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Snowshoeing is an excellent winter workout that can help burn calories, strengthen muscles and boost cardiovascular health. Explore the top 8 snowshoeing spots and experience this ultimate workout adventure! Significant Health Benefits: Exceptional cardiovascular workout – burn up to 1,000 calories per hour! Low-impact muscle building Endurance building Balance strengthening and agility Improves your sense of well-being by connecting to nature Prepping for Your Adventure There are some crucial details to think about when it comes to snowshoeing, especially if you are a beginner. Make sure to pick the right kind of footwear to go on top of your snowshoes; a pair of comfortable waterproof boots are a great choice and remember to wear lots of layers. Several local places rent snowshoes if you aren’t sure about spending money on a pair. Check out Bobos Ski and Board Patio or our local REI Co-Op. Check out REI’s Beginner’s Guide to Snowshoeing for reference. 8 Cool Snowshoeing Spots 1. Galena Creek Park Close to Reno, this beautiful, low-altitude park offers several trails. You’ll find various creeks and streams under cover of pristine ponderosa pines. From beginner to advanced, the differing trail systems provide a challenge for everyone! Head west on State Route 431 (Mt. Rose Highway) for about seven miles until you see the park sign on the right side of the highway. 2. Tahoe Meadows – Chickadee Ridge This local favorite not only gives fantastic views of Lake Tahoe but the best part? – friendly little chickadees will eat seeds right out of your hand! Be sure to pack plenty of sunflower birdseed, as that seems to be their favorite. From the trailhead parking lot, head southeast into the open meadow. Then follow the ridgeline to your right (southwest). Continue southwest up toward the top of the ridgeline to the west, and you’ll get to Chickadee Ridge in just under two miles. 3. Spooner Lake Trail The easy 2.5-mile loop around Spooner Lake is excellent for all skill levels. This alpine lake is surrounded by aspen trees which house varied bird species, so bring your binoculars! Dogs are allowed on a leash, and all-day parking is $10. 4. Kirkwood Ski Resort You’ll need a trail pass, but this South Lake Tahoe resort has various routes from beginner to advanced, with roughly 50 miles of terrain. Nighttime snowshoe treks during the full moon are also available throughout the winter. Kirkwood is located on Highway 88, close to Carson Pass. 5. Camp Richardson Heading north, you can find this well-established and favorite local snowshoeing spot. If you’re up for an adventure, you can trek up to Fallen Leaf Lake. It’s located off Highway 89 and near Fallen Leaf Road. 6. Dry Pond Loop This moderate, 6.5-mile loop near Washoe Valley has impressive views of Carson Valley, Washoe Lake, and the Mt. Rose Wilderness. If you like the sound of rushing water, most of the trail meanders along White’s Creek. This area is dog-friendly and kid-friendly, which makes it a family favorite. 7. Royal Gorge Soda Springs is home to this resort, which is well known for its cross-country skiing trails. Enjoy extensive trails leading deep into the trees with spectacular views. Find Royal Gorge from the Soda Springs exit on West Interstate 80. 8. Ash Canyon Creek Tucked away in the Carson Valley, these trails are filled with mountain bikes in the spring and provide excellent snowshoeing trails in the winter. Find it from Interstate 580 by taking the Highway 395 Business exit to Winnie Lane.

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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

Meet and get to know Patty Warren, our featured Sterling Silver Club member this fall. You may recognize her from the latest Senior Care Plus commercial on television, where she joins a coffee chat discussing the many benefits of being a Senior Care Plus member. She’s one of the kindest souls you’ll ever meet – and has a positive outlook on life that we should all strive for. Patty's Story Patty was born and raised in a small Kansas town called Baxter Springs, where she grew up with an older brother, an older sister and two younger sisters. She and her siblings all enjoyed playing sports like softball and basketball, in addition to playing instruments. Patty developed a love and passion for music at a young age that carried into her adulthood. “I wanted to be an opera singer,” said Patty. “I decided to go to college at Pittsburg State University in Kansas where I majored in vocal performance.” After college, Patty moved to Manhattan in New York City to audition to be an opera singer, but she soon realized it wasn’t what she wanted to do after all. She eventually decided to work in the brokerage industry.   After living and working in New York for three years, Patty moved back to Kansas where she later met the love of her life, Michael. “In 1992, I had put a dating ad in the local newspaper,” said Patty. “I received over 30 responses, and I went out on quite a few dates.” Then she had her first date with Michael, and the two of them quickly realized how much they liked each other. He asked her to marry him on Valentine’s Day in 1993, and they went on to get married in front of the Justice of the Peace on May 3, just a few months later. “We had a small wedding so that we could move into our first home together,” said Patty. A few years later in 1999, Patty and Michael moved to Arizona, where they lived for 22 years. Patty worked at Edward Jones Investments for 18 of those 22 years and loved her job and the people that she worked with. She retired in January 2021 during the pandemic, and three days later she and Michael moved to Sparks, Nevada.

