Nursingmatters November 2016 • Volume 27, Number 9
www.nursingmattersonline.com
INSIDE:
Being human and having fun …
2
Learn what to do to vote …
4
Help bring men into nursing …
6
Puerto Rico suffers doctor shortage …
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HSHS
From left, Jen Witterholt, Mary Schueller and Beth Simoens of Hospital Sisters Health System-Eastern Wisconsin Division are selected as the only nursing team from Wisconsin to participate in the National Institutes of Health “Geriatric Oncology: Educating Nurses to Improve Quality Care” project.
Quality care for older adults: Are we prepared? Hospital Sisters Health System-Eastern Wisconsin Division colleagues: Mary Schueller, MSN, RN, AOCNS, CHPN, oncology clinical nurse educator Beth Simoens, BSN, RN, OCN, facilitator clinical RN, outpatient medical oncology Jen Witterholt, BSN, RN, OCN, manager, inpatient medical, Hospital Sisters Health System-St. Vincent Hospital
Are nurses caring for more and more older adults? If so, it’s really no surprise. Life expectancy in the United States is increasing, and the number of “Baby Boomers” age 65 and older is expected to almost double by the year 2030. In addition, the Institute of Medicine reports there is a current and projected future shortage of nurses with experience in geriatrics to provide care for the growing population of older adults. Those whose nursing practice includes caring for patients with certain diagnoses
– like cancer – are impacted even more by the aging population. Almost 60 percent of all cancer cases and 70 percent of all cancer mortality occur in patients age 65 and older. The number of older adults with cancer is predicted to dramatically increase in the upcoming years. That raises important questions. Are most nurses prepared to provide quality care for older adults? Do nursing-education programs include competencies in the care of older adults? Without a doubt, there has been progress in the care of older adults in the past several decades, but significant gaps in
geriatric training and practice remain. Less than 1 percent of nurses and less than 3 percent of advanced-practiced nurses in the United States are certified in geriatrics by the American Nurses Credentialing Center. Yet older adults are health care’s core business. They are cared for in many settings – primary care, hospitals, home care and skilled nursing facilities to name just a few – and utilize the majority of health-care services in this country. The National Institutes of Health has played a pivotal role in advancing geriatric nursing. In 2016, the National Institutes of Health began a five-year project specifically related to care of older adults with cancer. Entitled “Geriatric Oncology: Educating Nurses to Improve Quality Care,” the project consists of a two-and-a-half-day
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Nursingmatters is published monthly by Capital Newspapers. Editorial and business offices are located at 1901 Fish Hatchery Road, Madison, WI 53713 FAX 608-250-4155 Send change of address information to: Nursingmatters 1901 Fish Hatchery Rd. Madison, WI 53713 Editor........................................... Kaye Lillesand, MSN 608-222-4774 • kayelillesand@gmail.com Managing Editor................................... Julie Belschner 608-250-4320 • jbelschner@madison.com Advertising Representative.................... Teague Racine 608-252-6038 • tracine@madison.com Recruitment Sales Manager.......................Sheryl Barry 608-252-6379 • sbarry@madison.com Art Director...........................................Wendy McClure 608-252-6267 • wmcclure@madison.com Publications Division Manager.................. Matt Meyers 608-252-6235 • mmeyers@madison.com Nursingmatters is dedicated to supporting and fostering the growth of professional nursing. Your comments are encouraged and appreciated. Email editorial submissions to klillesand@sbcglobal.net. Call 608-252-6264 for advertising rates. Every precaution is taken to ensure accuracy, but the publisher cannot accept responsibility for the correctness or accuracy of information herein or for any opinion expressed. The publisher will return material submitted when requested; however, we cannot guarantee the safety of artwork, photographs or manuscripts while in transit or while in our possession.
