IN THIS ISSUE
APP SPOTLIGHT
SPECIALTY SPOTLIGHT: UROLOGY!
FOOD DRIVE RECAP
UPCOMING EVENTS/CME
Hello wonderful APPs! Hopefully you have all had a chance to relax and regroup this summer and maybe even go on a vacation! We wanted to take a moment to touch on work life balance. Healthcare is arguably one of the most difficult fields to attain a healthy work life balance. From unsigned notes, to patient messages, to seemingly endless emails and phone calls, it can quickly feel overwhelming; especially when we care so much. Healthcare is a field that most of us got into because we genuinely want to help people. While we may want to go that extra mile, it can be very difficult and disheartening when our time does not allow for us to do so. You are not alone! Never forget how valued you are and how big of a difference you are making each day. While there may not always be a perfect solution, perhaps some of the tips below can help.
1.) Be kind to yourself. Care for yourself as if you are caring for a patient. Your body also needs rest, fluids, exercise, and nourishing foods!
2.) Create boundaries at home. Whether this means shutting off the computer at a certain time during chart prep, not answering messages past a certain hour, or encouraging your brain to stop the work thoughts once you walk in the door. You are important at work, but you are irreplaceable at home.
3.) Ask for help. It is okay to speak up if you are feeling overwhelmed or spread thin. Reach out to your manager and discuss your concerns and work together on ways to improve your day-to-day experience.
“Success is not final; failure is not final; it is the courage to continue that counts.”
Independence
Specialty Spotlight: Urology
We are thrilled to highlight Urology for our specialty spotlight this issue. We would like to give a huge thank you to Morgan Kiebler, PA-C for providing the great information below. Morgan is a PA with Urology. She completed her schooling at Saint Francis University in 2019 and has been with us ever since. In her free time, she enjoys running/working out, trying new restaurants/breweries, and spending time with her fiancé and their two cats.
What are the most common consults you see (inpatient and outpatient)?
The most common consults we see are kidney stones, overactive bladder, BPH, elevated PSA, urinary retention, recurrent urinary tract infections, and hematuria. We also diagnose and treat a significant amount of prostate, bladder, and kidney cancers.
Are there any specific consults that you feel could often be managed by the primary service? Or is there anything you wish other services knew about your specialty?
Specifically in the inpatient setting, consults for simple urinary retention requiring a Foley catheter could likely be managed by the general medical/primary team (especially if the patient is not ready for a voiding trial any time soon).
What are some of your favorite things about your specialty?
One of my favorite things about this specialty is that there is a lot more to it than you would initially expect. It's a good combination of medical and surgical management as well as numerous different office procedures.
What are the biggest challenges of your specialty?
One of the biggest challenges of this specialty is that urologic problems can sometimes be a sensitive thing for patients to talk about. Patients may only feel comfortable seeing a specific gender provider to discuss their issues.
Urology Pearls
The most important clinical pearl for primary care providers would be knowing prostate cancer screening guidelines:
Current American Urological Association prostate cancer screening guidelines state that PSA screening should be performed for men ages 55 to 69. Routine screening is no longer recommended in men 70+ years of age, or any man with less than a 10-15 year life expectancy.
Patients with chronic catheters of any type will be chronically colonized. Recommend judicious use of antibiotics in these patients. Also, do not typically recommend treating asymptomatic positive urine cultures/asymptomatic bacteriuria!
Test your urology knowledge!
(Answers on last page of Newsletter)
1. What is the most common type of kidney stone?
a.) Uric acid
b.) Calcium phosphate
c.) Calcium oxalate
d.) Magnesium ammonium phosphate
2. What is one possible side effect or risk associated with use of Myrbetriq (often prescribed for OAB)?
a.) Dry mouth
b.) Elevated blood pressure
c.) Dry eyes
d.) Confusion
Our first APP to highlight this issue is Emily Bele, CRNP. Emily is a nurse practitioner with pulmonary and critical care medicine at Westmoreland Hospital. She started her nursing career in 2007 after earning her BSN from Waynesburg College. She then worked in med/surg for two years followed by the CCU. She was later accepted int Penn State’s FNP program which she graduated from in 2013. As a nurse practitioner, she worked with the hospitalist group for two years prior to transitioning to critical care in 2015 where she now remains.
Emily Bele, CRNP
Independence Health System, Westmoreland Hospital: Pulmonary and Critical Care Medicine
What is your favorite thing about your career? My great coworkers!
What is your current role like?
I work in critical care which includes our ICU and step-down unit at Westmoreland Hospital. I work 12 hour shifts. Besides managing critical patients and collaborating with multiple specialties I also perform a variety of bedside procedures including intubation, bronchoscopy, central and arterial line insertion, thoracentesis, paracentesis. Working in step down allows me the opportunity to work to my full potential with a lot of autonomy in the management of my patients.
