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When thinking about taking care of your total health, what comes to mind? Perhaps participating in your annual check-ups, taking your prescribed medication, eating a nutritious diet, checking in with your mental health, the list goes on and on.   Now, put yourselves in the shoes of someone who may not know where their next meal may come from, someone who may be homebound and not have access to transportation, someone who may be on a fixed income, someone facing homelessness or even someone who may be struggling with substance abuse issues. Getting healthy – and staying healthy – comes with a unique set of obstacles, or social determinants of health, for these patients to overcome. Inequities around social determinants and health behaviors have an outsized impact on patient outcomes, and social and economic factors make up 40 percent of those inequities.  This is where the caring and compassionate community health workers, social workers and registered nurses that make up Renown’s Community Care Management (CCM) department rise to the occasion. As the need for resources grows in northern Nevada, these dedicated team members fill those gaps and ensure every patient feels prepared, educated and equipped with everything they need to continue their care journey and live a healthy, fulfilling life.  Defying Disparities  When our community at risk faces healthcare disparities, it can create complications in each patient’s life that may keep them from addressing their healthcare needs and affect the likelihood of them being admitted or readmitted to the hospital or continuing to struggle with their care management – but not on CCM’s watch. Whenever possible, the CCM team steps in to provide critical resources, education and care journey guidance for any patient that finds themselves in need.  “In the simplest terms, we do outpatient case management with vulnerable populations,” said Barb Mader-Scherrer, Director of Community Care Management. “It may be anyone from elderly people who need help managing chronic diseases, to patients experiencing homelessness who are being discharged from the hospital. We work with folks who are facing all sorts of challenges.”  Several roles make up the CCM department, including Community Health Workers. These team members are the resource experts, on the front lines of helping educate patients and supporting them as they navigate through the facets of their care. Their main goals? Avoid admissions and readmissions to the hospital and continue to meet their unique goals.  “I have the pleasure of working with patients who may need financial help, transportation help or even help utilizing the food pantries in our community," added Steve Arm, Community Health Worker. “We help patients navigate healthcare and social services, address social determinants of health, encourage self-efficiency and provide general health education for many chronic conditions. We also provide home visits for our patients who need extra support.”  “The day in the life of a Transitional Community Health Worker is to outreach to the patient while being admitted, do a bedside assessment, complete the social determinants of health evaluation and provide any resources needed to avoid readmission,” added Sherrie Skaggs, Community Health Worker. “Our main population is Medicaid, and many are homeless and financially challenged. As needed, we continue to ensure that follow-up is completed, and all needs and goals are met.”  For those learning to cope with their condition and needing hands-on help especially after discharge, the CCM Social Work Care Coordinators take on this complex aspect of the healthcare journey. These individuals provide support and intervention for Renown patients facing a chronic, behavioral health or substance dependency condition to improve their overall quality of life beyond hospital walls, developing a strong framework to build a long-term healthcare plan.   “As social work care coordinators, we help connect patients with mental health resources, welfare programs, community support, caregiver burnout resources, placement for loved ones with terminal illnesses and much more,” said Irina Osmolovska, Social Work Care Coordinator. “Requests that come to us run the gamut of homelessness, family crisis, food insecurity and even situations where a patient has no electricity for their life-saving medical equipment. We receive challenging requests and are always ready to go above and beyond to advocate for our patients.”  Possessing a profound understanding of the delicate balance between medicine and the patient spirit, the CCM RNs help bridge the gaps between the hospital or primary care practice and post-discharge settings, ensuring a smooth transition for patients as they move from one healthcare setting to another. With their expertise in care coordination and patient education, these RNs help enhance patient outcomes and promote continuity of care.  “Our group is responsible for making discharge follow-up calls to patients who have Medicare, as well as scheduling their hospital follow-up visit if needed,” said Vanessa Alford, Consulting RN. “The goal is to have every patient see their primary care physician within 14 days of discharge for continuity of care and to prevent readmissions. We also screen patients for eligibility for Chronic Care Management or Personal Care Management. In addition to setting up the patient for follow up, I review each patient's medications, answer any questions they may have about their medications and health conditions.”  As another important part of unpacking the intricate web of social determinants impacting health, CCM RN Care Coordinators have the extraordinary opportunity to extend this department’s compassionate care beyond the boundaries of the traditional in-office environment. Whether it be through virtual connections, heartfelt conversations over the phone or in-person encounters outside the hospital, RN Care Coordinators create holistic and enduring plans of care for individuals facing chronic challenges – including behavioral health issues and chemical dependency struggles – at every stage of life.  All in all, the CCM department recognizes the interconnectedness of physical, emotional and social well-being for all patients, fostering a sense of wholeness and empowerment to ensure they continue to meet their goals and live healthier, happier lifestyles.  “Our team has a holistic approach to our work,” said Barb Mader-Scherrer. “We look at the whole picture. What are the medical things we can do for this person? What education do they need to help them manage their condition? Do they have food in their house? Do they have a safe living environment? Are there substance abuse issues? Do they need help in managing their medications?”  “My 18 years of experience in various areas of hospital nursing and home health have given me the knowledge to serve patients in our community holistically, and I feel good about what I do,” added Vanessa Alford. “I hope that I am able to lessen the load on the medical assistants and providers in the clinics so they can focus on their patients on site.”

