09/03/18

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Kathy Smith is the nurse manager at The Rehabilitation Center at Norman Regional Health System.

by Bobby Anderson, RN, Staff Writer

For more than 40 years, Kathy Smith, RN, MSN, CRRN worked in critical care.
Taking care of and doing for her patients was all she had ever known.
But the next chapter of Smith’s nursing career would lead her into rehabilitation nursing and a change that would make her head spin.
“It was almost a year to get (critical care) out of me,” Smith laughed.
Now the nurse manager for The Rehabilitation in the Norman Regional Health System, Smith is looking for nurses to share in the kind of career resurgence she experienced.
“I probably have seen more of an integrated team in rehab than in med/surg or critical care,” Smith said. “Over there the nurse feels like it’s all me. In rehab it’s not, it’s physical therapy, speech, OT, the neuropsychologist.”
Smith is actively searching for certified rehab nurses.
The rewards in rehab nursing are both instant and long-term. Helping patients make those incremental improvements each day provide instant gratification.
Seeing them come back for the yearly Christmas party or just stopping by to say thank you bring all those feelings back.
“You really can establish relationships here and you want nurses that want to do that,” Smith said. “They’re not just in and out. Our average stay right now is about 10 days. Then you have those that are here about a month.”
“It’s a neat thing for us to see we were a part of that person’s recovery.”
Motivation and behavior modification are hallmarks of rehab nursing. Letting the patient do as much as they can while teaching them along the way to independence is vital.
“In rehab it really does take a more specialized rehab nurse to understand we need to mimic with the patient exactly what we want them to do at their house,” Smith said. “I’m trying to recruit nurses who really have a lot of patience and know you have to give them time to do what they need to do. You can’t rush them.”
“It’s all about teaching.”
Smith’s nurses see a range of patients from traumatic brain injuries and strokes to falls at home or other accidents.
“Most of the people who come to rehab have had a life-changing experience,” Smith said. “So many of these people have to be motivated. You have to have that nurse in rehab that can help that person become motivated.”
The majority of Smith’s career has been spent doing what patients could not.
Now her and her nurses spend their time restoring patient’s to their former lives.
Earning her CRRN designation solidified for her that she was indeed in a unique nursing field.
“I didn’t realize that until I got into it and then I saw why,” Smith said. “I’ve noticed after being in critical care you have more aggressive, assertive people in critical care. When I got to rehab I noticed the type of nurse here is more soft about what they do. They’re more patient about letting them do it. We’re taught as nurses to do everything for the patient.
“You get over here in rehab it’s different, it’s more therapy. You’re supposed to let them do as much as they can.”
One of the advantages Smith’s staff enjoys is being inside the hospital.
“You get a lot of support in the hospital especially from the (Medical Intervention Team) they’re a lifesaver,” Smith said. “We don’t want patients to code over here and rarely do we have a code. Now we also have the hospitalists over here and you have that support as internists for you. You also get the support of the nephrologists, the neurologists – plus the ER is right here.”
The Rehabilitation Center is designed to provide the highest quality care possible.
It is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) for the Adult Inpatient Rehabilitation program and the Stroke Specialty Program with an established pattern of excellence.
Smith said the facility participates in a rigorous CARF review every three years to maintain this accreditation.
The center’s 2017 scores show it’s making a difference for patients:
* 99 percent of patients say they would recommend The Rehabilitation Center to others.
* 97 percent of patients ranked The Rehabilitation Center as a 9 or 10 out of 10 compared to other rehabilitation centers.
* 80 percent of patients who were discharged from The Rehabilitation Center were able to return to an independent living setting.
* The average length of stay for a patient is 12 days.
The rehabilitation team includes:
* Rehabilitation physicians
* Rehabilitation nurses
* Physical therapy
*Occupational therapy
*Speech therapy
*Dietary services
*Social work and case management
*Psychology services
*Respiratory therapy
*Pharmacy
*Admission liaison

We Are Hiring
Rehab RN $3000 SIGN ON BONUS
$3000 ADDITIONAL BONUS for CRRN (Certified Rehab RN)
7p-7a Job #10400
Apply Online at NormanRegional.com
or call Julia Burleson BSN RN CHCR at 405.307.1554 for more information
An Equal Opportunity Employer
Norman Regional Health System
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(left) Barbara J. Holtzclaw, Ph.D., RN, FAAN, and Carol Rogers, Ph.D., RN, PHCNS-BC, CNE will be formally recognized as Fellows of Gerontological Society of America.

