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Department Spotlight: Acute Care Rehab Therapy
Being admitted to the hospital is never easy. Being admitted for a traumatic injury can be even harder. Whether it's learning how to walk again or powering through a new speech therapy routine, recovering from an injury that may affect the course of your life can be daunting. But it doesn’t have to be, thanks to the Acute Care Rehab Therapy team at Renown Health. The smiling faces of the Acute Care Rehab Therapy team at both Renown Regional Medical Center and Renown South Meadows Medical Center will make you see that there is a light at the end of the tunnel. Your dedicated physical therapists, occupational therapists and speech language pathologists are here to serve you and place you back on the right path to recovery and function. The Role of Acute Inpatient Therapy The Acute Care Rehab Therapy team comes in at a critical juncture in a patient’s care process after hospital admission. As one of the primary rehabilitation partners on a care team, these dedicated therapists are here to maximize every patient’s safe and independent living before they set off back home – all while reducing the risk of hospital readmission. “As physical therapists, we address musculoskeletal deficits and assess a patient’s current function after acute injury or illness from their baseline and develop a plan for functional recovery,” said Kristie Eide-Hughes, Physical Therapist at Renown Regional. “We also use our clinical expertise to assist with the discharge process and make sure each patient has the best durable medical equipment the first time around, removing the guesswork.” “On the occupational therapy side, we work with patients to facilitate their independence with basic life skills, such as dressing, bathing and using the restroom,” added Jeanne Clinesmith, Occupational Therapist at Renown Regional. “In the pediatric setting, we help babies and kids get back to what they were doing before they came into the hospital,” continued Rhonda Yeager, Pediatric Occupational Therapist at Renown Regional. “In the NICU specifically, we support the development of babies, trying to prevent problems from worsening. It’s nice to be a source of positivity in an otherwise intimidating situation.” The role of therapy in this setting reaches all ages, from babies in the neonatal intensive care unit (NICU) to adults approaching end-of-life care. Every therapeutic approach is tailored specifically to each patient. “Therapy is more of a habilitative approach for infants in the NICU, while it is more of a rehabilitative approach for kids and adults following injury or illness,” said Sara Carolla, Physical Therapist at Renown Regional. Each team member in the Acute Care Rehab Therapy department is dedicated to each patient, helping them make progress from start to finish and giving them the tools to succeed along the way. “I enjoy the variety of the patients we get to see and the ability to see them make gains from the wonderful treatment they get in the hospital from my team,” said Kelly Schwarz, Occupational Therapist at Renown South Meadows. “We provide education as each patient’s acute issues evolve,” added Nicole Leeton, Speech Language Pathologist at Renown Regional. “One of my favorite parts of my work is the patient and family education aspect, and that includes other healthcare provider education as well. It’s a moving picture.” Moreover, every team member gives each patient tools to learn how to be themselves again and empowers them to continue striving for the best possible result of their therapy “We get the opportunity to make a person’s bad experience in life better even by spending one session with them, giving them the keys to unlock something that they didn’t think they had the ability to do,” said Dana Robinson, Occupational Therapist at Renown Regional. On the Road to Independence Our dedicated therapists in the Acute Care Rehab Therapy team set the stage for a patient’s recovery process after trauma, showing them their potential for independence. With a multitude of patients coming into the hospital with many degrees of medical complexity, each day is different while the end goal is always the same: to optimize function as early as possible while overcoming any barriers and paving the way for a comfortable and effective quality of life. “Early intervention is a big piece,” said Nicole Leeton. “Us seeing patients early can get them recovered and independent more quickly and help prevent future illness and injuries. For example, in speech therapy, getting in early and facilitating communication skills for patients with impaired speech can make a huge difference.” Acute Care Rehab therapists dig deeply to see the whole picture of each patient’s situation to foster their independence – their history, social skills, support system and more. “Sometimes, we are the difference between independence and dependence,” said Dana Robinson. “We are the eyes and ears because we have so much time with the patients. Our team is extremely collaborative and develops a great rapport with patients, so they feel comfortable telling