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    • Women's Health
    • Prevention and Wellness
    • Screening

    The Expanded Role of OBGYNs in Women's Healthcare

    Obstetrician-gynecologists (OBGYNs) see patients from menses (the monthly menstrual cycle that occurs as a part of the female reproductive system), pregnancy and childbirth through menopause and play a pivotal role in managing reproductive health and overall wellness. Dr. James Alexander with Renown Women's Health explains. "As experts in women's health, we are uniquely positioned to recognize subtle changes or symptoms that might indicate broader health issues. This comprehensive approach allows us to serve as a valuable first touchpoint for various health concerns." Preventive Screenings: A Proactive Approach One key aspect is an OBGYN's ability to recommend preventive screenings based on your symptoms, age, lifestyle and medical history. For instance, lipid screenings are critical for monitoring cholesterol levels, which can be a significant factor in women’s heart disease. An OBGYN keeps up with the current guidelines for routine screening as well as in women with risk factors such as high blood pressure, diabetes, or a family history of heart disease during your visit. By identifying risks and abnormal screening early, they can collaborate with you to implement lifestyle changes or treatments to reduce your risk of heart conditions. Schedule Your Screening Appointment Make an Appointment by Phone: 775-982-5000

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    • Women's Health
    • Prevention and Wellness

    Understanding the Reasons Behind Heavy Menstrual Cycles

    While menstrual cycles can be an annoying inconvenience for many women, heavy bleeding (menorrhagia) is not normal and can disrupt your life. A few days of heavy flow at the start of your period is usually nothing to worry about. However, if you’re frequently experiencing very heavy periods, you should discuss it with your gynecologist or primary care provider.  Dr. Megan Fish, an OB-GYN with Renown Women’s Health, discusses various reasons, evaluation and treatment methods when it comes to heavy menstrual cycles.  What is classified as heavy menstrual bleeding?  The American College of Obstetricians and Gynecologists considers heavy bleeding to be any of the following signs: Bleeding that lasts more than 7 days. Bleeding that soaks through one or more tampons or pads every hour for several hours in a row. Needing to wear more than one pad at a time to control menstrual flow. Needing to change pads or tampons during the night. Menstrual flow with blood clots that are as big as a quarter or larger. What are the most common reasons for heavier periods?  A variety of reasons why someone might have heavy periods. Fortunately, most of these problems are treatable. Because each woman's period is unique, only a doctor can definitively determine the cause of your heavy periods. Some of the most common issues that cause heavy periods include: Hormone imbalances such as anovulation, thyroid disease and Polycystic Ovary Syndrome (PCOS). Structural abnormalities in your uterus such as polyps or fibroids.  Precancer and cancer such as uterine, cervical, vaginal, ovarian or endometrial hyperplasia.  Infections such as chlamydia, gonorrhea, endometritis or vaginitis. Other medical conditions such as liver disease, kidney disease or Pelvic Inflammatory Disease. Medications such as blood thinners and aspirin, hormone replacement therapy, Intrauterine devices (IUDs), birth control pills and injectables. Pregnancy-related problems such as a miscarriage or ectopic pregnancy.

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    • Employees
    • Nursing
    • Safety