Two faculty members from the Fran and Earl Ziegler OU College of Nursing, University of Oklahoma Health Sciences Center, have been named fellows of the Gerontological Society of America, the nation’s largest interdisciplinary organization devoted to the field of aging.
Barbara J. Holtzclaw, Ph.D., RN, FAAN, and Carol Rogers, Ph.D., RN, PHCNS-BC, CNE, will be formally recognized in November during the GSA’s annual scientific meeting. The induction honors their outstanding work the field of gerontology, including research, teaching, administration, public service, practice and participation within GSA.
Both registered nurses, Holtzclaw and Rogers have had distinguished careers in education and research since entering the academic realm. Their involvement with GSA has furthered that work by connecting them with collaborators and resources across the nation.
“We’re very proud of the work that Drs. Holtzclaw and Rogers have done to improve the care of elders,” said Gary Loving, Ph.D., interim dean of the College of Public Health. “Research and service related to geriatric nursing has been a top focus for the Fran and Earl Ziegler College of Nursing for many years now. These two scholars exemplify that focus.”
Holtzclaw and Rogers have made significant contributions to the field of nursing – and the larger health care system – through their individual areas of research. Holtzclaw’s research focuses on thermoregulatory responses in vulnerable populations. Her investigations have centered on “the metabolic cost of shivering” – the energy cost to patients whose bodies try to recoup heat by shivering. This occurs, for example, when a patient who undergoes open-heart surgery begins to warm up after being cooled down for the procedure. It also occurs when the body turns up its internal thermostat to cause a fever.
Holtzclaw has studied the violent shaking that occurs when immunosuppressed patients with cancer get fungal infections and are intravenously given a drug called amphotericin B. The body responds strongly to the drug, running a fever and shivering, which is the body’s way of warming itself up. Holtzclaw studied the same process in fever management of patients with HIV and as a possible mechanism in older adults who experience night sweats.
“I’ve been researching the effects of temperatures changes in the body for a long time, and most of the populations I’ve worked with have been older adults,” she said.
Rogers’ research focuses on helping older adults age in place and maintain physical function. People overwhelmingly want to live out their lives at home surrounded by their support system. But when people begin to lose balance and function, there’s usually a tipping point when they can no longer live at home.
Rogers is researching the effectiveness of Sign Chi Do, a mind-body-spirit exercise, mostly with people who attend community senior centers. She measures how Sign Chi Do affects their balance, strength, flexibility and endurance, as well as the cardiovascular response of the intervention. She also studies the effect of Sign Chi Do on sleep and fatigue symptoms in women with a history of breast cancer.
“Quality of life is the overarching goal,” Rogers said. “When people can’t take care of themselves functionally, it can also lead to depression and other psychological problems. It affects social interaction and so many aspects of life.”
In the OU College of Nursing, Rogers serves as assistant director of geriatric training programs, and Holtzclaw is associate dean for research and associate director of translational geriatric science for the Donald W. Reynolds Center for Geriatric Excellence.
“Teaching future nursing researchers is gratifying because of the passion and insight the next generation will bring to the improvement of health care,” said Rogers. “Nurses have a lot of clinical insight from working with patients, and they want to improve their patients’ outcomes. It’s rewarding when you see students begin to understand the needs of older adults.”

