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Women undergo multiple hormonal changes throughout their lives, leading to different physical and emotional experiences. Dr. Carilyn Hoffman, at Renown Women's Health, explains these confusing life stages and helps decode menopause. Perimenopause: Transitioning Towards Menopause Defined as the time "around menopause," perimenopausal symptoms are caused by hormonal fluctuations that occur as the ovarian function declines. Levels of estrogen and progesterone decrease, and follicle stimulating hormone increases. These hormonal fluctuations may cause a range of symptoms including: Irregular or abnormal periods: Initially cycles intervals vary in length by greater than 7 days, then in later stages the interval increases to greater than 60 days between cycles Hot flashes and night sweats: This is the most common symptom and 50-82% of women will have vasomotor symptoms Mood swings and memory problems Anxiety or insomnia Heart palpitations Decreased libido and vaginal dryness Weight gain and thinning hair Increased risk of urinary tract infections Decreased bone density Menopause Menopause is defined as year without a menstrual cycle and marks the timeframe when the ovaries stop making estrogen. This signifies the end of the reproductive years. The average age of menopause is 51; however, the menopausal transition can last about 8 years. This means that women in their late 30’s and 40’s may start to have symptoms of perimenopause. The worst vasomotor symptoms are typically experienced at the one-year mark since the last period. Unfortunately, some women experience symptoms throughout the entire menopausal transition. Postmenopausal After 12 months without a menstrual cycle, a woman is confirmed to be postmenopausal. This is sometimes difficult to define, as women may have had procedures that cause menstrual suppression such as a uterine ablation or hysterectomy or they may still be on contraception. Sometimes, lab work may be recommended to help determine menopausal status. However, due to the broad time period that the menopausal transition occurs and the variations in normal hormone levels throughout a cycle, lab work is not always helpful. Dr. Hoffman explains the importance of thorough counseling for patients seeking to "check their hormone levels." She emphasizes that menopause is diagnosed clinically, focusing more on the individual's symptoms rather than lab values. This approach ensures that patients understand the implications of the test results and the treatment strategy. Menopause Medical Management Medical management of symptoms should be tailored to the individual’s concerns. Abnormal Bleeding: There are a range of medications, IUDs and procedures available if the main concern is irregular or prolonged menstrual bleeding during perimenopause.  Hot Flashes and Night Sweats: Hormone Replacement Therapy (HRT): HRT is currently the most effective method for relieving vasomotor symptoms. However, it's important to discuss potential risks with a healthcare provider, as HRT can increase your risk of blood clots and breast cancer. If improperly prescribed, it can also increase the risk of uterine cancer. The American College of Obstetricians and Gynecologists recommends the lowest dose for the shortest duration. Low-dose antidepressants: SSRIs/SSNIs may mitigate hot flashes and mood disorders for those who are not candidates or prefer to avoid HRT. Currently, only Paroxetine is FDA-approved for this use.  Fezolinetant: This is a newly FDA-approved non-hormonal medication that works at the brain's level to treat vasomotor symptoms. Gabapentin: This is an anticonvulsant medication that has been shown in several studies to be helpful for vasomotor symptoms, but it is not currently FDA-approved. Genitourinary Symptoms of Menopause:  Vaginal estrogen: Vaginal dryness and pain with intercourse due to thinning vaginal tissue is a common symptom of menopause. Vaginal estrogen is highly effective at decreasing these symptoms and has fewer side effects than systemic HRT. Ospemifene: This is a selective estrogen receptor modulator that is a non-hormonal FDA-approved medication for severe vaginal dryness. Natural Symptom Relief Strategies: Nutrition: Incorporate calcium, vitamin D, and high-quality protein to support bone health and muscle maintenance. There are limited studies on phytoestrogens (found in soy and tofu) and vasomotor symptoms. While the data doesn’t necessarily support that these phytoestrogens relieve symptoms, no detrimental effects were found and these tend to be high quality and healthy proteins. Exercise: Regular physical activity can ease menopausal symptoms and support weight management. Data doesn’t support that this reduces vasomotor symptoms, but it can be helpful in weight management and sleep quality. Beverage choices: Limiting alcohol and caffeine can help decrease the frequency of vasomotor symptoms and may also improve sleep quality. Alternative remedies: One study shows that Chinese herbal medicine and acupuncture are effective at relieving vasomotor symptoms. There is not enough evidence to recommend Black Cohosh, and it is associated with liver toxicity in high doses. Studies don’t show that St. John’s Wart or Gingko Balboa are any better than placebo.  Always mention your alternative medical therapies to your provider as some do interact with other prescribed medications. By understanding and recognizing that the symptoms of menopause are real and treatable, women are empowered to manage this transition better and can maintain their well-being and quality of life. Please schedule an appointment with Renown Women’s Health if you’d like to discuss your menopause symptoms with a provider.

