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Northern Nevada's stunning lakes, including Lake Tahoe, with its average summer water temperature of 50 degrees, present a potential risk of hypothermia. Unlike mild 50-degree air, water at the same temperature poses severe, life-threatening risks, including rapid-onset hypothermia and drowning. Awareness of the symptoms and taking proper precautions are crucial to prevent cold-water drowning. The 4 Phases of Cold-Water Drowning 1. Cold Shock Response: This response affects breathing and happens within the first minute. An automatic gasp reflex occurs in response to rapid skin cooling. If the head goes below water, water may be breathed into the lungs, resulting in drowning. A life jacket will help keep your head above water during this critical phase. Additionally, hyperventilation, like the gasp reflex, is a response to the cold and will subside. Panic will make this worse, so the key is to control breathing. 2. Cold Incapacitation: This response occurs within the first five to 15 minutes in cold water. In order to preserve core heat, vasoconstriction takes place decreasing blood flow to the extremities to protect the vital organs. The result is a loss of movement to hands, feet, arms and legs. Unless a life jacket is being worn, the ability to stay afloat is next to impossible. 3. Hypothermia: Important to note, it can take 30 minutes or more for most adults to become hypothermic. So there’s time to take action and survive. Keeping panic at bay is critical, as you have more survival time than you think. Symptoms include: Shivering Slow and shallow breathing Confusion Drowsiness or exhaustion Slurred speech Loss of coordination Weak pulse 4. Circum-rescue Collapse: This experience can happen just before rescue and is not well understood. Symptoms range anywhere from fainting to death. Some experts believe an abrupt drop in blood pressure may cause this final stage of cold water drowning, post-rescue. Additional Safety Tips and Helpful Resources Always wear a personal flotation device as well as a wetsuit or drysuit. Your personal flotation device is the most important piece of water safety gear. Try not to panic as the first phases will subside. Controlled breathing is to staying calm. Research suggests the body can withstand the cold longer than we think. The Heat Escape Lessening Posture (HELP) is a position which helps conserve energy if you’re wearing a personal flotation device. By hugging your knees to your chest, this posture helps maintain body heat for some time.

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Whether you're a parent, grandparent, caregiver, or sibling, it's vital to recognize that drowning is the second leading cause of death among children," states Dr. Leland Sullivan, of Northern Nevada Emergency Physicians. "While we diligently work to protect children from water-related accidents, there's a lesser-known threat that often goes unnoticed—dry drowning, also known as delayed drowning. Surprisingly, many people remain unaware of its existence and potential dangers. Dry drowning defined Dry drowning is a side-effect of a near-drowning experience and includes spasms of the vocal cords and larynx — known as a laryngospasm. This occurs when the body attempts to shut down the passage of any liquid into the lungs. Unfortunately, it can also shut down the passage of air into the lungs and force fluid into the stomach and lungs. Often the condition is not discovered until it's too late — severe cases can cause death within one to 24 hours after a water incident occurs. Who is susceptible? Novice or first-time swimmers are at increased risk, as are children with asthma and known breathing issues. In addition, children who have had pneumonia or experienced acute respiratory distress syndrome are also at greater risk. To reduce these factors, caregivers should be exceptionally watchful of inexperienced swimmers. According to Dr. Sullivan, children under the age of 5 are most susceptible to drowning and often drown in residential swimming pools. Infants less than 1-year-old most often drown in bathtubs. What are the signs of a dry drowning episode? If your child has a near-drowning incident, a few moments of coughing until they calm down is normal. However, you should know the more severe signs and symptoms to watch for during the 24 hours following the incident, including: Persistent coughing Difficulty breathing and/or shortness of breath Chest pains Extreme fatigue and/or lethargy Change in typical behavior Face becomes pale   What is the treatment and prognosis for dry drowning? Dr. Sullivan recommends that all victims of near-drowning incidents seek medical attention, even if they have no symptoms. If caught early, dry drowning can be treated. If you think your child is experiencing a dry drowning episode, go to the nearest emergency room as quickly as possible — do not attempt treatment at home. Healthcare professionals will work to supply oxygen to your child's lungs to restore and regulate breathing.

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Renown Health is home to three 24/7 Emergency Rooms (ERs) providing comprehensive emergency and trauma care, access to specialists and inpatient services backed by the area's most extensive health system. In 2023, Renown Health cared for 132,340 patients across three ER locations. Renown is also home to the region’s only level II trauma centers for both adult and pediatric patients.   We spoke to three patients who sought immediate medical attention for various ailments and conditions to learn more about their emergency care experience and why they chose Renown ERs.   Kamrin’s Story: From Worrisome to Critical  In the spring of 2021, Danielle and her 13-year-old son Kamrin visited his primary care doctor for unexplained vomiting and were promptly referred to Renown Children's ER via ambulance for further evaluation and seen by board-certified emergency physician, Dr. Lisa Nelson. What initially began as an unassuming doctor's visit quickly turned into something much more severe after several tests confirmed a devastating abdominal tumor and a stage-four cancer diagnosis, unbeknownst to the family.  Kamrin was immediately admitted to the Pediatric Intensive Care Unit (PICU) and referred to a Pediatric Oncologist at Renown Children’s Hospital to begin his plan of care with expert pediatric hematology and oncology specialists.  Regarding the board-certified physician, who delivered the results to the family, Danielle said, “She was so calming to us, even as the diagnosis haunted us. She led us by guiding our family through the unknowns. She felt like a family member to us in that moment, letting all the unknowns be well known.”  “The love, empathy, support and guidance these employees gave us carried us. The care team quickly and easily became a source of relief, knowing we were their priority and in the best hands. We are forever grateful for the team at Renown Children's Hospital and Renown Children’s ER; they truly saved our son's life and continue to be our guiding light whenever it's needed in our son’s health journey,” Danielle said.   Today, Kamrin is in remission and navigating the aftereffects of chemotherapy, including an immune system deficiency. However, his family chooses to navigate each day by embracing the positive side of things, such as the life-saving impact of his treatment.  Did you know? Renown Children's Pediatric Hematology and Oncology is located within Renown Regional Medical Center and offers expert pediatric specialists dedicated to providing comprehensive treatment for pediatric hematology and oncology, including chemotherapy, radiation therapy and infusion services.  Taylor’s Story: From Crisis to Recovery  Promptly after cosmetic surgery performed by a medical professional not associated with Renown, Taylor Salas (Chacon) began to lose consciousness and notice her post-surgery drainage systems, also known as Jackson-Pratt drains, fill with blood. She was transported to Renown Regional ER via ambulance and immediately seen by ER staff and board-certified emergency physician Thea Berning, MD, for medical assessment.   