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Stephanie Vlot, LPN, has been a nurse for 4 years. Working for Apex Home Health, she enjoys seeing patients in their own home.

by Vickie Jenkins – Writer/Photographer

Apex Home Health was recognized and certified in 2007 by Centers for Medicare and Medicaid Services as one of modern home-health care agencies which are scientifically measured and assessed to have high-quality home-health care services for promoting health and improving the quality of life. Medicare Certified Services includes Nursing, Physical Therapy, Occupational Therapy, Speech Pathology, Medical Social and Home Health Aide.
Meet Stephanie Vlot, LPN for Apex Home Health, who has been an LPN for 4 years. “Apex Home Health is the best organization to work for because we have that small company feel,” commented Stephanie. “They truly take care of us and it is a great place to work,” she added.
The small company feel of Apex Home Health reminds Stephanie of growing up in Moore, OK. “Back then, Moore was a small town, or so it seemed,” she laughed. “Because it was so small, I spent a lot of time going to Norman where I worked at Sterling House as a Health and Wellness Coordinator. From there, I was a CMA and then, I went on to be a LPN,” she said. “I had some really good instructors and I always looked up to them. They helped me so much and I will always be thankful for everything they did for me.”
Asking Stephanie what her favorite thing about her job is, she replied, “I love being in the home of the patient because it helps me develop a real relationship with them, allowing me to better care for their whole being. I love getting to know the patients on a one-on-one basis. On the other hand, we also have a few challenges. Sometimes, we have patients that we (health care professionals) just can’t help, whether it is due to lack of resources, disease progression, family dynamics, or even noncompliance on the patient’s part,” she replied. “It can make a health care professional lose sleep at night,” she added. “Well, I am speaking for myself.”
In your opinion, what qualities should a nurse have? I ask Stephanie. “The basics would be compassion, humbleness, common sense and investigative skills. Rarely do you get the whole story about a patient, so you have to, well, to put it nicely, do some digging. It all goes back to that one-on-one compassion between the caregiver and the patient. Never be afraid to learn something from your patients, other nurses, CNA’s, CMA’s, Activity Directors or even, the billing department! Always be willing to learn because every aspect of these titles has an impact on your patient. Also, that is why I call myself a fighter. I fight for passion and injustice, always rooting for the underdog and holding onto hope even when it may seem hopeless.”
On a personal note, when Stephanie was little, she didn’t want to be a nurse, like all the other little girls, or so it seemed. “Actually, I just knew I would grow up and be a singer or an actress. Well, I can’t carry a tune in a bucket and Hollywood isn’t ready for me yet,” she said. “I do have compassion and I am glad I am a nurse now, she added.
One of Stephanie’s hobbies has been very helpful for her. “I love to journal. A wonderful woman at church presented the idea during our Relief Society CARE meeting and it made a big difference in my life. It is also a great treasure to leave behind to my grandchildren one day.
Stephanie enjoys spending time with her husband and her three daughters, 13, 12, and 9 years old. “My husband is my biggest supporter and when I want to do something, he is there for me. He usually ends it with a yes honey.” My three daughters are wonderful and they all have their own personalities which makes them so different from each other. They are all really good girls. Then there are the pets; Molly, a 7 year old Boxer/Pit Bull, along with Tiger, the 1 ½ year old cat. The dog thinks she is a princess and the cat thinks he is a dog,” she said. “What’s wrong with this picture?” she laughed.
“I love being a nurse, and I am proud to work for Apex Health Care and I wouldn’t have it any other way.”

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As Oklahoma’s largest healthcare provider, Saint Francis Health System invites you to experience a personally and professionally fulfilling career on the cutting edge of quality and technology. Explore nursing opportunities with Saint Francis Health System today! http://bit.ly/2vTTcdj

As Oklahoma’s largest healthcare provider, Saint Francis Health System invites you to experience a personally and professionally fulfilling career on the cutting edge of quality and technology. Explore nursing opportunities with Saint Francis Health System today! http://bit.ly/2vTTcdj

As Oklahoma’s largest healthcare provider, Saint Francis Health System invites you to experience a personally and professionally fulfilling career on the cutting edge of quality and technology. Explore nursing opportunities with Saint Francis Health System today! http://bit.ly/2vTTcdj