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Obstetrician-gynecologists (OBGYNs) see patients from menses (the monthly menstrual cycle that occurs as a part of the female reproductive system), pregnancy and childbirth through menopause and play a pivotal role in managing reproductive health and overall wellness. Dr. James Alexander with Renown Women's Health explains. "As experts in women's health, we are uniquely positioned to recognize subtle changes or symptoms that might indicate broader health issues. This comprehensive approach allows us to serve as a valuable first touchpoint for various health concerns." Preventive Screenings: A Proactive Approach One key aspect is an OBGYN's ability to recommend preventive screenings based on your symptoms, age, lifestyle and medical history. For instance, lipid screenings are critical for monitoring cholesterol levels, which can be a significant factor in women’s heart disease. An OBGYN keeps up with the current guidelines for routine screening as well as in women with risk factors such as high blood pressure, diabetes, or a family history of heart disease during your visit. By identifying risks and abnormal screening early, they can collaborate with you to implement lifestyle changes or treatments to reduce your risk of heart conditions. Schedule Your Screening Appointment Make an Appointment by Phone: 775-982-5000

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Dr. Carilyn Hoffman with Renown's Women's Health explains the symptoms, causes and treatments of Polycystic Ovary Syndrome (PCOS) (also referred to as Polycystic Ovarian Disease (PCOD)), a prevalent condition among women of reproductive age that influences hormonal balance, metabolism and fertility. Make an appointment with Renown Women's Health Click here to schedule Call to schedule: 775-982-5000 PCOS Defined PCOS is a constellation of symptoms characterized by two of the three criteria: multiple small cysts on the ovaries visible via ultrasound, irregular periods and signs of hyperandrogenism. Other symptoms include infertility, insulin resistance, and increased risk of cardiovascular disease. Symptoms of PCOS The symptoms of PCOS can vary from woman to woman, but some of the most common include: Irregular menstrual cycles: This is often one of the first signs of PCOS. Women may experience fewer than nine periods a year, more than 35 days between periods, frequent spotting, and/or abnormally heavy periods. Excess androgen levels: High levels of male hormones may result in physical signs such as excess facial and body hair (hirsutism), severe acne and male-pattern baldness. Polycystic ovaries: Enlarged ovaries containing numerous small cysts can be detected via ultrasound.     Causes and Risk Factors The exact cause of PCOS is unknown, but several factors may play a role: Genetic predisposition: A family history of PCOS increases the risk. Insulin resistance: High insulin levels might increase androgen production, causing difficulty with ovulation. Obesity: Women with elevated BMI’s are more likely to have PCOS, although 20% of women with PCOS are not obese. Diagnosis and Treatment Dr. Hoffman outlines that diagnosing PCOS requires a medical history review, a physical exam, blood work and an ultrasound to evaluate the ovaries. Treatment options can range from lifestyle modifications, like diet and exercise and weight loss, to medications for menstrual regulation, fertility assistance, and rarely surgery. Lifestyle Changes A healthy lifestyle is a cornerstone of managing PCOS. Regular exercise, a nutritious diet, and weight management can help reduce symptoms and the risk of long-term health issues. In overweight patients, weight loss as little as 5% has been shown to improve symptoms of PCOS. Medication Medications may include hormonal contraceptives to regulate menstrual cycles, anti-androgens to reduce hair growth and acne, and Metformin to address insulin resistance. Fertility Treatment For women with PCOS who are trying to conceive, ovulation induction with clomiphene or letrozole is sometimes necessary. Sometimes a referral to a reproductive endocrinologist and infertility specialist is needed for more advanced technologies like IVF. Health Implications PCOS is not just about cystic ovaries or irregular periods; it can have profound implications on a woman's overall health. Women with PCOS are at an increased risk for several conditions, including type 2 diabetes, high blood pressure, heart disease, and endometrial cancer.

