RCS Newsletter May 2010_final

8/9/2019 RCS Newsletter May 2010_final

1/10

Volume 1, Issue 4 The First Breath of News May, 2010

Happy Mother's Day! Page 1

RESPIRATORY CAREAll the News You Can Inhale

1 Editorial Comments & Employee in Focus

2 Creative Cooking Corner

3 Cinco de Mayo

4/5 Night Shift Newzzz / Essential Education

6/7 Employee Artwork / Prairie Dawn

8/9 Respiratory Care High Fives / Other Stuff

10 Credits / The Mother's Influence / Congratulations

Random Meanderingsby Terry Nuttall, Editor

Thank you to everyone who contributed tothis May's newsletter which almost was

not to be this month. I want to especially

thank Becky Riederer for her excellent

story and Becky Nichols for her completely

spontaneous artful creation which she generously agreed to

donate to this newsletter. Also thank you to Carla Riehl for the

story she found, The Mother's Influence, for Mother's Day and

Karen Jones for her ongoing food recipe column, Creative

Cooking Corner. People like you keep this newsletter going

with your contributions and is why I continue being editor of it.

Cinco de Mayo is May 5th and is a reason to celebrate withfood, fun and beer while also celebrating the experiences and

culture of those with Mexican ancestry. Milwaukee has many

activities planned for Cinco de Mayo, one being the annual

Cinco de Mayo SpringFestdowntown. Did you know the official

colors of Mexico are redand green? They symbolize salsaand

guacamole.

That is all for random meanderings for this month.

Employee in Focusby Terry Nuttall

In this month's newsletter's ongoing quest to recognizeeach invaluable employee who doesn't mind the limelight,

Becky Riederer has generously volunteered to be our

fourth subject in our series, Employee in Focus.

Becky began her education in nursing but she soonrealized that was not what she wanted to do. After her

dad passed away of lung cancer, she felt inspired to enter

a Respiratory Therapy program at Northwest Technical

College in Green Bay, from which she graduated in 2008.

Her dream since high school has been to work with

children and when her clinical training took her

to Children's Hospital of Wisconsin, the experience

confirmed her love for taking care of kids. She then knew

that Pediatric Respiratory Care was her calling. Becky

loves to interact with the kids she works with and she

loves being able to learn something new every day.

Becky grew up in Sheboygan and currently lives inManitowoc, 80 miles north of Wauwatosa. She and her

husband, Dennis, have three beautiful girls: EmmaRae is

10, Abagail is 5 and Madalynn is 4 years old. Becky loves

Continued on page 2

Becky Riederer and her beautiful family
http://www.umos.org/special_events/cinco_de_mayo.aspxhttp://www.umos.org/special_events/cinco_de_mayo.aspxhttp://www.umos.org/special_events/cinco_de_mayo.aspx


2/10



being a mom and finds it an extremely rewarding experience.

Also in her family are Chester the dog, Ciate (see-ah-tea) the

cat and Diego and Silver, the 2 robo hamsters.

During her spare moments, Becky likes to cook, play card orboard games, listen to music and dance with her kids as well

as do crafts with them, go for walks and bargain shopping in

addition to just spending quality time with her husband. While

watching television Becky is a fan of Desperate Housewives,

American Idol and Survivor. Striving to find comic relief in

many types of situations, Becky loves to laugh and make

others laugh too. She also loves to discover arcane facts

about interesting subjects. Did you know Wilma Flintstone's

maiden name was Wilma Slaghoopal, and Betty Rubble's

Maiden name was Betty Jean? Also, no piece of paper can be

folded in half more than 7 times. How many of you are going

to try this now? I don't know about you but I also find this stuff

fascinating.

In summertime months Becky and her family are often eitherswimming in their own pool or at the beach. They also have

started to take up camping and look forward to experiencing a

camping adventure this summer. Becky is very grateful to her

husband for introducing her to the joy of watching Packer

games in which she now often finds herself immersed in the

excitement of. Her extended family is extremely important to

her and they try to find time to be together as often aspossible.