EDITORIAL BOARD Vivien DeBack, RN, Ph.D., Emeritus Nurse Consultant Empowering Change, Greenfield, WI Bonnie Allbaugh, RN, MSN Madison, WI Cathy Andrews, Ph.D., RN Associate Professor (Retired) Edgewood College, Madison, WI Kristin Baird, RN, BSN, MSH President Baird Consulting, Inc., Fort Atkinson, WI Joyce Berning, BSN Mineral Point, WI Mary Greeneway, BSN, RN-BC Clinical Education Coordinator Aurora Medical Center, Manitowoc County Mary LaBelle, RN Staff Nurse Froedtert Memorial Lutheran Hospital Milwaukee, WI Cynthia Wheeler Retired NURSINGmatters Advertising Executive, Madison, WI Deanna Blanchard, MSN Nursing Education Specialist at UW Health Oregon, WI Claire Meisenheimer, RN, Ph.D. Professor, UW-Oshkosh College of Nursing Oshkosh, WI Steve Ohly, ANP Community Health Program Manager St. Lukes Madison Street Outreach Clinic Milwaukee, WI Joyce Smith, RN, CFNP Family Nurse Practitioner Marshfield Clinic, Riverview Center Eau Claire, WI Karen Witt, RN, MSN Associate Professor UW-Eau Claire School of Nursing, Eau Claire, WI © 2015 Capital Newspapers
November • 2016
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Live life with Reflection and Humor Kaye Lillesand NursingMatters Editor
Recently I received two emails worth sharing. One is full of food for thought; the other is full of wonderKaye Lillesand ful laugh-out-loud humor. If anyone has thoughts on the rules for being human or has interesting experiences trying some of the “ways” below, we would be happy to share them in NURSINGmatters. Email kayelillesand@gmail.com with comments or stories. Enjoy! Rules for being human 1. You will receive a body. You may like it or hate it, but it will be yours for the entire period this time around. 2. You will learn lessons. You are enrolled in a full-time informal school called life. Each day in this school you will have the opportunity to learn lessons. You may like the lessons – or may think them irrelevant and stupid. 3. There are no mistakes – only lessons. Growth is a process of trial and error, and experimentation. The “failed” experiments are as much a part of the process as the experiment that ultimately works. 4. A lesson is repeated until learned. A lesson will be presented to you in various forms until you have learned it. When you
have learned it, then you can go on to the next lesson. 5. Learning lessons do not end. There is no part of life that does not contain its lessons. If you are alive, there are lessons to be learned. 6. “There” is no better the “here.” When your “there” has become a “here,” you will simply obtain another “there” that will again look better than “here.” 7. Others are merely mirrors of you. You cannot love or hate something about another person unless it reflects something you love or hate about yourself. 8. What you make of your life is up to you. You have all the tools and resources you need. What you do with them is up to you. The choice is yours. 9. Your answers lie inside you. The answers to life’s questions lie inside you. All you need to do is look, listen, and trust. 10. You will forget all of this. – Anonymous Ways to maintain a healthy level of insanity • At lunch time, sit in your parked car with sunglasses on and point a hair dryer at pasting cars. See if they slow down. • Page yourself over the intercom. Don’t disguise your voice. • Every time someone asks you to do something, ask if they want fries with that. • Put your garbage can on your desk and label it “in.” • Put decaf in the coffee maker for three
weeks. Once everyone has gotten over their caffeine addictions, switch to espresso. • In the memo field of all your checks, write “For sexual favors.” • Finish all your sentences with, “in accordance with the prophecy.” • Don’t use any punctuation. • As often as possible, skip rather than walk. • Order a diet water whenever you go out to eat, with a serious face. • Specify that your drive-through order is “to go.” • Sing along at the opera. • Go to a poetry recital and ask why the poems don’t rhyme. • Put mosquito netting around your work area and play tropical sounds all day. • Five Days in advance, tell your friends you can’t attend their parties because you’re not in the mood. • Have your co-workers address you by your wrestling name, “Rock Bottom.” • When money comes out of the ATM, scream, “I won! I won!” • Tell your children over dinner, “Due to the economy, we are going to need to let one of you go.” • And, the final way to keep a healthy level of insanity … send this list to someone to make them smile. It’s called … therapy.
curriculum developed by the National Institutes of Health for the project was led by a multidisciplinary team of experts from across the nation. Advancing nurse knowledge, attitudes and skills related to caring for older adults was the goal; numerous topical areas
were addressed. A few examples are listed; discuss them with nursing colleagues. They can serve as a great starting point for examining the care provided to older adults.
Older adults
continued from page 1 conference where a team of oncology nurses gain knowledge in caring for older adults with cancer. They then develop implementation plans to integrate the information into their own organizations during the next 12 to 18 months. Although the content is oncology-specific, much of the information can be applied broadly to the care of older adults. Each institution applying needs to commit to sending a team consisting of a nurse manager, nurse educator and a nurse who provides direct patient care. Of the competitively selected nurses from throughout the nation who participated this year, one team from Wisconsin was selected – a team from Hospital Sisters Health System-Eastern Wisconsin Division. We were delighted to represent Wisconsin. We traveled to Anaheim, California, in late July to increase our own knowledge so we could share what we learned with others upon our return, and ultimately improve care for older adults. The interactive, targeted educational
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November • 2016
Older adults
continued from page 2 Assessment: Central to caring for older adults is assessing functional status, frailty and falls. Use a “TUG” – Timed Up & Go, grip strength and fall risk. Assess if older adult patients are able to perform basic and more complex tasks that are central to independent living. Refer to patients by their functional or physiological ages rather than their chronological age. Cognitive Impairment: Age, vascular health status, lifestyle, and genetic susceptibility all contribute to cognitive impairment. Learn to distinguish delirium from dementia. Assess if specific cognitive changes have occurred as a result of the patient’s diagnosis and/or treatment – such as “chemo brain” for the cancer patient. Nutrition: Older adults often have decreased total caloric intake, impairments in sense of taste and smell, difficulty chewing, or difficulty with availability and/or preparation of meals. Know nutrition “red flags” to observe for, such as body mass index outside of range, weight loss greater than 2 percent in a month, albumin at less than 3.2 grams per deciliter, etc. Sleep: Insufficient quality or quantity of sleep is common among older adults. Sleep deprivation predisposes to delirium, which is an independent prognosticator of poor outcome. Utilize a standardized assessment for insomnia like the
Advancing nurse knowledge, attitudes and skills related to caring for older adults is the goal of a National Institutes of Health program.
