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

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

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“Safety is Number One,” isn’t just a saying – it's a fact of life, especially at Renown Health. The safety of all patients, visitors, staff and volunteers is always the top priority, and our Security Department takes that commitment seriously. This team is devoted in their efforts to provide a safe environment for all, building cooperative and proactive security processes leveraging crime prevention techniques and state-of-the-art technology. Renown Security sets the safety and well-being bar high, and they continually exceed that standard day in, day out at all of our hospitals and urgent care, primary care and lab locations.  Specially Trained, Continually Present  Our Security Department isn’t staffed with your run-of-the-mill Security Officers; these team members surpass security and safety expectations. Think city and state police-level standards. You read that right – many of Renown’s Security Officers come from Nevada Highway Patrol, the Washoe County and Carson City Sheriff’s Offices, the state probation and parole board and more.   This team fosters specialized training in a collaborative environment. Every member of the security team has extensive training in compassion, empathy and de-escalation techniques to provide the highest levels of safety and security. They implement this training in all their daily duties, whether they are saying a simple ‘hello’ to a patient passing by or preventing harm to a staff member.  Before their shift begins, the team meets to debrief meeting to discuss major incidents that occurred on the previous shift. These meetings ensure the next shift is aware of situations to be on special alert for and individuals to look out for. After, the team members head off to their assignments.  “The day could be as mellow as greeting someone at the welcome table, or it could be as chaotic as de-escalating someone in distress,” said Emmanuel Fernandez-Orozco, Supervisor of Security at Renown Regional. “Regardless of the day, every experience is rewarding in its own way. The only thing that is promised is that every day will be different.”  While every Security Officer has varying experiences, one aspect of their job always stays the same: they are always on alert for any potential safety issue. Even on the “slowest” days, it is important for this team to stay vigilant in order to mitigate any potential risks. There are several security programs that the team uses to keep everyone at Renown safe and secure: Renown's security operations center team (also known as dispatch) monitors all cameras in real time, with security officers patrolling parking areas 24/7.   Security escorts are always available for any employee, patient or guest at every Renown location. Security Officers can escort anyone to their designated site, check surroundings for danger and monitor the person until they safely leave for their next destination.     Rescue officers are available for any Renown location where an employee feels unsafe.  Security maintains a strong relationship with the Reno Police Department (RPD) and assists with reporting and providing information that aids RPD in pursuing and deterring criminal activity.  “In security, we are a counselor, teacher and rule enforcement officer, all rolled into one,” said Bob Stone, Supervisor of Security for Renown Health. Talk about master multitaskers!  Protection is only one part of the job. Through positive and meaningful interactions with guests, patients, community and staff, regardless of where they are posted, the Security Department continually helps Renown achieve its mission of making a difference for the people they serve.  Devoted Dispatch Speaking of multitasking, no one does this better than the Security Dispatch Center. Security Dispatchers are the “eagle eyes in the sky” at Renown, keeping a close watch on everything that happens within every Renown location, as well as REMSA (including Care Flight). From overlooking the many cameras around campus and administering codes over the PA system to manning the radio and phones to ensure Security Officers are dispatched quickly, our dispatch team helps ensure every safety or security issue at Renown is immediately addressed.  When a call comes in, dispatchers like Jessica Fernandez, Security Dispatcher for Renown Health, go through a quick discovery process (sometimes in seconds) to figure out the details of the situation or code and what level of security is needed to assess and de-escalate.   According to Jessica, the ability to prioritize is something she values in her work. “80 percent of our duties are on the phone and the radios, and we are skilled in prioritizing concerns based on the sheer volume of calls we get,” she said.  Jessica and her teammates are proud of the outcomes from their calls. Their attentiveness to every nook and cranny at Renown and their quick response times to make them not only a valued partner to the Security Department but also a necessity to our health system.  Your In-House De-Escalation Experts  Being in a hospital environment is undoubtedly stressful for any patient, and many factors can increase these emotions. The Security Department takes these feelings seriously and never hesitates to take appropriate action to ensure the safety of everyone at Renown. With the unfortunate rise of violence against healthcare workers, especially amid the pandemic, our first-rate security team has been crucial in countering violence with specialized de-escalation techniques.  The key to de-escalating, according to the Security Department, is to put yourself in the shoes of whoever you are working with. As stated by Bob Stone, the team approaches each situation by asking themselves: How would I want to be treated if I was in the same circumstance?  “Being empathetic to their situation and listening to what is going on in their lives is key to re-directing them accordingly,” said Bob. “Applying real-life experience to similar circumstances can make them feel like they are not alone. Educating people on hospital policies can also help them reduce their anxieties and solve the problems.”   Jhorddy Lopez, Security Officer at Renown Regional, approaches each situation with the mindset of knowing that each person’s reactions are different. “Different techniques need to be implemented every time,” said Jhorddy. “You have to use your best judgment call.”  Quick and effective judgment calls are a task that the Security Department has conquered. Rosie Garcia, Security Officer at Renown Regional, knows that using your best judgment means getting both sides of the story. “Whenever I need to step in and de-escalate a situation, I first speak with whoever is attending to the patient and gather information,” said Rosie. “Then, I always get the patient’s side as well. I want to understand how they’re feeling, so both the staff member and the patient can meet in the middle and come up with a collaborative solution.”  An example of the heroism and advanced de-escalation displayed by our Security Officers takes us back to last spring. In the middle of the night, a Care Flight helicopter transporting a patient and their family was about to touch down on the landing pad outside of Renown Regional. Right as the helicopter was about to land, an individual jumped over the safety barricade and onto the landing pad. Alexander Pico, a former Security Officer Lead at Renown Regional (who recently joined the Carson City Sheriff’s Department) immediately communicated with the individual to leave the area. The individual then went under the rear blade, which is the most dangerous part of the helicopter. Knowing that he had to risk his own life at this point to save another, Alexander ran around the back of the helicopter and tackled the individual, preventing catastrophic injury or even death. Steve Perkins now uses this example of a swift judgment call, which was captured on dispatch cameras, as training material for new staff.  Exceptional character, compassion and emotional intelligence are the attributes that every member of the Security Department holds. As noted by Steve Perkins, these attributes “allow for a quick assessment of each situation in order to de-escalate and move towards the best possible solution."  Securing the Job  The Security Department at Renown is actively hiring caring, dedicated team members who are ready to jump in and perform exceptional high-risk healthcare security services for our health system.  “We seek people with the right combination of ability and demeanor,” said Steve Perkins. "The training and skills development we provide result in a high caliber of success.”  Every team member in the Security Department is passionate about the same thing: helping others. And in a healthcare environment, this is important.  “Working a healthcare security job is far different than working any other security job,” said Jhorddy Lopez. “At a hospital, you get the chance to interact with people one-on-one. I get to experience the feeling of, ‘I can make a difference in this person’s life.’”  Any interaction can change the course of a person’s day, and the Security Department embraces this fact. “I really do love helping people so much, whether it be an elderly patient who needs help with their wheelchair or a situation where I need to step in and de-escalate,” said Rosie Garcia.   In order to succeed in this fast-paced department, being a collaborative team member is crucial. “A good coworker is a team player – someone that loves to work in a team atmosphere,” said Emmanuel Fernandez-Orozco.  Jhorddy Lopez reiterates this, adding that “communication and trust are also extremely important. Everyone has to have great communication skills and have each other’s backs.” For people like Bob Stone, having a special connection to Renown inspires him to serve. As someone who experienced two life-saving hospital stays here, he is proud to give back to the organization that gave so much to him. “It was only natural to return to a facility I was familiar with my entire life,” said Bob. “After serving as a paramedic and transporting patients into Renown from Plumas County, I knew I was not done giving back to the community. Renown was the place to do exactly that.”  All Genders Welcome  A common misconception about the security field is that it is strictly a “man’s job.” In Renown’s Security Department, that couldn’t be further from the truth.   As a female Security Officer, Rosie Garcia is a prime example of proving that idea wrong. As a master patroller and de-escalation expert, she ensures everything is running smoothly and that everyone feels safe at all times.  “When I first started here, I knew right away that nobody that works here is biased,” said Rosie. “Everyone is equal, and I am treated as an equal in this department. I know I can do the job as well as any man."  Both Rosie and her counterparts in the Security Department firmly believe that this line of work is for everyone, and they continually lift each other up and support one another.  “No matter your gender, as long as you have confidence and integrity, you will do well,” adds Rosie.  The Bottom Line If you are passionate about creating a secure environment to ensure patients get the care they deserve and employees receive the safety they merit, the Security Department is your team to join.  “I come into work with pride,” said Jhorddy Lopez. “Knowing that I can change someone’s life – that makes me proud to work here.”  “You’re in good hands with us,” closes Steve Perkins.

