MEET THE FORT SMITH AREA’S BEST NURSES PA G E S 2 - 9 M E R C Y N U R S E S L E A R N T O S H I N E PA G E 1 0
REWARDING TALENT What nurses want employers to know PART OF GATEHOUSE MEDIA’S
Sunday, April 21, 2019
The Times Record
Sunday, April 21, 2019
Babies inspire Baptist Health — Fort Smith nurse Chambers found her calling early in life By Carole Medlock Special to the Times Record
Katy Chambers always knew she wanted to work with babies. Her grandmother knew it too. “I knew I wanted to be a baby nurse. That’s what I always said. I was very blessed to get that speciality,” Chambers said. Chambers is a registered nurse who works in the Neonatal Intensive Care Unit at Baptist Health — Fort Smith. “She’s always said that,” echoed Connie Watson, Chambers’ grandmother. Chambers was recently nominated by Watson as one of the area’s top nurses. Watson said it was her knowledge of Chambers’ love for what she does that prompted the nomination. “Because I know how much she loves, loves what she is doing … and she deserves it,” Watson said. A graduate of the University of Arkansas at Fort Smith nursing program, Chambers has worked in the NICU at Baptist Health for almost three years. She said although she completed a NICU/maternity rotation as part of her nursing education, her desire to work with babies predated her educational experience. Chambers said two personal experiences precipitated her interest in baby nursing. First, Chambers said, she remembers watching a nurse conduct a jaundice test on a friend’s baby when she visited the new mother/baby in the hospital while still in high school. While watching that simple medical test, Chambers remembered thinking how much she wanted to become a nurse and work with babies. In addition, Chambers said
Katy Chambers has worked in the NICU at Baptist Health - Fort Smith for almost three years. [CAROLE MEDLOCK/SPECIAL TO THE TIMES RECORD]
she was inspired by the story of a family friend who gave birth to twins at 25 weeks of pregnancy. While one of the the babies, who weighed in at 1 lb 5 oz, did not survive the premature birth, the other baby did. Chambers said she was inspired by a story in which modern medicine gave a baby born weighing 15 oz a chance at life. That baby is now 10 years old. “It’s an incredible story,” Chambers said. Watson said Chambers’ demeanor makes her the perfect nurse. “The fact that she loves babies, she loves everybody. She is a very caring and protective person. This has
always been her passion,” Watson said. Chambers is from Magazine and commutes nearly an hour each day to report to work. She attended and graduated from high school in Magazine, where her husband is the football coach. In addition to her nursing duties to help sick babies, Chambers said she also interacts with parents as a part of the process of getting babies well enough to go home. Chambers educates parents about what milestones a baby in the NICU might have to achieve in order to be released to go home. She said when a baby is sent home there are many precautions that must
be taken and parents must be educated about those also. The best part of working in the NICU is watching babies, especially those born prematurely, hit imperative milestones, Chambers said. She added that even the smallest turning point for a baby can be a very big deal for parents dealing with a premature or sick baby. One of the challenges of the job is the percentage of babies in the NICU because of drugaddicted mothers, Chambers said. And in some cases, Chambers said it is difficult to see those same babies not be able to be sent home with their mom or dad. A new mother of a 6-month
old son, Chambers said it is hard to separate herself, sometimes, from what goes on in the NICU. Watson said Chambers has always given her all at everything she does. “That’s her story. Whatever she does, she does to the max,” Watson said. “Whether it’s school, college, family, nursing … she puts her whole heart into whatever it is.” Chambers said she would eventually like to return to school to pursue a career as an Advanced Practice Nurse, probably through an online degree program. She is interested in a speciality in women’s and children’s health, she said.
Sunday, April 21, 2019
Career path change leads Mercy nurse to job she loves Adams doesn’t let anything slow her down By John Lovett Times Record firstname.lastname@example.org
Tracy Adams, RN, was born to be a nurse, although she didn’t realize it at first. With 30 years of experience at Mercy Fort Smith, the much-loved heart nurse actually missed out on a free car from her father over nursing. Chuck Perriello, a former nurse who became a hospital administrator, told his daughter he would buy her a car if she took up his challenge to become a nurse. She chose business school instead. After a year at the University of Arkansas, she quit and moved back to the River Valley and started work for a trucking company. One day, with the trucking company in dire straights, Adams' friend Tammy Hayes said “Let’s go to nursing school.” They both enrolled at Westark Community College, now University of Arkansas at Fort Smith. Adams called her father and asked if the offer for a car still stood. Unfortunately, the opportunity had passed for the car. But the career option of becoming a nurse had not. While her friend dropped out in the third semester, only to come back later and finish up, Adams stuck with it and started at Mercy as a nurse's aide while she finished up her training. After graduation in 1990, she started full-time at Mercy as a registered nurse and has spent most of her career either in or around the cardiology “cath lab.” Her husband, Eric Adams, also works at Mercy Fort Smith as a pharmacist. “My husband asked me just the other day, ‘If I could do it all over again, would I?’ I said ‘Yes. I would be a nurse again.
Tracy Adams, RN, is seen April 8 at the caridology department in Mercy Fort Smith. Adams has worked most of her 30-year career in or around the cardiology “cath lab” at Mercy and is one of the nurses highlighted for the Times Records’ Salute to Nurses. [JOHN LOVETT/TIMES RECORD]
I love what I do,'” Tracy said. Her infectious grin and positive attitude show it. Her soft voice and light-hearted demeanor can help reassure patients and put them at ease, even going into a heart operation. She says she just likes meeting and talking to people, inside and outside of the hospital. It wasn't ever necessarily "a calling," she added. But it certainly worked out for her. “Nursing school was the best thing I’ve ever done,” Tracy added. “My dad must have known.” Something neither she nor her father knew, however,
was that life was about to throw her a major curveball. Diagnosed in 1994 with multiple sclerosis, Adams forged through the effects of the crippling disease using medication to delay progression. She is now in the secondary progression phase, she said, and has an eye on retirement. Several years ago, after a fall caused by her condition, she took herself out of the “cath lab.” She has been in the cardiology department’s preparation and recovery rooms since then. It was a hard decision for her. She
loved being in the operating room with the patients, and says she still tears up a little when she goes by the “cath lab,” knowing she is missing out on the main event. Cathy Hightower says in her Salute to Nurses nomination letter that Adams is both a “top notch person and nurse.” Hightower explains she met Adams about two years ago when she was her “prep nurse” for a heart catheter operation at Mercy. “She always strives to please and goes beyond the call of duty,” Hightower wrote. “Tracy is battling
her own disease of Multiple Sclerosis but she just keeps on going. I have encountered many nurses in my time but I have to say Tracy is the one!” Tracy Adams credits the staff and management at Mercy Fort Smith for being both very accommodating and supportive of her through her career, and her physical challenges. She also credits her patients. “I get inspiration from them all,” Tracy said. “I battle MS, but I have a very good support system. My family, my husband … my friends. Everybody has their battles.”
