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Departamento destacado: Oncología radioterápica
Up to half of all men and one-third of all women will face a cancer diagnosis in their lifetime, according to the Nevada Cancer Coalition. Chances are, you or someone you care about has been affected by cancer and has witnessed the ultimate fight for life. More than likely, your loved one’s cancer journey involved radiation therapy – and in fact, more than half of cancer diagnoses are treated in whole or in part with radiation. At first glance, this treatment plan can sound scary to any person. With a cancer care journey, it takes a village, and at Renown Health, we have top-notch leaders of the village roads that lead to radiation. Meet our Radiation Oncology team at the William N. Pennington Cancer Institute. From intake to inpatient, this department of passionate physicians, radiation therapists, registered nurses, medical assistants, intake coordinators, schedulers and more are here to help every patient dealing with the intimidating diagnosis of cancer. Any patient that needs radiation as a part of their treatment is in the best of hands with this team, who will stop at nothing to ensure each patient under their care knows that they have a village Fighting the Good Fight right alongside them. Teamwork in Tackling Tumors One of the most common forms of cancer treatment, radiation therapy uses high-energy X-rays to minimize cancerous cells. But with Renown’s Radiation Oncology department, the impressive cancer care doesn’t stop there – this team leverages advanced technology right at their fingertips. In fact, our cancer institute has the most state-of-the-art radiation therapy system of its kind – the ultra-precise Varian TrueBeam radiation therapy system – and is the very first program holding American College of Radiology accreditation in the entire region. Given the advanced nature of their jobs and the high standard of care their patients expect them to uphold, it’s no question that the days-in-the-life of each team member is complex and can continually change every day. “There are many moving parts in radiation oncology on any given day,” said Sandra Bailey, Manager of Radiation Oncology Services. “The radiation oncologists consult newly diagnosed patients, follow up with previously treated patients and oversee daily treatments for patients actively receiving treatments. Nurses and medical assistants move around the clinic to support the physicians with patients and provide education and other supportive care.” The physics and dosimetry teams work diligently alongside the physicians to design the most beneficial treatment plan for each patient. Once a patient begins their treatments, the radiation therapists administer the daily treatments with the utmost precision. Intake coordinators, schedulers and patient access representatives make surethe patients have their insurance authorization and are processed through the system appropriately. Like any well-oiled machine, each part is necessary for the other to function at peak performance to ensure our patients receive the quality care they deserve and expect. Like many other clinical departments at Renown, teamwork coupled with education is crucial to best serve radiation therapy patients. Our nurses on this team are experts at exactly that, serving as a reminder of the transformative power of care in the face of a daunting disease. “Radiation oncology is a unique world,” said Kristen Reed, Registered Nurse. “We have many different team members that play a role in how we function as a department. We all work together in some aspect to provide care for our patients. As a nurse, I provide patient education to all my patients before starting treatment to go over potential side effects and expectations on their treatment. Daily, we see new patients and follow-ups, plan simulations to start patients for radiation treatments and provide radiation treatments, among many other daily tasks.” The unique role of our radiation therapists, the team members who are on the frontlines of giving radiation treatments, helps this department stand out from the rest with their tireless dedication to fighting against cancer with compassion and expertise. Not only are they armed with technology, but they are also armed with hands that deliver healing rays of radiation. “As a radiation therapist, our daily tasks can vary pretty widely,” said Casey Johnson, Radiation Therapist. “We rotate between three radiation treatment machines called linear accelerators – one of which we use for stereotactic radiosurgery, a minimally invasive form of surgical intervention. We also staff the CT simulation room where we construct all the patients' treatment devices and perform their ‘mapping’ scan. We then coordinate with the dosimetrists and physicians to determine the specifics of the patients’ course of treatment. The most important parts of our job are patient care and education. Even though our job is very technical and requires tremendous attention to detail, the critical part is remembering that our average workday could be a monumental day for a new patient.” “Our day-in-the-life in Radiation Oncology is centered around patient care,” added Haley Longfield, Radiation Therapist. “Although we do not spend a ton of time with our patients, we see them every day. We are able to build a wonderful rapport with our patients that is top-notch. We set up the room with their treatment devices, get them set up appropriately and administer their radiation treatment. On average, our patients are here for about 15 minutes.” The bottom line: our Radiation Oncology team’s unified commitment to both excellence and innovation promises a brighter future for those battling cancer. No one is ever alone in their fight, and this team makes sure of that, no matter what. Radiating Excellence in Cancer Care The Pennington Cancer Institute boasts a stellar reputation in our community for offering best-in-class, evidence-based care and cutting-edge research, improving outcomes for patients battling cancer. This fact is what inspired many Radiation Oncology team members to take their talents to this department in the first place. “I chose to work at the Cancer Institute because I believe we offer the best patient care experience, along with the most advanced radiation treatments in the area,” said Casey Johnson. "I am a fifth generation Reno resident, and I am part of this community through and through,” added Haley Longfield. “I always knew that I wanted to work here.” The success of our cancer institute starts with our people – and many members of the Radiation Oncology team witnessed this firsthand upon their arrival in this department. “I was initially inspired to move across the country to work in the Cancer Institute by the vision of the senior leaders and the future growth plans for the entire institute; once I arrived, I