Journeys | Winter 2017

JOURNEYS “Destiny is not a matter of chance, it is a matter of choice …” – William Jennings Bryan

WINTER 2017

Restoring Bridgette’s dream

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JOURNEYS WINTER 2017

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FROM OUR PRESIDENT

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PATIENT EXPERIENCE Bridgette reaches her goals

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CRETE AREA MEDICAL CENTER In-home physical therapy is music to her ears

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SIMULATION CENTER Patient simulator mannequins teach lessons about reality

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CARE TRANSITIONS Smoothing the path after hospitalization

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BRYAN HEART Celebrating 50 years of open heart surgeries Football fan tackles STEMI Seward man first to receive dissolvable heart stent at Bryan Welcome, Dr. Hargreaves

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MEDICAL STAFF SPOTLIGHT Ask the doctor: What do my blood pressure numbers mean?

MEDICAL STAFF UPDATE New faces at Bryan ADVANCES IN SURGERY Spinal disc prosthesis preserves neck flexibility: An alternative to spinal fusion PALLIATIVE CARE Program improves experiences for patient, loved ones facing serious illness BRYAN LIFEPOINTE MEDSPA MedSpa restores Deb’s self-image NEW AT BRYAN Team discovers, then helps defeat Mary Jo’s lung cancer

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VOLUNTEERS & CUSTOMER CARE Creative intervention: Art Committee enhances healing atmosphere

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BRYAN COLLEGE OF HEALTH SCIENCES

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ACHIEVEMENTS

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COMMUNITY CALENDAR

Small change adds up to big gifts for NICU and local elementary Bryan Health and Holmes Elementary School together raised more than $16,000 — that would amount to 1.6 million coins if converted to pennies — through their Big Change Challenge.

This fundraiser benefits students at Holmes and patients and families at the Bryan Neonatal Intensive Care Unit. It all began four years ago, when Holmes challenged Bryan to participate in the effort.

Students, teachers and other staff members collected loose change at Holmes, which borders the Bryan East Campus.

Visitors, guests and staff also were encouraged to add to collection boxes at various points around Bryan, and these combined donations were emptied into a large Plexiglas container in the hospital lobby. Other NICU graduates Cooper and Caitlin Hoffman, twins born four years ago, helped empty the community groups, container at Bryan East Campus. such as students from Lincoln High School and the University of Nebraska-Lincoln, also became involved.

Donations totalled $16,016, and the coins and bills weighed nearly three tons. Proceeds will be split evenly between Holmes and Bryan.

We appreciate the efforts of Union Bank & Trust, our partner in this project, and Rochester Armored Car for transporting the change. n

ALL ABOUT JOURNEYS

STAY IN TOUCH

Statesman William Jennings Bryan, one of the original benefactors of Bryan Health, said:

We welcome your comments. For more information about Journeys, contact the Advancement team by calling 402-481-8674.

To learn more about Bryan programs and services, visit us online at bryanhealth.org.

“Destiny is not a matter of chance, it is a matter of choice; it is not a thing to be waited for, it is a thing to be achieved.”

Journeys tells our story of how Bryan chooses to achieve. This free publication is mailed quarterly to the communities we serve.

ON THE COVER Bridgette Baden appreciates the efforts of Bryan’s staff to help her recover from injuries suffered in a car crash.

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OPPORTUNITIES TO SUPPORT Your contributions help us care for those who come to Bryan at every stage of life. To find out how you can participate, call 402-481-8605, or write to us at: Bryan Foundation, 1600 S. 48th St., Lincoln, NE 68506.

You can learn how to help and make a gift online at bryanhealth.org/bryan-foundation.

Kimberly Russel President & CEO, Bryan Health John Woodrich President & COO, Bryan Medical Center Edward Mlinek Jr., MD Chief of Staff, Bryan Medical Staff Bob Ravenscroft Vice President of Advancement & CDO Edgar Bumanis Director of Public Relations Kevin Rummel, MD Medical Editor Paul Hadley Editor

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FROM OUR PRESIDENT

“Knowing is not enough, we must apply. Willing is not enough, we must do.”

— Bruce Lee, actor and martial arts expert

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ach month, more than 100 people join our Bryan Health team. This increase in co-workers is in response to the growing number of people in the region who are choosing Bryan for their health and wellness needs.

Among those 1,200-plus annual hires are more than 350 registered nurses. We take their commitment to Bryan and their profession very seriously, so it is imperative that we set these nurses on a course toward success.

That’s why this winter we’ve launched a new Nurse Residency Program. All newly graduated RNs hired to work at Bryan Medical Center are enrolled in one of three groups launching each year. Our most experienced nurses mentor and stand by these new grads to support them as they move from knowledge to application. From theory to action. From passion to purpose.

For more details of this exciting new program, visit bryanhealth.org/jobs or send questions to NurseResidencyProgram@BryanHealth.org.

Rest assured that we will continue to work tirelessly to build a workforce that will always be prepared to provide excellent care to you and your family. We are 90 years young and look forward to keeping your family healthy for generations to come. Bryan Health. Forward. Together.

Kimberly A. Russel President and Chief Executive Officer, Bryan Health

Trauma champion Taylor reaches new milestones A lot’s been going on in the life of Taylor Graham.

You may recall that he was featured in the Summer 2015 edition of Journeys after being honored at the Tribute to Trauma Champions. Taylor had been injured in a 2013 motorcycle crash and began his inspirational recovery at Bryan.

He’s since won national championships in singles and doubles wheelchair tennis and can walk when using forearm crutches.

Taylor and Hannah were married Oct. 29, 2016 — they met during his therapy at Madonna Rehabilitation Hospital — and in December he earned a Southeast Community College associate degree in welding Taylor aces technology. recovery He’s continuing to live life to the fullest. n

JOURNEYS “Destiny is not a mat

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PAT I E N T E X P E R I E N C E

Bridgette Baden appreciates the teamwork of the Bryan staff, such as Sunnie Lefgren, RN, (left) and rehab service assistant manager Tracy Loveless, PT, who helped her recover from injuries suffered in a car crash.

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Bridgette reaches her goals

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ridgette Baden of Hebron is a college student with dreams about her future.

“I’d like to be a teacher.”

Those dreams, however, took a violent detour July 9, 2016.

She was a backseat passenger that night, traveling north on Highway 81 near McCool Junction, when the car was hit by a drunk driver’s vehicle. Bridgette was ejected and thrown several hundred feet. Emergency responders transported Bridgette to York General Hospital to stabilize her injuries, then an air ambulance flew her to the Bryan West Campus, where she was immediately taken into surgery.

Bridgette’s injuries were extensive — an open fracture of her left arm; concussion; facial fracture; deep lacerations on her face, foot and knee; and significant road rash on much of her body with glass and dirt in her wounds. She also was in respiratory failure.

Bryan’s trauma team worked to stabilize her injuries and repair the damage she’d suffered. After undergoing several surgeries and six days in the intensive care unit, Bridgette was transferred to the acute inpatient rehabilitation unit.

From trauma to rehab “When a trauma patient comes in, the rehabilitation department liaisons are the first to connect with the patient and/or family and monitor the patient’s progress,” explains rehabilitation services manager Bonnie Kreiter. “When the patient is medically stable and ready for the next step in recovery, our team collaborates with the acute care team to coordinate a seamless transition to the rehab unit.

“This allows us to provide continuity of care and the best outcome for our patients.”

As the medical director of the acute inpatient rehabilitation unit, Rhondel J. McCann, MD, directs and coordinates medical care and therapies for patients on the unit.

“We work closely with the trauma program to understand how patients are progressing through their recovery,” she says.

Rehabilitation physiatrists, like Dr. McCann, are responsible for outlining the patient’s care plan and monitoring medical

status. “When they’re ready, we work to maximize their independence while they’re healing and recovering from devastating injuries. It’s not what we as clinicians want to achieve, it’s what the patient wants to achieve,” she says.

Setting goals Upon entering rehab, Bridgette’s case was brought to the interdisciplinary rehabilitation team. With the patient at the center, the team includes a physiatrist and Bryan co-workers from physical therapy, occupational therapy, recreational therapy, speech therapy, rehab nursing, and other areas.

Working in collaboration with Bridgette, the “I have the team at interdisciplinary Bryan Health, as well rehab team assessed her goals and as my amazing family developed a care to thank for helping me plan for achieving those goals. every step of the way.”

For Bridgette, – Bridgette Baden the goal was to return to classes at the University of Nebraska-Lincoln as quickly as possible.

“Due to the extent of her injuries, we realized that she’d likely be in a wheelchair for a while,” says Bonnie. “Her therapy needed to include activities that would make it possible for her to get in and out of her apartment, carry her books and take care of herself.”

The rehab team talked with Bridgette regarding what to expect in 30 days and 60 days, along with the recovery process.

“I’m always trying to push my limits,” says Bridgette. “But it just takes time, which I didn’t realize at first. The staff could see my frustration and did their best to talk me through it.”

Dr. McCann points out that patients need to understand the time required to regain function. Frustration is a common emotion experienced during recovery.

“Treating patients on the rehab unit involves treating not

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PAT I E N T E X P E R I E N C E

Thanks to rehab teamwork, Bridgette’s story has happy ending only their physical health, but also their emotional and cognitive health,” she explains. “If the patient needs assistance breaking through specific mental barriers, we have resources we can bring in for psychological and spiritual health.”

Bonnie says patients often don’t realize how challenging it can be to complete everyday tasks, such as brushing their teeth, dressing themselves or using the bathroom.

“We try to make therapy fun,” says Bonnie. “But it’s hard work. Rehab is a series of a hundred little steps.”

Bridgette enjoys relaxing in the Bryan Rehabilitation Garden, where the team helped her work on using her arms and getting stronger.

A proven track record The acute inpatient rehabilitation unit at Bryan has been helping patients achieve their goals for over 20 years.

The unit has continually received the highest level of recognition by the Commission on Accreditation of Rehabilitation Facilities. The rehab unit treats more than 500 patients each year, with 83 percent able to discharge to their homes, compared to only 72 percent from other rehabilitation providers in the region. (See Page 35 for a related story.)

“Our outcomes in each of the following programs — child and adolescent, brain injury, stroke, amputee, and adult rehab — are above national and regional norms,” says Bonnie. “This is what makes our accreditation so important to our patients.”

The acute rehabilitation unit also focuses on leading-edge technology. The most recent addition are a Saebo device that fits over the hand and arm to help improve upper extremity grasp and rehabilitation, and a Lite Gait device that assists with functional walking.

“Bryan Health has been very supportive in providing new technologies to maximize patients’ outcomes,” says Dr. McCann.

Physicians provide expertise Physicians from many fields contribute to the rehabilitation team’s success at Bryan.

Jeffrey Wienke, DPM, is the director of the Amputation Prevention Center at Capital Foot and Ankle. He graduated from the Des Moines University College of Podiatric Medicine and Surgery and is certified by the American Board of Wound Management. His primary area of practice is limb salvage/amputation prevention.

Rhondel J. McCann, MD, is the medical director of Bryan’s acute inpatient rehabilitation unit. She graduated from Albany Medical College, New York, and completed her residency at the University of Texas Health Science Center at San Antonio. Dr. McCann is certified in Brain Injury Medicine and in Physical Medicine and Rehabilitation.

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PAT I E N T E X P E R I E N C E

Months after the crash, a fully recovered Bridgette shares hugs with Tracy at Bryan’s annual Rehabilitation Reunion.

“Technologies like the Saebo make a significant difference in a patient’s recovery and independence.”

Another thing that makes the acute inpatient rehabilitation unit so effective is the coordination of care among all disciplines. For example, Bridgette was able to see specialists like Jeffrey Wienke, DPM, a surgeon at Capital Foot and Ankle.

“I was able to monitor Bridgette’s lacerations throughout her rehabilitation journey — even after discharge,” he says. “The collaboration with the rehab unit on the Bryan West Campus is great. The ability for patients to receive specialty care on site leads to better and quicker outcomes.”