Read More About Patty Warren A Woman of Strength and Resilience

Stepping into the Renown Transfer and Operations Center (RTOC) means stepping into a transformative hub of excellence where lives are saved and healthcare is reimagined. As a cornerstone of Renown Health's commitment to exceptional patient care, the RTOC serves as a dynamic nerve center that seamlessly coordinates medical resources, ambulance rides, hospital bed space, remote home systems, hospital transfers and emergency preparedness. In this best-in-class facility, the boundaries of what is possible in healthcare are constantly pushed, and new horizons of patient care are discovered.   Staffed with a dedicated team of skilled professionals, the RTOC harnesses the power of advanced technology and compassionate expertise to ensure that patients receive the highest level of care and support, no matter where they are. Through a synchronized network of communication, coordination, and compassionate care, the RTOC team ensures that patients receive the critical support they need when it matters most, working tirelessly to redefine what it means to deliver world-class healthcare.   A National Standard  Charged with the goal of overseeing the placement and transportation for every patient, the RTOC officially launched in 2021 as northern Nevada’s first and only transfer center of its kind and a nationally celebrated facility. As Renown’s highly coordinated care logistics system, this team uses the cutting-edge technology at their fingertips to customize healthcare to the needs of every patient, manage patient flow and drive healthcare innovation.  “Compared to where we’ve started to where we are now, it’s a 180-degree difference,” said Kelli McDonnell, Manager of RTOC. “When we first started building our facility right before the pandemic happened, we took what was six conference rooms and classrooms and turned it into a command center that organizations across the country admire and come to Reno to see what we do. Mel Morris, the Director of RTOC, was recruited exclusively to build our facility with her history of building successful hospital command centers. Many people didn’t realize what a transfer center was or that Renown was the only center in the region – and we only continue to grow.”  This best-in-class facility, and the masterful team behind it, handles:  Coordinating all incoming patients transferred from neighboring hospitals and 27 counties across northern Nevada, Lake Tahoe, northeast California and neighboring states. Matching patients to the most appropriate bed placement using diagnostic, triage and Epic electronic medical record clinical information in conjunction with medical staff expertise to outline a plan of care that determines the best bed assignment given the patient’s needs.  Coordinating video-enabled Telehealth monitoring capabilities for Renown’s four Intensive Care Units (ICUs), as well as Renown patient Telehealth and virtual visits. Monitoring Remote Home systems with Masimo during the COVID-19 pandemic, where some patients received hospital-level care in the comfort of their own homes while Renown clinicians monitored and evaluated their data and plan of care.  Serving emergency and disaster management for area hospitals, first-responders and the community with local, regional and statewide emergency and disaster management for sudden-onset emergencies.  The RTOC is home to many different critical roles for our health system, including Transfer Center Nurses, Ride Line Coordinators, RTOC Coordinators and more, many duties of which each team member cross-trains on to be able to fill in whenever needed. While their roles may differ, their commitment to their patients remains the same – and they all work together to achieve the same outcome: delivering the right care, at the right time and place.  “As an RTOC Coordinator, we do a variety of different things,” said Anna Schaffer, RTOC Coordinator. “We do triage coordination to help our nurses and hospitalists get patients in the emergency department admitted, and we also do bed control to find patients appropriate bed placement. Communication is important, so we always make sure to stay closely connected with the charge nurses on those floors.”  “We start with a basic ‘need to know’ and place patients accordingly,” added Karly Brown, RTOC Coordinator. “We get surgery numbers, ICU capacity and discharges and find beds for all patients as quickly as possible. We have the advantage of being able to see the entire hospital.”  “I primarily schedule transportation for patients at the hospital who are either going home or going to a skilled nursing facility,” said Sarah Clark, Ride Line Coordinator. “I get requests from case managers to schedule rides, and I work with REMSA and other ambulance services to schedule them. It relies a lot on appropriate and efficient communication and critical thinking.”  Patients in facilities across northern Nevada and northeastern California, especially the rural communities, look to the RTOC to help guide ambulances, bed coordinators and hospital staff in finding care for our rural patients.  “As a transfer center nurse, I facilitate incoming patients from rural facilities in Nevada and surrounding areas in California,” added Meg Myles, Transfer Center Nurse Specialist. “There are days we may take up to 30 direct admissions from these areas.”  “We are the point of contact for inter-facility transfers, whether we are sending patients out or bringing them into Renown,” said Lisa Lac, Transfer Center Nurse Specialist. “We take phone calls from those rural areas, identify what services are needed, connect them to the appropriate provider and coordinate any transfers.”  “Simply put, we are the bed wizards,” said Addison Rittenhouse, RTOC Coordinator.  The RTOC team continues to break barriers and push the boundaries of medical excellence through leveraging the technology at their fingertips and their unwavering dedication to the health of our community. Inspiring a new era of medical possibilities, these team members have achieved a multitude of accomplishments for both their department and their patients since the birth of the center.  “We have significantly reduced the time it takes to get patient admit orders in, thanks in part to the new Triage Coordinator role, and we provide easier access for patients to transfer to us from other facilities,” said Beth Rios, RTOC Coordinator. “We have taken a bigger role in helping the smaller hospitals in our area in caring for patients and improve patient throughput.”  “As a team, we’ve done a lot of work in creating an engaging and positive environment, and our internal morale committee has been a huge help with that,” said Kelli McDonnell. “We’ve been working tremendously over the last year and taking all the feedback that we received from the Employee Engagement Survey to make improvements. We had 100 percent survey participation within five days, which is incredible.”  “I am so proud of our escalation and problem-solving skills,” said Becca Dietrich, RTOC Coordinator. “When an issue is raised to us, we will always find a timely solution on our end so our care teams can focus on the issue in front of them. We are the eyes in the sky, seeing movement everywhere.”  Each day in the life of our RTOC team members is a testament to their commitment, resilience and timework, making a profound impact on countless lives.