Taylor drifted in and out of consciousness as the ER team began blood transfusions and a CT scan to determine her plan of care. Dr. Berning began facilitating communication with a community plastic surgeon with privileges at Renown Health and emergency surgery was performed to stop Taylor’s internal bleeding. Taylor was placed on a ventilator due to respiratory distress and trauma from the event, then transferred to Renown’s Intensive Care Unit (ICU) to continue her care.  Thankfully, Taylor listened to her gut when something didn’t feel right after her surgery and sought immediate medical attention. The ER team's quick response, communication and collaboration with a plastic surgeon saved Taylor from severe internal bleeding. “I was informed every step of the way about what was happening and why. I felt comfort in this,” she said.   Did you know? Because of Renown Regional Medical Center’s Level II Trauma Center distinction, you have immediate access to an extensive list of specialists and physicians trained in a wide array of specialties, in the event of a traumatic injury or accident. This is one of the many benefits of Renown Regional’s Level II Trauma status.  Ted’s Story: The Unsuspected Threat   Bothered by symptoms of heartburn, fatigue, neck pressure and arm discomfort, Ted was in the middle of a busy workweek in June 2023 when he began to suspect something was wrong. Knowing the importance of addressing early heart attack symptoms immediately, Ted and his wife headed to Renown Regional ER because of proximity and some familiarity with Renown’s leading cardiology care and technological expertise. After prompt assessment by the Renown ER team, including blood work, imaging tests and the administration of medication, Ted was admitted to the hospital to treat the blockage and narrowing of his coronary artery. On June 8, Ted was admitted for treatment, where he successfully underwent a single bypass surgery and recovered in the Cardiac Intensive Care Unit (CICU), before being discharged and following up with the Intensive Cardiac Rehab (ICR) program at Renown. The ICR program at Renown played a pivotal role in Ted's 55-pound weight loss and overall health improvement, empowering him to embrace a healthier lifestyle and find ways to use his newfound energy and strength today. “Overall, I believe I had the best care possible because of the collective group of people at Renown caring for this community, who we could see in the grocery store, at the ball game and in the shopping malls. This community feeling is something you might not get in a big city hospital,” Ted said. Did you know? Intensive Cardiac Rehab at Renown Health is a medically supervised program designed to improve cardiovascular health after a significant heart condition or procedure. Since its inception in 2016, this program has been a pioneer in the region for cardiac rehabilitation focusing on three key pillars including exercise, nutrition and stress management.

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When an appliance or fixture stops working at home, who do you contact? If your lights stop working, you call an electrician. Is your air conditioning unit out of order? Reach out to an HVAC (heating, ventilation and air conditioning) technician. What about if your sewer drains start backing up? Time to contact a plumber. And if your fire safety equipment needs servicing? Better call a fire safety technician.  Regular maintenance and repairs on the inner workings of your household are always important, and when something goes wrong, it can be distressing and inconvenient to you and everyone living with you. You feel the need to get the issue resolved as quickly as possible, right?  Now imagine that those needs are magnified – to the tune of hundreds of thousands of people every year. Who could potentially take on such a monumental task? Enter: Facilities Engineering at Renown Health. Crucial to ensuring our health system performs at its peak, these team members step in to make sure every patient, team member and visitor who walks through any of our doors are able to access the facilities they need and make their time with us as comfortable – and as successful – as possible.   The Silent Heroes  As our care teams move heroic mountains to save lives, another set of heroes emerge behind-the-scenes. As a strong backbone of our health system, the Facilities Engineering department plays a key role in maintaining the infrastructure that supports patient care, from ensuring the HVAC systems are functioning optimally to maintaining the plumbing and electrical systems that keep the lights on and the equipment running smoothly.  Renown is fortunate to have some of the most dedicated journeymen in the business. This team boasts many experts, including:  Plumbers Fire Safety Technicians Craftsmen HVAC Journeymen Electricians Boiler Operators Facilities Technicians As one can imagine, every day brings on a new challenge for our Facilities team members.  “Each workday is always different; it could be water, power or HVAC issues or anything in between,” said Nhil Dado, Supervisor of Facilities Services. “We are proud of the services we provide for the needs of patients and employees.”  “Every day, we have a variety of equipment to work on,” added Alfred Santos, HVAC Journeyman.  “Whether it’s facility upkeep, plumbing, HVAC or electrical, we want to help,” added Brian McCarty, Facilities Technician.  This department works around the clock to ensure that every aspect of our hospitals and outpatient care locations meets the highest standards of safety and efficiency, from routine maintenance and equipment improvements to emergency repairs. These are huge responsibilities – all of which they perform with pride.  “As an HVAC journeyman, we are responsible for making sure the air circulating in the hospital is clean,” said Christopher Bobis, HVAC Journeyman. “It is also our job to make sure the air is positive and negative in isolation rooms and ensure patients are satisfied with the temperature in their rooms.”  “In addition to performing regular maintenance tasks like changing air and water filters, we complete any random work order that may come up,” added Brett Courtney, Facilities Technician. “We also recently switched out our lighting at Renown South Meadows to LED lights, which helps with energy savings.”  “I overlook the boiler house equipment and coordinate the fixing of maintenance issues reported by hospital staff,” added Arnt Utnes, Boiler Operator. “We also respond to every single alarm."  It’s difficult for us to imagine what our health system would be like without the Facilities team providing us with the comfortable and safe environment our patients need and deserve. Luckily, we’re never alone in our efforts to keep us running, and this department expertly leads that charge.  “Along with writing down the PSI readings in the gas rooms and answering calls from dispatch and the boiler rooms, I go through all the daily work orders and complete them,” said Ken Carrillo, Facilities Technician. “It always feels good to see when we complete all the work orders for the day, especially as the next shift arrives.”  “We fix, replace and dispose of pieces that are no longer in service – bottom line, we help keep the building up and running,” added Alejandro Cardenas, Craftsman.  But it doesn’t stop there – Facilities Engineering is currently in the midst of creating a whole new fleet vehicle program to improve the operations of our many on-site vehicles, including trucks, forklifts and more.  “I am the point of contact for all things fleet,” said Michelle Bay, Administrative Assistant. “We are building a new fleet program and working closely with leadership to move the program forward. I am involved with setting up new fleet fuel cards and can set up the program in the best interest of our internal customers while looking to the future for growth.”  It’s clear that the Facilities team is indispensable to Renown. Through their expertise, professionalism and commitment to quality, they stop at nothing to keep our health system functioning at its highest level.