us everything going on with them.” “For kids, we teach parents ways they can help their kids by setting up their homes and the equipment they need to succeed,” added Rhonda Yeager. According to the team, one of the biggest keys to independence is repetition. A continual flow of getting up and trying again is crucial for recovery. “Repetition helps people regain their quality of life back sooner and control their recovery process,” said Megan Hough, Physical Therapist at Renown Health. “Helping people continue to get stronger and more independent makes my job so rewarding,” added Sam Brown, Physical Therapist at Renown Regional. Knowing that they have made a difference and help shape a patient’s overall development inspires each therapist to never give up, regardless of how difficult an injury presents. There is no set schedule for recovery, and the therapists are always in the patient’s corner. “This team has the most passionate, caring and dedicated individuals that I know,” said Kendra Webber, Manager of Acute Inpatient Rehab Therapy Services at Renown Regional. They give 110 percent to every patient every time to ensure they have what they need to regain function and independence.” “By tailoring therapy to the individual, the bounds are virtually limitless for what we can accomplish,” added Dana Robinson. It Takes a Village Since acute inpatient therapy is never a one-size-fits-all approach, it truly takes a village for this team to move the mountains they do for patients every day. These teams are fact-finding masters, gathering all the necessary information from the patient, their family and their care team to figure out their precise needs. “We are a consistent presence for our patients, identifying a lot of different needs and meeting those needs to help patients grow in their treatment process,” said Kelly Schwarz. “By collaborating with each patient’s diverse care team, we are able to employ the clinical judgment to help patients overcome physical, emotional and environmental struggles and set them up with the proper resources once they leave our setting.” “Our team has steady communication with physicians, nurses, acute care technicians, respiratory staff, physician assistants, case managers and more to ensure the best possible care,” added Jet Manzi, Physical Therapist at Renown Regional. Constant communication and collaboration are also necessary beyond the acute treatment process. These skills are vital in order to facilitate discharge planning, and the Acute Care Rehab therapists are an essential resource in the discharge process alongside our Hospital Care Management team. “Often times, a patient’s family needs a lot of guidance in helping their loved ones determine the next level, and we help them navigate those steps and the resources available to them,” said Mark Stumpf, Occupational Therapist at Renown Regional. “And it’s all a team effort.” “Our therapists are the most committed, generous, hardworking people,” added Courtney Phillips-Shoda, Supervisor of Rehab Therapy Services at Renown Regional. “Despite being short-staffed, we come to work every single day and give everything to our patients. They are the priority.” If you take away one thing, know this for certain: Renown’s Acute Care Rehab occupational, speech and physical therapists will always be there to help patients continue on a positive trajectory to physical, mental and emotional recovery. “Whether you are a patient or a provider, if there is a problem, never hesitate to reach out to us,” said Nicole Leeton. “We are always receptive to anyone seeking our help.” With the Acute Care Inpatient Therapy team on their side, a patient’s journey to recovery is only just beginning.
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The Road to Recovery Close to Home
Meet Connor Smith Life was hectic for Connor Smith. He had just finished at the top of his class at both the fire academy and paramedic school and was looking forward to starting work in northern Nevada. It was winter 2019, and he was ready to have some fun. The plan was to ride ATVs at Sand Mountain with his brother Cody, dad Lance and some friends, but a jump would change everything. Connor’s ATV took off but landed awkwardly, and he remembers immediately knowing he was paralyzed. Connor’s mom, Dana Shugar, was at home when she received the upsetting call from Cody, who told her he had an accident. Connor was flown to Renown Regional Medical Center, the area’s only Level II Trauma Center. After a seven-hour emergency surgery, Dana learned that Connor would live but only had a slight chance of walking again due to a spinal fracture. “The surgeon saved his life. It’s amazing how your life can change in a matter of seconds,” she said. Once his condition stabilized, Connor moved to the Renown Rehabilitation Hospital and began physical rehabilitation. “Thank God for the people at rehab,” Dana said. “Dr. Pence, the therapists, nurses and all the employees were a wonderful support system, explaining everything and answering all our questions. The kindness they showed got me through.” Connor agrees, calling the Renown rehab team nothing short of amazing.