    Department Spotlight: Float Pool

    Ring in the New Year and the rest of the holiday season by celebrating Renown’s Float Pool team!  After coming out of the COVID-19 pandemic, it's no mystery that healthcare across the country has shifted and adapted to the growing needs and new demands of our patient populations. Renown Health is no different. As the largest not-for-profit health system in the region, we are no stranger to change, even when change presents challenges. Who do we call on when a unit needs more team members in the eleventh hour? Who can help when our patient volume spikes up with seconds to spare?  This is where the Float Pool at Renown comes to the rescue. Skilled in a wide variety of healthcare specialties, from acute care nursing and critical care to care aiding and patient safety, this is the team that can seamlessly step in to provide crucial patient care to the units that need it most, whether a team is understaffed for the day or needs extra all-hands-on-deck for a specific patient or procedure. Float Pool team members are equipped to work in virtually any clinical area at Renown, making a genuine difference with every patient they encounter.  A Pool of Relief Teams across Renown can breathe a sigh of relief knowing that Float Pool has their back in times of need. As the backbone of our health system, these dedicated team members possess a wealth of clinical knowledge and the ability to navigate diverse medical environments. Their flexibility allows them to fill staffing gaps and provide essential support to many different units.  “We fill in the gaps of staffing to make everyone's day better,” said Patti Crepps, Critical Care Float Pool RN. “A float nurse has to be flexible and able to adapt to different situations and places – basically, ‘go with the flow.’ Patient care is basically the same all over; we make patient care possible by being familiar with all the various specialties and providing the specific care needed depending on the population we are taking care of on that shift.”  “Float Pool staff members are like healthcare chameleons, transitioning between different departments,” added Shelby Riach, Acute Float Pool RN. “We incorporate flexibility, teamwork and a commitment to ensuring patients receive the best care, regardless of the setting or circumstances.”  This team thrives in uncertainty; in fact, no workday is the same in Float Pool – and that’s exactly the way they like it. Working with many different teams across a multitude of specialties, these Care Aides, RNs, Critical Care Techs, Patient Safety Assistants (PSAs), Certified Nurses Assistants (CNAs) and more enjoy facing change, while they all share a goal of providing the best patient care possible.  “No day looks the same; since we are the Float Pool, we are assigned a different assignment on Smart Square every day, whether it be as a care aide, a patient safety assistant, a unit clerk or patient transport,” said Melina Castenada, Care Aide. “If we are assigned as a care aide on the floor, we help assist with call lights and help with whatever nurses and CNAs may need, including feeding, transporting, walking, helping patients use the restroom, etc. When we are assigned as a PSA ‘sitter,’ we sit for the patient to help keep them safe. If we are assigned as unit clerk, we help answer phones and direct patients appropriately, file paperwork, answer call lights if needed and assist with office work.”  “I love that every day is a different floor with different tasks and a different atmosphere,” added Julia Chappell, Critical Care Technician. “I find out which floor that I will be on right before my shift starts and head to the floor to find out my assignment for the day. Depending on the specialty, such as the medical-surgical floor versus an intensive care unit (ICU), my daily job tasks can vary.”  When it comes to high-risk patients, who require special attention, PSAs within Float Pool step in to help.  “The PSA role within Float Pool largely consists of adverse event prevention for our high-risk patients, and being a Float Pool employee allows us to work wherever we are needed,” said Dimitri Macouin, Patient Safety Assistant. “Whether it be in the emergency department, neurology or pediatrics, the PSA will be the eyes and ears for the nurses working with this patient population.”  “Great strides have been made to ensure that PSAs remain vigilant and are recognized as an integral part of the patients' care team rather than 'just a sitter,’” added Karla Phillips, Patient Safety Assistant.  Float Pool also oversees our Discharge Lounge, which offers patients and their families a dedicated space to reconnect and prepare for their discharge from the hospital.  “The increase in utilization of the Discharge Lounge is something we are very proud of,” said Kara Abshier, Care Aide. “We assist in discharging patients from all over the hospital to help the floor and get new patients into rooms.”  Every day brings a new challenge for Float Pool. As these team members wake up with uncertainty, they are ready to embrace the diverse demands of caring for patients of all ages.  “The fact that Float Pool exists is amazing,” said Hannah Luccshesi, Acute Float Pool RN. “We wake up with no clue as to whether we will be working with babies, children or adults and then fill in the needs of the hospital.”

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    • Employee Story
    • Nursing
    • Cancer Care
    • Management
    • Employees

