Vol. 24 No. 28 www.bethesda.med.navy.mil July 12, 2012

By Bernard S. LittleWRNMMC Journal staff writer

Walter Reed Bethesda deployed oneof its two new mobile shelter systemsrecently to Adelphi, Md., as part oftraining for the medical center's con-tinuous readiness and emergency pre-paredness mission.

The medical center recently ac-quired the shelters, capable of deploy-ment to respond to contingencies andemergencies, as part of its BethesdaHospitals’ Emergency PreparednessPartnership (BHEPP) initiative, ex-plained Christopher Gillette, servicechief of Emergency Management (EM)atWalter Reed National Military Med-ical Center (WRNMMC).

The BHEPP was established follow-ing 9/11 based on a need for coordinat-ed collaboration in response to man-made or natural disasters,according toGillette. The partnership includes thefour major health care institutions inBethesda -- WRNMMC, National In-stitutes of Health Clinical Center,Sub-urban Hospital and National Libraryof Medicine – all located within a cou-ple of miles of each other.He added theinstitutions recognized the advantages

and importance of working togetherand established the emergency pre-paredness partnership,which includesshared resources such as the mobileresponse shelters to enhance surge ca-pacity expansion capabilities.

“Surge capacity is a limited capabil-ity throughout the region,” addedMelissa Knapp, program manager forEM Plans, Training and Exercises atWalter Reed Bethesda. “The sheltersare multi-purpose facilities that areprimarily designed for minimal careand medical surgical overflow; howev-er, they can also be used for initial ca-sualty receipt, treatment, and stabi-lization of patients.They are a tremen-dous asset for the hospital.”

With the two new mobile responseshelters, WRNMMC now has fourshelters, all housed on base and capa-ble of deployment within hours,Knappsaid.

“Overall, the new shelters offer amore efficient system and deployment[than the two older shelters],” Knappexplained. “There are fewer parts andpieces because lighting and electricaloutlets are integrated. Inflation time isfaster and there is less manual laborto inflate the [newer] shelters. This

saves time on the physical setup of theshelters. The new system also has anintegrated oxygen distribution systemand removable patient privacyscreens.”

Between the new and old shelters,Knapp said the systems are capable ofproviding up to 100 additional beds aspart of the BHEPP surge capacity ex-pansion.

The new, 25-bed multi-purpose fa-cility recently deployed to the ArmyResearch Lab in Adelphi gave EMstaff the opportunity to familiarizethemselves with the system’s set-upand capabilities, Gillette said.Also on-site was the medical center's incidentcommand vehicle (ICV), capable ofproviding mobile communication aswell as command and control supportfor deployed military treatment facili-ty resources.

Mark Miller, hospital decontamina-tion program manager, explained thenew mobile response shelter can befully deployed within five to six hoursby less than 20 people. He said thenew shelter is transported to a de-ployment site in three trailers. One

Walter Reed Bethesda Deploys New Mobile Shelter System

photo by Bernard S. Little

Mark Miller, Walter Reed Na-tional Military Medical Center(WRNMMC) decontaminationprogram manager, explains toemergency management staff ca-pabilities of the new mobile shel-ter system. See SHELTER page 8

By Mass CommunicationSpecialist 2nd Class

John K. HamiltonNSAB Public Affairs

staff writer

Residents in the Washington,D.C. area recently “weathered”what has been determined as aderecho (pronounced deh-REY-cho)storm, which left millions across theMidwest and mid-Atlantic withoutpower for days at a time. Meteorol-ogists blamed the violent weatheron the prolonged 100-plus tempera-tures last week.

“It was a total surprise. I’ve neverseen a storm like that,” said Ol-ubunmi Yinka-Jaiye, Naval SupportActivity Bethesda’s (NSAB) Man-agement Analyst. “Usually whenstorms pass in my neighborhood the

power will go out for a couple ofhours - we weren’t expecting it to goout for five days.”

A derecho is a widespread, long-lived wind storm that is associatedwith a band of rapidly moving thun-derstorms, intense lightning andhurricane-force gusts. In Spanishthe word “derecho” means“straight.” Although it can producedestruction similar to that of torna-does, the damage typically occursin one direction along a relativelystraight path.

“The major difference betweenthe storm that affected our areaand a hurricane is the time we hadto mobilize and respond to the ef-fects of the storm,” said LarryFrady, NSAB deputy emergencymanager.

'Derecho'Catches Many by Surprise

Courtesy photoSee DERECHO page 5

2 Thursday, July 12, 2012 The Journal

Published by offset every Thurs-day by Comprint Military Publica-tions, 9030 Comprint Court,Gaithersburg, Md. 20877, a pri-vate firm in no way connectedwith the U.S. Navy, under exclu-sive written contract with theWalter Reed National MilitaryMedical Center, Bethesda, Md. Thiscommercial enterprise newspaper is anauthorized publication for members of the mil-itary services. Contents of The Journal are notnecessarily the official views of, nor endorsedby, the U.S. Government, the Department ofDefense, or the Department of Navy. The ap-pearance of advertising in this publication, in-cluding inserts or supplements, does not con-stitute endorsement by the Department of De-fense or Comprint, Inc., of the products orservices advertised. Everything advertised inthis publication shall be made available forpurchase, use or patronage without regard to

race, color, religion, sex, nationalorigin, age, marital status, phys-ical handicap, political affiliation,or any other non-merit factor ofthe purchaser, user, or patron.Editorial content is edited, pre-pared and provided by the

Public Affairs Office, WalterReed National Military Medical

Center, Bethesda, Md. News copyshould be submitted to the Public Affairs Of-fice, Bldg. 1, 11th Floor, by noon one weekpreceding the desired publication date.News items are welcomed from all WRN-MMC complex sources. Inquiries aboutnews copy will be answered by calling (301)295-1803. Commercial advertising shouldbe placed with the publisher by telephoning(301) 921-2800. Publisher’s advertising of-fices are located at 9030 Comprint Court,Gaithersburg, Md. 20877. Classified adscan be placed by calling (301) 670-1700.

