Volume 25
Number 22
October 31, 2014
Hospital of the University of Pennsylvania
HUP at Night
A Behind-the-Scenes Look
On first glance, HUP seems almost deserted at night. The main lobby, normally teeming with activity, is quiet, with only an occasional person walking through. But, beyond the empty hallways, the machinery of the institution is going strong. `` HUP’s main lobby, usually teeming with activity, is quiet during the night shift. `` Respiratory therapists Jillian Cruz (l.) and Kelly Cloud place patients with obstructive sleep apnea on CPAP therapy at night.
Inside
Taking Time Out to Talk...........2 Ebola Preparedness Roundtable. ................................3 at Penn Medicine.......................3 Free Skin OncoLink Brown Bag Chat.......4 Cancer Screening......................3 Helping All.....................4 the Time.....4 PartnersPeople in Rehab. All Employee Meetings............4 Shortakes...................................4
The Benefits of Late-Night Work Coming into work while most of the world is settling down for the night is not for everyone. Staying awake and sharp during those hours — and regularly acclimating from nighttime working hours to daytime “off ” days — can be a challenge. But many of HUP’s late-night employees say the benefits outweigh the occasional bouts of yawning. They have greater autonomy, fewer meetings, and, with their reduced staffing numbers, a greater sense of family, team work, and comradery. “The nightshift crew sticks together,” said Karen Flanigan, RN, Nursing clinical coordinator. “You develop a rapport with staff from many areas.” And their benefits continue offshift as well. Running errands during the day is much easier — and faster — than in the evening. And, ironically, studies show that nightshift workers spend more time with their children than those with “normal” work hours. (Continued on page 2)
Heartfelt Thanks........................4
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(Continued from Cover)
HUP at Night
A Behind-the-Scenes Look
For the most part, patient care units have a more relaxed environment in the evening. With fewer, if any, visitors and no rounding, Rebecca Syx, MSN, of Rhoads 5, said the biggest bonus for her is the ability to spend more time with patients. “I get to tuck them in at night.” A slower pace is not the case for Pharmacy staff, however. Between 8 p.m. and 8 a.m., just three pharmacists tag team to verify medication orders and answer questions. On average, one central inpatient pharmacist verifies more than 500 orders in a single nightshift. They also cover rapid responses and codes. “Basically you have to be a jack of all trades,” said pharmacist Frank Suplick, PharmD. The ER doesn’t slow down during the evening either and often the staff is called upon to deliver more than patient care at night. “Sometimes a patient has no way to get home. And there are no social workers to turn to at that hour, no van to drive them,” said Carla Grasso, BSN, CEN. “One time we all chipped in and raised $84 for a patient to take a bus home.” Areas that support clinical care are kept busy as well. Two radiology techs must respond to all STAT requests to image patients at bedside, pushing a portable imaging unit throughout the hospital. Respiratory therapists are kept busy placing all patients with obstructive sleep apnea on CPAP machines and responding to emergent situations. “We try to be as quiet as possible when we’re in a patient’s room,” said Kelly Cloud, senior respiratory therapist. “We do a lot of our work in the dark.”
`` Jeff Moser, lead operator in Physical Plant, rounds throughout the hospital, checking to make sure all of HUP’s critical heating, ventilation, and other monitoring systems are operating in a safe and reasonable manner.
Resiliency and Creativity are Key Nighttime employees are especially adept at “rolling with the punches and being resilient,” Flanigan said. Suplick recalled a time, before Pharmacy moved to its new location on Ground Rhoads, when a pipe burst on the floor above the automatic dispensing area. “It suddenly started raining on the robot,” he said. After calling in reinforcements to control the flood and clean-up, “I wore a trash bag and just kept going.” Going above and beyond for our patients traverses all shifts but it requires a little more creativity in the middle of the night. Tilly Heggs, MSN, nurse coordinator, once received a call at 1 a.m. from the CICU. A patient on the unit, scheduled for a transplant the next morning, wanted to get married before the procedure. Heggs went into overdrive to pull it together. She contacted the on-call chaplain, who convinced a priest to come in, and then went to rooms on Silverstein 7 and 8 where patients had been recently discharged and grabbed flowers left behind for a bouquet for the bride. The marriage went forward and so did the transplant. “You just do what you have to do,” she said.