Sunday, April 21, 2019
Johnson finds calling, juggles many roles RN serves as Area Agency on Aging nursing supervisor, works with children at Brownwood By Mardi Taylor Times Record
For Tressa Johnson, what began as a way to earn extra Christmas money turned into a passion for helping others. Johnson, RN, is nursing supervisor with the Area Agency on Aging. She also works three evenings a week at Brownwood Life Center in Fort Smith, where she has worked since 2004. What she enjoys most about her work is knowing she’s having a positive influence on others. Johnson oversees the Area Agency on Aging offices in Fort Smith and Greenwood. Much of her day includes reviewing medical referrals and documentation, working with case managers and working as an advocate for those who need the services. Other available services include things like home repairs and housing assistance. The Northside graduate has been with the agency since 2015 and the nursing supervisor since 2018. She began her nursing career as a privateduty LPN while she studied to be a registered nurse. Johnson knew a resident at Brownwood back in 2004 and decided to apply for a position there. Brownwood is a 50-bed facility that helps people with disabilities. School-aged children can work with special education teachers and paraprofessionals there. Therapy, speech and physical therapy services are available. “A Christmastime job turned into 15 years later,” Johnson said. “You just fall in love with the kids. So I’m still there ... It’s rewarding. When you enjoy your job, it’s
Tressa Johnson, RN, nursing supervisor at the Area Agency on Aging, sits in her ofﬁce in downtown Fort Smith on April 10. Johnson has been with the agency since 2015. [MARDI TAYLOR/TIMES RECORD]
not really a job. I get paid to hang out with a bunch of kids that smile and make a difference. It’s really empowering them to live as normal a life as possible in their situation.” Juggling multiple jobs sounds challenging, but Johnson wouldn’t have it any other way. “It was the kids at Brownwood; I don’t want to leave them,” she said. “I never want to leave them, so how can I improve my situation and be able to be a part of their lives? Nursing, it’s been the best decision I’ve ever made. I feel like it’s a calling.” At the Area Agency on Aging, Johnson works with about 20 people each day, from case managers to aides, as well as outside clinics. “Everything is so different,”
Johnson said of working at the agency in comparison with working as more of a hands-on nurse. “In each position I’ve had, I’ve been able to feel like I’ve made a difference to the patients. Here, though, at this current position, because I am over so much, there’s so much more I can help with. I feel like I can make a bigger impact.” To receive assistance from the Area Agency on Aging, the first step is to call, Johnson said. “There are so many patients, and people in general, they don’t have to be our patients,” Johnson said. “You’re able to see a need and work with that.” Case managers work together to help those being served by the agency to assess their needs.
“If you need help, we’ll try our best to find it if we can,” Johnson said. “If we can’t provide it, then we can reach out to other resources to see what we can do.” Johnson is working toward a master’s degree to become a pediatric nurse practitioner. “That’s the great thing about nursing — you can do so many things,” she said of her long-term plans. Johnson said while working as an LPN at Brownwood, another nurse was working toward becoming an RN. “I would always talk about, ‘I want to be a (registered) nurse,’ but never really did it,” she said of her early days as an LPN. “I was talking about it, and one of the nurses at Brownwood just looked at me, and she said, ‘I’m tired
of hearing you talk about it; just go do it. And so I did. All the nurses there were very encouraging. Really, I don’t think I would have done it without that nurse saying ‘Do it.’” Johnson said she’s worked with a lot of supportive nurses and physicians over the years. “They were encouraging, and I think that’s really important, too, in the department you work in, making it a happy experience,” she said. Johnson was nominated by former co-worker Misty Hile, who is now with Mercy Fort Smith. “She pours her heart into her work, treats everyone with dignity and compassion, and believes in her ministry of service through her career,” Hile wrote in her nomination.
Sunday, April 21, 2019
GREAT CARE AND GREAT CAREGIVERS ARE AT SAINT MARY’S REGIONAL HEALTH SYSTEM
Looking for a rewarding career where both technical expertise and a compassionate attitude are valued? Discover how you can thrive as part of Saint Mary’s Regional Health System. Our system is anchored by Saint Mary’s Regional Medical Center. Joint-Commission accredited, Saint Mary’s strives to deliver quality care with safety and compassion as we hold to the values of communication, respect, teamwork, and integrity. These ideals carry over to our affiliate Millard-Henry Clinic, a state-of-the-art facility that is one of the region’s largest primary care and specialty clinics. Saint Mary’s Regional Health System is also proud to be a major employer in our area. We offer competitive wages and excellent benefits in a supportive, friendly environment. Saint Mary’s is an Equal Opportunity Employer (EOE). x x x x
COMPETITIVE WAGES & BENEFITS SIGN-ON BONUS IN CRITICAL NEEDS AREAS* SHARED GOVERNANCE STRUCTURE EDUCATIONAL ASSISTANCE *TO APPLY, ALL LICENSED APPLICANTS MUST BE CURRENTLY LINCENSED IN THE STATE OF ARKANSAS, WITH NO RESTRICTIONS.
1808 W. Main Street | Russellville, AR 72801 | saintmarysregional.com/careers | 479.964.5654
Sunday, April 21, 2019
Nurses Bridgett West, left, Alicia Petersen, center, and Maegan Haberer serve the Ozark Public School District. West works at Ozark Junior High and Ozark High School; Petersen works at Ozark Primary School; and Haberer works at Ozark Middle School. [MARDI TAYLOR/TIMES RECORD]
Caring for students
Ozark nurses discuss roles in school district By Mardi Taylor Times Record
OZARK — Being a school nurse means a lot more than just fixing scraped knees and
elbows. The school nurses who help keep things running smoothly at Ozark Public Schools know this firsthand. “I think (the public) might think we just hand out Bandaids and Tylenol; that’s kind of how I perceived it, to be
honest, and it’s nothing like that at all,” says Bridgett West, school nurse at Ozark Junior High and High School. “To me, there’s a lot more attachment with the kids than I think they think. We’re not just the old-school nurse that sits in there.”