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Three Emergency Room Options for You and Your Family
Renown Health has three emergency rooms open 24 hours a day, seven days a week, ready to serve our community. We checked in with Amy Hawkins, Manager of Clinical Nursing at Renown South Meadows, to learn more about the emergency room experience and how each can accommodate your emergency care needs. 1. Renown Regional Emergency Room The emergency room at Renown Regional Medical Center is the only Level II Trauma Center between Sacramento and Salt Lake City, treating more than 80,000 ER and trauma patients annually. Services Offered: This location offers immediate emergency care covered by general surgeons and coverage by the specialties of orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology and critical care. In addition, tertiary care needs include cardiac surgery, hemodialysis and microvascular surgery. (Patients may be referred to a Level I Trauma Center.) Renown Regional ER Location 2. Renown South Meadows Emergency Room South Reno is expanding, and so is Renown South Meadows ER! Exciting transformations are happening across this campus, including the new 121,000-square-foot specialty care center and upgrades to the existing medical center—expanding care to our patients. Added benefits to the more intimate setting at South Meadows: Smaller ER also means more personal experience. The team traditionally has more time to spend with each patient at the bedside. A smaller campus means convenient parking, as the ER is just outside the front entrance; however, patients are reminded to follow marked road signs when approaching the campus during construction. Most patients arrive by private vehicle versus an ambulance, so we are very accustomed to thinking quickly on our feet. Benefits to new construction: A new Cath lab will allow us to treat patients experiencing a heart attack and needing immediate intervention to open vessels in their hearts. Additional lab and imaging capabilities for our patients Services Offered: This location offers immediate emergency care staffed with board-certified emergency physicians. Patients can expect one-on-one interactions with trusted providers and shorter wait times. All emergency room services are open during construction, and patients are reminded to follow marked road signs when approaching the campus. South Meadows ER Location 3. Renown Children's Hospital Emergency Room This location offers immediate emergency care, with pediatric specialists always on staff. In addition, the Children's ER lobby is ideal for our littlest patients, with a child-friendly atmosphere and vibrant colors to help decrease the anxiety accompanying emergencies. Medical equipment is sized just for kids, and we offer a distraction machine, games and movies to help children cope with what can be a traumatic experience, like getting an IV. In addition, we have Child Life Specialists available to provide emotional support to both children and their families. When to Bring Your Child to the ER: Allergic reactions Asthma attacks Baby under three months old with a temperature higher than 100.4 degrees Fahrenheit Broken bones Burns Choking or poisoning Difficulty breathing Eye injuries Fainting, dizziness and confusion Head injuries Heart attack Rashes Seizures Severe bleeding Severe headache Severe pain Skin infections Stitches Stroke Venomous stings and bites Renown Children's Hospital Location
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Let Those Ears Breathe! Increased Headphone and Ear Bud Use Leads to Ear Wax Build Up; Renown Urgent Cares Offer Relief
Wearing headphones or earbuds is a daily activity for many of us. Listening to music, podcasts, meetings, phone calls; there are endless reasons to stick them in or on your ears. However, if your ears start to feel plugged, full; or you feel dizzy, lightheaded or hear ringing in your ears; you may be experiencing ear wax build up where your ear canals become blocked and affect your hearing. If you’ve tried to clean your ears (please don’t use Q-Tips®), but still have symptoms, pain, or hearing loss, it’s time to see your physician, nurse practitioner, physician assistant or visit Renown Urgent Care. “Ear wax isn’t dirty. It’s normal,” says Ryan Bristol, APRN, Advanced Practitioner of Nursing at Renown Urgent Care. “Ears are self-cleaning miracles, and naturally clean themselves with the help of jaw movement and skin migration. However, wearing headphones or earbuds for hours blocks earwax from naturally draining from the ear. Additionally, the dirt and bacteria that these headphones often carry can cause an infection on their own, and earwax buildup can trap dirt in the ear and block the canal completely. The snug fit of headphones can create a conducive environment for the accumulation of ear wax. It's crucial for individuals to be mindful of this and take necessary precautions to prevent complications." “Individuals experiencing symptoms such as ear pain, decreased hearing, or a sensation of fullness in the ears are encouraged to seek evaluation and treatment at their nearest urgent care facility,” says Rahul Mediwala, MD, CEO of Renown Medical Group. “By addressing ear wax build-up promptly, individuals can mitigate the risk of complications and maintain optimal ear health. Fortunately, prompt, pain-free and effective treatment is available