Epworth Sleepiness Scale. Be prepared to teach patients to utilize non-pharmacological techniques for managing sleep before medications are prescribed. Medical/Legal Concerns: Understand acronyms such as ADA, ACA, COBRA, FMLA and WHCRA that patients or their caregivers might
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encounter. Know where to refer them for further information. Know where the closest Area Agency on Aging is in a community; visit www.n4a.org for more information. Polypharmacy: Older adults often have more medications prescribed than are clinically indicated. Because of pharmacokinetic changes that occur with aging – hepatic blood-flow drops by 40 percent, protein-binding changes, etc. – polypharmacy can be especially dangerous. Review the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults and discussed it with pharmacy colleagues; visit www.americangeriatrics.org
for more information. Resources: Have evidence-based resources readily available to guide the nursing practice. • Visit www.ConsultGeriRN.org for more information; the Hartford Institute for Geriatric Nursing’s Try This® series is particularly helpful. • Visit GeroNurseOnline.org – this is the official geriatric nursing website of the American Nurses Association. • Visit www.nicheprogram.org to learn how to designate a work setting as a NICHE – Nurses Improving Care for Healthsystem
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November • 2016
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Nursingmatters
Learn what you need to do to vote Wisconsin Sen. Howard Marklein R-17, Spring Green
Election Day is Tuesday, Nov. 8, 2016 Election Day is nearly upon us and now is the time to prepare to cast your ballot. Following are clarifications and tips to help new — and seasoned voters — prepare to vote. Confirm Voter Registration – Visit myvote.wi.gov and search by name and birthdate to confirm voter-registration information is accurate. Register to Vote – Register to vote at the polls on Election Day, or prior to Election Day through Nov. 4 at your municipal clerk’s office. To register to vote, Sen. Howard you will need to bring proof Marklein of residence, such as driver’s license or state ID card, a property tax bill, a residential lease, a utility bill, etc. Wisconsin law requires 10 days of residence to register at a specific address. Find Your Polling Place – Visit myvote.wi.gov and enter your residential address to determine your polling place for in-person Election Day voting.
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Absentee voting is underway at the City Clerk’s office in the City-County Building. Votes are not counted until election day, Madison City Clerk Maribeth Witzel-Behl said.
Bring an ID to Vote – You will need to bring photo identification to vote. Visit www.gab.wi.gov/elections-voting/ photo-id for a full overview of the photo ID requirement. The following forms of photo ID are acceptable for voting purposes, and can be unexpired or expired after the date of the most recent general election – currently, the Nov. 4, 2014, election: • Wisconsin DOT-issued driver’s license, even if driving privileges are revoked or suspended • Wisconsin DOT-issued identification card • Wisconsin DOT-issued identification card or driver license, without a photo if issued under a religious exemption • Military ID card issued by a U.S. uniformed service • U.S. passport • An identification card issued by a federally recognized Indian tribe in Wisconsin; may be used even if expired before the most recent general election • A photo identification card issued by a Wisconsin accredited university or college that contains date of issuance, signature of student and an expiration date no later than two years after date of issuance. Also, the university or college ID must be accompanied by a separate document that proves enrollment. May be used even if expired before the most recent general election.
The following forms of photo IDs are also acceptable for voting purposes, but must be unexpired: • NEW: veteran’s photo identification card issued by the Veterans Health Administration of the federal Department of Veterans Affairs • Certificate of naturalization that was issued not earlier than two years before the date of an election at which it is presented • Driving receipt issued by Wisconsin DOT – valid for 45 days • Identification card receipt issued by Wisconsin DOT – valid for 45 days • Temporary identification card receipt issued by Wisconsin DOT through the Identification Petition Process – valid for 180 days • Citation or notice of intent to revoke or suspend a Wisconsin DOT-issued driver license that is dated within 60 days of the date of the election.