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The imaging department is where scientific precision and patient connection come together in harmony to help diagnose a multitude of conditions. When a mystery needs to be unraveled, experts in X-ray, CT, MRI, ultrasound, echocardiography, mammography and nuclear medicine step in to provide a deeper lens into each patient’s inner workings. At Renown Health, our imaging specialists exemplify this and more.  With the inpatient teams at Renown Regional Medical Center and Renown South Meadows Medical Center and many outpatient locations across Reno and Sparks, our dedicated and compassionate imaging and radiology technologists make this symphony of healing a melodious reality. Through the lens of their expertise and the state-of-the-art equipment at their fingertips, the invisible becomes visible, pain transforms into answers and the path to recovery.  A Picture Tells a Thousand Words  Every patient image tells a story, and Renown’s Imaging department is full of master storytellers. From X-rays that capture the intricate architecture of bones to MRIs that unveil the complex structure of organs, these team members use sophisticated techniques to make sure every patient receives the highest standard of care.  Within the imaging landscape, no day looks the same – and each team can expect a different set of challenges to overcome, all while helping providers gain better diagnostic clarity.  “Every day in imaging is a little bit different, and I love that,” said Savannah Terrana, Outpatient CT Scan Technologist at Renown X-Ray and Imaging – Vista. “We start like everyone else: getting our rooms stocked and ready for patients and protocoling the day's exams. We have a lot of different types of scans, like x-ray, CT and bone density, and a variety of conditions that we are evaluating for the ordering providers, like fractures, cancer, bleeds and more.  “When we get into work, we get a daily assignment that decides whether we are in one of our outpatient or inpatient rooms,” added Ireland Bennett, Echo Technologist at Renown Regional. “Then when we are on inpatients, we get our assignments for whether we are assigned to transesophageal echocardiograms, the cath lab or pediatrics. When we are on outpatients, we get a set schedule for the day with patients every hour from 7:15 a.m. until 4:15 p.m. We do our best to be efficient as possible to not delay any patient care or discharges.”  “X-rays aren’t just for bones; we do chest X-rays to look for pneumonia and intestinal issues, and we also do fluoroscopy, which is a live video X-rays while patients drink contrast or while surgeons fix fractures with screws and other hardware in the operating room,” said Amethyst Winters, Inpatient Diagnostics Imaging Lead at Renown South Meadows. “There is a lot of variety, and we provide imaging for patients in the entire hospital.”  Equipped with advanced technologies and the unique skills they acquired in a trade program, at the university-level or in the military, the Imaging department can deliver precise and comprehensive information to help providers make accurate diagnoses. And their role transcends beyond the image scanner.  “A typical day for an MRI Technologist depends greatly on outpatient or inpatient settings,” said Sean Fryer, Supervisor of Imaging for Renown X-Ray and Imaging – Pringle. “There is a lot of screen time and usually in dark areas, but this is where our technologist skill set comes into play – manipulating parameters to either increase quality by signal/resolution or decrease them a little to gain time."  “A day in the life as an ultrasound tech would of course be performing ultrasounds on our patient community, but there is much more to it,” added Mary Rushton, Ultrasound Specialist at the Renown Breast Center. “This includes keeping rooms clean and stocked with supplies, protocoling exams and studying patient history so you can give the best patient care possible, continuing education and training to keep up with new technologies and being an aide to your radiologist. Working with many different personalities, you recognize that you cannot complete every step of the patient care process all by yourself – it requires collaboration from your team to give the ultimate patient care experience."  Mary brings up an excellent point about the wide variety of people her team meets every day, on both the patient and employee side, with the common goal of solving diagnostic mysteries. This aspect of their work has become one of the highlights of their career.  “Working in imaging allows us to meet many members of our community,” Teresa Shutts, Breast Health Coordinator at Renown X-Ray and Imaging – Pringle. “We are responsible for providing imaging exams, managing patient needs and creating a comfortable and caring environment for people who are possibly going through the worst times of their lives.”  Along with every day being different, our Imaging team members thrive in their dynamic and fast-paced work environment, where efficiency and urgency are vital, especially among a constant stream of patients in need of timely diagnoses.  “Our days in CT are very fast paced,” said Shelly Lavin, Imaging Lead for Inpatient Diagnostics at Renown Regional. “Our modality is the first choice for assessing stroke and trauma patients. We are fortunate to have very competent tech aides who help work up CT orders by checking orders, IV status and labs. We generally have inpatients scheduled every half hour, and we work these around a very full ER list.  When we get extremely busy, we have to strategize how we schedule our patients in the various scanners to expedite exams and not delay patient care.”  “We provide patient care for those who come in for emergencies, trauma, inpatient care, surgery and fluoroscopy studies,” added Sean Elliott, Inpatient Radiology Technologist at Renown Regional. “I was always told in school that our main purpose was to help doctors better diagnose patients, and imaging provides many modalities to appropriately diagnose.”  Behind-the-scenes, our Imaging surgery schedulers are the keys to ensuring each appointment runs smoothly, communicating directly with patients to get their exams off to a good start.   “Every day it is my task to make sure we have everything we need to do the exam that is ordered for a patient,” said Isela Gonzalez, Surgery Scheduler for Renown X-Ray and Imaging – Double R. “This includes the order, authorization approval, completing the protocol, confirming the appointment, re-stating the address and directions, going over any prep for the exam and giving them their estimate cost for the exam. I always do my best to give the patient the best experience possible.”  Whether they are in the weeds of radiology or in the depths of patient coordination, Renown’s Imaging department is unmatched – and the direct beneficiaries are their patients.