As a slightly more tangible reward for consenting to thisexcellent story of how she came to us at CHW, here is a mug

filled with a beverage of Becky's choice. Deserving far more

than that though, I thank

Becky very much for her

support of this

newsletter and

elsewhere. We are truly

very fortunate thatBecky Riederer is with

us

Employee in Focus cont' Continued from page 1

Creative Cooking Corner

Enticing Chicken Enchiladas

2 cups cooked, diced chicken

1 can (10 oz) cream of chicken soup

1/2 cup sour cream

1tablespoon margarine

1 onion chopped

1 Teaspoon chili powder

1 small (4oz) can of chopped green chilies

1 can enchilada sauce

Salsa

Tortillas

1 cup shredded Mexican cheese

Preheat oven to 350

In small bowl mix soup and sour cream, set aside. Meltmargarine in medium saucepan over med-high heat. Add

onion and chili powder and saut until tender. Stir in chicken,

green chilies, 1/2 enchilada sauce and 2 tablespoons soup

mixture. Cook and stir until heated through.

Spread 1/2 soup mixture in a 9x13 pan. Spoon equal

amounts of chicken mix down center of tortillas. Roll up

tortillas and place seam sides down. Spoon remaining soup

mix over top, along with the remaining enchilada sauce and

dollops of salsa, sprinkle with shredded cheese. Bake 25

minutes or until bubbly and lightly browned, makes approx 8enchiladas. Muy Bien!! Great for

Cinco Del mayo, for breakfast

or for dessert! Thank you again

Karen for another delectable

recipe!

ByKaren Jones

our Krazy

Kook


3/10



After eating your Chicken Enchiladas, print this out and give this easy Cinco De Mayo crossword a go. The holidaycommemorates the Mexican army's unlikely victory over French forces at the Battle of Puebla on May 5, 1862, under the

leadership of Mexican General Ignacio Zaragoza Segun. In the U.S. this date is used to celebrate the culture and

experiences of Americans of Mexican ancestry. (FromWikipedia) Answers are at bottom of page upside down.
http://en.wikipedia.org/wiki/Cinco_de_Mayohttp://en.wikipedia.org/wiki/Cinco_de_Mayohttp://en.wikipedia.org/wiki/Cinco_de_Mayohttp://en.wikipedia.org/wiki/Cinco_de_Mayo


4/10



Night Shift Newzzz...By Anthony

E O S 2 0 1 0!

What has been done?

Im involved in decisions that affect my work

Before viral season began, we asked staff what their

preferences were in scheduling during this busy time. Were

continuing to do rounding to not only make sure you have what

you need for your job, but how can things work better. Were

on the eve of starting a clinical practice work group which will

be a golden opportunity to have input on clinical areas that

effect you work. The new trauma team is continuing to form,

which is a great opportunity to advance your skills and give

input on this fast paced environment.

Balancing work and family

The biggest change that was done to help balance work and

family is offering staff meetings on the night shift, as well as, on

Friday evenings. This has not only helped the weekend staff,

but also allowing people to attend staff meetings without

coming in on their days off. Both Julie and I have evaluated our

PPL guidelines to maximize the amount of vacations that are

taken. For the past 5 months, Ive asked staff to pick their

overtime shifts when needed. This has been widely received.

When last minute shifts have been needed, the hours have

been posted.

When staph drops by, visiting hours are over!

Im starting to map out orientations for the remainder of the

year. Currently, Todd Schleef is finishing up his PICU

orientation. Danielle will be starting in the NICU shortly. Elisa

will be starting in the PICU in August. If you have a desire to

be trained in the NICU, please let me know.

Oh I Got This!Riddle:

If April showers bring may flowers, what do May flowers

bring? Thanks to my son Kaden for the idea)

The first correct answers wins a Starbucks gift certificate.

Send your answer to:[email protected]

Congratulations to Katie, Beth & Becky R. who won last

month's Oh I Got This! answer: Runaway by Love and Theft.

______________________________________

CHW REPIRATORY NIGHT SHIFT______________________________________
mailto:[email protected]:[email protected]:[email protected]:[email protected]


5/10



overall, doing well. Please remember to always bill (the old

way) and complete the order.

The rounding project has been successful so far with over40 patients rounded on. Keep up the good work we are

being noticed out there!

Ed Days are planned and coming next week with the firstclass being 5/4. We have made some slight modifications to

the content and currently they are all on the following topics:

Congenital Heart Defects

De-Escalation

Trauma Education

Head and renal saturation monitoring

Non invasive mask fitting

Pulmonary Professional Development Committee all arewelcome to attend. We meet the 3

rdThursday of the month,

currently from 1630-1730. Next meeting scheduled 5/27

right before Ed day.

As mentioned last month, we have a few different subgroups.. If you are interested, please let me know..

Mentoring

Community Involvement

Respiratory Care Week Planning

Remember you dont have to come to the main meetingto be a part of the sub group.

