oncology patients and their families can find respite in the newly appointed room, which was designed to give families more opportunities to participate in their loved one’s care. It offers heated blankets, refreshments, and original artwork created by Sticks, a Des Moines-based art studio. The artwork adorns a custom-made wooden table and chairs, as well as an entire wall that displays imaginative nature-inspired 3D motifs anchored by the motto “Live life to the fullest every day.” That was Gary and Chris Hunziker’s mantra throughout their 38 years of marriage and certainly the deeply held outlook that propelled them through Gary’s three-year bout with multiple myeloma. While too many days during those years revolved around stem cell transplants and immunotherapy and countless chemotherapy treatments, the Hunzikers still stole away to tropical vacations with children Megan and Andy and their families. They followed their beloved ISU Cyclones to Big 12 basketball

tournaments and football bowl games. Chris retired from her family’s law ﬁrm. And Gary mentored son Andy as he learned the ropes of the family business. A Bond Instrumental to Gary’s pursuit of normalcy was Dr. Venkatesh Rudrapatna, a McFarland Clinic oncologist with the William R. Bliss Cancer Center. “When we ﬁrst met Dr. Rudrapatna, Gary told him, ‘I want to be able to live my life,’” Chris remembered. “And the doctor

said, ‘Yes, you can do that.’ He would change Gary’s appointments if we visited our daughter in Kansas City. He always spent an hour with us during ofﬁce visits if we needed that. He organized Gary’s medications to be put on ice so we could travel. And at the end, when we were pursuing clinical drug trials, he would pick up the phone and call doctors in Maryland to put in a good word.” Prior to Gary’s death at Israel Family Hospice House in May 2017 (just weeks shy of his 60th birthday), Rudrapatna spent

HEALTH CONNECT | Fall 2018 | www.mgmc.org

Gary and Chris Hunziker on vacation in Clear Lake. (Below) Each of the Sticks-designed chairs is engraved with an inspiring word.

said: Go big or go home.’ And we went big,” Loes remembered. Loes and his wife Vickie became fast friends with the Hunzikers in 1984 when they moved to the same Ames neighborhood. As Loes began dreaming out loud last year about how an empty oncology waiting room could blossom into a true respite for fellow cancer-affected families, he wanted most of all to honor Gary, “my very best friend in life.” “I knew how much Gary loved Sticks furniture,” Loes said. (In fact, as a child

considerable time with the Hunziker family discussing end-of-life choices. “He had such a way of talking about it—he and Gary were totally in sync in their philosophies on life,” Chris said. “He’d visit Gary in the hospital twice every day. He was absolutely the right doctor for us.” To show their family’s gratitude to the oncologist, the Hunzikers recognized Rudrapatna in June during a dedication of the renovated family comfort center. Gratitude Lifelong Ames residents, Gary and Chris discussed their desire to give back to Mary Greeley for the incomparable care Gary received. During additional hospitalizations at Mayo Clinic, Gary found comfort in the small things, like ice chips and warm blankets. Why not make those amenities available via self-service to Mary Greeley’s oncology patients as well? Enter Neal Loes, MS, BSN, RN, NEA-BC, Mary Greeley vice president and chief nursing ofﬁcer. “When Chris told me about her vision for Gary’s memorial gifts, I just said, ‘I’m sorry—but you know what Gary always

Gary grew up next door to Sarah Grant, Sticks founder.) Chris agreed including hand-crafted furniture in the room’s makeover would not only celebrate Gary’s passions but also contribute to the comfort of the space. The room’s round table’s artwork captures scenes important to Gary throughout his life: the love of family; the Hunzikers’ summer home on Clear Lake; their golden retriever, Hobie; sun-soaked vacations; and the ISU Cyclones. Outlining the tabletop’s perimeter are words Gary lived by: “Celebrate.” “Love One Another.” “Walk On The Beach.”