Sunday, April 21, 2019
West and fellow Ozark school nurses Maegan Haberer and Alicia Petersen have been recognized as some of the area’s top nurses. The three share a common school district, but each experiences something different at the schools they serve. Haberer is the school nurse at Ozark Middle School, while Petersen works at Ozark Primary School. Petersen, a native of Wisconsin, is in her first year as the Ozark Primary School nurse after working with children in Pre-K and Head Start. Having experience with young children led her to the school nurse position after nursing school. “I really enjoy working with little kids,” she said. “This is really where I wanted to be.” Petersen and her husband, Lucas, have two children (daughters ages 13 and 11), so working on a school schedule is beneficial for her. West, an Altus native, spends most of her day at Ozark Junior High because of a higher need for a nurse among its students, but she also works as the nurse at Ozark High School. With her husband, Eric West, Bridgett West has three daughters with ages 22, 17 and 14, as well as a 12-year-old stepson, a 10-year-old stepdaughter and a 6-month-old granddaughter. The teenagers attend Ozark High School, so they are near their mom during the day. Because she spent many years working with teens at the health department, Bridget West feels naturally drawn to them in her role with the schools. “With the older kids ... there are medical problems, but on the other hand ... I fix medical problems. I also help a lot with their day-to-day life problems,” she said. “I deal a lot with that, as much as the medical end of it. There are a lot of kids who go through a lot of things, from home life
has changed a lot,” West said. “It used to be your standard Band-aids and ice packs. Those kids (with serious medical issues) just didn’t come to school. It has changed a lot.” Changes in school nursing
Nurses Bridgett West, from left, Maegan Haberer and Alicia Petersen serve the Ozark Public School District. West works at Ozark Junior High and Ozark High School; Petersen works at Ozark Primary School; and Haberer works at Ozark Middle School. [MARDI TAYLOR/TIMES RECORD]
and dealing with a lot of stuff. Sometimes, we’re their only outlet (so) they come to us. It’s pretty hectic on a normal day.” Many of the younger children have issues with cleanliness that must be addressed, as well as other issues like head lice, Petersen said. Often, head lice is treated at the school because it’s not being dealt with at home, Petersen added. She agreed that often, school nurses serve as an outlet of support for their students. Haberer is an Ozark native and previously worked at a medical clinic but enjoys the better hours that come with working for a school district. She and her husband, Logan, are expecting their first child. She feels middle-school students are a good fit for her. “I have the teenagers, and
they’re not bad because they can tell you what’s going on and kind of help you a little bit more,” she said. Special needs In addition to her nursing duties, Haberer drives a special-needs bus for the district. Ozark now has the special-needs students at the regular schools instead of a special school and they regularly work with all three school nurses. Having the special-needs students at the regular schools has worked out well, West said. “The kids in the normal classes don’t see them any differently. It’s gone really well, I think,” she said. “My kids at this building, we’ve talked about how well they’ve adjusted to it. They don’t think anything about it ...
when they see the kids out.” The special needs range from simply being in a wheelchairs to dealing with ranges of autism, and their needs change regularly. “(Some students) can’t tell you, ‘My head hurts,’” West said. “So we’ve had to kind of learn them and their needs ... it has made it more challenging, but on the other hand, to me it’s really rewarding, because you get really attached to these kids. You see them more so than the kids in the regular classroom.” West has several specialneeds students who will be graduating soon, She says she’ll really miss them. Other students deal with headaches or must take medicine every day. Some deal with issues such as diabetes and they’re seen more than once throughout the day. “I think public school nursing
Paperwork is now a big part of the job, as is dealing with students and immunizations. Often getting students properly vaccinated is challenging, although the health department will now come to the schools to give students their vaccinations, as long as parents sign the paperwork. In addition, there are steps to take if a child has to take medicine during the day, something many parents may not realize. Other training involves taking care of students who participate in sports. The nurses have to have concussion training and work with coaches and athletes to get concussion testing done, for example. School nurses also take care of screenings for students, including BMI (body mass index), scoliosis, vision and hearing checkups. They also play a big part in making sure students are learning to their full potential, Petersen added. The nurses agreed that the family based nature in Ozark is a nice part of job. “Everybody knows everybody; it’s a small town,” West said. “But our administration, they’re very family based, and they all come together, and I like that. They support things.” Petersen said she was grateful for the support she’s gotten during her first year as a school nurse, both from the principals and from the teachers. “There are a lot of things I learned this year about school nursing, because it is different than clinic nursing,” Petersen said. “The teachers, they really really care about their students and want to help them.”
Sunday, April 21, 2019
Aimee Sanderson RN, BSN, at the Fort Smith Veterans Administration Clinic, is an Alma native who studied at the University of Central Arkansas. She says she has always been interested in the medical field. “Nursing suits my character of being empathetic, and wanting to help others,” she says. Sanderson has been a nurse for 23 years. She says the best part of her job is interacting with “all kinds of people.” She enjoys being able to find similarities with people who are very different from herself but still finding a way to make a connection. Seeing a person’s health fail when she’s done all she can do for them is the
most challenging part of her job, Sanderson says. “Nurses are ‘fixers,’ but when it is up to the patient to take responsibility for their health care and either they don’t or feel like they can’t, the education process is challenging,” she says. Anyone interested in going into the nursing field should do so because it is their calling, Sanderson says. “You have to have a true heart for it, otherwise you will not be happy,” she says. “You can have the best supervisor, money, the best hours — but unless you truly love what you are doing to help others, you won’t be happy.” Sanderson’s family includes three children.
Ashley Dodd is a native of Bryant who works as a nurse in Mercy Clinic’s General Surgery Department. She is a graduate of the University of Arkansas at Fayetteville. “My mom is a nurse, and we are very similar in the way we like to care for others,” she said. “I thought since she loves it so much, I would love it also.” Dodd has been a nurse for about 4½ years. The best part of the job is just working with the patients, she says. “I like to see the smiles on the patient’s face when you know you have worked really hard to care for them,” she says. “It makes me feel good knowing they feel good.” One challening part of her job is not
being able to help everyone, she said. “I love to see people happy and healthy, and when you are unable to provide that, it feels like you have failed them,” she said. Dodd says her advice to someone interested in becoming a nurse is to “learn to put whatever is going on in your life aside and don’t let it interfere with how you care for your patients. “Treat your patients the way you would want your most loved to be treated,” she says. Dodd’s family includes her daughter Mila Dodd, mother Cerisse Harcourt, father Jeff Roberts, sisters Brittany Bass and Anna Harcourt and niece Ava Goetz.
