10/02/17

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Courtney Gritz has worked for her entire 16-year career for Integris Health Systems, currently serving as endoscopy team manager.

by Traci Chapman, staff writer

Even before she became a nurse, Courtney Gritz knew healthcare was where she was meant to be. She says that belief has grown ever stronger each year.
Now 36, Gritz has worked with Integris Health System all her adult life. Starting in emergency room registration at Southwest Medical Center when she was just 20 years old, Gritz said she found she loved the fast pace, the people she worked with and those she was able to help start on a journey that she hoped would bring them recovery, renewal and better health.
“We had so many different people coming through the doors, and I could see such a range of emotions as they checked in to the hospital,” she said. “It was yet another inspiration for me to be able to do more for them, to care for them.”
While her job inspired her, so too did members of her family – both directly and indirectly, she said. Her aunt was a doctor and one of Gritz’s mentors, she said, spurring admiration from the young girl with her dedication, skill and care when dealing with her patients.
“Then, when I was older, my grandfather was diagnosed with cancer,” Gritz said. “He was surrounded by the most compassionate and loving nurses – from the start of treatments and surgical procedures to the hospice nurses who cared for him through the end of his life.
“I could see the difference they made in a very difficult journey, and it further fueled the fire in me to go into healthcare,” she said.
That fire was a driving force for Gritz as she worked toward an Associates of Applied Science in Nursing degree from Redlands Community College. The new RN then never looked back, she said.
“I’ve had various positions at Integris since my start in ER registration, but my current position is just amazing,” Gritz said.
That position is as endoscopy team manager at Lakeside Women’s Hospital. The first Oklahoma City healthcare facility to offer women’s services exclusively, Lakeside for many years was known for its mammogram and yearly examination services, opening in October 1997 with 14 rooms and nine doctors.
Today, Lakeside has moved far beyond its beginnings, with 48 doctors and hundreds of nurses on staff, much of that thanks to, officials said, a 2013 partnership with Integris Health Services. With the strength of Integris behind it, the north Oklahoma City hospital now offers everything from bone densitometry, breast surgery and childbirth and parenting education to hormone replacement therapy, laser/cosmetic/reconstructive surgery, massage therapy, neonatal intensive care, cardiology, oncology and endoscopy.
The facility also features a Level IV OB-GYN emergency room and staffs physicians and nurses who perform robotic surgery, hernia repair, appendectomies, gallbladder surgery and more, officials said.
The endoscopy treatment area is comprised of six pre- and post-op rooms, treating about 75 to 80 patients per month, Gritz said.
Most of the team’s treatments are colonoscopies, scheduled each Monday, Tuesday and Friday and one Saturday per month. Patients approach the procedure in many different ways, but she and her nursing team – Gritz, one full-time and two per diem nurses and a scrub tech – work to make sure a procedure that involves anesthesia and screening for cancer and other issues as positive as possible.
“Let’s face it, no one wants to have a colonoscopy – some dread the prep, some are nervous about the sedation, some are scared to have a procedure done, whether it is because they have had problems and are scared we might find something or just aren’t fans of the whole hospital environment,” Gritz said. “We take the time to walk them through what to expect from prepping before the procedure, what to expect upon arrival and, once they get there, we can explain the next steps in the process.”
Gritz, who helps process scopes, manages staff and doctors scheduling, posts charges and more administrative duties, said her daily patient care is the most important face of and her favorite part of her job – a position made even better because of the nursing team she works with, she said.
“The team I work with every day is made up of the most amazing people who truly know the definition of teamwork – we have each other’s backs, which makes for a very successful department,” Gritz said. “It’s so great taking care of patients and easing their fears, and it’s wonderful when they wake up (from the procedure) and tell us they can’t believe that it is over, that it was far easier than they expected and the prep was truly the worst part.”
Gritz lives in Mustang with her husband of 15 years, John, and two small daughters.