quickly realized what a great team I am now leading,” said Sandra Bailey. “The compassion and care the Radiation Oncology team provides our patients is second to none. Medical errors are rare in our department, and this can be attributed to not only the processes in place to prevent them, but everyone working together to deliver radiation treatments safely. Each day I witness a patient relationship being nurtured and developed. I am truly honored to be part of this team.” Inspired by Renown's integral role in the northern Nevada community, several team members were drawn to this department because of the opportunity to make a meaningful impact on patients' lives in a quiet healing environment. “As a student nurse, I had clinical and practicum on the cancer nursing unit here at Renown; I noticed the quiet, healing environment and a patient population enduring some of life’s most challenging hurdles,” said Rachel Bales, Registered Nurse. “It is in these moments that you can really make a difference as a nurse. After pursuing critical care as a new grad and working in Interventional Radiology with cancer patients, I knew that I had to find my way back to oncology. I applied to Radiation Oncology, and I am working towards my third year in this department. I have always known that I enjoy helping others, and the fulfillment that comes from working with this patient population is unmatched.” “Renown is a huge part of the community in northern Nevada, and I knew while I was in nursing school that I wanted to have a career here,” added Kristen Reed. “I ended up joining the Cancer Institute about two years ago. My patients are a huge part of why I stay. We really get to know these patients and their families well, especially because they come in from Monday through Friday for up to six weeks for treatments. Building connections and being able to support these patients during a difficult time in their life makes my job fulfilling.” From the initial consultation to the administration of therapy, the staff's commitment to personalized care remains strong. Patients and their families develop profound connections with these team members as they navigate through the challenges of treatment. “We have knowledgeable and caring staff that help guide our patients through treatment,” said Kristen Reed. “This starts on the day of their consultation and continues even after completion of treatment. The patients and families get to know the staff through their treatment, and having a familiar face can be reassuring to them. We also take time every week to see how they are doing physically and mentally while undergoing treatment and we give them a chance to check in with their doctor. Taking this time helps reassure patients and allows them to ask questions, and in turn, reduce some anxiety and worry.”
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El Papel de los Ginecólogos Obstetras en la Atención de la Salud de la Mujer
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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Understanding the Reasons Behind Heavy Menstrual Cycles
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.
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Optimizing Mammogram Screenings: A Genetic Approach to a Personalized Screening Schedule
Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.
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Departamento destacado: Radiología intervencionista
National Radiologic Technology Week is from Nov. 5-11, 2023. Join us in celebrating Renown's Interventional Radiology department!Try to put yourself in the shoes of someone who is told that they have a massive blood clot in their lung, someone who needs a biopsy to determine the next steps of their care, someone facing a stroke or brain aneurysm or someone who needs a catheter to receive treatment such as chemotherapy. You may immediately think that an intense and intimidating surgery is on the horizon. What if, instead of surgery, your care teams were able to use the necessary tools to treat your blockage or administer your medicine with an image-guided procedure? That’s precisely what the Interventional Radiology (IR) team at Renown Health does. Behind the doors of this department is where you’ll find a team of highly skilled individuals who operate like a well-oiled machine, ensuring that each procedure is executed with precision and care. Their commitment to excellence knows no bounds as they provide essential interventions to patients of all ages, from the tiniest newborns to the elderly. Their mission extends beyond diagnostic and therapeutic procedures; they are experts in understanding and serving the ever-evolving needs of their patients. Minimally Invasive, Maximally Impactful With their advanced expertise, our IR teams at both Renown Regional Medical Center and Renown South Meadows Medical Center harness the power of X-ray, CT and ultrasound technologies to navigate their way through life-saving minimally invasive procedures, such as thrombectomies, angioplasties, stent placements, embolizations, catheter and drain insertions and needle biopsies. In the world of medicine, Interventional Radiology often offers an alternative to traditional surgical methods, reducing the risk of hospitalization and helping patients embrace recovery more quickly. Our IR teams have a diverse and busy daily work life in order to make these complex and life-saving interventions happen – and they all have each other’s backs to ensure that every patient gets the care they deserve. “Every day is different, and no two days are alike,” said Ryan Nunes, Specialty Procedure IR Technologist at Renown Regional. “The day can start off first thing in the morning with several emergent cases, such as ruptured brain aneurysms to brain blockages. We all work really well together; we help each other out and come together to do things as a team.” Like every other team at Renown, patient well-being is always a number one priority. The IR department takes this commitment seriously, upholding the highest standards of ethics and safety. “We start the day by preparing rooms and making sure they are well-stocked, checking that all devices are working, performing safety checks and making sure the entire team is well-prepared for whatever cases come through the door,” said Aubrey Goldsmith, Supervisor of Clinical Nursing in IR at Renown Regional. “We have routine cases like drain placements, biopsies, line placements and more, and we also have life-threatening cases that come at a moment’s notice. Our nurses are responsible for monitoring patients throughout the procedure to make sure they are doing well the entire time and are there to respond if the patient has a decline.” "After completing the prior assessment of each patient, we look for any medical problems the patient may have before confirming it is safe for the patient to have procedure