MAY 2019

A SPECIAL SECTION FROM

Caring and listening impacts lives

Caring for people is a calling

Zooming in to help our littlest patients

Her dream took off in a helicopter

Stories Andrea Badrigian and Debora SpanoPhotos UMass Memorial

Graphic Design Shiela Nealon

Contents

Special supplement published by the Worcester Telegram & Gazette.Copyright by the Telegram & Gazette Corp.

100 Front Street, 5th floor, Worcester, MA 01608

3 Letter from Justin Precourt

4 Worcester pipeline to nursing

6 Taking care of business with

CipherHealth

7 Zooming in to help our littlest

patients

8 Face-to-face with the opioid

epidemic

9 Always looking for improvements

10 It’s a lifelong learning experience

12 Finding the right team for the new

cardiac and acute care unit

13 Impacting lives by simple caring

and listening

14 Her dream took off in a helicopter

15 Tips for communicating with

elderly

A SPECIAL SECTION FROM

Nisha Vats, RN, medical/telemetry unit, UMass Memorial Medical Center, was recently awarded a DAISY Award (Diseases Attacking the Immune System) citing she was caring, compassionate and a listener. The daughter of a patient who nominated Nisha, said, “Nisha acknowledged our concerns and set out to fi nd answers. She was a patient advocate between my mother and her physicians.”

The DAISY Award is a tribute to nurses in memory of Pat Barnes who experienced phenomenal care during the last eight weeks of his life. The DAISY Foundation was established by his parents, Mark and Bonnie, and his wife, Tena.

At UMass Memorial, a Daisy Award is presented each month to single out those nurses who make a real impact on patients and families.

“I feel honored and privileged to receive this DAISY Award,” said Vats. “I really believe that my job as a nurse is to cushion the sorrows and celebrate the joy every day while I am ‘just doing my job.’ I want to thank my nursing team who has helped all our patients and families heal holistically in any given situation.”

“The compassionate and quality patient care demonstrated by Nisha and the Team on 6 East makes it rewarding to be their nurse manager,” said Sharon Shoar, BSN, RN, CNML, surgical/telemetry unit.

PHOTO COURTESY OF ROB CARLIN

Justin Precourt, CNO, UMass Memorial Medical Center

As I begin my new role -

cer (CNO) at UMass Memorial Medical Center, I could not be more excited about our future. We are

point where technol-ogy and innovation are directly intersecting with patient care. With this, the role of the nurse has never been more important or valued. We serve as the voice of patients, the voice of families and, at times, the voice of advocacy. I am committed to ensuring our nurses lead clinical practice, innovation, research and scholarship to enrich them and the lives of their patients.

As the only academic health system

Massachusetts, UMass Memorial has a dis-tinct advantage over other academic systems throughout New England. Our nurses are actively involved in the innovations driving forward our Medical Center clinical practice and patient outcomes.

Our role, as the only hospital designated as a Level 1 trauma center; the regional refer-ral center for women with high-risk pregnancies and the regional neonatal intensive care unit (NICU) for seriously ill newborns; and a leading center for orthopedic, bariatric, cardiac and cancer care throughout the central Massachusetts, puts our nurses are at the intersection of technology and care.

We have led many innovations but some that deserve special attention are:

patient’s care across the system from primary care to radiology, the OR to the ICU. This reduces redundancy for patients and caregivers, and gives patients access to their health record and testing results.

to capture patient’s needs and requests in real-time to provide a timely response

critical care for stroke and ICU patients, in dermatology we can see patients in community hospitals without making a trip to Worcester, and we are ready to launch a pilot program with the NICU and community hospitals’ labor and delivery. Telehealth is the future of healthcare and nursing is at the center of care delivery and outcomes.

donors back to their normal lives in about half the time

expensive and high-tech environment that allows for quicker recovery, and less invasive approaches.

replacement through the arm instead of open heart surgery

We are also one of the only academic systems in New England that

challenges, but I believe we, as nurses, are at a pivotal point in our history where our future is at its brightest. We have to seize this moment, capitalize on it and elevate the cause of patient-centered care to daring new heights.

