Let’s celebrate National Senior Health and Fitness Day! Come join us at the park for activities including exercise demonstrations, health presentations, booths from local senior services, and volunteer opportunities. This is a FREE event for older adults in our community with a focus health, wellness and staying active.
1200 E. Seattle
Ellensburg, WA 98926 United States
Julie Harwell, RN, BSN is hosting a free webinar series through our Childbirth & Family Education Program at Kittitas Valley Healthcare. The most recent webinar titled “Creating Meaningful Learning Communities: How Covid has helped us to Reimagine Possibilities in Education” details how one local school adapted to the COVID-19 restrictions and found opportunities for resilience and growth in the classroom and our community.
“The Covid-19 Pandemic brought about many changes in the way we as a society approach school. In addition to the challenges, the past year brought many opportunities for us to reflect on education and how we can best support engagement in learning for children. We found great value in more outdoor education, multi-age groups, parent partnerships in learning, and extending the walls of the classroom to include more community places and partners. This year illustrated the great potential we have to provide meaningful learning experiences for our children when families, children, schools and community members work together.”
Webinar presenter Natalia Parker, a founder of and the current Director at Discovery Lab of Ellensburg, has worked with children and families in varying capacities for the past 20 years. After graduating with degrees in Psychology and Infant Mental Health, Natalia worked in various roles educating and supporting caregivers, children and students in grades Kindergarten through Post-Secondary. Currently, in her role at Discovery Lab she works to support meaningful and engaging teaching and learning practices that best support healthy child development. When she isn’t at work she loves to be outside exploring the beautiful area we live in.
Check out our website to learn more about the KVH Childbirth & Family Education Program.
Wear sunscreen. Stay hydrated. Wear light, loose clothing. Anyone who’s lived in Kittitas County for more than a year knows these basics for survival in the summer heat. If you’re diabetic, there’s another concern to add to the list: extreme temperatures can spike your blood sugar levels, and wreak havoc on testing equipment and medication.
Recent findings show that the summer heat drives more people with diabetes to the ER, and more diabetics are hospitalized due to heat illness.
“First of all, be aware of your environment. Watch the forecast. When we’re in for a hot spell, there are some things you can do to prepare for diabetic safety,” advises Nicole Norton, Diabetes & Nutrition Education Coordinator at KVH.
Careful planning of your diet is always important, but even more so in extreme temperatures. Think through any adjustments you need to make. And be diligent in avoiding added sugars. “A lot of folks reach for sugared sodas, sweet teas, and juices when they’re thirsty,” warns Norton. “For someone with diabetes, it’s safest to stick with water.”
Another common mistake is skipping meals. Norton explains, “We’re more active in the summer, and we get distracted, forgetting to eat when we should.” That’s not good in normal conditions, but in the heat of summer, it’s even more dangerous. Be familiar with the early symptoms of low blood sugar, and keep some carbohydrates with you to eat if you need to raise your blood sugar.
Once you put the steps into practice, diabetic safety becomes just another automatic healthy habit.
Medication storage is another concern. While unopened insulin should always be kept in the fridge, storing any medications in the heat can degrade them. “Don’t keep medications in your car,” advises Norton. “In a high temp situation, use an ice pack in an insulated lunch pail.”
More frequent testing is also a good idea. Your diabetes educator can help you with guidelines for an appropriate testing schedule.
It’s easy to forget, but foot problems are common for people with diabetes, and summer is all about bare feet, sandals, and open toed shoes. “Keep your feet covered in well-fitting shoes,” says Norton, “even in warm weather. Check your feet every day, and get treatment right away for any injuries.”
It’s a lot to consider, but, like using sunscreen and staying hydrated, once you put the steps into practice, diabetic safety becomes just another automatic healthy habit. “We all have health limitations of some kind,” says Norton. “With a little preplanning and awareness of their surroundings, people living with diabetes can enjoy themselves in the summer like anyone else.”
Article updated 7/2021. Original post 8/2017.
Managed by Kittitas Valley Healthcare, HealthNews does not provide medical advice. For medical advice, please see your healthcare provider.
KVH Contributor*
Nicole Norton, MDA, RDN, CDE
KVH Diabetes Education
The holidays are upon us and many of us are preparing for gatherings with friends and family. Although it can be a joyful time of the year to celebrate, a common worry revolves around overindulging on holiday favorites, and the potential for weight gain and elevated blood sugars. While it isn’t necessary to deprive yourself during the holidays or feel guilty about eating sweets, there are several things you can keep in mind to make it through the holidays without going overboard.
