A p r i l 2 0 1 2IN THIS EDITION

2 Betsy’s Corner2 Congratulations2 Mark Your Calendar2 Nurse / Clinical Support

Person of the Year & Nurse Walk

3 Web-Based Continuing Education Opportunity

3 Welcome to Our New Med-Surg Director

4 On the Move4 Notes from Shared

Governance4 I C.A.R.E. Survey5 Finding Humor in a

Difficult Situation5 Meet Charu

Raghuvanshi, M.D.6 ER 2012 Weight Loss

Challenge6 Congrats New CNRNs

Commonwealth Health Corporation’s nursing mission is to care for people

and improve the quality of life in the communities we serve through our practice, education, research,

innovation, and collaboration.

The Road to Nursing Certification

~ Communicating Helps Caregivers ~

The Nursing Development Council would like to say THANK YOU to all certified nurses for your commitment to the profession, continu-ing education, and providing the best patient care. The Nursing Development Council sets many goals each year to enhance nursing knowledge and skills, as well as provide standards for professional development. One of our goals is to encourage professional certification in your nursing specialty.

According to the American Nurses Credentialing Center (ANCC), certification is one way to validate a nurse’s knowledge, skills, and abilities in a particular field of nursing. The preparation and study necessary for successful completion of certification examinations improve a nurse’s ability to care for acute, chronic, or critically ill pa-tients. Certification also provides an individual with a sense of pride and professional accomplishment.

Some of you may have noticed baskets filled with candy and pamphlets about nursing certifications in your specialty area recently. As we recognize it is important to provide you with information to help get you started, we also had this thought: Wouldn’t it be nice to talk to nurses who have already achieved this goal and see what they have to say! Below are two nurses who have received their certification within the past year.

Lesa Moody, RN, CCRN, CNIV has worked in the CCU at The Medical Center for many years and recently transitioned to Interventional and Special Procedures Radiology Nursing. She started her career as an LPN in 1990 and received her ADN in 1997. She is currently working on her BSN. Her passion for critical care is evident by her 22 years of bedside critical care experience. Lesa recently set a goal, and with lots of self-study obtained her Certification in Critical Care Nursing (CCRN) in July 2011. Lesa states, “I treated the test like a class I signed up for at Western.” Lesa was motivated to pursue her CCRN for many reasons, one of them being a personal goal. “I wanted the certification that validated the experience. The bottom line is the more we put into our education and specialty area benefits not only us, but makes our patients the ultimate recipients!” Lesa describes achieving certification as taking her under-standing deeper, allowing her to feel more prepared as she cares for her patients. Lesa was also able to use her certification as a step in achieving her Clinical Ladder IV.

There are many types of certifications one can receive. Anna Sparks, RN, CAPA works in Ambulatory Surgery at The Medical Center. Anna has an Associates Degree in Nursing and a Bachelor’s Degree in Community Health. Anna has been in the nursing profession for 24 years, with most of those years spent in Medical-Surgical

Lesa Moody, RN, CCRN, CNIV Anna Sparks, RN, CAPA

Continued on page 3

2011

NUR

SES O

F THE

YEAR

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It’s hard to believe that it is April, and we have May flowers but no April showers as the old rhyme goes. Just as the weather is unpredictable, so seems to be our census — I greatly appreciate all that everyone has done to accom-modate our many patients in a timely manner. April was the new beginning of our fiscal year and, thanks to everyone’s hard work and watching our expenses, we had a positive year — unlike many other hospitals across our nation. Thanks to everyone for your commit-ment to make our hospital a success. The new chairs of the shared governance committees held their first meetings on April 3, so please give them your support by attending your assigned committee meetings. It is that time of year again when we select our Nurse of the Year and Clinical Support Person of the Year. The winners will be announced at a celebration in the Auditorium at 2:00

p.m. on Tuesday, May 8. On Saturday, May 12, a Walk with Your Nurse will take place beginning at 9 a.m. on our campus at the park adjacent to the Emergency Department. Please come and participate in this event to honor nurses for Nurses Day and bring your family and friends. The course will be around the hospital campus block. Our Nurse of the Year and Clinical Support Person of the Year will be presented to the public at this event. As I reflect on our last year, I would like to thank everyone who achieved their certifications for taking on the extra time and effort to improve their knowledge base. Congratulations to all who worked hard to complete their ADN, BSN or MSN this semes-ter! We look forward to you sharing your new evidenced-based knowledge with us in the coming months. The training for Computerized Physician Order Entry will begin the middle of May and will be utilized first by the hospitalists. Nurses will be required to take a class to learn how this new process works. Bedside Medication Verification will follow quickly as the next process in comple-tion of nursing documentation. Both of these initiatives will improve patient care processes and promote safety.