Letter from Justin Precourt, CNO

PHOTO: ROB CARLIN

By Andrea Badrigian

People become nurses because they are inspired by someone in the profession, are encouraged to care for others from an early age

or want to give back to their community by caring for its members.

have brought her to where she is today. Add to that her intellect, compassion and respect for others, and she is destined to

UMass Memorial Medical Center “brings ease to patients when they are arguably having the worst day of their lives,” said

emotionally intelligent and composed. That is unique, and particularly important,

get her inspiration? From participation

-ship initiative that raises awareness of the importance of the life sciences in students from underrepresented groups throughout Central Massachusetts.

-

honors student in her freshman year at

University Campus of the Medical Center where I shadowed the nurses and certi-

was unsure at the time what health care-related -

to the University of Connecticut and its nursing

mother’s long-held wish.

Guinea, West Africa, and moved to Worcester from

“My mother had wanted to go into health care, but

the opportunity wasn’t available to her

her older sister is an agency nurse and

“My younger sister and I are 11 months apart, and my mother enrolled us in school at the same time. We did a lot of

-tou said.

UConn was back in her community, at Fairlawn Rehabilitation Center in Worces-

care nursing called to her, bringing her

“I wanted to put the information I gained from nursing school to full use and build upon it. The nursing team here offers years of experience; they’re approachable, and I’m very inquisitive,”

life in my hands, and it’s so important to be always learning and getting the answers to the questions I have.”

Tessa noted that the smaller Memorial

feel. “Everyone, therefore, is involved in patient care with a team focus, and

member, from housekeepers to physi-

of her qualities of compassion and kindness.”

Many of the patients who come to the

population. “It’s important that I can be a role model for other people of color and bring more diversity

“I want to know that my care and my example can make a difference in people’s lives.”

Worcester Pipeline to Nursing:

By Andrea Badrigian

When you’re in the hospital, your entire life is dis-rupted. Not only are you feeling sick and uncertain

about a full recovery, you’re also concerned about the other compo-nents that make up your world. Are the things that are important to you being taken care of, too?

The nursing team at UMass Memo-rial Medical Center knows that hospitalized patients need more than medication; patients need a conver-sation that quickly resolves issues arising during their stay, so they can focus on getting better.

-orsey, RN, are members of a nursing leadership team piloting a new approach to daily patient check-ins.

acting problem solvers, proactively addressing patients’ concerns and freeing up bedside nurses to dedicate their every moment to care.

patient rounding to a whole new

she or Lori learn from a patient that

they send a message to the dietary or housekeeping departments on the spot. “It shows as an email alert, and we can include a photo, say of a

“Cipher has easily shaved more than an hour off the time we used to

info into our computers and making

added. There’s more time now for conver-

sations with patients.“We understand where patients are

coming from, and what would make their stay and eventual discharge

appreciative that the focus is on them, and that it’s coming from leadership responding quickly to their issues.”

that can frustrate or worry a patient, impeding their recovery.

“I learned from an elderly patient that the amount of food we were giving him each day was more than he eats in a week. It was so overwhelm-ing for him and he became agitated,”

immediately sent a message to dietary

thrilled.”“Another patient told me he had

a cat at home and no one was feed-

local agency and they fed his cat. We showed him the pictures they took! It was through my conversation with

him that we were able to discover this concern, solve the problem and keep him in the hospital.”

Cipher patient rounding puts Lori,

the care line of management” while strengthening their partnership with nursing staff. “It’s really a win-win. Nurses come let us know the patients we should visit right away. It’s so helpful to be able to respond quickly when nurses raise this need,” said

With this success, UMass Memorial -

ing across the Medical Center. The technology provides a wealth of data,

-tions and make improvements, such as ensuring that the vital information on white boards in patients’ rooms is complete.

“What’s truly been amazing is the

-isfaction, as measured by a survey that patients take after they leave the hospital,” said Lori. On her unit, the patient satisfaction score increased by

two and a half months of the pilot’s launch.

-ward to the day when another feature of the technology is implemented: “celebration emails.”

