Search

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.

Read More About Department Spotlight: Renown Transfer and Operations Center

Becoming a parent for the first time means lots of new unknowns – from learning to breastfeed and swaddle to buckling your newborn into the car seat for the first time. But when it comes to putting them to bed safely, it’s important to remember it really can mean life or death. It’s something we’re taught before our little one is even here: the correct way to put your baby to bed safely. Sadly though, the number of infant deaths continues to climb. The main culprit of sleep-related infant death continues to be all the items parents leave in the crib with their babies. According to the Center for Disease Control and Prevention, there are about 3,500 sleep-related deaths among babies each year. “The best advice is ‘bare is best.’ Keep your infant’s sleep space clutter free – no blankets, bumpers, toys or pillows,” said Karen Wagner, Pediatric Nurse Practitioner. Follow the ABCs for Safe Sleep Remembering the ABCs is an easy way to remember how to put your little one to bed safely. A: Alone No blankets, toys or pillows. “We do recommend using a sleep sack as a blanket alternative,” said Karen. “It prevents the risk of suffocation and keeps your baby warm.” Keep in mind, the greatest risk for suffocation happens when babies are under 1 year of age, so it’s best to save the toys, blankets and pillows for their “big kid bed,” or around 18 months old. B: Back The slogan “back is best” is another good reminder. Keeping your baby on their back until they’re old enough to rollover helps reduce the risk of Sudden Infant Death Syndrome (SIDS). C: Crib It is best to have your baby sleep alone in their crib. While co-sleeping may be enticing, especially after a late-night feed, it increases the risks of possible suffocation. However, “having your child in your room, in their own crib or bassinet, is protective for SIDS,” Karen said. “In fact, we think co-rooming reduces SIDS risk by almost 50 percent.” Co-rooming allows parents to keep new babies in close reach and helps parents oversee their baby’s sleep, just in case something happens.

