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As many nurses can attest, the journey they have taken to arrive at where they are today is full of twists and turns. For Zarah Jayco, an operating room nurse at Renown Regional Medical Center, her journey is nothing short of a fulfilling and exciting one. Zarah is no stranger to taking detours to find what truly makes her feel the bursts of passion she had been looking for her entire life. She found that passion in the operating room – and travel nursing led her to Renown Health. Today, she is a firm believer that she is exactly where she is supposed to be.  “I Just Want to Help People”  Throughout her life, Zarah knew she was destined for a meaningful career – but didn’t exactly know what. One day, she sat down with her mom, a nurse herself, where she asked the question that would ignite Zarah’s curiosity: What is important to you?  “That’s when I told my mom: ‘honestly, I just want to help people.’”  It was at that moment that she realized nursing could be a fit for her. Everything about venturing into the nursing field started to make sense.  So, that’s precisely what she did. Zarah went to nursing school. When she stepped into the OR during her clinical rotation, she was immediately inspired.  Zarah’s core values as a nurse were rooted from caring for her 90-year-old grandmother while she was in hospice. Her grandmother gave her some powerful lessons and words as she set off on her career: “You are in the right place.”  Upon completion of her perioperative program, Zarah the OR Nurse we know and love started her journey. She began her trek as a travel nurse, going up and down California to do exactly what she was meant to do: care for surgical patients.  “I Traded the Ocean Waves for the Mountains”  As Zarah continued to travel and find different locations for new assignments, her husband received an opportunity for work to transfer to the Biggest Little City. The duo packed up their California lives and moved to northern Nevada, where Zarah signed up for a night shift OR nurse position at Renown Regional Medical Center.  But the traveler’s mindset wouldn’t last long.  Renown embraced Zarah with open arms, and she was immediately drawn into the community-feel that our health system offered. She felt welcomed and surrounded by “loving, hardworking people” across her department and all other teams she encountered.  As Renown cares for patients across 100,000 square miles, Zarah was especially impressed with how rooted Renown is in northern Nevada, noting how it “truly feels like we are caring for the community” with our health system’s wide reach. She was inspired to live up to that mission and more.  “Reno and Renown really reeled me in, and I fell in love with the city and everything it has to offer,” said Zarah. “I traded the ocean waves for the mountains, and the more we got to know Reno, the more we realized that this change of pace and lifestyle was definitely a good fit for us.”  Zarah the OR Travel Nurse became Zarah the Renown OR Core Staff Charge Nurse. And she knew she made the right decision.  Working in the OR, according to Zarah, is challenging in the best way possible. At night, all surgery cases at Renown are emergencies. The team springs into action to answer one vital question: How do we provide the best care for this patient?  “It is essential for us to anticipate potential outcomes,” said Zarah. “When we book a surgical case, we look at everything to make sure we are absolutely prepared and ready.”  Staying at Renown was an easy choice for Zarah. To her, there is nothing like being a part of a core team that inspires her every day and ‘has each others’ back,’” Zarah stated. “During the course of my assignment at Renown, the culture harnessed a kind of environment that felt like a hardworking family. This was the hook that reeled me into considering being part of core staff. I am incredibly grateful for the opportunity to build relationships that I hold in the highest esteem.”