at Renown Urgent Care. We offer professional ear wax removal procedures performed by trained staff, providing relief to those experiencing discomfort or hearing impairment due to excessive ear wax build-up.” The experts at Renown Health gave us some background. What is ear wax and why is it healthy? Ear wax is a protective substance called sebum made of fat, skin cells and sweat. Ear wax is produced by glands in the ear canal. It helps protect the ear from germs and dirt and prevents the sensitive skin of the ear canal from becoming irritated. It is normal and healthy to have a thin lining of ear wax on the canal. Ear wax will sometimes accumulate and move to the outer ear canal, where it would typically fall out or be wiped away. This is also normal. When should I seek care? An ear canal has too much wax if the ear feels plugged or hearing is affected. The accumulation of wax happens very gradually, so ears do not necessarily feel waxy. The problem is usually noticed because of changes in hearing. Over the counter remedies may offer relief. However, in some cases, the earwax has built up or become impacted, and ears need to be treated. What is the treatment? At Renown Urgent Care, we offer professional ear wax removal procedures performed by trained staff, providing relief to those experiencing discomfort or hearing impairment due to excessive ear wax build-up. Wax is flushed from the ear canal using a syringe filled with warm water and saline or diluted hydrogen peroxide. Most patients find the procedure is fast, pain free and effective. How can I prevent earwax buildup from headphones and ear buds? Most people who wear headphones or use earbuds occasionally or intermittently don’t have difficulties with excessive ear wax. Wax accumulation also depends on the size of the ear canals and the productivity of the oil glands in the ear canal. You can choose to use over the ear headphones. If you prefer to use in-ear headphones, the best modes of excess ear wax prevention are to: Clean headphones and earbuds regularly with a cloth or disinfectant wipes; Avoid sharing headphones or earbuds with other people; Take breaks from headphones and earbuds so ears can breathe and get back to normal; Pay attention to your ear health. Should we talk about Q-tips? Yes! Q-tips (and similar products) are rarely helpful for managing ear wax. The cotton on the end of the Q-tip is usually unable to pull the wax out of the canal. Worse, they can push the wax deep inside the ear canal, and it can end up impacted. Where should I seek care? Individuals experiencing symptoms such as ear pain, decreased hearing, or a sensation of fullness in the ears are encouraged to seek evaluation and treatment at a medical facility. By addressing ear wax build-up promptly, individuals can mitigate the risk of complications and maintain optimal ear health. Renown Urgent Care sees patients 365 days a year for medical concerns that are urgent but not life-threatening at many locations across northern Nevada. Book ahead to reserve a time slot at one of our ten urgent care locations. If you do not see time slots that work for you, you can still go to any location that has "walk-ins available" listed. For more information, or to book an appointment, go to renown.org/Health-Services/Urgent-Care. Renown Health is the region’s locally governed, not-for-profit integrated health care network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,200 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health.
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Got a Cough, Runny Nose, Sore Throat and Fever? It Might Be RSV Virus
Renown Urgent Care team prepares you to stay alert and safe this season and is available for medical assistance, 7 days a week at 11 locations across northern Nevada. In June, staffers at the Centers for Disease Control and Prevention sent a Health Advisory requesting that clinicians and caregivers watch for the respiratory syncytial virus, usually known as RSV, an infection that puts thousands of toddlers and senior citizens in the hospital each year with pneumonia and deep lung inflammation. According to the CDC, RSV results in roughly 58,000 hospitalizations and 100 to 500 deaths each year among children under five as well as 177,000 hospitalizations and 14,000 deaths among adults 65 and above. RSV was cropping up in 13 southern and southeastern states, the agency warned, and clinicians should test for the virus if kids showed up sneezing, wheezing, or with poor appetites and inflamed throats. Usually a winter infection, RSV is usually gone by June. Instead, this year, it is spreading—and has since continued to spread across the country, and to northern Nevada. “We know that many of the good hygiene habits we developed to defend against COVID-19 disrupted the viral landscape over the past 16 months, suppressing infections from almost every pathogen. Now RSV’s out-of-season return tells us that we need to continue to be on the alert,” says Robert Thole, MD, a physician with Renown Urgent Care. “We are surprised to be seeing so many kids with RSV right now.” “We ask parents and caregivers to keep a watchful eye out for a respiratory syncytial virus (RSV) infection. Symptoms are usually mild and resemble those of the common cold. RSV infection sometimes leads to bronchiolitis, pneumonia, or both. Symptoms of these complications include; difficulty