Congratulations to Allison Wharton, RN ICU, on earning a DAISY Award!
Allison was nominated by several patients at the Mission Hospital in Asheville, North Carolina for her ability to help and comfort patients as well as thoroughly answer questions. Please see below to read some of her DAISY nominations.
Brooke Johns, an emergency room nurse at Southern Hills Hospital in Las Vegas, Nev., spends her days off brushing and braiding patients' hair. She started these acts of kindness to help patients who weren't able to have visitors due to the pandemic. She hopes to set the example for her three kids to give back. "Service is so important," said Brooke. "If they see mom doing it they are much more likely to do it too."
During the height of the COVID-19 pandemic last year when visitation at hospitals was restricted, the caring staff Presbyterian Saint Luke's Hospital (PSL), which is based in Denver, Colorado, sought to find an incredible way to honor the patients, who had passed away, especially those who did not have family by their side. "We knew that we did not want anyone to die alone," said Laura-Anne Cleveland, an associate chief nursing officer at PSL. "That is always our commitment, but more so when they [patients] couldn’t have visitors at their bedside." So, to help colleagues find peace after a patient passes away, medical staff now gathers in a circle to read a special message created by an unknown ER nurse.
Amy, a patient at TriStar Centennial Medical Center in Nashville, Tenn., has been battling COVID-19 since February 2021.She just recently came off extracorporeal membrane oxygenation (ECMO) after more than 140 days, just in time for her birthday. When the compassionate care team heard it was Amy's birthday, they provided Amy with an unforgettable birthday experience that she would never forget. The care team surprised Amy by recreating her favorite Italian restaurant, Olive Garden, in a hospital room, for a spontaneous dinner date with her husband. One of Amy's nurses, Jessica Lagoni, came in on her day off to be their waitress and to assist in serving Amy in a special way. We are grateful for the incredible team at TriStar Centennial Medical Center for their dedication to helping give Amy a wonderful birthday celebration.
A two-year-old Labrador retriever is helping keep patients, visitors and caregivers safe by sniffing for signs of COVID-19 at Doctors Hospital in Sarasota, Fla. "It's a distinct smell. The body's response to us fighting off COVID-19 is what the dogs are reacting to," explains Buffy's trainer Laska Parrow. The idea came about because Bob Meade serves as both a board member for the non-profit that trained Buffy, and is the CEO of the Doctors Hospital of Sarasota.
Amy Rushton, Vice President of Behavioral Health for HCA Healthcare, recently spoke about mental health awareness and how to practice self-care at work.
(Some responses have been edited for clarity).
How has HCA Healthcare responded to mental health needs over the past year?
I will say our leadership team at HCA Healthcare was very concerned about the impact that COVID-19 was going to have on everyone and tried to get things in place to provide support at all different levels in the company.
We are particularly proud of our nurse care hotline (800-480-1234), which is for nurses who are working in our facilities. That has been very highly utilized, especially during this past year.
In our facilities, we also posted electronic posters that reminded our staff members about signs and symptoms of stress. For our Behavioral Health service line, we had folks in divisions hosting wellness chats, which has been very well-received.
Some facilities set up a calming area where, if things were really stressful at work, colleagues could go to this room and just decompress.
In addition, our benefits department put together additional resources for our employee assistance program (EAP).
What are some signs of stress at work?
We’ve seen a whole bunch of different signs — from difficulty thinking clearly, confusion, difficulty problem-solving, making decisions and even some memory issues or misinterpretation of situations or comments.
Some behavioral signs may be risk-taking. This could be more alcohol consumption, conflicts with others, withdrawal and isolation. There are some physical feelings as well. We heard a lot about inability to relax and trouble sleeping. I think that was a huge one for many folks.
On the emotional side, there was anger, hostility, frustration, sadness, difficulty maintaining an emotional balance. There were a lot of symptoms related to excessive stress.
If you notice these symptoms in someone, what’s the best way to address it?
I think the most important way to address it is to ask them how they’re doing. I want to emphasize that it’s so important not to shy away from that conversation and to ask someone how they’re doing, really doing. Also normalize the experience that’s happened. We’ve all had extreme stress over this year. It’s okay for them to feel like they are stressed.