Therapy in the garden One of the unique features of the acute inpatient rehabilitation unit is access to the Bryan Rehabilitation Garden.

Established in 2015, this garden is dedicated to providing an enjoyable space for patients as they recover and rebuild.

Made possible through a gift from a former patient through the Bryan Foundation, the Bryan Rehabilitation Garden features a variety of surfaces, textures and grades for patients to test their gait, including a curb step and ramp. Occupational and physical therapists can assist patients in learning to use a

wheelchair or walker. Speech therapists can use the names of plants to help patients through memory and recognition exercises. Functional activities like filling the bird feeder or watering plants help with dexterity and strength.

Though it’s a benefit for patients, the Bryan Rehabilitation Garden also is a haven for families and caregivers.

“It’s beautiful to take in. Yet it’s amazing that every item in the garden serves a specific rehabilitation purpose,” says Bonnie.

The rehabilitation team used the Bryan Rehabilitation Garden to help Bridgette work on being able to reach and use her arms. Her therapist also worked with Bridgette on arm strength in pushing a wheelchair up steep grades.

“That’s what I was going to have to do on campus, so I got the opportunity to build my strength and practice in the garden,” says Bridgette.

Transitioning home After several weeks in acute inpatient rehabilitation, Bridgette was ready to return home.

“To discharge a patient, we need to ensure that they are independent with the activities of daily living. This means being able to dress, bathe, prepare meals, get in and out of the home safely, and other custom needs,” explains Bonnie.

Bridgette continued outpatient therapy following her hospitalization.

“That’s a strength we have at Bryan,” Bonnie says. “When a patient is discharged from inpatient rehabilitation to another area, there is excellent communication. We want outpatient therapists to seamlessly pick up where we left off.”

With the accident behind her, Bridgette says her life is almost back to normal. Minus the scars.

“I see my scars and I’m reminded how lucky I am,” Bridgette says. “I know things could have been a lot worse.”

She’s back to doing the things she loves — going to school and coaching and even playing volleyball, something she thought she may never do again.

“Being back on the court feels amazing. And I have the team at Bryan Health, as well as my amazing family to thank for helping me every step of the way.” n To learn how you can support the work of Bryan Health, please call the Bryan Foundation at 402-481-8605.

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CRETE AREA MEDICAL CENTER

In-home physical therapy is music to her ears

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ne day last spring, physical therapist Jeff Schultz saved a few minutes in his schedule to make sure he spoke with co-worker Tammy Schroeder, an advanced practice nurse practitioner at Crete Area Medical Center.

They had a patient in common — Pat Butt of Crete — and her last in-home physical therapy session raised red flags with him.

Pat was growing weaker and less active with each PT session, when she should have been gaining strength. Jeff thought Pat needed a higher level of medical care than she could receive at home.

It turned out Tammy had similar concerns based on a recent clinic appointment with Pat. The brief exchange between physical therapist and nurse practitioner that day was small, but crucial, demonstrating the significance of in-home physical therapy visits and of having a rural hospital with a close-knit staff.

Closeness benefits patients Following that discussion, Pat was admitted to Crete Area Medical Center, where she received daily physical therapy, balanced meals and medication at regular intervals. It allowed her to gain the strength to return home and work toward the active life she led before the infection that sent her to the hospital.

“Someone who hadn’t worked with Pat before would likely have thought this

Retired teacher Pat Butt (center) shared musical memories with former students Karla Renn, a surgical technologist at CAMC, (left) and director of organizational improvement Jayne Van Asperen. Each took clarinet lessons from Pat in 5th grade.

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CRETE AREA MEDICAL CENTER was simply a very sick lady who needed to get better, but knowing her and her abilities, I reacted differently than a therapist who would have been new to her,” Jeff says.

Pat can’t pinpoint when her infection began, but her downturn in health included unusual stomach pains and a growing fatigue. She thought it might be a virus.

She didn’t improve, though, and began to give up the routine activities she’d enjoyed for decades — such as teaching piano lessons; baking cakes for students and families for their special occasions; and playing the organ and hand bells at Crete’s First Congregational United Church of Christ and other local churches when they needed an organist.

Then came the Sunday when the hymnal seemed too heavy to lift onto the music rack.

Friends told her she looked ashen and urged her to see a doctor. They worried for their social friend who didn’t feel up to visiting much anymore. Pat was retired from a longtime career as an instrumental music educator; her husband Merlin Butt (“rhymes with foot,” he always said) had died two years earlier, and their grown children live out of town.

Pat finally made an appointment with Tammy, a neighbor and friend whose children crossed their quiet cul-de-sac to take piano lessons from Pat. Tammy expected the appointment would cover Pat’s chronic health conditions, including surveillance of stable heart and renal conditions. That day, though, her problems were acute.

An elevating white blood cell count and compromised kidney function hinted at a serious, possibly life-threatening infection.

“She was very weak,” says Tammy,

who sent Pat by ambulance to the Bryan East Campus in Lincoln, where she would recuperate for the next two weeks.

When she returned home, Crete Area Medical Center’s Physical Therapy and Rehabilitation Services made all the difference.

Its physical therapists, occupational therapists and speech language pathologists work as a team to share their clinical expertise in a caring environment, including inpatient, outpatient, skilled-nursing care or in-home settings (for patients with physical or health barriers that prevent them from easily leaving home).

Consistency is valuable The program’s structure provides consistency — patients often see the same physical therapist throughout their recovery. In Pat’s case, Jeff worked with her continually. As CAMC’s director of Rehabilitation Services, he sees patients in the hospital, on an outpatient basis, in their homes or in skilled-nursing facilities, through an agreement with Tabitha Health Care Services.

“One of the best things to come out of this is the continuum of treatment.

When you see someone in their home, you know if little problems are popping up; you know what’s typical or out of character and if a physician needs to be notified,” Jeff says. Working with Pat in her home allowed him to see that her condition had declined.

“In-home physical therapy lets us extend contact with patients beyond the clinic and hospital doors,” Tammy adds.

She appreciates the “second set of eyes” rehabilitation staff can offer on a mutual patient’s nutrition habits, response to medications and more.

Pat is gaining strength and becoming

more active now, progressing from simple exercises and walking a few steps, to strengthening exercises and walks across her home. “I really wanted Pat to get her quality of life back up, to be able to put health issues to the back of her mind and do the things she enjoys,” Tammy says.

Pat is looking forward now, too.

“I’m finally feeling stronger,” she says, sitting at her kitchen table with her walker nearby. “The occupational therapist and physical therapist were very consistent.

They pushed me, but in a friendly way.

They’re truly interested in your well-being.”

It feels good to walk across her house again; to water the plants on her porch by herself. She’d like to resume some piano lessons or stretch her fingers over the organ keys again. Music offers its own healing powers to Pat, who taught music for 38 years. Her illness demonstrated just how many friends she’d made over the years, teaching in Western, Dorchester and Crete.

The hospitalist who took care of her at Bryan Health? He learned the trumpet in her Crete classroom.

And Dr. Amy Vertin, an emergency room physician at CAMC? “Tenor sax,” Pat says.

Kurt Schmeckpeper, physician assistant at CAMC and Wilber Medical Clinic?

“I taught his children piano — they were excellent students.”

Her list of former students includes a neighbor, who knocks on the front door, delivering mail and asking if she needs a ride to her upcoming medical appointment.

When he leaves, Pat’s face breaks into a grin.

“French horn — Dorchester,” she remembers. n

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SIMULATION CENTER

Patient simulator mannequins teach lessons about reality

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n 2010, Bryan College of Health Sciences, Southeast Community College and Bryan Medical Center, with support from donors and Bryan Foundation grants, collaborated to create the Center for Excellence in Clinical Simulation.

The center, also known as the Patient Simulation Center, uses 10 state-of-theart patient simulator mannequins in a

Mannequins also are used in community education and for teaching new techniques and certifying Bryan staff. Ann Nieman, RN, labor and delivery, and her co-workers participated in a childbirth simulation.

Student nurses prepare to care for their patient in the simulation center at Bryan Medical Center West Campus.

highly realistic hospital setting to prepare students and clinicians for hands-on challenges.

In the six years since it was established, more than 24,000 students and clinicians from many disciplines have trained at the center. Nursing, nurse anesthesia, respiratory therapy, physical therapy and paramedic students routinely attend teaching laboratories there. Bryan nurses and other clinicians also use the simulator mannequins to learn new techniques and check competency.

The mannequins — five adult, two children, an infant and two birthing simulators — can be programmed to represent patients with a wide variety of medical conditions, complete with heart and lung sounds, vital signs and other indicators that respond to medications and other clinical interventions.

Faculty members use microphones to remotely provide the “voices” of the simulated patients to create teaching

scenarios varying in complexity from routine patient care to very challenging situations, like severe asthma and heart attacks. This helps instructors gauge students’ and clinicians’ abilities to think critically and prioritize care.

“Bryan was the first nursing college in Nebraska to use the high-fidelity human patient simulator,” says former Bryan College of Health Sciences professor Kim Leighton, RN, PhD, who helped pioneer the center.

In 2003, Phylis Hollamon, then president of the College, asked Dr. Leighton to evaluate the usefulness of patient simulators in teaching.

“I quickly realized that simulation had

Assistant Professor Jenna Dubas monitors the students’ progress during the scenario.

excellent potential as a teaching tool.

As a result, the college decided to bring patient simulators into all parts of the nursing curriculum,” says Dr. Leighton.

From there, patient simulation was

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SIMULATION CENTER coordinator Kara Burbach, MSN, RN, agrees. “After the teaching scenario, we can reflect back with students about decisions they’ve made.”

In this way, students safely learn to master complex skills.

Olivia Dunham, a nursing student from Lincoln who will graduate in 2018, says, “Some people are primarily handson learners, and some are book learners.

For a lot of people, the Patient Simulation Center is a great hands-on opportunity where concepts really ‘click,’ and confidence develops.”

Nursing research shows that patient simulation eases transition into practice for new nursing graduates by allowing

Students wear appropriate clothing to make simulations as authentic as possible. There are 10 patient simulator mannequins at the center, providing a full range of medical challenges.

adopted to teach students and clinical staff throughout the medical center, and the Patient Simulation Center was born.

Meanwhile, simulation emerged as an innovative clinical teaching tool nationally and internationally, and Dr. Leighton and the College of Health Sciences played ongoing, important roles.

Dr. Leighton summarizes the unique advantages of simulation in clinical learning. “A typical clinical day provides ‘random learning opportunities,’ where students work only with patients who happen to be in the hospital that day.”

Because patient simulators are programmable, however, instructors can tailor learning opportunities to focus on

specific skills. “Simulation also provides opportunities to learn from mistakes, repeat scenarios, and manage complex clinical situations,” she says.

Assistant Professor and simulation

Students watch a recording of the scenario.

Simulation coordinator Kara Burbach calls the center “an extraordinary success.”

more extensive hands-on learning.

It also can be useful providing continuing education and promoting retention of experienced nurses.

Barbara Sittner, PhD, RN, a nursing professor at the college, conducted a research study of rural nurses who provide obstetrical care.

In Dr. Sittner’s study, nurses cared for

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SIMULATION CENTER an obstetric “patient” who was admitted with hypertension, then experienced a difficult delivery and developed postpartum hemorrhage.

“When this happens, you must work very quickly,” Dr. Sittner says. “Simulation allows nurses to practice complex decision making and hands-on skills needed in emergency situations.

“Nurses can then bring these skills to ‘real life’ clinical situations to provide the highest quality care for patients and their families. That’s the beauty of simulation.”

Dr. Leighton, now an internationally recognized expert in simulation learning, eventually became dean of Educational Technology at the Bryan College of Health Sciences, and is assistant dean of Research and Simulation Faculty Development for DeVry Medical International’s Institute for Research & Simulation. Bryan College of Health Sciences continues to play a major role in promoting simulation learning nationally and internationally through the Simulation Education Graduate Certificate program established by Dr. Leighton.