    20 Years of Compassion and Dedication

    When you meet Poeth Kilonzo, Director of Oncology Nursing at Renown Health, you are immediately greeted with a warm smile that puts your mind at ease. Within the William N. Pennington Cancer Institute, Poeth enjoys a strong reputation among her employees and patients as someone they can always rely on, no matter how rough the tides may flow.   As an incredibly humble oncology professional, you may not realize that behind that smile is the power of a best-in-class nurse and leader holding a 20+ year career of diverse nursing experience and leadership excellence – dedicating the majority of her service to Renown Health.  Join us as we dive into Poeth’s unique journey through Renown.  Finding Her Passion  Ever since she could remember, Poeth has been a “people person.” Above all else, she cared for people – and she cared a lot. What better place for her to be than healthcare?  After moving to northern Nevada from Kenya, she began working in private patient care working with home health and dementia patients while taking classes at Truckee Meadows Community College (TMCC) in 2000. One day, a patient asked her a question that would change the course of her career journey: Did you ever think about becoming a nurse?  Driven by not only the words of encouragement of her patients and supervisors in home health but also the rallying support from her family and friends, including her husband and high school friend, who both have decades of experience interacting with nurses in healthcare (with her husband spending many of those years at Renown), Poeth knew this was the path she was meant to take.  “That was it; it was like a light switch had flipped,” said Poeth. “I switched to nursing overnight.”  According to Poeth, TMCC’s nursing program offered her an incredibly supportive environment, which was especially important as she was a young mom at the time. Working in healthcare, going to nursing school and raising a family all at the same time is no easy task, but to Poeth, this was her calling.  “Regardless of my path, I knew I wanted to be a nurse that was close to patients, sitting with them and holding their hand throughout their treatment,” said Poeth.  During nursing school, Poeth completed clinicals at several hospitals in Reno – three of them were at Renown Health (known as Washoe Medical Center at the time). What immediately stood out to her was the passion of the pediatrics unit, especially in the neonatal intensive care unit (NICU).  “While I knew that pediatrics wasn’t going to be my arena, some of the best times in my life were during my pediatrics clinical,” said Poeth. “It opened me up to how welcoming Renown is.”  While doing her rotations, nursing leaders helped Poeth and her fellow classmates discover Renown’s Nurse Apprentice program, an apprenticeship designed exclusively for local northern Nevada nursing students. One of those leaders asked her, “have you considered doing a rotation in oncology?”  And another light switch flipped.  “Bingo. I am becoming an oncology nurse apprentice,” Poeth recalls. And that’s exactly what she did.   After her four-month apprenticeship ended in February 2002, she walked into her interview with Joanna Gold, who would end up being her supervisor and one of her greatest mentors until she passed away in recent years. With her experience and enthusiastic spirit on her side, Poeth fervently expressed her passion and interest in working in oncology. And Joanna saw all of that and more.  In June 2002, Poeth was presented with a two-year oncology RN contract, which she easily signed – however, she knew right then and there but she was not going anywhere. Renown was her home, and oncology ignited the fire within her.  “The nurses in this unit are part of what kept me here,” Poeth remembers. “These nurses would really do anything for their patients. The commitment and love they all had for one another truly was like family. It inspired me to learn more and give even better care to my patients."  To Poeth, it didn’t feel like she was coming to work just to do a job – she was following her dreams.  “You don’t think about the work you do; you think about the service,” said Poeth.  From there, Poeth spent three years on the floor as an oncology RN and became a night shift supervisor in 2005. She was thriving.  But this part of her journey was only the beginning.  When Opportunity Arises, Take It  In March 2007, Poeth and her husband welcomed their third child – and for her, working a day shift position would serve her the best at her current stage of life. This revelation led her down to Renown South Meadows Medical Center, where she became a staff nurse in Medical Telemetry.  It was in the telemetry unit where Poeth contributed to one of the largest digital transformations Renown would ever go through: transitioning from paper records to electronic records on EPIC.  From there, Poeth was inspired to get back into leadership in 2012 as the Supervisor of Clinical Nursing overseeing nurses, clinical outcomes and payroll in the medical/telemetry unit and intensive care unit (ICU). The timing of her leadership role lined up perfectly with her decision to take her skills to the next level, achieving a bachelor’s degree from Nevada State College in 2016. The timing of her degree lined up perfectly with what was about to come; she embarked on her first leadership role at Renown  This is where she would happily stay for 11 years, eventually becoming the Manager of Nursing in telemetry and the ICU, noting that Renown South Meadows felt like a second home to her.  “I wore many hats at South Meadows,” Poeth recalls. “From piloting back coding and handling compliance work to being on the patient floor and heading up South Meadows’ first high school hospital volunteer program, I got very involved. We had seven years without having a single nurse traveler in our unit."  It wasn’t long before Poeth was inspired to expand her education even further, and she graduated in January 2018 with a master’s degree in nursing clinical leadership from Western Governors University. Thanks to Renown’s educational assistance programs, our health system invested directly in Poeth’s education with tuition reimbursement and a $1,000 nursing scholarship.  Soon after celebrating her achievement, Jennifer Allen Fleiner – who was the Director of Nursing at Renown South Meadows at the time – asked Poeth yet another question that would bring her to the precipice of another career detour: “Have you ever considered transferring from South Meadows to Renown Regional?”   Moments later, Alicia Glassco, Director of Nursing for Renown Regional, asked her the same question, noting that the hospital’s neurosurgery unit needed the leadership of someone just like Poeth.  “It took me a whole week to make a decision, because this was one of the toughest decisions I’ve ever made in my life,” said Poeth. “I truly loved South Meadows. After that week, my leader told me, ‘you know what, Poeth? You’ve reached your pinnacle. You need and deserve a new challenge. Learn from this new team and teach them something. I think you have a huge opportunity for growth.”  So, Poeth decided to apply for the position and shadow the neurosurgery team, where unlike her unit, the majority of the team at the time were travelers. But this was a challenge Poeth was up to – so she was accepted into the role.  “At the end of the day, these patients deserved consistent care,” Poeth emphasized. “I knew I had to take this position for the patients – they were the ones who sold me on this job. They are the reason why we are all here. It was important for me to be an advocate for them.”  