freshAIRA publication of

Onwardand

upwardResidents work

toward freedomfrom ventilator

2014

As we accomplish our goals,we help residents reach theirs

About this PublicationfreshAir Magazine is published each fall and is distributed to respiratory care residents statewide.

Rockcastle Regional Hospital and Respiratory Care Center, Inc. is a family-oriented team of healthcare professionals dedicated to delivering the highest quality of care to those we serve.

We extend our thanks to the residents, volunteers and staff who allowed us to share their stories of hope and accomplishment. To be added to or removed from our mailing list, or for more information about the facility or publication, contact Melissa Brock at 606-256-2195.

For info, contact:Carolyn Browning MSW, Admissions CounselorPhone: 606-256-7757Fax: 606-256-4579Email: c.browning@rhrcc.org

Writer/EditorDwain Harris

Special Thanksto Ann Abney, activities director, for coordination, advice and consulting

PhotographyLee Thomas Photography

Graphic DesignCathryn Hahn

On the CoverResident John Perkins poses for a photo on his last day at Rockcastle Regional Hospital. He was weaned from the mechanical ventilator and discharged after sevenmonths in the facility.

A publication of

As much as we strive to make Rockcastle Regional Hospital and Respiratory Care Center

a place of caring and comfort, we all know there is no place quite like home.

That’s why we work to wean as many of our residents as possible, giving them the independence they’ve sought since they first learned they would have to be placed on a mechanical ventilator. Some

are able to wean for a few minutes a day. As you’ll read in this freshAir magazine,

some are able to wean completely and go back home to normal life, while others are

able to wean for a few minutes each day.

The weaning process starts as soon as the resident comes in the door. If the ventilator is providing 18 breaths per minute, our team works with the resident to bring that number to 16. If it is 16, the target is 14, and so on.

That’s our goal, for each resident to wean by breathing on their own. Of course, the majority are unable to wean, but we never stop trying to improve their health and lives.

To that end, we’ve added a rehabilitation room that is used by more than a dozen residents each day to gain strength, endurance, and ultimately a better quality of life. We continue to provide a robust trip program that allows them to venture out on day visits to restaurants, museums, and cookouts. Our care planning team meets three times each week to make certain each resident is getting what he or she needs, physically, psychologically, and socially.

We think you will enjoy learning about these things and more as we share some of our stories in this publication. We hope you’ll note how we never stop striving to accomplish our goals. And we know you’ll be touched by our residents’ determination as they reach toward theirs.

Stephen A. EstesPresident & CEO

Page 2

Our Stories

4 Homeward bound

Care, 6carefully planned

Ready to ride 16

8 The energizer room

10 Teddy’s team baptism

A hero 12among us

14 Meggin’s story

Page 3

W earing his trademark Indiana Jones-style hat, John Perkins finished his last rep, raised his arms above his head, and declared, “I feel like Rocky today.”

Meanwhile, one of his therapists played ZZ Top’s “Sharp-Dressed Man” on an iphone. Perkins, who later that morning would be homeward bound after eight months as a ventilator resident at Rockcastle Regional, could not stop grinning.

It was his last session in the rehabilitation room with his therapist and motivator, Jeff Tyree. “If it wasn’t for Jeff,” Perkins joked, “I’d probably still be in bed.”

Tyree will tell you that he was exaggerating because Perkins’ own determination is one of the reasons he was able to wean from a ventilator. “He stayed after it,” Tyree said.

In many ways, Perkins is a fortunate man. Of those residents deemed to have any chance at all of weaning upon admission, he is one of the 38 percent who is able to wean completely. Others may only wean for an hour or so at a time.

In any event, for all of the effort Rockcastle Regional puts into the care and quality of life of its residents, everyone knows what residents want: to go home, to be independent.

“That’s the goal,” said Jeff Smithern, director of respiratory therapy. “That’s what we’re always striving for.”

The measures taken to help residents wean is what sets Rockcastle Regional apart from most similar facilities, Smithern said. “We take it in small steps, and it starts as soon as they come in the door.”

When residents are admitted, respiratory therapists use what’s

called a negative inspiratory force (NIF) meter to evaluate his or her ability to generate sufficient pressure for deep breathing and airway clearance.

“It may take several evaluations and various strategies,” said Ketan Buch, M.D., Rockcastle Regional’s consulting pulmonologist (See Q and A, page 6), “before a resident’s potential for weaning can be accurately assessed.”

Using individualized plans, staff works with residents daily, employing such techniques as inspiratory muscle training, which consists of breathing exercises that aim to strengthen the body’s respiratory muscles, making it easier to breathe.

Meanwhile, studies are done to measure oxygen, pH, and carbon dioxide levels in the bloodstream. Those tests will reveal any indication of respiratory progress. Physical and occupational therapy, as well as dietary counseling and speech therapy, also play major roles in helping residents restore the strength and functionality necessary to be weaned.