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If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.

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June offers an official welcome to summer and the height of outdoor activities in northern Nevada such as hiking, camping, days spent at the lake and embracing long days and warm evenings with friends and family. Enjoying all that the summer season has to offer may not be as easy for those living with chronic obstructive pulmonary disease, or COPD, which effects more than 15 million Americans. What is COPD? COPD is a group of lung diseases including emphysema and chronic bronchitis that result in airflow blockages from the lungs. People may experience frequent coughing and shortness of breath among other symptoms. COPD typically impacts adults ages 65 and older and is becoming increasingly more common among women. Although smoking plays a key role in the development of COPD, air pollution and indoor air quality, and respiratory infection also contribute to disease development. While there is no cure for COPD, limiting progression of disease and managing symptoms can be achieved through lifestyle changes, therapy, and medications. Tips for Living with COPD This Summer, and Always Stay Hydrated: Staying hydrated is extremely important for people with COPD, especially during the summer. Not drinking enough water can make breathing more difficult because it increases respiratory symptoms. Make sure to always keep a water bottle with you and aim to drink 8-10 glasses of water daily. Be Mindful of Temperature: COPD symptoms can be exacerbated by hot weather. It is best to participate in outdoor activities during the cooler times of day, like the morning or evening. Check Air Quality Before You Go: Before engaging in outdoor activities, be sure to check the air quality index and plan your activities accordingly. Pace Yourself: Exercising can be difficult for people who have COPD. To make the most of your summer, try not to push yourself too hard and take breaks when you need them. If you start to feel out of breath or tired, take a break in a cool, shaded area until you feel better. Take Matters Into Your Own Hands To address the needs of community members living with COPD, the Renown Health Research Office has teamed up with Pulmonary Medicine to provide patients who are former or current smokers and have a history of frequent exacerbations with an option to participate in the ARNASA study. "COPD exacerbations have a huge negative impact on patient’s lung function” states Dr. Farah Madhani-Lovely, Chief of Pulmonary Medicine at Renown Health and Assistant Dean of Clinical Research at the University of Nevada, Reno School of Medicine. “We have had inhalers and prednisone for decades but patients are still having exacerbations. Now we have a new pathway we think will prevent exacerbations which is what this clinical trial is designed to prove.” This study will evaluate the efficacy and safety of astegolimab compared with placebo in participants 40-80 years of age with COPD. “This study in particular is so exciting because of the enthusiasm from the sponsor’s end” says Katie Buckley, Lead Clinical Research Coordinator working on pulmonology studies at Renown’s Clinical Research Office. “Often times sites aren’t assigned particularly passionate or engaged personnel who aid in carrying out these studies, but you can tell Roche Genentech’s team truly cares about the success of the study, the safety of their participants, and proving the efficacy of the investigational agent. Working on a study like this takes a village, and when the individuals on all ends share similar mindsets and work towards success as a collective unit instead of as individual moving parts, it’s amazing to see everything we’re able to accomplish.” Renown’s team of expert pulmonologists and researchers are available to join patients with COPD in support of their healthcare journey. If you are interested in learning more about this clinical trial option at Renown Health, talk to your pulmonologist at your next appointment or contact us at 775-982-3646. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.

Read More About Living with COPD? How to Maximize Your Summer Experience

Over the past couple of years, pickleball has become the fastest-growing sport among people of all ages.  It’s a combination of tennis, ping-pong and badminton that originated in 1965. This sport can be played indoors or outdoors on a pickleball court where two players (singles) or four (doubles) hit a perforated hollow plastic ball over a 36-inch-high net using solid-faced paddles. A pickleball court is the same size as a double’s badminton court and measures 20×44 feet.  Pickleball is a fun, low-impact game that keeps people healthy and active. Kaitlyn Jacobson, Physician Assistant at Renown Urgent Care – Ryland, plays pickleball herself and is a big fan of the sport. Here she shares the top five health benefits of playing pickleball.