What are your future goals?
To be the best mom to my unborn baby girl, due to arrive in October!
What is one thing you could not live without?
I could not live without my family. I'm fortunate to have my parents, brother, and sisters all living within a few hours’ drive.
Our next APP spotlight this issue is Nikki Karatinos, CRNP. Nikki earned her BSN from Carlow University in 2010. She then worked in the OR at UPMC Presbyterian until 2014. She then went to Duquesne University for her CRNP schooling which she completed in 2018. She accepted the Urology position shortly after.
Nikki Karatinos, CRNP Independence Health System, Butler: Urology
What is your favorite thing about your career? Helping people and impacting their lives in a positive manner.
What are your favorite activities outside of work?
Any time I spend with my son. Playing mini golf, going to church, bible study, hiking, watching Schitts creek, Parks and Recreation, or Disney movies and going to Burn Bootcamp.
Who do you admire most? My dad.
What was your first job? CVS cashier.
What/where was your favorite trip? Any Disney trip!
APP Sponsored Donation Drive: A
Wrap-up from Angie Como and Rashelle Maderitz of the APP Community Engagement Committee
The APP-sponsored Donation Drive for the Food Institute was a TREMENDOUS success. From connecting APPs across the health system, to collaborating with an entity that is already making a huge impact in the community, to building on resources now available to our community at large, and beyond there are so many exciting things that contributed to the Donation Drive's success.
The items collected during the Donation Drive will benefit those in our region who have medical conditions and have difficulty accessing or affording healthy food. It also makes utensils, paper pantry, and feminine hygiene products more readily accessible to those individuals who may need them.
How many goods were collected and from how many different sites?
A picture is worth a thousand words (see photo below). However, it's not the number of items collected, it's the number of lives impacted by the generosity of our community that ultimately indicates the importance of those donated items and this number is immeasurable.
What challenges did you face with the donation drive?
Our largest perceived hurdles to making this Donation Drive an even greater success were centered around funding an event like this and driving committee participation interest. If we had funding, advertising for the event would have been more expansive and driven a greater IHS and general community participation. The APP Community Engagement Sub-Committee is in its infancy and, therefore, unfamiliar to many APPs within our healthcare system. Hopefully this sentinel event will inspire others who may be interested in future events to become a part of our APP Community Engagement Subcommittee.
Will the APP food donation drive be a yearly event?
The Donation Drive was a pilot event for the APP Community Engagement Sub-Committee. Considering the success of the event, we would like to make it an annual occurrence as long as there remains a need within the community.
Anything else you would like to add?
We would like to offer up a huge THANK YOU to all those who participated in and supported our efforts in making the Donation Drive a success. The impact YOU have made within our community through your generosity is inspirational.
APP Committee Meeting
9/11/2024 12:30pm- 1pm Tower Conference Room or via Zoom
9/11/2024 12pm via teams, link to be posted on the loop
Excela APP Clinical Excellence Presentation and Superlative Awards
9/24/2024 5pm- 7pm Westmoreland Hospital Campus: Memorial Conference Center
Butler APP Appreciation Event and Fellowship Reunion
9/26/2024 5pm-7pm Butler Hospital Campus: Findley Auditorium
Clinical Excellence Presentations, Fellowship spotlight, and Happy Hour
Be sure to check your email for the link to nominate!
Health Fairs/CV screenings
September 14, 2024: 8am- 12pm 2602 Wilmington Rd. Suite 101 New Castle, PA 16105
October 5, 2024: 8am- 12pm in Kittanning, precise location TBD
Services including: Health assessment and BMI, BP screening, EKG, lipid profile and blood glucose, vascular screening as well as hands-only CPR, lifestyle coaching, cooking demos
As always: if you have any ideas, anything you would like to see in the newsletter, if or would like to see a certain peer or specialty in the spotlight, please do not hesitate to reach out: katelyn.soldner@independence.health
UnwrAPPed CME: Concussion Care with Rachel Scaffardi, PA-C and Jason Kocian, PA-C
Welcome to the team newAPPs!
Amy L. Acie, CRNA - Anesthesiology, Excela Health Anesthesia, Westmoreland
Julie Ann Richards, CRNA - Anesthesiology, Excela Health Anesthesia, Westmoreland
Megan Kostek, PA-C - Internal Medicine, BMH Primary Care Benbrook
Robin Kelley Moore, PA-C - Dermatology, BHS Dermatology Associates Seneca
Sonya Mamoozadeh, CRNP - Urgent Care, BHS Faster Care
Brian Holt, CRNA - Anesthesiology, Excela Health Anesthesia
Kenneth Hile, CRNP - Nephrology, Coordinated Kidney Care Group