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Vitamin D, often hailed as the sunshine vitamin, plays a crucial role in our health by helping the body absorb calcium and promoting bone and teeth strength. However, despite its importance, Vitamin D deficiency is widespread, contributing to various health issues ranging from osteoporosis to type 2 diabetes. We asked Alexandra Westover, APRN for Renown Health, for more information. Understanding Vitamin D and Sun Exposure How Vitamin D is Synthesized Vitamin D functions like a pro-hormone produced when our skin is exposed to sunlight. It's vital for bone health and immune function and can even reduce the risk of type 2 diabetes by 15%. Challenges in Vitamin D Synthesis Achieving adequate Vitamin D levels is more complex than basking in the sun. The vitamin breaks down quickly; during winter in northern latitudes, UVB rays are often too weak to contribute to its production. Expert Insight Alexandra shares, "Vitamin D deficiency is linked to multiple health concerns, including cancer and depression. Unfortunately, deficiency rates are high in the U.S., partly due to limited dietary sources and the increasing prevalence of obesity." Dietary Sources of Vitamin D Foods High in Vitamin D: Fatty fish like salmon and tuna Fortified milk and orange juices Mushrooms Eggs Cod Liver Oil Alexandra's Advice on Supplements "While foods and over-the-counter supplements can help, they often fail to correct deficiencies. Many individuals need prescription-strength doses of Vitamin D."

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Renown Health has three emergency rooms open 24 hours a day, seven days a week, ready to serve our community. We checked in with Amy Hawkins, Manager of Clinical Nursing at Renown South Meadows, to learn more about the emergency room experience and how each can accommodate your emergency care needs. 1. Renown Regional Emergency Room The emergency room at Renown Regional Medical Center is the only Level II Trauma Center between Sacramento and Salt Lake City, treating more than 80,000 ER and trauma patients annually. Services Offered: This location offers immediate emergency care covered by general surgeons and coverage by the specialties of orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology and critical care. In addition, tertiary care needs include cardiac surgery, hemodialysis and microvascular surgery. (Patients may be referred to a Level I Trauma Center.) Renown Regional ER Location 2. Renown South Meadows Emergency Room South Reno is expanding, and so is Renown South Meadows ER! Exciting transformations are happening across this campus, including the new 121,000-square-foot specialty care center and upgrades to the existing medical center—expanding care to our patients. Added benefits to the more intimate setting at South Meadows: Smaller ER also means more personal experience. The team traditionally has more time to spend with each patient at the bedside. A smaller campus means convenient parking, as the ER is just outside the front entrance; however, patients are reminded to follow marked road signs when approaching the campus during construction. Most patients arrive by private vehicle versus an ambulance, so we are very accustomed to thinking quickly on our feet. Benefits to new construction: A new Cath lab will allow us to treat patients experiencing a heart attack and needing immediate intervention to open vessels in their hearts. Additional lab and imaging capabilities for our patients Services Offered: This location offers immediate emergency care staffed with board-certified emergency physicians. Patients can expect one-on-one interactions with trusted providers and shorter wait times. All emergency room services are open during construction, and patients are reminded to follow marked road signs when approaching the campus. South Meadows ER Location 3. Renown Children's Hospital Emergency Room This location offers immediate emergency care, with pediatric specialists always on staff. In addition, the Children's ER lobby is ideal for our littlest patients, with a child-friendly atmosphere and vibrant colors to help decrease the anxiety accompanying emergencies. Medical equipment is sized just for kids, and we offer a distraction machine, games and movies to help children cope with what can be a traumatic experience, like getting an IV. In addition, we have Child Life Specialists available to provide emotional support to both children and their families. When to Bring Your Child to the ER: Allergic reactions Asthma attacks Baby under three months old with a temperature higher than 100.4 degrees Fahrenheit Broken bones Burns Choking or poisoning Difficulty breathing Eye injuries Fainting, dizziness and confusion Head injuries Heart attack Rashes Seizures Severe bleeding Severe headache Severe pain Skin infections Stitches Stroke Venomous stings and bites Renown Children's Hospital Location

Read More About Three Emergency Room Options for You and Your Family

Pictured above: A section of Renown’s Labor Assessment Area.  When patients expecting a new child are about to give birth, nerves can be especially heightened. Questions flood their minds: Is the baby actually on the way? What’s going to happen next? Are we ready to push?   Lucky for them, at Renown Health, the guesswork can finally end with Renown’s Labor & Delivery unit Labor Assessment Area. This unique space is a triage area that helps make more precise labor diagnoses by determining exactly what stage expectant parents are at in the labor process.  Funded by a state grant more than a decade ago, the six-bed Labor Assessment Area sees 500-600 patients per month – from patients entering the unit directly, unsure if they are in active labor, to patients who are sent over from elsewhere experiencing labor symptoms, such as high blood pressure and water breaking. The area also serves as a pre-operation space for patients getting ready for procedures such as C-sections. The six cubicles that are enclosed with doors and curtains ensure each patient gets the private, one-on-one care they need. Furthermore, rather than sitting in a waiting room, this area allows expectant parents a comfortable place to prepare for labor.  “We are a unit that prides ourselves on getting patients into beds very quickly,” said Debbie Hawley, Associate Nurse Manager in Renown’s Labor & Delivery unit. “This area has allowed us to triage more effectively and allow more patients to collaborate with their provider in a quick manner.”