The big hills to climb didn’t slow down Poeth; in fact, the exact opposite happened. Within her first year in the neurosurgery unit, her team onboarded 18 new graduates and replaced travelers.  “We were hiring like crazy,” said Poeth. “My standing agenda at all section meetings focused on hiring and our quality metrics. I started having a relationship with our doctors. Once we created a strong doctor/nurse collaboration, our nurses started staying with us longer.”  Everything on the unit was going great.  Then, COVID-19 hit.   “Since we had private patient rooms, our unit became the first COVID unit at Renown Regional,” Poeth recalls. “My whole staff that I had built up had to be distributed elsewhere. I started caring for COVID patients. We relied on our Infection Prevention team a lot. And at the same time, I was worried about my family in Africa.”  Despite the stressful nature that the pandemic brought upon health systems everywhere, according to Poeth, she knew she had to continue on.  “The neurosurgery team ended up merging with orthopedic trauma, which was very difficult,” said Poeth. “We went from 28 beds to 58 beds. The key to success here was training. Nurses are very resilient, and through training, we were able to stabilize the unit.”  Noticing the opportunity for virtual demonstrations that were previously offered only in-person, Poeth spearheaded online trainings for nursing, physical therapy, mobility, head injuries and more, allowing teams across Renown to upskill in safe spaces.  These programs continued throughout the pandemic, and Poeth was proud to be a figurehead through it all, helping to stabilize the unit while creating strong relationships with the entire team, many of whom followed her from Renown South Meadows to Renown Regional.  Then, she gets another visitor – her Chief Nursing Executive – in her office with yet another opportunity.  Have You Considered...  In September 2022, Chief Nursing Executive Melodie Osborn walked into Poeth’s office with those three words that Poeth has heard for decades: “Have you considered...”  “Before Melodie could even finish, I thought, ‘I have considered A LOT in my career!’” said Poeth.  Melodie told Poeth that the William N. Pennington Cancer Institute was looking for a Director of Oncology Nursing, noting that this could be yet another growth opportunity for her and a chance for her to go back to her roots.  “I had just celebrated my twentieth year at Renown; I knew this was going to be a decision I really had to think about,” said Poeth. “Everyone believed in me. Alicia Glassco told me, ‘Poeth, you are ready for this. Go for it.’ Once I applied for the position and started getting my updated chemotherapy certifications, I thought, ‘they are right; I got this.’”  At this point in her career, Poeth had been hyper-focused on inpatient care, and this role would be her first time caring for patients in the outpatient setting. After going through the interview process, however, Poeth knew that this was where she was meant to be yet again – and colleagues she hadn’t seen in years reaffirmed that commitment.  “I felt the most excited about the job when I toured the facility,” Poeth recalls. “I’ll never forget what one of the infusion nurses told me on my tour. She told me, ‘I don’t know if you remember me, but I remember you; I came from Renown South Meadows, and you were so nice to me as I was precepting as a new nurse. Your kindness was unforgettable to me.’ The fact that people like her wanted me in the unit so badly inspired me to come back.”  Soon enough, Poeth became the Director of Oncology Nursing, a position she still proudly holds to this day. Once she was hired, she immediately went into deep learning mode, mastering skills such as revenue integrity, credentialing and the insurance process. She attributes Supervisor of Infusion Kaitlin Hildebrand and Director of Radiation Oncology Services Susan Cox for helping her succeed.  Shortly after assuming the position, Poeth noticed yet another opportunity for cross-training within the organization to combat short staffing – training nurses from the Float Pool to care for patients in Infusion Services.  “Between May and July of this year, we trained six nurses from Float Pool to do infusion therapy services, which offered so much relief to my team; I am so thankful to Rendee Perry, the Manager of Nursing in our Float Pool unit, and her team for their support,” said Poeth. “My mission in outpatient oncology is to serve the staff and patient population and create those strong relationships."  Poeth's efforts to circumvent nurse burnout go beyond cross-training – as a director, she is always there for her team members no matter what, leading with kindness every step of the way.  “I never miss a 7:45 a.m. huddle unless I am in a ‘cannot miss’ commitment; I want my employees to always know that I am there for them and that they are cared for both on and off the job,” Poeth emphasizes. “I want them to feel like they are valued, their families are valued and their mental health is valued; after all, without my team, we cannot care for patients. It’s important for them to know that I am here to be a security blanket and that there is always something we can do to solve a problem."  Today, Poeth enjoys a full team of core Renown staff members whom patients look forward to seeing – and the high patient satisfaction scores to prove it.  “Our team is so established that patients feel comfort in knowing they are always going to know exactly who they are being treated by,” said Poeth. “We will always work to maintain that consistency.”  Staying True to the Mission  Renown’s mission of making a genuine difference in the health and well-being of our community resonates closely with Poeth. Before she arrives at the infusion unit every day, she asks herself: What can I do to make it easier for my team to deliver care?  “It takes a village to deliver the care we do,” said Poeth. “Our nurses are priceless. You can’t place a monetary value on dealing with life and death every day. This is what inspires me. It’s all about helping each other out and keeping those relationships strong.”  Maintaining those relationships on the floor, according to Poeth, requires one main ingredient: work-life balance.  “I want my nurses to be able to balance sending their kids to kindergarten and giving their patients their first chemotherapy treatments,” Poeth emphasizes. “I genuinely care about their lives. It’s nice when you get to know your team’s children, grandkids, spouse and hobbies. I’m grateful that Renown has given us the autonomy to foster that flexible environment within our teams. It is so rewarding to have such a strong impact on these employees.”  To Poeth, it’s all about doing and then duplicating. Luckily for her team and infusion patients in northern Nevada, a new infusion center at Renown South Meadows is planned to open in the coming years as part of our commitment to expanding care. Her team is excited to grow their expertise down to south Reno – Poeth's original home hospital.  “I strongly believe that as nurses, we are meant to be where we are meant to be at the time,” said Poeth. “Be kind to yourself and remember your ‘why.’ Take advantage of the opportunity you have.”  To all nurses (and future nurses) out there, Poeth wants you to know that you are welcomed and valued. You are saving lives every day, and to her, that is worth everything.  “Always remain focused, even throughout all the challenges. Never forget why you got into nursing. And lastly, always stay true to your own mission,” closes Poeth.

