Health Care comes full circle
Ninety-one-year-old Evelyn Fries Milward is back home in Rhinelander, Wisconsin. She’s come full circle – and all around Ministry Health Care’s network of care – to the very place where her story began. To retrace the steps of her journey, one must start at the beginning ...
Evelyn was in her kitchen when she felt some chest pain – not severe. She took two aspirin. The pain didn’t go away so a friend took her to Ministry Saint Mary’s Hospital in Rhinelander – only minutes from her home.
“I didn’t know if I should go to the emergency room or through the front door,” Evelyn recalled. She decided on the latter, and proceeded to inform the receptionist that she believed she was having a heart attack.
The emergency team decided to send Evelyn by ambulance to Ministry Saint Clare’s Hospital in Weston where the heart care team was ready and waiting for her. They placed a stent into an artery that was 99 percent blocked. Evelyn’s procedure triggered artrial fibrillation that demanded a 6-day stay in the intensive care unit.
Atrial fibrillation occurs when electrical signals cause the heart to beat irregularly and very fast. Electrical cardioversion (an eclectic shock delivered to the heart) and medication helped stabilize her condition until she was strong enough to return home.
Evelyn convalesced at home under the watchful eye of her daughter-in-law, Jean Fries. Evelyn followed her discharge plan and got plenty of rest. “I kept telling Jean it was just a minor heart attack – nothing to worry about –– she didn’t need to stay with me any longer,” Evelyn chided. “Jean kept insisting there is no such thing as minor heart attack!”
A few weeks later, Evelyn was back at Ministry Saint Mary’s. Without the help of a family caregiver, Evelyn had become extremely fatigued and was having difficulty managing her medications. She couldn’t be alone, yet her children lived too far away to say with her. So she and her family started looking for options.
Although it’s a long way from Rhinelander, Evelyn decided that Saint Elizabeth’s Assisted Living Apartments in Wabasha Minnesota were a good temporary home for her since it was closer to her family.
Evelyn’s familiarity with Saint Elizabeth’s, also a Ministry Health Care Facility, spans several decades. Jean and Evelyn’s son, Walt, have made Wabasha their home for 31 years. They’ve also been avid supporters of Saint Elizabeth’s. Jean’s longtime involvement as a board member and volunteer offered many opportunities to sing the praises of Saint Elizabeth’s and its services to her mother-in-law. Evelyn’s awareness with Saint Elizabeth’s grew even stronger as she accompanied Jean on frequent visits to Saint Elizabeth’s—even to Ministry board retreats as Jean’s guest.
“When I suggested that my mother-in-law should consider a temporary move to Saint Elizabeth’s so she would be closer to family, she didn’t hesitate,” explained Jean. “She had always been impressed with the facility and its staff. As we weighed all the advantages this decision would offer, we wasted no time relocating her.”
Evelyn moved into Saint Elizabeth’s Assisted Living Apartments in February. In no time, she felt right at home.
At Saint Elizabeth’s Assisted Living Apartments, Evelyn had everything she needed. She made friends, participated in recreational activities, attended nutrition classes, exercised in the Wellness Center, received physical therapy, saw her local physicians and worshipped in the chapel –– all without leaving the facility.
“After my heart attack,” Evelyn said, “cardiac rehabilitation was recommended. I just hate to exercise, but I knew it was something I needed to do. The girls in the Wellness Center were kind and encouraging and actually made exercise fun. I can’t believe it, but I exercised five days a week!”
Evelyn also attended educational sessions that focused on nutrition, medications and other considerations when living with a chronic disease. Evelyn’s health steadily improved, so did her strength and ability to regain her independence. “The dietitians were terrific. They went above and beyond to help me change my eating habits. One of my greatest challenges was reducing the salt in my diet. I put salt on everything! They were never pushy and always presented choices and realistic solutions that I could live with.”
“During my days as an ombudsman for the state of Wisconsin, I had the opportunity to tour many nursing homes,” she said, “and I can honestly say that Saint Elizabeth’s is an A+++ facility. I’m going to miss everyone terribly.” With a gleam in her eye, she adds, “But I’ll be back!”