Thanks!Betsy

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Betsy’s Corner

Betsy KullmanChief Nursing Officer

Congratulations!The following are recognized for their recent accomplishments:

Kimberly WhiteInducted into the Sigma Theta Tau

International Honor Society of Nursing

Amy Groce and Gail Jaggers Passed the Certification of

Neuroscience for Registered Nurses (CNRN) Boards

See related story on page 6.

If you or someone you know should be recognized for an

accomplishment, contact Paula DeVore, RN, Nursing Notes editor.

Academy of Medical-Surgical Nurses

Every 3rd Tuesday 6:30 p.m.

3D Classroom

Please plan to attend!

For more information, contact Carolyn Simmons or

Gladys Sublett.

Mark Your Calendar

Nurse of the Year and Nursing Clinical Support Employee of the Year

Winners will be announced May 8 at 2 p.m.

The Medical Center Auditorium••••

Nurse WalkMay 12 at 9 a.m.

The park adjacent to the Emergency Department

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We are fortunate to have our new Medical-Surgical Director, Kevin J Ribby, MSN, RN, BC, GCNS. He came to us after serving as Clinical Manager at Sunrise Medical Center in Las Vegas, Nevada. He was Director of Nursing Education/Clinical Practice at St. Joseph Regional Medical Center in South Bend, Indiana. He retired as a Navy Nurse after 21 years of ser-vice and is board certified in Geriatric Nursing. He started as a diploma nurse and then received his BSN and MSN. He was published in the areas of restraints with confused patients in the 1990s to decrease use of restraints in the acute care.

Kevin is a proponent of Standards of Practice within the nursing pro-fession. He enjoys reviewing and applying Evidence-based Practice to many of the nursing processes such as monitoring restraints and continued

use of Foley catheters. He has pub-lished a research article in the 2006 Nursing Quality Magazine about the unnecessary use of Foley catheter in patient care. Please take time to look for his research at www.ncbi.nlm.nih.gov/pubmed/16816609.

He made the decision to leave Las Vegas and relocate to Bowling Green, accepting the position as Medical-Surgical Director of The Medical Center at Bowling Green. Kevin and his wife discussed the many opportuni-ties Bowling Green offered and felt it was a better place to raise their grand-daughter whom they homeschool. Bowling Green also places him and his wife in closer proximity to their other children, and they enjoy the variety of the seasonal changes.

Welcome to Our New Medical-Surgical Director by Nancy Evanoff, RN, BSN, NRT

Free Web-Based Continuing Education

Opportunity by Toni Coleman, RN

Treating Tobacco Use & Dependence in Kentucky Hospitals – Online course

This course, according to the University of Louisville’s online courses for continuing health sci-ences education, is “the first of its kind for Kentucky hospital medical professionals to address the number one preventable cause of disease and death in our state.” Examples will be given on how to successfully provide brief bedside interventions for all patients who use tobacco in three minutes or less. This course is designed for Nurses, Physicians, Nurse Practitioners, Physician Assistants, Respiratory Therapists, Pharmacists, Tobacco Cessation Specialists, Hospital Administrators, Supervisors and Support Staff. This online continuing education course, approved by the Kentucky Board of Nursing for 1.5 contact hours, will expire December 31, 2012. Participants must complete the en-tire session, provide license, social security number and complete the evaluation to receive contact hours. The course will take approximately 1.25 hours. For more information please call 502-852-6318. Go to http://uofl.me/treatingtobacco10 for more information.

nursing providing bedside nursing care. In November 2011, she received her Certified Ambulatory Perianesthesia Nursing Certification (CAPA). Anna’s motivation stemmed from her move to Ambulatory Surgery approximately three years ago. Anna states, “this was a new area and there was so much to learn. I wanted to be prepared and knowledgeable when patients asked me questions.” Once Anna decided to pursue the certification, she studied diligently for four months prior to sitting for the exam. Anna expressed feelings of gratefulness for the support and mentorship of her co-workers as they shared their test-taking experience and preparation strategies. Recognizing that fear of the test is a huge factor for many interested, Anna offers encour-agement with these words: “I wish more people would do it! Whether you pass or not, you will learn from it. It’s like the Nike slogan, Just Do It!”