“The Patient Simulation Center has been an extraordinary success for Bryan,” says Burbach.

“With the generous support of our donors, the foresightful leadership of the College, the successful collaboration with Southeast Community College and our ongoing faculty research commitment, we’ve become recognized leaders and innovators in simulation training.” n To learn how you can support Bryan Health, please call the Bryan Foundation at 402-481-8605.

To see a video about the Simulation Center, go to bryanhealthcollege.edu/ VIDEO simulation-center.

Estate gift becomes part of former Bryan teacher’s legacy

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ollowing her pioneering work at the Center for Excellence in Clinical Simulation, Kim Leighton, PhD, RN, became internationally known for her work as an educator, author and researcher in patient simulation in health care.

She has served as president of the International Nursing Association for Clinical Simulation and Learning, led development of the first Standards of Best Practice: Simulation and is a fellow of the National League for Nursing’s Academy of Nursing Education.

Dr. Leighton recently honored Bryan Health with a generous estate gift because of her gratitude to Bryan and the Bryan College of Health

Sciences. She says, “I’ve had an incredible career in part thanks to working and teaching at Bryan and collaborating with my colleagues to create the Simulation Center.”

Dr. Leighton’s estate gift will fund a faculty position to be called the Kim Leighton Professorship for Active Learning. The gift will provide salary and research support to help the college recruit and retain talented educators and researchers working with active learning strategies like simulation.

“Through this gift, I’ll continue to impact education of future nurses,” she says, “and that makes me feel very good.” n

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CARE TRANSITIONS

Smoothing the path after hospitalization

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hen Arlene Gettert of Albion talks about how Bob Focht, RN, helped in her late husband’s care at Bryan Medical Center, she uses the word “godsend.” Arlene’s husband, Duane, was diagnosed in 2015 with a rare tumor called chordoma, which surrounded the base of his brain and spinal cord.

As a member of Bryan’s Care Transitions team, Bob coordinated Duane’s care throughout his stay at Bryan, and helped his family solve problems, particularly as it came time for Duane to leave the hospital.

“As part of our work,” Bob says, “we manage the entire continuum of a patient’s care from admission until the time he or she transitions out of the hospital to the next phase of care. That includes assessing patients’ needs and meeting with family and helping them solve the everyday practical challenges people encounter during and after hospitalization.”

He adds, “Our Care Transitions program reflects a national trend that’s been refined over recent years to get patients safely through the next step after hospitalization, whether that’s going

home or to another care facility.”

Care Transitions director Leslie Bonelli, RN, explains, “The job of our team is ‘transitional planning.’ We at Bryan are responsible for patients’ quality of care after they leave the hospital, so we need to make sure they successfully transition to the next level of care.

“The Care Transitions team members make sure that move goes smoothly.”

In addition to nurses like Bob, the team at Bryan includes social workers, utilization managers and others.

The role of nurses on the Care Transitions team is to find care placement

Bob Focht, RN, talks with Arlene Gettert and Care Transitions co-worker Carmen Orr, RN.

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CARE TRANSITIONS

Helping prepare for life after hospitalization for patients and meet their posthospital needs by arranging services such as home health, equipment rental and assistance with obtaining medication.

Social workers also locate resources and services and address patients’ and families’ needs for psychological support.

Utilization managers work with insurance companies to cover patients’ medical necessities, including appropriate lengths of stay.

Rehabilitation liaisons identify patients who need rehabilitation services and match them to local care providers, and two additional team members help patients apply for Medicaid.

Care Transitions soon will add two new roles. n Care navigators — nurses who will work with patients in orthopedic and outpatient clinic areas — will assist patients in following their treatment plans. n A Care Transitions Call Center will make automated calls to all patients within three days of their discharge from the hospital to ask if they have concerns and whether they understand their post-hospitalization care instructions. If patients have problems or questions, a nurse will call them back to discuss solutions.

Bob helped the Gettert family solve several complex problems.

“When my husband began to have nightmares because of his radiation treatments,” says Arlene, “Bob helped by finding a psychologist, Dr. Chris Rathburn, who counseled Duane about how to reduce his stress during treatments, and that lessened his nightmares.”

Arlene Gettert cradles her cellphone while displaying a photo of her late husband, Duane.

As Duane began to improve, one goal was to get him into acute care rehabilitation services.

“Bob worked hard to get Duane into rehabilitation,” Arlene says. “There was some question of whether he was a good candidate, but with Bob as his advocate, he got in, and he progressed well.”

“We knew Duane wanted to get to a more home-like environment,” says Bob, “and to do that, he would have to get stronger. We advocated for him to get into rehabilitation, and once he did he worked hard and was able to leave the hospital.”

At that point, however, Duane needed care his family knew they couldn’t provide at home, so further services were necessary. Bob and the Care Transitions

team worked with insurers and health care services to locate assisted living care and eventually, hospice care.

Although Duane eventually died from his cancer, Arlene fondly remembers the attention he received from Bob and his Bryan co-workers.

“Bob was always available. He had an open-door policy and would listen carefully; then we’d brainstorm solutions together. It’s obvious that Bob’s heart goes out to his patients, and that his reward in his job is getting to help others. That came across clearly in the way he cared for our family,” says Arlene.

“We also had incredible nurses.

They were all just excellent — always compassionate and understanding of Duane’s needs. I had never seen anything like it.”

She particularly remembers Meghan Vanderkolk, a nursing technician who is now a registered nurse at Bryan. “She lit up the room when she came in, and her care was fantastic, every day,” Arlene says.

“This was an incredibly difficult time for our family,” she adds.

“But Bob and the staff throughout Bryan consistently showed great passion in caring not only for Duane as the patient, but for us as his family, so we were able to do what we needed to do, one day at a time.” n To learn how you can support the work of Bryan Health, please contact the Bryan Foundation by calling 402-481-8605.

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BRYAN HEART

Celebrating 50 years of open heart surgeries

1 Retired heart surgeon Stephen Carveth, MD, (front) and Bryan Heart cardiothoracic surgeons Robert Oakes, MD, Richard Thompson, MD, and Ryan Shelstad, MD, join the celebration Oct. 26.

2

3

Past and present physicians and staff honored the legacy of heart care pioneers. Dr. Carveth greets Keith Miller, MD (1), the family of Herb Reese, MD, gathers (2) and a video salutes pioneers, like Walt Weaver, MD (3).

Bryan Heart Executive Medical Director Dale Hansen, MD, addresses the crowd at the Cornhusker Marriott. To watch the video about the first 50 years of heart care at Bryan that was shown at this special event, go to bryanhealth.org/heart50.

VIDEO

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BRYAN HEART

Football fan tackles STEMI

H

usker football fan Cathleen (Cathy) Cummins and her twin sister, Chris Powers, of Omaha knew a Sept. 17, 2016 match up with traditional powerhouse Oregon had the potential for heart-pounding excitement. It was the first Big Game of a promising young season, after all.

But a STEMI hit Cathy that afternoon like a blitzing linebacker out of the blue.

A STEMI (shorthand for ST-Elevation Myocardial Infarction) is a very serious kind of heart attack, in which one of the heart’s major arteries is blocked. Cathy was at risk for a sudden cardiac arrest and needed help right away.

Fortunately, she had a team of championship-caliber providers on her side.

Not a typical football weekend “We’ve had season tickets for years,” says the 68-year-old.

“We park in the Haymarket District, so it’s a bit of a walk to get to Memorial Stadium several blocks away, and then we go up to the second level to get to our seats.”

She’d been sunburned at the previous game, so while Chris went into the stadium to see the players’ tunnel walk entrance, Cathy stayed temporarily in the shaded concourse to watch on TV. “All of a sudden I was drenched in sweat — which was very unusual — although I didn’t feel bad,” she remembers. “I started up the ramp to join Chris when a pain started above the elbow of my left arm like I’d never had before. It was terrible.”

Things quickly spiraled to fourth-and-long bad.

“Chris noticed I’d been sweating, but we didn’t think much of it because it was a warm day,” Cathy says. “But after about a minute more, I said I couldn’t stay at the game, the pain was just too much.

“So we left right before kick off, and as we were going down the ramp, I thought I should sit by the railing for a few minutes, and then we’d walk back to the car and drive home.”

To paraphrase a famous sports broadcast, “Man, woman and child — that would have put her in the aisles!”

asked if I needed medical assistance, and an EMT was there in less than two minutes!”

They rushed her by wheelchair to an emergency area in a lower level of the stadium.

On game days, Cathy Cummins always gets decked out in her favorite team’s colors. The retiree and her twin sister, who worked for Union Pacific Railroad, have been Husker football season ticket holders for years.

Help quickly on the way “A lady who was a nurse and a man who said he’d worked in a hospital suggested I lie down because I might have heat stroke, and he poured some water on my neck to cool me. But that didn’t explain this crazy pain in my arm,” she continues. “Someone else

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BRYAN HEART Dr. Johnson threaded a balloon catheter through an opening in Cathy’s wrist, known as the radial approach, instead of the more common entry through a femoral artery of the leg.

Pointing to a small mark on her arm, Cathy marvels, “After they reopened the blocked artery, they placed a mesh stent inside to hold it open — and can you imagine this is all the bigger my scar is? I have to say, it’s something to be avoided, but it was not a terrible experience.”

How unusual is this scenario? She says, “When Dr. Johnson came to check on me in the hospital the next day, he told me he does one or two heart caths every home game, when there are more than 90,000 fans in the stands.”

“I remember Cathleen’s case well,” the cardiologist says.

“Women with heart disease don’t always have the classic symptoms of massive chest pain and jaw pain that men usually have, and although her symptoms were atypical for a blockage, she was alarmed enough to seek help and activate the system.

“And early activation is definitely the key to success.”

The team that placed Cathy’s stent included cardiovascular technologist Michelle Glenn, cardiologist Matthew Johnson, MD, and cardiovascular RNs Louis Lemon and Jeremy Middleton.

“Then they put electrodes on me to get an electrocardiogram to record my heart’s electrical activity, gave me four aspirins, and somebody put an IV line in my arm,” says Cathy. “I thought the pain kind of went away, but then it returned with a vengeance.”

The University of Nebraska’s football game had just begun, but for Cathy it was time for an all-out, hurry-up offense.

Lincoln Fire and Rescue medics attended to Cathy and transmitted readings from its 12-lead EKG equipment ahead to Bryan East Campus, so that the cath lab was alerted that a patient with a possible STEMI was on the way. The LFR emergency medical tech and paramedic continued to monitor her condition as the ambulance quickly transported Cathy across town.

“They said it would be only about eight minutes to get me there,” she says. “They took me from the ER entrance directly to Bryan’s cath lab.”

Game faces on Cathy remembers, “We met the people in the cath lab and Bryan Heart cardiologist Matthew Johnson, MD, and the next thing I know, they’re getting pretty serious.”

Time is heart muscle Memorial Stadium has two aid stations for the public, staffed with providers from LFR and the American Red Cross, as well as providers who roam the stadium.

“They’re equipped to take care of any type of emergency, trauma or medical,” says EMS supervisor Aaron Pospisil of LFR. “Our LifePak monitor/defibrillators can obtain and transmit 12lead EKGs, so Cathy’s electrocardiogram was at Bryan East Campus before the LFR medic unit had even arrived to transport her. That really saves a lot of time.”

Because all of LFR’s ambulances have this capability, local hospitals usually need less than half of the recommended 90 minutes to progress “from door to balloon.” In Cathy’s case, it was only about 20 minutes.

“I went to her room post-stent, and it wasn’t even halftime of the game, and she was already sitting in a chair and cheering for the Huskers on TV,” says Dr. Johnson.

According to the physician, Cathy’s ability to recognize she was in trouble and seek help from emergency medical services was crucial. She responded to unusual symptoms and didn’t try to drive herself.