Naval Support Activity (NSA) Bethesda

Commanding Officer: Capt. Frederick (Fritz) Kass

Public Affairs Officer NSAB: Joseph MacriPublic Affairs Office NSAB: (301) 295-1803

Journal StaffStaff Writers MC2 John Hamilton

MC3 Nathan PardeSarah MarshallSharon Renee TaylorCat DeBinderKatie BradleyHelen Hocknell

Managing Editor MC1 Ardelle Purcell

NSAB Editor MCSN Dion DawsonWRNMMC Editor Bernard Little

Walter Reed National Military Medical CenterOffice of Media Relations (301) 295-5727

Fleet And Family Support Center (301) 319-4087

WRNMMC OmbudsmanJulie Bondar (443) 854-5167

NSAB OmbudsmanJojo Lim Hector (703) 901-6730

Visit us on Facebook:Naval Support Activity Bethesda page:https://www.facebook.com/NSABethesda

Walter Reed National Medical Center page:http://www.facebook.com/pages/Walter-Reed-National-Military-Medical-Center/295857217111107

Financial CounselingFree financial coaching for all service mem-

bers, federal employees, contractors, and fami-ly member is available at the Fleet and FamilySupport Center (FFSC) in Building 11. Help isavailable to analyze your credit report or cred-it scores; discuss retirement (Thrift SavingsPlan) options; create a budget, and more. Also,check out the following upcoming free finan-cial classes: Retirement Planning on July 18from 10 to 11:30 a.m. in Building 11, Room 8;Purchasing a New or Used Car on July 18from 10 to 11:30 a.m. in Building 11, Room 18;and Do You Want to be a Millionaire on July24-25 from 8 a.m. to 4 p.m. each day inBuilding 11, classroom 159. For more informa-tion or to register for any of the workshops,call the FFSC (301) 319-4087, or e-mailffsc@med.navy.mil.

Social Security Administration SupportSocial Security Administration (SSA) repre-

sentatives are available to assist all servicemembers with disability applications everyTuesday from 9:30 a.m. to 1:30 p.m. inTranquility Hall on the second floor of theSoldier and Family Assistance Center. Formore information, call Lisa Ramdass at (301)400-0208.

Education Services WorkshopsThe Fleet and Family Support Center

(FFSC) in Building 11 is hosting upcomingworkshops in July and August including:Maintaining Healthy Relationships on July 18from 10 to 11:30 a.m. in classroom 158;Assertive Communication on Aug. 2 from 10 to11:30 a.m. in classroom 158; and How to De-Junk Your Life on Aug. 9 from 10 to 11:30 a.m.in classroom 111. The workshops are open toall military members, retirees, Guards,Reservists, their spouses, Department ofDefense civilians and contractors. To register,call the FFSC at (301) 319-4087, or e-mailffsc@med.navy.mil using the respective sub-ject line: relationship, communication and de-junk life.

Bethesda NotebookBethesda NotebookCommander’s ColumnCommander’s ColumnSeveral destructive

storms recently sweptthrough our region, down-ing trees and power lines,leaving thousands with-out electricity for days onend. Fortunately, thanksto the dedicated staff,which for some it meantforging their way throughunimaginable conditionsto ensure patient carehere at Walter ReedBethesda was not impacted, and for thatI am forever grateful.

With this year’s hurricane season ex-pected to end Nov. 30 and predicted to bea 50% near-normal season for our regionby the National Oceanic and Atmospher-ic Administration (NOAA), according toNOAA, it is a general guide and doesn’tmean hurricane disasters can’t occur if aseason is relatively quiet. So, I urge youto please take the following precautionsto continue to keep you and your familysafe and to ensure uninterrupted patientcare during this often unpredictable timeof year.

Within your workplace, be sureyou’ve designated emergency personnel,and communicate with one anotherthrough a consistently updated emer-gency recall roster. In addition, to en-sure personnel can be accounted for,please continue to update the PersonnelAccountability Systems, required by theServices, the Air Force Personnel Ac-countability and Assessment System(AFPAAS), the Army Disaster Person-nel Accountability System (ADPAA),and the Navy Family Accountabilityand Assessment System (NFAAS).Marines should continue reporting totheir unit’s Marine On-Line (MOL) sys-tem to track their accountability.

When it comes to protecting your fam-ily and home against storm damage, fol-lowing a few simple measures and imple-menting lessons learned from paststorms could make all the difference.First off, when you become aware of astorm tracking through your area, please

check your yard for poten-tial items that may causedamage. This might meansecuring any objects suchas outdoor furniture, trashcans or hanging plants thatcould be picked up by thewind. Also, prior to stormseason, one might benefitfrom removing diseasedlimbs from trees to makethem more wind resistant.

