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Grand Rounds - Apr. 8, 2022
"Benzodiazepines - How They Work & How to Withdraw"

Speaker: Michael Levine, MD. University of California, Los Angeles.

 

 

Objectives

  1. Follow recommendations on CURES website for benzodiazepine prescribing.
  2. Manage the goals and limitations of benzodiazepine therapy with the patient, including the meaning of physical dependence and its implications.
  3. Recognize signs and symptoms of withdrawal.
  4. Implement validated clinical tools to assess and treat patients with these withdrawal symptoms and know when to refer.
  5. Utilize information relative to culture, age, and socioeconomics in indications and prescribing of benzodiazepines.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education 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.

The period to claim credit for this activity expires one year after its original publication. 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 [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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St. Charles’ hospital visitor policy changes next week

Starting Monday, April 4, St. Charles’ hospitals will no longer require visitors to show proof of vaccination, though wearing a mask will still be mandatory.

Signage posted at hospital entrances will encourage some visitors to leave, including those who have respiratory symptoms, have a pending COVID-19 test or who have been in contact with a known or suspected COVID-19 case in the last 14 days. Visitor screening does not apply to those seeking medical treatment or COVID-19 testing.

Additionally, all patients—including those who are positive for COVID-19—will be allowed two visitors at a time, who may come and go from the hospital as needed. The exception is the Emergency Department, where only one visitor will be allowed.

In some cases, visitors may be required to wear additional personal protective equipment for their safety.

“Two years ago, we instituted visitor restrictions to keep our caregivers and patients safe,” said Debbie Robinson, chief nursing officer, St. Charles Bend Campus. “We’re in a different place now. The number of COVID-19 cases and hospitalizations are low in our community, and we have vaccines and many effective treatments available.”

Door screeners will continue to be posted at hospital entrances through April 8 to help educate the community as this transition takes place.

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, La Pine, 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 4,600 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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St. Charles Prineville closing COVID-19 drive-through test site Thursday, March 31

BEND, Ore. – St. Charles Prineville is closing its COVID-19 drive-through test site on Thursday, March 31. After that time, tests will be available at the St. Charles Prineville Urgent Care on a walk-in basis, or by appointment at St. Charles Prineville Family Care.

St. Charles’ labs in Bend, La Pine, Madras and Redmond also offer COVID-19 testing, but a lab order is required.

COVID-19 testing is only available to those individuals who are symptomatic or who are scheduled for a procedure.

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, La Pine, 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 4,600 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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Grand Rounds - Mar. 25, 2022
"Sleep Disorders"

Speaker: Natalia Usatii, MD. Medical Director of Sleep Medicine Clinics in Bend and Redmond, St. Charles Medical Group.

 

 

Objectives

  1. Discuss and overview the most common sleep disorders.
  2. Identify who and when a patient would require a formal sleep consultation and/or a sleep test.
  3. Review diagnostic approach for sleep disorders in pediatrics.
  4. Review management of adult and pediatric sleep disorders.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education 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.

The period to claim credit for this activity expires one year after its original publication. 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 [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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You’ve probably heard of a win-win situation.

But how about a win-win-win-win-win situation?

That’s one way to describe St. Charles Health System’s CNA Trainee program, which provides a path to a career in patient care for caregivers in non-medical positions such as food services and housekeeping, as well as people outside the organization looking to get into health care.

CNA stands for certified nursing assistant, a position that performs important patient-centered tasks in collaboration with nurses and physicians. Recruiting and retaining CNAs has historically been a challenge for St. Charles, which is why the health system created the CNA Trainee program. Here’s why it’s a win-win-win-win-win:

  • Participants get paid a full-time wage while taking the course
  • St. Charles also pays the course tuition
  • Participants get wide-ranging, hands-on experience in various departments across the health system
  • People who complete the course are guaranteed a job with the health system
  • St. Charles fills an important CNA position with an educated, experienced person who already knows the health system’s policies, processes and culture

“We love this program because it really gives us the opportunity to develop people and it's a pipeline to bolster our workforce,” said Rebecca Berry, vice president of Human Resources for St. Charles. “It provides an opportunity for growth, development and career advancement for our caregivers, and it strengthens our organization by helping to attract and retain proven employees, which ultimately is good for our patients.”

Molly Barash loves the CNA Trainee program, too. She moved to Central Oregon five years ago, and spent four years working at a local restaurant that treated her “very well,” she said. Still, she longed to find a path to a career in health care, inspired by her experience caring for her father as he battled cancer.