Read More About Top Safe Sleep Tips for Your Baby

Renown Health strongly supports and advocates for innovative medical technology. Our diverse lineup of medical equipment enables our care leaders to provide quality care to every patient. But what if a piece of technology breaks down? What happens when our care teams are ready for technological upgrades? Where do employees go when they have a question about a complicated piece of equipment?  Enter the Clinical Engineering department. This sophisticated team is staffed with intelligent, science-minded individuals who are ready to jump in and help at any given second. From newborn incubators to robots that clean the hospital floors, these team members are the med-tech masters that keep our health system running.  Equipment Experts  Upon entering the Clinical Engineering department’s workshop, you are welcomed with an abundance of high-tech equipment undergoing repairs and upgrades. The department takes care of more than 26,000 pieces of equipment throughout the entire healthcare network, including the technologies at the University of Nevada, Reno School of Medicine, which they just took over this past year. To the average person, this may seem overwhelming; however, for this team, this is the exact environment they thrive in to make the technology magic happen.  “I am motivated and engaged every day at work,” said Tony Martinez, Supervisor of Clinical Engineering for Renown. “Our department is fast-paced and rewarding, and that’s a big plus.”  While some team members enter the department as equipment generalists, this team offers training to develop their skills on certain pieces of equipment, eventually becoming specialists.   “Every month, we encourage our colleagues to undergo specific training on more delicate equipment,” said Tony. “Once we get to that point in their training, we assign different equipment to our team members every month. They pick up the experience very quickly.”  As a Clinical Engineering Technician for Renown, Rylie Nickerson took advantage of the training and educational opportunities offered to her and is now a ventilator specialist especially for Renown’s neonatal intensive care unit (NICU). “Regardless of whether I’m working on ventilators or on another piece of equipment I’m assigned to, I’m always thinking about how I can help the patients, nurses and doctors,” said Rylie.  Raul Hernandez, a Clinical Engineering Specialist for Renown, is the go-to person for anesthesia, heart-lung bypass, red cell saver and life support equipment. He embraces the fact that, regardless of whether you are a specialist or a generalist, there is no typical day working in this department. “Every day brings different challenges,” said Raul. “I really enjoy the mental exercises I do every day. They keep me grounded and focused.”  On top of their day-to-day work and any special projects or emergencies that come up, the team is on an ongoing preventative maintenance schedule. Think of this work like your car’s oil change – routine maintenance to prevent something from breaking down in the future. “At any point, we might have 100-200 extra pieces of equipment to handle during preventative maintenance,” said Taylor Gray, a Clinical Engineering Technician for Renown. “We are always helping each other through any issues.”  Our Clinical Engineering team shows exactly what it means to be collaborative. Even though their to-do lists are ever-growing, this team never feels alone. They know they can always lean on each other for support, regardless of the workload.  “We always have each other’s backs,” said Taylor. “I feel so happy and satisfied in my job, and my coworkers are a large part of that.”  Celebrating the Genuine Difference  The Clinical Engineering department is driven by their desire to help and take care of the entire health system, and in turn, make a genuine difference for the communities we serve, from the medical staff to the patients.   “The satisfaction you get in our field when we impact patients’ lives and their healing process is so motivating and engaging,” said Tony Martinez. “It’s a great feeling.”  The team knows the common saying ‘Walk a mile in someone’s shoes’ very well; so well, in fact, that they take it to the next level, doing everything they can to prevent frustrations and extended down times. “We try to walk a mile in someone’s shoes before they get angry,” said Reagan Jordan, Director of Clinical Engineering for Renown. “Your satisfaction is our mission, and our team continually works to improve their outcomes every day.”  This department is where the entrepreneurial spirit and science-focused mind meet. For people like Raul Hernandez, who came from a business background as well as decades of medical technology experience, Renown helps him bring both his personal and business skills into focus. “This environment is very beneficial for Renown, me, and of course, the patients,” added Raul.  Being members of a team that is committed to excellence and purpose inspires them to reach new heights in patient care.  “I am constantly reminded of the positive impact we have by witnessing the individual experiences we have and hearing the enthusiasm and thankfulness in their voices,” said Raul. “It gives me a great sense of pride to work at Renown.”  "There is a strong feeling of mutual respect here,” added Ed Trejo, a Clinical Engineering Technician at Renown. “We are always here to help.”  The proof is in the data. The Clinical Engineering team scored as one of the top departments in the recent Renown employee engagement survey, with their results sitting at more than 94 percent.   “This speaks to not only our department leadership but also the team as a whole,” said Reagan. “I am extremely proud of them. Despite the pandemic, they are knocking it out of the park.”  For this department, coming to Renown is easy; staying at Renown is even easier.  “Staying at Renown is the easy choice,” said Raul. “And this team is only going to grow.”  Workflow Whizzes and Kindness Champions  “Rolling with the punches,” as Tony Martinez says, comes naturally to the Clinical Engineering team. With the constant workflow of equipment coming into the shop, every team member has learned how to be experts at prioritizing, especially based on the needs of our organization.  Even though their jobs can bring a lot of intensity, this department’s positive attitude radiates throughout the hospital. Upon entering the workshop, everyone is greeted with a smile from every team member, along with an immediate willingness to dive into the complex world of engineering.  “The experience of helping other people with their unique needs is invaluable,” said Taylor Gray.  If this work environment sounds enticing, great news – the Clinical Engineering team is growing. Motivated, aspiring engineers with a passion for healthcare and an associate’s degree in a related field are welcome.   Military experience is also valued very highly in this team. As many of our military servicemen and servicewomen gain specialized engineering experience while enlisted, the military-to-engineer career ladder at Renown is especially strong. In fact, according to Paul Joseph, a Clinical Engineering Technician at Renown, the majority of their teammates come from a military background.   Above all, being capable of prioritizing on the fly, thinking critically, having an open-mined outlook and being self-driven are the top skills that this department values. As Ed Trejo states, “If you’re willing to wear different hats, you will do very well here."  “Go with the flow, and expect the unexpected,” added Rylie Nickerson.  Those who join this team feel at home. The warm embrace of the team’s kind nature and the supportive environment they all foster inspires an efficient workflow that helps our entire hospital system function at the top of its game. At the end of the day, everyone who joins the team, or anyone who even interacts with the team in any capacity, will be in good hands.  Mandy Noriega, a Clinical Engineering Technician for Renown, closes these thoughts with a great reminder to each and every one of us: “After all, teamwork makes the dream work.”

