KVH News

How to Talk with Your Teen

Contributor Dr. Elise Herman

We all want to feel connected to our kids, but as they become teenagers, it may seem harder to engage them in conversation. Between their appropriate need to become more independent, their frequent use of their phones and social media, and all of life’s distractions, how can you create opportunities to have an honest conversation with your teen? Here are some suggestions that might help:

Be a good listener: Ask open-ended questions, avoiding those which would have a short “yes” or “no” answer. Do not interrogate but ask with a desire to learn- about their school day, friendships, and interests. Avoid lecturing and try to reserve judgment unless there is a real safety issue. If you disagree with what your child says, ask why they feel a certain way; try to see things from their point of view. Often, teens want to chat about a concern but do not want you to “solve” it. Ask if they like your advice or help before offering. Remember to listen without the distraction of phones or computers.

Empathize: Your teen has a lot going on with social media, relationships, and school pressures. Life is likely more complicated for them than it was when you were their age. Listen and empathize; don’t discount their feelings and struggles.

Please respect their privacy: Do not share your conversations with others. You want your teen to feel safe and comfortable being open with you.

Location counts: The dinner table is an excellent place to chat casually about school, activities, etc. (research has shown that regular family meals decrease risky behavior in teens). Start the family dinner habit when kids are young and keep it going as much as possible through the teen years. Even if they are quiet at the table (don’t force anyone to talk), connecting as a family is essential. When driving, it is also a great time to chat, especially if it is just the two of you. Frequent brief conversations are more accessible than longer, more formal ones and can make you both feel connected..

Let your teen lead:

  • Be open to discussing things they care about, such as social media, music, trends, etc.
  • Try to be aware of what teens are viewing and discussing online.
  • Don’t try too hard to be “hip”; aim to be curious and informed.

Encourage confidence: You know your teen and their strengths. Let them know you believe them to be capable of handling challenging situations but that you are always there for them, too, to be a sounding board or assist if it is appropriate.

Having regular, non-judgmental chats with your teen can maintain open lines of communication and increase your emotional connection. In addition, this will make it easier if they need to come to you to discuss important issues such as relationships, sexuality, mental health, or substance abuse.

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Dr. Elise Herman

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Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

National Rural Health Day

The National Organization of State Offices of Rural Health sets aside the third Thursday of every November to celebrate National Rural Health Day.

National Rural Health Day (NRHD) is an opportunity to “Celebrate the Power of Rural” by honoring the selfless, community-minded spirit that prevails in rural America. NRHD showcases the efforts of rural healthcare providers, State Offices of Rural Health and other rural stakeholders to address the unique healthcare challenges that rural citizens face today and into the future.

I knew at a pretty early stage in my medical training that rural medicine was where I wanted to spend my life. I became enamored with the people the types of lives that people live in rural communities, and I recognized that I was never going to have nearly as much fun working in an urban setting as I had worked in my rural training settings.

Andrew Thomas, MD | KVH Family Medicine – Cle Elum

Resource and Information / www.powerofrural.org

Coloring Book

National Rural Health Day (NRHD) is a day for both children and adults to celebrate doctors, nurses, and all of the people in your community who work and volunteer to keep you healthy and safe.

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Julie Petersen Wins Leadership Award

Kittitas Valley Healthcare CEO wins the prestigious Joe Hopkins Memorial Award from the Washington State Hospital Association

Ellensburg, WA, November 1, 2022 –Julie Petersen, Kittitas Valley Healthcare CEO was awarded the 2022 Joe Hopkins Memorial Award at the Washington State Hospital Association’s (WSHA) Annual meeting on Monday, October 17. The Joe Hopkins Memorial Award was created in 1987 to acknowledge an individual who displays the spirit of Joe Hopkins’ vision and dedication to Washington’s hospitals.

Julie began her career in health care almost 40 years ago as a staff accountant for Group Health Cooperative in Seattle. Since 2016, she has served as the CEO of Kittitas County Public Hospital District No. 1 and Superintendent of Kittitas County Public Hospital District No. 2 serving Upper Kittitas County. Julie has been a member and Chair of the WSHA Rural Committee and is the past president of AWPHD and past chair of WSHA. The American Hospital Association (AHA) invited Julie to be a member of its Task Force on Ensuring Healthcare for Vulnerable Communities and to represent small and rural hospitals on the AHA Regional Policy Board for Region nine.