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It’s July 23, 2022, and I am arriving in Downtown Reno to walk in my first-ever Pride Parade. Even more amazing, I am going to be walking with a group of my coworkers, announcing to our entire community that our employer supports us being our full and truest selves. I arrived alone, but in the staging area I met new people who worked in other departments of Renown, coworkers I might never have met if not for Pride. I even took a selfie with one of these new friends. Someone passed around flags for us to hand out to the audience as we marched by. I took a rainbow-striped temporary tattoo in the shape of the Renown “R” and used my water bottle to apply it. There was an overwhelming atmosphere of excitement and joy that can only come from gathering with other human beings who are overflowing with love. We started the Parade waving handfuls of Pride flags high and gave those flags out to the audience as we passed. By the time we were done walking, our hands were empty, but our hearts were full. I couldn’t have stopped smiling if I’d tried. I’d joined the parade as a single person, but as we walked, I became part of a community. Not only the Renown community, but a community of Proud queer people across northern Nevada. And by extension, the LGBTQIA+ community all around the world – past, present and future.  With the multiple recent state laws proposing to strip away the rights of LGBTQIA+ people, many of us have felt a noticeable decline in our mental health and feelings of personal safety.  As a member of the queer community, I have felt these mental health effects too. I am fortunate and privileged enough to not have experienced workplace discrimination in my current position. But before Renown, I – like so many others in the LGBTQIA+ community – had a negative experience at a previous job, and afterwards I was hesitant to share my full self while at work. To be able to walk in a Pride Parade with my current employer, healed a little bit of that past pain inflicted by my former employer.  When our liberties are under attack, Pride is more important than ever. We must remind ourselves, especially when others cannot seem to remember, that we are loved and worthy of love. I am grateful to work for an organization that is willing and able to fight this good fight with us.  I will certainly be back to walk in this year’s Pride Parade, and I sincerely hope to see you there too! Be sure to wear comfortable walking shoes, sunglasses and of course keep your skin safe with sunscreen. Whether you’re part of the LGBTQIA+ community, or just an ally, you are welcome.