    Read More About 20 Years of Compassion and Dedication

    • Prevention and Wellness
    • Primary Care
    • Vaccine
    • Screening
    • Expert Advice
    • University Health

    6 Healthcare Action Items for the LGBTQIA+ Community

    Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!  STI Testing  Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year.   Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you.  Prostate Exams  Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old.  These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened.  Pap Tests and Pelvic Exams  Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer.  Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings.  Mammograms and Breast Exams  People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual.  The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project.  Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.

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    • Prevention and Wellness
    • Surgery

    Sepsis: Causes & Symptoms

    According to the Global Sepsis Alliance, 1 in 5 deaths worldwide are associated with sepsis. If not recognized early and treated promptly, sepsis is the final common pathway to death from most infectious diseases worldwide, including viruses such as COVID-19. We spoke with Jeremy Gonda, MD, a critical care physician from Renown Health’s Sepsis Committee to increase public awareness of this preventable medical emergency. What is sepsis? Sepsis is a response to infection—bacterial, viral or fungal—and can start anywhere in the body and spread into the bloodstream. The body is trying so hard to fight an infection that it begins releasing chemicals into the bloodstream that cause inflammation and the shutdown of multiple organ systems. “It carries a very poor prognosis in general unless you catch and treat it very early,” said Dr. Gonda. “Any infection can lead to sepsis. Typically your immune system takes care of the infection. It doesn’t progress, but in cases where the infection becomes severe, or the immune system doesn’t function properly, people can certainly die. So there’s, unfortunately, a very high mortality rate associated with sepsis.” According to the Centers for Disease Control and Prevention, each year at least 1.7 million adults in America develop sepsis. While you can recover from sepsis if caught early, many sepsis survivors suffer from long-term physical and psychological effects. What are the signs of sepsis? One way to spot sepsis is to use the acronym SEPSIS: S – Slurred speech and confusion E – Extreme shivering or muscle pain/fever P – Passing no urine all day S – Severe breathlessness I – “I feel like I might die” S – Skin mottled or discolored Keep in mind that sepsis symptoms can vary depending on where the infection starts. “Patients may experience urinary burning if they have a urinary tract infection or a cough and shortness of breath if they have pneumonia first,” said Dr. Gonda. “However, often symptoms are more generalized or subtle such as fevers, confusion and malaise.” How do you develop sepsis? When germs enter your body, they can cause an infection. If you don’t stop that infection, it can cause sepsis. Areas of infection that more commonly result in sepsis include: Lungs, such as pneumonia Kidney, bladder and other parts of the urinary system Digestive system Bloodstream (bacteremia) Catheter sites Wounds or burns Who is most at risk? People with compromised immune systems are at greater risk for sepsis, such as “The very young, the elderly and any people who may have conditions that suppress your immune system,” said Dr. Gonda. “For instance, if you have diabetes or if you’re an organ transplant patient who is on immunosuppressant therapy, you’re at somewhat higher risk.” Sepsis is often considered a hospital-acquired infection, but a study in The Journal of American Medical Association found that 80% of sepsis cases occur outside of a hospital. That’s why it’s especially important to remember any infection can lead to sepsis, and anyone can develop sepsis from an infection. What do I do? Timing is critical in the case of sepsis and septic shock. According to a study on septic shock patients, there is a 7.6 percent decrease in survival for each hour treatment is delayed. On the other end, if treatment is given within an hour of the first drop in blood pressure, the survival rate is 80 percent. Because sepsis can be so deadly, it’s important to seek medical attention as soon as possible. “If you’re not getting any better, if you think symptoms are progressively worsening – you should definitely be evaluated by a doctor,” said Dr. Gonda. You can help #StopSepsis by getting involved at worldsepsisday.org.

    Read More About Sepsis: Causes & Symptoms

    • Physical Rehabilitation
    • Prevention and Wellness

    Preventing Spinal Cord Injuries: What to Know

    If you're not taking safety precautions during mountain sports, you could be at risk for a spinal cord injury. Dr. Benjamin Pence of Renown Rehabilitation Hospital explains the best way to prevent this serious injury. Mountain sports are a big part of the winter season here in our area, but if you’re not practicing all the proper safety techniques, you could end up with a serious spinal cord injury. Benjamin Pence, MD, Renown Rehabilitation Hospital, is here to offer tips to prevent this serious injury while you’re out enjoying what the Truckee Meadows has to offer. What is the spinal cord? The spine stretches from the base of your skull to the coccyx (commonly referred to as the tailbone). Your spine is made up of 24 vertebrae—seven cervical, which are in your neck, 12 thoracic, which are in your chest, and five lumbar, which are in your lower back. There are ligaments and muscles attached to each vertebra. These facilitate back movement and protect the bones from damage. There is cartilage between each vertebra which acts as a shock absorber for your spine. Finally, the spinal cord is a long, thin, tubular bundle of the nervous tissue and support cells that is enclosed in the spinal canal and send signals from the brain to everything from your arm and leg muscles to bowel and bladder function. The brain and spinal cord together make up the central nervous system.

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    • Prevention and Wellness
    • Respiratory
    • Urgent Care