Sometimes residents eventually wean completely; sometimes they breathe independently for a period of time each day.

“Weaning even for a few hours positively impacts a resident’s outlook and gives them a degree of independence,” said Dr. Buch.

Perkins, who was admitted to Rockcastle Regional in February after a series of cardiovascular events, began weaning 30 minutes a day. As he lost weight and gained strength, his weaning periods were gradually increased.

His tracheostomy, a surgically created hole through the front of the neck and into the windpipe, was “capped” in early August. A few more weeks, he’d be ready to go home.

“That’s what they want,” Smithern said. “Not everyone can wean, but when it happens, you’re excited for them and their families.”

Perkins was thrilled as he gathered his belongings on his last day, but he was also sad to be leaving his Rockcastle family. Tears flowed from staff as they said their goodbyes.

As he left, he recalled how they made him feel when he first arrived. “I remember thinking, ‘I’m not afraid here.’ The nurses and everyone calmed me down.”

Now, he has even less reason to be afraid, and he is anything but calm. He’s fired up and ready for a fresh start.

Effort to wean begins when residents arrive

Headed home

Shana McFerron, RRT, with the Negative Inspiratory Force meter. The instrument is used to measure residents’ ability to breathe on their own

Physical therapy assistant Jeff Tyree works with John Perkins on Perkins’ last day at Rockcastle Regional.

“That’s what they want. Not everyone can wean, but when it happens, you’re excited for them and their families.”-Jeff Smithern, RRT, director of respiratory therapy

Q: What goes into assessing a new patient for weaning potential?

A: The main reason that I am asked to see patients at Rockcastle Regional, in addition to helping with ventilator management, is to assess their ability to wean and help with the weaning process as needed. A patient’s lung health is by far the most important factor in assessing their potential for weaning, but it is by no means the only factor. When assessing a patient’s weaning potential, it is important to take into account their well-being as a whole. Not only must the major organ systems (heart, kidneys, brain) be in optimal condition, but the patient’s strength, laboratory parameters (electrolytes, hemoglobin), as well as their nutrition and mental health must be addressed. A patient’s age and condition prior to being placed on mechanical ventilation play a major role in determining their potential for weaning.

Q: If it is determined that weaning is a possibility, what must the patient and medical team do to maximize the chances? Is physical conditioning/rehab important?

A: Patient desire to wean and cooperation with the healthcare team is of paramount importance in the weaning process. For a vast majority of our patients this process is associated with anxiety and is a lot of hard work on their part. The medical team must make sure that they address the “whole patient” and not just ventilator and weaning parameters. This includes being their coach,

mentor, cheerleader, and fan at the same time.

Physical conditioning and rehabilitation is absolutely important. Physical and occupational therapists play a major role in helping our patients wean from mechanical ventilation.

Q: Even if patients can’t be permanently weaned, they often are weaned for short periods of time. What does it mean to the patient, physically and mentally, to get these

few minutes of breathing on their own each day?

A: Our priority is to try and wean patients and “liberate” them from mechanical ventilation, if at all possible. Sometimes, due to endurance or their underlying respiratory or cardiac illness, patients may be able to wean for a few hours or so but cannot be truly liberated from ventilator support. Weaning even for a few hours positively impacts a patient’s outlook and gives them a degree of independence, e.g. they are able to participate in activities without having to be attached to a ventilator.

Q: How do you approach the patient and family with the topic of weaning, knowing that they are all so very hopeful of one day weaning? In cases where weaning isn’t possible, how difficult is it to tell the families this?

A: Almost all patients who come to Rockcastle Regional come with the hope of returning home without a ventilator attached to them. Sometimes, they don’t even realize that it is possible for them to have that hope. I have tremendous faith in the abilities and dedication of our staff; therefore, I approach every patient as being weanable until proven otherwise. It may take several evaluations and various strategies before weaning potential can be accurately assessed. If weaning is not possible, I am honest with the patient and his or her family. It is not always easy for them to face this possibility, but I take solace in the fact that we have tried our best in every case to achieve the goal of weaning.

Dr. Ketan Buch, Rockcastle Regional’s consulting pulmonologist, evaluates every patient admitted into the respiratory care center. We sat down with him to get his

answers to some questions about the weaning process.

Page 6

Team uses proactive, inter-disciplinary approach

Great care,carefully planned

At Rockcastle Regional, teamwork is the key to quality care, and care plan meetings keep our team functioning at a high level.

Like clockwork, every Tuesday, Wednesday, and Thursday at 1 p.m., professionals from eight disciplines, as well as residents or their family members, gather to discuss the care of individual residents.

Each team member updates the group regarding specific aspects of the residents’ care. What emerges is a comprehensive picture of the resident, and it’s a picture that is highly detailed.