“I found great value in taking care of my dad and it made me want to pursue a career in nursing,” said Barash, 31. “I don’t think there are many more important jobs than caretaking for people who are in really vulnerable states. I like to be part of the process of healing.”

Financially, though, Barash couldn’t quit her job and focus on the education she needed to work in health care. So when her advisor at Central Oregon Community College told her about St. Charles’ CNA Trainee program, she pounced on the opportunity.

“I couldn’t have done it without that (program),” said Barash, who now works in the Progressive Care Unit at St. Charles Bend. “It was my ticket to being able to move forward.”

That’s a sentiment echoed by Penelope Story, 64, who was working at an ophthalmology practice in Bend when her husband suffered a series of strokes that put him in the hospital for an extended period of time, she said. While he was there, Story watched the CNAs who cared for him and realized she would benefit both professionally and personally if she could make the move into frontline patient care.

“I thought, ‘I can do that, and it would also help me learn how to better take care of him at home,’” she said. “I saw room for growth and room for salary advancement, so it was very appealing.”

Story learned about the CNA Trainee program through an online job site, applied, was accepted and joined St. Charles in October of 2020. She still marvels at the opportunity.

“You’re employed by the health system, so you’re getting paid to go to school, and your school is paid for as well. And then you’re guaranteed a position as well when you graduate,” she said. “It’s incredible for me to think about how that really happened.”

As a bonus, Story feels she is a much better caretaker for her husband. And she’s happy working on the Medical unit at St. Charles Bend.

“I feel at home on that floor. I really and truly do,” she said. “It’s busy, don’t get me wrong. But it’s a joy to work there. I feel blessed to be a part of that staff.”

The CNA Trainee program has been so productive, St. Charles is starting a similar program for medical assistants, Berry said.

“We need more MAs to help support our physicians as they care for our patients,” she said. “It’s our hope that this new MA Trainee program will start to bring in a steady flow of excellent medical assistants to St. Charles.”

The first MA Trainee cohort starts at the end of March, and Laura Terrazas is excited to be a part of it. Currently, she is a housekeeper at St. Charles Madras, but she got a taste of patient care when she worked at a pediatrician’s office in Alabama years ago.

“I didn’t have my license or anything, but the pediatrician there was cross-training me (to work with patients) and I just fell in love with it,” she said. “The more interaction I had with the patients, the more I could feel that this was something I wanted to do.”

Terrazas, 44, intended to start her schooling in Alabama, but a move to Oregon stalled that plan. With a busy life (including kids), she had trouble finding the time to pursue the education she needed to move into patient care. But then, St. Charles announced its MA program.

“I thought, ‘That’s my door right there,’” Terrazas said. “I decided I would apply and see what happens, and I got in. I’m just so excited to see what comes next.”

At St. Charles, we believe our strength is in our people. If you’d like to work here, please visit our Careers site.

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Earlier this month, I received a phone call from U.S. Air Force Brigadier General James Cunningham (Ret.) with some surprising news.

He wanted to set up a time to meet with me because the Employer Support of the Guard and Reserve (ESGR) State Committee had chosen St. Charles Health System to receive the Pro Patria Award. It’s the highest level of award bestowed by an ESGR State Committee.

I felt both appreciative and humbled.

We at St. Charles have been so grateful for the services provided to us by the Oregon National Guard through our mass vaccination clinic and two COVID-19 surges. The men and women of the Guard left their friends, families, jobs and communities to be here for us. As I shared with Gen. Cunningham when we met in person, I don’t know if we would have made it through the Delta and Omicron surges without the Guard’s support.

He assured me that we would have made it – but it would have been messy. He also shared the story of taking his elderly parents to the Deschutes County Fair & Expo Center in Redmond a year ago for their COVID-19 vaccinations. The first time they visited, it took about two hours to complete the process. When they returned three weeks later for their second dose, it was after the Oregon National Guard had arrived to provide support. The difference was noticeable.

“It took seven minutes,” Cunningham said.

His pride in the Guard is palpable and his reasons for nominating St. Charles for this award are heartfelt and sincere. The health system has openly welcomed the Guard and has provided a place of learning and growth. We have heard from many of the men and women who have spent time with us in recent months that they are now seriously considering careers in health care because of their experiences helping others here in Central Oregon.

Knowing that those who have been called to help in a time of crisis now see the value of health care as a career is truly a gift of the pandemic.

Thank you to Gen. Cunningham for visiting St. Charles Bend and meeting with me.

Thank you to the ESGR for the Pro Patria Award – an incredible recognition.

And thank you once again to the hundreds of Guard members who helped us in recent months. As we faced unprecedented challenges, your tireless effort and willingness to tackle any task was invaluable.