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American Nurses Association President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN.

by Bobby Anderson, Staff Writer

The head of America’s largest nursing organization will be the keynote speaker when the Oklahoma Nurses Association holds its annual convention Oct 18-19.
American Nurses Association President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, will speak during the two-day event.
The Oklahoma Nurses Association will present the 2017 Annual Nurses Convention, titled Dawn of a New Era in Health Care, at the Embassy Suites Hotel in Norman.
“It allows nurses to come together and network and learn about issues facing nurses and determine the focus of the association for next year,” said ONA Executive Director Jane Nelson.
During this two-day convention, Nelson said the association will focus on the evolving face of health care and its impact on nurses and nursing.
Attention will be given to emerging programs and trends that are in development at the state and federal level. Sessions will also highlight the power nurses have on state and local policymakers.
The convention also serves as an avenue for allowing nurses to share best-practice information.
VOICE OF 3.6 MILLION NURSES
Cipriano is the 35th president of the American Nurses Association (ANA), the nation’s largest nurses organization representing the interests of the nation’s 3.6 million registered nurses.
A distinguished nursing leader, Cipriano has extensive experience as an executive in academic medical centers.
In 2016, she was named one of the “Top 100 Most Influential People in Healthcare” by Modern Healthcare magazine for the second year in a row. In 2015, the publication also named her as one of the “Top 25 Women in Healthcare.”
Prior to becoming ANA president, Cipriano was senior director for health care management at Galloway Consulting. She has served in faculty and leadership positions at the University of Virginia (UVA) since 2000, and currently holds a faculty appointment as research associate professor at the UVA School of Nursing.
She is known nationally and internationally as a strong advocate for health care quality. She was elected to the International Council of Nurses Executive Board in 2017 and has served on a number of boards and committees for influential national organizations, including the National Quality Forum and the Joint Commission. Dr. Cipriano was the 2010-11 Distinguished Nurse Scholar-in-Residence at the Institute of Medicine.
Cipriano has been a longtime active member in ANA at the national and state levels. She was the recipient of the association’s 2008 Distinguished Membership Award for her outstanding contributions to ANA and was the inaugural editor-in-chief of American Nurse Today, the official journal of the American Nurses Association, from 2006-14.
She is certified in advanced nursing executive administration. She holds a PhD in executive nursing administration from the University of Utah College of Nursing, a master of nursing degree in physiological nursing from the University of Washington, and a bachelor of science in nursing degree from American University. She was inducted into the American Academy of Nursing as a fellow in 1991.
The Mission of the Oklahoma Nurses Association is to empower nurses to improve health care in all specialties and practice settings by working as a community of professional nurses.
Nelson said nurses can register for this year’s event by going to the association’s website at www.oklahomanurses.org. Nurses can also call the association at 405-840-3476 with any questions.
“It’s a great way to get involved and a great way to learn about the work of the association,” Nelson said of the yearly gathering of Oklahoma nurses.
The association’s house of delegates will meet on the convention’s first day to determine the group’s focus for the upcoming year.
Nelson said nearly 30 informational nursing practice posters created by Oklahoma nurses will be on display. The day will conclude with a reception allowing attendees an opportunity to talk to the poster presenters.
Cipriano will kick off the Thursday session at 8 a.m. with her presentation Nursing’s Voice in Health Care Reform. Breakout sessions begin at 10 a.m.
Breakout session topics include:
* Nurses improving care for health system elders
* Hooking a new grad is easy, but how do you keep them?
* The practice of mindful meditation as a self-care act
* Unconscious bias and gender neutral communication
* The enhanced nurse licensure compact
* Effectiveness of an educational intervention on health care and nursing student knowledge
* Overcomer: Thriving through professional challenges
* Humor as Medicine

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For Michelle Walton, nursing is about education, constantly learning, growing and expanding her knowledge and abilities to new areas - most recently as an Integris Baptist lactation consultant.