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Want to protect yourself from skin damage from the sun’s harmful rays? Dr. Angela Walker, dermatologist with Renown Medical Group, shares what you can do to prevent skin cancer. What can people do to prevent skin cancer while enjoying the outdoors? There are several steps you can take to protect your skin from the sun. “I caution all of my patients to avoid the sun during the hours of 10 a.m. until 2 p.m. when UV rays are strongest. I also encourage people to wear sleeves on cooler days. And don’t forget that we still need to wear sunscreen on cloudy days! UV rays can still cause sun damage on cloudy days. Preventing skin cancer also entails wearing sunscreen of at least SPF 30 everyday.  Are hats also a good idea for skin protection? Yes, of course! Choose a wide-brim hat that shades the face as well as the back of the neck for extra protection against UV rays. When it comes to identifying skin cancer, what should people watch for? We use easy-to-remember letters when checking for spots on the skin; it’s called the ABCDEs: A - Asymmetry: One half of the mole or lesion doesn't match the other half. B - Border irregularity: The edges of the mole are irregular, blurred, or notched. C - Color variation: The mole has different shades of color or uneven color distribution. D - Diameter: The diameter of the mole is larger than the size of a pencil eraser (about 6 millimeters) or is increasing in size. E - Evolution: Any changes in the mole over time, such as size, shape, color, itching, bleeding, or crusting. These guidelines can help in identifying potentially suspicious skin lesions, but it's important to consult a dermatologist for proper evaluation and diagnosis. Early detection is crucial for successful treatment of skin cancer.

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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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Raquel was 33 when she was diagnosed with breast cancer. It was April 2023, when she found a lump in her breast and was referred to the William N. Pennington Cancer Institute. After comprehensive imaging, she was diagnosed with invasive lobular carcinoma, which is a type of breast cancer that begins in the milk-producing glands of the breast. Between June 2023 and January 2024, she received a total mastectomy, chemotherapy and radiation at Renown Health. “Breast cancer is uncommon in women under 40, but any woman with a mass or lump in her breast should have an exam by a physician and imaging at any age,” said Dr. Lee Schwartzberg. In fact, according to the Centers for Disease Control and Prevention (CDC), only 9% of all new cases of breast cancer in the U.S. are found in women younger than 45. “It was a pretty scary diagnosis, but I’ve been led by great people through the process,” she said. “They were so helpful and there for me throughout the chemo and radiation.” Raquel's journey through breast cancer treatment at the William N. Pennington Cancer Institute was marked by the exceptional care provided by the Renown Health team, including nurses, nurse navigators, therapists, support teams and providers. Among the dedicated professionals, Dr. Michelle Chu and Dr. Lee Schwartzberg played pivotal roles in Raquel's diagnosis and subsequent treatment plan. Their expertise, compassion and commitment to patient care left an indelible impact on Raquel's experience. Their thorough examination and comprehensive approach ensured that Racquel received the best possible care for her invasive lobular carcinoma. In addition to the care provided at Renown, Raquel greatly benefitted from being connected with a mentor by Dr. Chu. This mentor, Kayla, had undergone a similar diagnosis and treatment plan, and at the same age Raquel. They texted and called each other throughout Raquel’s treatment, providing additional support through a challenging time. As of January 2024, Raquel is done with her treatment and continues to see her care team for follow-up appointments. “I’m through the worst and ready to rebuild my life,” Raquel said. To help celebrate this milestone, Nevada Athletics invited Raquel to receive the game ball at a Nevada Men’s Basketball game. She was joined on the basketball court for this special recognition by her husband, Raul; mother, Arlene; and two daughters, Ryleigh and Rhiannon. Racquel's journey is not only a testament to her resilience but also a tribute to the invaluable contributions of Dr. Chu and Dr. Schwartzberg in guiding her towards triumph over breast cancer.

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Embarking on the path to bariatric surgery is a unique and deeply personal journey. Individuals like Mary Escobar choose this life-changing route for reasons ranging from improved cardiovascular health to managing diabetes or finding relief from various health complications. In Mary's case, her two-decade-long healthcare journey not only underscores the challenges she faced but also highlights the support and expertise that ultimately led to her successful transformation through bariatric surgery. Mary's Resilience: December 2002 through February 2003 More than two decades ago, Mary experienced unforeseen health complications just days after giving birth via c-section. Septic shock, hemolytic uremic syndrome, thrombocytopenia, renal failure and a blood clot in her lung plunged her into a critical state. Intensive care, plasma exchange and a long recovery followed. After being discharged with compromised kidney function, Mary faced complete renal failure two years later, leading to dialysis and a spot on the donor list. Mary's brother, a perfect match, selflessly donated his kidney on Dec. 14, 2007, marking a turning point in Mary's health. However, the post-transplant period brought new challenges, including diabetes, high blood pressure and a significant weight gain, reaching 230 pounds. Determined to regain control, Mary explored various diets without success until she consulted with a bariatric doctor. Journey to Bariatric Surgery: November 2009 - April 2021 In November 2009, Mary opted for a gastric band, shedding 40 pounds within a year. Despite initial success, issues with the gastric band arose, prompting a consultation with Dr. John Ganser at Renown Health in April 2021. Together, they decided to transition to a gastric sleeve, with comprehensive education provided to ensure long-term success.