families love the Sticks décor,” said Sarah Heikens, MPA, MSN, RN, OCN, director of Oncology Services. “They enjoy looking at it, finding all the intricate parts of it. Everyone finds something different they like. This room is such a happy environment, and it makes people feel good. It’s a nice getaway for them.” “We are always happy to help our patients and their families with whatever they need,” Heikens added, “but the days get long for them and family members are often looking for something to do. By being able to grab blankets, drinks, and ice, relatives and friends feel like they’re contributing something to the care of their loved ones.” “We were so grateful Gary could stay in his hometown and receive the hospital treatments he needed,” Chris says. “The Burke family suites are amazing, and we appreciated having that extra space for family members. Hands down, Mary Greeley facilities are wonderful. And the new room is so reflective of Gary.” And of those who cared for him, according to Loes. “This beautiful comforting room allows visitors to get away from what they’re experiencing as loved ones,” he explains. “But it’s also a lasting tribute to two great people and their great family. What they’ve created will touch lives beyond what they’ll ever know.” But there will forever be a piece of them in that room. Etched onto a red heart at the base of one of the mural’s trees: “GJH + CAH.”

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The Hunzikers’ story of gratitude is just one of many at Mary Greeley. For more information on how you can share your story with the Foundation or how you can make a gift, please call 515-239-2147 or visit www.mgmc.org/grateful.

Positive Response “We hear often how patients and their

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Prime Time Alive & More PRIME TIME ALIVE

Created specifically for those age 50 and better, Prime Time Alive is a membership program (just $15 a year) that helps people live and age well. Learn about member benefits and how to join at www.mgmc.org/pta.

Prime Time Alive programs are designed to help you achieve a vital balance of the physical, financial, emotional, and spiritual components in your life. Don’t miss all the fun and learning! You can become a member and register for events online at www.mgmc.org/pta or by calling 515-239-2423 or 800-303-9574. Preregistration is required for all Prime Time Alive programs.  What’s with the Tinsel: Reclaiming Some Twinkle in the Heart and Soul of the Holidays Tuesday, Dec. 4, 2 p.m. Mary Greeley Atrium A Presented by Rev. Katherine Werner, Chaplaincy Services Coordinator, Mary Greeley Medical Center. For some, the holidays are consistently the most joyous season of the year. For others, they are the most draining. Come explore ways to keep the “twinkle” sparkling this holiday season so the “tinsel” doesn’t overwhelm our spirits in addition to our wallets.  Annual Holiday Gathering Thursday, Dec. 6, 1 p.m. Gateway Hotel and Conference Center Join your Prime Time Alive friends for holiday fun. There will be treats, entertainment (Terry Rich, President and CEO of the Iowa Lottery and international speaker), door prizes, and an abundance of holiday cheer at the annual holiday gathering. Don’t forget you need to be a Prime Time Alive member to attend. If you are not a current Prime Time Alive member and would like to join us at the Holiday Gathering, call 515-239-2423

or 800-303-9574 to request a membership form or join by going to mgmc.org/ptamembership. Pre-registration is required by calling the phone numbers listed above.  The Upside of Downsizing Wednesday, Jan. 16, 2 p.m. Mary Greeley Atrium A Presented by Tracey Stoll of Tracey Stoll Professional Downsizing. This presentation is designed to address the overwhelming task of downsizing— of letting go of possessions that are cluttering up your home or that need to go when you move to a smaller home. Tracey will get you motivated to start downsizing by sharing tips and stories. Her talk is infused with humor and “brutal truths” about who will or won’t want your things.  Cancer and Older Adults Thursday, Jan. 31, 2 p.m. Mary Greeley Atrium A Presented by Venkatesh Rudrapatna, MD, MPH, McFarland Clinic Oncology & Hematology. Age is the greatest risk factor for developing cancer. Knowing how cancer and treatment might affect you as an older adult is important.The best treatment plan for you depends on your general health, lifestyle, wishes, and other factors. Join Venkatesh Rudrapatna, MD, for a discussion on cancer and older adults.  Aspirin and Cardiovascular Events Thursday, Feb. 7, 2 p.m. Mary Greeley Atrium A Presented by Jason Rasmussen, MD, McFarland Clinic Cardiology. For more than 100 years, aspirin has been used as a pain reliever. Its use as a treatment to manage heart disease is not nearly as old. Join Dr. Rasmussen for a discussion on the history of aspirin and its role in primary prevention of cardiovascular events.