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

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Visiting a Renown Urgent Care location is an excellent option when you have a non-severe condition, such as a skin rash or sore throat, can't get in to see your primary care provider in a timely manner or if you need an appointment after regular business hours. To learn more about the ins and outs of Urgent Care, we spoke to David Lemak, MD, Division Chief Urgent Care, who let us know some reasons to visit Urgent Care, how to make your visit as efficient as possible, and more. Remember, for a life-threatening emergency, call 911 immediately! Urgent Care is similar to a Primary Care provider Urgent Care providers can do most of the things your Primary Care provider can do, with visits billed the same as an office visit. If you could put the word “severe” in front of your reason for visiting Urgent Care, please go to the emergency department right away For a list of what is an appropriate visit for Urgent Care click here. Also, we recommend that babies 2 months old and younger should go to the Renown Children’s Emergency Department, not Urgent Care.  Renown Health has 10 Urgent Care locations across northern Nevada There are five locations in Reno, two in Sparks, one in Carson City, one in Fernley and one in Fallon. For a complete list of Renown Urgent Care locations, click here.  Many of your Urgent Care needs can be accomplished via a virtual visit, from the comfort of your home or office Conditions Appropriate for a Virtual Visit Included:   - Common cold and cough symptoms - Muscular, tendon or joint pain not cause by injury  - Allergy or sinus symptoms   - Pink eye  - Urinary discomfort  - Backache  - Sexually transmitted illness screening   - Rashes or skin sores - Medication refills (no controlled substances) Some conditions are not appropriate for a virtual visit. They include:  - Chest or abdominal pain   - Shortness of breath  - Traumatic injuries  - Dizziness or confusion   - Bleeding    - High fever   - Persistent vomiting  - Loss of vision   - Substance abuse or psychiatric problems Book ahead for shorter wait times, but remember walk-ins are always available. Click here to make your appointment. This booking page conveniently shows the next available appointment at each location. Typically, mornings and late afternoon (right before dinner time) have the shortest wait times if you plan on walking in.   You will be asked to wait in your car when you arrive at a Renown Urgent Care facility. While you wait (or even before you arrive), patients are encouraged to complete all registration paperwork and co-pay information online.  Urgent Care is great for visits such as back-to-school physicals, camp physicals, commercial motor vehicle exams and more. Sometimes you cannot get in to see your primary care provider to meet the last-minute deadlines for certain school or work-related physicals. Many of these appointments can be completed at Urgent Care; we just recommend you call ahead and confirm that our facility offers what you need.  An Urgent Care provider can virtually order a PCR COVID-19 test.  Whether you have a possible exposure, are not feeling quite like yourself or need a negative test for upcoming travel, a COVID-19 test can be ordered for you. The cost for a visit to Urgent Care is dependent on your benefits, but the visit is billed the same as a standard office visit. If you don’t have insurance, a basic visit to a Renown Urgent Care will cost $125.