CAREERS IN NURSING
FULLFILLING BUCKET LIST OF ACHIEVEMENT, SERVICE, JOY: INTEGRIS BAPTIST

by Traci Chapman – staff writer/photographer

For many people, their bucket list might feature seeing the Scottish Highlands or parachuting out of a plane, but for Michelle Walton, her dreams are about nursing – and those dreams are big.
“I have really loved what I’ve done throughout my career, but there’s so much more, so many things that I want to be able to do to help people and to make a difference in their lives,” Walton said. “It’s just who I am and what I’ve always wanted to do.”
Walton’s service may have ended with nursing, but it didn’t begin with it. After earning bachelor’s and master’s degrees in education, Walton worked for about three years as a teacher – first at Kirkland Elementary School in Putnam City and then as a Midwest City High School vocal music teacher.
While Walton excelled at her job, which gave her the chance to celebrate daily her love for music, high school music teachers – both vocal and instrumental – often do not have the kind of hours enjoyed by many of their peers. Rehearsals, competitions and preparation often take up many breaks, weekends and evenings.
“I loved it in so many ways, but it was so stressful – and I had no time for family,” she said. “I couldn’t see how I could have kids, and I couldn’t properly do the job and be the best teacher I could without putting in all that extra time.”
Ironically, as Walton reflected on how she could continue her goal of service, she thought back to her early college days, a time when she almost made a change that would have dramatically changed her path.
“I was going to Oklahoma Christian University and was majoring in education, and I almost transferred to nursing – but my dad talked me out of it,” Walton said.
Years later, as her determination to make a professional change grew, Walton said she remembered that fleeting idea – and a friend and fellow teacher who went through an accelerated nursing program prompted Walton to make the leap.
That led Walton once again back to school, this time to Oklahoma City Community College, where she enrolled in BADNAP – Baccalaureate to Associate Degree Nursing Accelerated Pathway.
BADNAP was the program recommended by Walton’s friend; geared to individuals who already obtained an undergraduate or graduate degree, the 10-month concentrated study program allows students to complete 36 required nursing credits in that abbreviated time.
“It was a very, very intense program, such that most of the people went full-time and didn’t work while they were in it,” Walton said. “It was a really great program and a great experience, and I loved every minute of it.”
After graduating in 2015, Walton joined Integris Baptist, working both in the hospital’s mother and baby and labor and delivery units. When she had her first child, Walton discovered an opening in lactation services and immediately applied for it.
“I was so happy to get into this – it was one of the things on my bucket list, and I absolutely love it,” she said. “I really like being a part of the team of lactation consultants, of helping the mothers and their babies in such an important way.”
Walton – like the rest of the lactation nursing staff – took part in a 17-hour Breastfeeding Continuing Education program, a special session funded in part by Oklahoma State Department of Health and U.S. Centers for Disease Control and Prevention. While that training gave her a new perspective on her new specialty, it wasn’t enough for a woman always striving to learn every detail of her chosen study path.
“I wanted to do everything necessary to be as completely knowledgeable about lactation as possible,” Walton said. “That led me to IBLCE.”
International Board of Lactation Consultant Examiners is an independent certification aimed at helping health professionals across the world provide the most up-to-date breastfeeding care and education to patients. Tests are only offered twice a year, and those wishing to take it must apply five months in advance, Walton said.
“It’s a very intensive and well-respected certification process, but it’s something that really helps take your nursing in this field to the next level,” she said.
Lactation nurses are on call, working not only in the mother and baby ward – where most new mothers and babies are transferred after giving birth – but throughout the hospital and on an outpatient basis.
“It could be anywhere – ICU, the emergency room, pediatrics,” Walton said. “It could be a patient who’s having problems with breastfeeding or who has medical issues, or even a patient who’s comatose, and we help her family learn how to pump.
“It’s emotional on many different levels,” she said. “I like the teaching aspect – to see that lightbulb moment with mom, the joy that fills your heart when you know, ‘I’m feeding my baby.’”
Throughout her nursing journey, Walton has constantly worked to learn yet another aspect of nursing – next, perhaps, that’s something unusual in Oklahoma nursing now.
“My desire is to be a CMN – certified nurse midwife – someday,” she said. “That’s kind of where my passion for nursing is heading.”
While there are not any CMN programs in Oklahoma right now, Walton said she is hoping to be part of an effort to change that. Of course, that will mean yet more schooling, something she welcomes.
“I love learning things – it’s important to keep learning, to keep growing,” she said. “My son has always known me as a nurse because I started nursing school when he was eight weeks old, and I want him to know just how important this work is – not just to me professionally, but to helping others.”