Read More About Zarah Path from Traveler to OR Nurse

March is National Child Life Month. Join us in recognizing our Child Life team at Renown Health!  The hospital environment can be a daunting and confusing place for a child. Whether they are admitted to the hospital themselves or have a family member who is currently undergoing treatment, they undoubtedly bring along a lot of overwhelming questions and concerns.  No one would be better to guide them through the process than the Child Life department at Renown Health. Our devoted Child Life Specialists and Child Life Assistants dedicate themselves to helping our youngest patients and children of relatives in the hospital cope with their anxieties and fears. With the smiling faces of the Child Life team on their side, children at Renown have a sense of solace while they are in the hospital with a team to cheer them on every step of the way.  Offering a Hand to Hold  From the first moment of a child’s visit to Renown, they are never alone. The Child Life team, which is made up of three specialists and two assistants, is here to provide a helping hand throughout the entire hospital process, explaining each test, procedure and process every step of the way and creating the best possible plan for each patient – all while fostering and maintaining a safe and supportive environment.  “We are specifically trained to help patients and families throughout their healthcare experiences,” said Amanda Cleary, MS, CCLS, Child Life Specialist. “This looks different for every family. We are trained to tailor our services to meet individual family and cultural needs based on our assessment.”  “It does not take long for a Child Life Specialist to create a safe relationship with a pediatric patient,” added Angie McEvers, CCLS, CFLE, Child Life Specialist. “The Child Life department can help any care team do their job by redirecting a child’s focus and distracting them from painful interventions, and this is a win-win for both the patient and the care team.”  This team’s primary goal is to make talking to doctors and undergoing tests a little less intimidating for our youngest patients. Interaction is a crucial part of a child’s healthcare journey. Our Child Life Specialists are masters at procedure preparation, surgery preparation, trauma support and diagnosis education while meeting each child where they are at developmentally.  “A day in the life of a Child Life Specialist is never the same, and every child is different,” said Jennifer Nunzir, CCLS, Child Life Specialist. “To make sure patient care is possible, I make sure I am here mentally for the patients and families. I am ready with a smile to greet them and try to make them comfortable from the start. We are always present to support a patient and family with a new diagnosis, talk to children when there has been a tragic accident, make memories for families and giving children a distraction from tests and procedures.”  “One of the biggest benefits to our job is our ability to provide emotional support and communicate with families in a way that makes them feel seen and heard,” added Amanda Cleary. “We listen to the family’s past medical experiences and work on building rapport by building those connections. When you get a child to open up, you see who they are as an individual, and we build from there.”  The efforts of the Child Life team go beyond helping children with coping skills. They also jump in with activities to keep kids of all ages engaged – from arts and crafts to pet therapy.  “Bringing children smiles through play and giving them fun things to do – whether it’s watching a movie, playing a game, doing an art project, going for a wagon ride or taking them to the Children’s Healing Garden – makes me feel I am making a difference,” said Jennifer Nunzir. “If I can get the child and family to at least smile or laugh, I feel I have already eased some fear and anxiety. It truly is the best feeling to get them smiling and laughing.”  “Through play, conversation, distraction or relaxation techniques, patients cope better, and families are calmer,” added Angie McEvers.  Teaching Every Step of the Way  Education is a crucial aspect in this department. Each Child Life team member works closely with their patient’s care teams to break down “doctor speak” with age-appropriate explanations.   “Children come into the hospital for all sorts of reasons, from a broken bone to cancer; our background in child development and psychology helps us collaborate with the patients’ providers and explaining what each part of the care journey is depending on a child’s developmental level,” said Amanda Cleary. “For example, we can explain what a brain tumor is with playdough and help a child with a new diabetes diagnosis understand what it means to balance sugars using play food. It's all about providing family-centered support so that they feel more in control. I can’t tell you how many times I’ve seen parents’ eyes light up when the kids play. They are all coping, learning and growing together.”  To Help with the Happy and the Sad  When healthcare journeys don’t go as planned, support from care teams is crucial for families facing grief or loss. The Child Life Specialists are one of the first on the scene to provide support for children and their families, providing education on how to talk to children about death and helping families preserve the memories of their loved ones for years to come.  “One of the most difficult things we do is provide bereavement support,” said Angie McEvers. “Not only do we provide support for families of pediatric patients but also adult patients who have children. Our team takes the time to help families with memory making with handprints, journals, books, the list goes on. No one should have to go through this process alone, and we make sure that doesn’t happen.”  