done,” said Brandon Hartwig, Interventional Radiology RN at Renown South Meadows. “We work closely with the physicians on all our cases while assessing each patient, going through labs and vitals and personalizing the procedure for each patient.” Even though the procedures they oversee are minimally invasive, the IR team understands that any procedure, regardless of the severity, can be incredibly frightening for any patient. Their best tool for handling patient anxieties? Communication. "The best thing we can do to reduce anxieties and fears in patients is to have communication with them to ensure they know what is going on and what to expect,” said Megan Rios, IR Technologist at Renown Regional. "We set clear expectations for the patients and give reassurance throughout the entire procedure.” "All of our team members are very attentive to our patients when it comes to potential fears and anxieties that they may have,” added Jazmynn Kimsey, IR Technologist at Renown Regional. “We always take the extra time to listen to our patients and break things down, explaining every step before, during and after the procedure.” Knowledge sharing is also a crucial part of the IR process. No patient will ever have to wonder, “what exactly is going on here?” “We provide each patient with education and advocacy throughout the process,” said Blaire Henderson, Interventional Radiology RN at Renown Regional. “We ensure every patient is as comfortable as possible at all times.” “When it comes to procedures, patients tend to be scared and nervous,” added Ryan Nunes. “The silver lining to what we do is that it is all done through very small openings of the skin, and we all explain this to patients. Most procedures we do are done under moderate sedation which helps put the patient more at ease.” In a world where advanced medical care meets the human touch, the IR team exemplifies Renown’s commitment to making a genuine difference in the health and well-being of everyone they serve.
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6 Healthcare Action Items for the LGBTQIA+ Community
Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs. Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health. PrEP and PEP Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months. Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days. PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location. HPV Immunization All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime. The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never! STI Testing Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year. Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you. Prostate Exams Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old. These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened. Pap Tests and Pelvic Exams Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer. Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings. Mammograms and Breast Exams People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual. The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project. Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.
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Sepsis: Causes & Symptoms
According to the Global Sepsis Alliance, 1 in 5 deaths worldwide are associated with sepsis. If not recognized early and treated promptly, sepsis is the final common pathway to death from most infectious diseases worldwide, including viruses such as COVID-19. We spoke with Jeremy Gonda, MD, a critical care physician from Renown Health’s Sepsis Committee to increase public awareness of this preventable medical emergency. What is sepsis? Sepsis is a response to infection—bacterial, viral or fungal—and can start anywhere in the body and spread into the bloodstream. The body is trying so hard to fight an infection that it begins releasing chemicals into the bloodstream that cause inflammation and the shutdown of multiple organ systems. “It carries a very poor prognosis in general unless you catch and treat it very early,” said Dr. Gonda. “Any infection can lead to sepsis. Typically your immune system takes care of the infection. It doesn’t progress, but in cases where the infection becomes severe, or the immune system doesn’t function properly, people can certainly die. So there’s, unfortunately, a very high mortality rate associated with sepsis.” According to the Centers for Disease Control and Prevention, each year at least 1.7 million adults in America develop sepsis. While you can recover from sepsis if caught early, many sepsis survivors suffer from long-term physical and psychological effects. What are the signs of sepsis? One way to spot sepsis is to use the acronym SEPSIS: S – Slurred speech and confusion E – Extreme shivering or muscle pain/fever P – Passing no urine all day S – Severe breathlessness I – “I feel like I might die” S – Skin mottled or discolored Keep in mind that sepsis symptoms can vary depending on where the infection starts. “Patients may experience urinary burning if they have a urinary tract infection or a cough and shortness of breath if they have pneumonia first,” said Dr. Gonda. “However, often symptoms are more generalized or subtle such as fevers, confusion and malaise.” How do you develop sepsis? When germs enter your body, they can cause an infection. If you don’t stop that infection, it can cause sepsis. Areas of infection that more commonly result in sepsis include: Lungs, such as pneumonia Kidney, bladder and other parts of the urinary system Digestive system Bloodstream (bacteremia) Catheter sites Wounds or burns Who is most at risk? People with compromised immune systems are at greater risk for sepsis, such as “The very young, the elderly and any people who may have conditions that suppress your immune system,” said Dr. Gonda. “For instance, if you have diabetes or if you’re an organ transplant patient who is on immunosuppressant therapy, you’re at somewhat higher risk.” Sepsis is often considered a hospital-acquired infection, but a study in The Journal of American Medical Association found that 80% of sepsis cases occur outside of a hospital. That’s why it’s especially important to remember any infection can lead to sepsis, and anyone can develop sepsis from an infection. What do I do? Timing is critical in the case of sepsis and septic shock. According to a study on septic shock patients, there is a 7.6 percent decrease in survival for each hour treatment is delayed. On the other end, if treatment is given within an hour of the first drop in blood pressure, the survival rate is 80 percent. Because sepsis can be so deadly, it’s important to seek medical attention as soon as possible. “If you’re not getting any better, if you think symptoms are progressively worsening – you should definitely be evaluated by a doctor,” said Dr. Gonda. You can help #StopSepsis by getting involved at worldsepsisday.org.