Julie has been a strong leader for rural hospitals and all hospitals in Washington for decades, and she is particularly dedicated to ensuring rural residents have access to high-quality care in every community in Washington. When Julie returned to Ellensburg in 2016, Medical staff development and Board development were high on her list of priorities and resulted in the first medical staff development plan for Kittitas Valley Healthcare.

Additionally, Julie was also focused on improving partnerships with local private practices, Community Health of Central Washington, Central Washington University and our regional referral centers so KVH could serve more of our community here at home. As a result of this continuing work, access to healthcare in our rural county is stronger. In recent years Julie has led KVH through a worldwide pandemic and has been a key partner with other community agencies in caring for the residents of Kittitas County.
“Julie is a practical visionary,” stated Michele Wurl, Chief Public Relations Officer at KVH. “Whether focusing on bringing services to the bedside, resources to the workforce or partners to the table, she is skilled at looking forward and working with all partners to make a vision reality. Julie sets the tone for Kittitas Valley Healthcare through her dedication, hard work, tireless commitment and constant compassion for her employees and community.”

Photo: Julie Petersen, CPA, KVH Chief Executive Officer

Media Contacts:
Michele Wurl, Chief Public Relations Officer
509.933.8838
mwurl@kvhealthcare.org

Get With The Guidelines® Award

Kittitas Valley Healthcare has been nationally recognized for its commitment to providing high-quality stroke care

The American Heart Association presents the Get With The Guidelines®-Stroke Gold Plus Award for proven dedication to ensuring all stroke patients have access to best practices and life-saving care

Kittitas Valley Healthcare has received the American Heart Association’s 2022 Get With The Guidelines®-Stroke Gold Plus Award for its commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines, ultimately leading to more lives saved and reduced disability.

Stroke is the No. 5 cause of death and a leading cause of disability in the U.S. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood and oxygen it needs, so brain cells die. Early stroke detection and treatment are key to improving survival, minimizing disability and accelerating recovery times.

Get With The Guidelines puts the expertise of the American Heart Association and American Stroke Association to work for hospitals nationwide, helping ensure patient care is aligned with the latest research- and evidence-based guidelines. Get With The Guidelines – Stroke is an in-hospital program for improving stroke care by promoting consistent adherence to these guidelines, which can minimize the long-term effects of a stroke and even prevent death.

The Mission: Lifeline and Get With The Guidelines programs make it easier for our teams to put proven knowledge and guidelines to work on a daily basis, which helps us ensure more people in central Washington experience longer, healthier lives.

About Get With The Guidelines

Get With The Guidelines® is the American Heart Association/American Stroke Association’s hospital-based quality improvement program that provides hospitals with the latest research-based guidelines. Developed with the goal of saving lives and hastening recovery, Get With The Guidelines has touched the lives of more than 12 million patients since 2001. For more information, visit heart.org.

Respiratory Virus Season and Children

Contributor Dr. Elise Herman

As cooler weather approaches, the “sick” season does, too. For kids, this usually means respiratory illnesses, ranging from cold to croup or pneumonia. While these sicknesses are usually mild, more severe cases are rapidly increasing, with more kids going to the ER and being hospitalized. The viruses responsible include Respiratory Syncytial Virus (RSV), rhinovirus, adenovirus, and enterovirus. To complicate things, influenza season typically starts in October, and with COVID-19 currently spiking in Europe, a surge is predicted to hit the US soon.

Children are walking in nature, fall leaves.

This earlier and more severe start to the respiratory season for kids is felt to be related to gathering again (without masks) in schools and social settings. Kids do not have much immunity from last year when the respiratory season was milder due to social distancing and other anti-COVID measures. Wildfire smoke exposure may also be a contributing factor.

Most kids who contract these viruses will get a simple cold (“upper respiratory infection”), nasal congestion, mild cough, and mild fatigue. A low-grade fever is common for the first three days of illness. Kids may be sick for 1-2 weeks but remain fairly active with good fluid intake though overall eating is often decreased.

Younger or premature infants and children with lung problems like asthma are at increased risk of more severe illnesses like pneumonia. General warning signs include the pale or dusky color of the lips or skin, and increased work of breathing—rapid breathing with the ribs showing on inspiration (“retractions”). Unusually noisy breathing, such as wheezing (high-pitched musical noise with breathing out) or stridor (crowing noise with breathing in), is concerning. An infant who cannot feed well from a breast or bottle is worrisome. Extreme lethargy or limb weakness at any age is very concerning.