During a storm, havinga sufficient supply of bottled water, non-perishable items and prescription med-ications on hand, as well as a manual canopener, flashlight, a radio with plenty ofextra working batteries, and a first aidkit is also recommended. As witnessedby the past storm, it also may be a goodidea to keep at least a half a tank a gasin your car and a fair amount of cash onhand in the event that gas stations andbanks are closed.

Regardless of where you are when astorm hits, pay attention to the news, lis-ten for announcements from officials andbe ready to act quickly. I also urge youto ensure our most vulnerable popula-tion, the elderly and children, are out ofharm’s way.

After the storm has ended, use cautionwhen assessing your area, stay tuned forupdates as to the impact a storm mighthave had on your community and WalterReed Bethesda’s operating status andensure any food that may have perishedis handled properly. Also, if you have ex-perienced damage from a storm, contactyour insurance company to find out ifyou can be compensated.

As always, please remember to keepsafety at the forefront – not only duringthis stormy and unpredictable season,but year-round. What you do matters!!!We can’t fulfill our mission without you.

Commander sendsRear Adm. Alton L. StocksMC, USNWalter Reed NationalMilitary Medical Center

The Journal Thursday, July 12, 2012 3Thursday, July 12, 2012 3

By Sharon Renee Taylor andDavid Dickinson

staff writers

The sound of steel drums filled theair of the America Building Atrium atWalter Reed National Military MedicalCenter in celebration of Caribbean-American Heritage Month recently.

The festivities included a perform-ance by Caribbean American Interna-tional Steel Orchestra, a limbo contestand Caribbean food samples includingfried plantains, red beans and rice,meat patties and jerk chicken.

Army Staff Sgt. Tamar Bains, thenoncommissioned officer-in-charge ofthe Sterile Processing Department,demonstrated her skills in the limbocontest..The Queens,N.Y.,native spokeof her family's island roots in theCaribbean country of Haiti. She ex-plained why she participated in themedical center's celebration.

"I've always supported equal oppor-tunity events but also because I'mCaribbean-American," Bains said. Ac-cording to the Soldier, it's important tomark different cultural observances atWalter Reed Bethesda. "I think it's im-portant foreverybodyassigned [here] tosee different aspects of the groups thatwork [here], that live [here] to see howeveryone contributes," she said.

With 16 years in the Army, Bainssaid the June 29 event was the firstCaribbean-American celebration she'sseen at a military facility and was curi-ous to see how it would turn out. TheSoldier said she really enjoyed the fes-tivities and learned some new factsabout her heritage after she viewed aposter board displaying famousCaribbean-Americans.

Bains was surprised to learn thatshe shared her Haitian roots with

Americansociologist,historianandcivilrights activist W.E.B. Du Bois.

"I enjoyed how people were lookingat the photographs of individuals theyrecognized but were not aware thatthey were Caribbean-American. Theywere able to identify that," Bains said.

That's the purpose of festivities suchas the Caribbean-American HeritageEvent, explained Sgt. 1st Class JasonZielske,chair of the Bethesda Multicul-tural Committee.

"The Bethesda Multicultural Com-mittee is committed to providing ed-ucational and awareness opportuni-

ties to all personnel on NSA Bethes-da, in regards to cultural diversity,"Zielske said.

"The Caribbean-American HeritageMonth,along with all of our observanc-es, is designed to provide informationthat otherwise might not be readilyavailable."

The Soldier said Caribbean-Ameri-cans have contributed to the welfare ofour nation and have provided a valuedaddition to our national heritage as awhole.President Barack Obama signeda June 1 proclamation designating themonth of June as National Caribbean-

American Heritage Month."Individuals and families from

Caribbean countries have journeyed toAmerica's shores for centuries," readthe proclamation, which explainedsome were brought against their will inthe bonds of slavery, immigrated aschildren,or came as adults in pursuit ofa better life. "We celebrate their richnarratives and recognize their immeas-urable contributions to our country," itcontinued.

The president wrote that CaribbeanAmericans have shaped every aspect ofour society, "Enhancing our arts andhumanities as titans of music and lit-erature, spurring our economy as in-trepid entrepreneurs, making new dis-coveries as scientists and engineers,serving as staunch advocates for socialand political change,and defending ourideals at home and abroad as leaders inour military."

Noted Caribbean-Americans includeretired Army Gen. Colin Powell, of Ja-maican heritage.The four-star generalis the 65th United States Secretary ofState and served as Chairman of theJoint Chiefs of Staff from 2001 - 2005.Current U.S. Attorney General EricHolder hails Caribbean roots in Barba-dos. Holder is the first African Ameri-can to hold the position.

Other famous Caribbean-Americansinclude fashion designer Oscar de laRenta who was born in the DominicanRepublican, as well as rapper, singerand songwriter Nicki Minaj,a native ofTrinidad andTobago,along withAcad-emy award-winning actor Sidney Poiti-er who grew up in The Bahamas.

For more information about activi-ties and events sponsored by theBethesda Multicultural Committee,call Sgt.1st Class Jason Zielske at (301)400-2847.