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Older adults
continued from page 3 Elders – facility. Caring for an aging population with complex needs is a challenge, but each of us can have a role and advocate for older adults. We can dispel myths of aging, cultivate relationships, build and return trust, and be proactive in care coordination. We must base our care on the latest evidence and tailor our nursing interventions for those vulnerable and frail older adults among us. Research has shown that by educating ourselves in best practices, we can decrease mortality, reduce disability and illness, improve patient and family satisfaction, improve quality of life including at the end of life, and decrease
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November • 2016 health-care costs. When we do that, we improve outcomes for all generations. Let’s make sure that nursing leads the way! Email Mary.Schueller@hshs.org with questions or comments. Visit www.mycarg. org/r25 for more information on applying to participate in the National Institutes of Health project. Since 1875, the Hospital Sisters of St. Francis have been caring for patients in Illinois, Wisconsin and other locations in the United States and across the world. Today, Hospital Sisters Health System is a multi-institutional health-care system that cares for patients in 13 communities in Illinois and Wisconsin. HSHS
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Madison City Clerk Maribeth Witzel-Behl, left, and Mayor Paul Soglin announce record-setting early and absentee voting numbers.
Vote
continued from page 5 There are some exceptions to the photo ID requirement for military absentees, people who cannot leave their residence indefinitely, and for religious reasons. Visit http://bringit.wisconsin.gov/are-thereexceptions-new-law for more information. Get a Free Wisconsin Identification Card – If you do not have any of the IDs mentioned in these lists, visit a Wisconsin Department of Motor Vehicles – DMV – office to request a free Wisconsin Identification Card for the purposes of voting. Most people should bring a certified birth certificate, a Social Security card, and a utility bill or cell-phone bill for the required documentation necessary to get an ID. But if you do not have one of these items, there are other acceptable documents. The DMV’s requirements fall into four categories: • Proof of Name and Date of Birth – documents such as birth certificates, current U.S. passport, valid foreign passport, Certificate of Naturalization and more. • Proof of Identity – documents such as Social Security Card, Military Discharge papers, U.S. Government and Military Dependent ID card, Certified
Marriage Certificate, Judgement of Divorce and more. • Proof of Citizenship or Legal Status – documents such as U.S. state or local government-issued birth certificate, U.S. Certificate of Citizenship and more. • Proof of Wisconsin Residency – documents such as utility bill, cell-phone bill, bank-account statement, employee photo ID from a current employer, paycheck stub, hunting or fishing license, and more. • Visit http://bringit.wisconsin.gov/ how-do-i-get-free-state-id-card for a full list of valid documentation. • Visit http://wisconsindot.gov/Pages/ online-srvcs/find-dmv/default.aspx for a list of DMV locations. Preview Your Ballot, Do Your Homework, Study the Candidates – spend time digging into true facts of the election and review the candidates at every level of the ballot. If you are not sure who is on your ballot, visit https://myvote.wi.gov/en-us/ PreviewMyBallot to preview your ballot. Visit http://legis.wisconsin.gov/ senate/17/marklein or email Sen.Marklein@legis.wisconsin.gov or call 800978-8008 for more information or with comments or questions.
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November • 2016
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Wisconsin Men in Nursing: Standing together Barbara L. Nichols, DNSc (hon), MS, RN, FAAN, Wisconsin Center for Nursing diversity consultant
As part of its State Implementation Program grant from the Robert Wood Johnson Foundation, “Wisconsin Nursing Leads the PACC: Partnerships in Community Care,” the Wisconsin Center for Nursing and the Wisconsin Action Coalition have supported the growth of American Assembly for Men in Nursing chapters in Wisconsin. Historically nursing has been, and continues to be, a female-dominated profession. In Wisconsin, only 7.1 percent of registered nurses are male. Among licensed practical nurses, the percentage is even smaller at 5.2 percent. Barbara L. Nursing is one of the only Nichols health-care professions that has not kept pace with a gender-balanced workforce. A factor that encourages men to join the nursing profession and the many opportunities it offers Brent is an impending nursing MacWilliams shortage. With an anticipated increased demand for health-care providers, men in nursing will help fill those gaps for the future, both in the state and nationally. The American Assembly for Men in Nursing provides an excellent resource for support to men in the nursing profession. The mission of the organization is to shape
e in Complet s a as little
