FOR IMMEDIATE RELEASE
Feb. 21, 2019

BEND, Ore. – A team of surgeons at St. Charles Bend performed a novel surgery Feb. 10 that saved the life of a 79-year-old patient who couldn’t tolerate a more conventional—but invasive—open-heart approach.

The patient came to the hospital experiencing chest pain as the result of a leak in his ascending aorta. Years before he had undergone surgical reconstruction of his proximal aorta, an open-heart surgery that takes hours to perform and many days from which to recover. But now the repair was starting to fail, putting his life at risk.

Because of his age and condition, the patient couldn’t safely tolerate another such surgery, which is the normal standard of care, said Dr. Wayne Nelson, a vascular surgeon at Oregon Vascular Specialists who led the team. Also participating was Dr. Jason Jundt (vascular surgery), Dr. Jen Dixon (cardiothoracic surgery), Dr. Bruce McLellan (cardiology) and Dr. Brian Tomkins (anesthesiology).

After researching a variety of stent grafts, Nelson found a new one—released merely weeks ago—that could work. Though not yet approved by the Food and Drug Administration (FDA) for use in the ascending aorta, the stent graft’s dimensions would almost perfectly reinforce the wall of the patient’s leaking aorta and help keep the damaged area from rupturing.

But even after finding the right stent graft, the team was presented with still another challenge: the patient’s leg arteries, through which most endovascular surgeries are performed, were too small and diseased to safely deliver the stent graft. Dr. Nelson decided to try and advance the endograft into position using an incision in the patient’s neck and going through the right carotid artery instead. “We advanced the stent graft down his neck into the ascending aorta and deployed it where it should go,” he said. “It worked fantastic. He went home after two days.”

Nelson said this approach may be a viable option going forward in patients who have life-threatening conditions and no traditional surgical options. “It’s an innovative approach to fix a problem in someone who won’t tolerate the normal surgical standard of care,” he said. “However, this is only a limited, single event that we can’t draw any conclusions from. But it worked very well.”

About St. Charles Health System
St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,200 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

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FOR IMMEDIATE RELEASE
Jan. 28, 2019

BEND, Ore. – St. Charles Bend nurses represented by the Oregon Nurses Association have voted in favor of ratifying a new four-and-a-half year contract.

“We are happy to have reached a contract agreement that both the nurses and St. Charles leaders feel good about,” said Debbie Robinson, chief nursing officer for St. Charles Bend. “While it took many months of conversations, we ended in a good place and we are all ready to come together and continue doing what we do best – providing quality care for our patients.”

Now that the contract has been ratified, St. Charles and the ONA will work together to develop processes to put the new contract language into practice in the coming weeks.

“The newly ratified contract helps ensure we are providing the best quality care for our community,” said local nurse leader and ONA bargaining unit chair David Hilderbrand, RN. “We look forward to taking the next step of implementing the new contract and utilizing the new tools provided to address shared concerns like staffing and practice standards, which allows us to focus on our patients.”

Some highlights from the new contract include:

• New groups have been created so nurses float between similar departments, providing more flexibility for staffing and ensuring every patient is treated by nurses trained to meet their specific needs.
• Creates a shared governance structure to increase accountability around staffing and practice issues. The new shared governance model will allow direct-care nurses and managers to work together to quickly address practice concerns.
• Nurses can be hired into St. Charles at step levels that are consistent with their years of experience, which will enhance recruiting efforts.
• The teams reached a fair agreement on wages and benefits. Offers variable cost-of-living increases to provide financial flexibility for the hospital while helping recruit and retain nurses.

About St. Charles Health System
St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,200 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

The Oregon Nurses Association (ONA) is the state’s largest and most influential nursing organization. It is a professional association and labor union which represents nearly 15,000 nurses across the state. ONA’s mission is to advocate for nursing, quality health care and healthy communities. For more information, visit www.OregonRN.org.

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FOR IMMEDIATE RELEASE
Jan. 14, 2019

BEND, Ore. — After 26 negotiation sessions, St. Charles leaders and Bend hospital nurses represented by the Oregon Nurses Association reached a tentative agreement early Saturday morning on all remaining articles in the contract. Negotiations wrapped up after a marathon, two-day session that ended after 1 a.m.

“We want to thank the members of both bargaining teams for the months they have spent working toward a fair contract,” said Debbie Robinson, chief nursing officer for St. Charles Bend. “We greatly appreciate the dedication and commitment to our patients and community. We are thrilled to have reached a conclusion that both sides feel good about and are ready to move forward and focus on what we do best – providing safe, quality patient care.”

Full details will be shared with Bend nurses by the ONA in coming days and the union will schedule a ratification vote. The contract must be ratified by a majority of the more than 900 nurses represented within the bargaining unit before it is implemented. The nurses will continue working under the existing contract language, as they have throughout negotiations, until the ratification vote takes place.

“I’m proud of both negotiating teams for continuing to come back to the table and doing the hard work that led to this agreement,” said Aaron Adams, President for St. Charles Bend. “The teams came together and reached terms that both parties felt were fair. We are pleased with the result and look forward to the next four-and-a-half years of stability the agreement provides for our organization.”