For mild respiratory illnesses, the diagnosis is usually based on symptoms and examination alone. Checking respiratory rate, heart rate, and oxygen level are routine when the child is seen by a medical provider. Testing for viruses with a ‘respiratory panel’ can be done but is expensive and usually reserved for those more severely ill since there are few specific anti-viral treatments available. Specific testing for COVID-19 and RSV may be done, given that the implications of having these viruses are more significant regarding attending school, childcare, etc.

If your child has typical cold symptoms, it is essential to ensure they stay well-hydrated; solid food intake is less important. Offer infants extra breast milk or formula. Saltwater nose drops and nasal suction for infants can be helpful in terms of clearing mucous which interferes with breathing through the nose. Fever control with Tylenol (over age two months, though talk to a provider first) or Advil (over age six months) is primarily for comfort since fever, as part of the immune response, may help fight the virus.

No cold medications are recommended under the age of four years and should be used with caution for those 4-6 years old. These meds are usually not helpful and may have harmful side effects in younger kids. Honey (1/2 to 1 tsp by mouth) may help to cough but is safe only for those over one year of age.

To help prevent respiratory illnesses, keep up the frequent handwashing we have all gotten good at during the pandemic. In addition, kids should be reminded not to touch their faces and not to share food or drinks. Although not easy, masking (especially if your child will be in a large group) does help prevent illness. Lastly, it is vital to get your child vaccinated against those respiratory viruses for which we have safe, effective vaccines—COVID-19 and influenza.

Resource / HealthyChildren.org

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Dr. Elise Herman

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Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Curiosity in Children

Contributor Dr. Elise Herman

There are characteristics we hope to see in our kids such as kindness, intelligence, and perseverance. We may not put ‘curiosity’ high on this list, but in fact it is crucial to a child’s success in learning and school—and maybe, even in life.

Research has shown that those who are curious tend to be happier, less anxious, and have a greater sense of well-being. In children, studies connect curiosity to higher academic performance, and in adults it is tied to greater achievement at work.  When people are highly curious about a subject, they are more engaged with it and more likely to remember what they have learned. General memory is also improved for information unrelated to the original area of interest. It seems curiosity primes the brain to absorb and retain new information better.

Being curious has been shown to improve one’s patience. Those who are very curious seem willing to do the work themselves to figure something out as opposed to needing an answer immediately. Curiosity can lead to increased creativity, more original ideas, and a willingness to ‘think outside the box’. It also translates into greater empathy and stronger interpersonal relationships.

So despite the sometimes endless “why?” questions from our kids that can be a bit much, curiosity is a very good thing. There are lots of ways we can encourage this important trait:

  • Express curiosity and wonder yourself, e.g., “I wonder why the moon looks so big tonight?”  Have a back-and-forth discussion about possible explanations. Together with your child find resources to get answers (and not just online) such as books, the library, and knowledgeable individuals.
  • Ask your child questions about things from the everyday to the more fantastical and encourage them to go deeper with their theories and ideas.
  • When your child asks you questions, avoid the “just because” response and research together if you don’t know the answer.  You do not need to know everything, and it is valuable to show your child that you are still learning, too.
  • Encourage your kids to be aware and mindful, to be thinking about what they experience, and to use their full senses to engage completely.
  • Limit “screens” including TV, smartphones, and social media which generally are passive entertainment, though quality programing such as nature shows can encourage curiosity. Watch educational programs (on PBS and National Geographic for example) together so you can have discussions about the content.
  • Explore new things such as ethnic food, museums, and new cultures either through travel or online resources. This promotes not just curiosity but an openness to people different than us.
  • Encourage books about subjects that inspire curiosity such as history-making individuals, exploration, and science fiction.
  • Help your child to follow their interests and learn more about what they are naturally intrigued by.
  • Embrace outdoor activities, especially in nature such as walking in a park, hiking, birdwatching, and camping. These immerse us in the natural world and foster curiosity and wonder.

And enjoy being a bit of a kid yourself as you marvel and explore the world we live in with your child!

more about The contributor

Dr. Elise Herman

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Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Parent Advice / Back to School

Contributor Dr. Elise Herman

As summer winds down, parents and children are well aware of the approach of the new school year. Some kids are very excited about learning and seeing their teachers and friends again, while others have more reservations. COVID and recent school shootings complicate this often emotional transition. There are steps parents can take now to make this go more smoothly.

Sleep

If sleep schedules got lax over the summer, start now to get back on track. To make bedtime earlier, adjust the wake-up time, moving this up by 15 minutes a day. Kids ages 3-5 years need 10-13 hours total sleep daily, those ages 6-12 years should get 9-12 hours, and teens need 8-10 hours. Remember, no ’screens’ of any kind for at least one hour before bedtime. Reading to your child before bed (or kids reading on their own) aids in falling asleep and is an excellent habit to develop now.