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Chapter membership includes two categories: individual or corporate. Membership is open to any nurse, male or female, and is unrestricted by any consideration of age, color, creed, handicap, sexual orientation, lifestyle, nationality, race, religion or gender. Membership facilitates discussions to strengthen and humanize health care, in order to meet an important objective of the American Assembly for Men in Nursing. Collectively, the Wisconsin chapters have strategic priorities that • explore recruitment and retention incentives, • develop strategic relationships to promote local chapters and goals, With an anticipated increased demand for health-care providers, men in nursing will help fill those • advocate members’ profesgaps for the future, both in the state and nationally. sional growth, • gather member practice-expertise profiles, a more diverse and gender-balanced nursing practice, education, research and leader• utilize American Assembly for Men workforce. Local and/or regional chapters are ship for men in nursing, and to advance sanctioned and recognized under the national in Nursing resources on a variety of trends men’s health. Its purpose is to provide a and issues, and bylaws of the American Assembly for Men in framework for nurses, as a group, to meet, • assist in the development of men’s Nursing. The frequency of meetings is deterand to discuss and influence factors that health curriculum. mined by and specific to each chapter. Each affect men as nurses. At the helm of the All Wisconsin chapters were recogchapter is open to both males and females in national organization is Wisconsin’s own nized Oct. 21 at a reception hosted by the profession. Brent MacWilliams, PhD, ANP-BC, RN, the Wisconsin Center for Nursing at the Wisconsin has doubled its number of University of Wisconsin-Oshkosh College Madison Marriott West. Representatives chapters during the past two years, and of Nursing. MacWilliams began serving now has six active chapters and one interest of the Wisconsin Center for Nursing and as the national president in 2016, and has the Wisconsin Action Coalition congratgroup. All chapters are currently seeking been a champion for chapter development ulated the growth that has been achieved new members, and invite nurses to join. in Wisconsin for many years. by the Wisconsin American Growing the American Assembly for Assembly for Men in Nursing Men in Nursing chapters in Wisconsin offers Wisconsin Regional AAMN Chapters Contact Person chapters and wished them opportunities for nurses to participate in Kelsey Thompson Bellin College Chapter - Green Bay success on future endeavors current issues and trends facing the nursing kelsey.thompson@bellincollege.edu Coulee Region Men in Nursing - La to support men in the nursing profession. There is an opportunity to build Paul Larson Crosse plarson2717@gmail.com profession. Great Lakes Chapter - Oshkosh Brent MacWilliams Visit www.aamn.org for macwillb@uwosh.edu South Central Wisconsin Chapter Benjamin Eithun more information on the beithun@uwwhealth.org American Assembly for Norman Shanks Southeastern Wisconsin Chapter Men in Nursing. Visit www. Norman.Shanks@aurora.org wicenterfornursing.org for Mohammad Alasagheirin Northwestern Wisconsin Chapter alasagmh@uwec.edu more information on WisJo Anne Preston Men in Nursing Roundtable consin’s nursing workforce. Rural Wisconsin Health Cooperative jpreston@rwhc.com
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November • 2016
Patients left in limbo; doctors flee Puerto Rico DANICA COTO Associated Press
SAN JUAN, Puerto Rico (AP) — Wanda Serrano arrived at Puerto Rico’s largest public hospital before dawn to take her 17-year-old son to an appointment. Six hours later they were still in the packed waiting room hoping to see a doctor. They had gone to San Juan’s Centro Medico to see one of the many kinds of specialists the teen needs for treatment of a genetic disease called tuberous sclerosis, which can cause tumors to grow on his brain, kidneys and other organs. But specialized medical expertise is increasingly difficult to find in the economically troubled U.S. island territory. Six hours in a waiting room is no longer the exception, but the norm. A pediatric neurologist recently told Serrano that her son, Cedrik, needed to wait 10 months for an appointment. “I live terrified every single day,” Serrano said one recent morning as she clutched his medical records and peered anxiously down a fluorescent-lit hallway for a nurse or doctor. “You feel powerless. You can’t do anything except wait for that date to arrive.” Doctors have gradually left Puerto Rico during a decade-long recession that has gripped the island and driven more than 200,000 people to the U.S. mainland seeking better opportunities. Now the steady departure of pediatricians, surgeons, orthopedists, neurologists and others has become a stampede as the economy shows no sign of improving. Financial problems in the territorial health-insurance program make it nearly impossible for doctors to stay in business. Up to 700 doctors are expected to leave Puerto Rico this year, double the number
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Patients wait their turn at one of the Medical Center external clinics in San Juan, Puerto Rico. A steady departure of medical specialists from Puerto Rico has turned into a stampede amid the island’s ongoing economic crisis leaving patients with few doctors to take care of their ills.
from two years ago, said Dr. Victor Ramos, president of the island’s Association of Surgeons. The territory’s number of doctors has dropped from 14,000 to 9,000 in the past decade, the majority leaving for higher salaries and lower living costs on the U.S. mainland. The island of 3.5 million people now has only two pediatric urologists, one
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Dr. Reynold Lopez, center, a surgical oncologist and instructor at the University of Puerto Rico School of Medicine, is followed by medical students at the Dr. Isaac Gonzalez Martinez Oncological Hospital in San Juan, Puerto Rico, where services are offered to cancer patients with limited financial resources. Due to the financial crisis up to 700 doctors are expected to leave Puerto Rico this year, double the number from two years ago.