“We’ll be able to immediately send an email to any employee a patient praises as a result of their care here,” said Lori, emphasizing how important it is to recognize exceptional nurses.

says is the “understanding that it is

Taking care of business with CipherHealth

PHOTO: ROB CARLIN

By Andrea Badrigian

Nurses in care teams at two UMass Memorial

have been preparing for a new technology designed to enhance treatment when every second counts. The moment has now arrived to launch tele-medicine for newborns requiring intensive care outside of the Neonatal Intensive Care Unit (NICU).

rial Medical Center in Worcester, foresee its

by ambulance from the system’s community hospital to the NICU

nurse manager on the NICU, “the importance of seeing everything that’s happening all at once with a newborn at high-risk,” can’t be overstated. “A visual of the baby and the monitors as they measure breathing and blood pressure, allows a quicker response

This saves time when time is critical during transport.”

Telemedicine provides a “huge advantage,” according to Melody, who is director of maternal-child health at

like having a NICU neonatologist right at your side.”

and nurses in Worcester were on the

phone, hearing from the obstetrician or pediatrician and nurses in Leominster about the state of mom and baby. The ambulance team of respiratory thera-pist, nurse, nurse practitioner and/or neonatal fellow would be updated, if necessary, by phone while en route. With TeleNICU, transport team members can visualize the baby before departing and keep up with the care

teams can connect via a cutting-edge computer system, with enhanced audio and video camera functionality.

“The Worcester team can see where we are with the baby’s oxygen, help

if the baby’s color or respiratory signs

is needed, whether to speed it up or slow it down,” Melody explained.

team “can zoom in on a piece of

equipment or the baby, as well as zoom out so both teams can see each other while asking questions and receiving immediate feedback. The ability to now view the baby before the ambulance heads out, allows the neonatologist, charge nurse and ambu-lance team to discuss and anticipate the care needed when they arrive in Leominster.”

implementation involves compre-hensive simulations in the NICU and the maternity unit at the community

nurses on the 49-bed Level III NICU, provides support for the charge nurses and transport nurses as they begin to use this new technology that will help them make the best decisions about which team members should go and what additional supplies or medications may be needed. At

ton, Melody and her team performed Code White (mother-infant medical emergency) drills, simulating each step to be augmented with the telemedicine component, from delivery through trans-port activation.

“The feedback from the team was great,” said Melody, who manages 60 nurses and experienced the visual technology at work in a prior role at an Oregon hospital. “Telemedicine gives

respiratory team, the pediatric hospitalist, and the nurses to know that what they’re doing in real time is cor-rect because they are

from others who are seeing the baby under their care.”

Clinton, which provides Level 1 maternity care: “Our doctors and nurses will be able to determine with the NICU whether we can keep the baby here instead of transporting the child to Worcester,” she said. “If I was a patient delivering here, I would feel comfortable knowing telemedicine not only supports a transfer of my baby, if necessary, but also the option to receive treatment here if that’s best for my baby.”

“The improvement around accuracy and timing of care is the biggest take

“but the enhanced communication it brings to our care teams builds an even closer relationship with our partners at the community hospital.”

Zooming in to help our littlest patients

By Melissa EricksonMore Content Now

Nurses are always on the front lines of a crisis, including the nation’s opioid crisis. In their capacity as advocates for responsible prescribing of opioids and treatment

of addiction, nurses are battling a public health problem that takes 115 lives a day, according to the National Institutes of

Affecting people across all walks of life, the opioid epi-demic peaked around 2012 and is now experiencing a posi-tive downturn, said

assistant professor in

where she teaches a unique course that focuses on addiction and population health from a “social deter-minants of global health” approach, or the conditions in which people are born, grow, live, work and age and how that’s shaped by the distribution of money, power and resources. The course is part

its graduate and post-master’s nursing programs.

A comprehensive understanding of the complexities of the addiction crisis will allow health professionals to be better prepared to work with and alleviate the suffering that comes with opioid addic-tion, Eldershaw said.

