Sentara Marthamagazıne Jefferson SPRING 2022
Nursing
Shines Nursing excellence is a cornerstone of Sentara Martha Jefferson
PLUS: The Future is Here: Robotic Surgery Brings the Latest Advancements Hospital Volunteers: A Recipe for Success | Taking Time to Take Care of You
LETTER FROM THE PRESIDENT SENTARA MARTHA JEFFERSON BOARD Carol Hurt | Chair
Lillian BeVier Robert Broerman Rita Bunch, President Joshua Fischer, MD Paul Gaden Michael Gentry Samuel Hawley John Ligush, MD Lawrence Martin Douglas Moyer E. Ray Murphy Lou Patalanon
SENTARA MARTHA JEFFERSON ADMINISTRATORS
Rita A. Bunch, MPH, FACHE President
Amelia S. Black DNP, RN, NEA-BC Vice President, Chief Operating Officer
Johnsa Morris, MHA, MBA, RN, NEA-BC Vice President of Patient Care & Chief Nursing Officer
Paul Tesoriere, MD , FHM, FACP Vice President, Chief Medical Officer
SENTARA MARTHA JEFFERSON MAGAZINE EDITORS
Alyssa Pacheco Debra Thompson CONTRIBUTORS
Luanne Austin Karen Doss Bowman Preston Knight Lisa Smith
Looking Ahead to
A
New Seasons
s we usher in a new season and look toward a bright and hopeful spring, I would like to take a moment to recognize all of our team members at Sentara Martha Jefferson Hospital for the exceptional care they provide for our community each and every day. Although I have been in my new role as hospital president for just a few months, I have already had the opportunity to get to know so many of our team members, patients and neighbors who make this community so incredible. While we are all still coping with the impacts of COVID-19, it has been humbling to see our system and community come together to overcome obstacles with resiliency and compassion. This resolve has been an inspiration as I’ve taken on this new role, and I know it will help lead us beyond the pandemic and toward healing. Another thing that makes me so proud to be a part of the Sentara Healthcare system is the way we take care of and invest in the people who power our organization and care for our patients. In February, our president and CEO, Howard Kern, announced that Sentara is providing employees $110 million in pay increases and $15 million in benefit enhancements in 2022. Previously, in April and December 2021, Sentara also gave out monetary appreciation gifts of up to $3,500 total per team member, in recognition of our employees’ service to the public during the COVID-19 pandemic. All of these efforts should give our entire team and community even more pride in the work we do every day to support each other and care for our patients. In this issue, you’ll read about several exciting developments at Sentara Martha Jefferson. First, our hospital recently joined the ranks of other leading hospitals across the United States—including other Sentara facilities—in offering robotic-assisted surgery to its patients. Officially called da Vinci Xi, the robotic system enhances our surgeons’ ability to perform minimally invasive surgery by way of a console. Since the first robotic-assisted procedure at Sentara Martha Jefferson in January 2022, dozens of patients already have benefited from this technology. You’ll also have the chance to read about our hospital chaplains, who play absolutely critical roles in providing emotional and spiritual care for people in many stages of their health journeys, ministering to patients’ families and hospital staff, and advising hospital leadership. As one of our nurses is quoted in the story, “Almost every memorable story I have as a nurse has a chaplain in it.” And speaking of nurses, you’ll hear firsthand from two of our team members about the role nursing excellence plays as a cornerstone of Sentara Martha Jefferson’s Caring Tradition, an approach that emphasizes quality patient care, innovation and technology, and patient safety and satisfaction. While my roots in healthcare administration span more than two decades, I’m proud to continue this service with Sentara, which has such a strong legacy throughout Virginia. I know that together we will continue building upon our successes serving those in need of care, while advancing our Caring Tradition everywhere we serve our community. We wish you and your family a bright spring season.
PHOTOGRAPHY
Luca DiCecco Andrew Shurtleff Tommy Thompson DESIGN
Picante Creative
Rita Bunch President, Sentara Martha Jefferson Hospital
Contents SPRING 2022
24
Comforting the Mind and Soul Hospital Chaplains Minister to Patients, Families and Staff
19
28
The Future is Here
Nursing Shines
Robotic Surgery Brings the Latest Advancements to Sentara Martha Jefferson
Nursing Excellence is a Cornerstone of Sentara Martha Jefferson
Contents
SPRING 2022
14 D E P A R T M E N T S President’s Letter Inside front cover The Best Medicine
3
New & Noteworthy
4
Physician’s Perspective
6
9
On-Call Advice
Improve Health Every Day
14
Eat Well, Live Well Sentara Cares
33
11
17
Women's Health
33
Taking Time to Take Care of You
Health Matters
36
Health Insurance 101
La Salud Importa
37
Principios básicos del seguro de salud
Sentara in the Community
38
A Recipe for Success: Hospital volunteers bring ‘a little extra spice’ to the Sentara experience
17 Sentara Cares
Philanthropy
38
41
THE BEST MEDICINE BY MICHAEL CORDELL
The Trials and Tribulations
T
of a Garden-Variety Gardener
he arrival of spring brings with it several certainties: warmer weather, more daylight, and—for many homeowners—yardwork. I’m a big fan of two of those three, and you don’t need to be a genius to figure out which one doesn’t make the cut, since it includes the word “work.” I’ve never enjoyed yardwork, whether it’s weeding or pushing a wheelbarrow full of mulch. As a result, my yard generally looks as though I live next door to a wasteland, and is more likely to be featured in the latest issue of Toxic Waste Dump Monthly than in Better Homes and Gardens. It’s not that I don’t make any effort: I just don’t make much of one. I’m always upfront about that with the plants I buy. On the drive home, I explain to them that they’re pretty much on their own. I’ll put them in the ground— I feel that’s the least I can do, and I always try to do the least—but after that, it’s every root and leaf for itself. I also buy plants with description cards that include an image of a deer face with a red line drawn through it, which means the deer supposedly won’t eat those particular plants. Unfortunately, deer aren’t well versed in the use of emojis, so they fail to realize they don’t find those plants tasty, and thus proceed to eat them. Every. Single. Time. I’ve long recognized, however, that a lot of people do love gardening. Many find it to have meditative qualities. Plus, it’s a terrific source of exercise. We often equate exercise with weights and running shoes, but gardening can also be good for your health.
With that in mind, I’ve decided to make more of a concerted effort this spring and not rely solely on the theory of survival of the fittest—partly because I’ve learned the “fittest” plants are always the weeds. That hardly seems fair, since the free plants should be the fragile ones, whereas purchased plants should be the ones that thrive. Apparently, though, I don’t understand gardening. There are, however, some parts of yardwork I already enjoy. For example, who doesn’t love using a leaf blower? Walking around the yard, leaves flying and swirling in front of you at your command, it’s hard not to feel like Zephyr, the Greek god of wind. It’s like summoning the forces of nature with your finger. Give me a leaf blower and an expanse of leaves, and I’m set for hours, even if I’m just blowing the leaves up and down the street. However, one important consideration when doing yardwork is the noise level. My lawnmower sounds like a chainsaw convention, and some leaf blowers—especially the gas-powered ones— are louder than a garbage disposal with three spoons and a fork in it (don’t ask how I know that). With that in mind, be sure to read the article on yardwork hearing protection on page 11. One of the article’s helpful suggestions, which I have followed for years, is to wear protective hearing devices. I have often worn earmuffs myself to block out the noise while out in the yard. Not to block out the noise from lawn equipment, mind you—although now I see the value in that—but rather so I can’t hear the neighbors call out to me, “Great day to be doing yardwork, isn’t it?” I’m not sure if they’re just being friendly or trying to give me a hint, but looking at my lawn, I can guess.
sentara.com
|
3
new& noteworthy Sentara Martha Jefferson Hospital Recognized with Top Rating for the Fall 2021 Leapfrog Hospital Safety Grade Sentara Martha Jefferson Hospital received a grade of A—the top rating—for the Fall 2021 Leapfrog Hospital Safety Grade, a national distinction recognizing the safety fundamentals in protecting patients from errors, injuries, accidents and infections. An independent national watchdog organization committed to health care quality and safety, the Leapfrog Group assigns grades A through F to all general hospitals across the country every six months. The Leapfrog Hospital Safety Grade is the only hospital rating program based exclusively on hospitals’ prevention of medical errors and other harms to patients in their care. “Recognitions like these highlight the constant efforts our team puts forward daily to keep our patients safe,” says Paul Tesoriere,
To get connected with one of our providers, please call 1-800-SENTARA.
4 |
SPRING 2022
MD, Sentara Martha Jefferson Hospital vice president, chief medical officer. “We are proud to be recognized for the work we have done, and we continuously look for areas in which we can improve in order to provide the best care for our patients and their families.” The Leapfrog Hospital Safety Grade uses more than 30 measures of publicly available hospital safety data to assign grades to nearly 3,000 U.S. acute-care hospitals in order to assess performance in keeping patients safe from preventable harm and medical errors. The Hospital Safety Grade’s methodology is peer-reviewed and fully transparent, and the results are free to the public. “The Leapfrog grade, in conjunction with other acknowledgments, helps to give patients insight into the quality care we provide and can help to guide decisions on where to seek care,” notes Frank Jargowsky, Sentara Martha Jefferson director of quality and patient safety. “We strive to keep our community safe and to provide the highest-quality care to our patients.”
Arthur Bender Quality Award Congratulations to Holly Mason, MD, recipient of the 2021 Arthur Bender Quality Award. This award is given annually to a physician on the medical staff of Sentara Martha Jefferson Hospital who has provided outstanding service to our community, improving the quality of care we offer our patients. Thank you for your continued care for and dedication to our community!
Sentara Martha Jefferson has a new MRI suite!
Golf Tournament The 21st Annual Martha Jefferson Hospital Foundation Golf Championship will take place on Monday, May 23, 2022, at The Club at Glenmore. Please join us for a great day of golf and an opportunity to promote health and wellness in our community. This year’s tournament will benefit the Sentara Martha Jefferson Cancer Care Center and enable us to provide free cancer screenings for people in our community. Since the onset of the COVID-19 pandemic, cancer screenings have declined substantially—so much so that cancer programs nationwide report seeing an increased percentage of patients diagnosed with advanced disease. Not only does this impact health outcomes, but it also tends to increase treatment costs. Never has it been more critical to reach out to patients in our community—especially underserved populations—and provide them with appropriate screenings. For more information, visit mjhfoundation.org/Martha-Jefferson-Champions-Cup or call 434-654-8068.
The new Siemens MRI suite at the Proffit Road location opened the week of March 28. The transition from a mobile MRI to an in-house MRI suite allows for greater flexibility and an overall better patient experience. MRI (magnetic resonance imaging) uses magnets in combination with radio waves to obtain images of any body part. Our new state-of-the-art MRI suite allows patients in our community to benefit from a full array of technology without going into a hospital setting. In addition, the new MRI allows much more scheduling flexibility and better accommodates our patients and physicians.