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When it comes to your neurological health, seeking the expertise of a specialist is crucial. The Renown Institute for Neurosciences provides comprehensive care for complex diseases affecting brain, spinal cord and peripheral nerves. Let us help guide you through the appointment process to ensure a productive and informative first appointment. What to Expect at Your First Appointment at the Renown Institute for Neurosciences Duration and Purpose: Your first appointment will last approximately one hour. This time allows the doctor to ask specific questions, do a thorough neurological exam and discuss your concerns. Specialized Care: You will be matched with a provider who specializes in assessing and treating your specific ailment or condition. This tailored approach ensures that you receive care from an expert who has the specialized interest and expertise to address your needs effectively. Initial Assessment: During your visit, you will first see a medical assistant who reviews your medication history and standard screening questions provided by your doctor. Following this portion of your appointment, the neurologist will ask specific and detailed questions about your condition and conduct a non-invasive neurological examination to evaluate your brain and nervous system functioning. This exam involves painless tests assessing your cognitive function and nerve operation, including tests for sensation, strength and coordination. Treatment: After performing the neurological exam and addressing your questions, the neurologist will review the possible diagnosis and treatment plan, including any medication needs to help with your condition. Finally, your doctor may discuss the role of additional testing, including imaging studies (CT/MRIs), peripheral nerve testing (EMG) or brain wave testing (EEG), which will be scheduled for a later date. Making the Most of Your Visit To make your appointment as beneficial as possible, consider the following tips: Arrive Early: Plan to arrive at least 10 minutes early to fill out any necessary check-in items before your appointment's scheduled start time. This will ensure a smooth and timely visit. Bring Insurance Information: Have your insurance details readily available to facilitate the administrative process. This will help avoid any delays or confusion. Gather Medical Records: If you have received treatment or undergone tests with other healthcare providers relevant to your condition, bring along any medical records or test results. This information will assist your neurologist in gaining a comprehensive understanding of your medical history. Prepare Questions and Concerns: Consider noting the following, which can help you better answer questions the neurologist may ask during your appointment. The frequency, duration and severity of your symptoms. Share information about any medications or treatments you have tried for the condition and the outcomes. Prioritize questions to help the neurologist answer your most significant concerns during the initial visit. Your first appointment with a doctor at the Renown Institute for Neurosciences is an opportunity to receive expert care and gain insights into the best method of treatment for your condition. By understanding what to expect and following the tips provided, you can maximize your visit and be on your way to achieving overall health and wellness.

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Bringing in new life is an exciting and beautiful occasion. The possibilities for the newest members of our world are endless – what will the child grow up to become? What will they achieve in their lifetime? Anyone will agree that a new life is precious and protecting that life by any means possible is a necessity.  Sometimes, however, a baby’s journey into our world brings along obstacles. Prematurity, congenital defects and other complications can accompany a birth and the baby’s first few moments of life. But what happens when these complications happen outside of a fully-functioning Labor & Delivery unit, or if the complications need a special level of intervention with a health system capable of caring for their unique needs?  Enter the NICU Transport team at Renown Health. As the only Neonatal Intensive Care Unit (NICU) Transport team in northern Nevada, these dedicated nurses, respiratory therapists and neonatal nurse practitioners – who have normal unit duties of their own at Renown Regional Medical Center – step up to the plate to take on this extra duty to support members of their community facing some of the scariest moments of their lives. To them, transporting babies in critical condition and giving them the best chance of life isn’t just a responsibility; it’s a calling.  The NICU on Wheels  When the Saint Mary’s maternity unit, which was Renown’s partner in NICU transport duties, made the decision to close, our dedicated NICU nurses and respiratory therapists diligently rose to the occasion to fill the demand. Dubbed the “NICU on Wheels,” Renown’s team went from taking on transport duties every other day to 365 days a year – and they are always ready to go at a moment’s notice, whether it’s by ambulance or by fixed-wing aircraft.  “When we learned about the closure we knew it was our calling and knew we had to step up,” said Rachel D., Neonatal Transport RN at Renown. “We still have regular days on the floor, and we each switch off being on-call for transport. Once we get a distress call, we have 30 minutes to get to the hospital, grab our gear and go. We have to essentially put a whole room’s worth of portable equipment in one bag.”  “I really enjoy being a part of the transport team and making a difference from northern Nevada to northern California,” added Sam V., Supervisor of Respiratory Care at Renown. “We are able to practice at the top of our skill level and use autonomy that not every practitioner gets to use.”  Each NICU Transport unit works in teams of three when heading out into the field: one nurse (our bedside experts), one nurse practitioner (our education experts) and one respiratory therapist (our lung and breathing experts). With several years – and in many cases, decades – of experience in NICU nursing, NICU transport duties and respiratory therapy, this team is poised to provide state-of-the-art lifesaving care en route to the hospital. This diverse array of experiences among the team especially comes in handy as they continue to face the increased transport workload.  “We are so thankful to have Saint Mary’s employees come over and work on our team after their maternity ward closed,” said Melyssa H., RN, NICU Transport Coordinator at Renown. “Helping the babies, as well as helping the scared families, will always be our top priority.”  “I love the complexity that babies provide in the NICU,” added Jennifer J., Neonatal Transport RN at Renown. “Providing hands-on care right at the bedside along other members of the team is such a rewarding experience.”  