Above all else, the Child Life team are here, first and foremost, for the patients and their families. They are the drive that keeps them going – and helps them reinvigorate that passion for their work every day.  “I have met some of the most amazing children and families, and they definitely are what keep me here at Renown,” said Jennifer Nunzir.  The Road to Child Life  The journey to becoming a Child Life Specialist looks different for every team member, and many of them discovered the field while pursuing careers in other healthcare areas. Beyond their passion for children and families – and their Certified Child Life Specialist credential – our Child Life team members are also highly educated in the fields of human development, nursing and psychology, knowledge that benefits them greatly in their career.  Amanda Cleary had the unique experience of pursuing a Child Life career at Children’s Hospital of Los Angeles before she arrived at Renown last year, implementing her knowledge from her bachelor’s degree in human development and family studies into a clinical child life internship and a robust career in Child Life.  “While at Penn State, I learned about the Child Life career path through the Children’s Miracle Network Dance Marathon,” said Amanda. “I knew that this was the path I wanted to take. I did a 600-hour internship, and from there I was hired at Children’s Hospital of Los Angeles, where I stayed for 11 years. As a lifelong learner, I knew I wanted to pursue more – so I achieved my master’s degree online in child life leadership and advocacy at the Erickson Institute in Chicago, and what I learned in that program continues to serve me well in my career at Renown.”  Other Child Life Specialists, like Angie McEvers and Jennifer Nunzir, had already been with Renown for several years in other departments and built up a wealth of healthcare knowledge before discovering their passion for the mission of Renown’s Child Life program.  “I have been here for 23 years; I always knew I wanted to work with children in the hospital because I love kids, and although I originally wanted to be a nurse, I realized that I actually wanted to be on the other side of helping,” said Jennifer. “At the time, I didn’t know there was a job like the Child Life Specialist out there, and I feel so lucky to have found this career. Over the years, as Reno has grown, so has our program, which is very exciting. I knew Renown would be the place where I could grow as well."  “This year is my 24th year with Renown,” added Angie. “Before I worked here, I was an Advanced EMT/Firefighter while pursuing my nursing degree. In working with the medical team from Children's Hospital of Oakland in pediatric hematology/oncology, I was able to see first-hand the benefit of Child Life. I was driven to finish my human development degree and passed my certification testing, and ever since then, I’ve been with Pediatrics, PICU and the Children’s ER.”   We could not have said it better ourselves – this is a field that is constantly evolving and progressing, and while not everyone is familiar with it, our Child Life Specialists are ready to change that narrative.  “There is a lot of opportunity here to continue to grow the Child Life program,” said Amanda. “Not all hospitals have a Child Life program, but we are lucky that Renown does. Any aspiring Child Life Specialist should consider coming here, as it has been a great experience. It is a familial feeling here, and I definitely feel like I am in the right place.”  There is Strength in Numbers  It takes a village to serve the emotional needs of the many children and families that walk through the doors of Renown Children’s Hospital, and our Child Life Specialists are considered some of the key leaders of that village.   The outpouring of support for our Child Life program is astonishing. Not only have our patients and employees made generous donations, but members of the greater Reno-Sparks community are always there ensure kids in the hospital can be kids. The Nevada Wolf Pack, SCHEELS, Great Reno Balloon Race and Atlantis Casino are just a few of the many generous organizations that have donated both toys and time to our youngest patients.  To support any child dealing with a serious illness, especially cancer, Beads of Courage steps in to help children “visually record, tell and own their stories of courage” using beads as a symbol. Representatives from Beads of Courage volunteer their time to help our youngest patients keep track of their valiant fight against their illness, adding a bead to their necklaces after every step in their care journey.  “We rely on our generous community and donations that come in, and we see a lot during the holiday season – we definitely can benefit from this year-round,” said Amanda.  The donations allow the Child Life team to expand their play, coping and distraction opportunities for patients and families, allowing them to reach more children within their small, mighty and growing team of five.   “Our goal as a team is to work with as many pediatric patients and children of relatives seeking treatment as possible, so the opportunity to grow our team would be awesome,” said Amanda.  And grow they will! The team recently welcomed two dedicated Child Life Assistants, Marissa Arriaga and Sydnee Patterson, during Child Life Month. These team members work alongside the Child Life Specialists to help provide opportunities for developmental play, both in the playroom and at the bedside. Marissa and Sydnee ensure that the kids can still be kids, even while they are in the hospital.  Additionally, the Child Life department is currently hiring more Child Life Specialists. If this line of work speaks to you or someone you care about, they are strongly encouraged to apply, because in the end:  "We do it all for the kids,” closes Jennifer Nunzir.