Henry B. Thielbar Leadership in Governance Award On Nov. 4, 2021, the Henry B. Thielbar Leadership in Governance Award was presented to E. Ray Murphy and John Ligush Jr., MD. The Thielbar Award was established in 1999 to recognize individuals who have demonstrated a commitment to furthering the mission of Sentara Martha Jefferson Hospital through its governance structure with exceptional strategic vision and effective leadership, and who exemplify Sentara Martha Jefferson in a positive and compassionate manner, embodying its philosophy of service and care. Past Thielbar Award recipients joining us for the celebration included Bill Achenbach, Lillian BeVier, Carol Hurt, Jim Haden, Chuck Rotgin and David Sutton. Tremendous thanks go to Ray and John for all they have done and continue to do for Sentara Martha Jefferson Hospital and our community.
sentara.com
|
5
PHYS ICIAN’S PERSPEC TIVE
Weight Loss with SADI
Obesity continues to be a prominent health issue in the United States, with more than 40% of the adult U.S. population and more than 30% of the adult Virginia population considered morbidly obese. Unfortunately, despite the development of numerous medical weight-loss options, nutrition and health programs, and surgical interventions over the years, these numbers continue to rise. Obesity negatively impacts patient health in numerous ways, likely due to the increased incidence of obesity-related comorbidities, which are generally more challenging to treat. Morbid obesity—typically defined as a body mass index
6 |
SPRING 2022
(BMI) greater than 40 and a weight that is approximately 100 pounds over ideal body weight— is typically associated with higher rates of type 2 diabetes, high blood pressure, high cholesterol, gallbladder issues, depression, heart disease, stroke, cancer
By Timothy S. Snow, DO
incidence and even premature death. Not surprisingly, medical costs also tend to be much higher for obese and morbidly obese patients than for healthyweight individuals.
meaningful weight loss and resolution of medical problems, and is now the gold standard for combating this global epidemic. Bariatric surgery has undergone a dramatic evolution over the past 50 years. Although early techniques were fraught with complications, more recent innovations like the gastric bypass have yielded significant improvements in patient weight loss and overall health, with lower risks and minimal complications. Even with these successes, pioneers in the field have continued to search for new procedures to further improve patient outcomes. Some, like the gastric lap band, have come and gone, while others, like the gastric sleeve, persist as mainstays of the field.
SADI: A New Approach
Weight-Loss Treatment Options
Although diet and exercise can be important factors in combating excess weight, those methods alone are quite ineffective in treating patients with morbid obesity, showing failure rates of more than 90% in long-term studies. Even combined with the use of newer weight-loss medications, overall benefits and weight loss still fall short by a large margin. In the long run, weightloss (bariatric) surgery is much more effective in accomplishing
Sleeve gastrectomy and gastric bypass remain viable bariatric options for many patients, with up to 80% of postoperative patients experiencing significant long-term health improvement. However, despite technological and surgical advancements, physicians today are encountering patients with much higher BMIs than ever before (BMI>50), as well as patients with persistent weight regain and those who desire a more aggressive and durable weight-loss solution. For this subset of patients, conservative methods and older-generation bariatric procedures often aren’t enough to achieve their goals. In these cases, a more recent bariatric procedure known as single anastomosis duodeno-ileal switch (SADI) often can help. Also referred to by several other names and featuring variations in technique, SADI is essentially a combination of the sleeve
The restrictive and metabolic effects of the SADI procedure are the keys to its success, weighed against other surgical options. gastrectomy and gastric bypass procedures, performed laparoscopically with small incisions. During the SADI procedure, a sleeve gastrectomy is performed first, converting the stomach into a skinny, cylindrical tube, similar in shape to a banana. A bypass of the small intestines— longer than in the standard gastric bypass—is then performed directly below the stomach. In super morbid obese patients (BMI>60), SADI can be technically challenging. To accommodate these individuals, the procedure can be performed in a staged fashion, delaying the intestinal bypass portion of the procedure until a
sentara.com
|
7
Bariatric Surgery Benefits
Bariatric Surgery at Sentara Martha Jefferson
later date, in order to decrease time in the operating room and lower incidence of perioperative complications. The restrictive and metabolic effects of the SADI procedure are the keys to its success, weighed against other surgical options. Compared to the sleeve and bypass, SADI patients can achieve up to an extra 20% of excess weight loss, as well as similar degrees of improvement in obesity-associated medical diagnoses. Although less studied compared to the bypass and sleeve, long-term studies have shown better durability, increased overall weight loss, and more success in helping patients decrease or discontinue medications for related medical issues. SADI also gives patients the best chance of reaching a BMI of less than 30, which falls below the obese range. In terms of potential complications, a slightly higher rate of staple line leak has been observed with SADI compared to other bariatric procedures, but recent studies have shown no significant statistical differences. As well, SADI can result in nutritional deficiencies that require strict, lifelong adherence to a
8 |
SPRING 2022
vitamin regimen, and possibly more frequent monitoring. However, there seems to be a lower incidence of reflux with SADI than with sleeve gastrectomy, and less chance of ulcer formation, dumping syndrome or internal hernia development than with standard gastric bypass. SADI has a slight overall increase in perioperative risk, but this risk is still typically less than 5%. Although SADI is currently the most effective option for treating morbid obesity, ensuring appropriate patient selection and compliance is crucial for success.
Bearing the potential to have significant positive impacts on patients’ overall physical, mental, emotional and spiritual health, weight-loss surgery remains the best option for the effective, sustainable treatment of morbid obesity. And with worsening rates of morbid obesity and rising BMIs among the general population, finding even better bariatric procedures for our patients will continue to be a priority in the years to come. By offering SADI, Sentara Martha Jefferson is helping to broaden available weight-loss treatment options to improve the overall health of our community. As with any operation, the “best” bariatric procedure is the one that is most appropriate for each individual patient. At Sentara, we tailor our approach to make each decision about bariatric surgery and management options a personal one, guiding our patients to select the option that best meets their specific needs and health goals.
Typical weight loss at 12 months by a person with a BMI above 35 Surgery Type Stomach Intestinal Pylorus Sparing (SIPS)
90-100 60-85
Gastric Bypass
60-80
Gastric Sleeve 45-50
Gastric Band 10-20
Diet and Exercise 0
20
40
60
80
Percentage of Excess Weight Lost
100
ON-CALL ADVICE
Blue Ridge Region physicians of Sentara Martha Jefferson Hospital and Sentara RMH Medical Center answer your health and wellness questions
Getting Control of
Your Cholesterol ‘Good’ vs. ‘bad’ cholesterol, and what you can do about it There’s a lot of information
out there about cholesterol these days—particularly when it comes to foods that can help control cholesterol levels. For instance, you may have heard experts’ recommendations to eat more oatmeal and nuts, but less sugar and red meat. While that’s good advice, do you know what your cholesterol numbers actually mean? Let’s start with the basics. Cholesterol, which the body uses for a number of different biological functions, is found in all the cells in your body. Although the body typically produces all the cholesterol you need, you also take in cholesterol from the food you eat—and too much of the wrong type of cholesterol can lead to serious long-term health problems.
‘Good’ vs. ‘Bad’ Cholesterol There are two types of cholesterol: the “good” variety, known as high-density lipoprotein (HDL), and the “bad” variety, known as lowdensity lipoprotein (LDL). Since HDL plays a valuable role in helping to flush LDL out of the body, higher values of HDL are considered healthier. Following are some guidelines for desirable vs. at-risk HDL levels for men and women:
Desirable
At Risk
Men
60 or above
Less than 40
Women
60 or above
Less than 50
Source: https://www.mayoclinic.org/diseases-conditions/ high-blood-cholesterol/in-depth/hdl-cholesterol/ art-20046388
Too much LDL cholesterol, on the other hand, can build up in your blood vessels and increase your risk for heart disease and stroke. For that reason, lower values are considered desirable, with risk levels for various ranges outlined below (these numbers apply to both men and women): Optimal: Less than 100 Near optimal: 100-129 Borderline high: 130-159 High: 160-189 Very high: 190 or above Source: https://www.mayoclinic.org/diseasesconditions/high-blood-cholesterol/diagnosistreatment/drc-20350806
What Can You Do About Your Cholesterol Levels? If your cholesterol numbers fall within the optimal range, keep up the good work! Those readings indicate that you’re living a healthy lifestyle. If your cholesterol numbers are outside of the normal range, however, you’re at an elevated risk for heart problems
and should see a doctor to help manage your levels. Here are a few tips to help you manage your cholesterol: • Schedule an appointment with a primary care provider. If you don’t know your numbers, get your cholesterol checked via a very simple blood test. High cholesterol requires medical diagnosis and can be treated by medication. If you are diagnosed with high cholesterol and need additional medical attention, your primary care provider will connect you with a cardiologist, who will work with you to develop a comprehensive treatment plan. • Exercise. Experts recommend exercising 30 minutes a day, 5 days a week. • Lose weight. If you are overweight or obese, aim to lose at least 5 percent of your body fat. • Quit smoking. If you currently smoke, research shows that quitting smoking increases HDL levels. • Change what you eat. Avoid foods that raise cholesterol, such as fatty, fried, greasy food. Instead, add in more foods like fruits, vegetables, whole grains and beans to help control cholesterol. sentara.com
|
9
ON- C ALL A DVICE
Blue Ridge Region physicians of Sentara Martha Jefferson Hospital and Sentara RMH Medical Center answer your health and wellness questions
What is shift work
sleep disorder?
Shift work sleep disorder (SWSD) often affects individuals whose work schedules don’t mesh with the normal circadian rhythm—our internal “body clock”—which helps to control wakefulness/ sleepiness, hormone levels, hunger and body temperature. Characterized by excessive daytime sleepiness, insomnia, drowsiness and lack of refreshing sleep, SWSD has become more prevalent in recent years, since more Americans have been working nontraditional shift hours (e.g., evenings, nights, early mornings, and rotating or split shifts). Common symptoms of SWSD include: • excessive sleepiness, both on and off the job • insomnia that prevents a person from getting adequate sleep • difficulty concentrating, paying attention or retrieving memories • low energy levels • sleep that isn’t refreshing • irritability or mood disturbances • trouble with relationships Symptoms of SWSD should not be taken lightly, since sleep
10 |
SPRING 2022
deprivation can increase your risk of falling asleep at an unsafe time or place, and of making critical errors on the job. Over time, these impairments can take a negative toll on your physical and mental health. In addition, sleep deprivation can increase your cancer risk and negatively impact your heart health and digestive functions. If your job requires you to work nontraditional hours, here are some tips for lifestyle changes you can make to help you manage SWSD: • •
•
Keep a consistent sleep schedule, including days both on and off the job. Wear sunglasses when you leave work to help minimize sun exposure, which can help prevent your “daytime” clock from activating. When possible, take naps.
• •
• •
Create a dark sleep environment. Maintain a healthy diet, ensuring that you eat the right amounts of fruit and vegetables. Limit caffeine intake several hours before bedtime. Use a sound machine or wear earplugs to minimize sleep disruption.
To help improve sleep quality, remove as many sleep disruptions as possible. If you feel you could be experiencing negative impacts from SWSD, speak with your physician. Your doctor may prescribe sleep aids or over-thecounter medications to help you get enough rest. However, be sure to talk with your provider about possible side effects and review any drug interactions, and be sure never to take any medication without a physician’s approval.
IMPROVE HEALTH EVERY DAY
SPRING YARDWORK and Hearing Protection Spring has sprung, which means many of us are considering getting back out into our yards to clean up the remains of winter. But before you get started, did you know that some yardwork equipment— including many gas-powered tools, such as lawnmowers, leaf blowers and string trimmers—can put you at risk for hearing loss?
Be sure to take these steps to reduce your risk of noise-induced hearing loss: • Limit your exposure to loud equipment. • Always wear hearing protection. • Keep up maintenance on your machinery, as worn parts may increase noise levels. • Consider using a quieter alternative when possible (e.g., a rake instead of a leaf blower). Wearing hearing protection is recommended anytime you use loud equipment, since harm to your hearing can get increasingly worse with each repeated exposure. A wide variety of hearing-protection options exist, including earmuffs, earplugs and even Bluetooth-enabled noise-canceling headphones. Ultimately, the option you will use most often will be the best one for you. sentara.com
|
11
I M PROVE HEA LTH EVE RY DAY
Before You Plan Your
Beach Vacation
The sun is starting to shine brighter this time of year, so before you start spending more time out in the sunshine, be sure to schedule your annual skin exam. Skin checks, which are an essential part of your health care, provide opportunities to evaluate any abnormal moles, growths and spots you may have. While it’s important to schedule annual skin checks with your doctor, you also should monitor your skin regularly with self-examinations. According to the American Academy of Dermatology, nearly half of melanomas are self-detected. All you have to do is follow the “ABCDE” guidelines at right while examining your body in a mirror in a well-lit room:
12 |
SPRING 2022
•
A is for asymmetry: One half of the spot is unlike the other half.
•
B is for border: The spot has an irregular, scalloped or poorly defined border.
•
C is for color: The spot has varying colors from one area to the next, such as shades of tan, brown, black or dark purple, or areas of white, red or blue.