What’s important though, is to know that if it goes on for more than two to four weeks or interferes with your relationships, your work or your daily functioning, that’s when you really do need to seek some additional care.
If you’re a high-achiever and often do well in crises, it might not always be obvious when there is internal mental turmoil. Can you talk about that?
I think it’s so important to take time for ourselves. For high achievers, it’s knowing when you feel slightly different.
I can’t stress enough the importance of knowing how your body feels and also recognizing that it’s okay not to feel okay. We have to take time to just breathe, be in the present and feel how our body feels. That’s the best way to take care of yourself.
What are some things colleagues can do at work to alleviate stress or feeling overwhelmed?
Breathing in and out of your nose is such a powerful way to help calm yourself down. Also, taking a minute to just take a walk around the building, or eating, taking breaks, drinking fluids.
If you have a buddy at work that knows you, maybe check in with each other. And if you see someone maybe acting a little bit irritable, have permission with that person to say, ‘Look, you’re sounding a little irritable today, take a walk.’
What else should people know?
Just be very mindful of how you’re feeling. It does happen that some people will look back on this time over the past year and start to get anxious. That’s okay, and it’s really important to talk about that, especially if it continues to come up and you’re feeling some of those symptoms of stress again.
I think, we need to normalize mental health, talk about how we’re feeling and acknowledge that it’s okay if you need some more support.
Lauren Poliakin says her father’s knowledge, experience and compassion as a physician inspire her in the way she cares for her patients.
Lauren Poliakin and her father Raymond, an OB-GYN, share more than a profession as Raymond delivered his daughter at the same hospital — Los Robles Regional Medical Center in Thousand Oaks, CA — where they both now practice.
Lauren, who finished her residency in bariatrics just last year, often seeks guidance from her father, who has been in practice for 37 years.
Raymond frequently made the weekend rounds at Los Robles with each of his four children. Lauren, his eldest, was the one who was most eager to be there.
“It’s great working with her,” he says. “Every day is like ‘bring your child to work day.’”
Drawn to medicine
When Raymond was in the second grade, he wrote an essay about wanting to be a pediatrician. His pediatrician lived just a few blocks away from his family’s home and during a house call, diagnosed Raymond with appendicitis. His surgery, which was performed at a teaching hospital, made a lasting impression on him.
“They were all very supportive, very understanding, and they were caring. That was something that probably influenced me,” he recalls.
Raymond continued to excel in the sciences, never straying from his medical pursuits. When it came time to determine his specialty, he considered several areas: pediatrics, nephrology, general surgery and dermatology. Finally, he found his calling in obstetrics and gynecology.
“I found it very exciting and very rewarding — both the emergencies and delivering babies. So even though I gave up my sleep, I found that it was the happiest profession for me,” he says.
Dr. Raymond Poliakin, wife Victorine, and newborn Lauren in the late 1980s. Raymond delivered his daughter Lauren, as well as her three siblings at Los Robles.
Like her father, Lauren excelled in the sciences and in high school knew that she wanted to pursue a career in medicine. She initially thought she would focus on surgery, trauma and critical care. But in the third year of her surgery residency, she got the chance to work with a bariatric surgeon. That’s how she found her calling in bariatrics and obesity medicine.
“I love the anatomy of the esophagus, stomach and small bowel. And then the way that the surgery is done is very elegant, and I like that. I like that once you are able to master any of the bariatric surgeries, I think that you could do any type of surgery,” she says. “So, I liked that aspect, that knowing that these types of procedures are difficult, but once you’re able to master them, then you can feel confident with any other surgery.”
Her work is also rewarding because it often significantly improves the lives of her patients. Many tell her that their surgeries relieve back or knee pain they’ve endured for years and that they are able to be physically active with their families again.
“Most, if not all, of the patients are very happy after bariatric surgery because they get another chance at life,” she says. “A lot of people feel like they can’t have a second chance despite trying everything as far as diet, exercise and medications.”
Lauren says the best advice her dad has ever given her is to do what makes her happy. He also told her to always believe in herself and trust her own instincts.
Raymond says he wanted his children to experience the same job satisfaction that has sustained him throughout his career. He tells them: “Make sure that whatever profession you do choose, make sure that you’re not working every day of your life: that you’re going to work, but you don’t feel like you worked that day — because that’s how I feel,” he says.