“Our cases are more complex than they used to be,” said Elizabeth Tracy, RN, who leads the meetings. “Knowing the patient’s whole story is even more critical now because it gives each of us the context we need to make the best decisions.”

Often, residents have multiple chronic conditions that demand specific expertise. If those conditions change, they can have a rippling effect on their overall health.

For example, one’s nutritional status might affect energy level, which can affect the rehabilitation process and muscle tone over time. And all of those factors can make a difference in quality of life and even the weaning process. So the continuous sharing of information with each member of the care team is critical.

Equally important is the open communication with residents and/or their families in the care planning process. “The residents and family members are very much a part of this team,” occupational therapist Danny McNew stressed.

“Sometimes family members will come in with a written list of questions,” said respiratory therapist Shana McFerron. “We look forward to those opportunities. It gives us a chance not only to give them answers, but also engage them in the care of their loved one.

We know that as engagement increases, the chances of a more positive outcome are increased.”

And when families, who often live far away, can’t attend in person, efforts are made to use technology such as conference calling or videoconferencing. When they can’t attend at all, a team member calls them after the meeting with an update.

“Families often express their appreciation for the effort we put in to see this is done right,” Tracy said. “They comment

that our dedication to this process is evident. It’s always affirming and encouraging to hear that.”

Rockcastle Regional President and CEO Stephen A. Estes credits the care plan team as an outstanding example of the type of organization the hospital strives to be.

“We’ve long been a facility without silos,” Estes said, “because we recognize that great communication is essential to great care.”

“We’ve long been a facility without silos because we recognize that great communication is essential to great care.” -Stephen A. Estes

The care plan team uses regularly scheduled,

proactive meetings and an inter-disciplinary approach to

address each residents’ needs. Below is Elizabeth Tracy, RN,

who leads the team.

Page 7

When Eva Hendrickson was admitted to the Respiratory Care Center at Rockcastle Regional, she was surprised to discover a room dedicated solely to rehabilitation. A little

scared to try it at first, her fears quickly faded. “Once I got in the room, it was just like home and family.”

The opportunities the room presents are impressive. There are the parallel bars, for example, and the upper extremity bike. Then there’s the recumbent stepper, a cardiovascular device that anyone can use, even those who aren’t mobile or are in wheelchairs.

This specialized equipment, along with a team of top-notch therapists, make the recently opened rehabilitation room a place where residents go to push the bounds of the possible.

Mrs. Hendrickson used the facility to regain the independence she’d always known before heart problems sent her on a four-month medical journey, one that ultimately took her to Rockcastle Regional.

In the past, said Emily Valentine, physical therapist and rehabilitation services manager, all rehabilitation took place at bedside. But now, more than half of the resident population that gets rehabilitation is able to use the new facility.

Those residents get benefits on many levels. Clinically, the room allows for a team approach to care. Professionals from physical, speech, and occupational therapy can more easily co-treat. Communication among those disciplines is enhanced because treatment often is done at the same time and place, rather than each therapist going into a resident’s room at different times.

TheenergizerroomResidents use new space to push limits

Page 8

In addition, the equipment used in the room affords residents more types of exercises, leading to improved health.

What isn’t as easily measured, but is just as important, is the impact the room has on residents’ quality of life.

Residents in long-term care facilities often are in their rooms for extended periods of time. “The rehabilitation room gives them a chance to get up, get dressed, get out of the room, and socialize with other residents,” Valentine said.

Anyone who is a member of a workout facility can relate – your own energy levels rise amidst the activity of others.

Hendrickson agreed. “I loved the rehab room. I liked being motivated to get up and go and see that there were other people in the same shape as me.”

She also looked forward to working with the therapists. “Everyone I worked with treated me like family. I loved that we were able to joke around and have a good time even though we were working out and doing difficult things.”

Before being released to go home in May, Hendrickson had regained her independence.

“They brought me through some really tough times,” she said. She went from not being able to stand to being able to “walk out the doors on my own my last day.”

“That’s the most rewarding thing,” said Valentine, “seeing residents leave the room energized and optimistic. That’s when we know we’ve made a difference.”

“I loved the rehab room. I liked being motivated to get up and go and see that there were other people in the same shape as me.”-Eva HendricksonAmid a busy rehabilitation room, physical therapist/rehab services

manager Emily Valentine works with two-year-old Skyler Gayheart.

Page 9

Teddy’s baptism

When Rockcastle Regional resident Teddy Fulton said he wanted to be baptized,

he meant business.

Raised in the Southern Baptist tradition, he wanted it to take place in a church.

“I told them I wanted to do it right,” Teddy remembers.

The simple idea presented a big question: How would Teddy, a quadriplegic and respiratory care resident, be wheeled to a baptismal and then be safely submerged in water? Even routine trips require careful planning and preparation – and the accompaniment of a respiratory therapist – to make sure medical support is within an arm’s length should it be needed.