Read More About A Transformative Journey: Mary's Bariatric Surgery Story at Renown Health

For the average person, wounds aren’t an everyday worry. However, for at least eight million Americans, chronic wounds can pose a serious threat to health and well-being. From a person with diabetes experiencing painful neuropathy to a patient healing from a significant burn, caring for advanced wounds is a major part of their healthcare journey. Who do they go to get the care and guidance they need? The answer: Renown Wound Care. Serving patients in both the inpatient and outpatient settings, this department provides comprehensive, best-in-class treatments for severe and chronic wound healing and ostomy care. Our Wound Care team members have mastered the art of harnessing cutting-edge technologies and a patient-centric approach to redefine the standards of healing.  Advanced Care for the Best Repair  At Renown Health, we are fortunate to have a team full of nurses, physicians and more caring for patients with wounds caused by a wide variety of conditions. Those include:  Burns Trauma Vascular diseases Radiation therapy Pressure ulcers Diabetes and diabetic neuropathy Adding to the expert-level continuum of care, Renown is the only health system offering complete ostomy services in the entire region. The Wound Care team helps ostomy patients with the fitting of their medical bags, treatment of any skin conditions that may arise after ostomy bag placement, care coordination and much more.  With a multidisciplinary network of experts tailoring personalized treatment plans, there is never a dull moment on the floor. On the outpatient side, the team expects 50-60 patients in one day alone.  “As a clinician, wound care is a lot of ‘arts and crafts,’ so we get to use our creative and critical thinking skills to provide the best possible care,” said Samantha Moore, Advanced Wound Care Specialist RN for Outpatient Wound Care. “Each patient has an individualized plan of care – we greet them as they come into the clinic, escort them back to their treatment rooms and get their latest health updates and life situations before providing wound or ostomy care. We prepare each morning doing chart reviews to determine patient needs, wound progression and referral needs.”  “We are a highly specialized, dedicated group of professionals with a passion to treat and heal our patients’ wounds,” added Lori Conner, Advanced Wound Care Specialist RN for Outpatient Wound Care. “When a patient comes to our clinic for evaluation, they are given a dedicated appointment to thoroughly go over their medical and surgical history, medications and nature of the wound.”  Switching over to the inpatient care team, they operate like a well-oiled assembly line, navigating different daily assignments with precision and flexibility.  “On the inpatient side, our day starts in our office with triaging our consult list; after the triage process is completed, we get our assignments, which can consist of wound vacuum-assisted closure (VAC) patients, follow-up patients, ostomy education patients and new wound consults,” said Megan Uy, Advanced Wound Care Specialist RN for Inpatient Wound Care. “In the case of patients requiring wound VAC changes, we consider what kind of pre-medication for pain that they need. Although some patients may be seen on a time schedule, the day ends up flexible as patients are being seen by other specialties. This flexibility also benefits the patients, making them feel more empowered with their care.”  “Each day in the inpatient setting, we get to our office and sort through all the new consults that came in overnight, and the charge nurse makes the assignment for the day,” added Madison Arlin, Advanced Wound Care Specialist RN for Inpatient Wound Care. “After the assignment is completed, each nurse is responsible for researching their patients and organizing their day, typically by priority – wound VACs and ostomies usually take top priority.”  Now, how do these treatments actually work? This specialized field handles advanced methods of treating each condition, including:  Biological skin substitutes Surgical debridement Advanced wound dressings Negative pressure therapy Pre-ostomy markings and education Offloading techniques, such as padding or dressing “Before starting treatments, we communicate with our nurses and providers to make sure that the patient is comfortable prior to wound care,” said Dianna Seo, Advanced Wound Care Specialist RN for Inpatient Wound Care. “After we see the patient, if there is a need for escalated care, we contact the provider for additional testing or consults. We continue to follow-up on patients that have severe wounds, wound VACs and ostomies.”  In the hands of the Wound Care team, patients exit our hospital walls not only restored but also empowered, set on a trajectory for long-term healing. Your Expert Care Guides  No matter the case or the severity of the wound or condition, patient care, comfort and communication always come first – before, during and after treatment.   “Many of our patients have chronic needs, so we end up seeing them for several months, if not years in some cases; we stay up to date with their specific psychosocial needs and help remove barriers that would prevent their wounds from healing,” said Samantha Moore.  “I enjoy knowing that my positive attitude can improve our patients’ days,” added Maddie Pauley, Patient Access Representative for Outpatient Wound Care. “When they’re routinely coming to appointments they might not enjoy, hearing them praise our team and give their thanks is one of the most rewarding feelings.”  As a wound care patient, there can be a lot of unknowns when beginning their care journey. However, these team members carefully walk each patient through every step from beginning to end.  “When we go to see a wound care patient, our team is very consistent about explaining to the patients what our role is and what we plan to do with their wound, and then we continue to actively communicate throughout wound care each step that we are doing as we are doing it,” said Madison Arlin. “We also encourage some of our patients to listen to music that they enjoy during the wound care, or we will cover their eyes with a cloth if they request so that they don't have to see their wound. Sometimes, we will ask the family to stay at the bedside to hold their family member's hand.”  Education is crucial to ensuring each patient knows what to expect in order to care for their wound and understanding the stages of healing. Fortunately, this team is well-versed in the world of wound wisdom.  “A lot of education is provided on the type of dressing we are applying, and if the patient is going to be performing their own dressing changes, we will go over the entire change with them and provide supplies for discharge,” said Megan Uy. “Additionally, there will be written instructions in their discharge paperwork. In the cases of wound VAC dressing changes, each step is explained to the patient before doing it, and we also go over discharge options and expectations.”  “As a clinician who sees a lot of patients prior to having their ostomy placed (pre-surgical marking), one of the most important things we do is first sit with the patient and/or caregivers and talk about their fears, concerns, questions and goals,” said Samantha Moore. “We provide a lot of emotional support and education, helping identify community resources. For our wound patients, we spend a lot of time educating our patients/caregivers about how and why their wounds occurred. We try to connect with them on a personal level and help them identify ways to help their wounds heal.”  To see a patient’s care journey from the second they enter through our doors to the moment they return home is one of the most rewarding feelings for the Wound Care teams. In fact, they’ve had the pleasure of treating patients for years and seeing their wounds almost completely heal. The team collectively values the successful healing journeys of their patients as their proudest achievement.  “One of our team's greatest accomplishments was being able to see one of our long-term patients discharged with nearly resolved wounds,” said Megan Uy. “This patient had been in our care on-and-off for the past year with many hospitalizations and had complicated high-output enterocutaneous fistulas within his wound bed. These were incredibly hard to keep a dressing on successfully, and he often had issues with the dressing leaking. Eventually, we got a dressing that could remain intact until his next scheduled dressing change, and he was able to get surgery that fixed his fistulas. Being able to see him recover and heal his wounds was a very large accomplishment for us.”  The admiration and compassion this team has for their patients also extends to each other. The cohesive way they work together only further benefits their patients, offering the best-possible collaborative care.  “We have extremely skilled clinicians in our group that are not only incredible in the work that they do and the patient care that they provide but are also enjoyable to work with as well,” said Geane Weaver, Advanced Wound Care Specialist RN for Inpatient Wound Care. “There is something to be admired in each and every one of my coworkers.”  “Our team is very close and supportive of each other at all times,” added Madison Arlin. “I feel very lucky to work with such an amazing group of people. Our team is very proud of the work we do.” Fervently Fighting the Good Fight So, with the highly specialized nature of advanced wound care, how did these team members get inspired to join the Wound Care team in the first place?  Well, for many of these devoted employees, their first exposure to caring for wounds took place on different units – sparking their interest in making wound care their full-time career.  “Renown was the most welcoming towards me as a student nurse, and I liked that it was a teaching hospital,” said Madison Arlin. “I started in the General Surgical Unit (GSU) immediately after graduating nursing school and worked there for two years before transferring to wound care. I decided to apply to the wound team after watching the wound nurses do wound VACs and ostomy changes on the floor. I would ask them if I could watch, and I was always very fascinated by the wound healing process.”  “Prior to joining the inpatient wound team, like Madison, I was also a bedside nurse in GSU,” added Geane Weaver. “Working on that floor, I was already exposed to a lot of patients that were requiring some kind of advanced wound care in one way or another. Working in the GSU, I also cared for a lot of patients that had wound VACs and ostomies. These patients make up a huge group of the individuals that our team sees on a regular basis, and they've always been intriguing for me, so naturally, wound care has always been on my radar.”  For other team members, wound care has always been a point of curiosity throughout their education and career. From their very first exposure to this care area, they were hooked.  “I was always curious about wound care even through my nursing school experience,” said Dianna Seo. “When I was working on the floor, I would trade to do wound care for patients. When I had time, I would follow wound care and help when I could. I joined the skin team which drove me to be increasingly involved with wound care. As soon as there was a job opening, I applied for the position. I worked in outpatient wound care for approximately four years and now inpatient for another four years. I have enjoyed all aspects of wound care and patient care.”    “I had great clinical experience at Renown when I was in nursing school; I also was very interested in caring for trauma patients, and Renown being a Level II trauma center aligned with my interests,” added Megan Uy. “I began my nursing career in the GSU, but my dream job was always Wound Care. During my nursing school clinicals, I had the opportunity to watch some members of the wound team do wound VAC changes and thought it was incredibly intriguing and a great combination of utilizing the knowledge of anatomy and physiology while being creative with handicraft. A position opened on the team around the time I met the prerequisites to be eligible for the position, and luckily, I got it.”  Our Wound Care team has achieved significant employee and departmental milestones over the past year, reflecting their dedication to enhancing patient care and overall process improvement.  “We have had many accomplishments within the last year and are currently working on more to improve the hospital,” said Dianna Seo. “Madison Arlin won the DAISY Award for her great work with our patients. Megan Uy won Top Talent of the Quarter for helping a stranger. Ande Ferriera has worked tirelessly to improve our process improvement. Allie Saunders, as our leader, has worked to improve patient skin by getting new beds for Renown Regional. All our patients that have healed or are on their way to healing under our care is our greatest achievement that we as wound team is most proud of.”  “We are constantly updating protocols, notes and orders for bedside nursing so that it is a more straightforward and seamless charting process,” added Madison Arlin. “We have representatives of different supply companies come and present new products that we think may benefit our patients better. Our wonderful tech has even updated our department site on Inside Renown so that the nurses always have references available.”  Renown’s strong influence in the region – and the opportunity to give back to their community – was, and continues to be, a major draw for this team.  “Since I can remember, Renown has always been the most prevalent healthcare name for my family and has always taken the most amazing, thorough care of my loved ones,” said Maddie Pauley. “I have always wanted to work somewhere I could help people, and starting at Renown has really opened my eyes into how much of a difference each one of us can make.”  Our Wound Care department’s success stories and proactive approach not only reflect their passion for healing but also inspire a ripple effect of positive change throughout our health system. They proudly exemplify a shared commitment to enhancing the well-being of all patients under their care.  “Being part of Renown and part of this team has been my blessing; I get to do a job I love with people that love it too,” closed Dianna Seo.