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Much like general physical and mental health, sexual health is an essential aspect of your overall well-being. Therefore, educating yourself on your sexual health is an important piece regarding your overall wellness. Secure & Private Virtual Visits Did you know that many sexually transmitted disease appointments can happen virtually, in the privacy of your own home? Our providers can perform a screening examination for sexually transmitted illness (without symptoms) when it’s convenient for you. This is a great option if the topic makes you uncomfortable during an in-person visit, or if you can’t find time to visit your primary care provider or local urgent care. After the telehealth appointment, your provider will determine the  next steps for you. Remember, in-person visits are always an option as well.   Here’s how you can take charge of your sexual health:  Get Comfortable with Getting Tested  Surprisingly, some people with STDs don't show symptoms, meaning they may not even know they have an STD unless they get tested. Even if an STD shows no symptoms, the result of non-treatment can be serious. Bret Michael Bellard, MD, with Renown Medical Group, shares that it’s important for people to get tested for STDs because if left untreated, they can cause the following health problems: Loss of fertility Pregnancy complications Other health issues  When to Visit Your Primary Care Provider  Who should get tested and how often? “The recommendations are that everyone from ages 13 to 64 should get tested at least once for HIV. All sexually active adults should also be tested for other STDs once a year, and all pregnant women should be tested at the start of their pregnancy,” says Dr. Bellard. Some STDs, like syphilis, can be passed from mother to baby, so it's important for women to get tested as soon as they know they’re pregnant.  Dr. Bellard recommends going to your primary care provider for testing. “They can also give advice on prevention and other health topics.” If you don’t have a primary care provider, this is a great reason to get established with one. Women with an established OB/GYN can have STD testing done simultaneously with their annual pelvic exam. The providers in Renown's network care for patients of all ages and specialize in family medicine, internal medicine, pediatrics and OB/GYN.   Practice Safe Sex  STDs are preventable. Practicing safe sex and getting tested routinely are your best defenses against all types of STDs.  For many, the conversation about sexually transmitted diseases is awkward and many avoid it. To lower your risk of contracting an STD, don’t wait until you’re “in the moment” to have the conversation with your partner about the last time you were both last tested. If you haven’t gotten tested in-between new partners, use latex condoms every time you have sex until you are both confirmed negative of STDs. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly.   To establish Primary Care, visit renown.org/virtualvisits or call 775-982-5000

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

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While breastfeeding is natural, it's not always easy. We asked Certified Lactation Counselor Sarah Mitchell for some tips to help make the process easier for mom and baby. From increased infant immunity to improved maternal health and well-being, the benefits of breastfeeding are many. Still, only 60 percent of U.S. moms in the United States continue to breastfeed past their baby's first six months. There are for many reasons for why moms stop, including the mother's their need to return to work. We reached out spoke to Sarah Mitchell, a certified lactation counselor at The Lactation Connection at Renown, for some expert advice. Tip 1 At first, it's normal to expect obstacles. Even in cultures where close to 100 percent of moms breastfeed, they can experience issues, including getting the baby to "latch on," sore nipples, and milk production. In addition, it sometimes can take several weeks for mom and baby to get comfortable. Tip 2 Line up a coach, even before the baby is born. This can be a professional lactation coach, family member, or friend who is experienced and encouraging. While online videos can be helpful, most new moms need the one-on-one guidance that a coach can provide. Renown offers outstanding resources in its Lactation Connection center, including expert consultants, products, and support. Tip 3 Well ahead of the due date, set up a support network of friends, family members, or community groups such as La Leche League. Women historically have relied on extended support systems to help them with raising children, and breastfeeding is one of those areas that, while natural, still needs encouragement from the women who’ve been there. Tip 4 Don’t get discouraged if you need to supplement at times with formula. This, too, as it turns out, is not uncommon in other cultures. In other parts of the world, babies are given beverages and foods such as tea, broth, soup, juice, mashed bananas, and papaya. The American Academy of Pediatrics recommends supplementation only with approved formula -- but the point is, it’s ok to supplement if you need to. Finally, don’t forget the importance of breastfeeding for connecting with your baby. It’s essential to maintain breastfeeding over the weekends, preferably “on-demand,.” and will keep that special bond strong after you have returned to your job.