But this was altogether different. It was riskier and more complicated. And the team at Rockcastle Regional was prepared to move heaven and earth to make it happen.

During the course of several meetings involving what eventually grew to an estimated 40 hospital team members, the project was given the green light.

Soon a beehive of activity commenced. The church would have to be prepared, a platform would be built, and processes would have to be planned and reviewed.

Rockcastle Regional chaplain Luther Allen led the charge. “Teddy basically said he knew he wanted to be closer to God,” he recalled. Allens, with the help of Pastor Randy McPheron and Northside Baptist Church, was determined to help get him there.

Rockcastle’s Regional’s maintenance crew built a platform that would hold a portable baptistery while enabling the wheels of a hydraulic resident lifter to fit underneath.

Meanwhile, respiratory therapist Mike McFerron began to think through the most critical aspect of the baptism. As a ventilator resident,

Caring for the spirit too

Page 10

“The emotional, psychological, and spiritual aspects arejust as important as the physical.” -Sherry Saylor, RN

Teddy has a tracheostomy, a surgically created hole through the front of the neck and into the windpipe (trachea). Should even a tiny bit of water seep inside, the consequences could be serious – pneumonia, perhaps. Teddy would only be submerged up to the tracheostomy, not over it, but nothing was being left to chance.

Staff worked with Teddy, who had weaned before, to help him stretch his weaning time long enough for the ceremony. This would make matters much easier, as he would be on a simple oxygen line rather than the more cumbersome ventilator tubing.

McFerron would customize what’s called a “face tent” and a cloth to cover the tracheostomy during the ceremony.

There were test runs and rehearsals. There were updates in the hospital’s daily “safety huddles.” There was constant communication.

All of this might lead someone from the outside to ask “Why?” Why go to the trouble of the church baptism, when there was a perfectly good baptistery in the respiratory care center?

Because if it’s important to the resident, it is important to the Rockcastle Regional team.

“Our approach to care is holistic,” explained Sherry Saylor, RN, Teddy’s nursing coordinator. “It was really not a difficult decision. The emotional, psychological, and spiritual aspects are just as important as the physical. It’s part of our commitment to quality of life.”

Of course the most important person in this process was Teddy himself. Now 24, he was left paralyzed after an accident at age 16. He’s been at Rockcastle Regional since 2006, and has become

popular among residents and staff. “He is so positive,” Saylor said. “He just has a great outlook.”

Communication with Teddy was key. When Saylor talked to him about the risks involved, he expressed no hesitation, and part of Mike McFerron’s role was to reassure Teddy about the process so that he would stay relaxed during the ceremony.

So on a pleasant Sunday afternoon, around 50 people gathered at Northside Baptist Church to help a young man through his spiritual passage. In addition to those assisting with the ceremony, Teddy’s mother and sister were on hand, driving all the way from South Carolina. Also present was his other family – three dozen or so employees of Rockcastle Regional, attending on their own time because they wanted to show support for someone they work with every day, and because this is what you do for family.

After a few words from Pastor McPheron, the team lifted Teddy from his chair and into the water. As he was lowered, the water rose to just below the tracheostomy. Luther then poured water on Teddy’s head from a pitcher as Pastor McPheron completed the prayer. Mike, the respiratory therapist, kept a steady hand on the tracheostomy. Teddy was then lifted out of the water, safe and sound, and closer to God.

“I was excited,” Teddy recalled, “and at peace at the same time.”

The audience applauded, and many wiped tears from their eyes as they sang hymns of praise.

Soon after, Teddy with his mom and sister were taken out for a nice meal, like so many families enjoy on Sundays after church. It was another touch of normalcy for someone who appreciates such blessings in ways most of us cannot.

Far left, the team carefully lowers Teddy Fulton into the baptistery at his ceremony. It was important to Teddy that he be baptized in a church. “I told them I wanted to do it right,” he said. Left, Luther Allen, hospital chaplain, chats with Teddy. Allen led the team in organizing Teddy’s baptism.

Page 11

Caring for residents is always regarded as a serious responsibility by our staff.

Sometimes, it’s seen as a privilege.

For example, when respiratory therapist Ray Hensley, a U.S. Army veteran, found out he would be at the bedside of Command Sergeant Major Claude Meade in May, he immediately took note.

“I knew I wouldn’t call him ‘Mr. Meade,’” Hensley said. “He commands so much respect, I address him as ‘sergeant major.’”

Born the youngest of seven children to a Floyd County coal miner, Meade joined the Army at age 16. His 27 years of military service included two tours in Vietnam, where he was awarded a Bronze Star as a sergeant of a platoon that rescued an entire company of soldiers pinned down by enemy fire. He also earned an Army Achievement Badge and a combat infantry badge – in 1966 he was in constant combat with infantry for a year.