Lesa and Anna both agree pursuing certification has changed their practice as a nurse. Similarly, they described

obtaining certification has taken their current knowledge of practice to a deeper level of understanding. They feel better prepared as they care for population-specific patients, and best of all, the patients benefit the most!

I appreciate Lesa and Anna sharing their experiences as they journeyed to achieve Nursing Certification. I hope for those interested in taking this same road trip, you find encouragement and motivation in their stories. We have several skillful and wonderful certified nurses at The Medical Center who are more than willing to encourage and share their experience. Best of luck as you arrive to your destination!

If interested in more informa-tion regarding nursing certification, there are multiple websites such as ANCC and AACN. Feel free to ask your department manager for avail-able resources, or contact The Medical Center Education and Development Department.

The Road to Nursing Certification continued from page 1

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Standards and PracticeImmediate Action Results were

reported at 64% for the month of March. These results are lower than previous months, as some units had not submitted their data. CHF was reported at 80% for the month; a core measure worksheet has been developed and be-ing piloted on 4A. Beta Blockers core measure score has raised to 94%.Recruitment, Retention and Recognition

Faye White, Facilitator, reported finalization plans for Nurse and Clinical Support Person of the Year activities. There were 70 nominations for all 4 facilities; the voting process began on Friday, April 20. The Nurse and Clinical Support Person of the Year will be announced on Tuesday, May 8 and the Nurse Walk will be May 12 starting at 9 a.m. We had 47 new graduates scheduled for interviews earlier this month.Research

Wayne McGregor, WKU MSN student who is doing his practicum with Betsy Kullman, CNO, presented his research project of “Strategies for Employing Senior Nurses” with the purpose to identify what are the best practices as they relate to the employ-ment of nurses over the age of 40.Nursing Quality

ICU just started using pressure wedges to prevent skin breakdown. They don’t have any data yet, but have

seen a difference. The skin prevalence study results were reviewed. There was an increase in the prevalence of pressure ulcers. Bill Singletary gave a stroke update. Stroke recertification is coming up May 2013. Betsy Kullman gave a CHF update. Discussion was made about starting QI projects on every unit.Clinical Informatics

Computerized Physician Order Entry will go live in June. Staff will need to attend training sessions that will last approximately 3 hours; train-ing will begin on May 14.Nursing Development

It is that time of year to start our process of planning for annual competencies. As you are writing them, please use the Donna Wright Competency Assessment tool as a reference. Critical Care Competencies are to be submitted to Mary Pat Jackey and Med/Surg Competencies are to be submitted to Carolynn Burton in the Education Department, as they will be entering the competencies for each area. Continue to encourage staff members to obtain their certifications for their specialty field.Clinical Ladder

Twenty-one nurses challenged the Clinical Ladder this month and plan-ning for the Celebration Event was also discussed.

Notes From Shared Governance by Vickie Taylor, Executive Secretary, Nursing Administration

On the Move…Several staff members from The Medical Center had the privilege of an up-close look at the Hill-Rom Facility in Batesville, Indiana March 5–6. Representatives from ICU, CCU, Education, Rehab and Risk Management were treated to an overnight stay at the Jawacdah Farm as well as classes with hands-on opportunities in the ICU Room of the Future, Safe Patient Handling policy development, development/ research of patient equipment and a history of the company. They were invited to participate in an IT development project for the SmartBed information design and layout. The facility’s education department was top notch.

You will see staff from Risk Management and vendors making rounds to all our departments soon to assess lifting device possibilities as well as some education/training on the patient handling and lifting devices currently available in the facility. SURVEY

The survey is underway! Check your email for your invitation

to participate.All answers are held completely confidential.

Pictured above: Marianne Wilson, Courtney Calloway, Stacie Young, Michelle Marshall, Megan Bow, Jasamine Vincent, Carolyn Burton, Mary Teahan, Donita Monroe, and Gayle Atwell.