Nutrition

Ensure your child gets up early enough to have a healthy (not sugary) breakfast, improving attention and mood. If your child is taking lunch to school, review what they would like to bring—plan on including fruits and veggies and avoiding processed foods. Water is much better than juice; if they drink milk, nix the chocolate milk, which has as much sugar as soda. Family dinners are a great way to connect during the school year and have been shown to improve nutrition and emotional health. Although it can be tricky to have family dinners with kids’ sports and activities, try to make this a priority.

School Prep

For younger kids, being able to go to school and play on the playground now is very reassuring. Some schools will allow a visit to the classroom and a brief meeting of the teacher as well. You and your child can look at their school online, where they can see photos of the building and the school staff. Review transportation plans and always spend 10 minutes of “getting ready” time on school mornings so your child can be on time with less stress.

School Supplies

Look at the list for your child’s school and classroom (schools often post this on their website) and buy supplies early. Have your child practice packing their backpack and designate a place at home where it goes at the end of the day. All papers and notebooks should come out of the backpack daily so homework gets done and other things don’t accumulate. Pack the backpack with completed homework and any needed items the night before to help mornings go smoothly.

School Safety

In view of recent events, your child may have questions or concerns about school safety. Reassure them that a school is a safe place and that you are comfortable having them there. Although there may be a spike in COVID this fall, we have good tools (vaccines, treatment, etc.) to help. As tragic as school shootings are, they are rare, and schools continue to work on security to help prevent such violence. We must display confidence in our child’s safety at school, even if we are concerned.

Back to school “nerves”: If your child feels a bit nervous about the return to school, let them know they are not alone. This is common, especially if they are going to a new school (as will be true of many kids in Ellensburg with the new attendance zones). Talk up the positives of learning new things, making new friends, and meeting their teacher. If you recall feeling the same way, share that with them and how your nervousness dissipated over time.

Going back to school in the fall is a big deal for you and your child; let them know you have confidence in their ability to rise to this challenge. Planning a fun post-school activity and a special family dinner after that first day will give them something to look forward to and be a terrific way to celebrate this transition.

Local School Districts

Below is a list of Kittitas County school districts and their Facebook pages. Schools often post supplies lists, drop-off/pick-up info, scheduling, and other important information for parents and students.

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Dr. Elise Herman

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Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Mindfulness for Children

Contributor Dr. Elise Herman

We live in a busy and often stressful world. Mindfulness is a simple concept that can help parents and kids be calmer and enjoy life more. Mindfulness means being present, paying attention to what is happening, and accepting it non-judgmentally. This technique is helpful at all ages but learning this when young means children will carry it forward as they grow up. Kids’ brains are still developing, including the prefrontal cortex, which directs focus and control. Mindfulness targets this part of the brain, so it is an excellent opportunity to encourage these skills while the brain is actively growing. Research has shown that mindfulness helps decrease anxiety and improve attention in school-age children. As a result, many schools include mindfulness in their curriculum.

Like so many other things in parenting, modeling behavior is very influential. Practicing mindfulness also helps you parent more effectively. Slowing down, noticing the ‘little things’, making good eye contact, and eliminating distractions (e.g., phones) will help you be present for your child. Start this mindful practice early, beginning with feeding your newborn. Put your phone out of reach (or turn it off), so you won’t be tempted to be looking at it instead of your child.

You can promote mindfulness with your toddler by engaging in activities encouraging focus, such as looking at books, going on walks, and coloring. Just looking closely at grass or flowers (and maybe you’ll find a bug!) teaches patience and calm. Toddlers can also learn to take slow breaths when upset or frustrated. You can demonstrate this, too, and be an excellent example of handling difficult emotions.

Preschoolers can practice mindfulness and focus by being quiet for a short time and increasing this as their patience and ability to “be” increases. Some parents do this at bedtime, starting with kids having eyes closed, being quiet and calm for 15 seconds, then working up to several minutes or more. Your child may then be able to calm themselves more quickly at other times, such as when upset. Taking walks in nature and being attentive to clouds, leaves, birds, etc., encourages your child to be present and focused. Notice and discuss the five senses as you go about your day. What is your child aware of in terms of seeing, hearing, touching, tasting, and smelling? You can include mindfulness in eating– enjoying food slowly and being aware of taste and smell instead of just eating in a rush without truly paying attention.