Read More About Employee Blog: Team Renown at Northern Nevada Pride

If you’re expecting a new baby, you may have been given the advice to hire a doula. You may have seen statistics of improved outcomes among those who’ve had a doula attend their birth. Perhaps you’ve heard that the etymology is from the Greek word meaning “to serve.” But how does a doula serve their clients? A doula is a non-medical birth professional who will guide you through labor, birth, postpartum and beyond. Your doula can discuss your options with you so you can make informed decisions, as well as provide emotional and physical support to ease your experience. While each doula offers their own style, there are certain services that most doulas will provide for their clients. Typically, a birth doula will provide at least one prenatal visit, one postpartum visit and continuous support during active labor. A postpartum doula usually provides support during the 12 weeks immediately following birth, sometimes referred to as the “fourth trimester,” but some will continue care after that as well. Simply put, a doula provides informational, physical and emotional support during the childbearing year(s). Let’s take a closer look at these three ways a doula can support you. The Basics If you don’t know your options, you don’t have any. This is a common phrase in the world of birth work. When you’re in labor, you’re exhausted, in pain and there’s often urgency inherent or implied in any choices you make. So, when an intervention is offered, many birthing people accept it without question. One method that can help the decision-making process is to check your BRAIN: Benefits: What are the benefits of the proposed intervention? Risks: What are the risks of the proposed intervention? Alternatives: What are the alternative options? Intuition: What does your intuition tell you? Nothing: What if we do nothing? What if we wait? When you’re in active labor, you might have difficulty remembering this acronym; that’s where your doula comes in. At your prenatal visits, you can ask your doula for guidance in preparing your birth plan, which can include contingencies for certain potential interventions. And as choices arise during labor, your doula can guide you through the benefits and risks and can provide you with alternative options you might not otherwise be aware of that are available to you. Your doula can remind you to check in with your intuition and can help you quiet your mind so you can listen to your instincts. The Body Although we tend to see depictions of people giving birth on their backs with their feet in stirrups, this is only one of many ways to give birth. Walking and dancing can speed up early labor. Side-lying or hands-and-knees can prevent tearing during the pushing stage. Sometimes labor stalls, and a change of position is often helpful to get things moving again. Your doula can suggest positions depending on your stage of labor. Some labor positions might require the support of another person – your doula could fill this role or assist your partner in doing so. Some doulas also provide massage or even acupressure, and most will do the “hip squeeze” that so many laboring people swear by. If your baby is presenting posterior, or “sunny side up,” your doula can apply counter pressure to alleviate back pain during labor. Some postpartum doulas will do light housework while you rest and bond with your newborn. Others might care for your baby through the night so you can catch up on sleep. Many doulas have also gone through additional training to offer breastfeeding support and may be able to assist you with latch issues and nursing positions. The Mind Pregnancy, birth and postpartum periods can be some of the most emotional times in a person’s life. A doula will hold space for you and help you process your emotions before and after birth. It’s normal to feel apprehensive, or even fearful, about labor and birth, and discussing these feelings is the first step. A doula can help you navigate your concerns in a safe space so you can be prepared emotionally for your upcoming labor. Many doulas will also guide you through writing your birth plan, which can lessen anxiety about the unknown. If you have a history of trauma, your doula can assist in communicating this, so you don’t have to relive the experience every time you meet a new medical provider. Most people will experience some form of what’s often called the Baby Blues in the immediate postpartum period. The third day after birth tends to hit hard, as hormones attempt to regulate, but the Baby Blues can continue for weeks for some new parents. A postpartum doula’s support can be incredibly valuable during this time. When the baby blues last longer than a few weeks, it could considered a mood disorder. Most doulas will recognize signs of postpartum mood disorders and will have resources available for additional support. Choosing the Best Doula for You With so many wonderful doulas in northern Nevada, you might wonder how you could ever choose just one to attend your birth. Some expectant parents are unfortunately restricted by cost. With so many expenses related to a new baby, it can be difficult to budget doula services as well. Thankfully, Nevada Medicaid now covers doula care, and some commercial insurances are following suit. Check with your insurance company to find out if they might cover part of the cost for hiring a doula. If your insurance doesn’t cover doula services, some doulas offer a sliding scale based on income. You may want to interview multiple doulas to find the right one for you. If you’re the kind of person who wants all the information you can get, a more detail-oriented doula might be the best choice. But if you tend to feel overwhelmed by too many options, you might prefer a doula who only offers additional information as the situation calls for it. If you want massage or acupressure during labor, you might want to hire a doula with those certifications. Or maybe informational and physical support are not as important to you as emotional support, in which case your best choice could be a doula who has experience with postpartum mood disorders or trauma support. Regardless of who you hire, be sure to clearly communicate your desires and expectations – not just for your birth, but also for your doula. The most important thing when choosing your doula is trusting your gut. You need to feel comfortable with your doula, as they’ll be tending to you at one of the most vulnerable times in your life. When you find a doula that you click with, who listens to you and supports your choices, you have found the best doula for you.