Are you stressed out? Is work and life just not fun anymore? Are you just so tired of all the chaos? Do you wake up and groan if you have to get out of bed? If you answered yes to at least one of these questions, then you are in the top 99%, and the other 1% are lying. Welcome to the world of each of your co-workers, patients, families and, yes, even the managers.

The media is full of news related to the troubled economy: lay-offs, budget cuts and “reorganization,” the nurs-ing and healthcare shortage, the ever growing price of gasoline, the woes of our children and the most important issue…the increased cost of a vente caramel macchiato from Starbucks. Just what is our world coming to?!

Each generation has a solution and we all want to share our ideas on how to “fix” the problems and issues that invade our lives. As I am now of the “older generation,” I am ever amazed at what comes out of my mouth. I sound just like my father (a career Marine) — says a lot don’t you think? Who would have thought? I was such a rebellious youth and now I can have a meltdown with an “eye roll” on any given day! Are you laughing? You know it’s true!

Do I have your attention? Are you asking yourself the purpose of the article? Are you saying to each other…“I knew she was crazy”? The goal of all this rambling is to have some fun with very difficult situations and offer some ideas on more effective coping mechanisms.

Freud and Groucho Marx (if you don’t know who these people are, ask someone over 50) repeatedly discuss the healthy effects of humor and just general foolishness in our lives. Humor is only effective if you work at it and use it in the manner it was intended. Humor at someone else’s expense is harmful — it does not decrease stress but will increase the stress levels of those around you.

Work and life in general is in-creasingly more stressful. This is not specific to our town, our hospital or even our unit or department.

Each of us has the power to change our responses to a stressful or diffi-cult situation. In any given day, each person may become overwhelmed with “too much________ and not enough________.” You fill in the blanks as they fit in your life. The goal is to seek out and identify our own personal strengths and also address our weaknesses. Sherri Goldsmith, Director of Critical Care Services, has a sign in her office: “You are part of something BIG, and YOU ARE IMPORTANT.” This is something we should all remember.

So let’s all start looking within and become “A happy, funny, profes-sional, supportive, and healthy nurse”! WHEW—we can do it.

I am going to leave you with a few ideas on how you may manage your stress.

1. Take responsibility for im-proving your physical health. (Okay…less pizza…more chocolate).

2. Do not feed in to negative be-haviors (stay away from “Did you hear?”).

3. Laugh more and often.

Finally, I found this on line in Hospital Humor: What is the dif-ference between humor and aroma? Humor is a shift of wit.

More helpful hints coming soon to a unit near you. Remember: A good sense of humor prevents hardening of the attitudes.

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Finding Humor in a Difficult Situation by Alice Kirby, RN, MSN

Meet Charu Raghuvanshi, M.D.Child & Adolescent Psychiatrist

Psychiatric Associates of Bowling Green has expanded its services beyond adult psychiatry with the addition of Charu Raghuvanshi, M.D. Dr. Raghuvanshi completed her fellowship training in Child and Adolescent Psychiatry at Vanderbilt University. She is a Diplomate of the American Board of Psychiatry and Neurology in Adult and Child and Adolescent Psychiatry.

Dr. Raghuvanshi joins CHC after serving over eight years at Rivendell Behavioral Health Services, including serving as the Children’s Unit Medical Director. She brings her experience with dealing with the most severe cases of child and adolescent psychiatric patients to her new outpatient practice. The outpatient setting enables her to provide better continuity of care when she can help children after they leave an inpatient center.

“There is an immense need in the community for child and adolescent psychiatry,” Dr. Raghuvanshi said, particularly for a psychiatrist that accepts Medicaid. She sees patients ranging from ages 2 to 18 for a variety of problems including behavior issues, attention deficit hyperactivity disorder and autism.

Working with children and adoloscents is different from working with adults. Dr. Raghuvanshi has to address the many systems involved — the child, the family, school systems and in some cases Social Services.

Because language can be an issue with young children, Dr. Raghuvanshi uses play therapy to interact with children and assess their situation. “Play can tell you a lot about what is going on with the child,” she said. For adolescents, she uses more of the interview style.

In addition to her outpatient practice, Dr. Raghuvanshi will consult with pediatricians for children and adolescent patients at The Medical Center. Dr. Raghuvanshi’s office is located in the Medical Arts Building, Suite 206. To schedule an appointment, call 796-2540.