Education is also a crucial tool in NICU care, especially in the field. The nurse practitioners on this team make it their mission to outreach to the community, including our rural health partners, and help them build the tools and skills they need to care for our smallest and most critical patients.  “I have been on a few transports where we went out and did not have to bring the baby over to the hospital, and we were able to provide lots of education instead,” said Shiela A., Respiratory Specialist at Renown. “For instance, I was called out to Fallon for a baby that was in respiratory distress. When we arrived, we saw the baby was awake and active although intubated. The tube came out, and we retaped it. While we stayed to observe the baby to make sure everything was okay, the nurse practitioner on the team provided educational tools to the family on what they can improve on regarding their baby’s tubing. Our nurses do such a great job with these teachings.”  “When I started, I quickly noticed that more education was needed in the field,” added Jennifer J., RN. “Now I see the momentum we’ve had in these communities really take full force. Because of this education, and the confidence we instill in our patients’ families, each baby’s transition to our team has become so much easier. It has been awesome to watch this progress over the years.”  With immense experience, education and a strong commitment to their community under their wing, the NICU on Wheels is only just getting started.  Teamwork Makes the Dream Work  Running a successful NICU Transport operation, especially as the sole health system participating, takes a village. With only three professionals out in the field, the team leans on their fellow nurses, physicians, surgeons and specialists to make the operation run as smoothly as possible.  From REMSA and Care Flight helping load patients in and get them to the hospital safely, to Renown’s Clinical Engineering team who are first on the scene when machines need repairs and troubleshooting, everyone rises to the occasion to achieve the best-possible outcome for our youngest patients at some of the most challenging moments of the beginning of their lives – and they are fully trusted to move those mountains.  “Being a part of the NICU Transport team has given us the opportunity to facilitate a deeper, meaningful relationship with providers and a patient’s entire care team,” said Rachel D., RN. “They entrust us with our assessment skills, opinions and skill levels. There is an equal layer of trust between us and them.”  Despite the pressure they feel every day, the NICU Transport team never let it overtake them and instead let it empower them.  “We are under a lot of pressure and stress regardless of the case, and yet, we all work so well together; the teamwork really is incredible,” said Lisa A., Respiratory Specialist at Renown. “I am very proud of how our team steps up and is very intricate, even down to organization. For example, team members like Shiela arrange all the respiratory bags and make sure they are laid out in a way that makes the procedure as simple as possible to ensure there are no complications.”  The nurses and respiratory therapists also partner together on the NICU floor and are always ready to provide coverage when their transport colleagues get a call. Committed to collaboration and ready to jump into action, the NICU Transport team works together to elevate each other and the bottom line for each patient.  “This is a full-time gig, and the group works together to make sure everyone is covered; we are all very collaborative,” said Sarah K., Respiratory Specialist at Renown. “We all think of our patients as extra special, and it’s nice to know that you can make a difference in the baby’s life and the lives of the family. We all have a sense of purpose in giving back to the community.”  “I am just so thankful to be a part of this team,” added Marcia A., Neonatal Transport RN at Renown. “We really have developed a strong bond.”  A Track Record of Success  The life-saving measures that each member of the NICU Transport team take surpass hospital walls. The impact they have on each baby are remembered and celebrated for years, and they often develop lifelong relationships with patients and their families after their stay in the NICU.  One prime example of this can be found in an impassioned letter from Tess, the mother of a young boy who was in the midst of respiratory distress and needed immediate intervention. Because of the valiant efforts of Renown’s NICU Transport team, her child, Warren, is a healthy and happy baby to this day. She recalls the experience: Warren had stopped breathing while getting routine blood work. He was resuscitated twice while at an area hospital. We made the decision to transfer him to Renown for him to be admitted into the NICU. Within an hour and a half of this decision, Renown had sent a team consisting of a respiratory therapist, nurse and nurse practitioner to come and get him. As soon as the team entered the room, we immediately felt safe and comforted. The team made sure we knew exactly what was going on and what was going to happen in the following hours, and they let us know they would do everything for Warren. He was resuscitated two more times by the respiratory therapist while getting ready for transport. At that time, the decision was made to intubate for a smoother ride to Renown. We knew you all had his best interest in mind, and of course, we trusted you with everything. The intubation went well, and he was packed up and ready to drive. Today, Warren is hitting all of his developmental milestones and is a normal, happy baby in everyone’s eyes. We can’t thank the NICU Transport team enough for taking such good care of Warren and helping him Fight the Good Fight.  “This success wasn’t just due to our three-person unit – our manager, Jason, also jumped in and drove all the way to Carson City to stabilize the child,” said Shiela A. “This just goes to show that no matter our title, we are always here to help and make a huge difference in the lives of our patients.”  Success stories of children like Warren describe the common mission of the NICU Transport team in detail, and while there are more of these stories to come, the team is always ready to make the necessary sacrifices for the greater good of their patients.  “Sarah K. is like Warren’s guardian angel,” said Tess. “We call her ‘Auntie Sarah’ now. He wouldn’t be here if it weren’t for her and the entire NICU Transport team. It takes a special kind of person to work in the NICU. I can never repay this team for what they’ve done for Warren and our family.”  “I am proud of this team, their flexibility and the sacrifices they have made to do transport 365 days a year,” added Melyssa H., RN.”  The remarkable success of the NICU Transport team serves as proof of the unwavering and tireless commitment of each and every team member, bringing hope to families during their most difficult moments.  “NICU Transport forces you to be confident in yourself and your abilities and to push yourself a step further,” said Rachel D., RN. “I am a better nurse because I joined the transport team.”