Keeping the Systems Up and Running Though the hallways are empty and patient care units are generally quiet, the many nonclinical areas that keep the hospital running smoothly through the wee hours of the night remain on full alert. The two-man night crew from Physical Plant must be ready to respond to any problem, at any given time, said Dan Hazley, HVAC Operations supervisor, “anything from unclogging toilets to freeing people stuck in elevators.” Calls from patient unit are a priority, he said, and completing the job in a way that doesn’t disturb patients is “a must.” “It definitely takes a unique individual to work our nightshift,” Hazley said. “To borrow a phrase from my military days, he needs to be ‘high speed — low drag. Basically, do things well, efficiently and quickly.” `` Nightshift pharmacists are responsible for more than medications. Alex Szymanik, PharmD, responds to a nurse calling about a refrigerator with meds that went out of temperature range on the unit.
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HUP’s kitchen may close at 9 p.m. but Food Services employees are busy behind the scenes for much of the night. For example, Bryant Page, food transporter, works until 11 p.m., making sure the ED, patient care units and other areas have food and drink patients might need during the night. Theresa McKnight, a cook, begins her day at 3 a.m. to start preparing that day’s meals. “I love how quiet it is, with no distractions. I get a lot done,” she said. The pace for EVS employees doesn’t slow down either. Linda Savage, EVS Operations manager, said they strip and wax floors and shampoo carpets during the night hours, while also handling all discharge cleaning and responding to calls. Savage loves working nightshift. “I’m not a morning person. I prefer to get up in the afternoon and start my day at night,” she said, adding with a laugh. “When I die, my obit will say, ‘She’s doing what she always loved: sleep!’” Security staff continue rounds all night, throughout the hospital as well as Penn Tower, the Perelman Center and the Smilow Translational Center. Because everyone must come through the ED between 11 p.m. and 5 a.m., Security officers also greet visitors and patients, provide information and, along with the chaplain on call, try to be a calming influence. Understandably, “emotions can run pretty high. That time of night, people are nervous and anxious,” said Sergeant Lester Green. “We get a lot of people in the ED at night,” agreed Corporal Henry Watson. “And some of what we see is gut wrenching.” Of course, not every call to Security is serious. With HUP’s open visitation policy, “we sometimes have to locate a visitor who got lost trying to find his way out,” said Green. “And we do have the occasional baby delivered in our driveway… at least once every couple years!”
`` Radiology tech Joseph Purcell returns from a stat imaging request with the portable unit. They get, on average, around 70 such calls per night.
Check out this week’s issues of What’s New and the Presby Bulletin for a look at the night shift at Pennsylvania Hospital and Penn Presbyterian.
Ebola Preparedness at Penn Medicine As an academic medical institution, Penn Medicine stands ready to provide expert clinical care under a broad range of circumstances, keeping the safety and protection of our patients and staff as our top priority at all times. The likelihood of an outbreak of Ebola in this country is extremely remote, but we are nonetheless prepared for the possibility of any of our facilities receiving a patient who may have been exposed to or infected with the Ebola virus. The Hospital of the University of Pennsylvania has agreed to be among hospitals to care for U.S. medical workers who contract the virus while working in Africa, if needed. To date, we have no patients suspected of or confirmed to have the Ebola virus in our facilities. We are following the CDC’s patient screening criteria for Ebola, including both travel history and symptoms that may be associated with the disease. Media reports have mistakenly indicated that HUP is a regional referral center for Ebola patients. That is not true. While there is ongoing discussion at the state and city levels about regionalizing care for patients with Ebola, there are currently no public health plans to institute this model. HUP is prepared to isolate patients suspected of having Ebola in a Special Treatment Unit, which is separate from other patient-care areas and has been designed to ensure both optimal medical care for Ebola patients and the safety of our staff and other patients.
Two phone lines have been established to assist clinicians and staff around the clock:
• Clinicians with patient-related
questions should call 215.614.0524. A physician will answer and handle calls about screening, isolation and, if necessary, lead arrangements for patient transport to HUP from another entity.
• General questions not pertaining to
direct patient care can be directed to 215.615.2929.
In tandem with ongoing training for staff who may care for a patient with Ebola, information is added daily to the UPHS Intranet site for Ebola preparedness. Clinical staff are encouraged to check this site regularly to stay abreast of updates: http://pennpoint.uphs.upenn.edu/sites/ ebola/default.aspx.