breathing; wheezing; coughing that is getting worse; lethargy, increased tiredness, decreased interest in surroundings, or loss of interest in food,” explains Dr. Thole, who is board certified in family medicine. Catching and spreading the virus People with RSV infection may spread the virus through their secretions (saliva or mucus) when they cough, sneeze, or talk. You can catch the virus by: Touching an object or surface contaminated with the virus and then touching your nose, eyes, or mouth without first washing your hands. The virus can survive for more than 6 hours on countertops and other hard surfaces, such as doorknobs, and for 30 minutes on hands, clothing, or tissue. Close contact. If an infected person coughs or sneezes near you, you could breathe in RSV that is in his or her saliva or mucus. The virus spreads easily in crowded settings, such as childcare facilities, preschools, and nursing homes. Children attending school often spread the virus to their parents and siblings. The incubation period—the time from exposure to RSV until you have symptoms—ranges from two to 8 days but usually is 4 to 6 days. People are most likely to spread the virus within the first several days after symptoms of RSV infection begin and remain contagious for up to 8 days. Babies and young children may spread the virus for at least 3 to 4 weeks. Most children and adults feel better after a week or two. Treatment For an otherwise healthy child who has symptoms of an upper respiratory infection, such as a cough or runny nose, home treatment usually is all that is needed. It is important to watch for signs of complications, such as dehydration. Watchful waiting may not be a good choice when your child with an upper respiratory infection has an increased risk for complications. Watch your child closely if there are symptoms of an upper respiratory infection. If symptoms get worse or new symptoms develop, see a doctor right away. There is no vaccine and few specific treatments aside from supportive care, such as administering pain relievers and fluids. In the most severe cases, some children or adults might need additional oxygen. Not just in kids, older adults at risk Dr. Thole explains, “RSC is not only seen in children. Adults older than 65 have an increased risk of complications following infection with RSV. Pneumonia is a particular risk, especially if other health problems exist, such as chronic obstructive pulmonary disease (COPD) or heart failure. It may take older adults longer to recover from RSV infection and its complications than people in other age groups.” Call 911 or other emergency services immediately if: Your child has severe trouble breathing. Your child's breathing has stopped. Start rescue breathing. Call your doctor now if your baby or child has moderate trouble breathing. Call a doctor if your child: Breathes slightly faster than normal and seems to be getting worse. Most healthy children breathe less than 40 times a minute. Has cold symptoms that become severe. Has shallow coughing, which continues throughout the day and night. Has a poor appetite or is being less active than usual. Has any trouble breathing. Hospitalization Doctors sometimes give a monoclonal antibody treatment to high-risk babies throughout the respiratory season to prevent them from catching the virus or developing a severe infection. Some hospitals have started to increase use of the prophylaxis in response to the recent uptick in RSV cases. “Those kids were being protected,” said Kristina Deeter, MD who was quoted in a July 1st Wall St. Journal article on this topic. Dr. Deeter is a pediatric intensivist and medical director at Renown Children’s Hospital Pediatric Intensive Care and Hospitalist Medicine. Dr. Deeter, who also oversees Pediatrix Medical Group’s critical-care team in dozens of pediatric intensive care units across the country, said hospitals are also considering taking additional precautions in the neonatal intensive-care unit similar to some wintertime protocols. At Renown Children’s Hospital, there were no children hospitalized with RSV throughout the winter season, Dr. Deeter said, when there are normally hundreds of cases in our county- many of which do not need to be hospitalized.” A total of 31 cases have been reported in Washoe County, Nev., since April, and 26 of those occurred within the past three weeks. Preventing infection To prevent infection, or at least to mitigate them, wear masks, stay home when sick, and washing hands could make a difference in how the next viral season unfolds. For more information on RSV, visit renown.org. Renown Urgent Care Renown Urgent Care is available for medical assistance, 7 days a week at 11 locations across northern Nevada providing treatment for a wide range of minor injuries, illnesses and medical concerns that are urgent but not life-threatening. If you require same-day medical attention, you can avoid the long wait times and high prices of the emergency room at 13 convenient sites, including Reno, Sparks, Carson City, USA Parkway, Fallon and Fernley. You can walk-in or book ahead online. About Renown Health Renown Health is a locally governed, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to improve the care and the health of our community. For more information, visit renown.org.
Read More About Got a Cough, Runny Nose, Sore Throat and Fever? It Might Be RSV Virus