What began as a 4-week stay turned into a 2-month retreat. As her health steadily improved, so did her strength and ability to regain her independence. It was always her ultimate goal to return to Rhinelander.
Today, Evelyn is back home in Rhinelander regaining her strength and continuing her rehabilitation at Ministry Saint Mary’s. Evelyn is still full of vim and vigor, and believes she’s got a few more years of independent living to enjoy!
Obstetrical nurses gain extra training in Marshfield
Saint Elizabeth’s Medical Center has been providing obstetrics (OB) and birthing services to moms and families for more than 114 years.
Saint Elizabeth’s is an especially valuable OB resource for the region, since it offers options not readily available in many hospitals across the state, such as delivery in a warm pool of water rather than a traditional birthing bed. Families come from as far away as the Twin Cities to experience the benefits of waterbirth.
Ensuring that parents have the best birthing experience possible requires highly skilled OB nurses who support the patient and her delivery provider. One of Saint Elizabeth’s greatest challenges is to provide intensive OB orientation and training to new nurses. Due to lower birthing volumes, (an average of 90 babies are delivered each year at Saint Elizabeth’s), it can often take many months before a nurse has received enough hands-on, experiential training to gain the level of competency and proficiency needed to skillfully perform his or her role as a member of the delivery team.
“It is our goal to orient our regularly scheduled registered nurses to all areas of acute care,” explained Kathy Lueders, DON. “Comprehensive orientation and training takes a lot of time, especially in OB. When we began exploring better and faster options to bring our five newer nurses up to speed in OB, we looked to Ministry Health Care sister hospitals. One of the benefits of being part of a large system is the ability to share resources. We pitched our idea to the OB department at Ministry Saint Joseph’s Hospital (MSJH) in Marshfield and the response was overwhelmingly positive. They were more than happy to become a host site for OB training.”
Kim Schmitz and Monica Walters,
registered nurses at Saint Elizabeth’s
Medical Center, are the first to
participate in the collaborative OB
training. Before Saint Elizabeth’s nurses Kim Schmitz, Monica Walters, Tera Binner, Jamie Mau and Alyssa Rogers could begin their formal training in Marshfield, they needed their Wisconsin nursing license and needed to complete a basic fetal monitoring course. Kathy Lueders, RN, a 20-year OB nurse veteran, formulated the curriculum and facilitated a day-long fetal monitoring class that prepared Saint Elizabeth’s nursing team for the next leg of their education.
With the assistance of Jackie Kerchefski, manager of patient care clinical operations of the Birth Center at MSJH, an onsite training schedule was created. A team of two nurses from Saint Elizabeth’s rotated through the 3-week program, which included shadowing physicians, nurses and ancillary staff in all areas of OB – vaginal births, cesarean sections, post-partum and neonatal intensive care.
“It was an amazing experience,” shared Monica Walters. “The staff at Ministry Saint Joseph’s exceeded all my expectations. They were very professional, open and welcoming. The physicians and nurses encouraged our involvement and engaged us in all areas of OB nursing.”
“They offered a wonderful learning environment. They shared openly, eagerly answered our questions, and were equally interested in our organization and our differences,” added Kim Schmitz. “The size and scope of their department exposed us to a broad range of experiences –– from routine to high-risk. What we received in 12 days at MSJH would have taken 12 months and then some at Saint Elizabeth’s.”
“For instance, MSJH has central fetal monitoring,” shared Walters. “A computer screen, located at the main nursing station, displays the fetal heart beats of all babies being monitored. The staff can easily observe a baby’s heart rate from the patient’s room or the nursing station. We don’t have that capability at Saint Elizabeth’s. Instead, paper strips are generated from the fetal monitor near the patient’s bedside. Even though the process is different, the techniques and skills needed to read and evaluate the changes in fetal heart rate are universal.”
According to Walters and Schmitz, their confidence and expertise accelerated with each new experience and practiced skill. Although the breadth of services and technology cannot be compared to Saint Elizabeth’s, many of the skills, policies and procedures that were learned can be applied on a smaller scale.
During their 3-week training, Walters and Schmitz helped deliver six vaginal births and six c-sections. They were equally impressed with the patients.