Sannia Robinson Green Sannia Robinson Green of Fort Smith has worked for Bost Inc. with people who have disabilities for 18 years, but her career stretches back more than 50 years to a time when segregation forced her to leave her friends and family in Fort Smith to attend nursing school at the University of Arkansas for Medical Sciences Green in Little Rock. “I passionately wanted to be a nurse,” Green says. “African Americans weren’t accepted into LPN classes between 1961 and 1963 at St. Edward Hospital (currently Mercy Fort Smith) or Sparks (currently Baptist Health).” Green said she was drawn to nursing through a “desire to protect, prevent and help alleviate means of suffering.” She also found it natural to be a health care advocate for people and was attracted to the human side of the nursing profession more than the analytical or clinical research side. The best part of nursing, Green said, was to see a patient she has helped to recuperate and return to their normal
health and better way of life. She said she feels privileged to experience a bond with her patients, and even sometimes the patient’s family members. “It is very rewarding when I hear they are pleased with my service,” Green says. The most challenging part of her job, she adds, is found in “under staffing,” as well as being able to trust her ability to correctly observe, monitor and maintain records of communications with patients, staff, doctors and family. She also said that challenges are found with having the drive to continue even when diagnostic circumstances are not positive for the patient. “It requires an abundance of compassion, commitment and empathy, along with a high level of energy to be a good nurse,” Green said. Her advice to those who are interested in nursing as a career including making sure you “have a desire for care giving.” “Study diligently to learn everything about your profession and continue to study always,” Green says. “Understand that you are becoming a servant to your patient ... Patient care is the most important component of the nursing profession. And please be kind.”
Baptist Health-Fort Smith nurse practitioner honored Oliver named one of state’s ‘40 Nurse Leaders Under 40’
“Each day, I get the chance to work alongside wonderful physicians Times Record State and make a real impact in the lives Nycole Oliver, DNP, APRN, of Bap- of our patients.” tist Health Family Clinic on Dodson Nycole Oliver Avenue in Fort Smith, recently was selected as one of the Arkansas Center for Nursing’s “40 Nurse Leaders been recognized for her leadership and Under 40” for 2019. nursing skills. Oliver has won numerous The recognition is intended to awards from the American Association identify, celebrate and encourage of Nurse Practitioners (AANP) and the exemplary dedication and leadership Emergency Nurses Association. She’s in the nursing profes- had the privilege of traveling the world sion, states a Baptist and speaking to other nurse practitioners Health news release. at international conferences, as well as Applicants were also writing content for nursing education selected for their com- guidebooks, the release continues. mitment to wellness in Oliver earned her doctor of nurstheir communities. ing practice from the University of Oliver “I am truly thank- South Alabama in 2015. She began her ful for this recognition career in health care in the Emergency and the opportunity to be a nurse Department of Baptist Health-Fort practitioner in the western Arkan- Smith in 2001. The Greenwood native sas,” Oliver says. “Each day, I get the is married with one son. chance to work alongside wonderful Oliver will be recognized alongside physicians and make a real impact in other nursing professionals during the lives of our patients.” a ceremony April 30 at the Benton This isn’t the first time Oliver has Event Center in Benton.
Sunday, April 21, 2019
“You have to have a true heart for it, otherwise you will not be happy,”
Rebecca Sisemore Rebecca Sisemore is a California native who grew up in Charleston and now lives in Fort Smith. She works as a nurse with Dr. John Swicegood at Advanced Interventional Pain and Diagnostics. She studied at Westark Community College and the University of Arkansas at Fort Smith. Sisemore has been a nurse for 38 years and says a love of science and helping others was part of what drew her to the field.
Lucille Archie is a native of Fort Smith who has been a nurse for 42 years. She studied through Sparks (now Baptist Health-Fort Smith) and Westark Community College (now the University of Arkansas at Fort Smith). She currently works for Baptist Health-Fort Smith. Archie was drawn to nursing through her
“My grandma wanted to be a nurse and never got the opportunity,” she says is another reason she joined the field. The best part of the job is helping people to improve their situation and seeing the difference she can make, Sisemore says. The most challenging part is when a patient’s health doesn’t improve and there’s a negative outcome. Sisemore encourages future nurses not to
give up. “School can be hard, but success comes to those who persevere,” she says. “Also, be willing to work hard and adapt to change. It’s important to love what you do!” Sisemore’s family includes husband Randell, sons Andrew, Cole and wife LaShey, Connor, Cade and Cooper, daughter Kaitlin and husband Ryan, mother Aleta and Otha Sewell and father Jim and Jenny Gattis.
“Treat your patients the way you would want your most loved to be treated.” Ashley Dodd
“It requires an abundance of compassion, commitment and empathy, along with a high level of energy”
Sannia Robinson Green
“Be willing to work hard and adapt to change. It’s important to love what you do!”
love of helping others and taking care of sick or hurt people. She has two daughters, a granddaughter and a great-grandson who are also nurses. She says the best part of her job is making patients feel better. “Going into their rooms and they would always say my smile made them feel better,”
she says. A challenging part of the job is seeing those patients leave after they get well because of the attachments that are made. Archie encourages anyone who is interested in nursing or the medical field to enroll in school, study hard, and don’t give up.
“My smile made them feel better.” Lucille Archie
:PV$PNF'JSTU Medical Staffing Private Duty and Home Care Nursing Assistant Training Licensed Medicaid Provider
Locally Owned & Operated Since 1990
We can help you for a few hours or 24 hours a day, 7 days a week!
VA and Insurance Accepted
4500 Rogers Avenue Fort Smith, AR 72903
Sunday, April 21, 2019
Letting nurses SHINE Mercy Fort Smith program allows nurses to collaborate on hospital improvements, other opportunities By Mardi Taylor Times Record
Nurses at Mercy-Fort Smith have found that putting their heads together can help create real change and real results. The hospital’s SHINE program (Shaping and Inspiring Nursing Excellence) is in its third year and provides Mercy nurses with an outlet for developing new programs, offering input or collaborating to make changes that help improve workflow at the hospital. Nurses also can find certification and volunteer opportunities through SHINE. The program is voluntary, and those who take part do so during their own free time. But the outcome is worth it. “What SHINE does is empower that bedside nurse to have a voice,” said Nicole Harp, Stroke Program coordinator at Mercy Fort Smith. Historically, processes were made by management and above, Harp said, and those processes were provided to the bedside staff, so nurses weren’t involved in the initial decision-making off the bat. Nurses are the ones who see the issues and can figure out ways to do things better and more efficiently, Harp added. Cross-training SHINE also allows nurses to cross-train in different areas, making them even more valuable members of Mercy’s staff. “If there’s a staffing crisis
A bulletin board at Mercy-Fort Smith was created by a SHINE nurse to offer information and communication for nurses at the Mercy ER. [MARDI TAYLOR/TIMES RECORD]
and we have more patients than we have staff, I can easily transition to that other role to complement the staffing, to be able to give good patient care and keep our patients here at this hospital,” Harp said. Advanced education and increased certification are all included with what SHINE has to offer. Stroke education is one registered nurse program also recognized by SHINE; Mercy Fort Smith has 12 nurses who have that
certification. There are only 40 throughout the state of Arkansas. “That makes you a champion within the department,” Harp said of the extra certifications. “If you have a complicated stroke patient or a complicated trauma patient, you have those nurses who are certified, you have that higher level of understanding to help your team members.” The ER nurses’ certifications are on display in the department.