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Puerto Rico
continued from page 7 orthopedist specializing in ankle and feet, one pediatric cardiologist, and a handful of geneticists and endocrinologists. It can take a year to see a specialist, Ramos said. “People are waiting much longer for appointments, including one that could be a matter of life or death, because there is simply no room,” he said. Dr. Hiram Luigi, an orthopedic surgeon, said he needs to realign the bones of patients a couple of times each month because they did not see a specialist in time. “I have spent 30 years in orthopedics, and I have never seen something like this,” Luigi said. The lack of specialists has adversely affected patients, whose health conditions often worsen before a doctor sees them. Many people like Serrano have moved to the United States specifically to get medical care. “I’m searching for quality of life,” she said. Puerto Rico’s financial woes are largely to blame. The government is behind on insurance payments as it scrambles to make payments on debts that have ballooned in recent years to nearly $70 billion. Doctors not only struggle with delayed reimbursements for services but continued on page 9
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Dr. Reynold Lopez, one of the few surgical oncologist on the Island and teacher at the University of Puerto Rico school of medicine, performs thyroid surgery with resident physicians at Dr. Isaac Gonzalez Martínez Oncological Hospital in San Juan, Puerto Rico. The territory’s number of doctors has dropped from 14,000 to 9,000 in the past decade, the majority leaving for higher salaries and lower living costs on the U.S. mainland.
Orthopedic technician Francisco Blasco Reillo attends to a patient at the Medical Center pediatric orthopedics clinic in San Juan, Puerto Rico. The exodus of doctors to the United States in search of better wages is one of the main factors linked to the current shortage of specialists in the Island.
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Miguel Perez, an intern student from the University of Puerto Rico School of Medicine, puts away his cell phone before walking into the operating room at the Dr. Isaac González Martínez Oncological Hospital in San Juan, Puerto Rico. Once they complete their general surgery training, many residents are moving to the United States in search of better wages, one of the main factors linked to the current shortage of specialists in the Island.
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November • 2016
Nurses honored for saving boy
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CATHY DYSON The Free Lance-Star
FREDERICKSBURG, Va. — The first time the two nurses laid eyes on Jonathan Starkey, his face was bluish-purple from a lack of oxygen. The latest time they saw him — at an event honoring them for saving his life — Jonathan once again was cloaked in blue. Jonathan, 8, had dressed for the occasion in a royal blue shirt and blue plaid tie, black pants and shiny black shoes. After he reached for those who literally breathed life back into his body, the boy gave the understatement of the year. “I’d say they’re very nice,” Jonathan said. About 100 people gathered Oct. 4 in the atrium of Mary Washington Hospital in Fredericksburg to heap accolades upon Jessica Mountjoy and Kathy Wirtz. Both are registered nurses in the hospital’s cardiac catheterization lab, and had no idea that all the people in suits and scrubs had assembled on their behalf. Until the applause started. And Jonathan stepped forward to embrace them both in a group hug. “I don’t even know what to say,” Mountjoy said, as she stepped up to the podium. “I am so happy to see that little face right there. He means a lot to us. I don’t think he knows what he means to us.” Jonathan’s loved ones certainly seemed PETER CIHELKA/THE FREE LANCE–STAR
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Puerto Rico
continued from page 8 receive less money through the government’s Medicare and Medicaid programs, as well as from private health insurance, than they would for the same services on the U.S. mainland. Many specialists no longer accept patients with Medicaid, which covers about half of Puerto Rico’s population. The great majority of patients like Serrano’s son now seek specialists at Puerto Rico’s largest public hospital, arriving as early as 1 a.m. daily to wait for medical care. “It’s truly the final stop for many people,” said Edgar Colon, dean of the University of Puerto Rico’s School of Medicine. “We can’t keep up.” The hospital is buckling under a surge of patients as it operates with a dwindling budget, unable to buy certain medical supplies like it previously did when the government could still borrow money. Jorge Vidal, president-elect of Puerto
Mary Washington Hospital cardiac nurses Jessica Mountjoy, left, and Kathy Wirtz reunite with Jonathan Starkey, 8, during a surprise ceremony in their honor. They were on vacation when they saved Jonathan’s life after an accident.