“Don’t sit at home, wondering if you have the flu or denying what your chest pain might mean,” Dr. Johnson warns. “We tend to know our own body well, so I tell my patients if it’s a discomfort between the nose and bellybutton, it could be heart-related. We want patients to be aware of the symptoms of blockages and call 9-1-1 because early response is key.”

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BRYAN HEART

Cathy’s option call puts life-saving teamwork in play Pospisil agrees it’s better inside wall of one of the vessels and blocked to call for an ambulance, as its the artery. The front vessel was 100 percent crew can be taking care of you closed, so they stented it. and transmitting EKG info to help “My sister had a heart cath about four the hospital get ready — while years ago, but my symptoms were different traveling much faster with sirens from hers, so it didn’t click with us that I was on and emergency lights flashing having a heart attack. In fact, the physical than you can expect to drive.

I’d just had two weeks before showed my “It’s all about teamwork. cholesterol levels were in the right ranges — The LFR team has to get the so, this STEMI was a big surprise!” patient treated, EKG conducted and transmitted to the hospital, Cheers for heart team cardiac alert declared, and “I was very, very lucky,” she continues. patient prepared for transport “The Bryan staff and the Lincoln Fire and in a relatively short period.

Rescue team members were excellent, and The sooner we’re called, the my doctor says there was no heart damage, Chris (left) and Cathy meet legendary Husker quarterback sooner the process begins,” says and Heisman Trophy winner Eric Crouch. so we’re all thrilled.”

Pospisil. “We’ve built a great But that’s not the whole post-game relationship with Bryan; they wrap-up for this Big Red fan. trust what they’re hearing over the radio and the EKGs we send.”

“I’m doing much better at watching what I eat, and I’m in Years ago, Bryan Health helped pay for the first systems in cardiac rehab in Omaha now — my doctor thinks that all the Lincoln’s ambulances to record and transmit EKGs. Now all of walking I do there and the prescribed meds are making a big the LFR medic units are equipped this way due to additional difference in my cholesterol and overall health. And this incident funding from the Community Health Endowment, and many local encouraged Chris to be tested again, too — and she seems to be emergency crews also have the technology. LFR works closely with doing fine.” many rural volunteer EMS providers, who start the EKG Cathy didn’t attend process, and Lincoln Fire and Rescue arrives to complete any more of the home the patient transfer to Lincoln. games in 2016 but, like all “This statewide EKG network has really revolutionized life-long fans, continued to ST-Elevation Myocardial Infarction how we treat STEMI,” Dr. Johnson says. follow Husker broadcasts.

(STEMI) is a very serious type of heart “As they say, saving time equates to saving heart She’s learned from attack. One of the heart’s major artermuscle cells. The more quickly we can restore blood to the the ups and downs of ies is blocked — putting the patient at heart, the better patients do in the long term.” the past season and is risk of a sudden cardiac arrest. working hard to prepare Know the signs for challenges ahead.

Signs and symptoms include: The physician notes, “The classic presentation is Just wait until next • Chest pain or discomfort substernal pressure or a heaviness that radiates to the season! n • Shortness of breath jaw or left arm. There’s a build up of pressure, that we call • Dizziness or light-headedness To learn how you can angina. But atypical things to look for are nausea or being • Nausea or vomiting • Sweatiness support the work of Bryan very sweaty — Cathy didn’t have a lot of pain or pressure, • Palpitations Health, please contact the but she had those symptoms — or recognize other • Anxiety Bryan Foundation by callunusual feelings, like tooth pain or ear pain.” ing 402-481-8605.

Cathy says, “Pure and simple, I have coronary artery Call 9-1-1 right away! disease. Apparently a piece of plaque had broken off the

What is a STEMI?

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BRYAN HEART

Seward man first to receive dissolvable heart stent at Bryan Doctors at Bryan were the first in Nebraska to commercially implant FDA-approved Absorb, a fully dissolvable heart stent that is safer for patients and restores and expands blood flow to clogged coronary arteries.

In the first eight months after the U.S. Food and Drug Administration approved Absorb in March, more than 1,500 people received the device.

Bryan Heart cardiologist Scott Coatsworth, MD, was the first in Lincoln to place the device outside of clinical studies.

Jim Spahr of Seward received two Absorb stents on Oct. 14, 2016.

“Heart disease is the No. 1 killer in the United States, with over half a million Americans losing their lives to this condition every year,” says Dr. Coatsworth. “This new stent is proven technology that will provide better results and safer long-term outcomes to our patients. We’re privileged to offer this type of advanced heart care.”

Unlike traditional metal stents, Absorb is a plastic, temporary material that is fully absorbed over time, eliminating foreign material that can irritate vessels or lead to infection or future heart troubles.

The stent begins to dissolve within a year and is fully absorbed into the artery within two or three years, after it has promoted a healthy healing of the vessel.

Dr. Coatsworth says, “Our goal is to provide the best possible care to patients that will allow them to return to their normal, active lifestyles.”

To learn more, visit bryanheart.com. n

Sara Hargreaves, MD, and Brian Kunzle take their son, James Alan, and Tulip for a walk in their Lincoln neighborhood.

Welcome, Dr. Hargreaves Sara Hargreaves, MD, is the newest member of Bryan Heart Vascular Surgery.

This graduate of the University of Texas Health Science Center medical school completed a vascular surgery fellowship at the University of Virginia in 2016.

She treats peripheral vascular disease — problems in blood vessels in areas of the body other than the heart — which can cause poor circulation and pain in the arms, legs and abdomen. As a vascular surgeon, Dr. Hargreaves removes plaque buildup in vessels, repairs aneurysms and treats varicose veins.

Scott Coatsworth, MD, greets Jim Spahr during a news conference after Spahr’s historic heart stent procedure.

VIDEO

See Page 20 to read Dr. Hargreaves’ biography. To watch a video introducing Lincoln’s newest vascular surgeon, go to bryanhealth.org/drhargreaves.

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MEDICAL STAFF SPOTLIGHT

Ask the doctor:

Q: What about stress?

Stress is not necessarily a bad thing in and of itself, but too much stress may contribute to increased blood pressure. It is difficult to determine if physical and mental stress cause high blood pressure. Stress is most likely a factor in high blood pressure, but the studies are still out on the exact impacts of stress as a factor because stress is intangible by nature.

What do my blood pressure numbers mean?

Wasim Chughtai, MD, answers questions about how to manage your blood pressure.

Dr. Chughtai is associated with Holmes Lake Family Medicine, which is part of the Bryan Physician Network.

Please tell us a little about yourself.

I grew up in Pakistan and lived there until graduating from King Edward Medical College in Lahore, Punjab, Pakistan, when I went to England. My medical training was through the British system, and I stayed there until 1992.

Then I completed a residency at St. Vincent’s Medical Center in Bridgeport, Connecticut, before moving to Nebraska in 1995. I am certified by the American Board of Internal Medicine.

Q: Why Nebraska?

The “good life” of Nebraska brought me here. It’s what makes Nebraska so wonderful and special. I earned my citizenship while living and working in Plainview, and I’ve practiced in Lincoln since 1998. This is home.

Generally speaking, we treat patients 18 and older. Younger patients usually still see a pediatrician, family practice physician or other specialist.

Q: What aspects of this career are rewarding for you?

To help patients live a healthier life is very rewarding.

Having the opportunity to treat patients who have conditions and keep people healthy is an honor.

Q: We are living in a highpressure, go-go-go world, and one thing that we often hear about is blood pressure. Why is it important to know if I have high blood pressure?

It is important because it is a risk factor for so many conditions — and also almost 100 percent preventable.

Q: Why did you choose internal medicine?

What is the role of these physicians?

By nature I am inquisitive and detailoriented — this is at the core of internal medicine.

Besides diagnosing and treating adult diseases such as diabetes, heart disease and cancer, prevention is an integral part of internal medicine and that means treating risk factors. In internal medicine, you diagnose and treat the quality that impacts any system or part of the body.

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MEDICAL STAFF SPOTLIGHT Q: Is blood pressure determined by environmental or genetic factors or both?

Yes, both. Variables can include family history, age, gender and race.

The genetic factor is why we ask about family history.

Family history is a risk for developing hypertension. If your parents or other close blood relatives have high blood pressure, it increases your risk, too.

KNOW YOUR NUMBERS

•

DIASTOLIC mm Hg (Lower #)

BLOOD PRESSURE CATEGORY

SYSTOLIC mm Hg (Upper #)

Normal

Less than 120

AND

Less than 80

Prehypertension

120-139

OR

80-89

High Blood Pressure (Hypertension) Stage 1

140-159

OR

90-99

High Blood Pressure (Hypertension) Stage 2

160 or higher

Maintaining a normal body weight.

• Eating a healthy diet rich in fruits, vegetables and low-fat dairy, and foods low in sodium.

• Regular aerobic exercise.

• Limiting alcohol intake.

Q: Why should I know my numbers?

There is no other risk factor that can be treated and impacted Hypertension Crisis in a positive way that reduces Higher than 110 OR Higher than 180 (Emergency care needed) so many big health problems Q: Overall, what do the numbers Data from the American Heart Association than maintaining a healthy blood represent? pressure. Hypertension is the The top number tells how much pressure biggest modifiable factor for heart disease, There are all sorts of blood pressure machines your blood is exerting against your artery stroke, kidney disease and poor circulation, out there — arm cuffs, wrist cuffs, finger walls when the heart beats. This is called the and these are preventable. For example, if measurements and so forth. The arm cuff systolic blood pressure. A number of 140 or you want to reduce heart attacks, maintaining measurements tend to be the most accurate. higher indicates systolic hypertension. a healthy blood pressure is the best way to The bottom number, called diastolic Q: Will my blood pressure be different from mitigate and prevent a negative outcome. blood pressure, indicates how much pressure time to time or even if the cuff is put on my your blood is exerting against your artery left arm instead of my right arm?

Q: Do you monitor your own blood pressure? walls while the heart is resting between Blood pressure numbers can vary, but Yes, I do. I check my own blood pressure beats. A number of 90 or higher is diastolic there should not be a large variance. It is a monthly, but I check more frequently when my hypertension. good idea to check both arms. Whichever arm numbers are on the higher end. gives you the higher reading, use that arm for Q: Where can I get a blood pressure reading? future readings.

Q: How often should we have our blood A physician’s office is the best option for pressure checked? an accurate and complete blood pressure Q: Please describe healthy and unhealthy If your numbers are out of normal range, reading. Additionally, many pharmacies will blood pressure ranges. see your physician and make a plan. Generally check your blood pressure, and you can Normal blood pressure is 120/80 or less. speaking, we tell our patients to check blood monitor your blood pressure at home. Having Blood pressure of 140/90 or higher pressure two or three times a week at home your blood pressure checked once in a indicates hypertension. Prehypertension is and see a physician as needed. If blood three-to-six-month period provides helpful 120/80 to 139/89. pressure is well controlled, follow-up may be measurements to discuss with your physician.

You may not be in the high blood pressure every three to six months. range during a checkup, but your reading may Q: How long does it take? indicate prehypertension. If so, it is important Q: If I haven’t had my blood pressure checked Blood pressure checks take only five to discuss changes that will prevent high blood for a while, what should I do? minutes or less. That is a good use of five pressure and return to normal levels.

Call and set an appointment with your minutes, in my opinion. There is a little physician — especially if you have a family pressure on your upper arm or wrist Q: What if I have high blood pressure? history and if you are overweight. The best if a cuff is used during the check, See your physician for further monitoring way to have a good outcome is to know your but it is not painful. of blood pressure and recommendations. Also, numbers and make a plan, if needed. Feel free start to monitor your blood pressure at home. to call our office and I will be happy to help Q: How do I know my you in living a healthy life. n numbers are accurate?

Q: What proactive steps can I take to keep my See your physician if you have questions Try to take your blood pressure in a healthy range? about blood pressure. blood pressure The first step to normal, healthy blood Go to bryanhealth.org/drchughtai twice and then pressure is to stay healthy. Do this by leading to meet Dr. Chughtai, or contact his average out a healthy lifestyle and implementing healthy office at 402-489-3200.