“All these different certifications any nurse can get benefits their department,” added Brandon Thomas, RN. “The SHINE program really encourages staff members to pursue those where they otherwise wouldn’t or maybe hadn’t thought about it.” Through the SHINE program, Alyson Allred, RN, recently helped spearhead safety changes within the ER. This included changing some elevator access that had been questioned.
“We identified the need to improve the safety and security for our co-workers and our patients within the department, and as a result, (Allred) leads that process of improvement and development, instead of it being management down; it’s the bedside nurse-up type of thing,” Harp said. “You’re improving those processes ... with the support of leadership, versus management making these decisions and developing these processes
Sunday, April 21, 2019
and saying, ‘This is how you’re going to do it.’ It really does empower that nurse.” Community action Allred said other SHINE initiatives include engaging nurses to seek out opportunities within the community, such as volunteering. Many nurses volunteer at the Riverview Hope campus in addition and helping with activities like first aid at marathons, she said. “Not everything they do is geared toward the medical side,” added Thomas. “Getting nurses out into the community is one goal of the SHINE program.” Most of those projects circle back and make patient care better, said ER manager Bobbi Anschutz. “We also develop different programs within our department. Some special training is needed for some specialized duties at the hospital, and nurses are able to complete this training as well as yearly competency,” she said. Nurses are eligible to participate after completing one year on the job. Meetings are held every first Wednesday of the month so nurses can discuss issues and talk about opportunities. Other subcommittees within the SHINE group will meet at different times to focus on their individual projects. “It’s not necessarily for us just to help out the hospital’s patient care, but it provides us in the ER an insight to what goes on upstairs,” Thomas said. “By knowing what goes on after they leave (the ER), it helps me prepare the patient or family for what’s to be expected.” Getting things done Implementation of the suggested changes made through SHINE has been high. Changes are researched and discussed
at length before they are presented to management. “There hasn’t been much that we thought needed to be made better that we haven’t been able to make better,” Harp said. “There’s not a ‘Here’s a ceiling, and you can’t go past this.’” Mercy Fort Smith Chief Nursing Officer Jennifer Thomas was key to getting SHINE off the ground, Harp said. She said Mercy executives have been “100 percent supportive” of the program. “Anything we feel passionately about, we don’t give up,” Allred said. “We just keep finding another avenue to get it to work.” Anschutz encouraged nurses within the ER to participate when SHINE first began. Intially, six ER nurses
“Getting nurses out into the community is one goal of the SHINE program.” Brandon Thomas
joined, but that number has reached at least 28 now, she said. “When the SHINE program was first presented, I thought, ‘I don’t have time for that,’” Allred said. “‘It’s too much, I don’t want to mess with that.’ But (Anschutz) encouraged all of us to do it, and looking through the steps we have to go through ... it’s actually been enjoyable. I enjoy the research, and following up and seeing the changes that come in the department, and seeing younger nurses grow their skills, the way they develop things ... it’s been
Nurses’ certiﬁcation plaques hang in the ER Department at Mercy Fort Smith. [MARDI TAYLOR/TIMES RECORD]
Sunday, April 21, 2019
enjoyable.” Worth the effort There’s an educational aspect to the programs as well, with communications boards hung at Mercy that offer information for nurses to learn new things. The “quick education” boards are created by SHINE nurses and are a good way to get communication out to all nurses, Anschutz said. Because the program calls for extra involvement outside normal shift hours, time management is key, Thomas said. “Once you sign up, you sign up knowing that this is going to take a little bit of your extra time,” Harp said. But in the long run, the improvements that you make over all with your job and the processes are worth it, she explained. “We can all sit around and complain about a process,
or we can present potential solutions,” Harp said. “Then we can seek out those solutions. Usually that’s what leads the nurses to participate: They have a frustration, and they see you can make change through the SHINE program, so they want to participate to see those changes happen.” Anschutz said before SHINE began, there may not have been a lot of faith in the fact that management cares what the frontline has to say. “They’re the ones who do the work, they’re the ones who are going to help us make this be the best place for patients, and so as more have taken an interest ... it really brought that following along,” she said. “My sincerest hope is that we keep growing and everybody keeps gaining faith that we’re listening to them, and we want their work lives to be as successful as possible.”
Mercy-Fort Smith ER nurses Alyson Allred, left, and Brandon Thomas, center, participate in Mercy’s SHINE program with Stroke Program Coordinator Nicole Harp, right. [MARDI TAYLOR/TIMES RECORD]
Van Buren School District Health Services Team
Ashley Fleming, Sherri Marvin, Brooke Parks, Rachel Bond, Amanda Reese, Lisa Elkins, Tara Dorrough, Amber Anderson
Thank you to our dedicated team of school nurses for helping ensure the health and safety of our students!
Sunday, April 21, 2019
RETENTION What nurses want employers to know By Melissa Erickson More Content Now
“New graduates need a nurse residency program for their first year to support their development of their professional practice. They need ongoing mentoring and support with a defined career path. Clinical advancement programs that provide promotional opportunities are also important.” Kimberly Glassman, NYU
ealth care job growth continues, but nursing school enrollment has leveled off as a wave of retirements breaks, according to the National Health Care Retention and RN Staffing Report. Demand outpaces supply, and retention of nurses is a serious issue. More than half of America’s 3 million nurses are expected to retire by 2022, according to the Bureau of Labor Statistics, which also estimates that more than 1 million new nurses will be required to meet health care needs. Solving the labor problem will require a long-term strategy, said Kimberly Glassman, senior vice president of patient care services and chief nursing officer at NYU Langone Health and associate dean for partnership innovation at NYU Rory Meyers College of Nursing. “New graduates need a nurse residency program for their first year to support their development of their professional practice,” she said. “They need ongoing mentoring and support with a defined career path. Clinical advancement programs that provide promotional opportunities are also important.” Financial pressures Hospital turnover is on the rise, and
financial pressure is a leading reason for patient and employee dissatisfaction, according to the retention report. Executives and leadership need to recognize that the bottom line may be important but it can’t be the No. 1 reason behind how nurses do their jobs, said Catherine Schmitt, assistant professor in the College of Nursing at University of Wisconsin Oshkosh. “I would like leadership to see nurses and patient care as patient-focused and not business-focused,” she said. “Our focus is taking care of patients with an eye on the bottom line, but the bottom line shouldn’t be No. 1 in our minds.” As skilled and valuable members of the health care team, nurses are paid pretty well, yet that often leaves them vulnerable when leadership looks at where costs can be cut, Schmitt said. Other factors Nurse-to-patient ratios and shift lengths can also play into employee satisfaction, Schmitt said. “Many nurses are women often with families and young children. The model of a 12-hour shift from 3 p.m. to 3 a.m. or 5 a.m. to 5 p.m. just doesn’t work. Try finding child care for those hours,” Schmitt said. Instead, literature supports eighthour shifts, Schmitt said. Work longer than that, add in commute time,
and fatigue and sleep deprivation set in. The result can be similar to the functional equivalent of an increased blood alcohol content, Schmitt said. Insufficient nurse staffing can also lead to job dissatisfaction, Schmitt said. California was the first state to mandate minimum nurse-topatient ratios in acute care hospitals, and 14 others have addressed staffing in hospitals with laws or regulations, according to Nursing World. “It all sounds well and good, but it cuts both ways. If there’s a big turnover or people are out sick, then overtime will have to be mandated,” Schmitt said. Money not the only benefit To keep nurses on the job, “money is always important,” Schmitt said. Sign-on and retention bonuses may help get someone through the door and on board, but unless a nurse feels valued and supported, he or she will not necessarily stay, she said. “Things like salary and benefits alone don’t work. The practice environment where nurses can be autonomous professionals and provide the care they determine patients need is essential,” Glassman said. A shared governance model that gives nurses a voice is essential for job retention, Schmitt said. Things need to operate “not so much top-down but a blend of bottom up,” Schmitt said.
