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In recent years, workplace violence against healthcare workers has been on the rise. According to the Occupational Safety and Health Administration (OSHA), about 75 percent of nearly 25,000 reported annual workplace assaults occur in healthcare and social service settings. Those who don’t work in healthcare may be surprised to learn that violent altercations are so common in our field. Hospital settings can create fear and stress for patients and their families. Pain, mind-altering medications and drugs, and difficult prognoses can amplify these feelings. While inappropriate responses may be understandable, violence cannot be tolerated. As the leader of a health system, protecting our employees is an issue that I take seriously. Reporting Workplace Violence Unfortunately, sometimes employees don’t report dangerous incidents fearing they might be blamed, or not realizing it’s a reportable offense. At Renown Health, we take these events seriously. We have clear, mandatory policies and protocols for reporting and investigating violent incidents. Each incident is investigated to ensure follow through and accountability. We also teach de-escalation skills to our hospital security teams, clinicians, and other frontline employees. As an added layer of protection, Renown Health has a first-rate security team that closely monitors activity on our campuses, addressing potential issues before they escalate. Our organization values our partnerships with community organizations including local law enforcement agencies like the Washoe County Sheriff’s Office and the Reno Police Department. Renown Health maintains a close relationship with these partners, and we alert them when our care teams experience an increase in violent incidents. I also recognize that workplace violence is a national problem that demands collaborative solutions. That’s why I am also proud to serve as a member of the American Hospital Association’s Hospitals Against Violence Advisory Committee. Nurses, doctors, paramedics, and frontline health workers care for us every day. It’s our responsibility to support them by ensuring they feel safe at work.

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If you think sore nipples are just a normal part of breastfeeding, think again. Robin Hollen, APRN, and Breastfeeding Medicine Specialist, says that nursing can be an enjoyable experience for mom and baby without pain and discomfort. A top concern of nursing moms within the first week after delivery is how to prevent sore nipples. Even moms who’ve nursed before struggle with this common issue. While many women think it is a regular part of the nursing experience, it is actually a sign that something isn’t quite right. “Nursing your baby should be enjoyable,” says Robin Hollen, Breastfeeding Medicine Specialist with Renown Health. For over 30 years Robin has been supporting moms to breastfeed. Below she shares some valuable information and tips, helping you create a happy and healthy breastfeeding experience for you and your baby. What causes sore nipples? The most common cause of sore nipples involves incorrect latching. For a proper latch, a baby’s mouth takes in the entire nipple and some of the breast, so that the nipple rests at the back of the mouth where the palate is soft. With an improper latch, the mouth may slip down to the tip of the nipple while the baby nurses. This constant pressure on your sensitive skin may cause discomfort and pain. A board-certified lactation consultant can help assess if your baby is latched correctly and troubleshoot your breastfeeding concerns. Less common causes of sore nipples include: • Improper tongue placement of baby • Clenching • Incorrect breast pump use How can a mother prevent sore nipples from an improper latch? Breastfeeding is a learning experience for both mom and baby. Ask for help with the latch so your baby learns it correctly and maintains its depth. In the past, new mothers were surrounded by a community of women — their own mothers, grandmothers, or other family and friends — to provide assistance and guidance with every latch at the beginning of an infant’s life. In today’s culture, new moms can find themselves on their own with no extended family to lend their knowledge. Nurses, pediatricians and lactation consultants now fill that role; they are the eyes and hands along with the much-needed experience to guide new mothers. Our Breastfeeding Medicine experts assist nursing moms with latch every day. Even a single visit with a lactation consultant observing your breastfeeding baby can provide valuable insight on achieving, and maintaining, the proper latch - preventing future nipple soreness and discomfort. How to heal sore nipples from breastfeeding To heal sore nipples, you must first fix the cause, and correcting the latch prevents further damage. A lactation consultant can also help you address the pain. Below are some breast healing tips: • Your own expressed breast milk is excellent to rub into the nipple for anti-bacterial protection. • For those moms who need more lubricant or fat than breast milk offers, use a lanolin or a cream that is labeled safe for the baby. • Soothies are a gel pads providing comfort in between feedings, but should not be used with lanolin products. • Breast shells, not to be confused with shields, can guard the nipples from irritation or pressure in between feedings. If you have more questions about preventing and healing sore nipples or general breastfeeding concerns, talk to your pediatrician or a Renown Health Breastfeeding Medicine specialist at 775-982-6365.