 Getting Organized: Where Is It When You Need It? Tuesday, Feb. 12, 2 p.m. Mary Greeley Atrium A Presented by Barb Wollan, Human Sciences Specialist, Family Finance, Iowa State University Extension and Outreach. When you need to find a document, you usually need it now. But will you be able to find it? Or, if someone else needed to hunt through your papers, would they be able to find it? This session offers guidance on what to keep, where to keep it and for how long, as well as tips for getting (and keeping) your files in order.  Cherish the Moments: Caring for Someone with Alzheimer's Disease Thursday, March 7, 2 p.m. Mary Greeley Atrium A Presented by Laurie Yocum, Director, Adult Day Center, Heartland Senior Services. This program will help you learn to “Cherish the Moments” by empowering caregivers through ideas and tips for engaging projects to stimulate brain activity and to give back moments of joy, happiness, and an improved quality of life.  Cooking Demonstration: Scrumptious Spring Sampler Wednesday and Thursday, March 27 and 28, 2-4 p.m. (select one day to attend) Cook’s Emporium, 313 Main St., Ames Presented by Marg Junkhan, cooking instructor, Cook's Emporium. Put some zip in your spring menu. Enjoy a salad, a soup, and a sorbet. You must be a Prime Time Alive member to sign up for this class.

HEALTH CONNECT | Fall 2018 | www.mgmc.org

NOVEMBER Kristi Carlson Woodcuts and paintings Main entrance, west hallway

Art

Schedule

Stewart Buck Pastels and prints Main entrance, west extended hallway Art Ciccotti Glass Main lobby display case DECEMBER Kristi Carlson Woodcuts and paintings Main entrance, west hallway

Auxiliary Gift Shop

Proceeds from the Gift Shop support Auxiliary scholarships, programs, and services of Mary Greeley Medical Center. For more information, call the Gift Shop at 515-239-2190.  HCI Fundraising $6 Sale Monday, March 25, 7:30 a.m. to 5 p.m. Tuesday, March 26, 7:30 a.m. to 3 p.m. Atrium Conference Rooms A&B This is our always popular, semi-annual sales event. Incredible savings on reading glasses, collegiate items, jewelry, seasonal fashion accessories, CDs, flashlights, gadgets for the home, and much, much more!

Connect with us!

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Jackie Stoken Photography Main entrance, west extended hallway Dos Mariposas Jewelry Main lobby display case JANUARY Gary Hoard Photography Main entrance, west hallway Jackie Stoken Photography Main entrance, west extended hallway

Dos Mariposas Jewelry Main lobby display case FEBRUARY Gary Hoard Photography Main entrance, west hallway Joe Geha Oils Main entrance, west extended hallway

MARCH Dick Shook Paintings Main entrance, west hallway Joe Geha Oils Main entrance, west extended hallway Bob Lyall Metals Main lobby display case

Dos Mariposas Jewelry Main lobby display case

MARY GREELEY RECOGNIZED FOR PATIENT AND CUSTOMER FOCUS BY PRESTIGIOUS BALDRIGE PROGRAM First organization in Iowa to earn Baldrige recognition.