Sunday, April 21, 2019
How to address
By Melissa Erickson More Content Now
T “It is essential for the human brain to have breaks in performance. How many shifts are you working in a row? During your shift, are you taking your scheduled break time? When was your last ‘vacation’ or time off the unit?” Vicki S. Good
here’s a misconception that burnout, which is widespread in nursing, is an individual’s responsibility. Many experts say that when demands grow too large, changes must be made at both the personal and organizational levels. “Burnout occurs along a continuum. There’s a very strong element of emotional exhaustion, lack of personal accomplishment, lack of meaning that occurs over time. You don’t just wake up one day feeling it. It’s an insidious process,” said Cynda Rushton, professor of clinical ethics at Johns Hopkins School of Nursing. At the most severe is burnout syndrome. “Burnout syndrome consists of three primary components: exhaustion — both emotion and physical — depersonalization and reduced feeling of accomplishment,” said Vicki S. Good, chief quality officer at Mercy health system in Springfield, Missouri, and a past president of the American Association of Critical-Care Nurses. Severe burnout is identified when clinicians experience all three components. About 30 percent of clinicians are experiencing severe burnout syndrome and up to 60 percent of clinicians are experiencing mild to moderate burnout syndrome, with one to two symptoms, Good said. Burnout occurs because of a whole range
of factors, from an individual’s coping style to unrelenting stress in the workplace and outside of it, Good said. Moral distress can also play a part if a clinician’s sense of intergity is compromised, Rushton said. Sometimes there is a restraint against what a clinician knows she ought to be doing (for example, spending more time with a patient) and so she can’t be the nurse she wants to be, Rushton said. It’s not a matter of simply becoming more resilient, although building up personal resilience is beneficial. “CliniRushton cians must be able to meet the challenges without so much cost to ourselves,” Rushton said. When a clinician is headed toward burnout, the first steps are prevention and awareness so that interventions can be taken, Good said. Seek resources Many facilities have programs for employees primarily focused on the physical health of their co-workers, such as mindfulness and exercise programs. “While these programs have clear benefits for physical health, there is a clear impact to the emotional health of the nurse as well. Seek out opportunities to seek guidance from
Employee Assistance Programs, peer mentors or other networking/support groups,” Good said. Get your rest “It is essential for the human brain to have breaks in performance. How many shifts are you working in a row? During your shift, are you taking your scheduled break time? When was your last ‘vacation’ or time off the unit?” Good said. Develop resiliency “Resilience skills are different for every indiGood vidual. Some nurses will respond well to mindfulness activities such as meditation, others prefer physical exercise and others prefer to engage in outside hobbies,” Good said. “It is important to identify how you best respond and bounce back from stressful situations and know that it is critically important to build in recovery and resilience time.” Beating burnout is not on the backs of clinicians alone. “Individual responsibility is important, but organizations also have to commit to removing the barriers that make burnout happen,” Rushton said. “Burnout is not a failing. The demands have exceeded capacity.”
Sunday, April 21, 2019
Nursing numbers to know By Melissa Erickson More Content Now
n the list of most in-demand jobs for 2019 from jobs site CareerCast, registered nurse ranked third, behind application software engineer and medical service manager. Right now is a great time to be or to become a nurse. Look at these statistics: 1.6 million With an aging population and exciting advances in medical care, the country is in great need of more health care professionals. Georgetown University’s Center on Education and the Workforce projects that the economy will create 1.6 million openings for nurses through 2020.
200,000 The nursing workforce is facing a projected shortfall of about 200,000 by 2020, according to the Center on Education and the Workforce. Of the job openings, 700,000 will be newly created opportunities, and 880,000 will result from retirements. $68,450 The median wage for registered nurses is $68,450, according to the Bureau of Labor Statistics. Earning potential rises with specialization and experience and varies by location and other factors. For example, the median wage of a nurse practitioner is $107,460.
15 percent Rising faster than the average, registered nurse employment is expected to grow at 15 percent through 2026, according to the Bureau of Labor Statistics. Nurse practitioner employment is expected to grow by 31 percent. 61 percent While hospitals employ the largest number of registered nurses, 61 percent, other opportunities for employment include nursing and residental care facilities (7 percent) and doctors’ offices (7 percent). Top 5 Physician assistant was ranked No. 3 on U.S. News & World Report’s list of Best Jobs of 2019. Nurse
anesthetist tied for fifth place with orthodontist. No. 1 For the 17th consecutive year, Americans named
nursing as the most trusted profession, according to Gallup Poll. More than 4 out of 5 people rated the honesty and ethical standards of nurses as high or very high.
THANK YOU to our School Nurses! Diane Parker, RN — Alma Primary School — 37 years Lisa Timmerman, LPN — Alma Intermediate School — 16 years Michelle Holland, RN — Alma Middle School — 5 years Jennifer Brown, LPN — Alma High School — 5 years
Alma School District appreciates our School Nurses for their expertise and service to our students, schools and community!