“Nursing is synonymous to patient advocacy; as a nurse, it is our responsibil-ity to advocate for the patient in each and every aspect of their care,” said registered

ing at Greenhouse Treatment Center in

cators, interpreters, the bridge between doctor and patient and anything else we must be to provide quality care and lead them to the road to recovery.”

One of the biggest issues nurses who work with opioid-addicted patients face is dismantling stereotypes of substance abuse.

“We’re also changing what it means to care for patients with an opioid addiction while also managing chronic pain issues,”

pushing a new understanding of addic-tion and treatment, said Kelly Turner, assistant professor and graduate coordi-

“I wish I had this education as a new provider,” Turner said.

Not all pain is manageable, and America has found itself in a precarious predicament where it seems pain-free is a necessary outcome. To achieve this required higher and higher doses of opioids, a sole focus on prescriptions and the insistence that medication is the only option, Eldershaw said.

“This undermines pain management philosophy,” she said.

“Now, there is a stigma attached to opioid use, but for many years patients have been prescribed opioids in high doses and have been told it’s safe. It’s medicine,” Turner said. “Now we think about it differently. There’s been a shift in the message, and some people feel almost betrayed. It can be a high-stress conversation” when talking to patients

who have become addicted to medications prescribed by health professionals.

“On a daily basis, we see patients and families affected by this epidemic grasp-ing at any glimmer of hope that their loved one will one day overcome this disease that has taken over our country,”

Nurses need to have compassion as well

“Those will help get your patients

sion and empathy are what allow you to reassure your patient that it will get better and the horrible feeling they have right now will not last forever.”

The best nurses meet the patients where they are.

“Whether they are in active addiction

addiction is a disease that must be man-

FREE

PIK.COM

Patricia Eldershaw

Kelly Turner

Face-to-face with the

opioid epidemic

Always looking for improvements-

both large and small -

for patientsBy Andrea Badrigian

There is much more behind the warm smile and calming voice of nurse

-

caregiver who loves taking on a chal-lenge, introducing new ideas and raising a hand to

All hospitals are busy places, but it’s the nature

of community hospitals to really buzz. Everyone

the patients, families and visitors who are also their neighbors.

-tains her nursing philosophy: “When you keep the patient at the center of all you do, you can never go wrong.”

than 30 years, practicing in both free-standing clinics and hospitals at times throughout her

her colleagues cover all inpatient and outpatient endoscopy care, with teamwork resulting in a smooth process for patients.

“From the scheduler to the technicians to the nurses and doctors, it takes everyone to make it

includes making sure lips are moistened with

shaven for procedures.

the latest improvements in medical technology and equipment and knowing that sometimes it’s

experience an excellent one.

the endoscopy team has two rooms to work with

introduced the idea to dedicate one room for nurse one-to-ones with each patient, offering privacy for discussions about health history and lifestyle. “I assured the team that I had done this at another

-ality and no interruptions as we talk with patients and answer their questions.”

suggested implementing at the hospital, after

throughout the years. “The masks in particular I knew would be great for us and they have become rewarding products that the team couldn’t do

a patient’s mouth so that they remain protected while the physician can easily insert a scope.

are heading into health care while one is a talented

and is continually challenging herself. In addition to assisting with upper endoscopy, colonoscopy, bronchoscopy, and endoscopic retrograde cholan-

the responsibilities of a semi-retired colleague to serve as a resource nurse at both endoscopy facili-ties. “It’s been a learning curve, but I’m getting a handle on scheduling,” she said. “I make certain to match skills and training to the appropriate inpa-tient or outpatient location.”

Additionally, although new to her, she said yes when a surgeon needed a nurse to assist him twice a month with biopsies, abscesses and melanoma excisions. “I told him I’ve never done this before, so please be gentle with me,” she said, adding, “I

she knows best, there is always something to learn.

a combination of other medical issues as well. It involves discovering and asking those questions that get to the bottom of it.”

With much to think about and many responsibil-

each patient like family, like one of your own.”