Read More About Department Spotlight: Clinical Engineering

Eating a well-balanced and nutritious diet when pregnant is one of the more essential things you can do for your baby and yourself. The basic principles of what to eat when pregnant are quite similar to how we should be eating all the time. This includes focusing on fruits, vegetables, whole grains, lean protein and healthy fats. Of course, there are a few areas that you should pay close attention to when you’re pregnant and a few foods you should avoid. We consulted Renown Health’s Caitlin Bus, RD, LD, CDE to learn more about pregnancy nutrition. Foods to Eat Regularly: Veggies Vegetables of all kinds -- and in all forms -- are beneficial for you and your baby during pregnancy. Veggies ensure your body is getting the fiber, vitamins and minerals it needs. However, fresh or frozen veggies are considered best, but if you choose to eat canned veggies, make sure you choose a low sodium product. The more greens, the better! If you have an aversion to vegetables, especially in the first trimester, try sneaking them into smoothies. Healthy Proteins Protein-rich foods support your baby's growth while giving your body the nutrients to build and repair tissues, including your muscles, hair, skin and nails. Although protein requirements vary from person to person, a pregnant woman needs additional protein for her baby's growth, especially in the second and third trimesters. Regularly eating high protein foods -- like fish, chicken, turkey, eggs, peanut butter, nuts and beans –– promotes your baby's healthy brain and heart development. Grains Food like brown rice, quinoa, whole-wheat pasta and oatmeal are great to eat while pregnant. They are rich in fiber, iron, B vitamins and folic acid, which are all beneficial to physical development. Grains also help alleviate constipation and hemorrhoids. Fruits Fruit can help satisfy any sugar cravings you have when pregnant while also supplying your baby with nutrients – it's a win-win. Some people advise against fruit consumption while pregnant, but this is a myth. Like with all foods, moderation is key. Fruit can be high in sugar, so it is important to be aware of your intake. Also, make sure you are mindful of your preparation – thoroughly rinse produce under running water for 30 seconds to help avoid foodborne illness. Pasteurized Dairy Dairy products like milk, cheese and yogurt can be great sources of protein and calcium needed for the healthy development of a baby's bones, teeth and muscles. These foods also help with ensuring healthy heart function and nerve transmission. When buying these products, make sure to choose pasteurized products to avoid exposing your body to germs and bacteria. The American College of Obstetrics and Gynecology recommends 1,000mg of calcium per day for pregnant and lactating women. This equates to 4 servings of dairy or calcium-rich foods such as leafy greens, broccoli, tofu, almonds or dried figs. DHA Omega-3 Fats Omega-3s like DHA help support the health of a baby's brain and parts of their eyes. Women who are pregnant or breastfeeding should eat at least 8 ounces and up to 12 ounces of seafood each week. Ideally, food sources that offer DHA omega-3 and that are lower in mercury should be emphasized in your diet, including fish like salmon, sardines and anchovies. If you do not eat fish or omega-3 fortified foods, a DHA omega-3 supplement is recommended. Choline Did you know that 92% of pregnant women fail to meet the daily choline recommendation? Choline is crucial for an infant's brain and central nervous system development. One egg supplies 33% of the recommended daily intake. Although choline is often absent or low in prenatal vitamins, the best food sources include eggs, meats, fish, dairy, navy beans, Brussels sprouts, broccoli and spinach. Iron and Folic Acid Iron is the most common nutrient deficiency during pregnancy. Foods with high and moderate amounts of iron include red meat, chicken, fish, fortified cereals, spinach and beans. Folic acid is used to make the extra blood your body needs during pregnancy. Consuming adequate folic acid early in pregnancy reduces the risk of birth defects that affect the spinal cord. It is recommended to consume 400 micrograms (mcg) per day for pregnant women. This amount is included in your prenatal vitamins. Water Staying hydrated is one of the best things you can do for yourself and your baby when pregnant. In addition to just being good for you, hydration alleviates morning sickness and nausea, while dehydration can lead to contractions and even pre-term labor. Aim for 10 cups of fluids per day, on top of the water naturally occurring in foods. Foods to Avoid: Raw Fish and Fish with High Mercury Content Sorry sushi fans, according to the Center for Disease Control and Prevention, pregnant women are 10 times more likely to get infected by Listeria, a bacteria found in raw or undercooked fish. Also, avoid fish often found to be high in mercury, including swordfish, king mackerel, tuna and marlin. Processed or Raw Meat Similar to eating raw fish, eating undercooked or raw meat increases your risk of infection while pregnant. Hot dogs and lunch meats should also be avoided, unless they have been reheated to be steaming hot (for example, in a microwave). Alcohol Drinking alcohol when pregnant can impact your baby’s brain development and increases your risk of premature birth, low birth weight or miscarriage. Just don’t do it! Minimize Caffeine High caffeine intake during pregnancy can restrict your baby’s growth; therefore, it is recommended that pregnant people limit their caffeine intake to less than 200 mg per day – that’s roughly two cups (16 fl oz) of coffee per day. Runny Eggs Eating raw or runny eggs when pregnant increases your risk of Salmonella, which can cause fever, nausea, vomiting, stomach cramps and diarrhea. Always make sure your eggs are cooked through or use pasteurized eggs.

