Thursday, June 26, 2014

GRMC's Dream Team

"We closely watch over our patients at night as they rest and heal. We make sure patients are safe, control their pain, offer snacks, and listen when they can't sleep," says Claire Shefchik, RN, who has been a night nurse at GRMC for 12 years.

The night shift at GRMC involves 20 to 30 people each night, depending on patient census, 365 days a year. These dedicated individuals watch over patients, assist emergency department patients, complete laboratory tests, and clean the facility with a family-like commitment.

"We are a close-knit family working at night," says Laura Cellucci, an RN in GRMC's intensive care unit who has worked nights for more than 15 years.

The night staff members who care for inpatients explain they prefer the night shift because it fits their personal lifestyle.

"Some of us are night owls," says Merna Nelson, RN, who has worked for 18 years at GRMC.

Many of her night shift peers agree.

"It's natural for me. It fits my circadian rhythm of life. Some people just prefer to be up at night," says Traci Smith, who has worked for 16 years in the emergency department.

Teamwork rules the night

During the night shift, the medical surgical unit secretary may need to go to the ER to support an influx of patients. Nurses may shift from ICU to the med surg unit depending on patient needs.

Amy Murty, RN, a 16-year veteran of the night shift says, "It can be rather wild. With fewer staff working - no internal medicine, no anesthesia, and no surgeon in house - we can experience more intense nights. When we do experience the codes and traumas at night we need everyone to help. It's all hands on deck."

Michelle Van Gorp has been a night radiology tech for nine years. Her philosophy for success is to see what needs to be done and do it.

"When I work day shift, I feel like I'm working in the radiology hallway and only radiology. But when I work the night shift, I feel like I work for GRMC," she says. 

The environmental services and security departments work during the evening and into the night to keep the facility clean, maintained, and safe.

A crew of nine environmental services members takes on the never-ending job of cleaning surgical suites, procedure rooms, floors, bathrooms, handrails, doors, window, and waiting areas. Dan Perkins, a night staff floor tech, has been part of the team for more than 21 years. Though known as GRMC's resident baseball and sports expert who has hundreds of autographed baseball cards from the pros, Perkins explained that his primary duty is cleaning floors and that's done in the evenings and nights when GRMC has fewer people in the building. He enjoys the shift and the people. 

"I've worked in many places during the night shift, and this is the best group of people to work with. We have a really great team."

The night is watching

Night staff becomes the eyes and ears for physicians. In quiet moments, they talk to patients and hear about their concerns. 

Staff echo a common sentiment that the nights are quieter in general. Patients are not going in and out for testing, doctors or specialists are not assessing patients, and non-clinical staff and visitors are not coming into the area. In general, the night has fewer interruptions.

"We fell we can spend more one-on-one time with our patients because they have fewer interruptions. Patients may not be able to sleep well so we spend time talking to them, getting to know them and their families," Amy Murty says.

Patients can be restless at night in a different environment. Sundowners, a term for early dementia patients who experience radical personality changes in the evening, need extra attention.

"For these patients, a nurse will sit in the room and talk with the patient. This helps calm them and keep them safe," says Michelle Murty, med surg tech for ten years.

Diane Brennan, unit secretary, loves the patient interaction. "We've had a few patients sit at the nurses' station and fold towels - something to keep their hands busy. We talk to them and they share their life with us. It's a special bond we build with our patients." 

In the ER department, no two nights are the same and they are never quiet. Smith, who is also a paramedic with East Poweshiek Ambulance, shares a passion for helping residents.

"I enjoy helping people on possibly one of the worst days of their life, either with the ambulance crew or the emergency department. That's what drives me to do this job for more than 20 years," she says.

In the heat of the night

Working the night shift means being awake when other people are fast asleep and trying to sleep when most of the world is active. People sometimes suggest that the night staff doesn't have to do anything because patients are sleeping. This is far from the truth.

In the OB department, the best practices encourage moms to keep the babies in their rooms, especially during the day As a result, the night shift is often busy providing care for the baby while new moms get some sleep.

"We will conduct preventive screenings such as congenital heart disease, hearing testing, immunizations, and noninvasive tests. We even take baby pictures during the night shift. We're busy with the babies as well helping the mothers relax and rest."

In the ICU, nurses need to be autonomous and be able to respond to situations quickly with confidence. 

"It's not that day shift doesn't do the same thing, it's that at night we don't have an internal medicine physician on campus. We try to avoid calling and waking a physician unless we really feel it's necessary for the patient," Cellucci says.

Night staff always have physician support on campus. A physician is always in the emergency department 24/7. If a patient experiences a dramatic condition change during the night, the ER doctor and team can assist.

The night staff is a mix of new employees and long-tenure employees. There's a misconception that the new people "get stuck" with the night shift. In reality, GRMC has a solid core of nurses and techs who choose the night shift.

"We have lots of experience working the night crew," Nelson says. 

Thursday, June 19, 2014

Want to Learn Infant Massage?

One of the most essential components in the life of a newborn is the establishment of the parent/child bond. This is a child’s first and primary relationship that sets the example for relationships to come. Like many relationships, it develops in ways that are unique to the parents and the baby.