WRNMMC Celebrates Caribbean-American Heritage Month

Photo by Sharon Renee Taylor

Army Staff Sgt.Tamar Bains,noncommissioned Officer-in-charge ofthe Sterile Processing Department shows skill in the limbo contest.The Queens, N.Y. native shares island roots in the Caribbean coun-try of Haiti.The limbo contest was a part of the Caribbean Ameri-can Heritage Event held in the America Building atrium at WalterReed National Military Medical Center recently.The festivities in-cluded a performance by Caribbean American International SteelOrchestra and Caribbean food samples including fried plantains,redbeans and rice, meat patties and jerk chicken along with punch.

By Bob Goldberg,RD, CDE, CSSD

Nutrition Services Department

Numerous world-class athletes havesponsorship deals with sports drinkcompanies whose products claim to in-crease athletic performance, but aresuch claims true? Will you be faster,stronger, have more endurance and beable to perform like a top-ranked ath-lete if you drink a sports drink?

Before we get to the answer,let's lookat the main ingredients of these drinks.Sports drinks typically contain a cer-tain amount of carbohydrates (usually5 to 10 percent) and some sodium andpotassium. The carbohydrates provideenergy while the sodium and potassi-um are there to help replace sweat elec-trolyte losses. Sodiumhastheaddition-al benefit of stimulating thirst whichcan help prevent dehydration.

According to the American College

of Sports Medicine's Position Stand onExercise and Fluid Replacement, con-suming carbohydrate can be beneficialto sustain exercise intensity duringhigh intensity exercise of 60-plus min-utes.This is also true for lower intensi-ty exercise events sustained for longerperiods. That being said, if you are ex-ercising at a low to moderate intensitylevel for less than 60 minutes, youprobably are not going to see any per-formance benefits from drinking asport beverage unless you are dehy-drated before you start exercising.

If you are exercising for longer than60 minutes, the general recommenda-tion is that for every hour of continuousexercise, individuals should consume30 to 60 grams of carbohydrate in orderto sustain exercise performance. Keepin mind the carbohydrates do not nec-essarily need to come from beverages.Other non-fluid sources could be in theform of gels, energy bars, and other

foods. But if the carbohydrates are con-sumed in the form of a beverage, theliquid can help keep you hydrated.

Hydration is another important top-ic to keep in mind when it comes toathletic performance. Being dehydrat-ed can significantly affect aerobic exer-cise performance,particularly in warmand hot weather. The general recom-mendations for fluid intake with exer-cise are to consume 12 to 20 ounces ofwater or sports drink two to threehours before a workout, and six to 12ounces for every 15 to 30 minutes of ex-ercise. In general, your pre-workoutweight should be the same as yourpost-workout weight. If you are signif-icantly lighter after a workout due tosweat losses, a simple guideline is toconsume 16 to 24 ounces of fluid forevery pound lost.

If you are doing cardiovascular ex-ercise for 60-plus minutes, try to con-sume 0.45 to 0.7 grams of carbohy-

drate/pound body weight within 30minutes along with seven to 10 gramsof protein after your workout becausethis can increase glycogen (stored car-bohydrate) storage, stimulate musclerepair, and decrease recovery time.

So, to answer the initial question ofif you drink a sports drink will you befaster, stronger, or have more en-durance? It really depends on the type,length and intensity of the exercise.Sports drinks have not been shown tobe particularly helpful for anaerobic ac-tivities like strength training, but forlonger (60-plus minutes),higher inten-sity cardiovascular exercise,most likelythe sports drink will help you havemore endurance. For shorter (less than60 minutes), lower intensity exercise,sports drinks will probably have no im-pact on your performance. For thoseexercise sessions, you'd be completelyOK drinking good old fashioned water.

Sports Drinks - Do You Really Need Them?

4 Thursday, July 12, 2012 The Journal

By Sarah MarshallJournal staff writer

With a continued focus on patientand family-centered care since Wal-ter Reed Bethesda opened its doorslast fall, the Peripherally InsertedCentral Catheters (PICC) Service isgaining momentum educating staffabout its specialized services.

The PICC Service is made up ofan Army nurse, a Navy corpsman,and two civilian nurses, who are re-sponsible for inserting PICC linesfor all in- and out-patients in allclinics and wards, according toArmy 1st Lt. Amanda Langley, theteam’s service chief.

“We support the entire hospital,adults, pediatrics, [and] woundedwarriors,” Langley said.

A PICC line is a long, thincatheter inserted into the peripher-al veins of an individual’s upperarms. These pathways travel tolarger vessels that lead into theheart, allowing better dissemina-tion for certain medications, such aschemotherapy, antibiotics, or nutri-tion, she explained. This may alsobe used to prevent interaction withother medications, especially whena patient is on multiple medica-tions.

“It’s more long-term than a regu-lar IV,” said Elvie Castro, a memberof the PICC Service.

The PICC line can remain insert-ed for up to a year; therefore, an ul-trasound is used to help guide theline into place to ensure it’s insert-ed properly, Castro said. Followingthe two to three hour long proce-dure, which involves patient consul-tation, the actual insertion, place-

ment verification and documenta-tion, patients may return homewith the PICC line.