Diane Parker, Lisa Timmerman, Michelle Holland, Jennifer Brown
Alma School District
Sunday, April 21, 2019
Tips for communicating with elderly patients By Melissa Erickson More Content Now
earning how to communicate effectively with aging health care consumers is a fundamental skill for the nurses who treat them. Laura Reyher, instructor of nursing at West Texas A&M University, has dedicated almost her entire career to providing care to and teaching others how best to care for geriatric patients. “Nurses can make a big difference in their geriatric patients’ lives with the right communication skills,” she said. “We can help prevent complications, reduce the likelihood of being readmitted, promote recovery, improve their ability to care for themselves and help keep them independent as long as possible.” Reyher One of the challenges is that geriatric patients may be experiencing a variety of issues, including pain, chronic illness, disability, sleeplessness or fear of becoming dependent, Reyher said. Don’t assume these issues will make them unable to comprehend what a nurse is saying. If they don’t have cognitive problems, “geriatric patients can always learn new information, but they usually need a little extra time to process everything,” Reyher said. Recognize that an older patient might have sensory challenges. If he’s lying in bed, he may have taken off his
glasses or hearing aids, Reyher said. Make sure patients are in a good state to listen to your directions. Check to see if they got enough sleep the night before. If a patient was up most of the night, she may need a nap before you talk with her, Reyher said. “Speak slowly; do not shout,” Reyher said. Many women have higher-pitched voices, which can be more difficult to hear. Use a lower tone of voice and add extra breath-force in the voice when speaking, Reyher said. Remember that medications can cause drowsiness, foggy thinking and confusion, and that anesthesia can have prolonged effects on a patient’s thinking abilities, Reyher said. A few more of Reyher’s tips to communicate effectively with geriatric patients: • Ask if they would like to go to the restroom before your talk. • Be sure there is good lighting in the room with light on the speaker’s face. Don’t sit with your back to the window. Turn down the television or close the door to limit background noise. • Always sit down at eye level where they can easily see you. • Use plain language with no abbreviations or acronyms. • Provide all handouts with large print and include only necessary information written at about a fifth-grade level. Make sure there is plenty of white space with bullet-point information in order of importance. “Health care information
can be like a foreign language regardless of their educational level,” Reyher said. • Tell them to ask their pharmacist to put large print on medicine bottles. “Medication errors are the leading cause of emergency room visits for geriatric patients,” Reyher said. • Use the “show me, tell me” technique after sharing important information to help with understanding and to spot gaps in knowledge. For example, after demonstrating how to change a wound dressing, ask the patient to show you how to do it. • Watch for signs of anxiety, depression and/or hopelessness. • Take your time. The tone of your voice and the look on your face and in your eyes can demonstrate to a patient that you care about him. • Always ask patients whether they have family nearby and if they would like their family to be present when you share information. They can be the extra set of eyes and ears to help absorb the information. “As a nurse, it’s helpful to recall a senior adult in your life who was special to you and think about how you would want them treated,” Reyher said. Ask a few questions about their lives, such as where they grew up, what they did for a living or if they have grandchildren. “Never forget the power of touch. Geriatric patients often feel untouchable and that no one cares for them. The nurse’s gentle touch on their hand or shoulder can tell a patient that they really care about them,” Reyher said. “Lastly, give hope. Be encouraging and positive. Put a smile in your voice.”
Sunday, April 21, 2019
Face-to-face with the
By Melissa Erickson More Content Now
urses are always on the front lines of a crisis, including the nation’s opioid crisis. In their capacity as advocates for responsible prescribing of opioids and treatment of addiction, nurses are battling a public health problem that takes 115 lives a day, according to the National Institutes of Health. Affecting people across all walks of life, the opioid epidemic peaked around 2012 and is now experiencing a positive downturn, said Patricia Eldershaw, assistant professor in the School of Nursing at Bangor, Maine’s Husson University, where she teaches a Eldershaw unique course that focuses on addiction and population health from a “social determinants of global health” approach, or the conditions in which people are born, grow, live, work and age and how that’s shaped by the distribution of money, power and resources. The course is part of Husson’s required curriculum for its graduate and post-master’s nursing programs. Turner A comprehensive understanding of the complexities of the addiction crisis will allow health professionals to be better prepared to work with and alleviate the suffering that comes with opioid addiction, Eldershaw said. “Nursing is synonymous to patient advocacy; as a nurse, it is our responsibility to advocate for the patient in each and every aspect of their care,” said registered nurse Velondria Bursey, director of nursing at Greenhouse Treatment Center in Grand Prairie, Texas. “We are their educators, interpreters, the bridge between doctor and patient and anything else we must be to provide quality care and lead them to the road to recovery.” New expectations One of the biggest issues nurses who work with opioid-addicted patients face is dismantling stereotypes of substance abuse.
“We’re also changing what it means to care for patients with an opioid addiction while also managing chronic pain issues,” Bursey said. Courses like the one at Husson are pushing a new understanding of addiction and treatment, said Kelly Turner, assistant professor and graduate coordinator in the School of Nursing at Husson. “I wish I had this education as a new provider,” Turner said. Not all pain is manageable, and America has found itself in a precarious predicament where it seems pain-free is a necessary outcome. To achieve this required higher and higher doses of opioids, a sole focus on prescriptions and the insistence that medication is the only option, Eldershaw said. “This undermines pain management philosophy,” she said. “Now, there is a stigma attached to opioid use, but for many years patients have been prescribed opioids in high doses and have been told it’s safe. It’s medicine,” Turner said. “Now we think about it differently. There’s been a shift in the message, and some people feel almost betrayed. It can be a high-stress conversation” when talking to patients who have become addicted to medications prescribed by health professionals. “On a daily basis, we see patients and families affected by this epidemic grasping at any glimmer of hope that their loved one will one day overcome this disease that has taken over our country,” Bursey said. Striking a balance Nurses need to have compassion as well as firm boundaries. “Those will help get your patients through some of the most difficult days of their treatment,” Bursey said. “Compassion and empathy are what allow you to reassure your patient that it will get better and the horrible feeling they have right now will not last forever.” The best nurses meet the patients where they are. “Whether they are in active addiction or just beginning their life in recovery, addiction is a disease that must be managed one day at a time,” Bursey said.
Sunday, April 21, 2019
BABY BOOM 15 labor and delivery, NICU staffers pregnant at one hospital By Beth Whitehouse Newsday
MINEOLA, N.Y. — It seems pregnancy is contagious among the mother-andnewborn-care staff at NYU Winthrop Hospital in Mineola, New York — 15 women in the labor and delivery unit and the adjacent neonatal intensive care unit are due to give birth between now and October. “We should make an announcement: ‘Anybody else? Come forward now,’” joked Katelyn O’Connor, 31, a physician assistant from Stamford, Conn., who is due to have a boy June 6. “Everyone says, ‘Don’t drink the water here,” said Kimberly Fan, 29, of Merrick, New York, a nurse due to have a boy Aug. 6.