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New centers offer patients better options for accessible, convenient, community-based care

Mercy-GoHealth Urgent Care is opening two new state-of-the-art urgent care centers in North Edmond and Oklahoma City. The two centers are the first of many that will soon open in the Oklahoma City metro area. GoHealth Urgent Care, one of the country’s largest and fastest growing urgent care companies, and Mercy, one of the most innovative health systems in the U.S., have already begun developing urgent care centers in St. Louis and Springfield, Missouri, and will soon begin opening centers in northwest Arkansas as well.
Mercy-GoHealth’s easy-to-use online check-in and pre-registration system, dynamic wait clocks, mobile X-ray capabilities and award-winning center design are just a few features of this new model that will benefit local families, employers and other community members.
Following a welcome event on Aug. 30th, both Mercy-GoHealth Urgent Care centers in North Edmond at 1380 W. Covell Road, Suite 132, and North Oklahoma City location at 12220 N. Macarthur, Suite D, will open to patients in need. The Mercy-GoHealth centers welcome patients year-round, seven days a week, from 8 a.m. to 8 p.m. Monday through Friday, and 9 a.m. to 5 p.m. Saturday and Sunday.
“We are excited to open our first urgent care center to customers in the greater Oklahoma City area, further expanding our multi-market joint venture with Mercy,” said Todd Latz, CEO of GoHealth Urgent Care. “We are focused on delivering unparalleled customer experiences and high-quality care to communities across Oklahoma City, and to demonstrating to our newest market how effortless it can be to return to better health.”
Mercy-GoHealth Urgent Care treats adults and children 6 months and older with non-life-threatening illnesses and injuries such as colds, flu, fever, asthma, allergies, emphysema, minor skin lacerations, cuts, burns, urinary tract infections, fractures, sprains and strains. Mercy-GoHealth Urgent Care accepts most major insurance plans.
“We regularly ask our patients how we can better serve them and what we hear consistently is they want quick, convenient, affordable care close to where they live and work,” said Donn Sorensen, regional president of Mercy in Oklahoma. “Mercy’s partnership with GoHealth is a response to those needs, and we’re proud to offer a new type of urgent care experience.”
Mercy-GoHealth Urgent Care patients will experience visits that on average cost substantially less than a trip to the emergency room. The open floor layout of the centers enables caregivers to directly engage with patients, in comfortable and spacious exam rooms that can accommodate entire families. Every center is equipped with on-site X-ray and laboratory services for patient convenience.
Mercy-GoHealth Urgent Care is on track to launch more than 30 urgent care centers across Mercy’s service area, including additional locations in Oklahoma. Information about each existing location as well as future locations can be found at www.gohealthuc.com/Mercy.

Oklahoma’s largest healthcare network is still growing.
Be part of a rapidly growing, locally owned and operated, not-for-profit organization dedicated to the health and wellness of eastern Oklahoma. As Oklahoma’s largest healthcare provider, Saint Francis Health System invites you to experience a personally and professionally fulfilling career on the cutting edge of quality and technology.
Why now is a great time to join our team:
• $10,000 sign-on bonus and relocation assistance for experienced RNs*
• Great benefits, including paid time off, tuition assistance, medical and dental insurance, retirement plans, onsite childcare, adoption benefits and more
• We are a qualified not-for-profit organization, so you may be eligible for federal student loan forgiveness**
• With hospital campuses and Warren Clinic locations throughout eastern Oklahoma, we offer opportunities in virtually any nursing capacity
Saint Francis Health System includes:
• Saint Francis Hospital
• The Children’s Hospital at Saint Francis
• Warren Clinic
• The Heart Hospital at Saint Francis
• Saint Francis Hospital South
• Laureate Psychiatric Clinic and Hospital
• Saint Francis Hospital Muskogee
• Saint Francis Hospital Vinita
• Saint Francis Glenpool (opening September 2018)
Explore nursing opportunities with Saint Francis Health System today. To view our current openings, please visit saintfrancis.com/nursing. For more information, please call 918-807-6048 or toll-free 800-888-9553.
*Applies to registered nurses in select patient units with at least two years of nursing experience. Two-year work commitment required.
**View program details at studentaid.ed.gov.
Equal Opportunity Employer: Disability/Veteran

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Q. I am single, not currently dating and enjoying my life. It would be great to find a healthy man to have a relationship with and I hope that is in my future. What I find so sad are some of my friends who are in relationships that are not healthy, in fact two of them are down right toxic, but they won’t leave because they don’t want to be alone. They are already alone!! What is wrong with them?