Read More About What Foods to Eat and What to Avoid When Pregnant

If you think sore nipples are just a normal part of breastfeeding, think again. Robin Hollen, APRN, and Breastfeeding Medicine Specialist, says that nursing can be an enjoyable experience for mom and baby without pain and discomfort. A top concern of nursing moms within the first week after delivery is how to prevent sore nipples. Even moms who’ve nursed before struggle with this common issue. While many women think it is a regular part of the nursing experience, it is actually a sign that something isn’t quite right. “Nursing your baby should be enjoyable,” says Robin Hollen, Breastfeeding Medicine Specialist with Renown Health. For over 30 years Robin has been supporting moms to breastfeed. Below she shares some valuable information and tips, helping you create a happy and healthy breastfeeding experience for you and your baby. What causes sore nipples? The most common cause of sore nipples involves incorrect latching. For a proper latch, a baby’s mouth takes in the entire nipple and some of the breast, so that the nipple rests at the back of the mouth where the palate is soft. With an improper latch, the mouth may slip down to the tip of the nipple while the baby nurses. This constant pressure on your sensitive skin may cause discomfort and pain. A board-certified lactation consultant can help assess if your baby is latched correctly and troubleshoot your breastfeeding concerns. Less common causes of sore nipples include: • Improper tongue placement of baby • Clenching • Incorrect breast pump use How can a mother prevent sore nipples from an improper latch? Breastfeeding is a learning experience for both mom and baby. Ask for help with the latch so your baby learns it correctly and maintains its depth. In the past, new mothers were surrounded by a community of women — their own mothers, grandmothers, or other family and friends — to provide assistance and guidance with every latch at the beginning of an infant’s life. In today’s culture, new moms can find themselves on their own with no extended family to lend their knowledge. Nurses, pediatricians and lactation consultants now fill that role; they are the eyes and hands along with the much-needed experience to guide new mothers. Our Breastfeeding Medicine experts assist nursing moms with latch every day. Even a single visit with a lactation consultant observing your breastfeeding baby can provide valuable insight on achieving, and maintaining, the proper latch - preventing future nipple soreness and discomfort. How to heal sore nipples from breastfeeding To heal sore nipples, you must first fix the cause, and correcting the latch prevents further damage. A lactation consultant can also help you address the pain. Below are some breast healing tips: • Your own expressed breast milk is excellent to rub into the nipple for anti-bacterial protection. • For those moms who need more lubricant or fat than breast milk offers, use a lanolin or a cream that is labeled safe for the baby. • Soothies are a gel pads providing comfort in between feedings, but should not be used with lanolin products. • Breast shells, not to be confused with shields, can guard the nipples from irritation or pressure in between feedings. If you have more questions about preventing and healing sore nipples or general breastfeeding concerns, talk to your pediatrician or a Renown Health Breastfeeding Medicine specialist at 775-982-6365.