In the neonatal intensive care unit for premature or sick babies, eight nurses and a physician assistant are pregnant, and all the women except one are expecting their first child. In the labor and delivery unit, six staff members are pregnant on the heels of seven other colleagues who have given birth since the fall. C.J. Catalano, nurse manager of labor and delivery, has been in her position for 18 years, and she said she’s never seen a baby boom like this one. “That is unusual. I can’t explain it,” agreed Dr. Nazeeh Hanna, chief of the neonatology department, also known as the NICU. A similar story about nine staff members pregnant at the same time in a labor and delivery unit at a hospital in Maine went viral recently on the
internet, and O’Connor said at least three people sent it to her because she works with babies. “I say, ‘Come down to the NICU. We’re living that right now,’” she said. “I think the funniest reaction is from our co-workers who don’t want to get pregnant. They say, ‘Stay away, don’t come near me.’” LaShon Pitter, nurse manager for the neonatal intensive care unit, which uses about 120 nurses to care for up to 27 babies around the clock, said she’s not shocked that the baby boom happened because seven of the nine pregnant women in the NICU got married in the past two years. “We didn’t make a pact,” joked NICU nurse Monica Lecrichia, 27, of Seaford, who is due Sept. 25. Sara Chewens, 33, of Glendale, Queens, was the
seventh NICU employee to come forward with her pregnancy — she’s due Aug. 23. “I took a long time to tell everyone, because I was in denial,” she said. She said she couldn’t believe she was expecting, too. She was trying, though, she admitted. Seeing everyone else pregnant gave her baby fever. Katherine Kent, 35, of Massapequa Park, is a labor and delivery scrub nurse who helps with C-section deliveries and is due with her second child on June 23. “It’s been amazing. It’s the best unit to be pregnant in. We deal with pregnant women every day,” Kent said. Working in the NICU can be sobering because the nurses see what can go wrong. “This job lets you know more than you should, the possibility of
the sad stuff,” Chewens said. But she focuses on the excitement and joy, she said. The NICU nurses often turn to Amy Florio, 39, of Franklin Square for advice — she’s the only one of their group expecting a second baby, a girl due May 3. Her daughter Hailey is 2. She’s a live version of “What to Expect When You’re Expecting” for her coworkers — she’s been asked everything from which stroller to buy to details about banking babies’ cord blood, which she did with her first, she said. Heather Beebe, 28, of Floral Park, New York, was the first NICU nurse to get pregnant — she was due April 17. “I knew it was possible there would be others following me,” she said. “It’s definitely a cool experience sharing it with them.”
Sunday, April 21, 2019
Telemonitoring can reduce appointments for low-risk pregnancies Michelle Andrews Kaiser Health News
When Allison Matthews was pregnant with her first child four years ago, her obstetrics clinic scheduled frequent appointments to make sure everything was proceeding normally. “I was taking time off work and it wasn’t doing a lot for me,” said Matthews, who was considered at low risk for complications like pregnancy-related high blood pressure, also known as preeclampsia. “I kind of felt like I was almost doing it more for the clinic’s benefit than for myself.” When she got pregnant again early last summer, the obstetrics practice at the Mayo Clinic in Rochester, Minnesota, gave her the option of coming in for just eight clinic visits rather than the usual 12 to 14. Matthews is a clinical services designer at the Mayo Clinic. As part of its OB Nest program for low-risk expectant mothers, she would monitor her weight and track her blood pressure and fetal heart rate at home with equipment provided by the clinic. If she had abnormal results or any questions or concerns, she could contact her nurse online or by phone. If she wished, she could join a social media group of other OB Nest patients monitored by clinic nurses. Matthews loved the idea. The approach fit with her wish to treat pregnancy as a normal, healthy process rather than a medical illness that required frequent clinical
interventions. Doing the tests at home also made monitoring the baby’s progress a family event with her husband, Marc, and 4-year-old son, Gus, who could listen to his sister’s heartbeat. “It was something we explored together rather than having it done for us,” said Matthews, 35. Their daughter, Lottie, was born about a month ago. Technology increasingly allows clinicians and patients to connect online, via video or remote monitoring rather than face-to-face. But most obstetrics practices continue to follow the traditional model that includes at least a dozen in-person office visits over the course of an average 40-week pregnancy, with lab work and ultrasounds at intervals along the way. According to the American College of Obstetricians and Gynecologists, the standard pregnancy visit schedule is once every four weeks up to 28 weeks, every two weeks until 36 weeks, and weekly after that. Although prenatal care is important for healthy outcomes, how much low-risk pregnancies need is debatable, health researchers say. A study published in the Journal of Perinatology in 2016 found that babies born to women with uncomplicated pregnancies who had more than 10 prenatal visits were no healthier than those born to women with fewer, based on outcomes such as admission to the neonatal intensive care unit, low scores on the Apgar test that
evaluates a newborn’s wellbeing, and death. Women with more than 10 prenatal visits, were, however, more likely to be induced or have a cesarean section delivery, the study found. Patients at the Mayo obstetrics clinic in Rochester, many of whom, like Matthews, are employees of the medical center, can still go the traditional route. They can also opt for OB Nest or have joint appointments with other pregnant women in a group. “Our goal is that OB Nest care becomes the model for low-risk women,” said Dr. Yvonne Butler Tobah, a Mayo obstetrician and health sciences researcher. Most pregnancies are low-risk, and if more patients choose OB Nest, which was added as a standard option for patients in 2016, it frees up time for doctors and midwives to focus on patients with high-risk pregnancies, she said. But fewer visits may not translate into out-of-pocket savings on health care costs for women, since professional service fees for pregnancy, labor and delivery and postpartum care are typically bundled if the woman uses the same physician or physician group, said Katy Kozhimannil, an associate professor of public health at the University of Minnesota who studies women’s health care policy. Women find savings in other ways, said Butler Tobah. Many patients say the convenience helps save time and money, Butler Tobah said. “If it was their second or third child, patients (with an appointment at the clinic
have) to pay for parking, get child care and wait in the doctor’s office, only to be told after a 15-minute visit that their pregnancy was fine.” The potential of programs like OB Nest to make care more convenient and easily accessible to women who don’t live in urban areas is very appealing, said Kozhimannil. Although Mayo offers the program only in Rochester, it is moving ahead with plans to offer OB Nest to patients outside the Rochester area, said Butler Tobah. Other obstetrics practices are experimenting with remote-monitoring programs for low-risk expectant mothers, said Dr. Nathaniel DeNicola, co-chair of the telehealth task force for the American Congress of Obstetricians and Gynecologists.
At the George Washington University Medical Faculty Associates in the District of Columbia, where he works, they’re one of several practices nationally using an app called Babyscripts to educate expectant moms, who can also transmit their weight and blood pressure data to the practice via a Wi-Fi connection. Some expectant mothers who use the app have fewer clinical appointments compared with the standard, he said. A crucial element of these emerging remote-monitoring programs is that they’re closely integrated with the work of clinical staff, DeNicola said. “All the remote monitoring is a way of augmenting traditional care, not replacing it,” DeNicola said.
Sunday, April 21, 2019