VIDEO your numbers. lifestyle changes to include: OR

100 or higher

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MEDICAL STAFF UPDATE

New faces at

Bryan

Welcome these colleagues to the Bryan medical community

Christopher Crawford, MD, general surgery, is associated with Surgical Associates, 402-441-4760.

Dr. Crawford graduated from the Medical College of Wisconsin, Milwaukee, in 2010. He completed a general surgery internship and residency at Marshfield Clinic/Saint Joseph’s Hospital, Marshfield, Wisconsin, and an advanced gastrointestinal/minimally invasive surgery fellowship at the University of Nebraska Medical Center, Omaha. He was the principal investigator for a study at Marshfield Clinic involving surgical site infections in breast surgery. Dr. Crawford is certified by the American Board of Surgery.

Sara Hargreaves, MD, vascular surgery, has joined Bryan Heart Vascular Surgery, 402-481-8500.

Dr. Hargreaves graduated from the University of Texas Health Science Center at San Antonio, Texas, in 2009.

She completed a general surgery residency at Union Memorial Hospital, Baltimore, and a vascular surgery fellowship at the University of Virginia, Charlottesville.

She also presented at the Vascular and Interventional Radiology Conference at the University of Virginia.

While in medical school, Dr. Hargreaves taught in the Raytown Public School District, Raytown, Missouri.

Harvey Hopkins, MD, FACCP, pulmonology, is associated with Nebraska Pulmonary Specialties, 402-483-8600.

He graduated from the University of Nebraska Medical Center College of Medicine, Omaha, in 1987. Dr. Hopkins served at the Naval Hospital in San Diego, then completed an internal medicine residency at the University of Nebraska Medical Center and a pulmonary and critical care medicine fellowship at the University of Iowa, Iowa City.

He is certified by the American Board of Internal Medicine in the areas of pulmonary medicine, critical care medicine and sleep medicine and by the American Board of Sleep Medicine. He also reached the rank of commander in the U.S. Navy Reserves and is a fellow of the American College of Chest Physicians.

Before joining Nebraska Pulmonary Specialties, Dr. Hopkins practiced in Omaha.

Zachary Martens, MD, anesthesiology, has joined Associated Anesthesiologists, 402-489-4186.

Dr. Martens graduated in 2011 from the University of Nebraska Medical Center College of Medicine, Omaha, where he completed an internship.

This Lincoln native completed an anesthesiology residency and perioperative echocardiography fellowship at the University of Utah School of Medicine, Salt Lake City.

He is certified by the American Board of Anesthesiology and the National Board of Echocardiography.

Josh Miller, MD, emergency medicine, is associated with Nebraska Emergency Medicine, 402-481-3142.

Dr. Miller graduated in 2006 from the Creighton University School of Medicine, Omaha.

He completed an emergency medicine residency through the San Antonio Uniformed Services Health Education Consortium, where he later served as a staff physician. While serving as a physician in the U.S. Air Force, he earned a meritorious service medal during a deployment to Bagram Air Field, Afghanistan; he was deployed twice more to Afghanistan and received the Bronze Star. Before joining Nebraska Emergency Medicine, he practiced in Omaha, and he remains an ultrasound instructor at the

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MEDICAL STAFF UPDATE University of Nebraska Medical Center, Omaha. Dr. Miller is certified by the American Board of Emergency Medicine. He also has been published in the American Journal of Emergency Medicine and was an ultrasound instructor in Cuba, Kentucky and the University of Nebraska Emergency Medicine Residency Program.

Monica Oldenburg, MD, anesthesiology, has joined Associated Anesthesiologists, 402-489-4186.

She graduated from the Creighton University School of Medicine, Omaha, in 2003 and completed a residency in anesthesiology at the University of Texas Medical Branch, Galveston.

Before moving to Lincoln, Dr. Oldenburg practiced in Pueblo, Colorado.

Horacio Alvarez Ramirez, MD, family medicine, is associated with People’s Health Center, 402-476-1455.

Dr. Alvarez Ramirez graduated from the University of Nebraska Medical Center College of Medicine, Omaha, in 2013 and completed the Lincoln Family Medicine Residency Program. He also has participated in mission trips to Mexico, Nicaragua and Jamaica.

Ted Triggs, DO, FACP, internal medicine, has joined Lincoln Hospitalist Associates of the Select Specialty Hospital, 402-483-8444.

Dr. Triggs graduated in 1997 from Kirksville College of Osteopathic Medicine, Kirksville, Missouri, and completed a residency and internship at Genesys Regional Medical Center, Grand Blanc, Michigan.

He is certified by the American Osteopathic Board of Internal Medicine and is a fellow of the American College of Physicians. Before joining Lincoln Hospitalist Associates, Dr. Triggs practiced at CHI Health St. Elizabeth in Lincoln.

Bradette Varilek, MD, internal medicine, is associated with Lincoln Hospitalist Associates of the Select Specialty Hospital, 402-483-8444.

Dr. Varilek graduated from the University of Nebraska Medical Center College of Medicine, Omaha, in 2003 and completed an internal medicine residency at St. John’s Mercy Medical Center,

St. Louis.

She served on a national committee for developing computerbased physician order entry sets for Catholic Health Initiatives hospitals and is on the University of Nebraska College of Medicine faculty.

Jacob Yetzer, MD, DDS, oral surgery, is associated with Nebraska Oral and Facial Surgery, 402-327-9400.

Dr. Yetzer graduated in 2008 from the University of the Pacific School of Dentistry, San Francisco, and in 2012 from the University of Florida College of Medicine, Gainesville.

He completed an integrated residency in oral and maxillofacial surgery and a fellowship in head and neck oncology and microvascular reconstruction.

Before moving to Lincoln, Dr. Yetzer was a Mayo Clinic Scholar in Rochester, Minnesota.

He also is a diplomate of the American Board of Oral and Maxillofacial Surgery. n

Welcome, advanced practice providers These advanced practice providers are working at Bryan Medical Center: Jennifer Axt, APRN, Lincoln Nephrology & Hypertension Marc Biggerstaff, PA-C, CHI Health Creighton Orthopedics Lauren Chatwell, PA-C Nebraska Trauma & Acute Care Surgery Brandi Craig, CNM, Integrated Women’s Health Angela Davies, APRN, Lincoln Nephrology & Hypertension Maggie Glawatz, APRN, Bryan Palliative Care Claire Green, APRN, Southeast Nebraska Cancer Center Amy Hecker, PA-C, CHI Health-Creighton Orthopedics Sev Linder, APRN, Bryan Acute Pain Service Carly Maack-Chee, APRN, Heartland Neonatology Kerri Purkeypile, APRN, Antelope Creek Family Physicians Kelli Schreiner, APRN, Bryan Palliative Care Jelayna Stauffer, APRN, Gastroenterology Specialties Diana Zapp, PA-C, Bryan Heart Vascular Surgery

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ADVANCES IN SURGERY

Spinal disc prosthesis preserves neck flexibility

An alternative to spinal fusion

I

n fall 2014, avid powerlifter “Mobi-C is approved for replacement to traditional spinal fusion surgery, in which Aaron Marshbanks of Lincoln was of up to two spinal discs between the third vertebrae are surgically joined to keep working out at the gym when and seventh vertebrae in the neck,” he pressure off a damaged disc and nearby he realized something was very says. Dr. Vande Guchte emphasizes that nerves. A problem with the fusion approach wrong. disc prostheses preserve rather than fully is that it can cause reduced spine flexibility.

Aaron, vice president of restore neck mobility. “These implants Fusion also requires bone chiseling and nonprofit charity Tiny Hands International, return a patient’s neck motion to what he placement of screws into the vertebrae, had severe pain in his neck and arms. So, or she had before being injured.” while placement of the Mobi-C is less he went to see Lincoln orthopedic surgeon invasive, as it’s held in place by small metal Robert Vande Guchte, MD, of Lincoln Advantages over fusion prongs. Eventually, surrounding vertebral Orthopaedic Center, who found that Aaron Placement of Mobi-C is an alternative bones grow onto the endplates to securely had severely damaged a spinal disc in his neck.

He told Aaron about several options, including replacing the damaged disc with a new prosthetic spinal disc implant called Mobi-C from Zimmer Biomet.

The implant is made up of two metal endplates and a plastic centerpiece. Surgeons place Mobi-C between bones (vertebrae) of the neck to replace a spinal disc damaged by injury or arthritis. The implant improves neck movement, and removal of the damaged disc can reduce pain in the patient’s neck, shoulders and arms by taking pressure off inflamed nerves.

Disc prosthesis placement was introduced in America in 2009. Mobi-C was approved in the U.S. about four years later, and Dr. Vande Guchte performed the first Mobi-C Orthopedic surgeon Robert Vande Guchte, MD, (right) discusses the advantages of the Mobi-C prosthetic disc procedure in Nebraska in 2014. implant procedure, which he performed on powerlifter Aaron Marshbanks at Bryan West Campus.

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ADVANCES IN SURGERY

Mobi-C implants have advantages over fusing spinal discs which were damaged by injury or arthritis.

hold the Mobi-C device in place.

“Another advantage of spinal disc implants like Mobi-C is that because we don’t need to cut bone or place screws to seat the implant, patients may have less pain postoperatively than after spinal fusion,” says neurosurgeon Andrew Livingston, MD, of Neurological and Spinal Surgery.

“Patients also usually return to Andrew Livingston, MD normal activities more quickly than those with fusions,” he says.

Benjamin Gelber, MD, one of Dr. Livingston’s partners, adds, “Most of our patients receiving implants are seen Benjamin Gelber, MD as outpatients, and many go home within four hours of surgery.”

All three surgeons emphasize that prosthetic spinal disc implants like Mobi-C might lessen patients’ risk for additional spinal surgeries.

That’s because, while spinal fusion increases stress on discs in adjacent vertebrae, implants reduce this stress by improving flexibility. So, implants may reduce problems with adjacent vertebrae in the neck and patients’ needs for further surgeries down the road.

others will likely become available. We’ll continue to use the best option for each patient.”

Dr. Vande Guchte agrees. “Technology gives us many options, but we always base our treatment decisions on each patient’s situation and physical assessment findings.”

Often covered by insurance Placement of prosthetic disc implants in the neck increasingly is being covered by medical insurance.

“Many insurance companies understand that placement of an artificial disc is cost-effective, so they’re approving this treatment,” Dr. Gelber says. Spinal disc prostheses also can replace damaged discs in the lower back, but insurance covers that procedure less often.

Many options, customized care Other types of prosthetic discs are available for use in the neck, but Lincoln surgeons most often use Mobi-C because, unlike other implants, its centerpiece is flexibly attached to the bottom endplate, allowing increased neck movement.

Other surgical options exist for patients with damaged spinal discs.

“The Mobi-C is an exciting new option we offer as part of a range of potential treatments for the neck,” says Dr. Livingston.

Dr. Gelber adds, “Competitor implants are made by at least two companies, and

Aaron’s recovery The typical patient treated with a prosthetic disc is an adult who doesn’t have long-lasting pain, extensive arthritis or joint looseness such as that caused by rheumatoid arthritis, but who experiences sudden pain after an injury.

“That means there is a sizable group of patients who are candidates for prosthetic discs,” says Dr. Vande Guchte, “if that’s what’s right for them.”

Aaron was just such a patient. When his symptoms didn’t improve with medication, rest and physical therapy, he returned to Dr. Vande Guchte, who replaced his damaged disc with the Mobi-C implant. Aaron’s symptoms lessened immediately after surgery, and in three weeks he was back to his everyday activities, including a full return to powerlifting. ”The disc replacement was the best decision I could have made,” Aaron says.

“I went back to my normal lifestyle quickly, without the extended recovery time other options required.

“My only regret is that I didn’t do it sooner.” n To learn how you can support Bryan Health, please contact the Bryan Foundation at 402-481-8605.