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One of the most pressing issues in modern medicine is the need to improve rural healthcare. This challenge hits particularly close to home, as Renown Health is the only provider covering 100,000 square miles in northern Nevada, an area that’s mostly rural. People in rural areas suffer from chronic diseases such as heart disease, cancer and respiratory disease, at higher rates than the general population. One of the largest contributors to these health disparities is a lack of access to health services. Many rural communities have fewer providers and care facilities. This forces residents to travel farther to receive preventive care and medical treatment. We must identify ways to better support the health needs of the millions of Americans who live in rural communities. Ideas for improving rural healthcare Health systems must identify innovative ways to leverage existing resources and new technologies to care for patients in these communities. For example, telehealth can help diminish a person’s need to travel long distances to receive specialty care. Similarly, online classes can help educate patients about preventive behaviors. Remote monitoring technology also allows patients to track their health conditions from home. Additionally, we can address physician shortages by empowering health professionals such as nurse practitioners, physician assistants and technologists to care for patients. These providers receive excellent training and have demonstrated success in improving health outcomes. Renown Health cares for people from diverse backgrounds and we are dedicated to caring for patients in every community we serve. Renown Telehealth We’re leading the region in using video conferencing technology to provide the best care possible – no matter where you are. Renown Telehealth is telemedicine that gives you access to top-level care and better outcomes with less stress and fewer travel costs. Learn More

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On behalf of Renown’s more than 7,000 employees, we are thrilled to introduce our healthcare system’s next CEO and President, Brian Erling, MD, MBA. Dr. Erling joins Renown after working for more than 20 years in Colorado, most recently as the CEO and President of Penrose-St. Francis Health System in Colorado Springs for Centura Health. “I am so excited to join Renown Health at this important time. Healthcare and our economy are amid a major transformation, and Renown Health is very well positioned for the future,” Dr. Erling said. “Our ongoing success will hinge on our ability to establish positive and productive relationships, maintain high-quality patient clinical outcomes and experiences, reduce healthcare costs, encourage innovation and improve access and affordability for patients and members.” Q: Let’s start at the beginning. When did your interest in healthcare first begin? A: Believe it or not, I started my healthcare career during high school in Minnesota when I worked as a nursing assistant. I then worked as a monitor tech while pursuing my undergraduate degree in biology from Drake University in Des Moines, Iowa. Q: Where did you go to medical school, and what was your first job after training? A: After graduating from The John Hopkins University School of Medicine and spending three years at the University of Virginia for my residency, I spent more than a decade in the emergency department at a level 1 trauma center. Q: Does your experience as a physician impact your approach to healthcare leadership? A: Yes, absolutely. I have worked my fair share of nights, weekends and holidays, and I know the sacrifices healthcare workers – and their families – make to care for our communities. I will never take it for granted. I also understand how complex healthcare organizations are, and I have experienced these complexities from both the clinical and non-clinical sides. I have provided clinical leadership for a large, regional health system and understand that quality, safety and innovation come from the people doing the work, not from a corporate office. But you also need strong managers and leaders to facilitate and prioritize the work while providing support and coaching. Q: What is the key to a successful healthcare system? A: Teamwork. In fact, being part of a high-performing, mission-driven team is my number one motivation. It’s what gets me up in the morning and why I work in healthcare. I view our greatest resource to be our people, meaning Renown’s more than 7,000 employees. Modern technologies – such as fancy robots and imaging equipment – are essential and pretty cool, but they are not why our patients choose us. They come for trusted care in their hometown. Q: Renown Health is going through a lot of exciting changes right now. What is one thing that excites you about joining this healthcare system in a rapidly expanding area of the country? A: I am very excited about the new partnership with Renown and the University of Nevada, Reno School of Medicine. While still in its infancy, it provides the platform for us to be the center for training, research and tertiary care for the region and beyond. Q: What is something you have learned from working with CEOs at other healthcare systems? A: Healthcare leaders often have a short half-life, but that is not me. I believe it is difficult to create and move an organization toward a unified vision when your leader changes every few years. As my track record will support, this is not my style. I have been in Colorado for over twenty years and now look forward to making Reno and Renown my home for years to come. Q: As you know, Hometown Health is Renown’s health insurance arm. How does equitable access to insurance fit into a person’s and a community’s overall well-being? A: Most health systems would love to have their own health plan. The reality is that you cannot meaningfully improve the health of the population without managing value and risk. We are fortunate to have Hometown Health as part of Renown Health, and in our community, and I am excited to work with Bethany and the team to fulfill the mission of the organization. Q: What does working at a not-for-profit healthcare system mean to you? How does it differ from the for-profit sector? A: I have worked in for-profit and not-for-profit healthcare. Renown is unique as the only not-for-profit health system in the market. What that means is that we invest every penny earned back into caring for our community. We don’t send money to shareholders in California or Pennsylvania, we invest it right here in Nevada. Not only is a not-for-profit healthcare organization where I want to work for, but it is where my family and I want to go for care. Q: What do you like to do for fun? A: I love spending time with my wife and three adult children. I met my wife, Jessica, while attending medical school in Baltimore. She was working as a nurse in the surgical ICU, and I was smitten. I offered to help her with a 3 a.m. bed linen change and bath for our trauma patient, and the rest was history. I also love exploring the outdoors, especially snowboarding!