Read More About Breast Feeding Doesn't Have To Mean Sore Nipples

While breastfeeding is natural, it's not always easy. We asked Certified Lactation Counselor Sarah Mitchell for some tips to help make the process easier for mom and baby. From increased infant immunity to improved maternal health and well-being, the benefits of breastfeeding are many. Still, only 60 percent of U.S. moms in the United States continue to breastfeed past their baby's first six months. There are for many reasons for why moms stop, including the mother's their need to return to work. We reached out spoke to Sarah Mitchell, a certified lactation counselor at The Lactation Connection at Renown, for some expert advice. Tip 1 At first, it's normal to expect obstacles. Even in cultures where close to 100 percent of moms breastfeed, they can experience issues, including getting the baby to "latch on," sore nipples, and milk production. In addition, it sometimes can take several weeks for mom and baby to get comfortable. Tip 2 Line up a coach, even before the baby is born. This can be a professional lactation coach, family member, or friend who is experienced and encouraging. While online videos can be helpful, most new moms need the one-on-one guidance that a coach can provide. Renown offers outstanding resources in its Lactation Connection center, including expert consultants, products, and support. Tip 3 Well ahead of the due date, set up a support network of friends, family members, or community groups such as La Leche League. Women historically have relied on extended support systems to help them with raising children, and breastfeeding is one of those areas that, while natural, still needs encouragement from the women who’ve been there. Tip 4 Don’t get discouraged if you need to supplement at times with formula. This, too, as it turns out, is not uncommon in other cultures. In other parts of the world, babies are given beverages and foods such as tea, broth, soup, juice, mashed bananas, and papaya. The American Academy of Pediatrics recommends supplementation only with approved formula -- but the point is, it’s ok to supplement if you need to. Finally, don’t forget the importance of breastfeeding for connecting with your baby. It’s essential to maintain breastfeeding over the weekends, preferably “on-demand,.” and will keep that special bond strong after you have returned to your job.

Read More About 4 Breastfeeding Tips for New Moms

If you’re a parent, you’ve probably been there — the sometimes-nightly struggle to get your little ones off to bed. Elaina Lantrip, an APRN with Renown Pediatrics, offers some tips and explains how your child’s electronics may be getting in the way of a good night’s sleep. These days, kids are consuming media from a very early age on all types of devices — from tablets and phones to TVs. While they can benefit from some media use, it can have a negative impact on bedtime. We asked Elaina Lantrip, an advanced nurse practitioner with Renown Pediatrics, for some advice on downloading a better bedtime routine. What are the most important practices for parents to establish for their children’s bedtime routines? I often have parents tell me that their child won’t go to bed — or to sleep. Parents frequently ask for tips on bedtime routines that work. My first question is whether their regular bedtime routine involves television, iPad, tablet, phone or anything with a screen. It’s very important that bedtime includes a bath, reading a story, talking, singing and bonding with young ones, rather than using any devices. Why shouldn’t children have a device at bedtime? A growing body of research supports that screen time at bedtime contributes to delays in a child’s falling to sleep; overall inability to reach the important REM, or deep sleep; waking up during the night; nightmares and night terrors. For older youth, engaging with social media before bedtime can bring up stresses, emotions and relationship issues with peers that don’t exactly create peaceful bedtime thoughts. Bedtime should be a screen-free, stress-free, peaceful time of day. It’s a great time for parents to promote self-esteem, talk through things going on in the child’s life, to encourage and build them up. Children grow up fast — bedtime is a great the opportunity with younger children to cuddle up and read a story or sing a lullaby. What are other major considerations in making bedtime smooth and relaxing for kids and their parents? Another factor that contributes to positive sleep habits includes children getting enough activity during the the day so they’re genuinely tired at night. Also helpful are ambient noise makers, peaceful music, avoiding sugar two hours prior to bedtime, consistency in bedtime routine, comfortable pajamas and comfortable temperature in the home. Is it important to keep the child’s bedroom dark? Dimming the lights is important, regardless of the time of year. This is another reason to ban screens, as they emit light that stimulates wakefulness.

Read More About How to Get Your Kids to Sleep, Screen-Free

One of the most pressing issues in modern medicine is the need to improve rural healthcare. This challenge hits particularly close to home, as Renown Health is the only provider covering 100,000 square miles in northern Nevada, an area that’s mostly rural. People in rural areas suffer from chronic diseases such as heart disease, cancer and respiratory disease, at higher rates than the general population. One of the largest contributors to these health disparities is a lack of access to health services. Many rural communities have fewer providers and care facilities. This forces residents to travel farther to receive preventive care and medical treatment. We must identify ways to better support the health needs of the millions of Americans who live in rural communities. Ideas for improving rural healthcare Health systems must identify innovative ways to leverage existing resources and new technologies to care for patients in these communities. For example, telehealth can help diminish a person’s need to travel long distances to receive specialty care. Similarly, online classes can help educate patients about preventive behaviors. Remote monitoring technology also allows patients to track their health conditions from home. Additionally, we can address physician shortages by empowering health professionals such as nurse practitioners, physician assistants and technologists to care for patients. These providers receive excellent training and have demonstrated success in improving health outcomes. Renown Health cares for people from diverse backgrounds and we are dedicated to caring for patients in every community we serve. Renown Telehealth We’re leading the region in using video conferencing technology to provide the best care possible – no matter where you are. Renown Telehealth is telemedicine that gives you access to top-level care and better outcomes with less stress and fewer travel costs. Learn More