RN Management in Assisted Living Rico’s Radiology Association, said he cannot perform some procedures because he can’t obtain two types of specialized needles. “There’s a very simple reason they haven’t bought them,” he said. “They cost $300.” Such problems pushed pediatrician Dr. Hector Nieves to move to Florida in February 2015. In his new office, the answering machine offers same-day appointments. “I don’t regret leaving,” Nieves said. “Puerto Rico’s problems are much bigger than people think.” Those who have stayed say it will only become worse. More than 20 percent of the island population is 60 years and older, and that percentage is expected to spike as not only doctors but all types of Puerto Ricans leave for the U.S. mainland. Serrano and her son will move soon to Orlando to join her husband, who found a job there. She is optimistic about finding specialists to provide the checkups her son needs every six months. “I’m leaving in peace,” she said. “I feel like I’ve been born again.”
Greater Milwaukee Area
Considering a change to assisted living? Seeking a management position with a progressive organization that will support your personal development?
Join an organization that is a recognized leader in the industry.
Laureate Group, a leading provider of senior housing and assisted living services in the greater Milwaukee area is seeking an energetic RN to join our team. This is a great position for someone who is looking for a good balance of both management responsibilities and care time duties. Candidates for this hands on position will be organized and results-oriented with prior supervisory/management experience. Must be able to implement systems, effectively interact with residents and families and have proven problem-solving and leadership skills. Alzheimer’s/Dementia experience preferred. Computer skills essential. This is a Full Time Day Position. Join an organization that is a recognized leader in the industry. This is a challenging yet rewarding position in a residential setting. We offer a competitive salary and comprehensive benefits package including health and dental insurance as well as matching 401(k) contributions. Apply conveniently online at www.laureategroup.com or send resume to Lisa.Stueland@laureategroup.com
EOE
1805 Kensington Drive, Waukesha, WI 53188
November • 2016
Page 10
Nursingmatters
Rescue
continued from page 9 to grasp how important the nurses were to them. “We’re blessed that he’s still here,” said Jonathan’s mother, Shannon Adams. “Jesse and Kathy will always be special to us.” His stepmother, Ashley Starkey, added: “Everybody should know what they did.” Almost a month to the day earlier, Jonathan had been part of a “guys’ trip” with his dad, Steve Starkey, and step-grandpa to Busco Beach and ATV Park in Goldsboro, North Carolina. The facility is about 230 miles south of Fredericksburg and features more than 2,000 acres of water holes and hills for camping and riding. It was the Saturday of Labor Day weekend, and the nurses, whose families go places together, hadn’t planned to be at Busco until Sunday. Mountjoy’s husband, Rocky, knows Jonathan’s dad, but Wirtz’s husband, Kevin, said Rocky is the kind of guy who always knows somebody almost everywhere they go. The two families had come to Busco a day earlier than they planned and had been riding for several hours when they noticed some commotion. Jonathan was riding a utility terrain vehicle side-by-side, a model that looks
PETER CIHELKA/THE FREE LANCE–STAR
Mary Washington Hospital nurses Jessica Mountjoy, left, and Kathy Wirtz saved Jonathan Starkey, hugging them at a recent thank-you ceremony. They saved his life with CPR on Labor Day weekend.
sort of like a dune buggy, into the muddy waters of the man-made pond. He was wearing a helmet and a four-point seatbelt harness and sitting beside the driver. The UTV was too far to one side and started to sink, his dad said. The driver was able to undo his seat belt, and Jonathan took off his helmet, but couldn’t unsnap the seat belt. “I remember closing my eyes and holding my breath and going under the water,” Jonathan said. Adults struggled to pull the vehicle out of the mire and free Jonathan. The vehicle never turned over but sat upright
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the whole time. The murky water didn’t help with the rescue, and his dad estimates Jonathan was submerged at least five minutes. Meanwhile, the nurses knew they would be needed and were ready. As soon as Jonathan’s body was pulled from the UTV, with his face an awful bluish-purple color, they started cardiopulmonary resuscitation. Mountjoy did the compressions Jonathan is riding again after being submerged on a utility terrain vehicle. and Wirtz gave him quick breaths. Wirtz had no sense asked Jonathan’s stepfather, John Adams, of how long the CPR lasted. Was it 10 to sit in the room with him. minutes? Twenty? She couldn’t say. In “I was freaking out,” she said. the midst of the crowd and the commoJonathan divides his time between his tion around her, she tuned out everything mother and stepfather in Orange County, but her CPR partner and the little boy on where he’s a third-grader at Locust Grove the ground in front of them. Elementary School, and his father and “All I could hear was Jesse’s voice,” stepmother in King George County. He’s Wirtz said. the oldest of seven children, between the Jonathan’s dad guessed it took about two families. two minutes before his son started to The incident didn’t leave too many cough and gurgle. Jonathan was loaded scars. Jonathan’s already