A. I think “being alone” is such a difficult “situation” to treat. It casts such a spell on the person that it almost shuts down their cognitive processes and creates an illusion that becomes their reality.
An illusion of “I am not alone because I have John sitting on the sofa with me.” Never mind that John rarely communicates in a loving dialogue unless he wants something or that he belittles you in front of his friends or that he shows you no affection in public to the point that others don’t even know you are a couple.
If you leave John and this abusive relationship you will be alone. That means “without John.” Why is alone worse than being with abusive John? You are now free to be with others.
When women NEED a man, or men NEED a woman, that is a bad start to the connection and will prevent you from taking action when you read “the writing on the wall.”
When I was working with Sharon all she could focus on was “wanting to be married.” It was not about the quality of the man as much as not wanting to be alone (and also wanting financial security.) She found her man. In the beginning she pointed out some negatives, i.e., he was overweight and drank more than she liked. (She had been married twice before, both alcoholics).
As the relationship progressed she talked more about his money than his drinking or his weight. She also had concerns because their politics were at opposite ends of the spectrum. He also was controlling of her time. But he had money and she didn’t want to be alone.
They married almost a year later. When I saw her a few months after the wedding, her spirit seemed subdued. Her vibrant energy channeled differently.
But she was not alone; she was married, she had her man!!
There are certainly no guarantees about the sustainability of relationships. I think it is healthy for people to be able to “be without an intimate/partner relationship” and be comfortable. That does not mean it is “forever.” Perhaps the less we think about it and just live our lives, who knows who the Universe will put in our path.
In the mean time, get a dog, cat, bird, plant; something you can nurture and love until “your person” comes along. Read some good books. Learn to like being with you.

Vicki L Mayfield, M.Ed., R.N., LMFT Marriage and Family Therapy Oklahoma City

If you would like to send a question to Vicki, email us at news@okcnursingtimes.com

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Oklahoma Medical Research Foundation scientist Roberto Pezza, Ph.D.

Oklahoma Medical Research Foundation scientist Roberto Pezza, Ph.D., has received a five-year grant from the National Institutes of Health to study cellular mechanisms that regulate DNA metabolism, particularly how damaged DNA is repaired.
The grant, awarded by the National Institute of General Medical Sciences, will provide Pezza with $1.4 million to better understand how errors in DNA repair result in serious health consequences.
DNA repair errors are responsible for a variety of birth defects as well as conditions like Down syndrome or Turner syndrome that result from an incorrect number of chromosomes in an individual, also called aneuploidy. Every year an estimated 7.9 million children—6 percent of total births worldwide—are born with a serious birth defect of genetic or partially genetic origin.
Pezza’s lab used reproductive cells from both male and female mice to study damage and repair of DNA. Accurate division and chromosome segregation in reproductive cells is essential to avoiding aneuploidy and maintaining stability of the genome —the complete set of genes or genetic material in an organism.
To study this process, Pezza looked at how chromatin affects repair of DNA. Chromatin is the material the material of which the chromosomes of several organisms are composed. It consists of protein, RNA and DNA.
“One essential function of the chromatin is to package DNA inside the nucleus of a cell. This creates a compacted environment that makes repair of DNA very difficult for the cell,” he said.
The cell seems to have evolved a mechanism that easy this problem allowing DNA repair by loosening the compacted chromatin and allowing the original sequence of DNA to be restored. Pezza’s lab is working to unravel how these helpful mechanisms—that involve protein complexes called chromatin remodeler complexes—control the function of DNA repair, and ultimately what role they play in maintaining chromosome stability and their correct number in male and female gametes.
“By better understanding how damage and repair of DNA occur in the context of the chromatin it could allow for the future development of therapeutic targets to help prevent disease conditions,” Pezza said.
The grant, R01 GM125803-01A1, is funded through the National Institute of General Medical Sciences, a part of the National Institutes of Health.