    Your Ultimate Cold and Flu Survival Guide

    While viruses can attack year-round, colds, flus and other respiratory illnesses are typically more prevalent during fall and winter. People spend more time indoors, which allows viruses to pass more easily from one person to another. The cold, dry air can also affect the respiratory system, making it more susceptible to germs. According to the CDC, flu activity in the U.S. often begins to increase in October and peaks between December and February. “Flu season” can last as late as May.  When it comes to the cold and flu, prevention and preparation are key. Getting the flu shot and a COVID-19 vaccine is the first and most crucial step in protecting against these two respiratory illnesses. Preventative actions, such as washing your hands, covering your mouth and nose when coughing or sneezing and getting enough sleep can also help you avoid getting sick. However, despite your best prevention efforts, the time may come this winter when you start to feel a little scratch in your throat or a fever coming on. By taking steps ahead of time to assemble a cold and flu survival kit, you’ll be more prepared for whenever illness strikes, allowing you to stay home, rest and avoid spreading germs.  Tips for Managing Symptoms Keep these tips in mind to ease your cold or flu symptoms: Stay home and rest Drink plenty of fluids Treat aches and fever with over-the-counter medication such as ibuprofen or acetaminophen Manage a cough with over-the-counter expectorants or suppressants  Run a humidifier or sit in a steamy bathroom to ease congestion What to Stock in Your Flu Survival Kit Be ready when a cold or the flu strikes by having a flu survival kit filled with these get-well essentials stocked in your pantry, fridge and medicine cabinet: Over-the-Counter Medications: Take advantage of over-the-counter medications to make yourself feel better and ease most common flu symptoms of fever, headache, cough, muscle aches, sore throat, and runny or stuffy nose Pain relievers - Ibuprofen (Motrin and Advil) or Acetaminophen (Tylenol): for fever and aches Decongestants: for sniffles and congestion Cough expectorant (guaifenesin): for a “wet” cough to help clear secretions from the lungs Cough suppressant (dextromethorphan/DM): for a severe “dry” cough to block the cough reflex Cough syrups and drops Drinks: Water Herbal tea Low-sugar sports drinks Pedialyte Foods: Chicken soup Broth Vitamin C-containing fruits and vegetables Oatmeal Toast (add some avocado, honey or egg) Miscellaneous items: Tissues Lozenges Protective mask Thermometer Humidifier When to Seek Care and Where to Go Most healthy adults who have a cold, the flu, or other mild respiratory illnesses don’t need to see a care provider and will recover at home with self-care measures. Because these are viral illnesses, antibiotics won’t work against treating them. Your care provider may be able to prescribe an antiviral medication that can relieve your symptoms and shorten the duration and severity of your illness; however, this needs to be started within 48 hours of symptom onset and is often only prescribed to individuals at high risk for developing complications from the flu or those experience severe symptoms. Primary Care or Urgent Care Contact your primary care provider or visit an Urgent Care if you are at an increased risk, including those who: Are 65 years of age or older Have chronic medical conditions Are pregnant or recently gave birth Have a weakened immune system Find a primary care provider If you are otherwise healthy and not at increased risk of complications, seek medical advice if your flu symptoms are unusually severe, such as mild difficulty breathing, a severe sore throat, coughing that produces a lot of green or yellow mucus, or feeling faint. Emergency Care Go to the Emergency Department if you are experiencing emergency warning signs such as severe pain (chest, abdomen), concern for heart attack or stroke (slurred speech, new localized weakness), severe dehydration (needing IV fluids) or severe shortness of breath.

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    • Safety
    • Employees
    • Careers