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March is National Child Life Month. Join us in recognizing our Child Life team at Renown Health!  The hospital environment can be a daunting and confusing place for a child. Whether they are admitted to the hospital themselves or have a family member who is currently undergoing treatment, they undoubtedly bring along a lot of overwhelming questions and concerns.  No one would be better to guide them through the process than the Child Life department at Renown Health. Our devoted Child Life Specialists and Child Life Assistants dedicate themselves to helping our youngest patients and children of relatives in the hospital cope with their anxieties and fears. With the smiling faces of the Child Life team on their side, children at Renown have a sense of solace while they are in the hospital with a team to cheer them on every step of the way.  Offering a Hand to Hold  From the first moment of a child’s visit to Renown, they are never alone. The Child Life team, which is made up of three specialists and two assistants, is here to provide a helping hand throughout the entire hospital process, explaining each test, procedure and process every step of the way and creating the best possible plan for each patient – all while fostering and maintaining a safe and supportive environment.  “We are specifically trained to help patients and families throughout their healthcare experiences,” said Amanda Cleary, MS, CCLS, Child Life Specialist. “This looks different for every family. We are trained to tailor our services to meet individual family and cultural needs based on our assessment.”  “It does not take long for a Child Life Specialist to create a safe relationship with a pediatric patient,” added Angie McEvers, CCLS, CFLE, Child Life Specialist. “The Child Life department can help any care team do their job by redirecting a child’s focus and distracting them from painful interventions, and this is a win-win for both the patient and the care team.”  This team’s primary goal is to make talking to doctors and undergoing tests a little less intimidating for our youngest patients. Interaction is a crucial part of a child’s healthcare journey. Our Child Life Specialists are masters at procedure preparation, surgery preparation, trauma support and diagnosis education while meeting each child where they are at developmentally.  “A day in the life of a Child Life Specialist is never the same, and every child is different,” said Jennifer Nunzir, CCLS, Child Life Specialist. “To make sure patient care is possible, I make sure I am here mentally for the patients and families. I am ready with a smile to greet them and try to make them comfortable from the start. We are always present to support a patient and family with a new diagnosis, talk to children when there has been a tragic accident, make memories for families and giving children a distraction from tests and procedures.”  “One of the biggest benefits to our job is our ability to provide emotional support and communicate with families in a way that makes them feel seen and heard,” added Amanda Cleary. “We listen to the family’s past medical experiences and work on building rapport by building those connections. When you get a child to open up, you see who they are as an individual, and we build from there.”  The efforts of the Child Life team go beyond helping children with coping skills. They also jump in with activities to keep kids of all ages engaged – from arts and crafts to pet therapy.  “Bringing children smiles through play and giving them fun things to do – whether it’s watching a movie, playing a game, doing an art project, going for a wagon ride or taking them to the Children’s Healing Garden – makes me feel I am making a difference,” said Jennifer Nunzir. “If I can get the child and family to at least smile or laugh, I feel I have already eased some fear and anxiety. It truly is the best feeling to get them smiling and laughing.”  “Through play, conversation, distraction or relaxation techniques, patients cope better, and families are calmer,” added Angie McEvers.  Teaching Every Step of the Way  Education is a crucial aspect in this department. Each Child Life team member works closely with their patient’s care teams to break down “doctor speak” with age-appropriate explanations.   “Children come into the hospital for all sorts of reasons, from a broken bone to cancer; our background in child development and psychology helps us collaborate with the patients’ providers and explaining what each part of the care journey is depending on a child’s developmental level,” said Amanda Cleary. “For example, we can explain what a brain tumor is with playdough and help a child with a new diabetes diagnosis understand what it means to balance sugars using play food. It's all about providing family-centered support so that they feel more in control. I can’t tell you how many times I’ve seen parents’ eyes light up when the kids play. They are all coping, learning and growing together.”  To Help with the Happy and the Sad  When healthcare journeys don’t go as planned, support from care teams is crucial for families facing grief or loss. The Child Life Specialists are one of the first on the scene to provide support for children and their families, providing education on how to talk to children about death and helping families preserve the memories of their loved ones for years to come.  “One of the most difficult things we do is provide bereavement support,” said Angie McEvers. “Not only do we provide support for families of pediatric patients but also adult patients who have children. Our team takes the time to help families with memory making with handprints, journals, books, the list goes on. No one should have to go through this process alone, and we make sure that doesn’t happen.”  Above all else, the Child Life team are here, first and foremost, for the patients and their families. They are the drive that keeps them going – and helps them reinvigorate that passion for their work every day.  “I have met some of the most amazing children and families, and they definitely are what keep me here at Renown,” said Jennifer Nunzir.  The Road to Child Life  The journey to becoming a Child Life Specialist looks different for every team member, and many of them discovered the field while pursuing careers in other healthcare areas. Beyond their passion for children and families – and their Certified Child Life Specialist credential – our Child Life team members are also highly educated in the fields of human development, nursing and psychology, knowledge that benefits them greatly in their career.  Amanda Cleary had the unique experience of pursuing a Child Life career at Children’s Hospital of Los Angeles before she arrived at Renown last year, implementing her knowledge from her bachelor’s degree in human development and family studies into a clinical child life internship and a robust career in Child Life.  “While at Penn State, I learned about the Child Life career path through the Children’s Miracle Network Dance Marathon,” said Amanda. “I knew that this was the path I wanted to take. I did a 600-hour internship, and from there I was hired at Children’s Hospital of Los Angeles, where I stayed for 11 years. As a lifelong learner, I knew I wanted to pursue more – so I achieved my master’s degree online in child life leadership and advocacy at the Erickson Institute in Chicago, and what I learned in that program continues to serve me well in my career at Renown.”  Other Child Life Specialists, like Angie McEvers and Jennifer Nunzir, had already been with Renown for several years in other departments and built up a wealth of healthcare knowledge before discovering their passion for the mission of Renown’s Child Life program.  “I have been here for 23 years; I always knew I wanted to work with children in the hospital because I love kids, and although I originally wanted to be a nurse, I realized that I actually wanted to be on the other side of helping,” said Jennifer. “At the time, I didn’t know there was a job like the Child Life Specialist out there, and I feel so lucky to have found this career. Over the years, as Reno has grown, so has our program, which is very exciting. I knew Renown would be the place where I could grow as well."  “This year is my 24th year with Renown,” added Angie. “Before I worked here, I was an Advanced EMT/Firefighter while pursuing my nursing degree. In working with the medical team from Children's Hospital of Oakland in pediatric hematology/oncology, I was able to see first-hand the benefit of Child Life. I was driven to finish my human development degree and passed my certification testing, and ever since then, I’ve been with Pediatrics, PICU and the Children’s ER.”   We could not have said it better ourselves – this is a field that is constantly evolving and progressing, and while not everyone is familiar with it, our Child Life Specialists are ready to change that narrative.  “There is a lot of opportunity here to continue to grow the Child Life program,” said Amanda. “Not all hospitals have a Child Life program, but we are lucky that Renown does. Any aspiring Child Life Specialist should consider coming here, as it has been a great experience. It is a familial feeling here, and I definitely feel like I am in the right place.”  There is Strength in Numbers  It takes a village to serve the emotional needs of the many children and families that walk through the doors of Renown Children’s Hospital, and our Child Life Specialists are considered some of the key leaders of that village.   The outpouring of support for our Child Life program is astonishing. Not only have our patients and employees made generous donations, but members of the greater Reno-Sparks community are always there ensure kids in the hospital can be kids. The Nevada Wolf Pack, SCHEELS, Great Reno Balloon Race and Atlantis Casino are just a few of the many generous organizations that have donated both toys and time to our youngest patients.  To support any child dealing with a serious illness, especially cancer, Beads of Courage steps in to help children “visually record, tell and own their stories of courage” using beads as a symbol. Representatives from Beads of Courage volunteer their time to help our youngest patients keep track of their valiant fight against their illness, adding a bead to their necklaces after every step in their care journey.  “We rely on our generous community and donations that come in, and we see a lot during the holiday season – we definitely can benefit from this year-round,” said Amanda.  The donations allow the Child Life team to expand their play, coping and distraction opportunities for patients and families, allowing them to reach more children within their small, mighty and growing team of five.   “Our goal as a team is to work with as many pediatric patients and children of relatives seeking treatment as possible, so the opportunity to grow our team would be awesome,” said Amanda.  And grow they will! The team recently welcomed two dedicated Child Life Assistants, Marissa Arriaga and Sydnee Patterson, during Child Life Month. These team members work alongside the Child Life Specialists to help provide opportunities for developmental play, both in the playroom and at the bedside. Marissa and Sydnee ensure that the kids can still be kids, even while they are in the hospital.  Additionally, the Child Life department is currently hiring more Child Life Specialists. If this line of work speaks to you or someone you care about, they are strongly encouraged to apply, because in the end:  "We do it all for the kids,” closes Jennifer Nunzir.

Read More About Department Spotlight: Child Life

Senior Care Plus is pleased to announce we are now a proud sponsor of Jam On It Pickleball, open to the community seven days a week at the Reno Sparks Convention Center. We’re excited to help promote this fun activity to our members, employees and the public. Pickleball has many wonderful health benefits – particularly for seniors. It’s a low-impact game that raises the heart rate, improves hand-eye coordination and increases mobility. In addition to the obvious physical benefits, pickleball is a great social activity. Getting out of the house and playing a fun, easy-to-learn game with others is a great way to make new friends while improving your physical and mental health!   Ralph Barbato, a Senior Care Plus member from Reno, is a huge fan of pickleball and all it has to offer. “Pickleball has made such a positive impact on my life. I love the physical and mental health benefits along with the social aspect – it’s a great way to meet new people and I’m excited to have it in our community,” said Ralph.

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March is Colorectal Cancer Awareness Month, and we want you to receive the best preventative care possible. Early detection can help prevent serious illness, yet many people still choose to skip their annual exams and routine screenings. Bonnie Ferrara, MD, MPH, Section Chief for Primary Care at Renown Medical Group, further explains the importance of this simple, easy way to stay healthy. Why are annual exams so important? The benefits of early detection and prevention to save lives and reduce the impacts of disease have been proven. These exams are the perfect opportunity to get your health questions answered. “This is your chance to sit down with your provider and talk about your overall health and your family’s health history as well as your concerns for the future,” says Bonnie Ferrara, M.D., family medicine. “It’s the opportunity for your provider to talk with you about your lifestyle, tobacco use, exercise and alcohol use, all of which make a difference in your future longevity.” The annual wellness exam is also an ideal time for most adult patients to discuss health screenings. In addition, these visits are the perfect time to address issues that may not directly relate to a particular medical problem or immediate illness. A good rule of thumb is to schedule these appointments around your birthday each year to make sure you and your provider are both updated on your care. Why would you need an annual exam if you aren’t feeling sick? According to Dr. Ferrara, seeing your care provider when you aren’t sick is one of the best times. “It is better if you try to arrange this visit when you are not feeling ill,” she says. “It is an opportunity to talk about wellness. Not only how to contribute to your wellness but also the changes that you can make that will make huge dividends in the future for your wellness. In addition, it allows us to do some education about what to expect in the coming years as far as your health and lifestyle changes.” What can you expect at an annual exam? Annual exams usually check your: History – lifestyle behaviors, health concerns, vaccination status, family medical history Vitals – blood pressure, heart rate, respiration rate and temperature General appearance – your care provider can find out a lot about you just by watching and talking to you Dr. Ferrara adds, “If this is a Medicare annual wellness exam, it is an opportunity to talk to your provider about depression and dementia as well as be tested for those.” You can also leverage your annual exam to speak to your provider about managing your chronic health problems. "As a provider, these visits give us the opportunity to hear how the medications and lifestyle changes we have recommended are working and if you are having problems with these, we have the opportunity to make suggestions of how to do things better for the future," Dr. Ferrara.