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PA L L I AT I V E C A R E

Program improves experiences for patient, loved ones facing serious illness

B

ryan Medical Center’s Palliative Care Program manager Denise Borton, MS, RN, has a favorite quote by American philosopher John Dewey: “We do not learn from experience. We learn from reflecting on experience.”

This is true for many of us — growth is in the reflection of an experience. And this is especially true in the palliative care world where reflection and a focus on the experience are at the center of inpatient care. The Palliative Care Program began in August and already has served more than 350 patients.

Patient-centered goals “True palliative care involves a lot of dimensions — the physical, psychosocial and spiritual. The definition is focused on the patient and family. It’s not focused on the disease or illness, it’s really focused on patientcentered goals and managing the illness for the best experience possible for the patient and their family,” says Denise.

Palliative care improves quality of life for you and your family and maximizes the opportunity for positive experiences when dealing with any serious illness. Palliative care,

also known as palliative medicine, is not the same as hospice. It is specialized medical care that provides relief from symptoms and stress of a serious illness with the goal of improving quality of life.

Denise says, “Generally, people tend to equate palliative care with hospice. This is understandable when you look at the evolution of palliative care. Originally, hospice care came first, and palliative care became a part of hospice care. Now that there is a broader focus on palliative care to include life-limiting and chronic illnesses, palliative

Janelle Moran tells Nancy Steckelberg, APRN, and Nicole Espinoza, RN, stories about her life as a flight attendant and nurse.

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PA L L I AT I V E C A R E care addresses issues along the entire disease trajectory, including end-of-life and hospice.”

At Bryan Medical Center, palliative care is provided by a team of specialists who work with the patient’s other doctors to provide an extra layer of support. This care is appropriate at any stage in a serious illness, and it can be provided along with curative treatment.

Your doctor on the team Denise points out that our palliative care team of specialists includes board-certified physicians, nurse practitioners, nurses, social workers and chaplains. Ellen Miller, MD, is the program’s medical director, and the nurse practitioners are Mary Christensen, Maggie Glawatz, Kelli Schreiner and Nancy Steckelberg. Together with your doctor, they make sure that you receive the care you need, whether that is symptom management or advance care planning, home care services or, when ready, hospice.

“Palliative care also focuses on patientfamily communication,” she adds. “Sometimes the patient wants one thing while the family may want another, or a family is struggling to understand what is happening with their loved one.

“By facilitating these conversations, we can help patients and families develop a common understanding of the illness and present the resources and options available for the best care possible.”

Holistic approach Palliative care at Bryan has a unique spiritual component.

Chaplain Nina Redl is part of Bryan’s palliative team. When a patient wants spiritual guidance or counseling, she is available to provide services or coordinate with other chaplains within the Bryan team and with clergy throughout the community or the patient’s hometown.

Nina says, “To me, palliative care is holistic, that is a whole person approach. As patients and families face life-limiting and lifethreatening illnesses, it is more than just their

Is palliative care right for you?

Getting the palliative care you need is easy. Just ask your doctor for a referral. We work together with your primary doctor and health care team.

Our palliative care team is available for inpatients on Bryan East Campus and Bryan West Campus. The service is offered on weekdays 8:30 a.m.-3 p.m., except on holidays.

For more information, contact Palliative Care Program manager Denise Borton at 402-481-3313 or email denise.borton@bryanhealth.org.

bodies that need to be cared for.

“The focus of pastoral care is upon the healing, guiding, supporting, reconciling, nurturing, liberating and empowering of people in whatever challenging situation they find themselves. It means trying to secure life quality even in the face of death.”

She emphasizes that palliative care is available to make sure life quality is met at its highest until the very last moment of life. “As a chaplain, I try to contribute to patients’ and families’ spiritual, emotional and psychosocial well-being.”

Focusing on quality of life Nurse practitioner Steckelberg sums it up well by saying, “In short, we help patients improve their ability to carry on with daily life in the best way possible and keep the focus on quality of life,” she says.

Denise, Nina and Nancy all feel that one of the best parts of their job is helping others during transitions. One of their current patients is Lincoln resident Janelle Moran.

Nancy says, “I really find it satisfying to be able to spend time with patients and their families to discuss long-term goals and quality of life issues. These are conversations that I previously had with transplant patients when

in another role at Bryan, and I’m happy I’m able to use that experience with palliative care patients.

“Everyone has a life story, and Janelle is no exception. Janelle has a wonderful sense of humor. She knows her wishes and is not hesitant to discuss them. She is very comfortable with discussions regarding how she would like to spend the rest of her life and how she wants her family to know.”

Janelle began her career as a teacher and then worked as a flight attendant for Pan Am Airlines. She traveled the world, routinely flying to Australia and Asia, often serving famous performers, such as Frank Sinatra and The Ink Spots. In her 40s, she went to nursing school at Lincoln General Hospital (now Bryan West Campus) to become a licensed practical nurse. She worked as an LPN for many years, and she and her late husband, John, raised two adopted children.

Janelle has a special view of the care because of her nursing background.

“I have always loved medicine and the opportunity to care for others. I loved my coworkers and those for whom we cared,” she says.

Now Janelle is receiving that same loving care. “I have really appreciated the palliative care program because it has made my life tremendously easier and gives me the ability to enjoy my days more,” she says.

“The skilled staff does everything for me, from sorting my daily medications to assisting with mobility needs and care coordination.”

When asked if she would recommend palliative care to others, she notes, “I am choosing the best quality of life possible for this period of my life. I will always be thankful for the professional care of the providers — who are now my friends.” n To learn how you can support Bryan Health, please contact the Bryan Foundation at 402-481-8605.

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B RYA N L I F E P O I N T E M E D S PA

MedSpa restores Deb’s self-image

W

hether you’re hoping to minimize the appearance of scars, reduce the signs of aging or simply improve the overall health of your skin, the Bryan LifePointe MedSpa has a track record of results.

Just ask Deb Gangwish of Shelton.

“I was initially referred to the MedSpa

to treat a few discolorations on my skin,” Deb says. “At the time, I didn’t realize quite the extent of what they could do at the MedSpa — but that perspective definitely changed after my accident.”

The crash In 2013, Deb and her husband, Paul, were motorcycling through Wyoming

Debra Gangwish shares photos with Carrie Kleinschmidt, PA-C, (right) and Rubab Husain, MD, (left) to illustrate improvements in her health and appearance since a 2013 collision.

when a deer bounded onto the interstate and collided with their bike. The couple was thrown, sending Deb sliding about 150 feet down the highway.

The crash ripped Deb’s scalp from her head, requiring extensive surgery to repair. Besides road rash, the incident left Deb with a significant and very noticeable scar on her face.

While her plastic surgeon successfully completed the reconstruction of her scalp and forehead, Deb needed additional work to refine the appearance of her scar.

As the face of her family’s business and a representative for a Midwest agricultural collective, Deb is constantly in the spotlight.

“I do a lot of public relations for our farm. I’m constantly talking with people about issues and ideas related to agriculture,” she says. “First impressions, which include appearance, are invaluable for establishing rapport and trust. I didn’t want my scars to detract from the message I was delivering.”

As a physician assistant at the Bryan LifePointe MedSpa, Carrie Kleinschmidt was one of the first MedSpa team members to work with Deb. “The health and appearance of your skin are vital components of self-esteem and mental well-being,” says Carrie. “We always make sure to gather a full health history along with the goals and outcomes our clients desire.”

Rejuvenating and restoring One of the first areas of focus was getting rid of the hyperpigmentation associated with Deb’s scars. To do this, Carrie and her team used chemical peels that combine high-performance

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B RYA N L I F E P O I N T E M E D S PA brightening and anti-inflammatory agents with peeling acid solution to accelerate skin cell renewal. This helped to diminish the appearance of Deb’s hyperpigmentation.

“Clients like Deb experience great results with chemical peels,” explains Carrie. “They typically come back every three to six months to sustain their results.”

Due to the severity of the accident, the nature of her injury and her reconstructive surgery, Deb’s face now has a bit of asymmetry, specifically in the eyebrow region. Thankfully, Carrie and her team can even out the skin and balance muscle appearance using botox injections. For additional rejuvenation and refinement on the scarred areas, Deb also utilized microneedling.

“Microneedling uses tiny needles to create tiny holes in the skin,” Carrie says. “The process stimulates your skin’s natural ability to heal itself and in the process, produces collagen and elastin.

It helps smooth out the scar and can be helpful with blemishes like stretch marks or acne.”

Procedures like microneedling, along with the type of products used, are what differentiate the Bryan LifePointe MedSpa from traditional spas.

MedSpa versus traditional spas “If you go to a traditional spa, you may see many of the same services listed,” says Carrie. “But MedSpa offers medicalgrade products, which are stronger and more effective than what you get over the counter. We also have specific procedures that are often not done in traditional spas.”

The Bryan LifePointe MedSpa also is overseen by a physician within the Bryan Physician Network — Dr. Rubab Husain of Southeast Lincoln Family Medicine.

can be done. They can always call us or come in for a consultation, and we can talk with them about their options.”

Some of the most popular services at the MedSpa include facials, microdermabrasion, peels, skin analysis, microneedling, botox and fillers, laser hair reduction and Deb Gangwish recovered from her motorcycle crash and specialty massage. today says, “My injuries are barely noticeable anymore.”

While most of the services at the MedSpa are private “With each new client, we complete pay, insurance may cover treatment a health history, including an inventory in rare cases, such as the treatment of of products utilized in the past and severe acne. Individuals are encouraged any medications that may impact our to contact their insurance company if they treatment plan,” Dr. Husain says. “We have questions about coverage. also capture a ‘before’ photo to establish a visual benchmark that we can use to measure results.”

Maintaining great results She points out another benefit to Two years after the accident, Deb’s having MedSpa located at Bryan LifePointe. scar is a ghost of what it once was.

And she continues to come back to the “Being part of the Bryan system MedSpa for treatments every six months. creates a great opportunity for continuity of care,” she explains. “Because our “It’s amazing how these treatments locations are connected, we have access have made a difference,” says Deb. to records and medical histories that help “I am blessed to have great doctors guide us as we consider a procedure or and great skin professionals at the treatment.”

MedSpa. My injuries are barely noticeable anymore.” n

Extensive services The MedSpa continues to see an interest in skin care procedures, thanks to social media and the internet.

“People are actively researching things like laser hair removal, acne treatment, aging prevention and treatment, and more,” says Dr. Husain.

“That’s just the first step. The next step is finding out specifically what

For more information or to learn about special events and promotions, call Bryan LifePointe MedSpa at 402-481-6321 or visit bryanlifepoint.com/medspa.

To learn how you can support the work of Bryan Health, please call the Bryan Foundation at 402-481-8605.

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NEW AT BRYAN

Team discovers, th

L

ucky.

That’s the word Mary Jo Oie uses to describe her life.

“My doctors and nurses told me that lung cancer usually isn’t discovered until it’s too late,” she says. “The team at Bryan Health found my cancer early. And that makes me a lucky gal.”

An unexpected finding It all started with a trip to the emergency room.

“I was having severe abdominal pain,” Mary Jo recalls. “So I went to the emergency room at Bryan, and they did a CT scan.”

What the doctors found was an acute bout of appendicitis. Mary Jo had surgery to remove her inflamed appendix, and she was able to go home the next day.

What she didn’t realize, however, was that the CT scan of her abdomen also captured the lower lobes of her lungs. And images of her lungs are all the team comprising the Bryan Lung Nodule Program needs to spot irregularities or nodules that may be lung cancer.

The seemingly always upbeat Mary Jo Oie of Lincoln gives back to her community by being a Meals on Wheels volunteer.

Why program is needed “There are many different reasons for a CT scan of the abdomen, head and neck area or even the chest. Those scans all capture some portion of the lungs,” says Ruth Van Gerpen, APRN-CNS and oncology nurse navigator for Bryan Health.