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Three different topics will be presented: » Session 1 (10 a.m.): The Ins and Outs of Medicare Open Enrollment: What’s New for 2015? » Session 2 (11 a.m.): The Affordable Care Act: An Update for 2015 Are you interested in learning more about the nuts and bolts of the Affordable Care Act? Join OncoLink for an informative insurance education seminar on Thursday, November 6, at HUP’s Hirst Auditorium or via live webcast (and available for replay) at www.oncolink.org/webinars.
» Session 3 (Noon): The Pennsylvania Medicaid Expansion: What do Healthcare Providers Need to Know? Nurses and social workers who attend (in person) can receive three continuing education credits.
Helping People All the Time
Service excellence, ie, going above and beyond, isn’t necessarily a huge action. Sometimes it’s someone who displayed “amazing teamwork during an emergency situation” or showed kindness to a patient: “Your compassion is unequaled.” These actual submissions to Helping People All the Time weren’t major efforts, but they clearly had an impact. The next time you see someone making a difference, submit that person’s name to our service excellence program. It’s easy. Go to http://pennpoint.uphs. upenn.edu/sites/HUP/hupse. Click on “HUP Service Excellence Nomination” and then “New” at the top of the chart to get started. You can also read additional submissions demonstrating how much employees help our patients and each other. Names can also be submitted on a paper form, available at various locations throughout the hospital. Congratulations to the winners of July’s Helping People All the Time raffle: Robyn Berger. . . . . . . . . . . . Dulles 6
Megan Campbell. . . . . . . . . Rhoads 7
Erica Brennan . . . . . . . . . . . Dulles 6
Alana Carter. . . . . . . . . . . . . Rhoads 7
Janelle Heyward. . . . . . . . . Dulles 6
Nicole Mazzotta . . . . . . . . . Rhoads 7
Danny Vong. . . . . . . . . . . . . . Vascular Lab
Mae McHugh. . . . . . . . . . . . Rhoads 7
Rachael Dowrick. . . . . . . . Founders 12
Alicia Carovillano. . . . . . . . Radiology
Thomas McIntosh. . . . . . . . Founders 12
Candace Harrell . . . . . . . . . Radiology
David Allen. . . . . . . . . . . . . . CT SICU
William Lawrence. . . . . . . Radiology
Erin Hendrickson. . . . . . . . . Radiation Oncology
Joseph Robinson. . . . . . . . . Patient & Guest Services
Stacey Hopkins. . . . . . . . . . Ravdin 9
Cheryl Brown . . . . . . . . . . . Silverstein 10
Carolyn Dorobra . . . . . . . . . Rhoads 2
Lizzy Abraham. . . . . . . . . . . Silverstein 7
Rachael Pasternack. . . . . . Rhoads 2
Heather DeRafelo. . . . . . . . Silverstein 8
Sarah Smyth. . . . . . . . . . . . . Rhoads 6
Dominque Williamson. . . . Silverstein 8
Tyrone Taylor. . . . . . . . . . . . Rhoads 6
one of the upcoming All Employee Meetings. Members of senior leadership provide updates and answer questions.
All Employee Meetings are held in Medical Alumni Hall, on 1 Maloney.
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My son frequents UPenn Oral and Maxillofacial dentistry due to his medical condition. I wanted to take the time to share with you my appreciation of Mr. Joseph Robinson [ambassador in Patient & Guest Services]. He is always so cheerful and helpful when I pull up for valet. I have three children under the age of 6 and he seems to understand how difficult managing 3 young boys can be. You must be doing a wonderful job of training your employees to have positive and helpful attitudes. Thank you for hiring such fantastic employees. It really makes a difference!
HUPdate Editorial Staff Sally Sapega Editor and Photographer Trissy Harding Designer
Administration
Susan E. Phillips Senior Vice President, Public Affairs Holly Auer Director of Communications
Come to learn more… Do you want to learn more about HUP and the Health System? Be sure to attend
Heartfelt Thanks
The next three will be held: Tu esday, November 4 Noon to 1 p.m. Tu esday, December 9 5:00 to 6:00 p.m. W ednesday, January 14 8:30 to 9:30 a.m.
Contact HUPdate at: 3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 email: sally.sapega@uphs.upenn.edu HUPdate is published biweekly for HUP employees. Access HUPdate online at http://news.pennmedicine.org/inside/hupdate.