Meade eventually rose to the rank of command sergeant major, the highest possible for a non-commissioned officer.

“They don’t give that rank away,” Hensley said. “It only goes to the best of the best.”

So does placement in a hall of fame. In July, Meade was inducted into the Kentucky Veterans Hall of Fame at a ceremony in his hometown of Morehead, KY. He was chosen from among 3,000 nominations.

“There are a lot of veterans who deserve this kind of recognition,” Meade said. “I don’t know why they picked me, but it was an overwhelming honor.”

His community service after retiring from active duty surely played a part in his being inducted. He spent much of the last 20 years volunteering with veterans’ advocacy groups, Shriners Hospital, and a number of civic groups.

“As a conservative guess, I’d estimate he’s put in 20,000 hours of volunteer service over the last 20 years,” his daughter, Shawn Justice, said.

He has also started several organizations, including the ROTC program and Student Veterans’ Association at Morehead State University.

Meade, 74, looks like he’s in his fifties, and up until recently enjoyed good health. He ran five or six miles a day as he approached 70. But things took an unexpected turn in January when he underwent elective hip surgery. Complications resulted in multiple hospitalizations, cardiac arrest, and stays in intensive care. This spring he was admitted into Rockcastle Regional as he traverses a long road to recovery.

He’s pleased with the care he’s gotten here. “Everyone works so hard,” his wife, Robbie, said, “and we’ve never been in a cleaner place. Of all the places he’s been, this is, by far and away, the best.”

That’s what Ray Hensley likes to hear. The best, as he sees it, deserves only the best.

It’s our privilege to serve the best

A heroamong us

Page 12

“I don’t know why they picked me, but it’s an overwhelming honor.”-Command Sergeant Major Claude Meade

Page 13

Oh, the places Meggin Nunamaker has been. Western Kentucky, eastern Kentucky, Germany, Hawaii. The depths of heartache, the height of personal accomplishment, the head of Rockcastle Regional’s

resident council table, walking across a university stage to accept her graduate degree after residing inside the four walls of discouragement for so long.

The world of higher education learned that if you want to stop Meggin Nunamaker, you’ll have to do better than send her a handful of rejection letters.

Don’t misunderstand. She’ll be as devastated as the next person. “I just bawled,” she recalled after getting the fifth letter denying admittance into graduate school. But to know Meggin is to know that she will not stay sad. She will keep moving, thinking, looking for an opening. She calls it her I.M.A. philosophy: Improvise, Modify, Adapt. It is a philosophy she developed out of necessity.

When Meggin was young, her family knew something was wrong. What would later be diagnosed as muscular myopathy limited her strength and stamina, and eventually her mobility. She would never be able to run or walk with the same carefree zeal as other kids, or ride a bicycle through the streets of her neighborhood.

But rather than coddle her, her parents equipped her.

“They always tried to teach me to find a way,” she said. Since she couldn’t ride a traditional bicycle, her father got her a three-wheel version, and then pried her away from her comfort zone. “Go faster, Meggin, faster,” he would say. They supported her, yet challenged her to “figure it out” when she encountered obstacles. It was the right kind of preparation for what lay ahead.

Perhaps she also learned some of those adaptation skills as a child of a member of the U.S. military. She spent most of her school days in Germany, getting an American education but sharing the classroom with classmates of different cultures.

StoryMeggin’s

Determination keeps hermoving, succeeding, leading

Meggin Nunamaker’s curiosity and energy makes her a leader and lifelong learner. She recently has taken up calligraphy, and uses it to create certificates for her fellow residents when they reach personal milestones. Physical activity has always been important to her; she’s pictured at right as a youth league baseball player.

Page 14

An interest in speech pathology led her to Murray State University, her mother’s alma mater, and gave her a first look at the state of Kentucky. Shortly after graduating with a bachelor’s in communication disorders, she rejoined her parents, who were then stationed in Hawaii. There she worked for a time at an elementary school teaching kids with special needs.

It was in Hawaii that she took the graduate school admittance exam for the first time with the knowledge that adaptations such as rest breaks were available to those with physical challenges such as hers. Her score soared from previous attempts, and with a 3.68 grade point average, she was accepted into the online communication disorders master’s program at Western Kentucky University.

Shortly before her acceptance, her father had accepted a job offer from the Blue Grass Army Depot in Richmond. So the family moved to Kentucky, and Meggin began graduate school.

She knew the most challenging part of the program would be the six-week clinical “boot camp,” which would require her to be on campus in Bowling Green. It was in fact difficult for her, but she was plowing through until the myopathy worsened, and while doing observations in nursing homes, a cold reality began to set in: Times have changed, and speech pathologist jobs’ often entail a range of physical movement that Meggin was losing.