•
D is for diameter: While melanomas are usually greater than 6 millimeters (about the size of a pencil eraser), they may be smaller when diagnosed.
•
E is for evolving: The spot looks different from others or exhibits changes in size, shape or color.
If something unusual appears, it’s essential to get it checked out for proper diagnosis and treatment as soon as possible. Early detection of skin cancer is the key to lesser treatment needs and successful outcomes.
Know the Facts About
ASTHMA
If you or a loved one suffers from asthma, here are answers to some of the most common questions about the condition:
Getting Ready for
SPRING ACTIVITIES Now that the weather is getting warmer, you may be itching to get out and do all the outdoor activities you haven’t been able to enjoy during the winter months. However, since you probably haven't done these activities for quite a while, it’s important to start slowly to avoid injuries. Here are some tips to help you stay healthy as you get back into your favorite outdoor activities: Start slowly: Overuse injuries are very common at the start of spring, so take time now to prepare your body before you overexert yourself. Stretch and warm up before any physical activity: Take 5–10 minutes to elevate your heart rate and increase blood flow to your muscles. Warmups can include lunges, jumping jacks or light jogging. Stay hydrated: Although this is good advice anytime, it’s especially important when you’re engaging in physical activity. When dehydrated, your muscles and tendons are less flexible, which can increase your risk of muscle strain. Listen to your body: If you feel any discomfort, stop the activity and assess why you may be feeling pain. If the pain doesn’t subside after using conservative measures like ice, heat and elevation, see your doctor.
What causes asthma?
In many cases, patients are born with asthma. Often, children’s asthma improves after puberty, but it can return in later life. Some patients develop asthma during adulthood, perhaps due to an acute lung infection like pneumonia or bronchitis, or due to exposure to noxious chemicals. In some cases, however, asthma has no apparent cause.
What treatment options are available?
Asthma is treated with various inhaled medications, and treatment is based on the frequency of symptoms. If a patient is having symptoms at night or more than once a week, they are usually placed on a daily medicine to prevent and control asthma symptoms. For acute asthma symptoms, patients are normally instructed to use a rescue inhaler to help open their airways and allow them to relax. In addition, patients also may be placed on medications for allergies, postnasal drip and heartburn.
Are there ways to avoid or minimize attacks?
Using inhalers appropriately; minimizing exposure to triggers like smoke, dust and other allergens; and monitoring your symptoms are a few ways to minimize the frequency and severity of attacks. In addition, therapies may need to be escalated with changes of season, so it’s important to talk to your physician about preventive options. sentara.com
|
13
EAT WELL , LIVE WELL
Eat More
FIBER! By Leigh Steiniger, MS, RD, CDCES Sentara RMH Medical Center
We’ve all probably heard that fiber is good for us, but some of us may not fully understand why. While fiber is most well known for helping to relieve constipation, it actually features many other health benefits as well. So even if you don’t struggle with constipation, there are several other great reasons to increase your fiber intake. Unfortunately, only 5% of Americans regularly meet their recommended daily intake of fiber, since the typical American diet is high in processed foods and refined carbohydrates, which are all low in fiber. By choosing whole foods such as whole grains, fruits and vegetables, you should have no problem meeting your dietary needs.
What Foods Contain Fiber? Fiber is found in plant-based, whole foods such as fruits, vegetables, nuts, seeds, whole grains and beans. There are two types of dietary fiber, both of which are important for digestion and overall health: Soluble fiber: This form, which dissolves in water and forms a gel, slows down the passage of food from the stomach to the intestines. Food sources include beans, oats, peas, barley, bananas, apples and psyllium (often found in fiber supplements). Insoluble fiber: This form, which does not dissolve in water, adds bulk to
14 |
SPRING 2022
Recommended Fiber Intake FEMALES
FIBER INTAKE
stools, promotes the daily the next week, and 19-30 years 28 grams movement of material so on, until your fiber goal 31-50 years 25 grams through the digestive is met. 51+ years 22 grams system, and is espeStay hydrated. Hydration MALES cially helpful in alis important for a lot of rea19-30 years 34 grams leviating constipation 31-50 years 31 grams sons, but it’s especially cruand regulating bowel 51+ years 28 grams cial for preventing constipamovements. Food tion. Aim to have at least 64 Source: 2020-2025 Dietary Guidelines sources include wholefor Americans fluid ounces per day. grain products, nuts, beans, berries, corn, carrots Eat whole foods. Typiand cauliflower. cally, the more refined and processed a food For an extensive list of high-fiber foods, see this is, the less fiber it contains. For example, a resource from the 2020-2025 Dietary Guidelines for medium orange has 3.7 grams of fiber, comAmericans at https://www.dietaryguidelines.gov. pared with 0 grams of fiber in 4 fluid ounces of orange juice.
•
•
Why Should We Eat More Fiber?
Below are several good reasons to boost your fiber intake: Normalizes bowel movements: Fiber can be beneficial for both constipation and diarrhea by adding bulk to stools. Promotes bowel health: A high-fiber diet can help prevent hemorrhoids, diverticulosis and colon cancer. Fiber also serves as a “prebiotic,” acting as a food source for healthy bacteria in the digestive tract. Supports heart health: Soluble fiber binds with cholesterol in the digestive tract, preventing absorption into the body. This, in turn, can lower LDL (bad) cholesterol levels and reduce the risk for heart disease. Improves blood sugar: Soluble fiber, in particular, can help lower blood sugar after meals by slowing down the release of sugar from the digestive tract into the bloodstream. Aids in weight management: A high-fiber meal or snack contributes to a feeling of fullness and increased satiety, which can lead to eating smaller volumes of food per meal and decreasing snacking between meals.
Tips for Increasing Dietary Fiber:
• Add it in slowly. Adding in more
fiber than your body is used to at one time can cause some unwanted side effects, such as cramping, bloating and constipation. Instead, try adding an extra 5 grams daily for a week, then adding another 5 grams
• Choose beans at least 2–3 times per week.
Beans are an excellent protein source and are high in fiber. So instead of meat, aim to have beans as your protein source several times per week.
• Read food labels. Try to choose grain
products like cereal, bread, pasta, crackers, etc., that contain 4 grams or more of dietary fiber per serving. Look for products that have “whole grain” listed as the first ingredient.
• Add in some seeds. Chia seeds and flax
seeds are especially high in fiber and can be sprinkled on top of foods for an added boost. One tablespoon of chia seeds contains 6 grams of fiber!
• Ask about fiber supplements. It’s always best to start with whole foods first, as they contain other beneficial vitamins and minerals to support your health. However, if you find you’re unable to consume enough fiber from food, you can ask your healthcare professional about using a fiber supplement.
sentara.com
|
15
EAT WELL, LIVE WELL
Here are some high-fiber recipes to get you started:
Overnight Oatmeal with Berries Ingredients 1/2 cup low-fat milk (or less for thicker oatmeal) 1/4 cup fat-free Greek yogurt 2 teaspoons honey 1/4 teaspoon cinnamon 1/4 teaspoon vanilla extract 1/2 cup uncooked rolled oats 1/4 cup frozen raspberries Directions 1. Combine milk, Greek yogurt, sugar, cinnamon and vanilla extract in a container or jar with a lid. 2. Add oats and mix well. 3. Gently fold in raspberries. 4. Cover and refrigerate 8 hours to overnight. 5. Enjoy cold, or heat as desired. Nutrition Facts: 311 calories, 4 g total fat, 53 g carbohydrates, 9 g dietary fiber, 17 g protein
Quinoa and Black Bean Salad Ingredients 1/2 cup quinoa (dry) 1 1/2 cups water 1 1/2 tablespoons olive oil 3 teaspoons lime juice 1/4 teaspoon cumin 1/4 teaspoon coriander (ground, dried cilantro seeds) 2 tablespoons cilantro (chopped) 2 scallions (medium, minced) 1 can black beans (15.5-ounce can, rinsed and drained) 2 cups tomato (chopped) 1 red bell pepper (medium, chopped) 1 green bell pepper (medium, chopped) 2 green chiles (minced, to taste) black pepper (to taste) Directions 1. Rinse the quinoa in cold water. Boil water in a saucepan, then add the quinoa. 2. Return to boil, then simmer until the water is absorbed, 10-15 minutes. 3. Cool for 15 minutes. While quinoa is cooking, mix olive oil, lime juice, cumin, coriander, chopped cilantro and scallions in a small bowl, then set aside. 4. Combine chopped vegetables with the black beans in a large bowl, then set aside. 5. Once quinoa has cooled, combine all ingredients and mix well. Cover and refrigerate until ready to serve. Serving size: 1 cup Nutrition Facts: 199 calories, 5 g total fat, 32 g carbohydrates, 9 g dietary fiber, 9 g protein Recipes sourced from the U.S. Department of Agriculture.
16 |
SPRING 2022
Sentara Cares about advancing health equity and ensuring that all members of our community have access to the resources they need to live their healthiest and most fulfilling lives. We’re guided by our understanding that our overall health is greatly influenced by where we’re born and where we live, learn, work, play, worship and age. In fact, these environmental factors account for nearly 80% of health outcomes, while direct health care accounts for only 20% (as seen in the “Social Determinants of Health” graphic at right). Our purpose, then, calls us to address these issues on the ground every day where people live—not just when they’re under our care. Only then can we help to eliminate health disparities and promote equitable access to nutritious foods; education; safe and affordable housing; and stable, rewarding job opportunities. We know such disparities can’t be solved solely in the exam room, and they can’t be solved solely by Sentara. However, through our partnerships we continue to make both immediate impacts and lasting change for our community. continued
sentara.com
|
17
NG
IVE G D
USI HO
SKILLED CAREERS INSPIRING TEAM MEMB E R S
Sentara Cares Focus Areas Keeping our communities safe Keeping our communities informed and assured Pivoting vital resources Addressing unprecedented food insecurity Accelerating affordable housing Serving our most vulnerable populations Building better careers and financial stability Fighting hunger every day Boosting behavioral health services Connecting partners to ensure more equitable service delivery Supporting the next generation of healthcare leaders
ITY
VIN DRI
C
LTH EQ U
We inspire, empower and support our community
SE
HEA
RSITY AN D
L
H
NG
SPRING 2022
RA
LT
RI
18 |
O VI
A HE
U
We know that the substantive initiatives we’re undertaking through Sentara Cares will take time to bear fruit. To ensure that we’re meeting not just long-term goals but also immediate needs, we’re proud to partner with an extensive network of organizations working to improve lives in a variety of ways every day.
HA
N
ITY
Sustaining Momentum
O
CUR
Our ability to effect lasting change in our community hinges on our understanding that the direct care we provide addresses only a fraction of what we need in order to live our healthiest, most fulfilling lives. That’s why we actively partner with organizations and support initiatives to advance our communities holistically in a variety of areas to improve where we live, work, learn, play, worship and age.
BE
SI
C EN OM GA M GE UN M ITY EN T
D SE
Addressing Root Factors
C
LU
FOO
Sentara Cares is about transforming the lives of our neighbors by focusing on the root factors that affect our health, beyond the clinical care we receive. To truly live our mission to improve health every day, we must help to: • Fill the unprecedented need for behavioral health practitioners in the field and ensure greater access to behavioral health services for children, families and adults. • Secure consistent, equitable access to nutritious food—every day and in times of emergency need. • Support targeted training and development programs for higher-paying skilled careers. • Develop more robust emergency and scattered housing solutions in our communities. • Dismantle barriers to accessing health and human services in traditionally underserved populations. In addition, we mustn’t lose sight of engaging organizations and supporting assets that strengthen the very fabric of our community, such as arts and cultural programs and recreational features that can unite us and foster a greater appreciation for the places we call home.