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While menstrual cycles can be an annoying inconvenience for many women, heavy bleeding (menorrhagia) is not normal and can disrupt your life. A few days of heavy flow at the start of your period is usually nothing to worry about. However, if you’re frequently experiencing very heavy periods, you should discuss it with your gynecologist or primary care provider.  Dr. Megan Fish, an OB-GYN with Renown Women’s Health, discusses various reasons, evaluation and treatment methods when it comes to heavy menstrual cycles.  What is classified as heavy menstrual bleeding?  The American College of Obstetricians and Gynecologists considers heavy bleeding to be any of the following signs: Bleeding that lasts more than 7 days. Bleeding that soaks through one or more tampons or pads every hour for several hours in a row. Needing to wear more than one pad at a time to control menstrual flow. Needing to change pads or tampons during the night. Menstrual flow with blood clots that are as big as a quarter or larger. What are the most common reasons for heavier periods?  A variety of reasons why someone might have heavy periods. Fortunately, most of these problems are treatable. Because each woman's period is unique, only a doctor can definitively determine the cause of your heavy periods. Some of the most common issues that cause heavy periods include: Hormone imbalances such as anovulation, thyroid disease and Polycystic Ovary Syndrome (PCOS). Structural abnormalities in your uterus such as polyps or fibroids.  Precancer and cancer such as uterine, cervical, vaginal, ovarian or endometrial hyperplasia.  Infections such as chlamydia, gonorrhea, endometritis or vaginitis. Other medical conditions such as liver disease, kidney disease or Pelvic Inflammatory Disease. Medications such as blood thinners and aspirin, hormone replacement therapy, Intrauterine devices (IUDs), birth control pills and injectables. Pregnancy-related problems such as a miscarriage or ectopic pregnancy.

Read More About Understanding the Reasons Behind Heavy Menstrual Cycles

Ring in the New Year and the rest of the holiday season by celebrating Renown’s Float Pool team!  After coming out of the COVID-19 pandemic, it's no mystery that healthcare across the country has shifted and adapted to the growing needs and new demands of our patient populations. Renown Health is no different. As the largest not-for-profit health system in the region, we are no stranger to change, even when change presents challenges. Who do we call on when a unit needs more team members in the eleventh hour? Who can help when our patient volume spikes up with seconds to spare?  This is where the Float Pool at Renown comes to the rescue. Skilled in a wide variety of healthcare specialties, from acute care nursing and critical care to care aiding and patient safety, this is the team that can seamlessly step in to provide crucial patient care to the units that need it most, whether a team is understaffed for the day or needs extra all-hands-on-deck for a specific patient or procedure. Float Pool team members are equipped to work in virtually any clinical area at Renown, making a genuine difference with every patient they encounter.  A Pool of Relief Teams across Renown can breathe a sigh of relief knowing that Float Pool has their back in times of need. As the backbone of our health system, these dedicated team members possess a wealth of clinical knowledge and the ability to navigate diverse medical environments. Their flexibility allows them to fill staffing gaps and provide essential support to many different units.  “We fill in the gaps of staffing to make everyone's day better,” said Patti Crepps, Critical Care Float Pool RN. “A float nurse has to be flexible and able to adapt to different situations and places – basically, ‘go with the flow.’ Patient care is basically the same all over; we make patient care possible by being familiar with all the various specialties and providing the specific care needed depending on the population we are taking care of on that shift.”  “Float Pool staff members are like healthcare chameleons, transitioning between different departments,” added Shelby Riach, Acute Float Pool RN. “We incorporate flexibility, teamwork and a commitment to ensuring patients receive the best care, regardless of the setting or circumstances.”  This team thrives in uncertainty; in fact, no workday is the same in Float Pool – and that’s exactly the way they like it. Working with many different teams across a multitude of specialties, these Care Aides, RNs, Critical Care Techs, Patient Safety Assistants (PSAs), Certified Nurses Assistants (CNAs) and more enjoy facing change, while they all share a goal of providing the best patient care possible.  “No day looks the same; since we are the Float Pool, we are assigned a different assignment on Smart Square every day, whether it be as a care aide, a patient safety assistant, a unit clerk or patient transport,” said Melina Castenada, Care Aide. “If we are assigned as a care aide on the floor, we help assist with call lights and help with whatever nurses and CNAs may need, including feeding, transporting, walking, helping patients use the restroom, etc. When we are assigned as a PSA ‘sitter,’ we sit for the patient to help keep them safe. If we are assigned as unit clerk, we help answer phones and direct patients appropriately, file paperwork, answer call lights if needed and assist with office work.”  “I love that every day is a different floor with different tasks and a different atmosphere,” added Julia Chappell, Critical Care Technician. “I find out which floor that I will be on right before my shift starts and head to the floor to find out my assignment for the day. Depending on the specialty, such as the medical-surgical floor versus an intensive care unit (ICU), my daily job tasks can vary.”  When it comes to high-risk patients, who require special attention, PSAs within Float Pool step in to help.  “The PSA role within Float Pool largely consists of adverse event prevention for our high-risk patients, and being a Float Pool employee allows us to work wherever we are needed,” said Dimitri Macouin, Patient Safety Assistant. “Whether it be in the emergency department, neurology or pediatrics, the PSA will be the eyes and ears for the nurses working with this patient population.”  “Great strides have been made to ensure that PSAs remain vigilant and are recognized as an integral part of the patients' care team rather than 'just a sitter,’” added Karla Phillips, Patient Safety Assistant.  Float Pool also oversees our Discharge Lounge, which offers patients and their families a dedicated space to reconnect and prepare for their discharge from the hospital.  “The increase in utilization of the Discharge Lounge is something we are very proud of,” said Kara Abshier, Care Aide. “We assist in discharging patients from all over the hospital to help the floor and get new patients into rooms.”  Every day brings a new challenge for Float Pool. As these team members wake up with uncertainty, they are ready to embrace the diverse demands of caring for patients of all ages.  “The fact that Float Pool exists is amazing,” said Hannah Luccshesi, Acute Float Pool RN. “We wake up with no clue as to whether we will be working with babies, children or adults and then fill in the needs of the hospital.”