“If we are able to review patients’ scans to look for nodules or abnormalities in the portion of the lungs that are

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NEW AT BRYAN

s, then helps defeat Mary Jo’s lung cancer captured on the images, we can identify areas that require further investigation and may be cancerous.”

Bryan Heart cardiothoracic surgeon Richard Thompson, MD, also directs the Bryan Health Lung Cancer Center. In 2014, he spearheaded an initiative to review scans.

“We discovered that two patients recently diagnosed with advanced lung cancer had a CT scan of the chest done over a year before, and each had shown a suspicious nodule. The scans had been done for issues with their heart, not their lungs, and there was no follow-up related to the nodule,” he notes. “For those two patients, their cancer had already spread to other parts of the body, and surgery was no longer an option for treatment.

Surgery gives us the best chance of removing the cancer from the body — and of people living longer.”

Ruth says, “Based on this realization, we knew regular review of CT scans for incidental nodules or other findings in the lungs could save lives. So, we launched the Lung Nodule Program.”

Each week, more than 300 scans are performed that include some portion of the lungs in the images. All of those are reviewed by a radiologist, looking for findings related to the reason for the scan.

They also note any additional findings, such as nodules, a mass, a lesion — all of which indicate an abnormality in the lung.

Ruth and her team have reviewed more than 35,000 CT scans since 2014.

Of the scans produced in a typical week, around 15 percent will show an abnormal result. Ruth reviews each of

Oncology nurse navigator Ruth Van Gerpen (left) and Richard Thompson, MD, share smiles with Mary Jo after her keynote presentation at the Shine a Light on Lung Cancer event.

these reports and determines whether the scan was done with the intent of monitoring the nodules.

Once she has determined the intent or who ordered the scans and if further follow-up has been arranged, a small stack of reports remains. These are the cases for which further follow-up is completed.

Each week, Ruth and a pulmonologist from Nebraska Pulmonary Services review those reports and scans and confirm recommendations for a follow-up CT scan, a PET scan or further evaluation.

“While the majority of the scans are clear, a handful — about 20 each week — have abnormal findings,” says Ruth. “In the cases that do end up being cancer,

we’re saving lives, which is what we set out to do with this program.”

Begins with a letter When the radiologist reviewed Mary Jo’s scans from her visit for appendicitis, the images also showed a 17mm nodule on the lower part of her right lung.

“I got a letter from Ruth, as well as a phone call from my doctor, Holly McMillan, MD, of Lincoln Internal Medicine, who said I should have this checked out,” says Mary Jo. “I absolutely agreed.”

Patients whose scans show an abnormality are sent a letter, encouraging them to talk to their primary care provider about the findings. The patient’s doctor

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NEW AT BRYAN Ruth kept Mary Jo informed throughout the process, from diagnosis to recovery.

also receives a letter and a copy of the CT scan. Many of these scans that show nodules had not been ordered by the primary care provider, but often were done in the Emergency Department or by a specialist.

Physician support “The physicians in our community have been very receptive to the process,” says Ruth. “I keep track of all of the scans that are done and the letters that are sent out. We’ve seen great follow-up by the physicians in Lincoln.”

When Mary Jo followed up with her own doctor, she took action to have the nodule examined further.

“I had a PET scan, and that thing just lit up like the Fourth of July!” says Mary Jo. “At that point, I was very thankful I’d had appendicitis — otherwise, that scan would never have been done!”

It was determined that Mary Jo’s cancer could be treated surgically, so she was scheduled for a lobectomy.

“I was excited to learn that Dr. Thompson was going to be my surgeon,” says Mary Jo. “I had the opportunity to work with him a few years ago, when he replaced a valve in my heart.”

Dr. Thompson treated the cancerous area by removing the lower right lobe of Mary Jo’s lung. After a seven-day stay in the hospital, Mary Jo was able to go home with a drainage tube, which was taken out a week later.

“They were confident most of the cancer was gone, but just in case, I had four rounds of chemotherapy with Dr. Scott McHam of Southeast Nebraska Cancer Center,” Mary Jo says.

“My last treatment was on Halloween.

I’ll always remember that!”

Throughout the process, she worked

with Ruth to learn about her lung cancer, what to expect for recovery and the journey going forward.

“Ruth’s title is nurse navigator, but she’s so way more than that!” says Mary Jo. “She made me feel like I was at the Bryan Health resort and spa, because I didn’t have to lift a finger.”

Spreading the word Often called the “silent epidemic,” lung cancer is the second leading cause of death, with the first being heart disease.

It can strike individuals regardless of their smoking history.

“There are still many misperceptions about lung cancer being a smoker’s disease,” says Ruth. “While a history of smoking significantly increases your chances of developing lung cancer, you can still develop lung cancer if you’ve never smoked a day in your life.”

As Mary Jo told her story at the Shine a Light on Lung Cancer event last fall, she reminded the audience of the power of early detection.

“Catching this thing early saved my life,” she says. “By sharing my story, I can give people hope. It can happen to anybody. You need to be proactive with your health.”

Having recently retired from a 30-year career with the Nebraska Department of Roads, Mary Jo is excited to take advantage of her renewed lease on life.

“I have three grandsons, and Claude and I just celebrated a big wedding anniversary,” she says with a smile. “I am thankful every day, full of love each day and want to make the most of my life.” n To learn how you can support cancer care, please contact the Bryan Foundation at 402-481-8605.

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VOLUNTEERS & CUSTOMER CARE

Creative intervention

Art Committee enhances healing atmosphere

S

ince 2014, the Bryan Art Committee has brought unique, exciting artwork into the Bryan community with the goal of promoting healing, enhancing quality of life for patients and families, and affirming the human spirit.

The committee’s efforts have taken off rapidly and include the thriving gallery of the work of Nebraska artists on the first floor of Bryan East Campus, selection and placement of artworks throughout Bryan Health, and the highly successful employees’ photography gallery on Bryan West Campus.

The Bryan Art Committee also has Valery Wachter, administrative assistant Dorinda Magnus, Anne Pagel, Volunteers and Customer Care director Ellen Beans and June Pederson enjoy paintings the Bryan Art two innovative collaborations underway Committee selected, to liven up the walls of the Bryan East Campus cafeteria. with Lincoln Public Schools — the “Welcome to the Neighborhood Project,” in Lincoln; and Anne Pagel, curator of the upbeat or lighthearted. We also choose in which large-scale student artworks will Robert and Karen Duncan Art Collection, art that is comforting, such as for the be displayed on the fence around the make up the three-member committee. recovery area where family members wait construction area at Bryan East Campus, “Our goal is after surgery.” and “The Graffiti Project,” to give patients, “Humanity has always put important, in which graffiti-inspired clinicians, visitors and heartfelt ideas into art — perhaps not student artworks portraying employees a break as verbal expression, but something positive, supportive from the cares of the powerfully communicated all the same,” messages will appear in day through artworks,” Anne says. “And artwork also can take selected parking areas. says Valery. “People one’s thoughts away from the troubles These messages will often find something of the day. These are two very valuable, communicate to patients in a specific piece of wonderful things art does for us.” n and visitors, as they walk art that helps them into Bryan, that our staff The work of the Bryan Art Committee feel positive and is and clinicians understand, is funded through the Bryan Foundation refreshing to their care for and support them. and donations to the Healing Arts spirit.”

Valery Wachter, a This print by Tom Prinz is Fund. To learn how you can support “We know that art professional artist with among the many artworks this project, please contact the Bryan can do many things,” the Burkholder Project; installed at Bryan.

Foundation at 402-481-8605.

June adds. “Some June Pederson, retired helps us feel serene, director of Aging Partners

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BRYAN FOUNDATION

Luncheon links donors and scholarship recipients

Student Lisa Lanin-Clarke with Connie Ganz.

Retired facilities management director Harold Kelley met scholarship recipient Leigh Grosvenor during the Oct. 19 Bryan College of Health Sciences Scholarship Luncheon at The Cornhusker Marriott.

Student Madeline Noecker with Kay Abbott.

Former vice president and Bryan alumna Phyllis Bovee chats with nursing student Karlee Gansebom.

Student Chelsea Flaska with Ellen Weissinger, PhD, who was the event’s keynote speaker.

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BRYAN COLLEGE OF HEALTH SCIENCES Meet six of the newest members of the college faculty and staff.

Associate Professor Kelsi Anderson, PhD, Biomedical Sciences Program director, teaches Scientific Literature, Genetics and Microbiology.

Education: This Lincoln native earned a Bachelor of Science in Biology at North Park University, Chicago, and a doctorate in Microbiology at the University of Nebraska Medical Center, Omaha.

She says, “I’m looking forward to growing the program, interacting with students and supporting the faculty in the Biomedical Sciences division.”

Assistant Professor of Nursing Melissa Blome, MSN, RN, teaches Family Health Nursing.

Education: Her hometown is Wilber, and she received a Bachelor of Science in Nursing from the University of Nebraska Medical Center in 1993. Blome is enrolled in the education doctoral program (EdD) at Bryan College of Health Sciences.

Experience: Two years at the Crete Municipal Hospital (Crete Area Medical Center now is part of Bryan Health) and was a nurse in the labor and delivery and mother/baby units on the Bryan East Campus for 18 years.

“For the past three and a half years, I’ve been a clinical instructor for the Union College nursing program, and I’ve worked as an adjunct faculty member at Nebraska Wesleyan University for about nine months,” she says.

“I look forward to working in the family health area and seeing familiar faces at Bryan.”

Rita Brummond, BS, RT (R), RDMS, is the Diagnostic Medical Sonography Program director and is an instructor at the college.

Education: She grew up in Marysville, Kansas, and while earning an Associate Degree in Radiologic Technology from Southeast Community College in 1994, Bryan Health was her clinical site while earning the degree.

“From there I went straight to the University of Nebraska Medical Center and graduated with a Bachelor of Science in Diagnostic Medical Sonography in 1995 — and Bryan Health was my first ultrasound job,” she recalls.

Experience: “I was a mobile ultrasound tech for many years and also specifically in obstetrics and gynecology. I’m looking forward to connecting with students and introducing them to the exciting world of sonography.”

Assistant Professor Leslie Cosgriff, MSN, RN, teaches senior level students in the BSN program.

Education: She grew up in Republican City and graduated from Bryan’s nursing school in 2005, then earned a Bachelor of Science and Master of Science in Nursing from Nebraska Wesleyan University.

Experience: Cosgriff began her nursing career in 2005 and joined the Bryan staff in 2009, working on the neuro/ oncology unit and in the Float Pool.

She says, “I am extremely honored to have the opportunity to get to know the students while impacting their educational journey.”

Assistant Professor Ashley Kennedy, EdD, RN, teaches a senior level course in the

BSN program at the Bryan College of Health Sciences.

Education: She received a Bachelor of Science in Nursing from the University of Nebraska Medical Center in 2008, then a Master of Science in Nursing from the Nebraska Wesleyan University in 2012.

Kennedy recently earned a Doctorate in Nursing Education and Leadership from Clarkson College, Omaha.

“I developed a desire to become a nurse, which grew into a passion for nursing education,” she says.

Experience: 11 years in medical-surgical nursing, including six years in nursing education. Her career includes nine years at Bryan Medical Center.

Deb Maeder, MS, is the director of Distance Education.

Education: Bachelor of Science in Education from the University of NebraskaOmaha in 1994 and a Master of Science in Education with an emphasis on Assessment Leadership from the College of Saint Mary, Omaha, in 2013. She is pursuing a Doctor of Education (EdD) in Educational Leadership with an emphasis on higher education from William Howard Taft University.

Experience: 20 years of classroom experience coupled with five years of technology administration and four years of assessment stewardship. Before joining the college staff, Maeder worked at Bellevue University in course design, learning management system administration, and assessment design and evaluation. n

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Commencement

BRYAN ALUMNI NEWS

Dec. 16, 2016

Bryan College of Health Sciences awarded 77 diplomas during commencement at Saint Paul United Methodist Church.