Older kids can understand more about the concepts of mindfulness and master mindfulness techniques. By learning to observe something with curiosity and acceptance instead of having an immediate emotional reaction, your child will be better able to handle complex and stressful situations. By fully paying attention to the present, it is easier to let go of regrets about the past and worries about the future. A simple technique is focusing on the breath; counting each breath up to 10 (‘one breath’ equals breathing in and out) helps with this. Imagining each breath as a gentle wave can also be very calming. Mindful breathing is a form of meditating and can be done for just a minute or more throughout the day. This really does train the mind to focus and be more grounded.

There are lots of helpful online resources. “Smiling Mind” is an Australian website and free app with good info about kids and mindfulness, regulating emotions, and how to promote empathy and connectedness. Other apps have fees but can be very valuable including “Headspace for Kids” and “Calm.” Your child is always learning from you, so the more ‘present’ you are with your child (this means putting down phones), the more both of you can be mindful, calm, and enjoy life.

Resources

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Dr. Elise Herman

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Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.

Update: Talking to Your Child about Traumatic Events

Note: This article was first published in 2017 after the Las Vegas mass shooting. Other than updating the location of recent mass shootings, little else was changed. A sad statement that these horrific tragedies continue.

Contributor Dr. Elise Herman

In the wake of the most recent mass shootings in Buffalo, New York and Uvalde, Texas, we all feel sad and stressed.  Parents also wonder if they should discuss traumatic events such as this with their children, what they should say and how to best reassure their child. Depending on the age of the child, how to do this will vary. 

Under age 2 years, kids do not understand exactly what is happening but often pick up on the emotions of the adults around them, and may cry more often, be fussy and be less social. Preschoolers may have some understanding that something bad happened and will look to their parents for reassurance and a sense of normalcy.  Kids in elementary school may develop fears depending on the trauma (especially a school shooting) and not want to go out to school or other activities. Regressive behavior and wanting more help from their parents are normal.

Preteens through teens, often very informed due to their exposure to media, may feel very worried and overwhelmed. They may minimize their feelings, withdraw, or not want to talk about the event. Their stress could come out in being more argumentative or they may have more physical complaints such as headaches.

Parents are crucial in helping their kids through a traumatic event such as a mass shooting. For the child old enough to express themselves who asks about the event, find out what they know or have heard. Keep your discussion age appropriate, and don’t volunteer additional details that may add to your child’s distress. For a preschool child, a simple explanation that a bad person hurt people but can’t hurt anyone anymore is enough. Of course, reassurance that they are safe is vital.

With their access to the news via their phone or computer, older kids may have more specific questions and worries.  They may have heard misinformation from their friends and social media. Give them your full attention and listen carefully. Address their concerns and correct misperceptions. Remind them of the plans in place to help prevent these events and plans that go into action if /when such events occur- and that as tragic as a mass shooting is, it is very rare.

Kids of all ages benefit in these situations from parents being very available, whether it is for questions and conversation or just warm hugs and time together (take your lead from your child). Keeping the family routine including school, activities, and family meals is important.

It is healthy to express your emotions and encourage your child to do the same but process your own feelings before addressing the event with your child. Seeking help from a counselor, health care provider, or clergy member is appropriate for anyone feeling distraught and overwhelmed weeks later, or if you are worried about how your child is coping. 

We have ‘screens’ everywhere and younger children may think every photo or video is actually another tragedy happening. Children with Internet-connected devices should avoid overexposure to the event- the same goes for parents. Younger kids (some say under age 11) should not watch the news or news videos online at all because the visuals can be too overwhelming.

In the face of such incomprehensible tragedy, we can remember PBS’ Mr. Rogers recalling what his mom told him:

Look for the helpers. You will always find people who are helping.

Good advice for all of us. Highlight the bright spots—the first responders, the heroes, average people doing what they can, be it donating blood or giving money to help. Tweens and teens may want to get involved to help promote social change; the non-profit website DoSomething.org is a fine place to start. There is a lot of the good in the world, and we can be the good and an example to our children. Be extra kind, help your child do something nice for someone else, and make your corner of the world a reassuring place for your child. 

Resources:

more about The contributor

Dr. Elise Herman

Blog Posts
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Dr. Herman is passionate about community health outreach, school programs, and child/family health and wellness. She has more than 31 years of experience as a pediatrician in Ellensburg, Washington, the last 3 with KVH Pediatrics. In 2022 Dr. Herman retired from practice and continues to contribute blog posts and remain a visible advocate for kids in the community.