It has been our honor to work alongside you.

Sincerely,
Joe

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Positive COVID-19 cases have decreased in our community, and fewer COVID-positive patients are being admitted to St. Charles’ Bend hospital. The state of Oregon ended its indoor mask requirement on March 12 and, for many, it feels like we are finally starting to put this pandemic behind us.

It is important to remember, however, that COVID-19 is still transmissible, and it is still a threat, especially to unvaccinated people. Here are some things to keep in mind as we move forward:

  • Masks are still required in health care settings. This is for your protection and the protection of our caregivers. Please be prepared to follow our masking policy when visiting any St. Charles facility.
  • The mask mandate has ended, but people may still make the choice to wear a mask in indoor public spaces such as movie theaters, grocery stores and restaurants. Please be respectful of everyone’s individual choice and comfort level with masking. You never know when someone is immune compromised or simply feels safer with the mask on.
  • We are in the process of reviewing our current visitor restrictions. For now, vaccinations are still required for most non-patients entering our facilities. Check our visitor restrictions page on the St. Charles website for the latest updates.
  • The state mandate for health care workers to be vaccinated against COVID-19 has not changed. St. Charles will continue to follow state and federal law.
  • If you have not yet been vaccinated or boosted for COVID-19, it’s not too late. Vaccination continues to be the most important tool in keeping people from being hospitalized or dying from the virus.
  • If you are feeling sick, stay home. Guidance on COVID-19 testing continues to change as we have more access to COVID-19 treatments and home testing kits. Our St. Charles website has many resources that will help you determine when a laboratory test for COVID is necessary.

Thank you for doing your part to keep our communities healthy and safe. We appreciate your support of our efforts to do the same.

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St. Charles is a great place to work full of people who care about making a difference in our community. But you don’t have to take our word for it. Hear from Amor in the Lab about why she loves working here.

Join the Family

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March 17, 2022

Network issues throughout St. Charles Health System

Starting at about 3 a.m. today, St. Charles experienced an unexpected disruption of service from its major internet provider. The outage is resulting in a loss of access to many critical systems on an intermittent basis. The outage is system-wide affecting all St. Charles facilities. 

Our Information Technology team is working to troubleshoot issues with our internet service provider. At this time there is no known cause of the outage. It is not believed to be malicious in nature. 

Thank you for your patience as we work to address the issue with our internet service provider.   

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Two years ago today, I sent out a message letting our community know that we had identified the first presumptive positive case of COVID-19 in Central Oregon. It was only the second community message related to COVID we shared -- which has been a critical communication channel between St. Charles and the people we serve for more than 700 days.  

As I reflect on all that has happened and in the many ways our world has changed over the past two years, I wanted to stop and thank you for being engaged. Every time one of these messages goes out, I am inundated with responses. It has been wonderful to know that you are reading, listening, learning and taking action based on the information we have shared.

In many ways, it is thanks to you that we have come so far.  

While we still have COVID-19 patients in the hospital, the number of positive cases continues to decrease dramatically, and it feels as though we are finally putting the Omicron variant wave behind us.   

Now that the state indoor mask mandate is lifted and we all start working our way back toward a new normal, I have just a few reminders to share:  

  • For the time being, masks will still be required in health care settings. This is for your protection and the protection of our caregivers. Please be prepared to follow our masking policy when visiting any St. Charles facility.
  • While COVID numbers remain low, people will have the choice to wear a mask in other indoor environments like movie theaters, grocery stores and restaurants. Please be respectful of everyone’s individual choice and comfort level with masking. You never know when someone is immune compromised or simply feels safer with the mask on.
  • The state mandate for health care workers to be vaccinated against COVID-19 has not changed. St. Charles will continue to follow state and federal law.
  • If you have not yet been vaccinated or boosted for COVID-19, it's not too late. Vaccination continues to be the most important tool in keeping people from being hospitalized or dying from the virus.
  • If you are feeling sick, stay home. Check our St. Charles website for current information and resources that will help you determine when a laboratory test for COVID-19 is necessary. Guidance on COVID-19 testing continues to change as we have more access to COVID-19 therapies and home testing kits.

Thank you, again, for taking the time to read and understand how your actions make a difference to our health care community. Although we’ll continue to keep the door open for further messages from the health system, it is my hope that we are entering a phase of the pandemic where the need for communication on COVID is much less frequent.   

For a behind-the-scenes look at how our caregivers have endured the past two years, please watch this short video. If you can, thank a health care worker and remind them that two years later they are still the heroes of this pandemic.  

Sincerely,  

Joe

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