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Departamento destacado: Respiratory Care
This Department Spotlight is dedicated to Jason Simpson, Manager of Respiratory Services at Renown Children’s Hospital. Take a moment to breathe deeply. Inhale in, exhale out. We rely on our lungs to provide us with the air we need to live a healthy life – and this essential bodily function is something that many of us don’t think twice about since it comes easily for us. Now, imagine yourself as someone who is living with severe asthma, chronic obstructive pulmonary disease (COPD) or someone who was recently diagnosed with a frightening respiratory condition like COVID-19 or pneumonia. The simple act of breathing can prove to be an intimidating venture requiring the care of a professional. Who are the people that take on the challenge? Meet Renown Health’s Respiratory Care Services department. Serving patients across 13 service lines, three acute facilities, outpatient locations and telehealth, our respiratory specialists – including respiratory therapists, respiratory care aides, inpatient COPD respiratory therapy navigators and educators and more – use their expertise to help restore the vitality of all their patients with every inhale and exhale, shaping a healthier livelihood one lung at a time. The Guardians of Respiratory Wellness Whether they are managing lifelong respiratory conditions or offering crucial support in emergencies, the Respiratory Care team strives to enhance the quality of life for every patient. As an indispensable member of the clinical team at Renown, our respiratory therapists work collaboratively with doctors and nurses to tackle a wide range of tasks, tailoring care for each patient’s unique needs. “Respiratory care is involved with all stages of life, from beginning to end,” said Sarah Kurtz, Respiratory Therapist. “We work closely with nurses and doctors and perform arterial punctures, breathing treatments, weaning maneuvers for patients on life support, intubations and much more. We assess patients constantly to see if their care needs to be upgraded or if they can be weaned to get them back home with their families.” “You start your morning researching your assigned patients,” added Tim Start, Respiratory Specialist. “We go over lab values and chest radiographs and decide the best plan of care for each patient. Our objective is to improve their respiratory status by giving them medications and doing breathing exercises. We participate in other forms of care with nurses, such as activities of daily living (ADLs) and mobilization. We work as a team, and that enables us to provide great patient care.” For patients living with COPD, enjoying all that life has to offer comes with a separate set of obstacles. According to the Centers for Disease Control and Prevention (CDC), over 200,000 people across the Silver State are living with this chronic condition. Luckily for them, Renown has a specialized team to help these patients optimize their life and manage their condition with individualized treatment and education. “We run a report every morning to identify all the patients currently admitted who have a history of COPD, take respiratory medications or smoke,” said Amber Beck, Inpatient COPD RT Navigator. “After looking through their charts, we visit with the patient (and possibly their family) at the bedside to help them better understand how to manage their breathing issues.” As a vital part of the Respiratory Care team, Renown’s respiratory care aides help ensure the seamless operation of our respiratory care services. These dedicated professionals provide essential support to respiratory therapists not only during intricate procedures but also outside of face-to-face patient care by transporting equipment, restocking supplies, assisting in the mobilization of patients and more. “We are responsible for the maintenance of unit supplies and making decisions regarding levels of stock to be maintained,” said Dia Ramos, Respiratory Care Aide. “We also transport equipment, refill the oxygen tanks on the floors and intensive care units (ICUs), order and stock respiratory care supplies, mobilize patients and assist the respiratory therapists during bronchoscopies in the ICUs. In addition, we clean respiratory equipment like mechanical ventilators, continuous positive airway pressure (CPAP) and bilateral positive airway pressure (BiPAP) machines, high flows and aerosol poles.” Once the COVID-19 pandemic hit, a special spotlight shined upon respiratory care teams across the country for the heroic care they provided patients in respiratory distress. While their roles in health systems have gained a better understanding nationwide, this team understands it is vital for them to educate the community about the important jobs they hold for our patients. “Respiratory care can be under the radar,” said Pam Umek, Respiratory Specialist. “Once, when I told someone that I am a Respiratory Therapist, they said, ‘Oh, like a yoga breathing instructor?’ I then explained all the things we do: intubation, extubation, bronchoscopies, transports, traumas, codes, rapid responses, pediatrics/NICU, breathing medications/therapies, open heart rapid ventilator weaning … needless to say, that individual walked away with a better understanding of not just Respiratory Care Services but also the enormous effort it takes to care for our community.” The accolades and achievements continue to pour in, from national awards and certifications to implementing different jobs in care units to optimize the patient care experience. “We have earned and continue to maintain the Joint Commission Disease-Specific Certification for COPD,” said Amber Beck. “We are well below national averages for 30-day readmissions, lengths of stay and mortality due to COPD. Sandy, one of our COPD Coordinators, was a recipient of a patient advocacy award from the American Association of Respiratory Care and FACES Foundation.” “We have started implementing Respiratory Care Aides in the critical units, starting with the Cardiac ICU,” added Dia Ramos. “We work as one team and are always helping each other with their tasks.” Education and mentorship are at the core of Renown’s mission to make a genuine difference in the health and well-being of every patient. Nurturing the next generation of medical professionals – including respiratory care professionals – is a task that the Respiratory Care team takes seriously. “It has been great being able to help educate students in different disciplines,” added Pam Umek. “We have been able to offer shadow shifts to students in emergency medical services (EMS), nursing and medical school. These opportunities help students entering the medical field have a better understanding of the many ways we can help care for our respiratory patients.” From the moment of birth to the final stages of life, Renown is fortunate to have a Respiratory Care team that tirelessly ensures every breath counts, safeguarding their role as a trusted partner within our health system. A Tribute to Jason Simpson, Healthcare Hero
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Department Spotlight Community Care Management