Read More About Department Spotlight: Child Life

Heading into surgery of any kind can bring along feelings of intimidation. With a best-in-class surgery team at Renown Health, patients rest assured that they are in the most capable hands for their entire procedure from start to finish – and while the physical preparation is vital, mental and emotional preparation is equally as important to ensure each patient has a smooth and comfortable experience. The Surgical Preadmission department (a.k.a. “preadmit”) at Renown Regional Medical Center and Renown South Meadows Medical Center is a dynamic and compassionate group of nurses, case managers, chart managers and more who are dedicated to guiding each patient through the surgical process. With extensive knowledge and expertise under their belt, the teams are equipped to make a genuine difference in the health and well-being of all patients, for all surgeries, at all times of the year. Surgery Starting Ground The Surgical Preadmission teams are crucial aspects in the successful outcome of every surgical procedure. Comprised of skilled healthcare professionals, this department is dedicated to providing comprehensive support and care before heading into the pre-operating room. “Our job is to prepare every patient for surgery, make sure all their pre-surgery testing is done, ensure they understand their fasting and medication instructions, have had their questions answered, have a ride home and know what to expect during surgery and after so their recovery can go smoothly and without complications,” said Debra Bennett, RN, Supervisor of Surgical Preadmission at Renown Regional. “Each patient is unique, so each experience is different.” Our preadmit nurses are the masters of communication, directing thorough assessments – including medications, tests and clearances – and addressing any questions or concerns patients may have, never missing the opportunity to inform them of exactly what they will expect in surgery. “I do a complete history on every patient while giving them detailed pre-operating instructions and helping them answer any questions to the best of my ability,” said Nancy Hilts, Surgical Preadmission RN at Renown Regional. “I am proud to be able to help allay their fears and concerns using my 30 years of pre-op experience. I offer an avenue for them to feel comfortable opening up to me.” “We always tell patients that they have great surgeons and a fantastic team that will be watching over them and taking care of them every step of the way,” added Jon Capallupo, Surgical Preadmission RN at Renown South Meadows. “We also give them plenty of educational handouts and video content, in addition to verbal instruction, to ensure they are as prepared as possible.” The nurses then pass the reigns onto the chart managers, who prepare the charts for surgery and ensure all documentation is up-to-date before sending them to the pre-operative team. The expert surgical case managers also step in to prepare a thorough discharge plan, along with reviewing pre-operation orders for status, consent, codes and more. The team does several of these initial visits virtually, and they are looking forward to soon phasing all preadmit case manager preliminary visits into a virtual model. From assisting the pre-op and post-anesthesia care unit (PACU) teams with discharge planning concerns to helping on the outpatient side with anything from oxygen equipment and catheters to transportation issues and those experiencing homelessness, our pre-admit case managers are always up to the challenge. "We are true patient advocates, alleviating concerns and fears along the way,” said Mary Carl, RN, Case Manager at Renown Regional. “Just to name a few things we do on a daily basis, we see our total joint and non-weight bearing patients during their preadmission appointment, so they are aware of the medical equipment they need and if it is covered by insurance; provide education for Aspira catheters and gastrostomy tubes; advocate to ensure tube feeding and dressing changes are set up for hospice and home health patients; and escalate concerns of patient safety to ensure a safe discharge.” In the midst of it all, there is never a dull moment in the preadmit teams. At Renown Regional alone, the preadmit professionals see more than 1,600 patients a month – and each one has a hyper-personalized experience with their very own preadmit team. “Many times, we are the first impression a patient has on our organization; after all, we touch more than 97 percent of patients that are scheduled for surgery, cardiac catheterization lab procedures or interventional radiology,” said Amy Schler, Surgical Preadmission RN at Renown Regional. “We also collaborate with many other departments in the hospital as well, from surgeons and anesthesiologists to case managers and nurse navigators. Our work in preadmit impacts the entire surgical process.” Holding a diverse array of experiences, our preadmit department plays an integral role in our commitment to providing the highest quality of care to every patient. Knowledge is Power Heading into surgery feeling fearful and worried is normal for any patient. However, how would you feel knowing that each individual member on your preadmit team has, on average, 23-25 years of experience in the field? This is the reality for our Surgical Preadmission department – and they put that vast knowledge to great use to bring a sense of calm to patients. “Our team members have worked in various departments within our organization, and they bring a wealth of knowledge that we share with each other, and most importantly, with our patients,” said Amy Schler, RN. “If you have hundreds of years of nursing experience, you can speak not only as a nurse