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A well-child checkup is a great opportunity to monitor your child’s growth and development, and it's also a chance to establish a trusting relationship with your child’s pediatrician and have your questions answered. What to Expect at Each Checkup At every checkup, a comprehensive physical examination will be conducted to assess your child's growth parameters, including height, weight and head circumference. A developmental assessment will evaluate the progress of your infant or young child in achieving age-appropriate milestones, encompassing language skills, motor development, problem-solving abilities and psycho-social skills. In addition, your pediatrician will address common concerns such as feeding, sleep patterns, oral health and general infant care. Unless there are specific needs or concerns for your baby, routine laboratory tests are typically unnecessary. Your pediatrician will provide guidance on immunization schedules, post-vaccination expectations and when to seek medical attention. Furthermore, during each visit, you will receive age-specific guidance to help you anticipate your child's expected growth and development, along with essential safety precautions and illness prevention measures. Your pediatrician will discuss various topics, such as placing your baby to sleep on their back, utilizing rear-facing infant car seats until around age two, maintaining home water thermostats below 120 degrees Fahrenheit, ensuring dangerous objects and poisonous substances are out of sight and reach, emphasizing dental health and promoting the use of bike helmets, among other things. Preparing for Your Visit It is recommended that, as a parent, you write down any questions beforehand, so you don’t forget them in the moment. Most importantly, feel comfortable asking your pediatrician about anything that might seem unusual, as you are the parent, and you know best! Before leaving the pediatrician’s office, be sure that you fully understand any instructions given to you and ask for clarification if needed. From your child’s birth through young adulthood, you will be visiting your pediatrician regularly. The American Academy of Pediatrics provides what a regular schedule might look like. Well-Child Checkup Schedule Two to three days after birth and at one month Two months Four months Six months Nine months One year 15 months 18 months 24 months 30 months Three years, and yearly after

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Taking a few minutes to prepare for your child's pediatrician visit helps ensure that all your child's medical needs are met. Knowing the right questions to ask your provider can help you get the most out of your visit and ensure you and your child feel comfortable and informed. It is essential to base your questions on your child's specific health needs, but the ten options below are a great place to start. How is my child's overall health and development progressing? Is my child meeting their developmental milestones, and are there any areas where they may need extra support? What vaccinations does my child need, and are they up to date on all required immunizations? Are there any nutritional recommendations or concerns for my child's age and stage of development? What are some strategies for promoting healthy habits and physical activity for my child? Are there any warning signs I should look out for regarding my child's health or behavior? What can I do to help prevent common childhood illnesses like colds, flu strains or ear infections? What should I do if my child gets sick, and when should I seek medical attention? Are there any changes to my child's medication or dosage that I should be aware of? Is there anything else I should know or be aware of regarding my child's health or development?