When thinking about taking care of your total health, what comes to mind? Perhaps participating in your annual check-ups, taking your prescribed medication, eating a nutritious diet, checking in with your mental health, the list goes on and on. Now, put yourselves in the shoes of someone who may not know where their next meal may come from, someone who may be homebound and not have access to transportation, someone who may be on a fixed income, someone facing homelessness or even someone who may be struggling with substance abuse issues. Getting healthy – and staying healthy – comes with a unique set of obstacles, or social determinants of health, for these patients to overcome. Inequities around social determinants and health behaviors have an outsized impact on patient outcomes, and social and economic factors make up 40 percent of those inequities. This is where the caring and compassionate community health workers, social workers and registered nurses that make up Renown’s Community Care Management (CCM) department rise to the occasion. As the need for resources grows in northern Nevada, these dedicated team members fill those gaps and ensure every patient feels prepared, educated and equipped with everything they need to continue their care journey and live a healthy, fulfilling life. Defying Disparities When our community at risk faces healthcare disparities, it can create complications in each patient’s life that may keep them from addressing their healthcare needs and affect the likelihood of them being admitted or readmitted to the hospital or continuing to struggle with their care management – but not on CCM’s watch. Whenever possible, the CCM team steps in to provide critical resources, education and care journey guidance for any patient that finds themselves in need. “In the simplest terms, we do outpatient case management with vulnerable populations,” said Barb Mader-Scherrer, Director of Community Care Management. “It may be anyone from elderly people who need help managing chronic diseases, to patients experiencing homelessness who are being discharged from the hospital. We work with folks who are facing all sorts of challenges.” Several roles make up the CCM department, including Community Health Workers. These team members are the resource experts, on the front lines of helping educate patients and supporting them as they navigate through the facets of their care. Their main goals? Avoid admissions and readmissions to the hospital and continue to meet their unique goals. “I have the pleasure of working with patients who may need financial help, transportation help or even help utilizing the food pantries in our community," added Steve Arm, Community Health Worker. “We help patients navigate healthcare and social services, address social determinants of health, encourage self-efficiency and provide general health education for many chronic conditions. We also provide home visits for our patients who need extra support.” “The day in the life of a Transitional Community Health Worker is to outreach to the patient while being admitted, do a bedside assessment, complete the social determinants of health evaluation and provide any resources needed to avoid readmission,” added Sherrie Skaggs, Community Health Worker. “Our main population is Medicaid, and many are homeless and financially challenged. As needed, we continue to ensure that follow-up is completed, and all needs and goals are met.” For those learning to cope with their condition and needing hands-on help especially after discharge, the CCM Social Work Care Coordinators take on this complex aspect of the healthcare journey. These individuals provide support and intervention for Renown patients facing a chronic, behavioral health or substance dependency condition to improve their overall quality of life beyond hospital walls, developing a strong framework to build a long-term healthcare plan. “As social work care coordinators, we help connect patients with mental health resources, welfare programs, community support, caregiver burnout resources, placement for loved ones with terminal illnesses and much more,” said Irina Osmolovska, Social Work Care Coordinator. “Requests that come to us run the gamut of homelessness, family crisis, food insecurity and even situations where a patient has no electricity for their life-saving medical equipment. We receive challenging requests and are always ready to go above and beyond to advocate for our patients.” Possessing a profound understanding of the delicate balance between medicine and the patient spirit, the CCM RNs help bridge the gaps between the hospital or primary care practice and post-discharge settings, ensuring a smooth transition for patients as they move from one healthcare setting to another. With their expertise in care coordination and patient education, these RNs help enhance patient outcomes and promote continuity of care. “Our group is responsible for making discharge follow-up calls to patients who have Medicare, as well as scheduling their hospital follow-up visit if needed,” said Vanessa Alford, Consulting RN. “The goal is to have every patient see their primary care physician within 14 days of discharge for continuity of care and to prevent readmissions. We also screen patients for eligibility for Chronic Care Management or Personal Care Management. In addition to setting up the patient for follow up, I review each patient's medications, answer any questions they may have about their medications and health conditions.” As another important part of unpacking the intricate web of social determinants impacting health, CCM RN Care Coordinators have the extraordinary opportunity to extend this department’s compassionate care beyond the boundaries of the traditional in-office environment. Whether it be through virtual connections, heartfelt conversations over the phone or in-person encounters outside the hospital, RN Care Coordinators create holistic and enduring plans of care for individuals facing chronic challenges – including behavioral health issues and chemical dependency struggles – at every stage of life. All in all, the CCM department recognizes the interconnectedness of physical, emotional and social well-being for all patients, fostering a sense of wholeness and empowerment to ensure they continue to meet their goals and live healthier, happier lifestyles. “Our team has a holistic approach to our work,” said Barb Mader-Scherrer. “We look at the whole picture. What are the medical things we can do for this person? What education do they need to help them manage their condition? Do they have food in their house? Do they have a safe living environment? Are there substance abuse issues? Do they need help in managing their medications?” “My 18 years of experience in various areas of hospital nursing and home health have given me the knowledge to serve patients in our community holistically, and I feel good about what I do,” added Vanessa Alford. “I hope that I am able to lessen the load on the medical assistants and providers in the clinics so they can focus on their patients on site.”