“The moms were so accommodating. They understood the value of our presence,” said Schmitz. “Never were we asked to leave. We were made to feel welcomed and appreciated for our role in their care and delivery. Fortunately, every birth we experienced had a positive outcome.”
Both Walters and Schmitz also credit their teammates and families for their support, which added to the success of their training. Sacrifices were made. Nurses had to cover for them while they were away; families missed their presence at home. But all agree it was a small price to pay for a wealth of new knowledge. They now look forward to sharing their experience with their colleagues and putting their new skills into practice.
“We are extremely grateful to Ministry Saint Joseph’s Hospital,” added Walters. “Every physician and employee we encountered exemplified our shared mission, promise and values. We are very proud to be members of the Ministry team!”
This collaborative experience exposed the Saint Elizabeth’s nurses to a variety of situations that may otherwise have taken them a year to experience at Saint Elizabeth’s, since birth rates are so different at the two facilities.
Now they will bring the training they gained back to Wabasha to help our expectant moms and newborns.
Kim Schmitz and Monica Walters, registered nurses at Saint Elizabeth’s Medical Center, are the first to participate in the collaborative OB training.
Saint Elizabeth’s Medical Center is a Level IV Trauma Center
What happens in that first hour after a severe injury is known as the “golden hour.” It often impacts the outcome of the situation. The chance of complete recovery, or even survival, becomes a race against the clock – and a trauma system helps win that race.
A trauma system helps ensure that patients receive the highest quality emergency care, and are transported promptly when the severity of the illness or injury requires more extensive treatment.
In September 2010, Saint Elizabeth’s Medical Center met the criteria to be designated as a Level IV trauma center, which is the designation of most of the emergency departments in the state.
According to the Minnesota Department of Health’s State Trauma Advisory Committee, Saint Elizabeth’s is required to work with the local ambulance service to provide training and feedback for improvements.
Internally, Saint Elizabeth’s provides trauma training for physicians and registered nurses and maintains certifications in comprehensive advanced life support (CALS), advanced cardiac life support (ACLS), basic CPR, and the neonatal resuscitation program (NRP).
The physicians may also take advanced trauma life support (ATLS) and the nurses are encouraged to take a trauma nursing core course (TNCC) as well as pediatric advanced life support (PALS).
Saint Elizabeth’s status as a Level IV trauma center requires regular site reviews of the emergency department, charting, radiology and laboratory experiences of patients from arrival to discharge.
“Our ER was given the highest compliments by the reviewers,” said Theresa Hager, RN, ED coordinator. “We comply with all aspects of the state and regional trauma system and are certified for a 3-year period.”
Is it time for a fresh start?
Fresh Start is one of many programs offered in the Wellness Center located in the lower level of Saint Elizabeth’s Medical Center. Fresh Start features an extensive array of exercise and educational resources.
Fresh Start’s coordinated system of preventive, diagnostic and therapeutic measures provide cost-effective, quality health care for patients who have, or are at risk for, specific chronic illnesses or medical conditions.
Fresh Start is Saint Elizabeth’s Medical Center Wellness Center primary prevention / disease management program that utilizes exercise and education to help people modify their risk factors for prevention or management of chronic conditions such as: coronary artery disease, heart valve disease, congestive heart failure, angioplasty / stent, diabetes, hypertension, overweight / obesity, high cholesterol, inactivity, pulmonary disease, metabolic syndrome, peripheral artery disease, atrial fibrillation, and implantable cardiac devices.
Fresh Start’s 8-week education / support / monitored exercise series engages participants in an intensive program of monitored exercise, education, goal setting and support. Monthly reports are sent to each person’s physician for approval and recommendations.
Saint Elizabeth’s Fresh Start program utilizes an individualized approach to help people develop a lifelong commitment to regular exercise. The program includes:
- Initial reviews of pertinent medical history that include diagnoses, an assessment of risk factors for diabetes and cardiovascular disease, medications, orthopedic limitations, psychosocial assessment, and other conditions.
- Development of an individualized exercise prescription based on recommendations from the American College of Sports Medicine, the American Association for Cardiovascular and Pulmonary Rehabilitation, and the American Diabetes Association.