"Being touched and caressed, being massaged,
is food for the infant. Food as necessary as minerals,
vitamins, and proteins."  - Dr. Frederick Laboyer
Infant massage is an excellent way to strengthen that bond. Time spent during massage is focused, quality time between a parent and their baby. Benefits go both ways. Parents who routinely massage their infants say that it decreases their stress levels and helps them to learn more about their newborn.

Additionally, benefits for baby include:
·       Improved quality of sleep
·       A strengthened immune system
·       Helping digestion and constipation
·       Helping to prevent and relieve colic
·       Encouraging baby’s coordination and flexibility
·       Relief and comfort from teething
·       Fostering a sense of calmness for both parent and baby

Our Licensed Massage Therapists also work in the GRMC Kintzinger Women’s Health Center and provide massage to mothers and newborns in those very early days of life.

Want to learn infant massage?

GRMC offers infant massage classes on the first Wednesday of every month on the second floor of Postels Community Health Park. Thanks to a grant from Massage Therapy Foundation, these classes are free to all. The class begins at 1 p.m. and is open to parents, grandparents, caregivers, anyone who would like to learn how to massage an infant. Plan to spend about an hour at the class. These classes are led by GRMC’s Licensed Massage Therapists.

Even though there is no charge, they would like to know you are coming. Please call 641-236-2953 or email postels@grmc.us.

You may choose to bring your child or not. If you do not bring your child, please bring a large stuffed animal or baby doll to practice on. Bring along a blanket or towel. We will provide oil for massage.

We often see the parents’ self-esteem increase by reinforcing and enhancing their skills as parents, and validating their role. It gives parents quiet time for one-on-one play with their infant. Through simple instruction, this can be a wonderful part of your daily routine together.

On the web:

Thursday, June 12, 2014

How to manage your risk of getting shingles

Before we began vaccinating children against chickenpox (varicella) kids routinely got this childhood disease and were rather miserable for the week to ten days we lived with it. And then we thought we were all done with chickenpox.

Not so. Anyone who has had chickenpox has a one-in-three chance of getting shingles, also known as
herpes zoster. By the way, even though it has the word ‘herpes’ in the name, it is not the same virus as genital herpes at all.

Children and young adults can get shingles, but it is most prevalent in people age 60 and older. Odds are that people who are 80 and older have a 50 percent chance of getting shingles.

If you thought having the chickenpox was no fun, shingles is most certainly something to avoid. This painful skin rash can take weeks to run its course. Shingles usually appears on one side of the face or body and lasts two to four weeks. Its main symptom is pain, which can be severe. Other symptoms can include fever, headache, chills, and upset stomach. With rare infections, the shingles can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis), and death.

The good news is that there is a shingles vaccine available to people 50 and older to lower the risk of getting shingles or help to lessen the pain for those who do end up developing this disease.  The vaccine is called Zostravax and it can reduce the risk of getting shingles by 50 percent.

Some individuals should not receive the vaccine if they have a weakened immune system, pregnant, or have experienced a life-threatening reaction to gelatin or the antibiotic neomycin. Contact your primary care provider to see if getting the shingles vaccine is a good option for you.

Grinnell Regional Public Health is now offering the shingles vaccination. Call 641-236-2385 to schedule an appointment.

For more information on shingles:



Wednesday, June 4, 2014

Man up and Get a Physical

Getting an annual physical is something women are used to doing, for themselves or for their kids. Whether it is scheduling a well-child visit or their own annual physical, most women see it as a regular part of their healthcare routine.
 
On the other hand, men don’t always see a reason to get an annual physical other than to have a checkup to
see how things are going. But for many of the same reasons why women get one, men need to get one too. It’s about prevention and screening for various health risks such as hypertension or high blood pressure, cholesterol, glucose, and specifically for men, prostate health. Many health conditions can be prevented or detected early during a regular checkup.

As we age, annual physicals for men and women become even more important. Some of the screenings don’t enter the health picture until we turn a certain age or if we have a family history. Colonoscopies are just one example.

It’s also important to have annual checkups with the same healthcare provider so that they can get a long view of your health over several years. Think of it as setting a baseline. Each checkup and test result can be compared or contrasted to previous years’ results. And, if something is detected, you have an established relationship with a healthcare provider. These days, we call that ‘having a medical home.’ For some of us, we’ve had a physician or clinic we’ve visited and relied on for years. Others are just now gaining health insurance coverage and are developing a relationship with a medical home.

If you are a man, put “get an annual physical” on your list of things to do. If doing this for yourself doesn’t motivate you, think of those people in your life who rely on you – family, friends, co-workers – who need you to be healthy and well as best as you can be. Do it for them. The women in your life make it a point to do this on an annual basis and it is rarely on anyone’s list of fun things to do. But the women in your life do it because they recognize how important it is for themselves and to the people who love and rely on them, too.

If you are a woman, please encourage the men in your life to get an annual physical. Did you know that women make up to 80 percent of the healthcare decisions for their families? Women schedule doctor’s appointments for their family members and take them to the appointment. Women have a great deal of influence over these decisions for their family. If you have a man in your life who needs to have a checkup, offer any assistance you can to make it happen.


Who’s ready to man up and make an appointment for an annual physical?