I need some volunteers to help with Ed days. Please help!

Here is what I need5/27: Someone to teach non invasive mask fitting from

2000-2030. Korina Flint, the non invasive specialist from

sleep lab will train the trainer prior to this half hour session.

6/17 and 8/26: Someone to teach trauma education for

hour from 2030-2100 or any half hour from 2100-2200 Time

to be determined based on another speaker that I am

awaiting confirmation from.

I will let you know what the trauma education consists ofwhen you let me know that youll help.

Thank you for considering!!

Essential Education

by Heather Knez

Get Unstuck when you are in a crucial conversation

We have all been there you know when you are having avery important conversation with someone and that

conversation is going nowhere fast You immediately

recognize that you are stuck because you keep arguing back

and forth about an issue, or the dialogue turns into a debate.

So, what do you do?

Well, you dont want to roll your eyes! That is surely onlygoing to make matters worse (trust me Im speaking from

experience here). You need to take a deep breath, step back

and re-evaluate the situation. Ask yourself and or the person

you are speaking with.. What is our mutual purpose here?

What do we both want to happen with this conversation (or

dialogue)? Once you have this evaluated, it is smooth sailing!

So, a few things that cause people to be stuck in

conversations are these:

When we dont stay focused on what we really want

but instead move from sharing ideas to trying to win.

When we fail to notice that safety is at risk and people

are either attacking or withdrawing.

When we care a great deal about a topic or point and

use debate tactics such as speaking abrasively and

not persuasively.

And finally, when we fail to turn crucial conversations

into action; we dont clarify whats going to happen

next and who is going to do it. Long story short holding each of us accountable for our own actions.

Our ABL 80 competencies are mostly done. If you dont haveyours done, remember, it goes in your file and will be evaluated

at eval time as it was a mandatory requirement with a

deadline.

For those of you who have been running tests, good job on theprogress! We are missing a few things here and there, but


6/10



Thank you Becky Nickels for this very creative interpretation of the classic Tootsie Pop

commercial, created freehand during her 'off-hours'. For the full video visit Classic

Tootsie Roll Pop Commercial (Link does not work in-hospital due to Internet filter.)
http://www.youtube.com/watch?v=yzhB0gF5GTIhttp://www.youtube.com/watch?v=yzhB0gF5GTIhttp://www.youtube.com/watch?v=yzhB0gF5GTIhttp://www.youtube.com/watch?v=yzhB0gF5GTIhttp://www.youtube.com/watch?v=yzhB0gF5GTI


7/10



Study Updates

The Lucinactant study has concluded. We had zero patientsenrolled in this study over the last two years. As you can guess,

the enrollment criteria and enrollment window were both very

narrow and it made it difficult to qualify patients.

The Calfactant study in the PICU is still on-going. CHW hasenrolled 11 patients in the last two years. There has been a

change to the enrollment criteria. They will now only enroll

patients over 12 years old unless they are Oncology pts.

Oncology pts of any age can be included. We expect there to

be fewer patients for this study from now on. Gregg Hack, Mike

Paquette, and Heather Knez are all study administers. You

may be asked to help with one of these; they will explain your

role when you are needed.

The Unplanned Extubation study in the PICU is still ongoing.We have enrolled 10 pts since February 1

st. We are on pace to

see about 35 - 45 UPE events this year! Everyone is doing a

great job getting all of the paper work completed thanks!

Remember that you need to fill in your years of experience and

your workload (number of points - your charge RCP can help

you figure that out). Bob Todd has done a great job keeping the

W3 ventilator days up to date and counting all the ventilator

days for that unit. March had 252 ventilator days - wow! I still

need volunteers for the other two units. If interested, please

see me or Bob so that you can understand the job

responsibilities.

Ventilator Volume Guarantee

A couple of RCPs working in NICU noticed that volumeventilation is becoming more popular in the NICU. They wanted

to share some interesting facts about volume ventilation with

the Evita ventilators.

Volume modes for the Evita are volume guaranteed. This

means that the machine is looking for a returned (exhaled)

volume that equals the set volume.

The advantage to this is that you can set your 4-7ml/kg volumesand be assured that you are not under-ventilating the pt or

causing a volu-trauma to the pt by using too high of volumes.

For non-leak situations, everything works perfectly.

For leak situations, the machine keeps adding volume above theset volume in order to see the desired returned volume. For

instance, if you have a set VT at 7 mls, your inspired volumes

may read 10-15 mls so that you are getting 7 mls exhaled.