One trick to prevent overeating is having a pre-snack before heading to a holiday party. Going on an empty stomach may leave you famished and overeating large quantities of less than ideal foods. Try a combination of complex carbohydrates with protein and healthy fats for a satisfying snack you can feel good about. Examples include an apple with almonds or whole wheat pita chips with hummus.
To avoid excess calories from mindless eating at parties, distance yourself from the food table. It may be easy to continuously eat with the temptation of appetizing food within arm’s reach, so dish up a plate and hold a conversation away from the food. If you find yourself tempted to return to the table often, chew a piece of gum to keep yourself from reaching for the snacks.
While alcohol is common for people to consume during the holidays, it can add several hundred calories on top of the calorie dense foods you may already be eating. Alcoholic beverages can range from 100 to 300 calories, depending on the alcohol and mixers. To reduce your calories, drink a glass of water or flavored seltzer water between drinks.
When it comes time for the big meal, be smart about your choices. Resist the urge to put everything on your plate. Scan the buffet first to check out all of your options so you can decide which items you are most interested in. And remember to pile on the veggies. A general rule for someone with diabetes to follow is to fill half the plate with vegetables. If you aren’t sure what foods will be available at the party, bring a vegetable dish so you know you’ll be able to include vegetables at the meal. Try parmesan mashed cauliflower or garlic roasted green beans.
Even with those additional vegetables, your overall calorie intake may still be higher than usual. Eating your meal slowly and stopping to take a break after finishing can help you allow time for the signal to get to your brain that you are full. Recheck your appetite before continuing to eat.
Continuing to stay active can help as well. Suggest a family walk after the big meal and before bringing out the dessert. Taking a 30 minute walk can burn about 109 calories for a 150 pound person, or 145 calories at 200 pounds; about the amount of calories in a scoop of ice cream or a cookie.
And in the end, remember to focus on more than food during the holidays. Focus on what matters most; spending quality time with friends and family, laughing, sharing stories and creating memories together. Cheers and happy holidays!
Resources: Harvard Health Publishing
Find healthy holiday recipes at diabetesforecast.org
*Opinions expressed by KVH Contributors are their own. Managed by Kittitas Valley Healthcare, HealthNews does not provide medical advice. For medical advice, please see your healthcare provider.
Familiar ground: GNP Jean Yoder, in the main conference room at KVH’s Radio Hill Facility. The room was once a dining area for assisted living residents at Royal Vista, where Yoder made weekly rounds. (Thumbnail photo: Radio Hill exterior.)
Jean Yoder has been a local fixture in senior patient care for the past 23 years.
“I’ve always liked working with elderly people,” says Yoder, who first ventured into the world of healthcare as a young candy striper, bringing meals and other items to patients in their hospital rooms. Years later, Yoder found her calling as a Geriatric Nurse Provider (GNP), bringing medical care to patients in their homes.
Yoder’s was the first class of GNPs at the University of Washington. “We learned from them and they learned on us,” she laughs. Then, after working with geriatricians in the Seattle area, Yoder learned about a program in Ellensburg led by then-director of Home Care and Hospice Carol Detweiler.
A fellow UW GNP graduate, Detweiler’s vision was to bring medical care delivery out of the traditional patient care setting and into the community, particularly for the frail elderly. It was a vision Yoder shared. “We wanted to make care available for those who couldn’t access it,” she recalls, “whether they were physically frail, struggled with dementia, or had other issues that made it difficult to get in and out of the home for medical visits.”
Soon, the program was underway with Yoder as the sole practitioner.
Yoder’s territory included Royal Vista (a skilled nursing facility) and Kittitas Valley Health and Rehabilitation. Every week, she spent two days at each location, and was on daytime call for both. Nights and weekends were covered by patients’ primary care physicians.
From the outset, the program included a collaborative practice with physicians in the community, starting with Drs. Wise, Schmitt and Anderson in Cle Elum, later expanding to Ellensburg and physicians such as Dr. Solberg, who was struck by the increased level of care his patients were receiving under the GNP program. “He and I made monthly rounds together in the skilled nursing facilities for years,” says Yoder.
The steady presence of a GNP helped fill the care gap for patients and their physicians, whose schedules didn’t often allow for regular visits to these facilities. “We could be on-site, evaluate an individual, see where their code status was, talk to family, talk to staff, and get a plan in place to set up and provide care.”
“We were very busy,” she recalls. “With up to 65 patients in each facility, there’s a lot that goes on from one day to the next.”
Covering the community.
Soon, a second GNP was hired, and Yoder began spending a day each week seeing assisted living patients at Mountain View Meadows (now Meadows Place), and eventually Hearthstone.