To become a PICC nurse, an indi-vidual must first become a regis-tered nurse, and then completecompetency in PICC line insertion,Castro continued. At Walter ReedBethesda, the PICC Service alsoruns its own accredited PICC inser-tion course for both registered nurs-es and doctors. Castro went on tonote that when she first beganPICC line nursing in the early1980s, interventional radiology wasused to insert PICC lines. Over theyears, technology evolved, allowingnurses to insert PICC lines usingan ultrasound at the patient’s bed-side, which proved more conven-ient, economical and less time-con-suming.

In 2004, Castro began working atWalter Reed Army Medical Center(WRAMC). She was later joined in2006 by her colleague, Tony Ju-rlano, who had previously workedin interventional radiology. At thetime, the former National NavalMedical Center (NNMC) had aPICC line nurse, and upon integra-tion between the medical centerslast fall, the PICC nurses came to-gether and formed the PICC Serv-ice. They’ve since added a techni-cian, Hospital Corpsman 3rd ClassMark Drewiske, who brought hisexperience in handling supplies.Now, the team hopes to continue ex-panding their team, as they staybusy inserting an average of aboutfive PICC lines each day, Langleysaid.

In addition to helping patients

PICC Team SupportsPatients, Educates Staff

See PICC page 6

photo by Sarah Marshall

The PICC Service Team, from left to right:Tony Jurlano,Army 1stLt.Amanda Langley,Elvie Castro,and Hospital Corpsmen 3rd ClassMark Drewiske.

Women's Memorial Trip

photo by Helen Hocknell

TheWomen's Leadership Group atWalter Reed National Mil-itary Medical Center recently visited the Women's Memorialin Arlington,Va.The group was formed earlier this year to fos-ter education,career development,networking and mentoringopportunities for female service members.For more informa-tion about the group's monthly meeting, contact Chief Hospi-tal CorpsmanTimika Figgs at timika.figgs@med.navy.mil.

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The Journal Thursday, July 12, 2012 5

“Typically, a hurricane that formsoff the coast gives us three to fivedays of tracking which allows pre-staging of recovery assets before itimpacts our area. The derecho thatimpacted our area on the otherhand only gave us hours of time totrack before it hit, which didn’t al-low us to stage recovery assets.However, with the few hours’ noticewe did have, we were able to antic-ipate the impact of the storm, alertthe public to the potential damagesand potentially mitigate some ofthe effects of the storm.”

According to National Oceanicand Atmospheric Administration,the storm stretched over more than600 miles and had winds in excessof 60 miles per hour. Despite top-pling power lines, downed treesand branches, NSAB sustained lit-tle damage in comparison to nearbyneighborhoods.

“NSA Bethesda weathered thestorm very well,” said CommandingOfficer Capt. Frederick Kass. “I wasextremely pleased with the team-work I witnessed in the cleanup ef-forts after the storm, especially

considering everyone keepingNSAB up and running were alsopersonally affected by it,” he said.

Master-At-Arms 1st Class DetraWorks, leading petty officer of secu-rity department for NSAB andcommand duty officer (CDO) on theday after the storm, said thecleanup crews were quick and effi-cient at removing the debris.

“When I came on for CDO Satur-day morning, the off going CDOand I did a tour of the installationto see what damage was caused tothe base,” said Works. “We had atree blocking the intersection be-hind Building 14 and some treesdown along the fence line on theperimeter. We had a lot of bushesand branches in the roads but oncewe contacted the landscaping crewfor the installation, they started toprioritize what needed to be doneso that the base was able to func-tion immediately,” she added.

For those off base and hit hard-est by the storm, a lack of powercaused many to wonder how muchof their stored food could be sal-vaged.

According to the Department ofAgriculture, if in doubt, throw itout. "Food left in the refrigerator issafe if the power has been off for nomore than four hours. After that,

discard perishables such as meat,poultry, soft cheese, eggs and left-overs. A full freezer can keep foodfrozen for 48 hours after a loss ofpower and a half full freezer cankeep food frozen for 24 hours.”

More common in the Midwest,the mid-Atlantic region gets onederecho about every four years.

“Preparing early is key to weath-ering a storm and its effects. Themost important thing a person cando to stay prepared for any type of

severe weather is to maintain anemergency kit,” said Frady. “Youremergency supply kit should in-clude items like non-perishablefood, water, a battery-powered orhand-crank radio, extra flashlightsand batteries.”

For more information on how toweather a storm or how to preparean emergency kit, visitwww.ready.gov.

DERECHODERECHOContinued from 1

Thursday, July 12, 2012 5

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6 Thursday, July 12, 2012 The Journal6 Thursday, July 12, 2012

and following up with pa-tients after their PICC lineis inserted, Langley saidthe team educates andtrains clinical staff on PICCcare and maintenance. “Wedo quarterly in-services forall the inpatient wards.”

The team also runs aclass in the Staff Educationand Training (SEAT) Simu-lation Center, teaching nurs-es how to use ultrasound toinsert PICC lines as well asregular IVs, and its membersregularly attend nationalconventions and conferences,giving presentations abouttheir services, Langley said.

Patient and family-cen-tered care also plays a largepart in their efforts, she con-tinued. Having the patientand their family involved incare helps alleviate theiranxiety and stress, she said.When inserting a PICC line,

the patient’s family memberscan stand at their side, hold-ing their hand and offer sup-port, she added.

Drewiske, responsible forthe team’s supplies, logisticsand patient care, said whathe likes most about his job isthe interaction with patients.He takes pride in knowingthat he’s making a contribu-tion to their care. “I enjoycoming to work every day,”he said.