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The American Nurses Credentialing Center has designated INTEGRIS Canadian Valley Hospital as a Pathway to Excellence® hospital for the second consecutive four-year term.
The Pathway to Excellence designation identifies elements of work environments where nurses can flourish. This distinction substantiates the professional satisfaction of INTEGRIS Canadian Valley nurses and identifies it as one of the best places to work.
“This national designation showcases the accomplishments of the INTEGRIS Canadian Valley Nursing department,” says Teresa Gray, vice president of Patient Care Services, chief nursing officer at INTEGRIS Canadian Valley. “Our hospital could not have been awarded this honor without our nurses’ dedication and commitment to our patients, their families, their colleagues and to the nursing profession. Achieving the Pathway to Excellence accreditation reflects our nursing team’s commitment to our INTEGRIS mission of improving the health of the people and communities we serve.”
The designation is granted based on the confirmed presence of characteristics known as Pathway to Excellence Criteria. To be named as a Pathway to Excellence organization, a hospital must undergo successfully a thorough review process that documents foundational quality initiatives in creating a positive work environment, as defined by nurses and supported by research. These initiatives must be present in the facility’s practices, policies and culture. Nurses in the organization verify the presence of the criteria in the organization through participation in a completely confidential online survey.
“We’ve worked to build a culture of trust and respect,” notes Gray. “By meeting the ANCC’s goals, we’re inspired to continue building on that foundation to give our nurses the tools and resources to provide the best possible patient care. “
“I am honored to work with such a dedicated group of individuals who are committed to our healing culture of not only caring for our patients, but for one another,” says hospital president Rex Van Meter. “To receive the Pathway to Excellence designation consecutively is a testament to our hospital, our nurses and to our medical staff whose support during this process is as appreciated as it is invaluable.”
As a Pathway to Excellence designated organization, INTEGRIS Canadian Valley is committed to nurses, to what nurses identify as important to their practice, and to valuing nurses’ workplace contributions. This designation confirms to the public that nurses working at INTEGRIS Canadian Valley know their efforts are supported. The honor encourages other nurses to join their colleagues in this desirable and nurturing environment.

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Health care professionals, community partners and others interested in health care quality improvement in Oklahoma are invited to attend this free, in-person conference event, hosted by TMF Health Quality Institute, the Medicare Quality Innovation Network Quality Improvement Organization (QIN-QIO) in Oklahoma. The TMF QIN-QIO is hosting four free, in-person conference events throughout Oklahoma between September and November 2018. Attendees will have the opportunity to earn free continuing education credits (CME, 2A for DOs, CNE, Pharmacy and medical ethics and professional responsibility) while attending sessions on the following topics.
„* Examining the opioid crisis in Oklahoma „* Implementing motivational interviewing techniques to help patients make lasting changes * Identifying and treating patients with sepsis„* Reducing antipsychotic medication use in older adults across care settings
Receive free assistance with Merit-based Incentive Payment System (MIPS) reporting
In addition to attending the conference sessions, attendees will have the opportunity to meet with TMF quality improvement consultants throughout the conference and for an hour at the end of each conference day. TMF consultants will be available to answer questions and provide assistance with reporting for MIPS. TMF consultants will also be available to answer questions about any other TMF QIN-QIO task or project.
Event Dates: All events are scheduled from 8 a.m. to 4 p.m. CT
Wednesday, Sept. 12, 2018, Oklahoma City, Wednesday, Oct. 17, 2018, Tulsa, Wednesday, Oct. 24, 2018, Lawton, Wednesday, Nov. 7, 2018, McAlester

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