Outcomes December 2017 Newsletter

6 Nursing Notes: Gladys D’Souza — A Hero Among Us Gladys D’Souza, MSN, MBA , has served as Barlow Respiratory Hospital Chief Nursing Officer since 2013 and previously held the title of Clinical Director, Nursing. As an administrator, she had imagined her bedside days were behind her when an announcement on her flight home from a conference asked for help with a passenger who was having difficulty breathing. “I always imagined I would be afraid to help in that sort of a situation. I have the knowledge, but I didn’t feel I had the skills. And there I was, volunteering to help without even thinking.” Gladys made her way to the passenger’s side and felt for a pulse. “It was very weak, almost nothing. And breathing was very faint. I was afraid we were going to lose him.” She helped to make the passenger comfortable, and asked the flight crew for medications and equipment. Slowly, the passenger’s heart rate normalized and his breathing settled into a stronger rhythm. Gladys stayed with him for the remainder of the flight and until Emergency Medical Technicians transported him to a local hospital. Despite her fear Gladys stepped forward to help.“When you are a nurse, you can’t help yourself, you just have to help,” she said. The airline thanked her with a note and a flight voucher. At Barlow, we thanked Gladys for being a hero among us and for reminding us that our mission to make a positive difference is with us everywhere we go. Barlow Respiratory Hospital RN Residency Program Awarded UniHealth Foundation Grant Barlow Respiratory Hospital Nursing Residency Program has been awarded a $33,600 grant from the UniHealth Foundation to support in-depth training to prepare new graduate nurses with the specialized skills needed to care for medically-complex and ventilated patients. “Nursing is essential to the exceptional level of patient care that Barlow Respiratory Hospital is known for.” The Program provides hands-on acute care experience and education. A classroom component includes specialized training to focus on serving patients with respiratory illness. Program participants care for Barlow Respiratory Hospital patients at all three locations; Barlow Main in Los Angeles, Barlow at Valley Presbyterian Hospital in Van Nuys and Barlow at PIH Health Hospital–Whittier. Barlow’s Nursing Residency Program serves to deepen our nurses’ level of expertise. In addition to registered Nurses, our professional multidisciplinary healthcare team includes Board Certified Physicians, and Licensed Respiratory, Physical, Occupational and Speech Therapists. Barlow Nursing Staff with Foundation Grant Check I guess I saved a life. 7 Physician’s Corner David R. Nelson, MD , Medical Director, Barlow Respiratory Hospital Scott A. Sasse, MD , Pulmonary Medical Director, Barlow Respiratory Hospital Barlow Respiratory Hospital is a unique place to practice medicine. The hospital is small, only 49 beds on the main campus in Los Angeles. The hospital was founded in 1902 as a Tuberculosis Sanatorium and remains surrounded by nature, despite its location only a few miles from downtown. At Barlow Respiratory Hospital, our interdisciplinary staff is tight-knit and works as a team. Our patients are primarily transferred to us from intensive care units at other facilities in the surrounding area. We have developed an effective methodology for in-line use of the Passy Muir ® Valve with mechanically ventilated patients. Physiologically, in the appropriate patient, the valve improves the ability to cough and clear the airways. It reduces the chance of aspiration and provides protection by decreasing the chance of bacteria lingering above the tracheostomy. Equally important is the psychological impact of being able to communicate. Patients on mechanical ventilators find it very difficult to communicate and that can lead to a great deal of frustration. All of that just goes away when they can talk – when they have a voice. When the Passy Muir Valve is inserted for early intervention and use with mechanical ventilation, it makes the patient happy, and it makes the family more content. In some cases, we can insert the valve into the circuitry of the mechanical ventilation in the morning, and that very same day, the patient can pick up the phone and talk to a family member who has not heard their voice for weeks, sometimes even months. Physicians’ Perspective on The Passy Muir ® Speaking Valve Each of us has seen the benefit of the Passy Muir Valve. Being able to communicate needs and feelings is very beneficial. It provides patients with a different perception of their physicians. Physicians are seen as helpful to their healing process. Typically, when patients see a physician coming, they sometimes cringe, expecting something that is going to hurt – another needle or another tube. But with the Passy Muir Valve, we are able to offer our patients something of medical value that also is painless and has the benefit of lifting their spirits. Communication is not only good for our patients, it is also good for us, as physicians. Patients can tell us what is going on with them. Both of us have a great deal of experience with using the valve and seeing its benefits. Each of us also has seen the benefit of the more aggressive use of the Passy Muir ® Valve through early intervention with patients who are mechanically ventilated. For many, many years, we had used the Passy Muir Valve when a patient was close to finalizing the weaning process or was completely off the ventilator. We have now made a change in our approach to when we introduce the speaking valve. Now, it is in our TIPS © Weaning protocol to try the patient on the valve much earlier, while still on the ventilator. We are very fortunate that our team includes exceptionally experienced Respiratory Therapists and Speech Therapists. They are proactive in identifying patients who are good candidates for early introduction of the valve. Overall, both of us are convinced of the positive physiological and psychological impact of the Passy Muir Valve for our patients. * The full article appeared in the Fall 2016 issue of Talk Muir. Reprinted with permission. From our point of view, the Passy Muir Valve offers patients a feeling that they can control their destiny. It gives the patient a sense of well- being, an ability to participate in their medical care, and restores a sense of independence. . Scott A. Sasse, MD (L) and David R. Nelson, MD (R)