It is likely that, as more volume is required, your peak inspiratory

pressure will increase. We can usually protect the patient from

occasional high pressures by setting the high pressure alarm

but this causes the breath to dump. When we dump the breath

continuously, the volume guarantee becomes meaningless andwe are essentially ventilating the child in a pressure mode only.

In leak situations, you need to be aware of a few things:

Always compare your inspired tidal volumes to your expired tidavolumes. The comparison can tell you how much of a leak you

have. The higher the leak %, the more trouble you may have

ventilating the patient. Sometimes, if you can express the

leakage in a % or # form, the docs may better understand the

situation. Always make sure that it is actually the pt that is

leaking and not the circuit. Micro cracks in the circuits can causevolumes to be way off. A check of the circuit can be done in

about 30 seconds in the set up menu by doing the leakage

test.

Always look at your peak inspiratory pressure and criticallyassess your high PIP alarm. Are most of the breaths able to be

administered without dumping the breath? Can I safely

increase my high pressure alarm? If not, there should be a

conversation with the MDs about what is happening.

Suggestions could include increasing the airway pressure alarm.Consider changing the mode of ventilation to a pressure so thatyou are once again in control of the ventilation. And finally

consider changing the ETT to another size or a cuffed tube.

Obviously, the final goal is to ventilate the patient adequately

while not having nuisance alarms if you can do that in volume

Prairie DawnBy Khris O'Brien


8/10



President's Challenge targets all, frominfrequent exercisers to 'champions'

Save your own life

May is the month of the President'sChallenge. It's a great opportunity

to have fun and get fit, individually or

with a group. Whether you are

presently inactive, seldom exercise,

or will be one of The President's

Champions, the challenge could put

you on the road to fitness and

strength.

The Active Lifestyle ProgramIf you are active less than 30 minutes a day, five days a week, thisprogram is what you need to strengthen your heart, increase your

endurance and give you a more positive outlook on life. The

program helps you set goals that encourage fitness for a lifetime.

You can choose from all kinds of activities. You'll get a personal log

to guide you on the way toward the Presidential Active Lifestyle

Award. The program asks you to be active five days a week for six

weeks.

The Presidential Champions Program

If are already active for 30 minutes a day, five days a week, theChampions Program will test just how high you can raise youractivity level. The guidelines are simple and you can choose from a

number of activities. The Champions also get a personal activity log

to help track their progress. There is a special segment for

performance athletes and others who want to train at advanced

levels. In either case, the goal is to see how many points you can

earn by being active. You could earn the Bronze award or keep

going for a Silver or Gold. You don't need an invitation to join. Just

go toPresident's Challengeand sign up.

Submitted by Deb Bakalarski

Thank a nurseMay 6-12, National Nurses Week

During National Nurses Week, we are reminded thatnurses are a pivotal component of medical care for people

of all ages. Here is a moving prayer written by an

unknown author, asking for the serenity and wisdom to

perform her nursing duties while under stress from sources

over which she has little control.

A Nurse PrayerUnknown Author

Dear Lord, Grant me the Serenityto accept the things I cannot change,

The courage to change the things I can,and the Wisdom

to hide the bodies of those DoctorsI had to kill because they pushed me too far

More than ever, as years go by, patient outcomes areknown to be more positive when skilled and sensitive

nursing is involved.

Because a "patient" may be an individual, a family, or acommunity, patient outcome is a broad term that is

amenable to change. Nurses are a positive influence in

these outcomes.

In addition to May 12 which is International Nurses Day,National Nurses Week also includes May 8, National

Student Nurses Day and Wednesday of Nurses Week,

National School Nurses Day.
http://www.presidentschallenge.org/http://www.presidentschallenge.org/http://www.presidentschallenge.org/http://www.presidentschallenge.org/


9/10



Honoree

Name

Submitted

byComments

Jason Ousey Karrina MaherThanks to Jason for doing all of the CFr's on the floors since we had a sick call tonight and I was

covering all of acute care. (Even though you were in W3) Much appreciated.

Julia

Halvoson

Anthony

Martinez

Excellent job following up on the incident reports while I was on vacation. I appreciate all the

time and effort.

Deborah

BakalarskiCarol Wegner

Thank you so much for your wonderful work while Lori was on medical leave. You showed such

commitment and caring for the children/families--plus you did a great job of teaching me.