By Karen Uttaro, RN, Director, Nursing Professional Development

A nurse’s education doesn’t stop after earning a degree. It is ongoing. The American Nurses Association (ANA)

education expects nurses to continue learning -

constantly uncovers new and innovative interventions which nurses need to apply to their practice. Lifelong and continuous learn-ing is vital to the nursing profession and to our patients.

On an annual basis, nurses at UMass Memo-rial continue their education using several options which are often blended. For example,

via e-learning, which is self-paced and uses computers, and there is a live classroom ses-sion for nurses to demonstrate the required skills. This approach allows for self-paced, on-demand learning.

Last spring, the Memorial Campus opened two new simulation rooms allowing for nurses to learn hands-on skills in a safe environment.

The simulation rooms have been staged to look and feel like an actual patient room. Whether it is used for learning new devices or running mock emergency response drills, simulating actual activities in a safe environment is ideal. This helps nurses apply the skills in a simulated setting while educators identify strengths and

our patients receive the safest care possible.Not all nurses are the same. Nurses practice

in cardiology, pediatrics, surgery and all have

-

years, more than 500 nurses attended onsite

Memorial. Nursing specialties such as medical surgical, critical care, neonatal, leadership and professional development each needs a special

and a national recognition of the expertise the nurse brings to his or her specialty.

for you at UMass Memorial are providing you with the best.

It’s a lifelong learning experience

Director, Nursing Professional Development

UMass Memorial Medical Center

N ursing is one of the few professions where each day you can go to work and make a difference in someone’s life. There are moments in a nurse’s

career when he/she can look back and know

football game or noticing a patient’s condition change and reacting to it quickly and correctly.

As a nurse, you make a difference, everyday,

trusted to care for someone’s most important

-ilege to have this trust and responsibility. As a nurse, I have always respected this responsibil-ity and I have done everything I could to foster that trusted nurse-to-patient relationship.

any day of the year and in any place in the

operating room or on a medical/surgical unit; by teaching; by working in an outpatient clinic or by being a visiting nurse for chronically ill children. There is always a new challenge or pathway ahead for a nurse.

We need to continue to attract people to nurs-ing who believe that caring for people is their

something that you must want to do. The abil-ity to care for people is not something that you learn, it is who you are, and this is what makes you want to care for patients. Key questions that students entering nursing school need to ask themselves are “Why I am here?” “What drives me to do this?” The answers need to come from inside.

Thank you to all nurses for all that you do for your patients everyday!

Nursing is a calling

Chief Operating Officer and Chief Nursing

Officer, UMass Memorial - Marlborough Hospital

By Andrea Badrigian

Frontline caregivers know what’s best for patients, and every member of the team can offer great ideas to improve care. These truths drive modern medicine’s pursuit of new and better ways to deliver health care, and they are the foundation for West 1, the reinvented and recently opened

cardiac and acute care unit at UMass Memorial Medical Center. The blueprint for West 1, part of the Medical Center’s MC2020 revitaliza-

on today’s best practices, including private patient rooms, convenient access to advanced therapies, and spaces that encourage care team collaboration and communication.

dedicated professionals who helped bring the design to reality. They offered valuable input on all the above

team of RNs and nurse practitioners who bring the right mix of experience, positive outlook, eagerness to learn, team orien-tation, and above all, patient-centered focus to West 1.

the right complement of acute

down from a challenge,” said Erin. And because the unit helps accommodate the increasing number of people seeking care at the Medical Center, “the task at hand was to get this unit open

nurse practitioners,” said Nicole. They were on it, with their

knowledge, experience and supe-rior ability to spot caregiving talent.

Nicole, who manages all inpa-

service line coordinator, studied molecular biology and bioinformatics as an undergrad and worked in a UMass

-for her

throughout the cardiology department and took her current role after her mentor

for change and took the leap,” Nicole said.

wasn’t her passion. “My mom’s a nurse, and when it’s in your blood, it’s in

pool manager. This role strengthened her aptitude for interviewing and onboard-ing new nurses as others left the pool for positions on the hospital’s units. Erin

currently manages more than 80 nurses and two units.On West 1, the 30 bedside nurses and six inpatient nurse

practitioners Erin and Nicole brought on board are themselves transforming the patient experience.