He enjoys helping Lauren perform surgeries and says she’s taught him new techniques.
“I am most proud of her when we are doing emergency surgeries that do not follow normal anatomy or present a unique surgical crossroad,” he says. “Her decision-making always leads her down the correct path.”
Lauren says her father’s calm demeanor during surgeries, his continual thirst for knowledge and his nurturing manner with patients inspire her.
“I liked seeing him speak with the patients and treat them. When I was younger, I didn’t really understand a lot that was going on, but I could see the patients’ facial expressions and when they were really happy — I liked the happiness part of it,” she recalls. “It was just a really positive atmosphere.”
Lauren trusts and respects her dad so much that she wants him to be her OB-GYN too.
“He is someone that I would let operate on me. And whenever I do end up having a baby, I want my dad to deliver the baby,” she says.
Nurse Haley Arnouville at Rapides Regional Medical Center in Alexandria, La. was working the Emergency Room check-in desk when Mr. Ben walked in and said he was looking for his wife. After trying to search for his spouse, she noticed him sitting in the ER waiting area alone. She checked on him and noticed signs of dementia. She took the initiative to search online for his name and discovered his family had reported him missing three days prior in Waco, Texas. Haley worked with the local sheriff's office to safely reunite him with his family.
Each May, in honor of Urgent Care Awareness Month, we recognize the pivotal role of the compassionate colleagues working in our
CareNow Urgent Care clinics play in the lives of millions of Americans. Their selfless dedication and tremendous sacrifice were exemplified this past year as patients came to our clinics for COVID-19 testing and care. Last month, we celebrated the thousands of physicians, clinicians and team members who provide quality, convenient and patient-centered care every day in our urgent care clinics.
“Our care teams made Olympic efforts throughout the pandemic,” says Tim Miller, president of HCA Healthcare’s urgent care services, which include 157 clinics and 2,000+ colleagues in 10 states. “Our CareNow clinics went through the H1N1 swine flu in 2009, which led to patients swamping our clinics, with lines out the door. But that is not what happened last March. Many people stayed home with minor symptoms and sheltered in place.”
Tim recalls urgent care reaching the lowest point of patients being seen on April 9, 2020. “We were averaging 16 patients a day. It was a substantial drop.” Instead of laying off or furloughing colleagues like other healthcare systems, HCA Healthcare implemented a pandemic pay program which guaranteed that full and part-time colleagues in clinical and non-clinical support services who could not be redeployed to other facilities would continue to receive 70% of their base pay if they were not scheduled for their full shifts. In 2020, this program has helped more than 127,000 members of our HCA Healthcare family continue to support themselves and their families.
“The way that HCA Healthcare handled the pandemic was so different – really taking care of and protecting employees. It was such an impactful message for anyone working for HCA Healthcare,” says Jaime Bailey, area practice manager for Charleston, South Carolina, and Jacksonville, Florida, in the South Atlantic Division.
Urgent care fills the gap between primary care and hospital emergency rooms offering increased convenience. When a patient has a medical condition that cannot wait for a scheduled appointment with a primary care physician, such as cuts, sprains or fractures that do not require a visit to the emergency department, CareNow’s urgent care
centers are equipped with X-ray, laboratory services and quality providers who are always available to perform minor procedures like suturing. Patients can also choose
Web Check-In® and skip the line by waiting at home. Our CareNow clinics also offer virtual care, allowing patients to check-in online and receive a link to set up a virtual visit with a provider.
But by the summer of 2020, patients were presenting to our CareNow clinics in large numbers. “Last July our patient volume spiked by 70% — a lot of that was driven by COVID-19 testing and it kept going up. The surge was beyond anything I’ve seen in close to 30 years in urgent care,” recalls Tim. “We were able to adapt quickly. Urgent care is always there for patients whether it is allergies, physicals or the flu. Urgent care is convenient so someone can see a provider quickly. What we needed last spring was a way to respond to the massive demand for COVID testing. Our teams had to respond and get creative to find other lab partners, so we could give patients what they needed when they needed it.”