Read More About Improving the Way we Deliver Quality Rural Healthcare

Dr. Max J. Coppes, Physician-in-Chief Renown Children’s Hospital, and Nell J. Redfield Chair of Pediatrics, UNR Med, talks about how much is too much when it comes to teens and social media. Social apps (Facebook, Instagram, Twitter, WhatsApp, Snapchat, TikTok, etc.) have become an integral part of most people’s lives. In contrast to traditional media — where one source goes to many receivers — social media operates in a dialogic transmission system. Many sources interact, sometimes simultaneously, with many receivers and provide for superior interactivity between its users. Not surprisingly, it also plays a significant role in our children’s lives once they are old enough to understand how to access and use these apps. On average, children start exploring social media at around ages 10 to 12. They rapidly discover that electronic communication allows for unique and personalized ways to make and keep friendships. They also use it to develop and expand family ties, get help with homework, share music, art, and experiences, and learn and discover the world. Social Media and Teens Surveys suggest that more than 90 percent of teenagers use social media. Additionally, approximately 75 percent have at least one active profile by age 17. Access to social media is greatly facilitated because more than two-thirds of teens have their own mobile devices with internet capabilities, a substantial change relative to previous generations. The use of social apps can have many positive aspects. But we now also recognize that it can also have negative impacts. The use of hazardous sites or the inherent risks of using social media (identity theft, being hacked, cyber-bullying, etc.) are indeed damaging to children. Any use of hazardous social apps is too much and carries serious hazards. But what about the use of “normal” and/or “safe” social media? Well, data suggest that too much use of “non-hazardous” apps can indeed affect health. How Much Do Teens Use Social Media? First, some basic data. For example, how much do normal teenagers use social media? A study from Pew Research found that more than 50 percent of 13- to 17 year-olds go online several times a day. This quickly increases during the teenage years to more than 70 minutes per day. Teenage girls have the highest usage at just over 140 minutes per day. It is important to recognize that non-school related use of the internet and social media is often beheld by teenagers as important for developing their self-esteem, their acceptance among peers, and their mental health in general. As parents, we recognize that the use of social media can indeed contribute, in many positive ways, to our children’s growth. At the same time, we also worry about them spending too much time online. We worry about their ability to communicate effectively in face-to-face settings or in writing. Many of us also feel and/or worry that our children are addicted. Social Media and Addiction Recent studies suggests that the overuse of social media indeed mirrors addiction. Reports now show that teenagers and college kids experience anxiety when deprived from their connected devices and consequently feel a compulsion to access their social applications. The emotional symptoms they experience are very similar to those seen in substance abuse. In fact, the American Psychiatric Association is considering making internet addition a bonafide diagnosis. Pediatricians therefore encourage limits on the use of social media, a recommendation more easily suggested than accomplished. So when should a parent consider seeking help? Aside from unhealthy use of these apps (cyber-bullying, sexting, online users asking for sexual relations, etc.), which should always trigger concern, the use of social media for more than 120 minutes per day should trigger parental concern. If you feel unable to address the overuse of social media, contact your pediatrician for help and guidance. Renown Children’s Hospital Whether it’s seeing a pediatrician, getting a sports physical or looking for advice, our care is centered around supporting and nurturing patients and families at our many locations. We have pediatricians dedicated to children who have experience recognizing children’s illnesses. They also have knowledge about tests and treatments for young ones to ensure your child gets the best care possible. Explore Children’s Services

Read More About Teens and Social Media: When Is it Too Much?