ary Greeley Medical Center has been recognized for best practices related to patient and customer service by the prestigious Malcolm Baldrige National Quality Award program. Mary Greeley received a site visit by the national Baldrige program in September. The medical center is the first organization in Iowa to receive a Baldrige site visit, and the first in Iowa to be recognized for best practices. The national Baldrige program recognized Mary Greeley for “role model practices related to its patients and other customers.” ”We are tremendously honored to be the first organization in Iowa to receive a site visit from the national Baldrige program, and it is particularly gratifying to be the first organization in Iowa to be recognized by Baldrige for best practices,” said Brian Dieter, president and CEO of Mary Greeley. “Everyone at Mary Greeley is focused on a common goal—making sure everyone who comes through our doors, whether they are patients or visitors, has a truly outstanding experience. We put enormous effort into ensuring we have the people and processes in place to meet this goal every single day.” Mary Greeley was recognized for best practices in the program’s Customers category, which focuses on how the medical center engages, listens to, serves and exceeds expectations of, and builds relationships with patients and other customers. Mary Greeley practices that were highlighted during the Baldrige visit included hourly patient rounding, the use of social media to interact with customers, and the role of the medical center’s Patient and Family Advisory Council in shaping the patient experience. “We may not have have been named a Baldrige Quality Award winner this time around, but we learned so much through this amazing experience,” said Dieter. “I am confident that Mary Greeley Medical Center will one day soon be a Baldrige Quality Award winning organization.” The Malcolm Baldrige National Quality Award is the nation’s highest honor for performance excellence. It recognizes exemplary practices among organizations and businesses for their drive for radical innovation, thoughtful leadership and administrative improvement.

Clinics & Classes Clinics  Childhood Immunization Clinics Mary Greeley Medical Center offers childhood immunization clinics for Story County residents on the second and fourth Tuesday of every month from 4:30 to 6:30 p.m. at the Mary Greeley’s Home Health Care office located at 1114 Duff Ave. Upcoming dates include Dec. 11, Jan. 8, Jan. 22, Feb. 12, Feb. 6, March 12 and March 26. Parents of children receiving immunizations are asked to bring previous immunization records with them. Even if a child has never received an immunization, he or she may start a program at any time. Call 515-539-6730 for more information.  Adult Immunization Clinics Mary Greeley Medical Center offers adult immunization clinics for Story County residents every week at Mary Greeley’s Home Health Care office located at 1114 Duff Ave. The clinics are held Monday and Wednesday from 8 a.m. to 12:30 p.m. and Friday from 10 a.m. to 2 p.m.

Senior Health Clinics

Mary Greeley Medical Center Senior Health Clinics offer foot care, blood pressure screening, blood sugar testing, and health education for Story County older adults. Call 515-239-6730 for more information. Mary Greeley will offer clinics at the following locations, dates, and times: Ames Green Hills Health Care Center Tuesday, Dec. 4, no January clinic, Feb. 5, March 5 1 to 3:30 p.m. Heartland Senior Services Thursday, Dec. 6, 13, 20, 27; Jan. 3, 10, 17, 24, 31; Feb. 7, 14, 21, 28; March 7, 14, 21, 28 9:30 a.m. to noon Keystone Apartments Thursday, Dec. 27, Jan. 24, Feb. 28, March 28 1 to 2:30 p.m.

Northridge Village Wednesday, Dec. 5, Jan. 2, Feb. 6, March 6 1 to 2:30 p.m.

Story City Cedar Place Thursday, Dec. 13, Jan. 10, Feb. 14, March 14 1 to 4 p.m.

Regency V Apartments Tuesday, Dec. 4, no January clinic, Feb. 5, March 5 10 to 11:30 a.m.

Story City Community Health Center Wednesday, Dec. 26, Jan. 23, Feb. 27, March 27 1 to 4 p.m.

Stonehaven Apartments Tuesday, no December clinic, Jan. 22, Feb. 26, March 26 10 to 11:30 a.m.