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

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I am regularly amazed by medical advancements and innovation in the United States. However, even as we make significant progress in many areas of medicine, there is still much more work to be done in others. One such area is patient safety.   What is Patient Safety? When we talk about patient safety, we are discussing how hospitals and healthcare organizations protect patients from errors, injuries and infections. Anyone can make a mistake at work, but in healthcare these mistakes can result in serious outcomes. In 1999, the Institute of Medicine released a report that estimated 98,000 deaths per year result from medical examination or treatment. The most recent study in 2013 suggested these numbers could range from 210,000 to 440,000 deaths per year. Many of these deaths result from preventable medical errors. This is inexcusable and shows how much more work our industry still needs to do to improve patient safety. Making Patient Safety a Priority Patient Safety is our number one priority at Renown Health. We dedicate a lot of time to establishing, reviewing, and revising our processes to prevent errors. Despite the obvious importance of patient safety, this issue is largely left to individual hospitals and health systems to manage. There is a surprising lack of national attention around this truly important issue. However, a silver lining of the COVID-19 pandemic is that it is igniting interest in hygiene and infection prevention. Patients want to learn more about the processes that are in place to prevent the spread of infections. In addition to the many protocols that guide our treatment of injuries and illness, Renown Health has implemented the following measures to prevent the spread of communicable diseases: Requiring everyone entering Renown sites to wear a mask or face covering. Establishing new processes to help patients and visitors practice social distancing. Limiting the number of visitors in our facilities. Screening all employees and patients for symptoms. Enhancing our already-thorough cleaning and disinfection processes. I hope patient safety and infection prevention remain in the national spotlight long after the COVID-19 pandemic has ended. The healthcare industry must come together to develop stronger systems and regulations to minimize preventable medical errors. We have a responsibility to our patients to do better.

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Virtual visits are basically secure, video conferencing visits with your health provider. Of course if you are sick, you want to avoid going outside of your house. With Renown Health’s virtual visit program, you can now see a provider from the comfort of your own home. As we work to keep all of our patients home and healthy, we’re here for any ongoing healthcare needs you have. There are two easy ways to access a virtual visit with Renown Health. If you need an urgent care visit, you can get in line using your MyChart account You can make a virtual visit with some Renown Health providers you see currently Virtual Urgent Care from a Renown Provider By using MyChart, you can now login and request to “Talk to a Doctor.” After filling in some information and confirming your healthcare concern, you will be put into a virtual line. The healthcare team will notify you by text or email when a provider is ready to talk to you virtually. Virtual urgent care visits are available for all ages. Get To Know MyChart Virtual urgent care visits are available for all ages, and can address: Common cold and cough symptoms Muscular, tendon or joint pains not caused by injury Allergy or sinus symptoms Pink eye Urinary discomfort Diarrhea without vomiting Rashes or skin sores Backache Nail problems Screening examination for sexually transmitted illness (without symptoms) Medication refills (not controlled substances) Symptoms for In-Person Urgent Care Visits Shortness of breath Chest pain Abdominal pain Numbness or weakness of any location that is new Traumatic injuries (including eye injuries or something in the eye) Severe pain of any other body location Dizziness or confusion Bleeding from any location High fever (greater than 102 degrees for all ages) Persistent vomiting Loss of vision Ear pain Substance abuse or psychiatric problems Virtual visits are open 9 a.m. through 6 p.m. Monday-Friday and 10 a.m. to 4 p.m. Saturday and Sunday for Nevada residents. Renown Provider Virtual Visits Many primary and specialty care appointments for adults and children are now available virtually. If you have a provider with Renown Medical Group, call 775-982-5000 to see if you can have a virtual appointment from the comfort of your home. MyChart Assistance If you need assistance with your MyChart account, please call 775-982-6686. For all other questions about scheduling and appointments, please call 775-982-5000.

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

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