Breast milk. It's often referred to as liquid gold. And fortunately, it can be safely refrigerated or frozen for later use, which can allow you to be a bit more flexible in your new routine with baby. Whether you're getting ready to return to work, planning for the chance date night out or just exclusively pumping, it's crucial to understand the guidelines for proper breast milk storage. Storing Breast Milk Use clean bottles with screw caps, hard plastic cups that have tight caps or nursing bags (pre-sterilized bags meant for breast milk). Be sure to label each container with the date the milk was pumped and your baby's name if the milk is going to childcare providers. You can add fresh, cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have two ounces of frozen milk, then you can add up to two more ounces of cooled milk. For healthy full-term infants, milk can be stored as follows: Room temperature - six to eight hours (no warmer than 77°F, or 25°C). Refrigerator - up to five days at 32°-39°F (0°-3.9°C). Freezer– Varies depending on freezer type. Up to two weeks in a freezer compartment located within the refrigerator. Three to six months in a freezer that is self-contained (standard kitchen fridge/freezer combination) and kept at 0°F (-18°C). Breast milk should be stored in the back of the freezer and not in the door. Six to 12 months in a deep freezer that is kept at -4°F (-20°C). Be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes. Thawing Breast Milk Place frozen breast milk in the refrigerator to thaw (about 24 hours) then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, remove it from the freezer and run warm water over it until it's at room temperature. Never microwave breast milk and do not refreeze it. Once your baby has started to drink from the bottle, you should use it within one hour. You may find that different resources provide different recommendations about the amount of time you can store breast milk at room temperature, in the refrigerator and in the freezer. Talk to your doctor or lactation consultant if you have any concerns or questions.

Read More About How to Safely Store Breast Milk

Many factors are contributing to the rise of early onset puberty in girls. Learn what they are below and how you can support your daughter. The number of girls experiencing early puberty has increased dramatically over the last few years and continues to grow. More and more girls in the U.S. are starting to show signs of development before the age of 8. Recent studies show that up to 10 percent of Caucasian girls and 23 percent of African American girls are showing signs of puberty by age 7. What’s Contributing to Early Puberty in Girls? Determining the exact cause is difficult. But experts agree that several factors may be contributing to these growing numbers. Increasing rates of childhood overweight and obesity. Excess body fat alters the levels of hormones responsible for the acceleration of pubertal timing. Physical inactivity may decrease melatonin levels, which can also trigger pubertal development. Increased animal protein intake. Higher total protein, animal protein and meat intake in children ages 3 to 7 have been associated with earlier onset of menstruation. High protein intake elevates IGF-1 levels and promotes growth, which could accelerate the onset of puberty. Poor diet. Children with lower-nutrient diets tend to enter puberty earlier. A diet rich in processed foods and meats, dairy, and fast food is disruptive to normal physical development. Exposure to EDCs (endocrine-disrupting chemicals). EDCs are synthetic chemicals found in plastics, pesticides, fuels and other industrial chemicals that inhibit or alter the action of natural hormones. Because EDCs accumulate in the fatty tissues of animals, animal foods contain higher levels of these chemicals than plant foods. Exposure to BPA (bisphenol A). BPA is an industrial petrochemical found in a variety of products including plastics, tin-can linings and even cash register receipts. Because it acts as a synthetic estrogen it may speed up pubertal development. Soy products. Soy contain isoflavones which are converted to phytoestregens in the body, and are similar to the hormone estrogen, Dr. Chelsea Wicks says. “Soy consumed from natural food sources is likely safe and will not cause abnormal hormones levels. However, when consumed in large amounts, such as with soy supplements or in more processed foods, there have been links to chronic medical problems due to elevated estrogen levels. I feel a good answer to this is to continue working on eating fresh foods and trying to avoid the processed, packaged foods as this will be best for overall general nutrition as well,” she adds. What You Can Do While some genetic factors play a role in the early onset of puberty, parents can help lessen environmental causes of the condition. Encourage and help your child to maintain a healthy weight with proper nutrition and exercise. Avoid exposure to hormones such as estrogen and testosterone that may be found in hair products, medications and nutritional supplements. Avoid exposure to EDCs and BPA. Offer your child a diet centered around whole plant foods rather than animal foods, which will help keep protein intake within a safe range and reduce consumption of EDCs. Create a supportive environment for your daughter. Avoid commenting on her appearance and instead focus on her achievements, academic successes or artistic talents. Speak to her openly and honestly about the physical changes she’s experiencing — that although these changes are normal, she’s simply developing early — and that ultimately her peers will undergo the same changes. Encourage your daughter to continue participating in social activities and pursuing her interests, and reassure her you are always open to discuss any questions or worries. If you are concerned that your child may be going through these changes before expected, speak with your pediatrician. Sources: Early Puberty: Causes and Consequences When Is Puberty Too Early? Precocious Puberty (Early Puberty) Precocious Puberty

Read More About Early Onset of Puberty in Girls on the Rise