About St. Charles Health System
St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,200 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

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FOR IMMEDIATE RELEASE
Jan. 8, 2019

ONA to hold informational picket at St. Charles Bend

The Oregon Nurses Association plans to hold an informational picket Jan. 21 at 2500 NE Neff Rd. It is not a labor strike or work stoppage.
St. Charles Health System and the ONA — which represents about 915 nurses on the Bend campus — have been negotiating a three-year contract since early June. The bargaining teams have met 24 times including several sessions with a federal mediator and have resolved most of the language changes in the contract. Nearly all contract language related to nurse staffing has been agreed upon. Outstanding issues include wages, benefits, the grievance process and unit practice committees.

“We respect our nurses and their right to hold this informational picket,” said St. Charles Bend President Aaron Adams. “While we have made much progress on the contract over the past six months, we have not yet reached a final agreement. We look forward to meeting again at the bargaining table later this week.”

The hospital will continue to operate normally during this event and is committed to providing the best possible care to the community.

“The majority of remaining issues have to do with wages and benefits,” Adams said.

The outstanding articles cover the process by which the nurses grieve disputes; continuing education; how nurses are selected for unit practice committees and incorporating some language from St. Charles Prineville’s contract. None of these items relate to patient safety or safe staffing.

“We value our nurses and are proud that they are among some of the highest paid in the nation,” he said. “We are committed to continue the hard work needed at the negotiating table to reach an agreement.”

In order to protect our patients and their privacy, we ask that members of the media stay near the picket outside of hospital property when conducting interviews. Contact Lisa Goodman if you wish to be escorted onto the hospital grounds.

About St. Charles Health System
St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,200 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

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“It’s really special to take care of people that are from the same community as me. I feel a different sense of connection taking care of people in my hometown. I loved Asante, I loved the patients there. But there’s just something about being from the same spot and taking care of patients from the same place I’m from ... this community made me who I am.”

- Anna, St. Charles Redmond nurse on moving back to her hometown

"I don’t want to sound totally corny, but we really do have great teamwork here. And everyone really collaborates. You pretty much have to. When we are dealing with trauma patients and chest tubes and pain and chronic pain and all this other stuff, you have to work together as a team."

- Amy, night shift registered nurse on the Surgical floor in Bend

"I kind of picture the ED people being like the party kids in high school. I think that having that kind of mentality, you know we see really sick people and being able to have fun here makes the place a lot looser. Otherwise, I think it would be a stress case here. It keeps the ED vibe in homeostasis."

- Tyler, St. Charles Bend Emergency Department

"What I love about this job and a town this size is I get to take care of my family, my friends and my neighbors. I get to meet the many visitors who come to my town. I want them to leave knowing it's a great place to visit and they'll always get great care."

- Dr. Fran McCabe, St. Charles Bend Emergency Department

Understanding concussions

A concussion is a traumatic brain injury caused by a bump, blow, or jolt to the head. Concussions can also result from a hit to the body that moves the head and brain back and forth rapidly. When an impact occurs, it causes the brain and surrounding cerebrospinal fluid to move within the skull. Because the brain is similar to Jell-O in consistency, when the head moves suddenly by force, the brain shifts, turns, and twists inside the skull causing chemical and metabolic changes deep in the brain tissue. The resulting concussion produces symptoms like confusion, dizziness, headache, and blurred vision.

So, do helmets help?

The short answer is no, football helmets are not designed to prevent concussions. Rather, their primary purpose is to prevent skull fractures. Even with recent advances in the development of football helmets, they do not prevent the brain from moving within the skull. Similarly, mouth guards can help prevent dental and oral injuries but not concussions. Research shows there is no reduction in concussion rates for players wearing mouth guards.

What can you do?

While there is nothing that can truly prevent concussions in football, there are a few things athletes can do to help reduce their risk of concussion. First, proper fit of the helmet is critical. Although the helmet itself cannot prevent a concussion, research shows that improper fit of the helmet can increase concussion symptom severity and duration. Next, proper tackling technique can help to reduce the risk of concussion by using the shoulder to initiate contact instead of using the head. Finally, neck strengthening can also be beneficial to help stabilize the head and dissipate the forces transferred to the head during collisions and rapid head rotations.

Learn more about concussion prevention

To learn more about concussion prevention and management, click here. For more on the role of helmets in concussion prevention, watch this TEDTalk by David Camarillo, PhD. Written by: Lindsay Hagler, MS, ATC, CSCS and former athletic trainer for the Center for Orthopedics & Neurosurgery and Mountain View High School in Bend, OR. 

References

Helmets and Mouth Guards: The Role of Personal Equipment in Preventing Sport-Related Concussions Daniel H. Daneshvar, MA,^a Christine M. Baugh,^b Christopher J. Nowinski,^c,d Ann C. McKee,^c,j Robert A. Stern, PhD,^c,kand Robert C. Cantu, MD^{c,e,f,g,h,i,l} https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987604/ Inadequate Helmet Fit Increases Concussion Severity in American High School Football Players Dustin A. Greenhill, MD,^*† Paul Navo, MPH,^‡ Huaqing Zhao, PhD,^‡ Joseph Torg, MD,^† R. Dawn Comstock, PhD,^§∥ andBarry P. Boden, MD^¶ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981070/

Grand Rounds - September 7, 2018
"Managing Subclinical Hypothyroidism"

Speaker: Linda Lester, MD. Associate Professor of Medicine, Division of Endocrinology, Diabetes and Clinical Nutrition, OHSU School of Medicine

Accreditation: St. Charles Health System is accredited by the Oregon Medical Association to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)^TM.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at 541-706-4680, [email protected]. For CME or Clerkship questions, contact Sheila Jordan, MMGT, CHCP, Manager of Continuing Medical Education at 541-706-6780, [email protected].