Support Groups

The Waterford at Ames (Assisted Living) 1200 Coconino Rd. Wednesday, Dec. 19, Jan. 16, Feb. 20, March 20 1 to 3 p.m. Windsor Oaks Apartments 1100 Adams St. Thursday, Dec. 20, Jan. 17, Feb. 21, March 21 1 to 2:30 p.m. Collins City Hall Senior Meeting Room Tuesday, Dec. 18, Jan. 15, Feb. 19, March 19 9 to 10 a.m. Colo Community Center Tuesday, Dec. 18, Jan. 15, Feb. 19, March 19 10:30 to 11:45 a.m. Huxley Nord-Kalsem Community Center Thursday, Dec. 6, Jan. 3, Feb. 7, March 7 1 to 2:30 p.m. Nevada Senior Center Tuesday, Dec. 11, Jan. 8, Feb. 12, March 12 12:30 to 2 p.m. The Meadows Apartments Tuesday, Dec. 18, Jan. 15, Feb. 19, March 19 1 to 3 p.m.

 Alzheimer’s Caregiver Support Group The Alzheimer’s Caregiver Support Group is free and open to the public. The group meets the second Thursday of the month from 6:30 to 8:00 p.m. in Atrium B at Mary Greeley Medical Center. Call 515-239-2502 or 515-2396862 for more information.  Courage in Motion This fitness program is for people who are undergoing cancer treatment or have gone through treatment in the past year. The patient’s caregiver is also eligible. There is no charge for this program, which is cosponsored by the William R. Bliss Cancer Center Cancer Resource Center and Ames Racquet and Fitness Club (ARFC). The program begins with a 6-week course of exercise at Mary Greeley Medical Center. Participants can then choose to continue with a 12-week program at ARFC. Contact the Cancer Resource Center at 515-956-6440 for information.  Grief Support Groups; Six-Week Group Winter support will meet Monday mornings, Jan. 7 through Feb. 11, from 10 to 11:30 a.m. All groups meet at Israel Family Hospice House. For more information or to register, contact Teske Vance, Bereavement Coordinator, 515-956-6038 or vance@mgmc.com.  Living with Cancer Support Group Contact the William R. Bliss Cancer Resource Center for details. Call 515-956-6440 for more information.

HEALTH CONNECT | Fall 2018 | www.mgmc.org

 Stroke Support Group The Stroke Support Group is free and open to the public. The group meets the third Tuesday of the month from 6:30 to 7:30 p.m. Location varies. Call 515-9562774 for more information.

 Breastfeeding Support Group Dec. 6, Jan. 10, Feb. 7, March 14 (North A&B) 10 to 11:30 a.m. Atrium A

 Power Hour Pump it up and join us for this total body strength training workout using free weights, bars, tubing, and more. This workout is appropriate for all fitness levels.

 Breastfeeding Support Group Dec. 6, Jan. 10, Feb. 7, March 14 (North A & B) 10 to 11:30 a.m. Atrium A

Fitness Classes

 Family Birthing Classes Register online @mgmc.org or call 515-239-2444 or 800-951-9222 for specific information and to register. Preregistration is required.

Ames Classes  Moms in Motion Designed for prenatal women, this aqua class includes gentle stretching, strengthening, and mild cardiovascular exercises. Following guidelines from the American College of Obstetrics and Gynecologists, Moms in Motion prepares women for the physiological changes associated with pregnancy and develops stamina and strength for labor and delivery. Class participants enjoy a unique bond exercising with other moms-to-be.

 Power Sculpt Challenging but easy to follow, this class combines light hand weights with yoga flow to work muscle groups that will enhance your yoga practice. We add core exercises, stretching, and fun music. Great for all ages!