IN
Focus Areas
THE
FUTURE IS HERE Robotic Surgery Brings the Latest Advancements to Sentara Martha Jefferson
Sentara Martha Jefferson Hospital has joined the ranks of other leading hospitals across the United States in offering roboticassisted surgery to its patients. “While robotic-assisted surgery offers a lot of benefits, the overall goal of any new medical technology is to improve patient care,” says Timothy S. Snow, DO, lead surgeon in the program.
sentara.com
|
19
Since the first robotic-assisted surgery at Sentara Martha Jefferson in January 2022, dozens of patients have benefited from this technology. The robotic system, officially called da Vinci Xi, doesn’t actually perform surgery on its own. Instead, the surgeon performs the procedure, with the da Vinci system providing the instruments by way of a console. Essentially, da Vinci enhances surgeons’ ability to perform minimally invasive surgery, a set of surgical techniques that enable surgeons to operate with less damage to the body than with traditional open surgery. In minimally invasive procedures, smaller incisions are made and techniques are used to avoid cutting tendons and splitting muscles. Laparoscopic surgery is a type of minimally invasive technique performed through one or more small incisions, using
20 |
SPRING 2022
small tubes along with tiny cameras and surgical instruments. Dr. Snow, who was actively involved in acquiring the robot for Sentara Martha Jefferson, had extensive training throughout both his residency and fellowship on different versions of the da Vinci systems. “I’m pretty excited about this,” says Dr. Snow, who joined the Sentara Martha Jefferson staff in fall 2019. His experience has helped him ensure a smooth start to the program. According to Dr. Snow, benefits of robotic-assisted surgery for patients include: • Decreased length of hospital stay • Fewer readmissions • Decreased operating times, in some cases
•
Overall decreased complication rate In addition to patient benefits, da Vinci also offers numerous advantages for surgeons: • The system’s advanced 3D camera provides a clearer image, enhancing visualization during procedures. • The robot’s 360-degree wrist motion makes certain tasks, like suturing, less technically challenging than in non robotic laparoscopy. • Sitting at a console to perform an operation is less fatiguing than standing for hours on end. With the da Vinci system, Sentara Martha Jefferson also is now able to offer more types of surgery than ever before.
“Previously, without da Vinci, we weren’t able to offer certain types of surgical options—specifically related to cancer care,” says Paul J. Tesoriere, MD, vice president, chief medical officer at Sentara Martha Jefferson. “With a robust, data-driven, integrative robotics program, we will be seeing more efficient surgery, superior outcomes and higher patient satisfaction.”
How the System Works
The da Vinci system consists of two major components: the operating platform and the surgeon’s console. “The operating platform is the mobile part that gets carted around the operating room,” says Dr. Snow. “That’s what sits next sentara.com
|
21
to the patient and is connected to the patient. The surgeon’s console, on the other hand, is like a very large desk.” During surgery, the surgeon sits at the console and looks into the view lens, manipulating the camera and controlling the
22 |
SPRING 2022
instruments. From the console, the surgeon controls the operating platform that performs the surgery from the bedside. “It’s kind of like a video game in one aspect, but you have complete control over the whole situation,” adds Dr. Snow.
To accommodate the operating platform and surgeon’s console, in addition to other necessary equipment and staff, the da Vinci system is installed in one of the hospital’s larger operating rooms. Due to
the hardware and tools required, it can’t be moved from one operating room to another. While the robot isn’t able to talk, it can communicate with caregivers. Signals on the console and the operating platform can alert the surgeon and operating room (OR) team about certain aspects of the procedure. For instance, light signals indicate proper instrument installation and placement, as well as attachment to the operating platform. Location markers on the console screen let the surgeon know the locations of instruments inside the patient’s body, and collision warnings alert the surgeon if two instruments are too close to one another. Also, the console has a builtin microphone and speaker that the surgeon can use to communicate with OR staff, enabling discussion without disrupting the procedure. “It’s pretty neat technology,” Dr. Snow says.
The Rollout
Even after several years of not performing robotic-assisted surgery, “getting back on the robot platform was like riding a bike,” recalls Dr. Snow. Still, he did participate in training to brush up on his skills and learn about upgrades to the technology. There are different tiers of training on the da Vinci system, depending on how long it’s been since the surgeon and other operating room staff have had robotic experience. “In most hospitals and programs, if it’s been more than two years since your last robotic use—no matter how much experience and train-
ing you’ve had previously—you have to be trained to get you back on track with the process,” Dr. Snow notes. The first tier of training is for people with absolutely no experience. The next level is for those for whom it’s been a long time since their last robotic surgery. And then there’s a learning path for those who have had recent experience. Assistants in the OR go through a separate training through Intuitive, the company that makes the da Vinci systems. First, they learn all the aspects of the system in online modules, and then they get on-site, handson practice with the robot. “So they’re familiar with it and acclimated by the time we get started,” says Dr. Snow. At Sentara Martha Jefferson, the first robotic-assisted surgeries were performed by a small group of surgeons who had expressed interest in incorporating the technology into their practice. “We planned on a slow rollout,” Dr. Snow says. “We did a few surgeries to start, to get the program going, then added on more days and more surgeons as the staff became more acclimated with the technology.”
An Important Step Toward the Future
Quite commonplace now, robotic surgery continues to expand into many surgical specialties, including general surgery, gynecology, thoracic surgery and urologic surgery. “Numerous operations in those specific fields are now performed robotically rather than laparoscopically or open, so having the capability to perform
them robotically will be extremely helpful in physician recruitment efforts,” notes Dr. Snow. Many surgeons now coming out of fellowships and residencies that include robotics training likely will want to use this technology in their practice. “If they come out from their training and there’s a hospital that has no robot, they’re probably not going to go to that hospital to work,” he says. “Having the robot helps us provide those physicians with state-of-the-art equipment.” A valuable new tool that will allow Sentara Martha Jefferson to recruit top surgical talent, da Vinci will help the hospital remain at the forefront of stateof-the-art care. “We have already seen significant interest from new surgeons we would not have been able to recruit without a robotics program,” says Dr. Tesoriere. “Acquiring a robot in the surgical space is just the beginning of our journey toward the future of health care.” sentara.com
|
23
Comforting the
Mind and
Soul Hospital Chaplains Minister to Patients, Families and Staff
Sentara Martha Jefferson Hospital nurse Ashley Mangum holds close to her heart the experiences she has shared with patients during their most vulnerable and anxious moments. She has held hands with patients as they’ve taken their last breaths, comforted COVID patients alone in their rooms and even wheeled a man outside to see the sun on his birthday after being in the Intensive Care Unit (ICU) for months. During each of these instances, a hospital chaplain was on hand to offer comfort and support.
24 |
SPRING 2022
I have happy memories of chaplains checking in, making jokes or offering me a cup of tea.”
“Almost every memorable story I have as a nurse has a chaplain in it,” says Mangum, a nursing professional development specialist at Sentara Martha Jefferson who helped out in the ICU during the early stages of the pandemic. “I have happy memories of chaplains checking in, making jokes or offering me a cup of tea. I also have memories of harder times. Even when my mother died, they supported me.”
’Not here to judge’
Chaplains provide emotional and spiritual care for people in many stages of their health journeys. In addition, chaplains minister to patients’ families and hospital staff, and also advise hospital leadership, according to Tammy James, the lead chaplain at Sentara Martha Jefferson. After 30 years as a nurse, James switched gears a decade ago and enrolled in a seminary to begin her journey toward becoming a chaplain. James treasures the time she has spent with patients, their families and staff. She also facilitates numerous support groups, counsels cancer patients, assists with advance care planning and serves on the hospital’s Ethics Committee, among other roles. Despite their eagerness to help, chaplains sometimes encounter patients who are hesitant to meet with them. James notes that some patients fear chaplains are there to deliver bad news or to preach to them about a specific faith. sentara.com
|
25
She recalls a patient several years ago who waved off her visit for religious reasons. “I said, ‘Give me five seconds, and I’ll be out of your room,’” remembers James, who has worked as a chaplain at Sentara Martha Jefferson for almost 10 years. “I said to him, ‘I’m not here to judge you, preach to you or convert you. I am simply here to support you during your health crisis.’” That experience started a friendship with the patient that continued for two years, while the patient was in and out of the hospital. “Each time he was readmitted, he requested a chaplain visit,” James says. “I had the privilege of providing comfort for him at the end of his life.”
Supporting Patients of All Faith Backgrounds
Sentara hospital chaplains are on hand to minister to all patients, regardless of faith—or lack thereof. “I am not a religious person, but I want everyone to know that our chaplains are nondenominational and nonjudgmental,” Mangum says. “They meet people where they are at any time of life, be it by
26 |
SPRING 2022
helping staff during an average workday or comforting a patient during a time of transition.” Although Sentara hospital chaplains are trained as interfaith chaplains, they do understand that some patients want guidance and support from a spiritual leader in their particular faith. They provide care to people of all faiths—or no particular faith— and will reach out to patients’ own pastors, priests, rabbis or other ministers to come in for a
visit, if preferred or requested by the patient. Former U.S. Army Chaplain Stephone Coleman, who also serves on Sentara Martha Jefferson’s chaplain team, often makes use of his military experience to cater his services more specifically to the needs of veterans. With a deeper understanding of the emotional and spiritual distress veterans frequently experience during a health crisis, Coleman, whose
Handmade Shawls Comfort Patients and Families When chaplains or hospital care teams sense a patient could use an extra boost of support, they may offer a shawl for comfort. The Women’s Committee of the Martha Jefferson Hospital Foundation provides funding for the yarn, and Caring Embrace volunteers knit or crochet the shawls. “We provide a shawl to many patients who are coping with a new diagnosis or nearing the end of life,” explains Tammy James, a Sentara Martha Jefferson chaplain. “Patients are touched by the gift of a shawl— sometimes they become teary-eyed when we wrap it around them. They cannot believe that a stranger would take the time to send healing thoughts and prayers for them as they knitted each stitch.” “Many times,” adds James, “patients’ loved ones tell us that the shawls have given comfort and strength to them after their loved one died.” To join the Caring Embrace committee, please call Renee Dinwiddie, Sentara Martha Jefferson volunteer coordinator, at 434-654-7327.
Sentara Martha Jefferson Support Groups service included combat tours in Iraq, is well trained in comforting veterans during difficult times.
Coping with COVID-19
For chaplains, traditional methods for supporting patients came to a halt during the early stages of the pandemic. With the medical community’s limited understanding of the COVID-19 virus and a short supply of personal protective equipment (PPE) at the onset of the crisis, chaplains were no longer permitted to go into patients’ rooms. At the same time, policies aimed at reducing the spread of the virus also prevented family members from visiting patients. Being sensitive to the isolation that patients were feeling, the chaplains adapted their practices for providing spiritual care. For example, Sentara chaplain Evangeline Calland applied for a Martha Jefferson Hospital Foundation grant to purchase iPads, which the chaplains then used to facilitate communication among patients and family members. Nurses would deliver the iPads to patients’ rooms, so they could FaceTime with their families and help ease their sense of isolation. When PPE became more plentiful, the chaplains welcomed the opportunity to be at patients’ bedsides again. They also consoled families who had lost loved ones to COVID-19 but could not be with them in person during their final hours. “I seek ways to bring understanding, grace and peace to even the most challenging of situations,” Calland explains. “My hope is that a
bereaved family eventually will be able to heal and move forward, knowing their family member was well cared for until the very end.”
Supporting Staff During the Pandemic
As weary hospital staff took care of COVID-19 patients, the chaplains realized they needed a way to help not just patients, but also the caregivers who were struggling through the ravages of the pandemic. To help support caregivers, the Sentara Martha Jefferson chapel was outfitted with water bottles, snacks, inspirational cards, employee assistance brochures and aromatherapy—a comforting “home base” of sorts where staff could regroup, reflect and relax during challenging moments, James explains. “They also offered blessings of the hands, reminding us of the great work we do with those hands,” Mangum remembers. “They frequently rounded on the floors and offered a variety of services to remind us that what we do is meaningful and important.” Although challenged by the pandemic to find creative ways to reach people, the chaplains truly cherish the opportunities the crisis gave them to help others in a time of great need. “It hasn’t been easy,” Calland adds, “but I am humbled to know that by providing spiritual support to hospital patients, families, staff and even administrators, I have been part of a truly awe-inspiring and historic effort to meet the needs of people in our community.”