Deborah

BakalarskiCynthia Gore

Thank you, Deb, for your tremendous hard work and job well done while covering Lori's 6 -week

leave! The trach-vent program ran seamlessly because of your efforts!

Deborah

BakalarskiLori Leiser

I just wanted to thank you for doing such a great job covering for me while I was off for the past

6 weeks.

Wendy

RobinsonKarrina Maher

Thank you Wendy for helping me out on the 15th when I was alone in acute care. You are

always willing to help out. It is much appreciated.

Katherine

HalvorsonKarrina Maher

Katie, thank you for checking to see if I needed help/or was doing okay the night of the 15th.

Also for being so concerned about my assignment.

Wendy

Robinson

Wendy

Sinjakovic

I just wanted to send a little shout out to Wendy for always helping out~ "W" --you are the best

PRN RT EVER!!!

Becky

Riederer

Anthony

Martinez

Becky is always willing to help out, but on a day when the noc shift had 2 call-ins, she took care

of 3 bid tx's and did another q6 tx early so that I wouldn't be overloaded with the first 4 hours of

my shift. Thanks again Becky!!!

Katie

HalvorsonBetsy Lane

Thanks Katie for being a part of our weekend. It's always nice to know you and Mike have the

NICU. You two work so well together.

Michael

Wolter Betsy Lane

Thanks for being so supportive and helpful Mike. You and Katie make a great team, and I can

always breathe a little easier when I know you guys are here

Mary Multhauf Betsy LaneThanks for being so helpful and willing to take on a student Sunday. Taking the transport

allowed me to stay with my patients, and be available for the other therapist.

Richard

NelsonBetsy Lane

On Sunday 4/25 - You were such a help. Thanks so much for everything you did to help when

things were so hectic.

Respiratory Care ServicesHigh Fives

Con ratulations to All!


10/10



C R E D I T S

Thank you very much to everyone who has contributedmaterial, support and ideas to this newsletter. It is your

contributions that make this possible.

Becky Riederer

Rebecca Nickels

Anthony Martinez

Khris O'Brien

Karen Jones

Grace Flanagan

Deb Bakalarski

Carla Riehl

Rhonda Duerst

Heather Knez

CALENDAR EVENTS

Clean Air Month

Lupus Awareness Month

Lyme Disease Awareness Month

Melanoma and Skin Cancer Detection Month

Mental Health Month

National Asthma and Allergy Awareness Month

National Bike Month

Jewish American Heritage Month

National Salad Month

National Physical Education Week: May 1 - 7

Be Kind to Animals Week: May 2 - 8

National Nurses' Week: May 6 - 12

National Stuttering Awareness Wk: May 10-16

Emergency Medical Services Week : 4th week

Save the Rhino Day: May 1

Cinco de Mayo: May 5

National Day of Prayer: May 6

Mother's Day: May 9

Lost Sock Memorial Day: May 9

Armed Forces Day: May 15

Shavuot: May 19

National Employee Health Day: May 19

Memorial Day: May 31

World No Tobacco Day: May 31

Congratulations Chas for passing your RRT!

Congratulations Khris O'Brien!

Khris OBrien has been appointed as Co-Chair of the Joint ClinicalPractice Council for CHW. The purpose of the council is to approve

CHW patient care P&Ps and guidelines. This council is also arecommending body for defining and recommending Standards of

Practice/Care to the Vice President of Patient Care Services. This is a

great honor for both Khris and the

department. She is the first

non-nurse who has been appointed

Co-Chair of this council -Rhonda

The young man who has forsaken the advice and influence of hismother has broken the last cable and severed the last tie that binds him

to an honorable and upright life. He has forsaken his best friend, and

every hope for his future welfare may be abandoned, for he is lost

forever. If he is faithless to mother, he will have but little respect for wife

and children.

The young man or woman who love their home and love their mothercan be safely trusted under almost any and all circumstances and their

life will not be a blank, for they seek what is good. Their hearts will be

ennobled, and God will bless them.

Search Lights On Health, Light On Dark Corners by Professor B.G. Jefferis M.D.,PHD. and J.L. Nicholas, A.M. Published by J.L. Nicholas & CO. Naperville, IL

1920 Copyrighted 1895

THE

MOTHER'S

INFLUENCEby Carla Riehl
http://www.holidayinsights.com/moreholidays/May/saverhinoday.htmhttp://www.holidayinsights.com/moreholidays/May/saverhinoday.htm

Documents

RCS Newsletter May 2010_final