This impressive mix of new and seasoned nurses proves that the two managers’ efforts more

than hit the mark.

the unit’s opening already show patient satisfaction is high, according to Erin.

“We’re excited about the feedback, particularly regarding communica-tion between nurses and patients.”

advanced features, especially the private rooms, provide everyone a boost.

A positive approach and team cohesiveness are ever-present, Nicole said. “Our nurses always ask us, and each other, ‘What can

I do to help?’” “From the start, every depart-

ment that would have anything to do with West 1 was engaged,” Erin

noted. “Our goal was to do things right here, from the beginning. We wanted to

hit it out of the park.”Nicole agreed. “Multidisciplinary rounds,

provider/team collaboration, bedside engage-ment of patients to empower them in their own

care. This was the spirit with which this unit opened.”

Finding the right team for the

NEW CARDIAC AND ACUTE CARE UNIT

By Debora Spano

L eading a team of 21, including six nurses, Gretchen Acevedo is proud of the interdisciplin-ary team’s patient-centered care

conduct face-to-face assessments with clients, and all clinicians have expertise in emergency evaluations with knowl-edge of medical, legal, emergency, and community services available to indi-viduals served.

“I didn’t understand addiction and mental health when I was working in the operating room (OR), but I found my true passion when I came to Community

impact people and save lives by simply caring and listening,” said Gretchen,

-tion Urgent Care.

“I can train anyone to do a client assessment, but I cannot train compas-sion,” said Gretchen. “It took me a year to fully staff this clinic because each employee had to be a true caregiver.

members have left in two years, and two of them are nurses who moved to other positions within UMass Memorial.”

one of three pilot programs that were -

a walk-in clinic for behavioral health addiction emergency services. And, it’s

emergency services including detox, post-detox and transitional support

from Central Massachusetts, though they do care for people throughout the state.

Addiction Urgent Care helping those in the Central Massachusetts community, data col-lected is shared with

overcome barriers to addiction treatment.

Whether a client needs counseling, addiction treatment, connection to ser-

and a shower, it’s all delivered without

question asked of visi-tors is “What brought you here today?”

because they are strug-gling with addiction and/or in a mental health crisis. They’re con-nected to services anywhere in the state,

outpatient programs. “I meet people where they are at,” said

Gretchen. “If they are not ready today, we’ll be here when they come back. I don’t care how often they come back; it means they are alive, and there is still hope.”

Gretchen worked in the OR at UMass

there so she could learn more about

struggled with addiction, and she didn’t

recovery and doing very well.)

“I was that mother, wife, sister, loved one of someone struggling with addic-tion, and there was no one who could help me,” said Gretchen. “I had no idea of what to expect or how to help.”

people can speak with staff to learn about what’s happening to their loved one. It’s scary for the client but also for family and friends who don’t know how to help. The conversation is meant to soothe and to assure that their loved one

but is being helped with compassion.“I go to bed a night thinking ‘what am

I going to do in our community to make it better for my kids?’ Working with the

Impacting lives by simple caring

and listening

“I didn’t understand addiction and mental

health when I was working in the operat-

ing room (OR), but I found my true passion when I came to Com-

munity Heathlink (CHL). I am able to directly impact people and

save lives by simply caring and listening,” said Nurse Gretchen

Acevedo, director, CHL Behavioral Health Addiction Urgent Care.

By Debora Spano

I t was her dream in nursing school to take care of the most critically

before, Kim Walker, RN, knew this is what she wanted to do with her life.

After 15 years as a nurse in the emergency department, Kim’s dream

Life Flight Air Ambulance team at

and six other nurses rotate through the

in one shift, which is not unusual, but it had my head spinning. Though I had

the real thing. I expected it would be different from an acute care setting of the emergency department but I have to admit, I was overwhelmed for the

A typical call can take three to four hours. It starts with the telephone call to Life Flight. When the call comes

be done and who is going to do it. No

helicopter and all questions will be answered once the vehicle is in the air.