To provide emotional support to patients who have been diagnosed with a specific disease or suffered a loss, Sentara Martha Jefferson Hospital offers a variety of support groups. Due to the pandemic, organizers have moved the groups online but hope to meet in person again eventually. Support groups at Sentara Martha Jefferson include: •
Book Club Support Group—Read and discuss books about living with a cancer diagnosis.
•
Couples Coping with Cancer—Explore the day-to-day challenges of living with cancer.
•
Empty Arms, Full Hearts—Meet with bereaved parents who have lost a baby to miscarriage or stillbirth, or within one month of birth.
•
Men’s Cancer Support Group—Discuss topics with other men living with cancer.
•
Living with Cancer: Facing Forward— Enhance your well-being as you adjust to life after cancer diagnosis and treatment. We will discuss nutritional, physical, emotional and spiritual dimensions of health.
•
Mind Over Matter—Learn strategies for managing anxiety and depression. Designed for people with cancer and their caregivers.
•
Mindfulness-Based Cancer Recovery Program—Discover your capacity for healing and thriving as you respond to your cancer diagnosis, treatment and healing.
•
New Cancer Patient Support Group— Explore your new patient notebook, navigate through questions and concerns, and learn about supportive resources as you adjust to life with cancer.
•
Sister to Sister—Find support from other women living with cancer. For timely information on when and how these groups meet, please call 1-800-SENTARA or visit https://www. sentara.com/charlottesville-virginia/ classesevents.aspx. sentara.com
|
27
28 |
SPRING 2022
Nursing Shines
Nursing excellence is a cornerstone of Sentara Martha Jefferson Hospital’s Caring Tradition, an approach that emphasizes quality patient care, innovation and technology, and patient safety and satisfaction. Since the emergence of the COVID-19 pandemic two years ago, the hospital’s nurses have maintained the courage, compassion and perseverance that exemplify heroism. sentara.com
|
29
Sarah Glatt, BSN, RN
Sara Morris, BSN, RN, RN-BC
To get a couple of firsthand viewpoints of nursing at Sentara Martha Jefferson, we recently asked Sara Morris, BSN, RN, RN-BC—a nurse in the Intensive Care Unit (ICU) who joined the hospital team in 2014—and Sarah Glatt, BSN, RN—a day shift nurse educator and Cornell 1 unit coordinator who was hired in 2016—to share some of their experiences.
Sentara Martha Jefferson Magazine: What drew you to the nursing field? Morris: My mother-in-law, who retired as a nurse at Sentara Martha Jefferson, encour-
30 |
SPRING 2022
aged me to consider nursing. Then, when I started college, I took a class in which they conducted an assessment of jobs that would fit well with our strengths and interests. Nursing was a top match for me. I completed the registered nurse (RN) degree program at Piedmont Community College and, after giving birth to my second child (out of five)—and while working full time—I went back to college for my Bachelor of Science in Nursing (BSN) degree from Kaplan University. Glatt: Growing up, I knew one person who was a nurse, and one day they let me shadow them. That opened my eyes to the whole idea of nursing as a career. For me, nursing seemed like a logical choice because I really loved science, and I really wanted to interact with people, rather than work in a lab environment. It wasn’t a great epiphany—it was just “one plus one equals two.”
SMJ Magazine: What do you like about working at Sentara Martha Jefferson? Morris: From early on, I noticed that even those in Sentara Martha Jefferson’s nursing management knew my name. At some hospitals, you can get lost and become a number—but at Sentara Martha Jefferson, you feel like you matter. And having a good manager means everything. In the ICU, for example, we have a wonderful manager who is understanding, sees you as a person and
Magnet® Honor Signals Excellence in Nursing
understands everyone’s unique situations. She also pitches in to help when needed. And we just have a great team. Everyone works well together, and we’re more like a family than just co-workers. Glatt: My favorite part of my job is educating nurses and patients. When the hospital acquires new equipment or rolls out new policies or procedures, I’m involved with creating learning experiences for other nurses—whether web-based instruction or hands-on practice in the Simulation Lab. For patients, it may be educating someone on lifestyle changes they should make after a heart attack, or how to live with heart failure.
SMJ Magazine: How have you gotten through the challenges of nursing during the COVID-19 era? Morris: When things get tough, I think positive change can start with each person. For me, I chose to help my team through the pandemic by focusing on resilience and using my gifts to make a difference. I’m a photographer, so I started taking pictures of team members and created a book. We all endured the loss of some patients, so I painted a tree of life in the ICU nursing station as a memorial where nurses could honor patients who died and recognize the many ways in which they have touched our lives. These kinds of efforts help bring comfort during challenging times. Glatt: There’s a strain on the whole healthcare industry—not just at Sentara Martha Jefferson—from COVID-19 and due to ongoing nursing shortages. For me, it’s about teamwork, and everyone on my unit comes together during stressful times. All of us lend each other
In 2021, Sentara Martha Jefferson Hospital received its fourth Magnet® designation from the American Nurses Credentialing Center, becoming the first Sentara hospital and the fifth hospital in Virginia to achieve this designation four consecutive times. This highest national honor, which distinguishes healthcare organizations that meet rigorous standards for nursing excellence, currently is bestowed on just 9% of all U.S. healthcare hospitals. Sentara Martha Jefferson also received the recognition in 2006, 2011 and 2016. “Achieving Magnet recognition is a tremendous honor, as it reflects our success in holding ourselves to a higher standard of care,” says Johnsa GreeneMorris, MBA/MHCM BSN NEA-BC, chief nursing officer for Sentara Martha Jefferson. “Our nursing team is compassionate, dedicated and innovative to the extreme, and I am so proud of their commitment to work harder each day to meet the healthcare needs of our patients and the community we serve.” To achieve Magnet recognition, organizations must pass a rigorous and lengthy process that demands widespread participation from leadership and staff. Healthcare organizations must reapply for Magnet recognition every four years. “Our nursing teams are committed to providing the best evidence-based care to our patients,” says Kelly Via, MSN, RN, NE-BC, director of Patient Care Services and Magnet program director. “Achieving Magnet recognition is more than just an award— it’s an important acknowledgement that everything we do is focused on raising the bar for patient care and inspiring every member of our team to provide excellent, compassionate care every single day.” Kelly Via, MSN, RN, NE-BC
emotional support and jump in to help when possible. When you have good teamwork and you feel like management listens to you, you feel empowered and set up for success.
SMJ Magazine: How does Sentara Martha Jefferson’s Magnet® designation—the highest national indicator of nursing excellence— enhance the working environment? Morris: The administration highly encourages empowerment of the nurses sentara.com
|
31
Empowered Nursing Professionals For Sara Morris, BSN, RN, RN-BC, receiving a scholarship was key to advancing her nursing training. Soon after the birth of her second child, Morris enrolled in an online RNto-BSN program through Kaplan University with support from Sentara Martha Jefferson Hospital’s Haden Institute for Nursing Excellence and Innovation. “The scholarship made it possible for our young family to afford having me go back to school,” says Morris, who earned her degree in 2013 and is now mom to five children. “I’m so grateful for that support.” Established in 2013 and supported through the Martha Jefferson Hospital Foundation, the Haden Institute for Nursing Excellence and Innovation funds educational opportunities to nurses at Sentara Martha Jefferson and other programs to recruit and retain nurses while advancing patient care. Through the Haden Nursing Institute, the Foundation provides nearly $1 million annually to the hospital, which funds programs like educational scholarships, loan forgiveness programs and professional development opportunities for our nursing team. Research shows a correlation between advanced education and improved patient outcomes/reduced patient mortality. These awards, which have helped nearly 200 nurses earn advanced degrees, bring Sentara Martha Jefferson closer to achieving its goal for 80% or more of its registered nurses to have at least a baccalaureate-level education. “In order to keep up with the changing healthcare landscape, at Sentara Martha Jefferson we encourage our nurses to continue the practice of lifelong learning,” says Johnsa Greene-Morris, MBA/MHCM BSN NEA-BC, chief nursing officer for Sentara Martha Jefferson. ”Advancement in education and certification keeps nurses current with best practices, positively impacts clinical outcomes, prepares nurses to serve as mentors and preceptors to less-experienced staff, and equips them for other potential professional development opportunities. Thanks to generous donations from the Haden Institute, our team members have received valuable opportunities to advance their educational status. We are very fortunate to have the support of community members who recognize the importance of ongoing education for nurses at Sentara Martha Jefferson.”
32 |
SPRING 2022
because they understand that will ultimately lead to better patient outcomes, as well as greater staff and patient satisfaction. Giving nurses more opportunities to be leaders is an important component of Magnet designation, and it helps boost morale. When you feel more empowered, you tend to do better at your job and feel like you have more purpose. We are encouraged to have a voice in making things better for our units and patients. Glatt: When I began applying to nursing jobs before graduating from the University of Virginia, Magnet status was an important quality I sought in potential employers. Part of that designation is about shared governance, and that aspect is robust here at Sentara Martha Jefferson. Anyone at any level can start an idea, see an issue, find a fix or create a new solution, and then bring it up the tree of leadership for consideration.
SMJ Magazine: Sentara Martha Jefferson takes pride in the Caring Tradition. How do you see that come alive in nursing care? Morris: We have “acts of kindness” gifts we can give patients to help them get through an illness. We also help them stay updated on their care. Many times, they can feel overwhelmed about medical concerns. We’re able to take extra time to explain things to them and their families. And during the pandemic, when patients couldn’t have visitors, we were able to help alleviate their fears and anxieties by reassuring them that we were looking out for them. Glatt: Good care is the baseline and the expectation. The Caring Tradition goes beyond that, taking care to a more personal level. It’s about getting connected with patients, understanding where they’re coming from and identifying their needs—not just medically, but also emotionally, mentally and socially. It’s making sure that they’re not just satisfied while in the hospital, but also comfortable and feeling as close to home as possible. Turning good care into a Caring Tradition comes down to the little details. For example, celebrating a patient’s birthday by having cake and balloons delivered, and the staff taking time to sing “Happy Birthday.” Or if they have a special request, you go out of your way to make sure it happens. It’s about making sure they feel heard, understood and not alone.
WOMEN'S HEALTH
Taking Time to
TAKE CARE OF
You
Focus on self-care to improve your physical and mental health
For many women, taking care of themselves often has to come after tending to a long list of other priorities, including kids, a spouse, parents, home responsibilities, work obligations and others. o, how can you shed some of life’s unrealistic expectations and create a more balanced, less stressful lifestyle? While the idea might only sound possible in an ideal world, you can make it happen in the real world, with a bit of strategizing to prioritize some of your own needs. That’s where the concept of “selfcare” comes in. The goal of self-care, a term that has gained prominence over the past few years, is to use intentional strategies to promote physical, mental and emotional health, explains Malinda Whitfield, APRN, family/psychiatric mental health nurse practitioner with Sentara
Behavioral Health Specialists in Harrisonburg. “These strategies are necessary to build and maintain resiliency in dealing with everyday life stressors,” Whitfield says. “Depending on your situation, self-care steps could be as simple as being sure to get enough sleep or going outside more. The key is to identify the stressors in your life and consciously make time to take a break from them.” Beyond those smaller steps, however, women also need long-term self-care strategies to cope with stress and build resiliency, Whitfield says. Since our physical health is intertwined with our mental health, nutrition and physical activity, selfcare should also play a role in these areas. sentara.com
|
33
W OM E N'S HEA LT H
To help develop a plan, we asked Sentara RMH Medical Center and Sentara Martha Jefferson Hospital experts in these areas for tips. Based on their guidance, the common thread seems to be about finding balance, rather than going to extremes. Extremes with exercise, food choices or other areas of your life likely won’t yield sustainable results. However, setting realistic goals and expectations can change habits and lead to better mental and physical health over the long run, making you more resilient when life gets hectic.