Read More About Department Spotlight Community Care Management
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Departamento destacado: Imaging
The imaging department is where scientific precision and patient connection come together in harmony to help diagnose a multitude of conditions. When a mystery needs to be unraveled, experts in X-ray, CT, MRI, ultrasound, echocardiography, mammography and nuclear medicine step in to provide a deeper lens into each patient’s inner workings. At Renown Health, our imaging specialists exemplify this and more. With the inpatient teams at Renown Regional Medical Center and Renown South Meadows Medical Center and many outpatient locations across Reno and Sparks, our dedicated and compassionate imaging and radiology technologists make this symphony of healing a melodious reality. Through the lens of their expertise and the state-of-the-art equipment at their fingertips, the invisible becomes visible, pain transforms into answers and the path to recovery. A Picture Tells a Thousand Words Every patient image tells a story, and Renown’s Imaging department is full of master storytellers. From X-rays that capture the intricate architecture of bones to MRIs that unveil the complex structure of organs, these team members use sophisticated techniques to make sure every patient receives the highest standard of care. Within the imaging landscape, no day looks the same – and each team can expect a different set of challenges to overcome, all while helping providers gain better diagnostic clarity. “Every day in imaging is a little bit different, and I love that,” said Savannah Terrana, Outpatient CT Scan Technologist at Renown X-Ray and Imaging – Vista. “We start like everyone else: getting our rooms stocked and ready for patients and protocoling the day's exams. We have a lot of different types of scans, like x-ray, CT and bone density, and a variety of conditions that we are evaluating for the ordering providers, like fractures, cancer, bleeds and more. “When we get into work, we get a daily assignment that decides whether we are in one of our outpatient or inpatient rooms,” added Ireland Bennett, Echo Technologist at Renown Regional. “Then when we are on inpatients, we get our assignments for whether we are assigned to transesophageal echocardiograms, the cath lab or pediatrics. When we are on outpatients, we get a set schedule for the day with patients every hour from 7:15 a.m. until 4:15 p.m. We do our best to be efficient as possible to not delay any patient care or discharges.” “X-rays aren’t just for bones; we do chest X-rays to look for pneumonia and intestinal issues, and we also do fluoroscopy, which is a live video X-rays while patients drink contrast or while surgeons fix fractures with screws and other hardware in the operating room,” said Amethyst Winters, Inpatient Diagnostics Imaging Lead at Renown South Meadows. “There is a lot of variety, and we provide imaging for patients in the entire hospital.” Equipped with advanced technologies and the unique skills they acquired in a trade program, at the university-level or in the military, the Imaging department can deliver precise and comprehensive information to help providers make accurate diagnoses. And their role transcends beyond the image scanner. “A typical day for an MRI Technologist depends greatly on outpatient or inpatient settings,” said Sean Fryer, Supervisor of Imaging for Renown X-Ray and Imaging – Pringle. “There is a lot of screen time and usually in dark areas, but this is where our technologist skill set comes into play – manipulating parameters to either increase quality by signal/resolution or decrease them a little to gain time." “A day in the life as an ultrasound tech would of course be performing ultrasounds on our patient community, but there is much more to it,” added Mary Rushton, Ultrasound Specialist at the Renown Breast Center. “This includes keeping rooms clean and stocked with supplies, protocoling exams and studying patient history so you can give the best patient care possible, continuing education and training to keep up with new technologies and being an aide to your radiologist. Working with many different personalities, you recognize that you cannot complete every step of the patient care process all by yourself – it requires collaboration from your team to give the ultimate patient care experience." Mary brings up an excellent point about the wide variety of people her team meets every day, on both the patient and employee side, with the common goal of solving diagnostic mysteries. This aspect of their work has become one of the highlights of their career. “Working in imaging allows us to meet many members of our community,” Teresa Shutts, Breast Health Coordinator at Renown X-Ray and Imaging – Pringle. “We are responsible for providing imaging exams, managing patient needs and creating a comfortable and caring environment for people who are possibly going through the worst times of their lives.” Along with every day being different, our Imaging team members thrive in their dynamic and fast-paced work environment, where efficiency and urgency are vital, especially among a constant stream of patients in need of timely diagnoses. “Our days in CT are very fast paced,” said Shelly Lavin, Imaging Lead for Inpatient Diagnostics at Renown Regional. “Our modality is the first choice for assessing stroke and trauma patients. We are fortunate to have very competent tech aides who help work up CT orders by checking orders, IV status and labs. We generally have inpatients scheduled every half hour, and we work these around a very full ER list. When we get extremely busy, we have to strategize how we schedule our patients in the various scanners to expedite exams and not delay patient care.” “We provide patient care for those who come in for emergencies, trauma, inpatient care, surgery and fluoroscopy studies,” added Sean Elliott, Inpatient Radiology Technologist at Renown Regional. “I was