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by Traci Chapman, staff writer

It’s a disease that affects about one in every 2,000 children, a condition many times overlooked by parents and health professionals – it’s a condition that needs nurses to help shine a light on it and help those afflicted by it.
That’s exactly what the organizers of Oklahoma PANDAS Awareness Days hope will happen.
“I would love for the information about this disease and this event to be spread throughout Oklahoma to our great nurses, so they can take part and can come and learn more about what it means and how many people it affects,” said one of those organizers, Kristen Murdock.
Murdock knows about the condition first-hand, both as an RN and as the mother of an 11-year-old son afflicted with PANDAS – Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.
“Our experience is important, not just for us and for other families, but also for my fellow nurses, because it is so debilitating to the children and their families affected, especially when it is misdiagnosed or overlooked,” Murdock said. “It’s up to us – nurses, doctors, other healthcare professionals – to get all the facts and spread the word about PANDAS.
“Children and families are counting on us,” she said.
Spreading the word is the focus of Oklahoma PANDAS Awareness Day, set for 10 a.m. until 1 p.m. Oct. 9 at the State Capitol. The event will feature speakers like Dr. Peter Stanbro, an Edmond psychiatrist who specializes in treating disorders like ADD, post-traumatic stress and autism, and behavioral health providers and other healthcare professionals will also be on hand to answer questions and provide information to both families and nurses and other healthcare providers.
“I consider Dr. Stanbro a PANDAS expert,” Murdock said. “He and the others participating can help and guide families dealing with this issue, as well as nurses and other healthcare professionals looking to learn more about PANDAS and better serve their patients.”
The Murdock family’s experience mirrors that of many others dealing with PANDAS, she said. For years, the family searched for answers to explain their son Ethan’s behavior – the tics, the rages, the mood swings. After being told by pediatricians who didn’t believe PANDAS was a real condition their concerns were invalid, they finally found the key, after a simple blood test revealed its presence.
“That’s what’s frustrating, or one of the frustrating things about this – it only takes a simple, inexpensive blood test to diagnose PANDAS,” Murdock said. “For some children, an intensive or long-term course of antibiotics can send them into remission.”
For Ethan Murdock, a tonsillectomy helped ease his symptoms so much doctors declared he had achieved remission. While the disease is still there and the battle is not yet won, Murdock said the family can now move forward knowing what they are dealing with and with hope Ethan can live without the constant challenges marking so much of his early life.
The problem with PANDAS is it is masked by what doctors might think are other conditions, things like attention deficit disorder, attention deficit hyperactivity disorder or obsessive-compulsive disorder – ADD, ADHD and OCD. Symptoms frequently suddenly appear, or become much worse in a child who already has any of those conditions, following a strep infection, while motor or vocal tics, compulsions or obsessions and rage episodes are also possible results of PANDAS.
While PANDAS strep reactions generally appear in children age 3 to about puberty, adolescents can also be affected, although those incidents are rare, according to U.S. Department of Health and Human Services National Institutes of Health.

PANDAS, while similar to PANS – pediatric acute-onset neuropsychiatric syndrome – is not the same, because children suffering from PANS have had an infectious or other trigger or environmental factor create what NIH officials called a “misdirected immune response results in inflammation on a child’s brain.” PANDAS, on the other hand, is strictly caused by strep infection.
“Learning about this can be particularly important for nurses in pediatric offices or behavioral health – they often spend more time with a child and can observe things parents relate to them,” Murdock said. “So many people have no idea what PANDAS is – including a lot of people in our field.
“I’ve had several of the nurses I know say, ‘What in the world is that – I’ve never heard of it,’” she said. “That tells me it’s important not just to offer information, guidance and comradery to families dealing with this, but also to reach out to everyone in the healthcare field to give them the opportunity to make a difference in the child’s – and their family’s – life.”
For more information about Oklahoma PANDAS Awareness Day, contact Murdock at 405-921-5534 or via email at kmurdock16@gmail.com.