 Big Brother, Big Sister Class Classes are offered for ages 2 to 4, mixed ages, and ages 4 and up. Ages 2 to 4: Dec. 4 Mixed ages: Dec. 14 Ages 4 and up: Dec. 18 Main Lobby

Childbirth Classes

Birthways offers a one-day and Tuesday series (two classes) childbirth class to help women in their seventh to eighth month of pregnancy and their support persons prepare for childbirth. A tour is included with the classes. $30 donation per class.  One-Day Childbirth Class Saturday: Dec. 1, Dec. 15, Jan. 5, Jan.12, Feb. 2, Feb. 9, March 2, March 9  Childbirth Class – Tuesday Class Tuesdays: Dec. 4 & 11, Jan. 15 & 22, Feb. 5 & 12, no classes in March 6:30 to 9 p.m. Atrium A (Jan. and Feb. classes North A & B)  Birthways Tour Wednesday, Nov. 28, Dec. 19, Jan. 30, Feb. 27, March 27 7 to 8 p.m. Atrium A Birthways offers tours of the hospital and unit for expectant women and their support persons  Breastfeeding Classes Monday and Thursday, Nov. 15, Dec. 3, Dec. 10, Jan. 7, Jan.17, Feb. 4, Feb.14, March 4, March 14 6:30 to 8:30 p.m. Atrium A Donation $10

Call for specific dates and times. Call 515-956-2731 for Ames classes or 515-733-4029 for Story City classes. Preregistration is required.

 Joints in Motion This 45-minute aqua class is designed for individuals with arthritis, fibromyalgia, and other related conditions. Using a wide variety of gentle exercises, the focus is on improving flexibility and range of motion, plus enhancing cardiovascular and muscular endurance. Story City Classes  50/50 Fit This class incorporates functional moves using a variety of equipment. Mix in some low-intensity cardio moves and you have a workout that improves your muscular strength and heart at the same time.  Barre Concept Tone your arms, legs, booty, and abs in this 45-minute class.  Boot Camp Our boot camps provide you with the latest tools and strategies to take your fitness to the next level. Join us for fun and games as you rev up your metabolism and greet the day energized, ready to burn calories all day long.

 SilverSneakers Have fun and move to the music through a variety of exercises designed to increase muscular strength, range of movement, and activity for daily living skills. Weights, elastic tubing with handles, and a ball are offered for resistance, and a chair is used for seated or standing support.  TBW (Total Body Workout) The TOTAL package—cardio, strength, and interval training. Build metabolismboosting muscle and improve cardiovascular endurance in this fun, fast-paced, hour-long workout.  Tramp & Strength This fun workout will get your heart pumping by using the Urban Rebounder mini trampoline intermixed with strength intervals.  TRX This small group specialty class uses the TRX suspension system to create unique exercises challenging your core, strength, stamina, and cardiovascular system. Class is limited to 10 participants. Please preregister at the front desk for each class you attend.  Yoga Combine traditional yoga postures with modern fitness moves for an excellent mind/body experience—perfect for those seeking strength, flexibility, stress reduction, and total relaxation. Bring your own yoga mat.

 Core Blitz Focus in on your core strength and stability in this 45-minute total core workout!

www.mgmc.org | Fall 2018 | HEALTH CONNECT

1111 Duff Avenue, Ames, Iowa 50010

Mary Greeley Home Health Services & Hospice Care

Providing comprehensive, coordinated and compassionate home health and hospice services to patients within a 50-mile radius of Ames.

Every member of our experienced staff is specially trained in the delivery of your in-home health care. Our services include: • Skilled nursing care. Under a physician’s order, registered nurses provide skilled nursing care. We have a registered nurse on call 24 hours a day. • Skilled services. We provide physical therapy, speech therapy, occupational therapy and medical social services. • Health maintenance. Our registered nurses will assist you with medication management, catheter care and blood draws in your home. • Home health aides. Our aides are trained to provide personal care, assisting in the patient’s comfort and well-being. • Homemaker services. We can help you with housekeeping, shopping or other personal needs. • Hospice care. We provide end-of-life care, as well as bereavement care, massage therapy and music therapy at home and at Israel Family Hospice House. Visit www.mgmc.org/homehealth Home Health: 515.239.6730 or 800.529.4610 Hospice: 515.956.6000 or 877.469.0079