She graduated using an alternative curriculum and proudly recalls the standing ovation she received as she crossed the stage using a walker. But she knew she couldn’t work in a traditional therapy setting.

She again forged ahead, moving to Richmond and working part-time as a tutor for Eastern Kentucky University. Then, heartbreak struck again. She fell in her kitchen and broke her leg in three places. Soon after, she was hospitalized with double pneumonia, spending 20 days in intensive care. The pneumonia paralyzed her already-weak diaphragm, and she was placed on a ventilator at Cardinal Hill Rehabilitation Hospital.

During this difficult time, her education in communication disorders at least gave her context and perspective. “I understood what was going on with the respiratory process,” she said. “I know the physiology. I understood why they were doing certain tests.”

She was discharged after six weeks, and with the help of family, spent the next year becoming more independent. She gained strength, lost 86 pounds, and grew more optimistic about the future.

But over time the falls became more frequent, and her muscle tissue was too deteriorated for further testing. In August 2013, she was admitted to Rockcastle Regional as a ventilator-dependent resident.

She wasted no time in sizing up the place and identifying opportunities to make a difference – for herself and others.

“From day one Meggin set out to keep her life as full as she possibly could,” said Ann Abney, activities coordinator, “and she continues to

bring new and exciting ideas to our facility. We are always eager to get to know new residents, and from her first day we knew Meggin was going to be a breath of fresh air.”

Put simply, Meggin is the type of person who makes things happen.

For example, she wrote a letter to the company that designed her tracheostomy tube system – called the Blom – praising the employees for their product. At their request, she eventually became a spokesperson for the company, even doing a promotional video and a webinar presentation in front of an international audience.

She is president of the resident council, a role she approaches with her usual vigor.

“If she sees opportunity for change and improvement she is quick to share those ideas and suggestions,” Abney said. “She takes a personal interest in residents and staff, and is currently working with staff to develop a reading program for several of our residents.”

Known for her creativity, she contributes an article to the facility’s monthly newsletter called “Chicken Soup for the Patient’s Soul,”

a funny and touching insight into the lives of residents and her family and friends. She also has taken up

calligraphy, and sometimes uses the skill to create certificates for her fellow residents when they

reach a personal milestone.

Meggin’s leadership qualities quickly became apparent to everyone – except, perhaps, her.

“I never think of myself as a leader,” Meggin said. “But I’ve always been outgoing and not afraid to ask questions.”

Rockcastle Regional welcomes and embraces those questions, she said. “The staff here is so

attentive – I just have every confidence in them. They keep us included in our own care, and are very

concerned about our quality of life.”

That emphasis on quality of life has resulted in the development of an array of activities, the most popular of which is the trip program. Meggin has taken full advantage, venturing out to the Titanic Exhibit in Lexington, the Spoonbread Festival in Berea, and to be a guest lecturer at Eastern Kentucky University to future speech pathologists.

Sometimes, venturing out doesn’t mean leaving the facility. It can mean heading down the hall to the newly built rehabilitation room, a workout facility for residents. Meggin grew up around sports, helping her mom — a softball commissioner for a league in Europe — with scorekeeping. Physical activity is important to her, and when she discovered that the room was only available on weekdays, she became the first resident to ask that it be opened on weekends. As a result, two activities associates were trained to work in the room on weekends.

“If you ever have trouble finding Meggin,” Abney said, “just check out the rehab room.”

There you’ll find her working hard, staying sharp, keeping herself in top form for things yet to do, people yet to lead, and places yet to go.

“The staff here is so attentive. I just have every confidence in them.” -Meggin Nunamaker

Page 15

Trip program gives residentsfreedom to travel

Rockcastle Regional Hospital and Respiratory Care Center is known for its award-winning day trip program, but the real reward is seeing the smiles on residents’ faces. Whether the excursion is to a restaurant, museum, or a family reunion, residents always look forward to venturing out. Resident Gina Merrick even got a very pleasant surprise on a recent trip to have lunch in Corbin, KY. Her wedding ring had been misplaced during a stay at an out-of-town hospital. At the restaurant, her husband, Dr. Bruce Merrick, was waiting for her with a brand new ring, making that particular trip one she won’t soon forget.

“The day trips are very popular with our residents. Many memories have been made because of this program.” -Ann Abney

What is the trip program?

An award-winning program designed to

allow residents to leave the facility for the day.

What do residents travel in?

A specially equipped van with an experienced nurse and respiratory therapist.

What is the ride like? Can residents see outside?

The van has floor latches that secure the resident’s wheelchair and gives them the opportunity to look out the large windows to enjoy the scenery as they travel. After being in a facility for long periods of time it is the first opportunity for many residents to be off campus.

How long is a typical trip?