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Q. Have you ever wondered why people don’t become more proactive and change some of the stress in their lives? I see people all the time whose lives could have more quality if they would make some life changes. I feel powerless to say anything, because it seems so obvious. Any ideas?
Monica

A. This is one of the best questions ever!!!
We are powerless to assist other people to make changes. Totally powerless!!! People will make changes when they are ready or they may choose to never make them.
It may lie in the motivation. Will the alcoholic stop drinking after the fourth DUI or will it take a fifth and a motor vehicle accident taking the life of an innocent person? Will the stressed out workaholic stop working so much or change to a less stressful job after a heart attack?
Will the overweight person put on their tennis shoes and walk a few blocks every evening if their doctor says diabetic medicine could be prevented if they lost 20 pounds? Will the person with IBS or other digestive disorders change their nutrition to prevent painful symptoms?
Will the female in an abusive, stressful relationship realize how much more she is losing than gaining and leave the relationship? Or the male who is in love with the female who has created more drama on an almost constant basis but makes excuses for her behavior, while he is slowly losing himself?
The examples are endless.
When I was a manager I went from excellent health at the beginning to testing for Lupus at the almost three year mark. I had joint pain, extreme fatigue and absolutely no self time. As the symptoms progressed I was encouraged to go to the doctor, which I finally did. He tested me and thankfully I did not have lupus but he said my symptoms were descriptive of lupus.
I will never forget our conversation before I left his office. He got out his prescription pad and wrote the following:
1. DON’T TAKE WORK HOME 2. DON’T SAY LATE 3. DON’T COME IN EARLY
I thought it was a joke, only he was not laughing!!. It was not a prescription for a drug, it was for a life change. Oh, he also said something else. “If you don’t learn how to deal with this stress better, you will die and someone else will raise your 4 year old daughter.”
That was what stayed with me. I would die and not be with my daughter!!! There was no job that I was going to die for!!!!
That was MY motivation………what will be yours??

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Cooler weather and spending time with family and friends during the holiday season. Mary Hayes, RN, BSN

Christmas with my family. Every other year we go to Colorado but this year we’re home. Rebecca Spencer, RN

Holidays. Christmas is my favorite time to be with my daughters. It’s joyous. Mona Gray, RN

Towards the end of the year I look forward to family being together. I look forward to basketball season for my 14-year-old, too. Genia Olsen, RN

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Karen Peters is a Registered Nurse and an assistant professor in the College of Nursing.