Jurlano agreed. It’s re-warding to help patients intheir recovery process, hesaid, and “They’re so thank-ful.”

Castro and Langleyshared the same sentiments.

“We enjoy knowing we area part of a team that con-tributes to the healing of thepatients,” Castro said.

“We have come far since[integration] in August andreally come together as ateam to provide our woundedwarriors and beneficiariesthe best care possible,” Lan-gley said.

PICCPICCContinued from 4

Story by PatrickFoughty

Commander, NavyInstallations

Command PublicAffairs

WASHINGTON (NNS) --When Chief Aviation Ma-chinist's Mate AnthonyHughes received news in No-vember 2011 that he was onthe Enlisted Retention Board(ERB) list, he felt like his lifewas over.

“I remember my CO (com-manding officer) sitting medown and saying ‘Chief, I'vegot some bad news,’ and I im-mediately knew what wascoming,” said Hughes.

His commanding officer in-formed him of his selection forERB, which angered him.

"I felt like I had honored mypart of the bargain, and theNavy had just backed out onthe deal," said Hughes.

Instead of giving up or feel-ing sorry for himself, Hughessaid he quickly accepted thenews and started looking to-ward the future.

"I literally knew exactlywhat I had to do at that verymoment; from that day on myonly mission was to get myfamily back home, so I couldget a new job ASAP."

Hughes was one of 2,946Sailors chosen for separationby the ERB in late 2011, all of

whom were from a list of ap-proximately 16,000 recordsthe board reviewed to help re-duce manning and meet quo-tas in various rates across thefleet. With record high reten-tion and low attrition amongactive duty Sailors, the Navybecame overmanned bygreater than 103 percent in 31of 84 ratings, resulting in in-creased competition and re-duced advancement opportu-nities for strong-performingSailors to reenlist.

The ERB was introducedto allow the Navy to achievestability and fit across theforce while retaining balancebased on seniority, skills, andexperience.

Chief of Naval OperationsAdm. Jonathan Greenert ex-plained in his official blogthat, "ERB reduces overallmanpower by reducing thenumber of Sailors in over-manned ratings through con-versions and separations."

Navy leadership realizedhowever, that while the ERBwas fair and necessary for theneeds of the Navy, it also leftSailors with questions andconcerns for their future.

"The ERB and follow-ontransition process have myfull attention," wrote Green-ert. "We are putting great ef-forts to ensure the ERBprocess is being conductedprofessionally and fairly.More

importantly,we look to ensurethat the means for transitionis clear, broadly applied, openand readily available."

For Hughes, that messagecouldn't have been clearer.

"I knew I couldn't messaround," he said. "With a wifeand two small kids, I havemouths to feed and bills topay. There was no way I wasgoing to let this situation messup my family and our way oflife, and as it turned out, nei-ther was the Navy."

Soon after Hughes receivedthe news, a representativefrom Challenger, Gray andChristmas (CGC), a firm con-tracted by the Navy to provideextensive transition servicesfor ERB Sailors, reached outto him and began workingwith him on his life after ac-tive duty.

"One thing that I reallyneeded to work on was my re-sume, I was taking action onall other areas of my life, frommy move to my out process-ing, but my resume neededwork,and the folks at CGC re-ally helped with it."

Hughes said he was veryimpressed with the compre-hensive resume services of-fered by CGC.

"I felt like I was talkingwith someone that had beenthrough the transitionprocess, was in a similar posi-tion in the service when they

were active duty,so they knewliterally all the aspects of cre-ating a resume for me," hesaid. "In the end my futureemployer told me my resumewas excellent, and a key rea-son I got the job."

CGC is an employmentplacement firm that was con-tracted to "continue to buildon the job skills, success andtraining acquired duringSailors' careers and succeedin the civilian job market,"said Rick Trimmer, a contractmanager for Commander,Navy Installations Com-mand, who manages CGC'scontract. "We (the Navy) haveasked them to reach out toeach ERB Sailor and offer asmuch assistance in their em-ployment transition as possi-ble, from resume writing tohelp finding employers thatneed Sailors with their specif-ic skill sets."

Hughes explained thatCGC worked in a partnershipwith other firms and assignedhim a personal coach to helpwith his transition.

"The coach I had, Dennis,offered to take my phone callswith questions or concerns atany time, he even gave me hispersonal cell phone number. Iknew he was doing everythinghe could to help me find a job,"he said.

Hughes reiterated thatwhile CGC was a great help,

they couldn't do all the work."A lot of this is self motiva-

tion," he said. "Sure, they'llhelp you, but you need to takeinitiative and work with themtoo. For instance they couldonly give me a draft for the re-sume; I had to fill out my in-formation before their editorscould make it presentable."

CGC is also contracted toassist with actual job searchhelp by providing employ-ment resources to Sailorsand even practice inter-views and salary negotia-tion techniques.

"I was overwhelmed withall they were offering, luckily,with my networking efforts Iwas fortunate enough to meetmy future employer here onNSA Crane, so I didn't reallyneed the full complement ofCGC's services," Hughes ex-plained.

In the end,Hughes' setbackturned out to be a road to anew a bright future, noted hiswife Nikki Hughes.