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There are nearly 1 million adults living with MS in the United States alone. For comparison, that is roughly the entire population of the Reno/Sparks and Las Vegas areas combined. MS is a neurological autoimmune condition which means that the immune system of patients with MS attacks the body’s myelin, a protective substance that covers your nerves. When this happens, the unprotected nerves can be damaged. Patients with MS may experience many different symptoms ranging from mild to severe, such as mobility and vision problems, fatigue and difficulty thinking. MS is usually diagnosed between the ages of 20-50, but late onset MS can occur in patients over 50 years old. While there is no cure for MS, there are effective treatments that can help reduce the burden of patients’ symptoms and create a positive quality of life. At Renown Health, we have joined the fight against MS through a partnership between advanced neurology programs and providers and our research office. We are proud to offer newly diagnosed MS patients the opportunity to choose between standard care treatment options or participating in an open label clinical trial, the AGNOS study. This study is assessing the impact of a new medication, ofatumumab, as the first disease modifying therapy participants receive for managing relapsing remitting MS, the most common form of MS.

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Becoming a caregiver or playing a more active role in another’s healthcare is a big responsibility. At some point, almost all adults will support an aging parent or a loved one in need. Keeping track of their needs and wellbeing, while also prioritizing your own can become overwhelming. It’s important to know: you are not alone, and help is available. Read on for 11 tips to help you manage your time, your own wellbeing and your loved one’s care. Self-care comes first. When your main priority is the person in your life who needs care, it’s easy for your own needs to take the backseat. Give yourself time each day to focus on your personal wellbeing. It’s hard to give a loved one the care they need if your own needs are not met. Prioritize the Activities of Daily Living (ADL). Make a note of what ADLs your loved one can do alone, what they need help with and what activities require the most help. This will help you work through the day with them, as well as plan out how the day’s activities will go. Do a home safety audit. Do showers, bathtubs and steps have safety grab bars? Look around the house for additional tripping hazards, like rugs or electrical cords. If your loved one struggles with day-to-day navigation of the home, consider scheduling an occupational therapy appointment. This type of therapy helps a person develop or maintain the motions required to accomplish daily tasks. You might also qualify for a referral to in-home healthcare, such as Home Care. Have the hard conversation. The best time to discuss views about end of life care and to learn what choices are available is before a life-limiting illness or crisis occurs. With advance care planning, you can help reduce the doubt and anxiety related to decision making at the end of life. Completing an Advance Directive is a great tool to sort out all these decisions before they’re needed. Attend a free workshop to learn more and complete this important document. Identify when you need respite. Respite care involves receiving a short-term break from caregiving. Organizing in-home care for your loved one will allow you to step away and tend to your needs. By identifying what kind of respite care you are seeking, you can find the right person to provide you with that much-needed break. Don’t wait until you feel overwhelmed, plan ahead. Write down insurance contact information. Have a direct connection to the right insurance professional for support and advice. If your loved one is eligible Medicare, this is a good opportunity to review their current selections and if they would benefit from a Medicare Advantage Plan or Medicare Supplement Insurance. Seeking out expert advice or information on Medicare options is a great way to navigate this. Consider calling a broker, or attend a free educational seminar with Senior Care Plus. Gather legal and financial information. Make a list of all existing legal documents and financial accounts that your loved one has. These might include a will, advance directive, power of attorney, bank accounts or investment accounts. If you have questions about how to manage them, or need assistance in setting up additional framework, reach out to a lawyer, legal service, financial adviser or bank representative. Create an inventory of medical information. Identify where all of your loved one’s medical records are, as well as a list of providers or healthcare practices where they have received care. Consider if you should have your loved one give you Proxy Access in MyChart, which allows you to access all the features in MyChart on their behalf, including viewing upcoming appointments, viewing test results and emailing a doctor on their behalf. Make a list of what others can do. Think about all the little (and big) things that need to happen, and write down tasks that others could take care of you. When someone says “let me know what I can do” you’ll be ready with a pre-written list of items they may be able to assist with. Tasks could include tackling around-the-house repairs, scheduling lawn work, helping to walk the dog, taking a car for an oil change and cleaning. Find programs and events for social enjoyment. If and when possible, seek an activity outside of the home. Look for community centers that have programs for seniors, recreational activities or meals that you can patriciate in together. If leaving the home is not an option, arrange for visits or in-home activities, such as movie nights, card games or time to visit with family. Research long-term options. If you will be considering a nursing home or assisted living, make a list of amenities that you and the person you are caring for would like. Take this list with you when visiting potential locations to make sure you don’t forget to ask about each item.

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