Healthy Nutrition
Busy women often skip meals, whether to save time or reduce their calorie intake. In either case, however, the practice usually backfires. First, skipping meals can cause your body to go into starvation mode, retaining weight instead of shedding pounds, explains Patricia Tyndale, clinical dietitian at Sentara Martha Jefferson. Second, skipping meals often causes people to become hungry and frustrated as the afternoon rolls on, leading them to overeat toward the end of the day. “You are better served to eat meals throughout the day, along with healthy snacks, rather than go all day and then just eat one meal,” Tyndale says. Another trouble spot for balanced nutrition involves popular fad diets like paleo, keto or intermittent fasting. Although you may lose weight at first on these diets, you will likely gain the weight back once you stop the restrictive eating, Tyndale adds.
34 |
SPRING 2022
A more balanced diet that will make you feel healthier includes: • Smart snacks: Greek yogurt with almonds, cottage cheese with fruit, peanut butter on rice cakes, hard-boiled eggs, fruits and veggies. • Better carbs: Fiber-rich, complex carbs such as whole grains, multigrain breads and oatmeal. Examples include quinoa, farrow, brown rice, sweet potatoes, and wholegrain or vegetable pasta. • Healthy fats: Nuts, seeds, nut butter, avocados and olive oil. • Lean protein: Chicken, turkey, lean cuts of beef, whitefleshed fish, Greek yogurt, tofu, nut butter, certain beans and lentils. Protein sustains you, making you feel full longer. It also fuels your cells and builds bones, muscles, cartilage and skin.
Physical Activity
Exercise builds muscles, helps shed pounds, improves your mental state, and helps improve health conditions like diabetes and high blood pressure. However, fitting exercise into a daily routine filled with time constraints and obligations can be challenging. One way to help you prioritize your physical fitness is finding out what motivates you, explains Alli Kinney, a fitness instructor at the Sentara RMH Wellness Center.
“For some, the motivation may be to lose weight or improve a health condition,” Kinney says. “Others might want to be able to play with their grandchildren or walk their dog.” Of course, be sure to talk to your healthcare provider if you want to start a routine and haven’t been exercising regularly. Eventually, aim for 150 minutes per week of moderate-intensity exercise or 75 minutes per week of vigorous exercise. Strength training is also necessary to build muscle mass, which can improve your metabolism and bone health. Here are some tips to help you prioritize your physical fitness: • Divide exercise into smaller chunks: Do 10 squats per hour for a few hours. Take a 15-minute walk during a work break. Lift weights during commercials.
•
Invest in home exercise equipment: If you can’t go
to a gym, consider buying equipment such as resistance bands, light weights, an exercise ball or a stationary bike/treadmill. Exercise videos also can be helpful. • Save the date: Put exercise on your calendar to help make it daily priority. • Make it social: Plan a walk or run with a friend. Find an exercise buddy to help keep yourself accountable. “What’s important is finding things that work for you, so you can maintain your exercise routine over the long term,” says Heather Moneymaker, site manager, fitness, at the Sentara RMH Wellness Center. “Find the right balance. Of course, you can switch things up, too—but don’t berate yourself if you happen to get off track. What’s important is consistency over time.”
State of Mind
The top three stressors for women typically involve issues with family, finances and physical health, notes Whitfield. “Trying to balance work life and family—especially during the pandemic—has had a significant impact on women’s health,” she notes. With so many demands, setting priorities can be tough. Here are some tips to help you simplify your schedule: • Determine and prioritize the tasks that absolutely must get done. • Manage expectations. • Set realistic goals of what you can accomplish in a day.
•
Learn to say no and try not to overextend yourself. • Get enough sleep, so you can think more clearly. Immediate stress busters can include taking deep breaths, journaling, listening to music, reading, meditating or going to a movie. Sometimes, life changes or circumstances can be too much to manage on your own, or even with the help of friends or family. Please seek help from a counselor if you feel helpless or hopeless, can’t sleep, contemplate hurting yourself, or withdraw socially, Whitfield advises.
Keep Tabs on Your Physical Health
Seeing your primary care provider (PCP) is crucial to staying healthy and identifying potential problems or conditions early. Unfortunately, when life gets busy and you feel fine, going to see the doctor can fall to the bottom of your priority list. However, Kathy Phan, MD, a family medicine physician at Sentara Forest Lakes Family Medicine in Charlottesville, recommends making a yearly physical appointment with your PCP. “Your self-care needs to include setting aside time to check on your physical health,” Dr. Phan recommends. “We can monitor current medical conditions and make sure you don’t have any concerning changes to your health.” Your PCP can: • Identify potentially harmful conditions before they become serious • Make sure your vaccines are up to date
•
Order blood work to check on cholesterol, any vitamin deficiencies, and blood cell counts that can indicate infection or cancer • Monitor your blood pressure • Review your family history, blood work and lifestyle to assess your risk for cancer and heart disease, the leading cause of death in the United States At the office visit, your PCP can order the appropriate cancer screening tools—such as a mammogram, colonoscopy or CT scan—and refer you to specialists for any chronic, unresolved medical conditions you may want to address. Although virtual appointments have become more common over the past couple of years, do make sure to see your PCP in person as well. “While virtual appointments can be useful, doctors like to see you face to face, too, so we can check your vitals and look at any areas of concern,” says Dr. Phan. “In-person visits also help doctors build relationships with patients. For me, that’s the best part of my job.”
sentara.com
|
35
HEALTH MATTERS
Health Insurance 101 New to health insurance? Need a refresher? Following are some terms and facts you should know.
Health insurance works by sharing the cost of health care between the insurer and the subscriber (policy owner). This cost sharing continues until the subscriber’s out-of-pocket maximum is met for the plan year. After that threshold is reached, the insurer covers 100% of the subscriber’s medical costs. Costs applied toward the maximum reset every plan year.
What You’re Responsible for Paying Monthly premium: the amount the insurance
costs per month Deductible: the amount you pay out of pocket before insurance pays for anything Copays: set payments you make for medical services; copays continue after you have met your deductible Coinsurance: the percentage of your medical bills you pay after the deductible is met, but before you reach the out-of-pocket maximum Note: Your monthly premiums don’t count toward your out-of-pocket expenses, but all other costs do.
What’s Covered Covered services vary by plan. Typically, most plans cover inpatient and outpatient services, mental health services, and rehabilitation services. However, the services must be medically necessary, as determined by the plan you purchase. It’s important to review your plan’s coverage limitations. Plans typically do not cover cosmetic services, experimental services, off-label medications or services not considered medically necessary by the plan guidelines.
36 |
SPRING 2022
Insurance Types Where you can receive healthcare services depends on what type of insurance you purchase and whether your healthcare provider participates. See below for details. Health maintenance organization (HMO): In this type of
plan, you can only see providers in your network. A referral from your primary physician is required for a specialist. Preferred provider organization (PPO): PPOs are generally
larger networks of providers. You may be able to see both in-network and out-of-network providers, but outof-network services will cost more. You can purchase additional out-of-network coverage, but you will still incur higher costs when seeking care from a nonparticipating provider. You do not need a referral to see a specialist. Point of Service (POS): In this type of plan, you can see both in-network and out-of-network providers. Out-of-network services will cost more. A referral from your primary provider is required for a specialist. Medicaid is a government program in which costs are
shared by the state and federal government, with low costs or no cost to the subscriber. Medicaid programs also can be HMOs and require that the patient seek services at a participating provider or hospital. Providers and hospitals can choose not to provide Medicaid services, with an exception for services covered by the Emergency Medical Treatment and Labor Act (EMTALA), a federal law that requires anyone coming to any emergency department to be evaluated and stabilized, regardless of insurance status or ability to pay. Medicare (traditional) is a government system of
healthcare insurance for people over 65 (or younger, with certain disabilities) that pays an average of 80% of healthcare costs. Subscribers can purchase a supplemental commercial plan to cover the 20% copay not covered by Medicare. For providers who accept Medicare, all services are considered in-network. Medicare Replacement or Advantage Plan: These plans
feature both Medicare and commercial insurance benefits and requirements. They cover everything that traditional Medicare covers but also have additional benefits, such as dental and hearing coverage. Since the plans have commercial benefits, they follow commercial insurance requirements, including deductibles, copays and coinsurance. The plans can be HMO, PPO or Private Fee-For-Service (PFFS) and will require your provider to participate to be in-network. Out-of-network services will cost more, if allowed by the plan.
LA SALUD IMPORTA
Principios básicos del seguro de salud ¿Es nuevo en el seguro de salud? ¿Necesita un repaso? Los siguientes son algunos términos y datos que debe conocer. El seguro de salud comparte el costo de la atención médica entre la aseguradora y el suscriptor (propietario de la póliza). Este costo continúa compartiéndose hasta que se cumpla el máximo de desembolso directo del suscriptor para el año del plan. Una vez alcanzado ese umbral, la aseguradora cubre el 100% de los costos médicos del suscriptor. Costos aplicados al restablecimiento del máximo cada año del plan.
Lo que usted es responsable de pagar Prima mensual: el monto del seguro por mes Deducible: el monto que paga de su bolsillo antes de
que el seguro pague por cualquier cosa Copagos: pagos fijos que usted hace por los servicios médicos; los copagos continúan aplicándose después de haber alcanzado el deducible Coseguro: el porcentaje de sus facturas médicas que paga después de que alcanza el deducible, pero antes de alcanzar el máximo de desembolso directo Nota: Las primas mensuales no se consideran para sus gastos de desembolso directo pero todos los demás costos sí.
Lo que está cubierto Los servicios cubiertos varían según el plan. Por lo general, la mayoría de los planes cubren servicios para pacientes hospitalizados y ambulatorios, servicios de salud mental y servicios de rehabilitación. Sin embargo, los servicios deben ser médicamente necesarios, según lo determine el plan que compre. Es importante revisar las limitaciones de cobertura del plan. Los planes, por lo general, no cubren servicios cosméticos, servicios experimentales, medicaciones no indicadas o servicios que no se consideran médicamente necesarios según las pautas del plan.
Tipos de seguro El lugar donde puede recibir servicios de atención médica depende del tipo de seguro que compre y de si su proveedor de atención médica participa. Para obtener más información, consulte la información a continuación.
Organización para el mantenimiento de la salud (HMO): en
este tipo de plan, solo puede consultar proveedores en su red. Se requiere una remisión de su médico primario para un especialista. Organización de proveedores preferidos (PPO): las PPO
son generalmente redes más grandes de proveedores. Es posible que pueda consultar proveedores dentro y fuera de la red, pero los servicios fuera de la red costarán más. Puede comprar cobertura adicional fuera de la red, pero aún incurrirá en costos más altos al recibir atención de un proveedor no participante. No necesita una remisión para consultar a un especialista. Punto de servicio (POS): en este tipo de plan, puede con-
sultar tanto los proveedores dentro como fuera de la red. Los servicios fuera de la red costarán más. Se requiere una remisión de su proveedor primario para consultar a un especialista. Medicaid es un programa gubernamental en el que
los costos son compartidos por el gobierno estatal y federal, con bajos costos o sin costo para el suscriptor. Los programas de Medicaid también pueden ser HMO y requieren que el paciente reciba servicios de un proveedor u hospital participante. Los proveedores y hospitales pueden optar por no prestar servicios de Medicaid, con una excepción para los servicios cubiertos por la Ley Laboral y de Tratamiento Médico de Emergencia (EMTALA), una ley federal que requiere que una persona que acuda a un departamento de emergencias sea evaluada y estabilizada, independientemente de la condición del seguro o la capacidad de pago. Medicare (tradicional) es un sistema gubernamental de
seguro de salud para personas mayores de 65 años (o menos, con ciertas discapacidades) que paga un promedio del 80% de los costos de atención médica. Los suscriptores pueden comprar un plan comercial complementario para cubrir el copago del 20% no cubierto por Medicare. Para los proveedores que aceptan Medicare, todos los servicios se consideran dentro de la red. Plan de reemplazo o Advantage de Medicare: estos
planes cuentan con beneficios y requisitos de Medicare y de seguro comercial. Cubren todo lo que cubre Medicare tradicional, pero también tienen beneficios adicionales, como cobertura dental y auditiva. Dado que los planes tienen beneficios comerciales, siguen los requisitos del seguro comercial, incluidos deducibles, copagos y coseguros. Los planes pueden ser HMO, PPO o privados de pago por servicio (PFFS) y requerirán que su proveedor participe para estar dentro de la red. Los servicios fuera de la red costarán más, si el plan lo permite. sentara.com
|
37
SENTA R A IN THE COMMUNITY
A Recipe for
SUCCESS
Hospital volunteers bring ‘a little extra spice’ to the Sentara experience Frank Carter and Jill Garnett possess valu-
able qualities that help them put others at ease. “I’m a people person,” Carter says. “I enjoy people.” And Garnett? “I can talk with a brick wall,” she says. “I just thoroughly enjoy people. They’re fascinating.” Carter and Garnett feel right at home in their respective roles as volunteers for Sentara RMH Medical Center and Sentara Martha Jefferson Hospital, projecting a sense of ease that tends to rub off on the people they interact with during their shifts. Carter, a Vietnam veteran who retired from a career at R.R. Donnelley, has been volunteering as a greeter at Sentara RMH’s Hahn Cancer Center for nine years. Garnett, a retired teacher and career specialist, has spent two years volunteering as a concierge at Sentara Martha Jefferson’s front desk. Without the dedication of such selfless people, Sentara’s mission to provide the best health care possible would be much more challenging. “Volunteers add passion and caring to the patient experience and the family experience, which directly supports our staff,” says Renee Dinwiddie, manager of Guest and Volunteer Services at Sentara Martha Jefferson. “Our volunteers really just add a little extra spice. They don’t replace staff members—rather, they are like the extra topping on our service to patients and families that sets us apart.”