Read More About Remove the Guesswork with Renown’s Labor Assessment Area

Parents welcoming their new bundles of joy into the world might be overcome with emotions. They're exhausted yet excited to meet their new baby and hold them in their arms. That’s where Renown Health’s Labor & Delivery (L&D) department comes in. When patients arrive at the L&D unit in Renown Regional Medical Center, they are embraced with caring, compassionate nurses, surgical technicians and physicians ready to serve their family. As they get ready for the big moment in their private L&D room or family suite, you can be certain that you, they can be certain that they will receive the excellent care they deserve. Unpredictable, but Never Unprepared  Ushering in new life can bring a lot of surprises for parents, but the L&D department is prepared for any challenge. Whether the unit is helping with a routine or high-risk delivery, every patient and newborn are treated with personalized care that is uniquely tailored to their own individual needs and birth preferences, from labor evaluation and birth to post-birth lactation consultation and navigating the nursery.  “Our floor is never predictable,” said Bri Goode, Renown L&D nurse. “Our nurses and our staff work as a team to ensure the best care for our patients. I commonly say that we are all 'nurses’ for each patient!”  The state-of-the-art technology at their fingertips – including advanced 3D ultrasound machines – coupled with the love and passion the team has for their patients allows them to create an optimal environment for every mother and baby. The unit is also equipped with a Labor Assessment Area, where expectant mothers are evaluated to determine what stage of labor they are in, removing the guesswork and allowing providers to treat the patient and unborn child more efficiently and meet them exactly where they are at in the labor process.  Nothing can replace the careful guidance and words of encouragement a patient needs in the delivery room. The L&D department are true patient advocates and firmly believe in the power of listening and the power of staying calm and collected.  “To help our patients and ease their fears and anxieties, we always ensure them that our biggest goal is to have a healthy mom and healthy baby,” said Lindsay Strowmatt, Renown L&D nurse. “We constantly reinforce that they are strong and capable. Empowerment goes a long way!”  “We always take the time to actually sit down and listen to the patient, no matter how busy we are,” added Krystie Mortensen, Renown L&D nurse and DAISY Award winner. “It’s important for us to understand where their nerves are stemming from and address any changes in plan of care along the way.”  While the L&D unit is seen as a “happy place,” as described repeatedly by the members of the team, a seemingly low-risk patient can also turn into an emergency in a matter of seconds.   "Our line of work can involve high-stakes emergency care,” said April Tucker, Renown L&D nurse. “We view change as a necessary part of growth, and we save lives.”  These steps result in high patient outcome scores, which can be attributed directly to the unit.  “We have continually great outcomes from hard work and consistency in care,” said Roya Galata, Renown L&D nurse and Nursing Organizations Alliance (NOA) Lifetime Achievement awardee. “I have tremendous love for my patients and the type of work I do.”  Awards Without End  With patient safety and experience always top of mind, and with the team continually going above and beyond for all parents and their newborns, it’s no wonder why the L&D department has achieved a long and growing list of both local and national awards and accolades.   This year, U.S. News & World Report ranked the L&D unit at Renown Regional as "High Performing in Maternity Care – Uncomplicated Pregnancy.” This award is only the latest in this department’s “Best Of” accolades list, as the unit also achieved a win as the Best Place to Have a Baby in the 2022 Best of Reno Awards.  Not only is the department continually recognized, but individual team members also receive coveted awards within their professional associations. As previously mentioned, Krystie Mortensen is a DAISY Award winner, which means that she has been recognized for the “super-human work” she has done throughout her career. Additionally, three team members, including Roya Galata, have received NOA awards, celebrating their contributions to the nursing profession as a whole.  Many nurses in this department also choose to pursue lifelong learning by taking advantage of the educational benefits that Renown offers. Several team members have completed their continuing education in midwifery and advanced practice, reaffirming their dedication to delivering healthy babies and helping parents manage their first few days with their newborns.  “The teamwork on this unit is phenomenal, and the energy and commitment that the staff comes in with every single day amazes me,” said Lora Carlson, Renown L&D Manager of Nursing.  