    Department Spotlight: Security

    “Safety is Number One,” isn’t just a saying – it's a fact of life, especially at Renown Health. The safety of all patients, visitors, staff and volunteers is always the top priority, and our Security Department takes that commitment seriously. This team is devoted in their efforts to provide a safe environment for all, building cooperative and proactive security processes leveraging crime prevention techniques and state-of-the-art technology. Renown Security sets the safety and well-being bar high, and they continually exceed that standard day in, day out at all of our hospitals and urgent care, primary care and lab locations.  Specially Trained, Continually Present  Our Security Department isn’t staffed with your run-of-the-mill Security Officers; these team members surpass security and safety expectations. Think city and state police-level standards. You read that right – many of Renown’s Security Officers come from Nevada Highway Patrol, the Washoe County and Carson City Sheriff’s Offices, the state probation and parole board and more.   This team fosters specialized training in a collaborative environment. Every member of the security team has extensive training in compassion, empathy and de-escalation techniques to provide the highest levels of safety and security. They implement this training in all their daily duties, whether they are saying a simple ‘hello’ to a patient passing by or preventing harm to a staff member.  Before their shift begins, the team meets to debrief meeting to discuss major incidents that occurred on the previous shift. These meetings ensure the next shift is aware of situations to be on special alert for and individuals to look out for. After, the team members head off to their assignments.  “The day could be as mellow as greeting someone at the welcome table, or it could be as chaotic as de-escalating someone in distress,” said Emmanuel Fernandez-Orozco, Supervisor of Security at Renown Regional. “Regardless of the day, every experience is rewarding in its own way. The only thing that is promised is that every day will be different.”  While every Security Officer has varying experiences, one aspect of their job always stays the same: they are always on alert for any potential safety issue. Even on the “slowest” days, it is important for this team to stay vigilant in order to mitigate any potential risks. There are several security programs that the team uses to keep everyone at Renown safe and secure: Renown's security operations center team (also known as dispatch) monitors all cameras in real time, with security officers patrolling parking areas 24/7.   Security escorts are always available for any employee, patient or guest at every Renown location. Security Officers can escort anyone to their designated site, check surroundings for danger and monitor the person until they safely leave for their next destination.     Rescue officers are available for any Renown location where an employee feels unsafe.  Security maintains a strong relationship with the Reno Police Department (RPD) and assists with reporting and providing information that aids RPD in pursuing and deterring criminal activity.  “In security, we are a counselor, teacher and rule enforcement officer, all rolled into one,” said Bob Stone, Supervisor of Security for Renown Health. Talk about master multitaskers!  Protection is only one part of the job. Through positive and meaningful interactions with guests, patients, community and staff, regardless of where they are posted, the Security Department continually helps Renown achieve its mission of making a difference for the people they serve.  Devoted Dispatch Speaking of multitasking, no one does this better than the Security Dispatch Center. Security Dispatchers are the “eagle eyes in the sky” at Renown, keeping a close watch on everything that happens within every Renown location, as well as REMSA (including Care Flight). From overlooking the many cameras around campus and administering codes over the PA system to manning the radio and phones to ensure Security Officers are dispatched quickly, our dispatch team helps ensure every safety or security issue at Renown is immediately addressed.  When a call comes in, dispatchers like Jessica Fernandez, Security Dispatcher for Renown Health, go through a quick discovery process (sometimes in seconds) to figure out the details of the situation or code and what level of security is needed to assess and de-escalate.   According to Jessica, the ability to prioritize is something she values in her work. “80 percent of our duties are on the phone and the radios, and we are skilled in prioritizing concerns based on the sheer volume of calls we get,” she said.  Jessica and her teammates are proud of the outcomes from their calls. Their attentiveness to every nook and cranny at Renown and their quick response times to make them not only a valued partner to the Security Department but also a necessity to our health system.  Your In-House De-Escalation Experts  Being in a hospital environment is undoubtedly stressful for any patient, and many factors can increase these emotions. The Security Department takes these feelings seriously and never hesitates to take appropriate action to ensure the safety of everyone at Renown. With the unfortunate rise of violence against healthcare workers, especially amid the pandemic, our first-rate security team has been crucial in countering violence with specialized de-escalation techniques.  The key to de-escalating, according to the Security Department, is to put yourself in the shoes of whoever you are working with. As stated by Bob Stone, the team approaches each situation by asking themselves: How would I want to be treated if I was in the same circumstance?  “Being empathetic to their situation and listening to what is going on in their lives is key to re-directing them accordingly,” said Bob. “Applying real-life experience to similar circumstances can make them feel like they are not alone. Educating people on hospital policies can also help them reduce their anxieties and solve the problems.”   Jhorddy Lopez, Security Officer at Renown Regional, approaches each situation with the mindset of knowing that each person’s reactions are different. “Different techniques need to be implemented every time,” said Jhorddy. “You have to use your best judgment call.”  Quick and effective judgment calls are a task that the Security Department has conquered. Rosie Garcia, Security Officer at Renown Regional, knows that using your best judgment means getting both sides of the story. “Whenever I need to step in and de-escalate a situation, I first speak with whoever is attending to the patient and gather information,” said Rosie. “Then, I always get the patient’s side as well. I want to understand how they’re feeling, so both the staff member and the patient can meet in the middle and come up with a collaborative solution.”  An example of the heroism and advanced de-escalation displayed by our Security Officers takes us back to last spring. In the middle of the night, a Care Flight helicopter transporting a patient and their family was about to touch down on the landing pad outside of Renown Regional. Right as the helicopter was about to land, an individual jumped over the safety barricade and onto the landing pad. Alexander Pico, a former Security Officer Lead at Renown Regional (who recently joined the Carson City Sheriff’s Department) immediately communicated with the individual to leave the area. The individual then went under the rear blade, which is the most dangerous part of the helicopter. Knowing that he had to risk his own life at this point to save another, Alexander ran around the back of the helicopter and tackled the individual, preventing catastrophic injury or even death. Steve Perkins now uses this example of a swift judgment call, which was captured on dispatch cameras, as training material for new staff.  Exceptional character, compassion and emotional intelligence are the attributes that every member of the Security Department holds. As noted by Steve Perkins, these attributes “allow for a quick assessment of each situation in order to de-escalate and move towards the best possible solution."  Securing the Job  The Security Department at Renown is actively hiring caring, dedicated team members who are ready to jump in and perform exceptional high-risk healthcare security services for our health system.  “We seek people with the right combination of ability and demeanor,” said Steve Perkins. "The training and skills development we provide result in a high caliber of success.”  Every team member in the Security Department is passionate about the same thing: helping others. And in a healthcare environment, this is important.  “Working a healthcare security job is far different than working any other security job,” said Jhorddy Lopez. “At a hospital, you get the chance to interact with people one-on-one. I get to experience the feeling of, ‘I can make a difference in this person’s life.’”  Any interaction can change the course of a person’s day, and the Security Department embraces this fact. “I really do love helping people so much, whether it be an elderly patient who needs help with their wheelchair or a situation where I need to step in and de-escalate,” said Rosie Garcia.   In order to succeed in this fast-paced department, being a collaborative team member is crucial. “A good coworker is a team player – someone that loves to work in a team atmosphere,” said Emmanuel Fernandez-Orozco.  Jhorddy Lopez reiterates this, adding that “communication and trust are also extremely important. Everyone has to have great communication skills and have each other’s backs.” For people like Bob Stone, having a special connection to Renown inspires him to serve. As someone who experienced two life-saving hospital stays here, he is proud to give back to the organization that gave so much to him. “It was only natural to return to a facility I was familiar with my entire life,” said Bob. “After serving as a paramedic and transporting patients into Renown from Plumas County, I knew I was not done giving back to the community. Renown was the place to do exactly that.”  All Genders Welcome  A common misconception about the security field is that it is strictly a “man’s job.” In Renown’s Security Department, that couldn’t be further from the truth.   As a female Security Officer, Rosie Garcia is a prime example of proving that idea wrong. As a master patroller and de-escalation expert, she ensures everything is running smoothly and that everyone feels safe at all times.  “When I first started here, I knew right away that nobody that works here is biased,” said Rosie. “Everyone is equal, and I am treated as an equal in this department. I know I can do the job as well as any man."  Both Rosie and her counterparts in the Security Department firmly believe that this line of work is for everyone, and they continually lift each other up and support one another.  “No matter your gender, as long as you have confidence and integrity, you will do well,” adds Rosie.  The Bottom Line If you are passionate about creating a secure environment to ensure patients get the care they deserve and employees receive the safety they merit, the Security Department is your team to join.  “I come into work with pride,” said Jhorddy Lopez. “Knowing that I can change someone’s life – that makes me proud to work here.”  “You’re in good hands with us,” closes Steve Perkins.