“Thanks to a collaboration with our divisions, HealthTrust and the lab service line, we were eventually able to obtain the rapid test in our clinics, and we were one of the first clinics in the country to do it,” says Tim. As of December 2020, HCA Healthcare urgent care clinics cared for more than 2 million patients and performed more than 706,000 COVID-19 tests.
“We leveraged a really great idea by our operations team to do curbside swabbing for COVID testing on the hour, which kept it really efficient for staff. Our team shared their viewpoints and thoughts because they know they are valued, and we were able to better serve our patients because of it,” says Jaime.
“Also, urgent care services had the technology built for web check-ins – but we needed to set thresholds to manage the volume of testing. We engaged with our developers in HCA Healthcare’s Information Technology Group (ITG) and within a matter of days they were able to set controls at the market and clinic level. This allowed us to effectively manage the work flow and available testing supplies,” says Tim. In 2020, 840,000 patients used web check-in at our CareNow clinics. More than 1.7 million people visited the COVID testing page on CareNow.com in 2020.
Tiffany Ridley, director of urgent care operations for the Gulf Coast Division, says the web check-ins also helped our teams manage social distancing.
“Since Houston was one of the hot spots early on in April and May, HCA Healthcare teams were mobilized to support us,” Tiffany said. “Colleagues across the country in Denver or Dallas were picking up phone calls from patients or helping us with web check-in. I have tears in my eyes thinking about the incredible support we received.” But across the Gulf Coast Division’s 19 locations, they still had people lining up before clinics opened each morning throughout the summer. “Between 15 and 30 people would be waiting ꟷ just wanting to come in. Our urgent care team developed a QR code for patients to scan so they could register, and we would get them in every 15 minutes. It also allowed people to come back for testing and that worked very well.”
“We didn’t have virtual care before COVID in our clinics, but we were able to stand up telehealth in all of our clinics within a week or two thanks to our collaboration with ITG. A lot of patients wanted to come in to be tested for COVID-19 but for those who couldn’t get in due to capacity, or they were afraid — we could still help those patients in their time of need,” said Tim.
“We did a soft launch one weekend in Charleston to prepare for adding telehealth and went live the following week,” said Jaime. “Now in 2021, we still see 20-30% of our patients through telehealth. I believe it will help us reach even more patients, long beyond the pandemic.”
As of December 2020, HCA Healthcare’s telehealth utilization increased 485% from previous years, with 1.23 million telehealth encounters in 2020. HCA Healthcare added 3,000 additional hospital-based telehealth services and supported an additional 6,000+ providers through our telehealth services and network to meet the demands from social distancing and quarantine mandates.
In 2020, HCA Healthcare also distributed nearly 1.2 billion pieces of PPE. This includes 5.7 million N95 masks, 1 billion pairs of gloves, 55 million masks and 1.1 million face shields.
“Our staff was fully protected thanks to HealthTrust and our supply chain sourcing so quickly,” says Tim.
“From gowns, gloves, masks ꟷ it was incredible to be able to have everything for the team and to be able to encourage universal masking without worrying about supplies,” says Jaime.
Tiffany says the resiliency of the Gulf Coast Division CareNow team was astounding. “The staff were amazing as they managed extremely high-stress levels. There were a lot of support conversations. HR was providing resources for mental health. We pulled staff from other clinics, PSG and division teams so we had an additional team member to support if someone was out. There was a lot of intrinsic motivation,” she said. “During our team huddles, we would ask, ‘Are you guys OK? We know it is stressful. What do you need?’”
“We have opened up COVID vaccination appointments now for patients, and we are so grateful for our hospital partners. They were willing to teach us their best practices to offer the vaccine to the community. They show us what works, how they run scheduling, and it’s been a tremendous help,” says Jaime.
Looking towards the future, Tiffany said, “Now it’s time to get back to basics. The pandemic put a wrench in everything — it was all COVID. So now that we have normalized COVID processes, we can do orientations and ongoing training with new staff on what to do when you see a patient who comes in with strep or a bicycle injury. We’ve also developed partnerships with radiology schools for our medical assistants to get X-ray trained. We have pathways for our colleagues to learn, develop and pursue leadership opportunities.”
“It is hard to put in words just how proud I am to have been able to serve the community and see all of our colleagues step up and thrive in taking care of patients and each other. We were close before the pandemic and now there is an unbelievable bond,” says Jaime.