“It’s not quite as intense as a skilled nursing facility,” says Yoder. “We focus on treating patients in their environment, keeping them healthy and hopefully away from the E.R.”
The GNP team worked with staff to prevent or treat conditions like urinary tract infections, pneumonias, skin tears, cellulitis, etc. With so many variables, says Yoder, “you never knew what your day would be like.”
Another major shift occurred when GNP Anna Collins entered the picture, joining forces with Yoder to divide up days and locations, increasing overall coverage. Collins took on Meadows Place, while Yoder continued at Hearthstone. “We added on Dry Creek (now Pacifica). And in the middle of all that, we started doing home visits.”
According to Yoder, GNP home visits serve those “who fall through the cracks, in the sense that they have many medical problems, but don’t qualify for the Medicare A Home Program” which covers services from KVH Home Health.
Thankfully, Medicare does allow nurse practitioners to do home visits. “It used to be called a doctor’s home visit,” explains Yoder. “We go through the physician to get a home visit, evaluate the patient and, with the patient’s permission, set up a care plan.”
Once they’ve established care with a patient in their home, GNPs make monthly visits unless a change in health brings them by sooner. “If there’s a spell of illness, or an issue like a wound needing frequent dressing changes, or someone is really fragile and needs more attention and services, we work with a physician to bring in Home Health.”
Taking on the trends.
One big change Yoder’s seen during her time as a GNP is the amount of medications taken by seniors. “It used to be that five medications was remarkable. Now, we have people on 15 or 20,” she says. “We look at the whole picture to see how it’s all working, and focus on comfort while getting rid of unnecessary medications and testing.”
Another trend Yoder sees is a faster discharge from hospitals. “Even if a patient rehabs in a skilled nursing facility, what happens once they get home?” The GNP program will soon begin making home visits after patients are discharged. “You can see when you walk into the environment, what’s working, or isn’t, and what we need to do. It involves quite a bit of detective work.”
The next chapter.
Last month, the GNP office relocated to KVH’s newly remodeled Radio Hill facility – formerly known as Royal Vista, the place where Jean first began her GNP rounds in Kittitas County.
Now that things have come full circle, Yoder is set to retire. “I’ve let go of a lot of things already,” she says, as the GNP team has grown to include practitioners Nenna Nzeocha, Marquetta Washington, and Mary Nouwens. “It’s great to have them here. They want to do this work, and they’re not frightened by the scope and intensity of it.” And while she’s ready to focus on family and home remodeling, there are things Yoder will deeply miss – especially her working relationship with Anna Collins. “We’ve enjoyed each other and we communicate well together. We worked hard!,” she laughs.
Yoder is confident that the GNP program, under the visionary direction of KVH Chief Medical Officer Dr. Kevin Martin, is positioned to continue a pattern of growth in caring for patients throughout the county. Yoder’s optimism rests on a legacy shaped by years of faithful service.
“Nurse practitioners make a difference for patients, family, and staff,” she says. “I really believe that.”
Managed by Kittitas Valley Healthcare, HealthNews does not provide medical advice. For medical advice, please see your healthcare provider.
Long before she helped launch KVH Wound Care, Mary Nouwens grew up on a ranch. Among her favorite things to do was to help her father treat injured or sick cattle.
“I like science,” she grins, “and I believe people have a God-given bent to what they like.”
As an adult, she moved from cows to sheep when her children were small. She enjoyed treating the sheep when they needed medical attention. But once her kids were grown, Nouwens’ dreams of becoming a veterinarian shifted. “I wanted to serve people,” she says.
And off to nursing school she went.
Nouwens went on to earn a Master’s of Science in Nursing from Washington State University. She joined the provider team at Community Health of Central Washington. “It was a wonderful experience,” says Nouwens, who had no intention of leaving the clinic – until KVH moved forward with plans for a wound care service at KVH Hospital.
In August 2018, KVH Wound Care launched with Nouwens on board. She wasn’t surprised when things took off quickly and didn’t slow down: “Before this service started, the closest one was in Yakima.”
What is Wound Care?
While people treat their own superficial wounds with a bandaid and some antibacterial ointment, the treatment of chronic wounds (which take more than two weeks to heal) requires a skilled team with a focused treatment program.
“We see such a variety,” says Nouwens, including post-surgical wounds and diabetic foot ulcers. Patients visit Wound Care over a period of several weeks to months depending on outpatient treatment.
“When a wound becomes chronic, the makeup of the wound changes,” says Nouwens. “There’s an increase in white blood cells call neutrophils which try to clean up the wound and fight any bacteria that would want to colonize there. That keeps the wound in an inflammatory state.”