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As many nurses can attest, the journey they have taken to arrive at where they are today is full of twists and turns. For Zarah Jayco, an operating room nurse at Renown Regional Medical Center, her journey is nothing short of a fulfilling and exciting one. Zarah is no stranger to taking detours to find what truly makes her feel the bursts of passion she had been looking for her entire life. She found that passion in the operating room – and travel nursing led her to Renown Health. Today, she is a firm believer that she is exactly where she is supposed to be.  “I Just Want to Help People”  Throughout her life, Zarah knew she was destined for a meaningful career – but didn’t exactly know what. One day, she sat down with her mom, a nurse herself, where she asked the question that would ignite Zarah’s curiosity: What is important to you?  “That’s when I told my mom: ‘honestly, I just want to help people.’”  It was at that moment that she realized nursing could be a fit for her. Everything about venturing into the nursing field started to make sense.  So, that’s precisely what she did. Zarah went to nursing school. When she stepped into the OR during her clinical rotation, she was immediately inspired.  Zarah’s core values as a nurse were rooted from caring for her 90-year-old grandmother while she was in hospice. Her grandmother gave her some powerful lessons and words as she set off on her career: “You are in the right place.”  Upon completion of her perioperative program, Zarah the OR Nurse we know and love started her journey. She began her trek as a travel nurse, going up and down California to do exactly what she was meant to do: care for surgical patients.  “I Traded the Ocean Waves for the Mountains”  As Zarah continued to travel and find different locations for new assignments, her husband received an opportunity for work to transfer to the Biggest Little City. The duo packed up their California lives and moved to northern Nevada, where Zarah signed up for a night shift OR nurse position at Renown Regional Medical Center.  But the traveler’s mindset wouldn’t last long.  Renown embraced Zarah with open arms, and she was immediately drawn into the community-feel that our health system offered. She felt welcomed and surrounded by “loving, hardworking people” across her department and all other teams she encountered.  As Renown cares for patients across 100,000 square miles, Zarah was especially impressed with how rooted Renown is in northern Nevada, noting how it “truly feels like we are caring for the community” with our health system’s wide reach. She was inspired to live up to that mission and more.  “Reno and Renown really reeled me in, and I fell in love with the city and everything it has to offer,” said Zarah. “I traded the ocean waves for the mountains, and the more we got to know Reno, the more we realized that this change of pace and lifestyle was definitely a good fit for us.”  Zarah the OR Travel Nurse became Zarah the Renown OR Core Staff Charge Nurse. And she knew she made the right decision.  Working in the OR, according to Zarah, is challenging in the best way possible. At night, all surgery cases at Renown are emergencies. The team springs into action to answer one vital question: How do we provide the best care for this patient?  “It is essential for us to anticipate potential outcomes,” said Zarah. “When we book a surgical case, we look at everything to make sure we are absolutely prepared and ready.”  Staying at Renown was an easy choice for Zarah. To her, there is nothing like being a part of a core team that inspires her every day and ‘has each others’ back,’” Zarah stated. “During the course of my assignment at Renown, the culture harnessed a kind of environment that felt like a hardworking family. This was the hook that reeled me into considering being part of core staff. I am incredibly grateful for the opportunity to build relationships that I hold in the highest esteem.”

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Senior Care Plus is pleased to announce we are now a proud sponsor of Jam On It Pickleball, open to the community seven days a week at the Reno Sparks Convention Center. We’re excited to help promote this fun activity to our members, employees and the public. Pickleball has many wonderful health benefits – particularly for seniors. It’s a low-impact game that raises the heart rate, improves hand-eye coordination and increases mobility. In addition to the obvious physical benefits, pickleball is a great social activity. Getting out of the house and playing a fun, easy-to-learn game with others is a great way to make new friends while improving your physical and mental health!   Ralph Barbato, a Senior Care Plus member from Reno, is a huge fan of pickleball and all it has to offer. “Pickleball has made such a positive impact on my life. I love the physical and mental health benefits along with the social aspect – it’s a great way to meet new people and I’m excited to have it in our community,” said Ralph.