- Establishing goals to meet the specific needs of each individual including activities of daily living, weight management, exercise duration and exercise intensity, among others.
People involved in Fresh Start have access to exercise and educational sessions.
Exercise Sessions are attended by participants 3 days each week for 8 weeks. The Wellness Center staff monitor exercise, EKG, heart rate, blood pressure, glucose, weight and oxygen. Participants often start with a light exercise program and progress to a more challenging program as they grow stronger.
Each person in the Fresh Start program will attend educational sessions to learn more about his or her condition and how that condition affects his or her body. There are several sessions offered.
Your Heart and How it Works teaches participants the basics of heart anatomy (atriums, ventricles, valves, coronary arteries, etc.,) and physiology (blood flow through the heart and lungs). Participants then learn how the anatomy and physiology applies to their own heart diagnoses. In addition, they learn about coronary artery disease and heart disease.
Take Charge! Identify and Modify Your Risk Factors teaches participants the major risk factors for heart disease and how those risk factors pertain to their situations. Participants also learn which risk factors they cannot modify, and ways to reduce or control the risk factors they can modify.
Introduction to Pre-Diabetes and Metabolic Syndrome highlights risk factors for pre-diabetes, identifies the effect of macro-nutrients on blood glucose, and reviews the statistics of pre-diabetes. The session also discusses diabetes prevention, screening and progress tracking. Participants will also learn the benefits of achieving a healthy weight, learn how to define a healthy weight, and learn how to set realistic expectations.
Nutritional Care of the Heart: Healthy Meal Planning reviews diet versus lifestyle change. It also gives participants the tools to build skills and confidence in food choices, shows them how to keep accurate records and review the entries to indentify food patterns and triggers for eating.
Exercise and your Heart: Home Exercise Program teaches participants why and how to develop an exercise prescription. Participants will leave with their own personalized exercise program tailored to meet their individual needs.
The Maze of Reading a Food Label identifies the key components on a food label. Participants will review label terminology and learn how to use the food label to optimize healthy food selection.
Medications are an important aspect of overall health. Participants will meet one-on-one with our pharmacist for an evaluation of their medication regimen (medications, vitamins, minerals, supplements, etc.,). This one-on-one sessions allows participants to understand the benefits, side effects, doses and other valuable information about the medications they are taking. Recommendations from this session will be shared with the participants health care provider.
Midway through the program and again at discharge, goals and plans will be evaluated and modified if necessary.
After participating in the Fresh Start program, a health care professional will follow-up with each participant to measure the impact of early intervention. Coaching and peer mentoring will ensure that former participants remain motivated, progress toward their goals, and do not relapse.
Participants in Fresh Start will also be able to continue exercising in the Wellness Center after completion of the 8-week program at a reduced rate.
Saint Elizabeth’s Wellness Center, staffed by clinical exercise physiologists / specialists, and a registered nurse provides a personalized approach to care and treatment. The facility has more than 20 pieces of cardio equipment, nine strength stations, and free weights to address all major muscle groups. The Wellness Center provides a great support network.
Get started with Fresh Start
Ask your physician for a Fresh Start referral. Once that is sent to the Wellness Center, we will contact you to set up your initial consultation. For more information, call 651.565.5519.
Saint Elizabeth’s Annual Holiday Bazaar & Dad’s Belgian Waffle Breakfast
Sunday, November 11, 8 a.m. – Noon at the Felix Auditorium, Wabasha, Minnesota.
All-you-can-eat waffles and toppings, plus sausage, juice, coffee and milk
Raffles & Auction
- Bake Sale
- Big Money
- Holiday Grocery Cart
- Quilt Prize/Raffle
- Silent Auction
- Taste of Mississippi River Valley
- Theme Baskets
Fun & Games
- Kid’s Prize Table
- Cheers for a Cause
Pre-sale - $7, At Door - $8
5 and younger eat FREE
Advanced tickets available at Saint Elizabeth’s or from an auxiliary member
Your donation will help fund Saint Elizabeth’s Advancement of CT Scanning Services
Sponsored by Saint Elizabeth’s Auxiliary & Employees