A Key Ingredient
According to Crystal Collins, team coordinator for Sentara RMH Volunteer Services, volunteers are stationed in about 15 different areas of the hospital, offering a wide range of helpful services. Volunteers run the gift shop register. They accompany cancer patients to radiation or the Infusion Center, picking up lunch for them if necessary. They serve as greeters, wayfinders and
38 |
SPRING 2022
shuttle drivers. And there are even a few furry four-legged volunteers who serve as therapy dogs. “Volunteers are very important to the hospital,” Collins says. “We need people who are flexible and able to work a few hours a week, and community members of just about all ages are welcome to serve. Before the pandemic, in fact, we had volunteers who ranged from ages 15 to 94.” Carter says he requested to be a greeter at the Hahn Cancer Center, having gone through chemotherapy there himself. According to Carter, he wanted to be able to give back to the people who provided him with such excellent care. “I know how challenging chemo can be,” Carter says. Having been in their shoes, Carter feels he knows when Cancer Center patients need someone to listen, and when the time is right to engage in conversation. What patients probably don’t realize, though, according to Carter, is that they’re doing as much good for him as he is for them. “I enjoy my little spot,” Carter says of his seat at the front desk. “They help me, and I help them. I’m a Vietnam vet. I still struggle with post-traumatic stress disorder and anxiety. As long as I have
someone to talk to, to laugh with, to joke with, I’m OK. I get to make so many valuable connections with patients.” Dinwiddie says that when someone expresses interest in volunteering, it’s essential for coordinators to find a “beautiful marriage” between the person’s skills and the hospital’s needs. “Volunteering should be a bright spot in their day,” she says. “We have a lot of different opportunities all throughout the hospital, so we try to identify what each volunteer is seeking in his or her heart. They don’t do frivolous jobs—they really impact the hospital’s success.” Dinwiddie notes, importantly, that no volunteers are put in harm’s way—an especially important consideration since the onset of the COVID-19 pandemic. “The safety of our volunteers, just like that of our patients and staff, is a major priority,” she says. “If a volunteer is a little concerned about being in too public of a setting, we can put them as far away as possible. Their comfort, confidence and environment are the main focus. If any of those factors is off, the volunteer isn’t likely to stay.”
The Joys of Volunteering
According to Collins, Sentara RMH typically has about 200 active volunteers at any one time, though the number has dipped to about 60 recently as needs and policies have changed with the pandemic. Sentara Martha Jefferson relies on more than 50 volunteers each day to assist with operations and clinical unit needs, Dinwiddie notes. Remarkably, the longest-tenured volunteer at Sentara Martha Jefferson has been in service there for 61 years. At Sentara RMH, when a prospective volunteer submits an application, Collins sets up an interview to review the volunteer’s expectations. Once all paperwork is returned, the volunteer receives a 90-minute orientation, followed by training in his or her specific volunteer area. “After that, they are ready to volunteer on their own,” Collins says. “We do ask for a one-year commitment and that they volunteer one shift per week of three to four hours.” The application process at Sentara Martha Jefferson follows sentara.com
|
39
SE NTA R A IN THE COM MU N IT Y
a similar route. When a prospective volunteer files an application online, Dinwiddie strives to match the individual with available volunteer openings. “I work hard to make sure I find the best possible match between the volunteer and his or her assigned area of work,” she says. Before work begins, the volunteer receives an orientation, fills out some paperwork and connects with the appropriate department contact. “Then they’re off and running,” Dinwiddie says. Since she started volunteering as a concierge at Sentara Martha Jefferson’s front desk about six weeks before the pandemic started in 2020, Garnett has been going full speed in her volunteer role. Although the timing of the pandemic may have been imperfect, Garnett’s volunteer assignment was a perfect fit for her. “It was exactly what I wanted to do,” Garnett says. “My volunteer position has been a really good match for me.” Prior to volunteering, Garnett was a high school marketing teacher and career specialist for
nearly 40 years. She enjoyed teaching customer service, never knowing how handy it would come in for her decades later. “It fit in so well with my professional experience,” she explains. For retirees who are considering volunteering— whether for a hospital or elsewhere—it’s important to draw on one’s past experience and find the right niche, she notes. “The biggest skill I didn’t realize I would need at the front desk is simply being a problem solver,” Garnett adds. “I take so many calls, and everybody has a different question, request or
need. It makes you realize how little you actually know.” In their volunteer positions, both Garnett and Carter have made countless connections with patients and their families over the years. Carter says that the bonds have grown so strong with some families that he has even attended funerals—evidence that the impact of his volunteer service reaches far behind the hospital walls. Garnett sees a parallel between the hospitals’ inviting atmosphere and the warmth involved in the volunteering experience. “The environment is absolutely beautiful,” she says. “Both hospitals are warm, welcoming and beautifully designed. And I hope, as volunteers, we’re able to extend that warmth to our patients and their families.” Interested in volunteering? Contact the appropriate person at your local Sentara hospital: Sentara Martha Jefferson Hospital: Renee Dinwiddie Manager, Guest and Volunteer Services rmwalker@sentara.com 434-654-7327
Sentara RMH Medical Center:
Crystal R. Collins Team Coordinator, Volunteer Services crcolli1@sentara.com 540-689-6413
40 |
SPRING 2022
CA RING TR ADI TION
A Sisterhood of
Care
The Women’s Committee Supports Breast Health at Sentara Martha Jefferson Hospital
After losing beloved family
members to cancer and going through multiple breast biopsies herself, Franchesca “Fran” Fede Gomez counts herself blessed to be cancerfree. She knows, however, never to take her health for granted. During her first visit to Sentara Martha Jefferson’s High-Risk Breast Program shortly after its inception in 2017, Gomez was assessed as having a lifetime risk for breast cancer of nearly 50 percent—significantly higher than the average lifetime risk of 13 percent. “That was definitely scary news to hear,” recalls the energetic attorney, 49, who juggles a full life as a mom to two daughters and two stepchildren, president of Allen & Carwile PC, and Waynesboro’s commissioner of accounts. Despite the many demands on her time, Fran takes action daily to reduce her cancer risk, from getting regular exercise to limiting her alcohol consumption. She also makes the
Fran Gomez credits the High-Risk Breast Program with helping her proactively manage her health.
mjhfoundation.org
|
41
trip from her home in Staunton to Sentara Martha Jefferson for increased monitoring through screening mammography and breast magnetic resonance imaging scans. “They really stay on top of things,” says Gomez of her team of nurse practitioners and oncologists in the High-Risk Breast Program, whom she credits with educating her about her risk and giving her the tools to respond proactively. Every year, an estimated 1,000 women like Gomez are identified at Sentara Martha
Marianne’s Room provides wigs, scarves, and other resources for breast cancer patients with funding from The Women’s Committee of the Martha Jefferson Hospital Foundation.
42 |
SPRING 2022
Jefferson as being at high risk for breast cancer. The High-Risk Breast Program, which serves the specific needs of these patients, is an integral part of Sentara Martha Jefferson’s nationally accredited Comprehensive Breast Center. The center’s hallmark is its holistic approach, which combines clinical excellence with a robust suite of programs that address body image, mental health and survivorship. Philanthropic support is the engine behind these personalized services, and for nearly 30
years, The Women’s Committee (TWC) of the Martha Jefferson Hospital Foundation has been an essential partner in supporting women’s health. Through annual fundraising events, including Martha’s Market and the In The Pink Tennis Tournament, TWC has contributed more than $6 million to the hospital. “We wouldn’t be able to offer this comprehensive program without The Women’s Committee,” says Crystal Chu, manager, Sentara Blue Ridge Cancer Program. “Our
Get Involved! community really comes together to help us offer everything our patients may need beyond their treatments.”
Women Helping Women
For their part, TWC members are inspired by a passion for ensuring that all women in our community have access to the care they need. “TWC members are all there for the same purpose: to save women’s lives and support those battling cancer,” says TWC Chair Jennifer McGlothlin, whose own family history of breast cancer drives her passion for supporting women’s health. “I just feel it’s my calling to make women aware of the importance of getting an annual mammogram.”
Sentara Martha Jefferson Hospital is offering four Free Breast Health Screenings in 2022: April 23, 2022 July 23, 2022 October 22, 2022 December 10, 2022 8:00 am to 2:00 pm Sentara Martha Jefferson Outpatient Care Center 595 Martha Jefferson Drive, Charlottesville For more information and to schedule an appointment, call 1-800-SENTARA (1-800-736-8272)
The Women’s Committee (TWC) of the Martha Jefferson Hospital Foundation champions the health and wellness of women in the Charlottesville community and beyond. This group of dedicated, determined women shares a passion for making life-saving programs, services and state-of-the-art technologies available for all women. “We share a camaraderie and excitement for what we’re doing,” says TWC Chair Jennifer McGlothlin, who makes time to lead the group as part of a busy life as president of her own pharmaceuticals company and a mom of four, including three college-aged children. “This has always been such a wonderful group of women. Whenever we meet, the joy among us is infectious.” Volunteers are needed for TWC’s two annual events— Martha’s Market and the In The Pink Tennis Tournament—and to support the Free Breast Health Screening Days, as well as other service opportunities. To find out more or get involved, please contact TWCchair@gmail.com, call the Martha Jefferson Hospital Foundation at 434-654-8258 or visit mjhfoundation.org/ the-womens-committee.
TWC funding and volunteer support enables Sentara Martha Jefferson to offer four Free Breast Health Screening Days annually. These events provide mammograms and health screenings for approximately 100 women who would otherwise forego care due to a lack of resources. TWC also established and supports Marianne’s Room, a special resource room for women diagnosed with cancer, providing wigs, scarves and special “chemo caps,” as well as soft prostheses and camisoles for breast cancer patients after a mastectomy. To help women care for their spirits through the cancer journey, TWC also makes possible healing services such as massage therapy, yoga, exercise classes and support groups. In addition, the group’s generosity supports blanket warmers and special chairs that bring comfort to Infusion Center patients dur-
ing treatment, and a survivorship program that helps women thrive through the physical and emotional changes that come with a cancer diagnosis. “We make sure that we’re taking care of every aspect of the cancer journey,” McGlothlin says. “We’re all about upholding the Sentara Martha Jefferson Caring Tradition.”