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Giving birth expends as much energy as running a marathon. And just like you would only run a marathon with training beforehand, there are exercises you can do to prepare for birth. But instead of a coach, you'll have your birth team. Your birth team exists to help you navigate pregnancy and labor and support your choices. Let's say you've never put together a birth team before and are wondering where to start. Today we'll go over the three main positions to fill for your birth team's starting lineup. Birthing Person The birthing person is the leader of the team. After all, you can't have a birth team without someone giving birth. This person could be the baby's mother, gestational surrogate, birth parent before adoption, a transgender father or a non-binary parent. If you are not the birthing person, don't presume to know what the ideal labor and birth circumstances should be. And if you are the birthing person, don't allow anyone else to tell you what you want. This is your body and your birth; you are the boss in the birth room. Doula No birth team is complete without a doula, and although doulas have increased in popularity lately, many people still don't know what a doula is. Simply put, a doula is a birth professional – not a medical provider – who offers emotional, physical and informational support during pregnancy, labor and beyond. Most doulas' services include at least one prenatal visit and one postpartum visit, as well as continuous care throughout active labor. Some doulas provide more than one prenatal/postpartum visit, so be sure to ask what is included in their fee. Even if you have a partner who will support you during labor, studies have shown that a doula can significantly increase your likelihood of a positive birth outcome. Even the most supportive partner needs to rest, and a doula can ensure that you still get the care you need while your partner gets a break. Midwife or Obstetrician Finally, you'll want to choose the medical professional who will attend your birth. Many folks choose to give birth with the OB/GYN who does their annual check-ups, but there are many reasons someone might choose a different provider for their birth. The first step to finding the best attending provider for your birth is to decide which model of care aligns closest to your values and goals: the Midwifery Model of Care or the Medical Model of Care. .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-qm8j{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-2rvk{background-color:#ffffff;color:#000000;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} Midwifery Model of Care Medical Model of Care Philosophy Birth is physiological. Birth is potentially pathological. Interventions Medical interventions can cause more complications, and therefore are only used as needed. Medical interventions should be used, even in non-emergency situations and sometimes as preventative measures. Decisions Birthing person is the key decision maker. Medical professional is the key decision maker. Provider’s Role Providers monitor labor and will intervene or transfer to hospital if needed. Providers assess and control the birthing process.

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Shining Brightly We all carry a light inside of us. Some people seem to have a constant glow while others flicker brightly here or there depending on what they’re doing or who they’re with. But for another select group, the light they embody is closer to a sunrise, illuminating and embracing everything and everyone it touches. Do you think that’s a bit heavy-handed or just a writer’s poetic exaggeration? Well, that’s because you haven’t met this issue’s featured Sterling Silver Club member, Tami, yet. But that’s about to change…  This Little Light of Mine  As an infant, Tami’s adoptive parents were drawn to her light, even though the couple had come to an orphanage in Washington state hoping to find an older child to add to their family.  “My parents always said that after seeing and holding me, they had to take me home,” Tami remembers and then smiles. “They also liked to tell the story of how they sold their prize baby bull, Johnny Apollo, to pay my adoption fees!”  Tami has fond memories of making mud pies and climbing trees as a child and feels privileged to have been raised by older parents.  “They both lived through the Great Depression and my dad proudly served in the U.S. Navy in World War ll,” says Tami. “I certainly attribute learning to love and give unconditionally through their humble ways. I had the honor of taking care of them both for about 10 years before their passing. When asked who my heroes are, though I have several, they are at the top of that list for sure.”  Today, Tami is married to her high school sweetheart, Richard. They’ve been together for 43 years and have five children – and 10 grandchildren – of their own.  Helping Others Through Darkness Tami started a highway construction business with her family in 2000, but focused 18 years of her career around her love of teaching, with seven years spent as Vice Principal of Academics at Reno Christian Academy. One of her greatest joys during that time was implementing Prime Time, a program that set aside special time for students who had experienced recent traumatic events. “I used puppets, sewing, crafts – any activity the students would respond to,” explains Tami. “But mostly, I listened.” And when one of her students shared, “I just want someone to listen to me for an hour today” – that’s what she did. “We sat on the sidewalk and ate Fudgsicles and giggled at the silliest things,” Tami recalls with some emotion. “And when we both left smiling, I was reminded that the most beautiful moments are when we are simply present with an open heart.”

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