Often, the work of the wound care team is to take an inflamed wound back to its original condition through a clearing and cleaning process. The team then uses a variety of tools to accelerate healing. “We have so many specialized tools,” says Nouwens. “Alginates and collagens, special hydrofiber foams, wound vacs, and more.”
Each patient visit lasts about 30 minutes, giving staff time to talk with patients about managing their conditions as (for example) the patient’s dressing is changed. Wound Care stocks a variety of materials on wound care and prevention. “We try to provide education every time.”
Beyond the bandages.
Nutrition is a frequent topic of wound care education, especially for patients dealing with complications from diseases like diabetes. “Nutrition is critical,” agrees Jim Gallagher, Director of Food & Nutrition Services at KVH Hospital. “It can reduce inflammation and also provide the necessary elements to produce new tissue for wound healing.”
Wound Care refers patients to Gallagher for nutritional services. Recently, “a patient got her dressings changed while we hung out for about half an hour and talked nutrition,” recalls Gallagher. “I want people to leave with a plan, so they know what they’re going to eat, and what they’re going to do. We pencil out a menu they can use.”
Based on individual patient needs, Gallagher often assigns more targeted therapies including certain vitamins, minerals, and amino acid supplements that can aid in healing. But for some patients there is also an underlying behavioral issue to address.
When it comes to diabetes, “some people just need to get ‘lean and mean,’” says Gallagher. “Others need to make sure they protect their feet, and take precautions to avoid wounds because they can they can be difficult to heal.”
“I’ve seen patients with Type 2 diabetes lose 40, 60, 80 pounds, and their diabetes disappeared completely,” says Gallagher. “Others had the symptoms disappear, but still needed to maintain preventative practices. Even elderly patients with Type 1 diabetes, if they eat right, stay active, and take their insulin when they should, may show very little ill effects from the disease.”
Positive changes start with attitude, believes Gallagher. “If you’re thinking about it, realizing you have a problem and you want to do something about it, that’s something we can definitely work with.”
April is Sexual Assault Awareness Month.
Last week, some 100 forensic nurses from around the country gathered in Washington DC, seeking help with funding for research, education and prevention efforts related to sexual assault. It’s an ongoing battle to represent the needs of patients who rarely speak for themselves.
Here in Kittitas County, we’re nearing the 6-year mark of our local Sexual Assault Nurse Examiner (SANE) program at KVH Hospital. The program involves a collaborative effort between local law enforcement, ASPEN, CWU, and the hospital; in every situation, trained staff are involved from the initial report of assault through the victim’s medical examination.
Ask any SANE and you’ll find a person who cares deeply about the care and treatment of sexual abuse victims. “It’s very emotional,” says Pam Clemons, RN and SANE at KVH Hospital. “One of the most important responsibilities we have is to be objective – but it’s not always easy.”
Objectivity for SANEs is key, because they are not only caring for and treating patients – they’re also collecting evidence. The SANE program is an example of forensic nursing, providing specialized care for victims and perpetrators of intentionally and unintentionally inflicted trauma. Forensic nurses have a specialized knowledge of the legal system and skills in identifying, evaluating and documenting injuries. According to the International Association of Forensic Nursing, after attending to a patient’s immediate medical needs, a forensic nurse often collects evidence, provides medical testimony in court, and consults with legal authorities.
As an emergency room nurse, Clemons was already familiar with helping patients in crisis situations. Then she saw an unmet need in care for sexual assault victims. “I thought, I can do this. I took the training, and the passion I now have grew out of my experiences.”
The nature of emergencies and traumas is unpredictable and unplanned, which means Clemons and other SANE professionals can’t predict how many patients they’ll see in a given month. Clemons says, “For some reason, patients often come in waves. We won’t see any for months, and then have 3 in one weekend.”
Weekends treating multiple sexual assault victims are tough on these examiners. The emotion and empathy, combined with heightened awareness needed not just for physical care, but forensic procedures, can quickly drain a nurse’s energy. But the sense of satisfaction that comes with helping victims can be almost as overwhelming. It’s one reason why Clemons encourages others who are interested to seek out SANE training. “Every time a nurse joins the group, we learn something from them,” she says. “They bring ideas and past experiences that give us a fresh perspective on what we’re doing.”
Video from the Office for Victims of Crime, US Department of Justice.
Related:
Online SANE training
Managed by Kittitas Valley Healthcare, HealthNews does not provide medical advice. For medical advice, please see your healthcare provider.