always told in school that our main purpose was to help doctors better diagnose patients, and imaging provides many modalities to appropriately diagnose.” Behind-the-scenes, our Imaging surgery schedulers are the keys to ensuring each appointment runs smoothly, communicating directly with patients to get their exams off to a good start. “Every day it is my task to make sure we have everything we need to do the exam that is ordered for a patient,” said Isela Gonzalez, Surgery Scheduler for Renown X-Ray and Imaging – Double R. “This includes the order, authorization approval, completing the protocol, confirming the appointment, re-stating the address and directions, going over any prep for the exam and giving them their estimate cost for the exam. I always do my best to give the patient the best experience possible.” Whether they are in the weeds of radiology or in the depths of patient coordination, Renown’s Imaging department is unmatched – and the direct beneficiaries are their patients.
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Zarah Path from Traveler to OR Nurse
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.”
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Departamento destacado: Finance
Help celebrate the end of tax season by recognizing Renown's Finance team! The financial health of every organization is integral to their mission delivery. A health system like ours is no different – and it comes with many intricacies that require a top-notch finance team. The work of financial professionals in healthcare goes far beyond just balancing the books and ensuring bills are paid on time; their work is instrumental to the sustainability and growth of every organization. The Finance department at Renown Health makes a genuine difference by partnering with every team across our health system to safeguard their financial vitality. From accounting and payroll to financial planning and analysis, this team manages our financial resources effectively to assure we can continue providing the highest quality of care to all patients. Money-Minded The team members in Renown’s robust Finance department run the gamut of financial expertise: Accounts Payable pays all our bills to our vendors. Tax and Treasury handles our business licensing and investments. Accounting records our financial transactions, prepares financial statements and reports transactions to the public and the government. Payroll ensures all our employees are paid for their service. Financial Planning and Analysis focuses on long-range planning and evaluates projects for a positive return on investment. As our in-house finance experts, this team’s workdays are anything but ordinary. Every day – and even every month and season – looks different than the last. On top of it all, these team members know exactly what it means to represent Renown’s cultural commitment to collaboration. “We handle a varied set of tasks daily, weekly, monthly, quarterly and yearly,” said Minty Huynh, Database Administrator for Renown Health. “We could be churning through a planning cycle involving multiple reports and leader meetings, or we could be diving into details about why a specific department has a charge that brings them over budget.” “Given that my role is tied with a lot of other finance and accounting departments, there is a lot of variability in the role on a day-to-day, week-to-week and monthly basis,” added Michaell Poertner, Financial Systems Administrator for Renown. “Regarding cross-functional collaboration, we meet with team leaders to address any issues or concerns they have with process or data, then work to alleviate those concerns. We all work together to ensure we record and account for our businesses within established rules and regulations.” Helping lead our leadership team through financial and strategic goals plays a major part in Renown’s success. Our Finance team has nailed this down to a science. That guidance is driven by two key aspects: data and determination. “Our team performs specific activities around planning and budgeting, financial effectiveness of current operations and planning for the future,” said Deirdre Maurer, Director of Financial Planning and Analysis for Renown. “We analyze data and provide support for our operations teams. Additionally, we manage Axiom, our financial performance management tool used for all our financial activities: capital planning and tracking, budgeting, long-term planning, management reporting and productivity.” The excitement of solving problems and presenting high-quality analyses drives this team to succeed. However, given the complexities of their everyday work, one may believe that they stay siloed in their own areas. The reality is the opposite – these team members appreciate each other immensely and attribute many triumphs to their colleagues. “I get to work on puzzles every day, such as taking capital projects and building a complete package of reports and documentation to support the many assets at Renown,” said Debra Reyes, Accountant for Renown. “I need and appreciate everyone: Accounts Payable for reclassing items, Finance for project funding, leadership for direction and departments across our health system for working with me on serial numbers and in-use information for capital items.” Our entire Finance team is committed to providing the necessary support and guidance to everyone at Renown, ensuring our financial well-being every step of the way. “The finance team supports business partners in managing current and future financial well-being,” said Nancy Perryman, Principal Financial Analyst for Renown. “We are here to help and work with every department that needs it.” Change Agents As an organization, Renown Health went through a significant change in 2022 that helped set us on a positive financial trajectory. Last year, our senior leadership decided to transition from a July 1 to June 30 fiscal year to a calendar fiscal year from Jan. 1 to Dec. 31 to link up with