As 2012 rolled around I began to think of all the New Years resolutions that come and go. I, myself, am guilty

of making many resolutions and never sticking with them until March, much less the entire year. One of the most popular resolutions among people is health-related: i.e., lose weight, eat healthier, exercise more, or get fit. So, I decided that I would see if there was an interest in my department to do a weight loss challenge. I kicked the idea around and found that many of my co-workers were indeed interested in doing this. Ideas were discussed and I developed a weight loss challenge to push myself and my co-workers into getting fit and making a change in their lifestyles for the better. Many stud-ies have shown that employee-based weight loss challenges are success-ful in providing individuals support, friendly competition, and many health benefits that directly affect the employ-ee and the organization.

Guidelines were devised and plans were made. We wanted the challenge to be over a long enough time to see results, but not too long to make people disinterested or fail at their challenge. We decided the challenge would last for 12 weeks. No specific diet guideline was introduced to the group. Instead, each individual de-veloped their own goals and utilized their own resources to get the weight off, such as Weight Watchers, diabetic reduced calorie diets, South Beach diet plans, or well balanced meals with exercise. Each individual makes a note of their initial weight. Weekly weigh-ins are done by the individual and the weight loss/gain is reported to me. We are tracking the weekly weight loss with visual aids to show our prog-ress. A weekly fee is collected with a penalty fine of gaining weight. As wellness leader, I send weekly emails

with tips, hints, and encouragement. Additionally, we have an informational highway bulletin board to utilize tips,

recipes, words of encouragement, and a tool to assist each of the members in their weight loss goals. Prizes will be awarded along the way with grand prize winners being rewarded with $$$$$$. What better motivational tool could you find?

According to the Weight-control Information Network (WIN), over two-thirds of all adults are overweight or obese. Between 12–17 percent of all children are overweight. Being over-weight and obese are both risk factors for diabetes, strokes, heart attacks, high blood pressure, high cholesterol

and other diseases/disorders. With the prevalence of obesity and related diseases, the cost of healthcare has risen. On the average, people who are obese pay $1,400 more in healthcare-related expenses than a normal-weight individual. Because we work in the health industry, we have witnessed this first-hand. We are now host to bariat-ric weight loss surgery and will soon have a new clientele with many related problems and illnesses to care for.

I challenge each of you to think about your own department. Maybe there are several co-workers that would like to do this challenge as well. It can be done…we are kicking that unwant-ed weight to the curb. Each and every one is committed to making the most of their challenge and really pushing to see how much weight we can lose. Our group goal is to lose the equivalent of a person, and we are right on track. We will keep you posted on our success — wish us luck!!!!

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ER 2012 Weight Loss Challenge by Renee Donaldson, RN, CMSRN, CNIII

Congratulations to two new CNRNs!by Sean F. McCracken, RN, MSN, MBA, CNRN, CNOR, CCRN, CNIM; Critical Care Educator, Nursing Education

Those who are passionate about nursing either love neuroscience or hate it. Those who love it immerse themselves into it and are impassioned about compassion, even when there appears to be no hope. They love the “jigsaw puzzle” of neuroscience—an area which includes the entire science of the nervous system. They can picture the complete puzzle even when there are a few pieces missing. For them, it is a beautiful conundrum to “wrap one’s mind around”—please excuse the pun—that they are using the brain to think about itself in order to understand its wonderful complexity and the mystery of another brain that was injured. They have a quality of critical thinking that makes them among the best in nursing; and which also makes them sometimes their own most severe critics.

I am extremely proud to say that Amy Groce and Gail Jaggers from The Medical Center ICU diligently prepared and studied for the Certification of Neuroscience for Registered Nurses (CNRN) Boards. Many hours of sweating bullets, combing through the Core Curriculum, quizzing themselves and each other, being bombarded with off-handed clinical questions from Neurosurgeon Naren Nathoo, MD and me resulted in them taking a Saturday of their own to sit the exam. And, yes, they are now Ms. Amy Groce, RN, CNRN and Ms. Gail Jaggers, RN, CNRN! Congratulations, ladies. I am very proud to call you my colleagues.

“Being overweight and obese are both risk factors for diabetes, strokes, heart attacks, high blood pressure, high cholesterol and other diseases/disorders.”