Read More About Department Spotlight: Float Pool

When you meet Poeth Kilonzo, Director of Oncology Nursing at Renown Health, you are immediately greeted with a warm smile that puts your mind at ease. Within the William N. Pennington Cancer Institute, Poeth enjoys a strong reputation among her employees and patients as someone they can always rely on, no matter how rough the tides may flow.   As an incredibly humble oncology professional, you may not realize that behind that smile is the power of a best-in-class nurse and leader holding a 20+ year career of diverse nursing experience and leadership excellence – dedicating the majority of her service to Renown Health.  Join us as we dive into Poeth’s unique journey through Renown.  Finding Her Passion  Ever since she could remember, Poeth has been a “people person.” Above all else, she cared for people – and she cared a lot. What better place for her to be than healthcare?  After moving to northern Nevada from Kenya, she began working in private patient care working with home health and dementia patients while taking classes at Truckee Meadows Community College (TMCC) in 2000. One day, a patient asked her a question that would change the course of her career journey: Did you ever think about becoming a nurse?  Driven by not only the words of encouragement of her patients and supervisors in home health but also the rallying support from her family and friends, including her husband and high school friend, who both have decades of experience interacting with nurses in healthcare (with her husband spending many of those years at Renown), Poeth knew this was the path she was meant to take.  “That was it; it was like a light switch had flipped,” said Poeth. “I switched to nursing overnight.”  According to Poeth, TMCC’s nursing program offered her an incredibly supportive environment, which was especially important as she was a young mom at the time. Working in healthcare, going to nursing school and raising a family all at the same time is no easy task, but to Poeth, this was her calling.  “Regardless of my path, I knew I wanted to be a nurse that was close to patients, sitting with them and holding their hand throughout their treatment,” said Poeth.  During nursing school, Poeth completed clinicals at several hospitals in Reno – three of them were at Renown Health (known as Washoe Medical Center at the time). What immediately stood out to her was the passion of the pediatrics unit, especially in the neonatal intensive care unit (NICU).  “While I knew that pediatrics wasn’t going to be my arena, some of the best times in my life were during my pediatrics clinical,” said Poeth. “It opened me up to how welcoming Renown is.”  While doing her rotations, nursing leaders helped Poeth and her fellow classmates discover Renown’s Nurse Apprentice program, an apprenticeship designed exclusively for local northern Nevada nursing students. One of those leaders asked her, “have you considered doing a rotation in oncology?”  And another light switch flipped.  “Bingo. I am becoming an oncology nurse apprentice,” Poeth recalls. And that’s exactly what she did.   After her four-month apprenticeship ended in February 2002, she walked into her interview with Joanna Gold, who would end up being her supervisor and one of her greatest mentors until she passed away in recent years. With her experience and enthusiastic spirit on her side, Poeth fervently expressed her passion and interest in working in oncology. And Joanna saw all of that and more.  In June 2002, Poeth was presented with a two-year oncology RN contract, which she easily signed – however, she knew right then and there but she was not going anywhere. Renown was her home, and oncology ignited the fire within her.  “The nurses in this unit are part of what kept me here,” Poeth remembers. “These nurses would really do anything for their patients. The commitment and love they all had for one another truly was like family. It inspired me to learn more and give even better care to my patients."  To Poeth, it didn’t feel like she was coming to work just to do a job – she was following her dreams.  “You don’t think about the work you do; you think about the service,” said Poeth.  From there, Poeth spent three years on the floor as an oncology RN and became a night shift supervisor in 2005. She was thriving.  But this part of her journey was only the beginning.  When Opportunity Arises, Take It  In March 2007, Poeth and her husband welcomed their third child – and for her, working a day shift position would serve her the best at her current stage of life. This revelation led her down to Renown South Meadows Medical Center, where she became a staff nurse in Medical Telemetry.  It was in the telemetry unit where Poeth contributed to one of the largest digital transformations Renown would ever go through: transitioning from paper records to electronic records on EPIC.  From there, Poeth was inspired to get back into leadership in 2012 as the Supervisor of Clinical Nursing overseeing nurses, clinical outcomes and payroll in the medical/telemetry unit and intensive care unit (ICU). The timing of her leadership role lined up perfectly with her decision to take her skills to the next level, achieving a bachelor’s degree from Nevada State College in 2016. The timing of her degree lined up perfectly with what was about to come; she embarked on her first leadership role at Renown  This is where she would happily stay for 11 years, eventually becoming the Manager of Nursing in telemetry and the ICU, noting that Renown South Meadows felt like a second home to her.  “I wore many hats at South Meadows,” Poeth recalls. “From piloting back coding and handling compliance work to being on the patient floor and heading up South Meadows’ first high school hospital volunteer program, I got very involved. We had seven years without having a single nurse traveler in our unit."  It wasn’t long before Poeth was inspired to expand her education even further, and she graduated in January 2018 with a master’s degree in nursing clinical leadership from Western Governors University. Thanks to Renown’s educational assistance programs, our health system invested directly in Poeth’s education with tuition reimbursement and a $1,000 nursing scholarship.  Soon after celebrating her achievement, Jennifer Allen Fleiner – who was the Director of Nursing at Renown South Meadows at the time – asked Poeth yet another question that would bring her to the precipice of another career detour: “Have you ever considered transferring from South Meadows to Renown Regional?”   Moments later, Alicia Glassco, Director of Nursing for Renown Regional, asked her the same question, noting that the hospital’s neurosurgery unit needed the leadership of someone just like Poeth.  “It took me a whole week to make a decision, because this was one of the toughest decisions I’ve ever made in my life,” said Poeth. “I truly loved South Meadows. After that week, my leader told me, ‘you know what, Poeth? You’ve reached your pinnacle. You need and deserve a new challenge. Learn from this new team and teach them something. I think you have a huge opportunity for growth.”  So, Poeth decided to apply for the position and shadow the neurosurgery team, where unlike her unit, the majority of the team at the time were travelers. But this was a challenge Poeth was up to – so she was accepted into the role.  “At the end of the day, these patients deserved consistent care,” Poeth emphasized. “I knew I had to take this position for the patients – they were the ones who sold me on this job. They are the reason why we are all here. It was important for me to be an advocate for them.”  