Former President Marilyn Moore, EdD, (left) gave the address. President Rich Lloyd, PhD, (center) presented diplomas to Bryan’s newest alumni, such as Health Professions graduate Micaela Stelling. Faculty Senate President Amy Knobbe, PhD, (right) led the procession.

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ACHIEVEMENTS

Suzan Mulligan

Award-winning Bryan nurses April Deis, (left) Sara Seemann, Lacie Ferguson and Lauren Kroeker

Social workers March of Dimes recognizes Deis and Seemann salute Mulligan and BSN students Ferguson and Kroeker Care Transitions manager Suzan Mulligan, MSW, is the Social Work Leader of the Year.

She received the accolade last fall during the annual meeting of the Nebraska Society for Social Work Leadership in Health Care.

Suzan has worked at Bryan Health for more than 30 years and also is as an adjunct professor at the Bryan College of Health Sciences. n

C

ongratulations to our co-workers who were honored in November with March of Dimes Nurse of the Year awards.

Mother/baby unit manager April Deis, RN, received the top nurse award. As nurse manager of mother/baby care and the lactation program, she was recognized for her focus on developing a collaborative team environment and for

implementing a lactation pod at Pinnacle Bank Arena.

Clinical nurse specialist Sara Seemann, RN, Emergency Department, won the Advanced Practice Provider Award. Her nomination notes Seemann exemplifies the roles of clinical expert, mentor, educator and leader in her interactions with patients and co-workers.

This former Nebraska Nurses Association president was

recognized for her work on throughput, strokes and protocol development.

March of Dimes recognized Lacie Ferguson, RN, 7N/7S critical care, and cardiovascular intensive care unit assistant nurse manager Lauren Kroeker, RN, in the nursing student category. Both earned Bachelor of Science in Nursing degrees from Bryan College of Health Sciences in December. n

Inpatient rehabilitation program earns CARF accreditation

T

he inpatient rehabilitation unit at Bryan Medical Center again earned three-year accreditation from the Commission on Accreditation of Rehabilitation Facilities International. CARF surveyors evaluated Bryan’s comprehensive inpatient rehabilitation program for adults and children, adolescents and specialty programs in brain injury, stroke and amputation.

“Successful outcomes for patients and their families is our priority,” says

rehabilitation services director Linda Stones.

“This accreditation serves as assurance that our Bryan rehab team maintains a commitment to the highest quality of care.”

According to Vice President Lisa Vail, the surveyors noted many strengths, such as embodiment of core values, succession planning, the patient tracer safety process, team communication, physician leadership, peer mentoring, patient education and a strong focus on employee education. They described the rehabilitation facility as a very

high performing organization.

She notes, “The efforts of the interdisciplinary members exemplify the mission, vision and values of Bryan in action. Our staff’s collaboration, desire for quality service and dedication to excellence in patient care led to one of our best CARF accreditation surveys ever.”

See the article beginning on Page 2 of this edition of Journeys to learn more about our rehabilitation program, or visit bryanhealth.org/inpatient-rehab. n Bryan Journeys 35

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COMMUNITY CALENDAR

Your Adventure Awaits We offer a variety of wonderful travel opportunities. These tours sell out quickly, so make your reservation early. Brochures with detailed information are available. Visit bryanhealth.org/travel to download trip brochures, or call 402-481-3355.

One Day Tours:

Multiple Day Tours:

April 13 – Topeka Tulips June 7 – The Dixie Swim Club starring Morgan Fairchild, Overland Park, Kansas Aug. 21 – Solar eclipse viewing, St. Joseph, Missouri Sept. 21 – Savor the Flavors of Europe, including four ethnic communities in western Iowa Oct. 17 – Discover the Flint Hills, Manhattan, Kansas

June 20-24 – Route 66 Memories July 31-Aug. 7 – Niagara Falls & Toronto Oct. 10-17 – Let Freedom Ring tour of Boston, Cape Cod, New York City and Philadelphia

Sterling Connection Enriching lives over 50

Bryan Health Radio A fast, easy way to learn from health experts while you’re at home or on-the-go!

Would you like to know more about a health topic or tips to stay well?

Check out Bryan Health Radio. Our free 10-minute podcasts offer valuable, useful advice presented our very own Here’s abysample ofdoctors someand ofhealth our experts. current podcasts:

Here’s sample of some of our current podcasts: • YouraBlood Pressure: The Numbers and How You Can Control Them • Your Blood Pressure: The Numbers and How You Can Control Them with Joseph Kummer, MD with Joseph Kummer, MD Helpful Ways to Manage Your Cholesterol with MD Ryan Whitney, MD •• Helpful Ways to Manage Your Cholesterol with Ryan Whitney, UseYour Your Antibiotics Responsibly with Kevin Sponsel, PharmD •• Use Antibiotics Responsibly with Kevin Sponsel, PharmD • Knee Replacement Surgery: When is the Right Time • Knee Replacement Surgery: When is the Right Time with Matt Reckmeyer, MD with Matt Reckmeyer, MD • Restless Leg Syndrome: Symptoms, Triggers & Treatments with Timothy Lieske, MD • Restless Leg Syndrome: Symptoms, Triggers & Treatments • Are You at Risk for Shingles? with Suzanne Vandenhul, MD with Timothy Lieske, MD •• Multiple Medications?

GetShingles? the Help you Need with Wasim Chughtai, MD Are You at Risk for with Suzanne Vandenhul, MD • Decrease Inflammation, Reduce Muscle Pain and Heal Faster Multiple Medications? Get the Help you Need • with with LorriMD Benamor, Bryan LifePointe withCryotherapy Wasim Chughtai, • • Regain Your Active Lifestyle: Treatment for Plantar Fasciitis, Decrease Inflammation, Reduce Muscle Pain Achilles and Elbow Pain with Michael Budler, MD and Accelerate Recovery with Cryotherapy • Colon is Very Treatable – Get Your with Cancer Lorri Benamor, Bryan LifePointe Screening Today with William Lawton, MD • Regain Your Active Lifestyle: Tenex Plantar Fasciitis, Achilles ToTreatment see our fullfor range of topics and Elbow Pain with Michael and listen to a free podcast, Budler, MD • Colon Cancer is Very Treatable — Get Your go to: bryanhealth.org/bryan-health-radio Screening Today with William Lawton, MD

Bryan Health Kids’ Club presents:

Home Run for Health with the Lincoln Saltdogs

Friday, June 9 Haymarket Park Home Run for Health Pregame Activities: 4:30-6:45 p.m.

• More than 30 exhibitors with interactive health and safety activities • Meet and greet with Lincoln Saltdogs players • Bounce houses and play area • One lucky child will be invited to throw the first pitch • Every child will receive a glow necklace

Baseball Game: Lincoln Saltdogs vs. Laredo Lemurs – 6:45 p.m.

Fireworks Show: Following the game

Tickets available May 1 at:

saltdogs.com/bryanhomerun • General Admission Berm Seat - FREE • Reserved Seat - $6 Both ticket levels include admittance to the Home Run for Health pregame activities.

To see our full range of topics and listen to a free podcast, go to: bryanhealth.org/bryan-health-radio

Your Adventure Awaits We offer a variety of wonderful travel opportunities. These tours sell out quickly, so make reservation early. Trip brochures with detailed information are available.

36your Winter 2017 Visit bryanhealth.org/travel to download your brochures, or call 402-481-3355.

One Day Tours: April 13 – Topeka Tulips June 7 – The Dixie Swim Club starring Morgan Fairchild, Overland Park, KS August 21 –36Solar eclipse viewing, 120832_Journeys_co2.indd

Multiple Day Tours: June 20-24 – Route 66 Memories July 31-August 7 – Niagara Falls & Toronto October 10-17 – Let Freedom Ring tour of Boston, Cape Cod, New York City and

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PUBLIC NOTICE

Discrimination is against the law

B

ryan Medical Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Bryan Medical Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

If you have questions about the law, please contact our Patient Experience Officer. You can either call at 402-481-0139, write to Bryan Medical Center, Attn: Patient Experience Officer, 1600 South 48th Street, Lincoln, NE 68506 or email patientexperience@bryanhealth.org.

Bryan Medical Center Provides free aids and services to people with disabilities to communicate effectively with us, such as: • Qualified sign language interpreters • Written information in large print, audio, accessible electronic formats or other formats Provides free language services to people whose primary language is not English, such as: • Qualified interpreters • Information written in other languages If you need these interpreter services, contact our Administrative Managers 24/7: 800-742-7844. You may also email a request for interpreter services: communicationassist@bryanhealth.org If you believe Bryan Medical Center has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Patient Family Relations Representative 1600 S. 48th Street, Lincoln, NE 68506 Phone 402-481-5761 - TTY 800-833-7352 - Fax 402-481-8306 patientexperience@bryanhealth.org You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Patient Family Relations Representative is available to help you. Please see the contact information above.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019 -TTY 800-537-7697 Complaint forms are available at http://www.hhs.gov/ocr/office/file/index. html.

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-800-742-7844; TTY: 1-800-833-7352.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-742-7844; TTY: 1-800-833-7352.

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-742-7844; TTY: 1-800-833-7352. 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-800-742-7844; (TTY: 1-800-833-7352）。 ‫م لحوظة‬: ‫ اذك ر ت تحدث ك نت إذا‬،‫ل ك ت تواف ر ال ل غوي ة ال م ساعدة خدمات ف إن ال ل غة‬ ‫ب ال مجان‬. ‫ ب رق م ات صل‬Fa1-800-742-7844 (‫وال ب كم ال صم هات ف رق م‬: 1-800-833-7352).

1-800-742-7844 (TTY: 1-800-833-7352).

ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-800-742-7844; (ATS: 1-800-833-7352).

XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 1-800-742-7844; (TTY 1-800-833-7352).

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-800-742-7844; TTY: 1-800-833-7352. 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-800-742-7844; (TTY: 1-800-833-7352) 번으로 전화해 주십시오. ध्यान दिनह ु ोस ्: तपार्इंले नेपाली बोल्नह ु ु न्छ भने तपार्इंको ननम्तत भाषा सहायता सेवाहरू ननिःशल् ु ोस ् 1-800-742-7844; ु क रूपमा उपलब्ध छ । फोन गनह

(दिदिवार्इ: 1-800-833-7352) ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-800-742-7844 (телетайп: 1-800-833-7352). ໂປດຊາບ: ຖ້າວ່າທ່ານເວົ້າພາສາລາວ,ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 1-800-742-7844 (TTY: 1-800-833-7352). ‫ئ اگ اداری‬: ‫ قە سە ک وردی زمان ی ب ە ئەگە ر‬،‫ي ارمەت ی خزمەت گوزاريەک ان ی دەکەي ت‬ ،‫ زمان‬،‫بەردە س تە ت ۆ ب ۆ بەخ ۆڕاي ی‬. ‫ ب ە پەي وەن دی‬1- 800-742-7844 (TTY (1-800-833-7352 ‫ب کە‬. ‫ت وجە‬: ‫ می گ ف ت گو ف ار سی زب ان ب ە اگ ر‬،‫راي گان ب صورت زب ان ی ت سه یالت ک ن ید‬ ‫ب ا شد می ف راهم شما ب رای‬. ‫ ب ا‬1-800-742-7844 (TTY: 1-800-833-7352) ‫ت ماس‬ ‫ب گ یري د‬. 注意事項：日本語を話される場合、無料の言語支援をご利用いただけます 1-800-742-7844; (TTY: 1-800-833-7352) まで、お電話にてご連絡ください

Bryan Journeys 37

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1600 S. 48th St., Lincoln, NE 68506

PRSRT STD US POSTAGE PAID OMAHA NE PERMIT NO 776

Address service requested

Patients and families are loving our new, free valet parking service!

They say it’s really convenient, and the valet parking staff is excellent. If you’re coming to Bryan East Campus, we can take the hassle out of parking. Stop at the front entrance of the medical center — we’ll park your car and get it for you when you’re ready to go!

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