Hometown Health’s fiscal year and the fiscal years of most health systems nationwide. From July 1 to Dec. 31, Renown navigated through a “stub period,” which was an opportunity for our team to build upon and deeply analyze our financial health in preparation for a strong, year-long fiscal year. This transition was accomplished with the dedicated, efficient Finance team, who led Renown through this tough time. In addition, their proactive approach to our calendar year planning during the stub period directly impacted Renown’s margin improvements and financial longevity into 2023 and beyond. “Changing our fiscal year meant that we needed a special audit only a few months after our last audit for the six-month ‘stub’ period between the old and new fiscal years,” said Shanna Entin, CPA, Senior Accountant for Renown. “There are a lot of challenges with a smaller audit, as some are familiar while some are new, but I’m proud to say we knocked that audit out of the water.” Despite this uniquely busy season, none of the Finance department’s additional duties fell by the wayside. They celebrated an expedited five-year plan completion, planning turnarounds and much more, all while guiding Renown through the stub period. “I am proud of this team for finishing our rolling forecasting within two weeks and completing the five-year plan within another couple of weeks,” said Michaell Poertner. “We converted our system to a calendar fiscal year and ensured data integrity was maintained the entire time." “We’ve had many great accomplishments involving expedited planning cycle turnarounds such as our five-year financial plans in two weeks, the calendar year 2022 finances in another two weeks and a fiscal-to-calendar year conversion,” added Minty Huynh. “We are proud of having pulled together to deliver our plans to the board on time.” Who can forget the ramifications of the pandemic? During this trying time, our Finance team supported COVID-19 initiatives to ensure all our care teams had the resources they needed to provide the highest standard of care for our most critical patients. “I am proud that our team was able to support the accounting team with data to reinforce the funding we received for COVID-related expenses,” said Deirdre Maurer. “Our team continues to be here to help any Renown employee, which we are happy to do.” And the successes of our finance change agents keep on coming – full speed ahead. “Simply put, we rock,” said Debra Reyes. “We have been able to record assets with more details than before, such as adding locations, serial numbers and more. We have had great audits because our reporting and eye for detail have been keen. We understand each other’s strengths and weaknesses, becoming friends in the process." Falling in L.O.V.E. with Renown Respect, reputation, relationships – this is the Finance department’s “Renown Why.” Acknowledging Renown’s community impact and giving back to the health system that provided vital support during some of their most daunting times were common themes among this team for why they joined our purple family. “I wanted to give back to the organization that had given me so much,” said Shanna Entin. “In March 2009, the ICU team went above and beyond trying to keep my late husband alive. He was a professional ski patroller caught in an avalanche while doing snow control work in Lake Tahoe. Even though he succumbed to his injuries, I will always be grateful to them for not giving up on him. Some 21 months later, my current husband landed in the same ICU with a flailed chest and various injuries from a skiing accident. The care he received in those nine days healed him enough to continue his care at home.” “I chose to work at Renown because we spent much time at this hospital when I was younger,” added Nancy Perryman. “My sister and I interacted with patients and delivered homemade cards to the elderly, and nurses brought us hot chocolate. Renown felt like home as much as possible when we were here with my father. Then, as an adult, when my father was in his final days, our family surrounded my father, and the amazing Renown staff surrounded us.” “Renown is a well-known name within the Reno area, and I wanted to work with a company with a good reputation and longevity,” added Michaell Poertner. Now, why do they stay? For this department, the answer is simple: their colleagues. Like many other departments at Renown, the encouraging and uplifting team atmosphere inspires them to continue making a difference. It helps them remain dedicated to Renown’s mission and vision. “What keeps me at Renown is the awesome team of professionals I get to call my colleagues,” said Shanna Entin. “We take our jobs seriously. And at the same time, dealing with life is always prioritized over work. So many people are willing and able to jump in to cover you when life throws a curve ball.” The proof “is in the pudding” – many members of this team have a 20+ year-long tenure at Renown, and they remain loyal to this day, excited for the journey ahead of them. “I applied here in 1999 to be an Accounts Payable Clerk at Renown South Meadows while I was wrapping up my courses at Career College of Northern Nevada; I’m thankful I’m still here,” said Debra Reyes. “I have a very interesting history with Renown and have experienced a wide range of things. That’s why I stay – for what lies ahead.” “I chose to work at Renown 20 years ago to make a ‘genuine difference,’ and I like that Renown had and still has a focus on the community and quality healthcare,” added Deirdre Maurer. “I am here today because I enjoy the people, our values and our continued commitment to our patients, community and each other. I am grateful for the opportunity to be part of a great organization.” The gratitude among this team transcends beyond office walls, and they welcome any fellow finance experts to consider joining their department and embracing the future together. “I’m thankful every day, even on the hard days,” closes Debra Reyes.