The big hills to climb didn’t slow down Poeth; in fact, the exact opposite happened. Within her first year in the neurosurgery unit, her team onboarded 18 new graduates and replaced travelers.  “We were hiring like crazy,” said Poeth. “My standing agenda at all section meetings focused on hiring and our quality metrics. I started having a relationship with our doctors. Once we created a strong doctor/nurse collaboration, our nurses started staying with us longer.”  Everything on the unit was going great.  Then, COVID-19 hit.   “Since we had private patient rooms, our unit became the first COVID unit at Renown Regional,” Poeth recalls. “My whole staff that I had built up had to be distributed elsewhere. I started caring for COVID patients. We relied on our Infection Prevention team a lot. And at the same time, I was worried about my family in Africa.”  Despite the stressful nature that the pandemic brought upon health systems everywhere, according to Poeth, she knew she had to continue on.  “The neurosurgery team ended up merging with orthopedic trauma, which was very difficult,” said Poeth. “We went from 28 beds to 58 beds. The key to success here was training. Nurses are very resilient, and through training, we were able to stabilize the unit.”  Noticing the opportunity for virtual demonstrations that were previously offered only in-person, Poeth spearheaded online trainings for nursing, physical therapy, mobility, head injuries and more, allowing teams across Renown to upskill in safe spaces.  These programs continued throughout the pandemic, and Poeth was proud to be a figurehead through it all, helping to stabilize the unit while creating strong relationships with the entire team, many of whom followed her from Renown South Meadows to Renown Regional.  Then, she gets another visitor – her Chief Nursing Executive – in her office with yet another opportunity.  Have You Considered...  In September 2022, Chief Nursing Executive Melodie Osborn walked into Poeth’s office with those three words that Poeth has heard for decades: “Have you considered...”  “Before Melodie could even finish, I thought, ‘I have considered A LOT in my career!’” said Poeth.  Melodie told Poeth that the William N. Pennington Cancer Institute was looking for a Director of Oncology Nursing, noting that this could be yet another growth opportunity for her and a chance for her to go back to her roots.  “I had just celebrated my twentieth year at Renown; I knew this was going to be a decision I really had to think about,” said Poeth. “Everyone believed in me. Alicia Glassco told me, ‘Poeth, you are ready for this. Go for it.’ Once I applied for the position and started getting my updated chemotherapy certifications, I thought, ‘they are right; I got this.’”  At this point in her career, Poeth had been hyper-focused on inpatient care, and this role would be her first time caring for patients in the outpatient setting. After going through the interview process, however, Poeth knew that this was where she was meant to be yet again – and colleagues she hadn’t seen in years reaffirmed that commitment.  “I felt the most excited about the job when I toured the facility,” Poeth recalls. “I’ll never forget what one of the infusion nurses told me on my tour. She told me, ‘I don’t know if you remember me, but I remember you; I came from Renown South Meadows, and you were so nice to me as I was precepting as a new nurse. Your kindness was unforgettable to me.’ The fact that people like her wanted me in the unit so badly inspired me to come back.”  Soon enough, Poeth became the Director of Oncology Nursing, a position she still proudly holds to this day. Once she was hired, she immediately went into deep learning mode, mastering skills such as revenue integrity, credentialing and the insurance process. She attributes Supervisor of Infusion Kaitlin Hildebrand and Director of Radiation Oncology Services Susan Cox for helping her succeed.  Shortly after assuming the position, Poeth noticed yet another opportunity for cross-training within the organization to combat short staffing – training nurses from the Float Pool to care for patients in Infusion Services.  “Between May and July of this year, we trained six nurses from Float Pool to do infusion therapy services, which offered so much relief to my team; I am so thankful to Rendee Perry, the Manager of Nursing in our Float Pool unit, and her team for their support,” said Poeth. “My mission in outpatient oncology is to serve the staff and patient population and create those strong relationships."  Poeth's efforts to circumvent nurse burnout go beyond cross-training – as a director, she is always there for her team members no matter what, leading with kindness every step of the way.  “I never miss a 7:45 a.m. huddle unless I am in a ‘cannot miss’ commitment; I want my employees to always know that I am there for them and that they are cared for both on and off the job,” Poeth emphasizes. “I want them to feel like they are valued, their families are valued and their mental health is valued; after all, without my team, we cannot care for patients. It’s important for them to know that I am here to be a security blanket and that there is always something we can do to solve a problem."  Today, Poeth enjoys a full team of core Renown staff members whom patients look forward to seeing – and the high patient satisfaction scores to prove it.  “Our team is so established that patients feel comfort in knowing they are always going to know exactly who they are being treated by,” said Poeth. “We will always work to maintain that consistency.”  Staying True to the Mission  Renown’s mission of making a genuine difference in the health and well-being of our community resonates closely with Poeth. Before she arrives at the infusion unit every day, she asks herself: What can I do to make it easier for my team to deliver care?  “It takes a village to deliver the care we do,” said Poeth. “Our nurses are priceless. You can’t place a monetary value on dealing with life and death every day. This is what inspires me. It’s all about helping each other out and keeping those relationships strong.”  Maintaining those relationships on the floor, according to Poeth, requires one main ingredient: work-life balance.  “I want my nurses to be able to balance sending their kids to kindergarten and giving their patients their first chemotherapy treatments,” Poeth emphasizes. “I genuinely care about their lives. It’s nice when you get to know your team’s children, grandkids, spouse and hobbies. I’m grateful that Renown has given us the autonomy to foster that flexible environment within our teams. It is so rewarding to have such a strong impact on these employees.”  To Poeth, it’s all about doing and then duplicating. Luckily for her team and infusion patients in northern Nevada, a new infusion center at Renown South Meadows is planned to open in the coming years as part of our commitment to expanding care. Her team is excited to grow their expertise down to south Reno – Poeth's original home hospital.  “I strongly believe that as nurses, we are meant to be where we are meant to be at the time,” said Poeth. “Be kind to yourself and remember your ‘why.’ Take advantage of the opportunity you have.”  To all nurses (and future nurses) out there, Poeth wants you to know that you are welcomed and valued. You are saving lives every day, and to her, that is worth everything.  “Always remain focused, even throughout all the challenges. Never forget why you got into nursing. And lastly, always stay true to your own mission,” closes Poeth.

Read More About 20 Years of Compassion and Dedication