The resident can leave the facility at 9 a.m. and return by 7 p.m. Accommodations can be made for special events outside the time frame.

Where can the residents go?

The destination can be as far as 2 ½ hours away, and the resident can choose where they would like to go. Some of our residents go home for the day to visit with family, friends, and their pets. Other residents attend concerts, go out to eat, shop, or go out to the movies. Residents have attended proms, graduations, sporting events, festivals, and exhibits.

What is the cost of the trip?

The trip itself is free. Residents and/or family will be responsible for the cost of activities while on the trip.

What happens if residents don’t feel well while on a trip?

The nurse and RT bring medication and are prepared to address health issues. Residents may decide to return to the facility at any time.

How do residents sign up for a trip?

After a destination is chosen, residents contact the activities staff. The trip coordinator submits a request for the physician’s permission. If granted, the outing is placed on the trip calendar.

Can family members accompany residents?

Yes.

Page 16

The campus of Rockcastle Regional Hospital and

Respiratory Care Center in Mt. Vernon, KY, becomes

as vibrant as a rainbow each spring and summer. Crafted for our residents

and employees, our Healing Garden and our Lambert Walk

at Stewart Gardens provide peaceful havens using nature’s colors and a gardener’s touch.

The Healing Garden

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MISSIONRockcastle Regional Hospital and Respiratory Care Center is a family-oriented team of healthcare professionals dedicated to delivering the highest quality of care to those we serve.

VISION Rockcastle Regional Hospital and Respiratory Care Center’s vision is to be the hospital of choice for healthcare in Rockcastle County and surrounding areas, and to be the nationwide facility of choice for ventilator care.

VALUESWe value excellence, friendliness, compassion, cleanliness and our commitment to our community.

ACCREDITATIONAll Rockcastle Regional Hospital and Respiratory Care Center facilities and programs are accredited by The Joint Commission.

REFERRAL CONTACTCarolyn Browning, Referral/Admissions Coordinator (606) 256-7757

PROFESSIONAL ASSOCIATION MEMBERSHIPS AND OTHER AFFILIATIONS• American Association of Respiratory Care• American Health Care Association• American Hospital Association• Kentucky Association of Health Care Facilities• Kentucky Hospital Association• Kentucky Medical Association• National Patient Safety Foundation

ROCKCASTLE REGIONAL PARTNERSHIPS WITH UK HEALTHCARE• Gill Heart Institute• KY Neuroscience Institute

ROCKCASTLE REGIONAL AFFILIATIONS WITH UK HEALTHCARE• UK Stroke Network Affiliate• UK Markey Cancer Center Affiliate

SPEAKERS BUREAUWe are pleased to present information about healthcare and healthcare professions to the public. To Schedule a speaker for your school, business, civic, healthcare or government organization, call Jana Bray (606) 256-7880.

LEADERSHIP Rockcastle Regional Hospital and Respiratory Care Center is governed by a local, volunteer board of directors. Joseph E. Lambert, Chairman Bige W. Towery, Jr., SecretaryWilliam B. Bailey, Sr. Jeffrey T. BurdetteDebra H. Lambert

EXECUTIVE MANAGEMENT Stephen A. Estes, President/CEO Christopher Nicholas Bastin, CFO Cynthia Burton, CNO

Rockcastle Regional Hospital and Respiratory Care Center is a not-for-profit community healthcare system that operates an emergency department, a 26-bed acute care hospital, outpatient services, a 93-bed long-term care program for residents dependent upon mechanical ventilation and three rural health clinics. Rockcastle Regional Hospital was established in 1956 and is accredited by the Joint Commission. The organization is a six-time Kentucky Hospital Association Quality Award Winner, a U.S. News & World Report Best Nursing Home for 2013 and 2014, a 2013 and 2014 winner of the Women’s Choice Award for America’s 100 Best Hospitals for Patient Experience, and a recipient of the 2013 Jackson Healthcare Charitable Services Award. For more information, please visit www.rockcastleregional.org.

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MEDICAL STAFF

CHIEF OF STAFFGeorge W. Griffith, MD, Family Practice

VICE CHIEF OF STAFFKevin Rowe, MD, Family Practice

SECRETARYKimberly Cornelius, MD, Internal Medicine/Pediatrics

Jon A. Arvin, MD, Family PracticeDavid L. Brabon, MD, Plastic SurgeryDavid S. Bullock, MD, Family PracticeKimberly Cornelius, MD, Internal Medicine/PediatricsEduardo R. Gomez, MD, RadiologyGeorge W. Griffith, MD, Family PracticeKevin Rowe, MD, Family PracticeKaren B. Saylor, MD, Internal Medicine/PediatricsCallie Shaffer, MD, Pediatrics