been back in on the stretcher — and told the nurses the saddle to race dirt bikes, though he he was scared. They were thrilled isn’t sure if he’ll ride a vehicle into deep he was alert enough to realize what water again. was happening. Meanwhile, co-workers of nurses Jonathan stayed in the intensive care Mountjoy and Wirtz sang their praises unit of Children’s Hospital of Greenand showered them with plaques, pins ville, North Carolina, for two nights. He and flower bouquets. Sharon Allen, the wasn’t too happy the first night, when he American Heart Association program couldn’t eat or drink because there was manager at the hospital, bestowed the still fluid in his lungs. But by the second Heartsaver Award upon them. It’s given night, when tests showed he had suffered to those who save lives by performno damage, he was able to have both. ing CPR. He said the hospital cheeseburger tasted Michael McDermott, the hospital’s especially good. chief executive officer, said the nurses’ When he arrived home to his mother, skills and actions contributed to a mirhe asked if he could take a bath. acle, along with them being where they “I was putting my head under like were needed a day earlier than they had nothing even happened,” Jonathan said. planned to arrive. His mother wasn’t quite so calm. She
RN
RN, DiRectoR of NuRsiNg
2nd or 3rd Shift
RegisteRed NuRses Are you looking for a wonderful opportunity to enhance your nursing identity and really make a difference? Mile Bluff Medical Center is a progressive facility located in rural Mauston, Wisconsin, where employees have a voice and a name. We currently have the following RN positions available: Nursing & Rehabilitation positions: ➣ Full time position available at Fair View Nursing & Rehabilitation Center. ➣ Full time position available at Crest View Nursing & Rehabilitation Center. ➣ Part time position available at Crest View Nursing & Rehabilitation Center to work every other weekend. Clinic positions ➣ Full time position available for a Family Practice RN at Mile Bluff Clinic. Minimum two years of experience preferred. ➣ Triage/Family practice, full time position available at New Lisbon Family Medical Center. Hospital positions ➣ Full time position available in the Medical/Surgical department for a 12 hour Night shift RN. Experience preferred, new grads will be considered. ➣ Charge RN, full time position available in the Medical/Surgical department. This is a 12 hour Night shift position. Please apply online by visiting our website at www.milebluff.com, or email your resume to humanresources@milebluff.com.
Mile Bluff Medical ceNteR 1050 Division St., Mauston, WI 53948
608-847-1465
nursingmattersonline.com
We are an Equal Opportunity Employer
Part-time with benefits
Saint John’s On The Lake is a well-respected non-profit continuing care retirement community located on the east side of Milwaukee. We provide seniors with independent living apartments, skilled nursing and assisted living. We are currently seeking RNs experienced in long-term care to work part time with benefits - .8 2nd shift or .5 3rd shift. Administer medication, perform treatments Observe and document responses to resident care Collect and document admission information, communicate as appropriate ➣ Assist with chart audits, update MARs ➣ Supervise staff As part of our unique person-first philosophy of care, you will enter into a care-giving relationship with the resident and family. Requires WI RN license, CPR certification and at least 2 years experience in geriatric/rehabilitation nursing including supervisory experience. ➣ ➣ ➣
We offer a superior salary and full benefit package, including free parking and use of our fitness center and sWimming pool.
Come join our team of dedicated staff! Bethany Lutheran Homes, the largest most innovative provider of senior services in Western Wisconsin, has a great opportunity for a qualified RN to use their high quality clinical, supervisory and customer service skills in our skilled nursing facility in La Crosse, WI. This position is a salaried full-time position primarily working weekday hours, but must be available for on-call rotation and varied shift times based on customer needs. The Director of Nursing will join us in leading a solid team of healthcare professionals delivering care to 123 residents needing rehabilitative care, long term and dementia specific skilled nursing care, consistent with regulations and established best practices. This Director of Nursing will also be instrumental in envisioning and implementing future models of nursing home care within Bethany Lutheran Homes. Requirements: The successful candidate must meet the following qualifications: • Currently licensed to practice in the state of Wisconsin as a Registered Nurse • 2-3 years experience in a leadership and/or supervisor capacity in health care or related field preferred • Demonstrated knowledge and experience in gerontological nursing, rehabilitative and restorative clinical practices; experience in acute care or long-term care is beneficial • Demonstrated compatibility with Bethany Lutheran Homes’ mission and values • Valid driver’s license and safe driving record • Intermediate computer skills, including ability to adapt to and lead team through changes Rooted in Christian Faith • Caring for Each Other Serving the Community • Great People, Great Care! View more details and apply at
please forward resume to djock@saintjohnsmilw.org.
www.bethanylutheranhomes.org
EOE/AA
Teamwork-Respect-Integrity-Commitment-Love EOE
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