"The main 'stressor' withgetting out of the Navy isclearly the job search," saidNikki Hughes. "But I mustsay, within the blink of aneye Anthony had a job of-fer...with the ERB resources(CGC) plus my husband'snatural abilities to takecharge of the situation, we

Transition Benefits: Life After Enlisted Retention Board

See ERB page 8

Army's Top NCO Visits Walter Reed Bethesda

photo by Bernard S. Little

Sgt. Maj. of the Army Raymond Chandler III (third from left) and his wifeJeanne speak with 1st Sgt.Gary McKinney ofWalter Reed National MilitaryMedical Center (WRNMMC) in Building 10 during Chandler's visit toWalterReed Bethesda recently. Chandler visited with wounded warriors and theirfamilies while at WRNMMC.

The Journal Thursday, July 12, 2012 7Thursday, July 12, 2012 7

By Sarah MarshallWRNMMC Journal

staff writer

Following a rigorous eval-uation process, Walter ReedBethesda’s Sleep Lab recent-ly demonstrated its dedica-tion to quality patient care,achieving accreditation bythe American Academy ofSleep Medicine (AASM).

The AASM has accreditedsleep facilities since 1977,and though accreditation ofsleep disorder centers is vol-untary, it demonstrates a“commitment to the provisionof quality diagnostic servic-es,” according to the organiza-tion’s website. AASM’s re-quirements are the “goldstandard” by which the med-ical community and publicuphold sleep medicine servic-es, the website states.

“It’s reassurance that weare doing the right things forour patients and at a veryhigh standard,” said Maj.Aaron Holley, Pulmonary/

Sleep and Critical Care Med-icine assistant program direc-tor at Walter Reed Bethesda.“It gives us that validation,and I think it’s great to beable to tell our patients that.”

In a recent e-mail to staff,Walter Reed Bethesda Com-mander, Rear Adm. AltonStocks, praised the Sleep Labfor their achievement.

“Your dedication and hardwork to keep us the Nation’sMedical Center is critical andmuch appreciated,” Stocksstated.

The five-year accredita-tion, a first at the newly inte-grated Walter Reed Bethes-da, allows the lab’s staff tocontinue taking pride in theirwork, said Holley. It’s also sig-nificant, given the Sleep Labis now larger and has morestaff since the integration be-tween the former WalterReed Army Medical Center(WRAMC) and former Na-tional Naval Medical Center,he added.

To earn accreditation, the

AASM evaluates the SleepLab’s equipment, treatmentand outcomes, the knowledgeof the staff, and how theymanage cases, from initialappointments to studies, ex-plained Holley, who is alsothe Sleep Fellowship Re-search Director. Although theprocess was somewhat intim-idating, Holley said he wasconfident in the lab and itsstaff, stating, “There’s a lot ofinstitutional knowledge be-tween the doctors and techni-cians.”

The 12-bed lab, with morethan 20 staff members, in-cluding active duty, civiliansand contractors, has an ac-credited fellowship trainingprogram and out-of-centerprogram, with a lab that seesabout 80 patients each week,Holley said. In addition tosleep studies, the lab vali-dates whether service mem-bers are deployable, and con-ducts various specializedtests to help treat complicat-ed breathing disorders relat-

ed to congestive heart failureand chronic obstructive pul-monary disease.

“We do a comprehensiveevaluation for any sleep prob-lem somebody might have.That can run the gamut frominsomnia to fatigue, to hyper-insomnia, where people areabnormally tired all day,” hesaid.

Among the general popula-tion, sleep problems areprevalent, he continued. Anestimated 10 to 20 percent ofAmericans have a sleep com-plaint. In the military, sleepproblems seem to be relatedto deployments, given thechange in environment andirregular schedules, he said,though studies are underwayto look at the correlations.Researchers are also study-ing the relationship betweensleep disorders and injurieslike post traumatic stress dis-order and traumatic brain in-jury, he added.

Regardless of a patient’sneeds,Holleysaid,“Wearehere

for them, should they need[help].” He noted the dedicatedstaff working around the clock,allhoursof thenight,“crankingout studies,” to meet the needsof patients.

Tim Andrada, the SleepLab’s clinic coordinator, saidhe takes pride in working forthe center – one of only a fewDepartment of Defense SleepLabs in the country accredit-ed by the AASM. Havingworked in the Sleep Lab atWRAMC since its establish-ment, about 26 years ago,An-drada said the accreditationis special because not allSleep Labs can say they haveit, and it’s difficult to obtain.

“They look at our studies[and] they look at our protocol.It’s veryhard,”hesaid.“Theac-creditation means we’ve ob-tained the highest standardquality medical care.”

Active duty members seek-ing a referral should contacttheir Primary Care Manager.

Sleep Lab Achieves ‘Gold Standard’ from Academy

By Helen HocknellNSAB Public Affairs

staff writer

“It is not the mountain weconquer, but ourselves,” saidSir Edmund Hillary,one of thefirst men to summit MountEverest.

That quote opens the Men-tal Skills Foundations chap-ter of the workbook for theComprehensive Soldier Fit-ness class offered by the Per-formance and Resilience En-hancement Program at NavalSupport Activity Bethesda(NSAB).

“The course is designed tohelp soldiers develop the men-tal strength to deal with all oflife’s challenges,whether that’son the battlefield or at home,”explained course instructor Dr.Stephany Coakley,who holds adoctorate in exercise and sportscience.