MID-LEVEL PROVIDERSCourtney Browning, APRN, PediatricsAlicia Cook, PA-C, Family PracticeChasity Frakes, APRN, Family PracticeShelley Grover, APRN, PediatricsTamar Greenly, APRN Family PracticeRuth Lane, APRN, Women’s HealthVirginia Mink-Cash, APRN, Family PracticeAngela Parsons-Woods, PA-C, Family PracticeBrittany Perkins-Saylor, PA-C, Family PracticeTiffany Patrick, CRNA, Hospital Anesthetist

CONSULTING PHYSICIANSMelina Aguinaga-Meza, MD, CardiologyPaul Anaya, MD, CardiologyMichael Anstead, MD, PulmonologySusanne Arnold, MD, OncologyAzhar Aslam, MD, CardiologyLouis Bezold, MD, Pediatric CardiologyDavid C. Booth, MD, CardiologyJeffrey T. Brumfield, MD, CardiologyKetan Buch, MD, PulmonologyLee Cain, OD, OptometryCharles Campbell, MD, CardiologyJamie Carter-Settles, DPM, PodiatryJennifer Chadwell, DMD, DentistryMara C. Chambers, MD, OncologyAftab Chishti, MD, Pediatric NephrologyJames K. Crager, MD, CardiologyBrett T. Comer, MD, OtolaryngologyKristopher Cumbermack, MD, Pediatric CardiologyW. Lisle Dalton, MD, GynecologyJohn M. Draus, MD, Pediatric SurgeryDavid Escalante, MD, EndocrinologyDeborah R. Flomenhoft, MD, Pediatric GastroenterologyAmy Hessler, DO, NeurologyThomas W. Howard, MD, RheumatologyJames Huffman, MD, OphthalmologyMark Huffman, MD, Ophthalmology

Joseph A. Iocono, MD, Pediatric SurgeryMary Ireland, MD, Orthopaedic SurgeryDennie V. Jones, MD, Hematology/Medical OncologyHeather Jones, MD, PodiatryMichael Jones, MD, CardiologyAnna Kamp, MD, Pediatric CardiologyAshok Kanthawar, MD, GastroenterologyStefan Kiessling, MD, Pediatric NephrologyLisa Klein, MD, Pediatric CardiologyChristian Knecht, MD, General SurgeryPaul K. Krestik, DPM, PodiatryChristian Lattermann, MD, Orthopaedic SurgerySteve Leung, MD, CardiologyIraklis Livas, MD, Allergy/ImmunologyMajd Makhoul, MD, Pediatric CardiologyAnne P. Marshall, MD, Pathology/CytopathologyJeremiah Martin, MD, Cardio/Thoracic SurgeryAshish P. Maskey, MD, PulmonologyRick R. McClure, MD, CardiologyAmr A. E. Mohamed, MD, NephrologyGustavo Morales, MD, CardiologyTimothy Mullett, MD, Thoracic SurgeryM. Elizabeth Oates, MD, TeleradiologyDouglas G. Owen, MD, OphthalmologyAnthony Parenti, MD, Wound CareNavin Rajagopalan, MD, CardiologyWilliam Robertson, MD, Nerve StudyAnthony Rogers, MD, Cardio/Thoracic SurgeryEdward Romond, MD, Hematology/OncologySarah S. Rugg, MD, CardiologySibu P. Saha, MD, Cardiothoracic SurgeryCameron S. Schaeffer, MD, Pediatric Urology/Plastic SurgeryDouglas Schneider, MD, Pediatric CardiologySteven Shedlofsky, MD, GastroenterologyPartha Sinha, MD, TeleradiologySean C. Skinner, MD, Pediatric SurgerySusan Smyth, MD, CardiologyVincent L. Sorrell, MD, CardiologyMark Vranicar, MD, Pediatric CardiologyJonathan Webb, MD, NephrologyByron T. Westerfield, MD, Sleep MedicineThomas Whayne, MD, CardiologyGreg Wheeler, MD, NeurosurgeryDenis Yalkut, MD, UrologyFrederick M. Zachman, MD, Gynecology

ALLIED HEALTHDaniel Albertson, APRN, PodiatryBernard Botiller, PA-C, NephrologyCharlene Broaddus, APRN, CardiologyKara Cole, PA-C, Pediatric SurgeryStephanie Copher, APRN, CardiologyMary J. Cowherd, PA-C, CardiologyNikki Lane, CRNA, Nurse AnesthetistWilliam Dan Manning, PA-C, Lexington CardiologyDavid McRae, PA-C, CardiologyBarry Moore, PA-C, GastroenterologyBridget Pagan, PA-C, CardiologyRose Pierson, APRN, Allergy/ImmunologyKathy Tincher, RN, Lexington CardiologyLuAnn West, CRNA, Nurse Anesthetist

Rockcastle Regional Hospital & Respiratory Care Center

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145 Newcomb AvenueMt. Vernon, Kentucky 40456