For safety and infection prevention compliance, employees who provide direct patient care, those who interface directly with patients, and those who handle patient equipment/supplies, food or medication that is consumed by the patient, may not wear any type of artificial fingernails. Natural nails should be kept clean and not exceeding beyond fingertip.
Thank you for your dedication to Patient Safety!
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).
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).
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.
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.
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.
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.’
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.
Topics: Healthcare, Mental Health Awareness
Topics: All Network Staff
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.”
Lessons learned
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.
Topics: Healthcare
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.
Learn more on facebook. To learn more about Rapides Regional Medical Center, click here.
Topics: Healthcare
Instances of erroneous blood pressure readings have been reported in a singular Facility. This is reportedly because of Welch Allyn vital sign machines losing seal at the juncture of the hose and the adapter/fitting for the blood pressure cuff. Reports have indicated that the failed seal results in devices losing pressure on higher blood pressure measurements, resulting in the need to retrieve and try multiple devices
Some departments have reinforced the seal with tape, which is not clinically advised by either Welch Allyn or GE Critikon manufacturers. Currently, the original fitting is removed and an adapter is being inserted that allows the Welch Allyn device to connect to GE Critikon blood pressure cuffs. Although this is common practice, it appears there is a general unawareness of any standard, manufacturer-recommended processes to insert the adapter in a way that successfully maintains a seal.
Please ensure you are following the facility established process for affixing the adaptors and GE Critikon blood pressure cuffs to the Welch Allyn machines.
Thank you for ALL YOU DO!
Topics: All Network Staff
Tomorrow is Juneteenth and has now officially been designated a federal holiday, the date marketing the end of slavery in the United States. The Emancipation Proclamation officially went into effect on January 1, 1863. But, it wasn’t until June 19, 1865, when Union soldiers arrived in Galveston, Texas to announce the end of the Civil War that those enslaved in Texas learned of their freedom.
Juneteenth, observed annually by generations of Black families, is a day to reflect, rejoice, and educate. Whether you plan to celebrate with friends or participate in a virtual event, we encourage you to observe this milestone in American history. This day is an opportunity to have Brave Conversations about the current struggle for racial equality and justice in our country.
Acknowledging and celebrating Juneteenth is just one step in our journey toward a healthier, more equitable tomorrow.
Topics: Special Holiday Message, Juneteenth
Our partners in the San Antonio Division, MHS, recently rolled out education around the Suicide Prevention Plan.
Please review attached education on the Suicide Prevention Plan including the Assessment, Interventions, and Documentation.
Thank you for your continued dedication to patient safety!
Topics: San Antonio Division, All Nurses
"I I never thought an EVS employee could be up on that award wall, much less me.”
Irene Salazar had an established career as a cosmetologist when she put it on hold to care for her husband when he had a stroke. She was his caregiver until he was well enough to return to work. But instead of returning to her former career, she joined the environmental services team as a housekeeper at West Valley Medical Center in Caldwell, Idaho.
Since assuming this new role two years ago, she’s come to love it for many of the same reasons she enjoyed her previous work: people.
“I have a service-oriented heart,” says Irene, an active church member who tries to model her Christian faith. “It’s not just housekeeping. It’s not just a job. It just blesses me that I get to go around and say, ‘Good morning. Good morning. How are you?’ I get to bring love and joy to people, and they delight in it.”
From the start, Irene noticed the lobby wall that held photos of West Valley colleagues recognized for demonstrating a commitment to a positive workplace culture. She imagined her own photo on the wall. Now her dream has come true.
A physician nominated Irene for the We Are West Valley award after witnessing her assist a patient with their shoes one day. Five other colleagues had also nominated Irene for the quarterly recognition. The hospital reviews all quarterly honorees, then selects an annual winner. This year, it was Irene.
“I couldn’t believe it. I was shocked. I have never gotten recognition like this — ever,” she says. “When I started on the night shift, I cleaned the lobby first and when I would dust the award wall, I would pray and say, ‘Lord, I know an EVS (colleague) can do it.’”
Her supervisor, Carlos Vazquez, says, “When I first met Irene, she was that type of person who made you feel like your mom was there. She was able to jump in and take care of everything and we have seen that continue to blossom. She rises to the occasion every single day.”
Carlos Vazquez, director of Environmental Services, Irene Salazar, award winner and Housekeeper
Irene says the most rewarding aspect of her job is when she gets to interact with patients in their rooms.
“They ask me to pray with them. They want hugs or just to be listened to. During COVID-19, they couldn’t have visitors, so they were so happy to see me,” she says. “Even on my lunch break, I would go back and visit with them because they were really missing family. Here at West Valley, we always say ‘Care like family.’ For me, that’s the highlight of my day, to see patients. Honestly, that’s why I’m here. I love it.”
Carlos says that Irene’s warmth and dedication is in demand throughout the hospital.
“Throughout COVID-19 she is one of those people who has kept things together for our team. Oftentimes, people come and praise our team for her efforts. She was helping out in the ICU recently and the nurses and physicians said they loved her and wanted her moved to their area,” says Carlos. “Irene is assigned to the behavioral health unit and checks all public areas such as restrooms and lobbies, but she is so invested we don’t even classify that as ‘her area’ ― the whole hospital is her area.”
“She would frequently sit and pray with COVID-19 patients who were in MICU or med/surg before they went on the ventilator. She had that opportunity to be with those patients and often comforted them before they went back or they were alone.”
An additional unexpected outcome of her career switch came in the form of emotional healing. The heavy burden of caring for her ill husband and the loss of her job as a cosmetologist were very difficult, and Irene found herself struggling with depression. When she began working at West Valley two years ago, she was assigned to the hospital’s mental health unit where she at first felt challenged, but where she soon found a sense of support.
“It was the hardest thing for me to see – but I had to. I couldn’t let it become my crutch,” she says. “I’m actually finding the freedom to speak about my depression because I was embarrassed about it. But I’m overcoming that.”
Irene also tries to inspire her fellow colleagues through leading by example.
“I always tell them, look for the opportunities that you’re missing. It’s not just a job,” she says. “I’m a housekeeper, but I understand how important it is that everything is clean and sanitized for patients. I really tell them how much it means to me that I get to clean their rooms.”
Topics: HCA Healthcare
“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.
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.
Topics: Healthcare, HCA Healthcare