but also as a patient. It allows you to give a more personal perspective on what patients can expect in their recovery. Being able to assess their emotions and provide feedback to our pre-op and PACU teams help the patient have a better experience.” “Many of our nurses have close to 40 years of experience each, and they have an extremely large knowledge base since we see patients from newborn to geriatric and from easy procedures to complex surgeries,” added Debra Bennett, RN. “Another great aspect of our team is the varied nursing backgrounds we all hold – surgery, pre- and post-op, labor and delivery, pediatric intensive care, cardiology, gastroenterology, urology, cardiac cath lab, home health and everything in between. Communication between departments is so important!” All members in this department, regardless of which clinical area they came from, surgical or non-surgical, can easily translate their skills into the work they do in preadmit – and they only continue to grow. “As a surgical preadmission nurse, I have used my years of experience as a nurse in surgical services,” said Terri Delatorre, Surgical Preadmission RN at Renown Regional. “I started as a floor nurse with orthopedics for 12 years, and then I worked with the PACU for 11 years. This has helped me give great understanding and care to our surgical patients.” “Because we have staff with such a vast knowledge base, we can rely on our years of working within our organization to help alleviate fears that the patient may have,” added Amy Schler, RN. We can prepare them for what to expect in pre-op and PACU and educate them on what to expect post-op, including any barriers they may face. For example, mastectomy patients may not realize they will not be able to raise their arms for 7-10 days post-op, and total knee patients have to navigate stairs and housing access. Helping patients think about barriers at home that they may not have thought about helps them prepare prior to surgery, enhances their healing and provides a better surgical experience.” The preadmit team works closely with our best-in-class surgeons and anesthesiologists, continuing to grow their expertise along the way while learning alongside our talented providers. For instance, when it comes to our Renown South Meadows preadmit department, anesthesiologist Nariman Rahimzadeh, MD provides excellent guidance for the entire team on state-of-the-art anesthesiology practices. “I am very proud of the work we do with Dr. Rahimzadeh,” said Lisa Closson, Surgical Preadmission RN at Renown South Meadows. “Together, we ensure patients are safe for both surgery and anesthesia.” Despite the challenges that come their way – whether it be changes to process and workflow to navigating support for patients after they leave the surgery floor – the preadmit team cleverly uses their collective wealth of knowledge to bring hope and comfort to all patients. “Our nurses are such warm, caring and compassionate humans that do their best to ease any fears and anxieties patients may have,” said Debra Bennett, RN. The Pride of Preadmission The pride of our preadmit team lies in their ability to make a positive impact on all patients they serve. To them, their work is not just a job – it's a calling. And they do it all while working together to elevate their team and performance. “Our team is most proud of the quality of care we provide to our patients and our abilities to troubleshoot difficult situations to ensure they have a great surgical experience here at Renown,” said Mary Carl, RN. The entire department supports each other by working collaboratively and relying on each other’s expertise to provide the best possible care for patients. They understand that their success as a team depends on their abilities to support and help each other. “Our team is awesome here at South Meadows,” said Jon Capallupo, RN. “We can turn to each other for support, and we all work very well with each other. I am glad to be a part of this team.” “I am proud of how well all of us in preadmit works with each other every day,” added Lisa Closson, RN. “We try to make patients feel comfortable from the moment they arrive to the time they leave the department.” The pride that our preadmit team expends goes beyond their departmental limits – these team members are also trusted teachers. They work closely with cancer nurse navigators to teach weekly classes for patients who have been newly diagnosed with breast cancer, coupled with lymphedema prevention and education classes. The team also encourages participation in Renown’s free smoking cessation programs to help their patients learn the risks and benefits of quitting smoking. When not serving patients or teaching classes, you can find many of these team members taking charge of multidisciplinary committees within our health system, including breast leadership, gastroenterology leadership, shared governance, infection control and recruitment and retention. On top of it all, this team certainly knows how to celebrate, with several of their members being a part of their own department-wide Celebration Committee, where they gather for retirement parties, baby showers and team get-togethers. Always active and never passing up a challenge, our preadmit department are shining examples of Renown’s Culture Commitments, especially Caring and Collaboration, and the pride in the vital work they do every day is limitless. “I am so happy my position in preadmit opened up for me at a time when I was really feeling challenged in my career,” said Nancy Hilts, RN. “The team that we have here is amazing. I am so grateful and thankful every day for the opportunity. It is an amazing place to work!”

Read More About Department Spotlight: Surgical Preadmission