After landing, there’s the assessment and stabilization of the patient, then transport to hospital. Once the patient is transferred to a physician’s care, the Life Flight team checks and cleans all the equipment, restocking whatever was used and repacks for the next call.

All medications, bags and

equipment are also checked twice per

for emergency response, the air ambu-

treat heart rhythm problems, venti-lators to help with breathing, heart monitors, oxygen and intravenous

“When you’re out on a call with

“It was a huge transition for me to be so independent after working as a

patient’s health and safety. We do have a Life Flight medical director who we can call from the scene or the helicopter to double-check our treat-ment plan.”

Though the Life Flight team is based at UMass Memorial Medical Center in Worcester, they actually take calls from all of Massachusetts, including the Cape and Islands, plus

cut and Rhode Island.

answered by the air ambulance, weather like snow, rain or fog, can

backup plan with two private ambu-lance services who rotate on-call coverage by the week.

huge responsibility,” said Kim. “We meet people on what could be the worst day of their lives and I have to know that I gave them every chance that could be had. That’s what keeps me going.”

reached her dream, they said, “Okay, great, but…are you sure?”

Her dream took off in a helicopter

By Melissa EricksonMore Content Now

Learning how to communicate effectively with aging health-care consumers is a fundamental skill for the nurses who treat them.

Laura Reyher, instructor of nursing at West Texas A&M University, has dedicated almost her entire career to providing care to and teaching others how best to care for geriatric patients.

“Nurses can make a big difference in their geriatric patients’ lives with the right communication skills,” she said. “We can help prevent com-plications, reduce the likelihood of being readmitted, promote recov-ery, improve their ability to care for themselves and help keep them independent as long as possible.”

One of the challenges is that geri-atric patients may be experiencing a variety of issues, including pain, chronic illness, disability, sleepless-ness or fear of becoming dependent, Reyher said.

Don’t assume these issues will make them unable to comprehend what a nurse is saying. If they don’t have cognitive problems, “geriat-ric patients can always learn new information, but they usually need a little extra time to process everything,” Reyher said.

Recognize that an older patient might have sensory challenges. If he’s lying in bed, he may have taken off his glasses or hearing aids, Reyher said.

Make sure patients are in a good state to listen to your directions. Check to see if they got enough sleep the night before. If a patient was up most of the night, she may need a nap before you talk with her, Reyher said.

“Speak slowly; do not shout,” Reyher said. Many women have higher-pitched voices, which can be more difficult to hear. Use a lower tone of voice and add extra breath-force in voice when speaking, Reyher said.

Remember that medications can cause drowsiness, foggy thinking and confusion, and that anesthesia can have prolonged effects on a patient’s thinking abilities, Reyher said.

A few more of Reyher’s tips to communicate effectively with geri-atric patients:

restroom before your talk.

the room with light on the nurse’s face. Don’t sit with your back to the window. Turn down the television or close the door to limit background noise.

where they can easily see you.

or acronyms.

include only necessary information writ-ten at about a fifth-grade level. Make sure there is plenty of white space with bullet-point information in order of importance. “Health-care information can be like a for-eign language regardless of their educational

level,” Reyher said.

large print on medicine bottles. “Medica-tion errors are the leading cause of emergency room visits for geriatric patients,” Reyher said.

sharing important information to help with understanding and to spot gaps in knowledge. For example, after demonstrating how to change a wound dressing, ask the patient to show you how to do it.

and/or hopelessness.Take your time. The tone of your voice

and the look on your face and in your eyes can demonstrate to a patient that you care about him.

family nearby and if they would like their family to be present when you share informa-tion. They can be the extra set of eyes and ears to help absorb the information.

“As a nurse, it’s helpful to recall a senior adult in your life who was special to you and think about how you would want them

about their lives, such as where they grew up, what they did for a living or if they have grandchildren.

“Never forget the power of touch. Geriatric patients often feel untouchable and that no one cares for them. The nurse’s gentle touch on their hand or shoulder can tell a patient that they really care about them,” Reyher said.

HOPE’‘GIVE

Laura Reyher