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    • Prevention and Wellness
    • Screening
    • Vaccine

    Prevention Against STIs Matters

    According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new sexually transmitted infection (STI) cases in the United States each year, with rates continuing to increase.  What you may not know is most STIs are preventable. We talked with Renown Adolescent Medicine Specialist, Caroline Barangan, MD to learn more about STIs.  How Can You Get an STI?  The CDC (Center for Disease Control) says that STIs are acquired through sexual contact. There are bacteria, viruses or parasites that can cause an STI which may pass from person to person in blood, semen, vaginal and other bodily fluids.  How Do You Know if You Have an STI?  STIs can have a range of signs and symptoms such as:  Warts, bumps or sores on or near the penis, vagina, mouth or anus Swelling, redness or severe itching near the penis or vagina Discharge from the penis Vaginal bleeding that’s not your period Painful or uncomfortable sex Vaginal discharge that has an unpleasant odor, causes irritation or is a different color or amount than usual  Weight loss, diarrhea or night sweats Aches, pains, fever and chills Jaundice (yellowing of the skin and whites of the eyes) Painful or frequent urination  Sore throat if you engage in oral sex It’s important to know that the majority of people who have an STI commonly have no symptoms at all, which is why it’s important to get regularly tested once you have had any sexual activity. Young people less than 25 years of age should be screened on a yearly basis at minimum.

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    • Sterling Silver Club
    • Diabetes
    • Prevention and Wellness

    Type 2 Diabetes: What You Should Know

    Type 2 diabetes, formerly known as adult-onset diabetes, is on the rise for adults and children in the United States. Although genetics play a role, you can take steps today to lower your risk of developing this life-altering condition. Michael Raymund Gonzales, MD with Renown Endocrinology answered our questions about Type 2 diabetes and gave us some useful tips for prevention. What effect does diabetes have on the body? And who’s most at risk? First, it’s important to know the difference between the two most common types of diabetes: Type 1 diabetes is the result of the body’s inability to make insulin, which is a hormone your body needs to be able to use sugar, or glucose, for energy. Type 1 is not preventable, and people who have it were either born with it or they developed it later in life due to an autoimmune process that attacked the pancreas that went unrecognized. Type 2 diabetes occurs when the body makes the insulin hormone, but it might not make enough or work well enough for the body to use sugar for energy. This is called insulin resistance. This condition usually develops later in life but is preventable with proper diet, exercise and weight loss. However, due to the obesity epidemic, type 2 diabetes is occurring more often in younger individuals.  Diabetes hurts the body’s ability to break down glucose, so rather than it being used for energy, glucose stays in the bloodstream, which can cause problems. But with early detection and the help of your doctor, diabetes can be managed so that complications are avoided. Left unmanaged, however, diabetes can affect major organs and lead to heart and blood vessel disease, nerve damage, kidney damage, eye damage, skin conditions and more. Type 2 diabetes also results from risk factors that you can’t control, including your family history, race and age. However, there are a few risk factors that you can watch out for, such as being overweight, inactivity, diet choices, having high blood pressure and high cholesterol and triglycerides.

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    • Primary Care
    • Urgent Care
    • Prevention and Wellness

    Make Hydration a Priority for Your Health

    As the temperatures skyrocket and we return to more outdoor activity, one thing is certain: you must hydrate to stay cool, healthy, and functional. But how much water do you need, and what are some easy ways to ensure you are getting enough? Aurosis Reddy, DO a family medicine provider with Renown Medical Group, shares what you need to know.  How Much Water Is Enough?  Experts agree that recommended daily water intake can vary depending on different factors such as your weight, metabolism, location, diet, physical activity, and health. As a rule of thumb, women should aim for a daily fluid intake of 91 ounces, and men should aim for 125 ounces. It is important to listen to your body and recognize when you might need to increase your water intake. For example, if you’re partaking in strenuous exercise, or spending time outside in the heat, you’ll want to give your body more water and electrolytes to function properly.  How Can I Tell If I Am Dehydrated? Decreased coordination Fatigue Less urination Dizziness Dry, sticky lips and mouth Increased thirst Headache

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