The class consists of threesessions, and is offered everytwo weeks. Topics include en-ergy management techniques,attention control, and confi-dence-building exercises. It isgeared toward wounded war-riors and their family mem-bers, but also open to WarriorTransition Unit staff.

Coakley said she tries toemphasize the importance ofstress management by show-ing a video clip about a Nation-

al InstitutesofHealthstudyonthe effects stress has on woundhealing. Researchers com-pared healing times for the su-perficial wounds of two groups:one consisted of individualsworking in high-stress envi-ronments caring forAlzheimer’s patients,the othera control group that experi-enced more typical levels ofstress at work and home. Onaverage, the caregivers’wounds took nine days longerto heal than those of the con-trol group.

After viewing the clip,many

students said it was eye-open-ing to see images comparingthe wounds of both groups,concrete proof of the impact ofstress on the healing process.

"That part was really inter-esting," said Army Spc. ErickDaniel Santos, a woundedwarrior and patient at WalterReed National Military Med-ical Center. "I didn't realizestress could keep you from get-ting better after you got hurt."

Coakley explained thatwhen your body perceives athreat, it goes into a “fight orflight” response, producing ex-

tra cortisol and adrenaline,commonly known as “stresshormones.” These chemicalsboost your heart rate, elevateyour blood pressure and in-creases the amount of glucose(sugar) in your bloodstream.

“Not all stress is bad,” ex-plained Coakley to her stu-dents. “Stress can pressure usto perform at our highest level.The danger is when it’s chronicand unrelenting.”

In the course, Coakleyteaches a variety of methodsfor reducing stress. Thesetechniques range from tacti-

cal breathing and visualiza-tion exercises to more generallifestyle adjustments, such asletting go and not worryingabout things beyond yourcontrol.

“It’s about cultivating theright mindset,” said Coakley.“None of this is really rocketscience, but you can practicecontrolling the way you think,and it makes a big difference.”

Surprised by how much helearned from the class, Santosadded that the most usefultechniques were from thechapters on goal setting andbuilding confidence.

“I never really bothered towrite ‘to do’ lists before, but assoon as you’ve written itdown, it’s real. You have to doit,” he said.

Santos explained the simpleact of crossing something off alist was a big confidence-boost-er, even if the task was fillingout medical paperwork or acompleting a household chore.He plans to start using thetechniques for bigger life goals- like finishing school.

“Anything that gets in myway is just a detour.”

To learn more about theComprehensive Soldier Fit-ness course, contact Coakleyat stephany.coakley@med.navy.mil.

Performance enhancement course offers tips, techniques to wounded warriors

photo by Helen Hocknell

Dr. Stephany Coakley teaches stress-reduction techniques as part of a mentalstrength class geared toward wounded warriors and their families.The course isoffered every other week.

8 Thursday, July 12, 2012 The Journal

trailer houses the system’s generator, while the oth-er two trailers store the three sections of the shelteras well as its lighting, electrical, heating, ventila-tion and air conditioning (HVAC) systems.

Once up, the shelter's lighting, electrical andHVAC systems are powered by the 400-gallondiesel-fueled generator capable of continuous serv-ice for up to 40 hours before needing to be refueled,Miller added.

“The footprint of a fully deployed system, whichincludes the three connected shelters and three trail-ers, is 144 feet long by 75 feet wide,” Knapp said.

The ICV supports the mobile response shelterwhen the unit is deployed. The command vehicle isused to communicate back with the hospital duringdeployment, or as a location for command and con-trol in the event of a hospital communication outage.Once set up, it’s a secure environment, Gillette said.

The high-tech, 30-foot long vehicle has internetcapability, a virtual private network (VPN), multi-phone lines, fax, video teleconferencing (VTC) ca-pacity, and an enterprise land mobile radio (ELMR)system. It is also equipped with satellite and localair television, a briefing and display system, aweather monitoring system, global positioning sys-tem (GPS), a mast camera for visual situationalawareness, galley, restroom, and uninterruptablepower source (UPS) backup.

8 Thursday, July 12, 2012

are ready for the next chapter!"Hughes has a job offer with a local contracting com-

pany in his hometown of Crane, Ind., where he plansto settle his family after he leaves active duty in Sep-tember 2012.

"I'll tell you this, no one is going to hand you a job,but with a little help from the Navy and CGC, plusmy willingness to lean forward and make a plan, Iwas able to ensure a future and a life after my 14 yearplus career in the Navy."

The Navy's contract with CGC is extensive andtasks them to reach out to all ERB Sailors.Sailors areencouraged to contact CGC by calling 1-800-971-4288or by e-mail at cgcusnavy@challengergray.com if theydesire services and have not heard from CGC.Sailorscan also contact the Help Center at Commander,Navy Personnel Command by calling 866-827-5672for more information.

For more information visit the NPC ERBWeb Pageat www.npc.navy.mil/boards/ERB/, contact theNPC customer service center at 1-866-U-ASK-NPC(1-866-827-5672) or email cscmailbox@navy.mil.

ERBERBContinued from 6

SHELTERSHELTERContinued from 1

Volunteer Landscaping Staff

Photo by Helen Hocknell

Volunteerlandscapingstaff assistswith stormcleanup ef-forts atNaval Sup-port Activi-ty Bethesda.

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