Read More About A Q&A with Dr. Brian Erling, CEO & President of Renown Health

Breast milk. It's often referred to as liquid gold. And fortunately, it can be safely refrigerated or frozen for later use, which can allow you to be a bit more flexible in your new routine with baby. Whether you're getting ready to return to work, planning for the chance date night out or just exclusively pumping, it's crucial to understand the guidelines for proper breast milk storage. Storing Breast Milk Use clean bottles with screw caps, hard plastic cups that have tight caps or nursing bags (pre-sterilized bags meant for breast milk). Be sure to label each container with the date the milk was pumped and your baby's name if the milk is going to childcare providers. You can add fresh, cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have two ounces of frozen milk, then you can add up to two more ounces of cooled milk. For healthy full-term infants, milk can be stored as follows: Room temperature - six to eight hours (no warmer than 77°F, or 25°C). Refrigerator - up to five days at 32°-39°F (0°-3.9°C). Freezer– Varies depending on freezer type. Up to two weeks in a freezer compartment located within the refrigerator. Three to six months in a freezer that is self-contained (standard kitchen fridge/freezer combination) and kept at 0°F (-18°C). Breast milk should be stored in the back of the freezer and not in the door. Six to 12 months in a deep freezer that is kept at -4°F (-20°C). Be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes. Thawing Breast Milk Place frozen breast milk in the refrigerator to thaw (about 24 hours) then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, remove it from the freezer and run warm water over it until it's at room temperature. Never microwave breast milk and do not refreeze it. Once your baby has started to drink from the bottle, you should use it within one hour. You may find that different resources provide different recommendations about the amount of time you can store breast milk at room temperature, in the refrigerator and in the freezer. Talk to your doctor or lactation consultant if you have any concerns or questions.

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Becoming a parent for the first time means lots of new unknowns – from learning to breastfeed and swaddle to buckling your newborn into the car seat for the first time. But when it comes to putting them to bed safely, it’s important to remember it really can mean life or death. It’s something we’re taught before our little one is even here: the correct way to put your baby to bed safely. Sadly though, the number of infant deaths continues to climb. The main culprit of sleep-related infant death continues to be all the items parents leave in the crib with their babies. According to the Center for Disease Control and Prevention, there are about 3,500 sleep-related deaths among babies each year. “The best advice is ‘bare is best.’ Keep your infant’s sleep space clutter free – no blankets, bumpers, toys or pillows,” said Karen Wagner, Pediatric Nurse Practitioner. Follow the ABCs for Safe Sleep Remembering the ABCs is an easy way to remember how to put your little one to bed safely. A: Alone No blankets, toys or pillows. “We do recommend using a sleep sack as a blanket alternative,” said Karen. “It prevents the risk of suffocation and keeps your baby warm.” Keep in mind, the greatest risk for suffocation happens when babies are under 1 year of age, so it’s best to save the toys, blankets and pillows for their “big kid bed,” or around 18 months old. B: Back The slogan “back is best” is another good reminder. Keeping your baby on their back until they’re old enough to rollover helps reduce the risk of Sudden Infant Death Syndrome (SIDS). C: Crib It is best to have your baby sleep alone in their crib. While co-sleeping may be enticing, especially after a late-night feed, it increases the risks of possible suffocation. However, “having your child in your room, in their own crib or bassinet, is protective for SIDS,” Karen said. “In fact, we think co-rooming reduces SIDS risk by almost 50 percent.” Co-rooming allows parents to keep new babies in close reach and helps parents oversee their baby’s sleep, just in case something happens.

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Choosing Renown Women's Health is the first step to a healthy pregnancy. Our exceptional family-centered care with complete prenatal services is designed for the health and well-being of you and your baby. Board-certified primary obstetricians (OBs) coordinate pregnancy care and develop personal relationships with every mom-to-be, understanding birth choices and preferences. Labor & Delivery: 775-982-5759 Our specialties include: Managing high-risk pregnancies including twins, multiples, multiple miscarriages, history of previous premature births and diabetes Age 40+ pregnancies Pre-pregnancy medical conditions Infertility evaluation and treatments such as: Hormone treatments, fertility drugs and surgery

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