A Sense of Security
For Gomez, who has a sister with stage 4 breast cancer and lost her mother to the disease, the hospital’s partnership with TWC has had a tangible impact on her life, giving her the tools to take responsibility for her own health, as well as the reminders and support to stay on track. Most of all, though, TWC has shown her that she’s not alone in her health journey. “I have lots of caring people looking out for me,” she says. “I feel safer knowing that.” mjhfoundation.org
|
43
CA RING TR ADI TION
Healing
A ENVIRONMENT
Exploring Sentara Martha Jefferson Hospital’s Commemorative Grove
O
n a chilly day last December, hospital staff and friends of the late Maurice Burnett gathered around a freshly planted white dogwood tree. It was the latest addition to Sentara Martha Jefferson’s commemorative grove, a beautiful stand of flowering trees in the front garden located on the hospital’s main grounds. Enlivened by the spirits of those beloved to the Sentara Martha Jefferson community, the grove is a living tribute to those who have made a difference in the lives of their families and others. That was certainly the case for Mr. Burnett. A native Englishman, he blessed his adopted home with a remarkable bequest in 2021 to the Martha Jefferson Hospital Foundation, which has improved quality of life for thousands of patients, families and caregivers over the years (see sidebar).
44 |
SPRING 2022
Last December, friends joined Martha Jefferson Hospital Foundation Executive Director Kimberly Skelly to dedicate a white dogwood in the commemorative grove in honor of Maurice Burnett’s extraordinary generosity.
For all nature is doing her best each moment to make us well. —Henry David Thoreau
“We were all so touched and moved,” recalls Kimberly Skelly, Martha Jefferson Hospital Foundation executive director, of the unexpected bequest, which provided critical support to every aspect of the hospital’s operations at a time when COVID-19 was taking a punishing toll on the community. To honor Burnett’s generosity, the Foundation’s Board of Directors unanimously approved planting the white dogwood. A site was chosen facing the beautiful vista of Monticello Mountain and Thomas Jefferson’s mountain estate. “I think Maurice would be pleased to know that his tree will grow with a view of Monticello,” reflected Skelly at the dedication, noting that Burnett also left a generous bequest to that historic site, which is forever linked to Sentara Martha Jefferson Hospital by the special connection between Thomas Jefferson and his daughter Martha, for whom the hospital is named.
A Hospital in a Park
As a lifelong farmer and naturalist, Thomas Jefferson well understood nature’s power to renew and inspire. “There is not a sprig of grass that shoots uninteresting to me,” he once observed. That same appreciation informs every aspect of Sentara Martha Jefferson’s 40 acres. Patient rooms face southwest toward unparalleled views of the Blue Ridge Mountains. Walking trails traverse the beautiful flowering white dogwoods, Eastern redbuds and green hawthorns of the commemorative grove, providing respite for patients, families, staff and community members. Peaceful spaces, including a pond, labyrinth and outdoor amphitheater, offer opportunities for quietude and reflection. “The whole campus is meant to be inviting and nurturing, and the trees are a part of that,” says Catherine Hughes, director of Patient Care Services. “Staff members walk around our campus, as well as runners from the community. We also encourage our patients’ family members to take walks to get breaks from the bedside.” Getting outside isn’t just nice, however—research shows that it also can be therapeutic. From lowered blood pressure and reduced pain, to faster healing with fewer complications, nature views and mjhfoundation.org
|
45
A Quiet, Humble Man Remembering the life of Maurice Burnett Last fall, Sentara Martha Jefferson Hospital received a remarkable bequest from Maurice Burnett, a native Englishman who came to Charlottesville and the rolling hills of Central Virginia by way of New York City, eventually settling at Westminster Canterbury of the Blue Ridge, where he lived for 14 years. As a young man, Burnett attended the University of Cambridge studying classics before entering the Royal Navy. His facility with languages earned him a spot at Bletchley Park, the top-secret British code-breaking facility, where he quickly learned Japanese and helped the Allies win World War II. Family and friends remember Maurice as humble and warm, with a quick mind and a dry sense of humor. After World War II, Burnett found his way to a banking career, first at the Bank of Scotland, then in New York City— where, he once quipped, he landed “in search of a better tax code.” In America, he married and had a son, Keith, with whom he shared a great love of sporting events, especially soccer. Ultimately, Burnett found his way to Charlottesville, a place he found reminiscent of the beloved English countryside of his youth. Here he mourned the loss of his wife and the untimely death of his son, ultimately making a home among friends at Westminster Canterbury of the Blue Ridge. His twin passions were studying history and working in his gardens, and he also spent several decades in volunteer leadership roles at Monticello. His generous bequests to that site and the Martha Jefferson Hospital Foundation will have a truly significant impact for years to come.
46 |
SPRING 2022
outdoor access can have measurable benefits in decreasing anxiety and quieting the body’s stress response. Even photographs of nature can reduce anxiety, leading Hughes and other hospital administrators to incorporate familiar natural landscapes in the hospital’s art collection. “I very much believe in the healing power of nature,” she says. “For most of us, nature instinctively helps us to slow down and be calmer.”
The Peace of Wild Things
Throughout the COVID-19 pandemic, the hospital’s beautiful outdoor landscape has been a source of peace and respite not only for patients and families, but also for exhausted and beleaguered staff. Esther Lozano Otis, an obstetrics nurse and the hospital’s staff resiliency coordinator, looks for opportunities to get team members outside for a quick break whenever possible. During the pandemic, she began leading nature walks around campus for her colleagues. “Just taking a few minutes in nature is so important,” she says, noting how walking the hospital’s nature trails makes it possible to unwind, reconnect with old friends and meet new colleagues. “It
brings an increased sense of community to the hospital, which is itself healing.” Philanthropic support from the Joseph and Robert Cornell Memorial Foundation and other leadership donors to the Foundation’s COVID-19 Emergency Response Fund is also enabling the creation of a rooftop Serenity Garden just a few steps from the hospital’s Intensive Care and Cardiac units, making it easy for staff to slip outside for a quiet moment of pause. Maurice Burnett likely knew that sense of solace in his own garden, tending to his beloved rhododendrons and azaleas. The visionaries who designed the Sentara Martha Jefferson campus knew the value of nature as well, viewing the world outside the hospital’s doors as an extension of the Caring Tradition that distinguishes the compassionate culture inside, and recognizing that few things are deeper or more universal than our connection to the natural world. As the poet Wendell Berry observes beautifully in his work “The Peace of Wild Things,” even in the hardest times, we have within us always the capacity to “rest in the grace of the world,” and be free.
Commemorative Trees: A Living Tribute To honor or remember a loved one or friend with a tree in the Sentara Martha Jefferson commemorative tree grove, visit mjhfoundation.org.
CA RING TR ADI TION
Fostering a Healthy and Connected
Community
For more than a century, Sentara Martha Jefferson Hospital has worked to improve the health of friends and neighbors in our community, providing compassionate care for all who walk through our doors and reaching outward to work for greater health equity in our community. Every three years, Sentara Martha Jefferson partners with colleagues at the UVA Health System and the Blue Ridge Health District to create a comprehensive study of the most pressing health issues in our community. The most recent Community Health Needs Assessment identified four priority areas: • Reduce health disparities and improve access to care. • Promote healthy eating and active living. • Address mental health and substance abuse. • Foster a healthy and connected community for all ages. Through the support of the Martha Jefferson Hospital Foundation, our Community Benefits team closely collaborates with community healthcare partners to address these urgent needs. Over the next year, we will highlight a few of the partners and programs we support and work with to improve the health of our community.
Habitat for Humanity of Greater Charlottesville
More than 200 Southwood community members are collaborating on the vision for their new neighborhood.
“All outcomes depend on real, spiritual ownership of your own community,” says Dan Rosensweig, president and chief executive of Habitat for Humanity of Greater Charlottesville. “That’s what makes communities last and makes them strong.” Rosensweig speaks from experience, having spent the past 30 years championing affordable housing in the Charlottesville area, first as a grassroots advocate and, for the past two decades, as Habitat’s leader. In that time, the organization has empowered thousands of people in our community to achieve economic
stability and obtain a safe, healthy place to live through homeownership. He says the work has changed him, making him less cynical and more aware of what is possible when people come together to make things better. And certainly, Habitat is changing the affordable housing landscape in our region. Since 1991, the organization has built and sold more than 200 homes to hard-working families, earning a reputation nationally mjhfoundation.org
|
47
as an innovator in developing adaptable, affordable mixed-use housing that makes families and communities healthier and stronger. Since 2007, the organization’s flagship project has been the Southwood Mobile Home Park, located on 120 acres just south of Charlottesville off Old Lynchburg Road, that is home to 1,500 residents—mostly Latino, and one-third children. Habitat bought the land and embarked on an ambitious community-development project, unique in its breadth, complexity and aspiration. More than 200 families are collaborating on a vision for the new neighborhood, where all current residents will have the option to rent or purchase their homes, with a commitment that no one will be displaced. To date, the organization has invested $25 million in the project, thanks to the generosity of local supporters. Additional funding has been secured through local, state and federal support, as well as through innovative collaborations with for-profit developers to create below-market-rate housing for Habitat families and market-rate housing options that will be sold to the general community—making Southwood a true public/private partnership.
“This project is too big for one entity,” says Rosensweig of the effort, which broke ground in September 2020. While the first homes are anticipated to be ready for move-in during 2022, the ultimate vision for Southwood will take several years to be fully realized. “To complete the project, we will need the stamina and perseverance of the entire community.” For its part, Sentara Martha Jefferson Hospital provided a $100,000 grant last year to help Habitat address imminent health threats posed by asbestos water lines, fuel tanks leaking into the soil, and sewage bubbling up from the ground—caused by years of neglected maintenance at Southwood. The grant recognizes that access to quality health services isn’t the only driver toward achieving healthy outcomes. Economic stability and the built environment around us are also of huge importance. Habitat assists in providing both elements through homeownership, helping more people invest in homes to care for their families and build personal wealth for future generations—at the same time developing safe, affordable neighborhoods that provide access to transportation and recreation, as well as healthy food, air and water quality. Given their shared mission to advance health and wellness for all people in our area, Sentara Martha Jefferson Hospital and Habitat for Humanity are natural partners. “We’ve got to go forward together,” Rosensweig says. “We need to maintain a fundamental commitment to help lift people up at Southwood and throughout our entire community.”
Our mission to improve health every day drives ev-
Habitat volunteers come together to care for their community.
48 |
SPRING 2022
erything we do to keep individuals, families and the community we serve healthy. We do this by establishing partnerships that create a positive impact in our communities. Through the support of the Martha Jefferson Hospital Foundation and the Sentara Healthier Community Fund, Sentara Martha Jefferson Hospital provides grant funding to community health partners, like Habitat for Humanity, located in the Blue Ridge Health District and surrounding counties. Find out more at SentaraCares.com.
ABOUT IMPROVING HEALTH. EVERY DAY. FOR EVERYONE. Sentara is focused on living its mission — to improve health every day. In addition to providing exceptional care, Sentara partners with organizations to provide significant support to address the conditions in which people live, work and learn to advance the overall quality of life. We are driven by one simple idea, Sentara cares about all the communities we serve.
Learn more at SentaraCares.com
Non-Profit Org. U.S. Postage
PAID
Sentara Martha Jefferson Hospital
Sentara Martha Jefferson Hospital 500 Martha Jefferson Drive Charlottesville, VA 22911 Sentara.com Change service requested
S E N TA R A S P OR T S ME DICINE CE N T E R
WE CAN’T KEEP YOU CLEAN, BUT WE CAN GET YOU BACK ON THE COURSE The harder you race, the muddier you get—and you love it! Don’t let pain keep you off the course. The experts at the Sentara Sports Medicine Center will get you back to you.
SENTARA SPORTS MEDICINE CENTER OFFERS PATIENTS: • Same day appointments • Two state-of-the-art facilities with access to onsite physical therapy and imaging • Fellowship-trained surgeons for every joint and bone in your body Same day appointments available. Call 434-654-5575 to schedule. For more information, visit SentaraOrthopedics.com. Follow us on Facebook @SentaraMarthaJeffersonHospital, and Twitter @MarthaJefferson.