Human trafficking is a serious problem across the United States, but health care professionals may be in a position to identify and help its victims.
The Fran and Earl Ziegler College of Nursing at the University of Oklahoma Health Sciences Center is holding a discussion, “The Health Professional’s Role When Faced With Human Trafficking,” on Friday, Sept. 29. Registered nurse Karen Peters, an assistant professor in the College of Nursing, will speak on the topic, along with representatives from the Oklahoma Bureau of Narcotics and The Dragonfly Home, a program in Oklahoma City that helps those who have survived human trafficking.
Below, Peters answers questions about the role of the health care professional in helping victims of human trafficking.
Q: Why is it important to educate both health care students and health care professionals about human trafficking?
Peters: Human trafficking is an unimaginable abuse of human rights that shatters people both physically and psychologically, as it undermines the health and safety of all communities it touches. Of the millions of people trapped within this lucrative business throughout the world, up to 50 percent end up somewhere within the health care system seeking care for illnesses or injuries sustained while in captivity. Tragically, the majority of these individuals are not recognized as victims of trafficking and therefore do not receive appropriate interventions to help them escape and reintegrate back into society. Because human trafficking has been identified in cities, towns and rural communities in all 50 states, it is imperative that health care professionals and any person seeking a career in health care equip themselves with knowledge on how human trafficking presents, be prepared to intervene when victims/survivors are identified, and work collaboratively with other agencies to protect them from further harm.
Q: In what settings would health professionals be likely to intervene?
Peters: Nurses, in particular emergency department nurses, are often frontline caregivers to these patients; therefore; it is crucial that they have appropriate training to help identify and assist potential victims. However, health care professionals in other settings need this training as well. Trafficked individuals have been found seeking care in urgent care and OBGYN clinics, health departments, dentist and physician offices and free clinics. Because the brutal nature of this business leaves many of these individuals with life-threatening illnesses or injuries, our ambulance services, including paramedics and EMTs, also need training.
Q: What can nurses and other health care professionals do to notice the signs of human trafficking?
Peters: According to the U.S. Department of Labor, more than 12 million people are employed in health care occupations – that’s almost 10 percent of the national workforce. Imagine the possibilities if these professionals received training on human trafficking. From the emergency responder to the triage nurse to the dentist to the social worker … every member of a health care facility has opportunities to identify and assist victims of trafficking. Training is the key. Health care professionals must have in-depth knowledge of human trafficking and its impact on the individual’s overall health; they must be skilled in identifying “red flags” that might indicate an individual is a trafficker or a victim; they must be skilled in providing appropriate interventions and trauma-informed care; and they must work collaboratively with other agencies and know what resources are available.
Q: What are some of those signs or “red flag” indicators?
Peters: First of all, it may be very difficult to recognize traffickers. They don’t fit the common perceptions that most people have. They are rarely those “creepy-looking characters” lurking in the shadows. Traffickers often present themselves as handsome boyfriends, representatives of employment agencies, parents or other close family members. They come from different social backgrounds, are of different nationalities and age, and can be women as much as men. Therefore, you must look for those “red flags,” and consider: Is this person continuously monitoring and controlling the patient? Or is there evidence of censored communication?
Potential victims are also difficult to recognize. They don’t speak a particular language; they are of no particular age, race or cultural background; and although the majority of those trafficked are women and children, they can look like anyone. Rarely will they openly identify themselves, so it’s crucial for health care professionals to detect the nonverbal cues and physical signs. A key to recognition is an understanding of stress and trauma and how it affects individuals who are trafficked. With this in mind, some behavioral indicators include:
* Gaps in memory, such as providing a disjointed timeline of events with inconsistencies or changing details.
* Showing high levels of fear and anxiety for service providers and law enforcement while expressing loyalty and gratitude toward the accompanying “controlling” individual.
There are also physical signs that indicate evidence of a general lack of health care, such as malnutrition, serious dental problems and poorly or untreated injuries or illnesses. With sex trafficking, the individual may present with evidence of frequent or untreated sexually transmitted infections. There also may be evidence of frequent abortions or miscarriages. A common finding throughout the United States is branding or tattooing. This permanent marking labels the individual as the trafficker’s property and helps him/her advertise to buyers who may be looking for a specific type of “product.” It also lets the individual know that the trafficker is in control and the relationship is permanent.
Q: What should a health care professional do if he/she suspects a patient is caught in a trafficking situation?
Peters: The health care professional must be aware of the following:
* If you think someone’s life or safety is in immediate danger, call 911.
* If the victim/survivor is a minor and there are suspicions of trafficking, the health care professional is under legal obligation to phone child protective services. Mandatory reporting laws must be followed at all times.
* If the victim/survivor is an adult, the health care professional cannot force him/her to report the crime or receive help. Remember, the individual and his/her family may be at risk for immense harm if reporting occurs. With this in mind, the health care professional must provide an environment that offers the individual every opportunity to receive help. The health care professional and the victim/survivor are encouraged to call the National Human Trafficking Resource Center for resources and guidance. The number is 1-888-373-7878. You can reach them 24 hours per day, seven days a week, and more than 200 language translations are available.
* Finally, if you have suspicions that you think need to be investigated, please contact the Oklahoma Bureau of Narcotics Human Trafficking toll free hotline at 1-855-617-2288.

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WHEN CAREGIVING HURTS

This event will be held at the OU Schusterman Center, Learning Library 4502 E. 41st Street, Tulsa, OK 74135 December 1st, 2017 9:00 a.m. to 4:00 p.m. (Check in/registration will start at 7:30 a.m. Session Topics: Violence in the workplace, Preventing Injuries at Work, Humor Amongst Healthcare, The Grieving Professional and Drug Use/Abuse Pre-registration $120 until November 24th, after that date $150 Lunch & CEU’s included Register at www.ohai.org. For more information call 1-888-616-8161.

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