Internally, the L&D department loves to show their spirit at Renown. In December, they received the Best Holiday Decoration award during the 2021 holiday season. The team also enjoys participating (and scoring well) in Renown-sponsored Halloween costume contests.  In 2023, the L&D department will only pursue greater heights to continue producing patient outcomes.  A Work Family  “I stay here because this is my family. My work family.”  These strong words were proudly stated by Jeanne Bufkin, Renown L&D Surgical Technician, and echoed by virtually every L&D employee. Having each other’s backs during both times of need and times of celebration is a must in this department, and they do so proudly.  “Our staff constantly back each other up,” added Lora Carlson. “They display a lot of adaptability and flexibility. That’s why our unit functions as well as it does.”  Several team members in this department experienced the care of the L&D unit at Renown before they became fully-fledged employees.  “I had two of my babies here and had wonderful experiences both times,” said Judy McBride, Unit Clerk. “I love being a part of the reason why the next woman can say the same!”  Bri Goode also delivered her child at Renown and loved her experience so much that she was also inspired to join the team. “I chose to work at Renown because when I had such a positive experience during my delivery while I was in nursing school, I knew it was a team I wanted to be a part of.”  Coming to Renown was clearly an easy decision for this team; staying at Renown is even easier.  “I stay here because I love what I do and who I do it with,” said Judy McBride. “I truly feel like I am treated as an asset to this department, and it makes me want to come to work every day and make a difference in these mothers’ lives.”  The closeness of this department and the top-of-the-line collaboration displayed by every provider can be felt by the patients during their entire stay at Renown.   “We have an amazing collaborative team of physicians, nurses, scrub techs, unit clerks, patient access representatives and environmental services personnel that strive to provide our patients with the best possible care,” said April Tucker.  The labor and delivery process is a team effort – and those interested in jumping in on this team effort are welcome to join. Delivering healthy babies and supporting new mothers are cornerstone acts in meeting Renown’s mission of making a genuine difference in the communities we serve. Our L&D department does precisely this and more, never giving up in Fighting the Good Fight.

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The emergency department is a central part of Renown Health’s hospitals. Serving patients in need of emergent attention, this team has an incredible level of dedication to not only tending to emergencies big and small, but also saving lives 24 hours a day and seven days a week. This critical work happens daily at Renown Regional, Renown South Meadows and Renown Children’s Hospital. Patients in Renown’s emergency rooms (ER) are in the best hands, and it is all thanks to the devoted, hard-working teams who run the show. Saving Lives Around the Clock  As the only Level 2 trauma center between Sacramento and Salt Lake City, taking care of a constant stream of patients in the Renown Regional, Renown South Meadows and Renown Children’s ERs come naturally for these teams. Whether it be 3 a.m. or the lunch hour, this team is always ready to spring into action to attend to virtually any health emergency under the sun. According to Gabby, an RN in the Renown Regional ER, everyone in the ER must be ready for anything. “We are the first line of care that the patient receives before they are admitted or discharged,” which means the team sees a wide variety of emergency situations each day.  Patients rely on the ER to protect them and help them heal from severe conditions. From head injuries and broken bones to heart attacks and strokes, this team has seen it all at every time of the day and night. “The ER is an uncontrolled, unpredictable environment,” said Miriam, an RN in the Renown Regional ER. “It’s essential that we all are ready to jump in and help at any time.”  Beyond the general ER at Renown Regional, Renown Children’s Hospital is the only accredited Children’s Hospital Emergency Room in all northern Nevada. The first and only facility of its kind in the Reno-Tahoe region, this robust emergency department is equipped with pediatric specialists and child-sized equipment to give children the highest level of support. “We are proud to keep a fun atmosphere with vibrant colors to help our young patients ease their anxieties, making them as comfortable as possible while providing excellent care,” said Ginger, Manager of Nursing for Renown Children’s ER.  While the majority of patients are treated onsite and discharged that same day, several ER patients get admitted to the hospital, when that happens, the emergency department works quickly with the Renown Transfer and Operations Center (RTOC) to get patients in a bed as soon as possible.   All day and all night, ambulances and helicopters deliver members of our community in need of care. But never fear – our incredibly capable emergency department is here. Kicking off into immediate action is a core requirement for the emergency department, and it is a task the entire team has nailed down to a science.   Team Tenacious  When asked about their team, members of the emergency department echoed the same notion: “I am not alone.” The emergency department never leaves their colleagues out to dry, and in an emergency environment, always being able to lend a hand whenever needed is vital. For Ashley, an RN at Renown Regional, one of the main reasons why she continues to work at Renown is because of her colleagues, along with a myriad of resources and state-of-the-art technology that are at their disposal. She adds, “It is such a joy to come in to work alongside my team.”  Amy, Supervisor of Nursing for the Renown South Meadows ER, feels the exact same way. “Being an emergency department, we sometimes see things you don’t always see every day,” said Amy. “It’s a relief for our patients to know that they are in the best place in the region for their care. I credit all of that to my team.”  As our emergency room capabilities continue to grow, this also includes our Children’s Hospital ER. Last year, the William N. Pennington Foundation provided a $7.5 million gift to the Renown Health Foundation to keep pediatric care – including pediatric emergency care – closer to home and expand our availability to our youngest patients. As reported last year, Dr. Joseph Gassen, a pediatric emergency doctor with Children’s Hospital, was the only pediatric emergency physician in the region as of 2021. Thanks to this gift, he was able to move to Reno to provide care in the Children’s Hospital ER.  “The hospital is dedicated to improving the care of children in northern Nevada, and I wanted to be a part of this amazing vision," said Dr. Gassen. “I would not have been able to relocate to Reno without the support from the hospital and the William N. Pennington gift.”  Besides achieving optimal outcomes for their patients, their efforts also paid off in the form of awards and recognition. Internally, the emergency department recognizes Employees of the Month for their outstanding work. Recently, Renown Regional Emergency Physician Dr. Patrick Russell and Claire, an RN, were recognized with this honor. Outside organizations have also noticed these exceptional team members. The Reno Gazette Journal’s recognized the Renown Regional ER as the Best Emergency Room in the 2022 Best of Reno Awards, complimenting Renown Regional’s wins as the Best Hospital and Best Place to Have a Baby.   The tenacity of the emergency department continues to surpass expectations, and their published achievements only scratch the surface of what is sure to come.  A Growing Team of Heroes  To continue meeting the growing need for emergency care regionally, especially when it comes to trauma and children’s services, the emergency department is looking forward to welcoming new team members. For those looking for a fast-paced, team-oriented atmosphere and the opportunity to be on the healthcare frontlines, the emergency department is a perfect fit.   As teamwork is clearly essential, the emergency department is an ideal environment for someone who is “not afraid to ask questions and always eager to learn new things,” according to Miriam. While one staff member’s patients may be settled, staff one assignment over could be overwhelmed with patient volume, so it is an imperative skill for a colleague to be a self-starter and take the initiative to help wherever needed.  Bryan, an emergency trauma technician at Renown Regional, emphasizes this point, adding, “A good colleague is one that knows you well and can infer your body language. They know how to read a situation and pre-plan for the next step. Being attentive, a valuable resource and knowledgeable about patient populations – that's the works!”  Career growth and lifelong learning are important to this group, so career-minded individuals will be in good company in the emergency department. “I choose Renown so I can jumpstart my career as a nurse in the top ER in the region,” said Gabby. This team is always learning and always on top of the latest research – which only further solidifies Renown’s place as the preeminent ER in northern Nevada and northeastern California.  If you take one thing from this article, let it be these parting words from Amy: “These are some of the smartest, most devoted individuals you will ever meet, and we are so lucky to have them serving our emergency department. You will only regret not working with this team.”

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