rady children's surgical services newsletter

Incisions & Decisions The Rady Children’s Hospital of San Diego Surgical Services Magazine

Celebrating Perianesthesia Nurse Week

Surgical Services Pink Day for Breast Cancer Awareness

Surgical Services stays in shape at the

Hot Chocolate Run.

Leadership rocks out at this

year’s Team Rady :) Nurse of Excellence Award Ceremony

Spring/Summer 2016

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Inside This Issue

Incisions & Decisions

Happy Retirement to Dr. Benz and Dr. Rodarte 3

And We Spend Our Spare Time With… 4

Spotlight On...Patient Care Liaisons 6

In Memory of Bea 7

A Conversation with PACU Leadership, Linda Sparks, RN 8

Education News We Can Use 9

Piecing Together the Surgery Schedule Jigsaw Puzzle with

Dr. Alvin Faierman 10

Spotlight On...Anesthesia Technologists 11

MD’s Take On It with Dr. Andrew Zimmerman 12

Tender Loving Care Committee, AKA TLC 13

Surgical Services Employees of the Month 14

Rosa Robot picture page 15

Recognitions & Accomplishments 16

Dear Appy 16

Picture Page 17

1st

2nd 3rd

4th 1st

2nd

3rd

4th

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Happy Retirement Dr. Benz!

Pediatric ENT surgeon, Dr. Ronald Benz practiced

here at Rady Children’s for over forty years.

Dr. Benz was always very pleasant to work with and

was a wonderful physician and Rady colleague.

As was his request, he didn’t desire a big fuss over

his retirement, but instead preferred to bow out

quietly and focus on the numerous memories he cre-

ated here. He did allow for a few farewell pictures

with some of the nurses and techs who commonly

worked with him and thanks to Sheila, I’ve been able

to include them here.

We hope you are enjoying your retirement Dr. Benz

and thank you so much for all of your dedicated years

of service. :)

Sheila M., CST, Dr. Benz

and Kit C., RN, CNOR.

Marilyn C., SPD

and Dr. Benz

Dr. Benz and

Barbara B.,

CST.

Dr. Alex Rodarte has been practicing as a pediatric anesthesiologist at Rady Children’s since 1982. For about ten years within that

time, he also worked as an intensivist in our critical care unit. Along with that commitment, he was also a part of the heart team,

leaving him on call for three out of four weekends every month!

Dr. Rodarte was very active in numerous research studies throughout his career, such as the effect of nausea and vomiting within

the admission of anesthesia, radiology studies and PK studies, to name a few. He has also been influential in helping to change some

standards of practice, such as labeling the Ondansetron (Zofran) in the anesthesia medical supplies cart and ordering the widely

utilized Hot Dog patient warming unit.

Some of his most memorable moments include caring for the first cyanotic live patient to test the efficacy of the saturation moni-

tor, aka pulse oximeter. It was a success and is now standard practice. Another notable moment was when the ICU went from a six

bed to a twenty four bed, along with a twenty five bed step down unit in the ‘90’s. Finally, the opening of our new Acute Care Pavilion

(ACP) six years ago was another memorable time within his tenure.

I believe I speak for us all when I say that it has been an absolute pleasure working with Dr. Rodarte over the years. He’s very per-

sonable, an excellent physician and I’ve always loved hearing his entertaining stories about growing up in East LA. We’ve still got a

couple of years left of his presence around Rady, as he was quick to remind me that though he has cut back extensively from full

time work, he’ll still be available to cover any gaps in the anesthesia schedule, which is great news. So, happy upcoming retirement

Dr. Rodarte! :)

Dr. Rodarte with Dawn O., RN and Barb B.,

CST

Dr. Alex Rodarte

“Don Alejandro” and his best buddy

Don Julio, relaxing.

Happy Upcoming Retirement Dr. Rodarte


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And We Spend Our Spare Time With...

PACU RN Zoe’s baby, Austin Riley, in

his very “Kingly” pose :)

PACU RN Juanita K’s

Great Pyrenees, Dually

and daughter Jamie

Lee. Dually is in training

for RCHSD’s Paws for

Hope program, by the

way. The kids are going

to love him!

SPD Elaine G. & son Adam along with

his dad. Surgical billing’s Gina G.

with her great nephew

Logan. Cutie pie Logan is

a previous patient & is

now doing great!

OR RN, Tena M.’s Pitbull baby, Duke

The beautiful Dizon family ;

husband Alexis, Jenna in the far

back, Ava in the middle, Jen, RN

& miss Audrey

Scheduler Lisa F.’s

prized fur baby, Fiona

La Tigresa Flores in

her festive outfits :)

Brady H. OR RN, & Ginger F. CST’s Burnese

Mountain, Storm (black, tan & white) &

their Newfoundland, Atlas (brown) doggies.

Melissa S., RN PACU,

baby boy, Moose :)

Nancy M., OR RN: “This

is Bob, AKA Knucklehead,

AKA Bubba.”

Surgery Scheduler,

Monique’s daughter

Ashley & fur baby,

Mollie :) PACU RN, Mike’s Roxie

& Roe :)

OR RN, Daniella’s J.’s “laser

eyed” brood, from left to

right: Zoey, Eli, and kitty

Milo.

PACU RN, Anjanette V. ‘s

Chocolate labs , Caasi &

Carly, son Isaiah & grand-

pa’s horse, Yeller

OR RN, Karina K.’s adorable Coco

Surgery

Scheduler,

Gina C.’s

guinea pig,

Skitty

Dr. Andy Z.’s cuties, Brittany & Beagle Cooper

Dr. Jen T.’s Gigi on

the left & Mochi on

the right.

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Just One Page Wasn’t Enough To Showcase All These Cuties!

OR RN, Kelly L.’s perfectly

color coordinated Yorkie

baby, Mochi

OR RN, Dawn O. & spouse, Maurice, son Gavin, & fur babies, Great

Dane, Elvis & Rat Terrier, Ren. Clearly, all sizes are loved in this

house :)

OR RN Supervisor, Katheryn K’s darlings from left to right: Boo-boo,

Kona & Mause

PACU RN, Mei’s son, Ryan & daughter

Mia, along with fur baby Toby

OR RN, Shonie N.’s

white Poodle rescue,

Annie & Weiner Doodle,

rescue Mimi

PACU RN Kelly M’s fur baby Coco Moe and

babies, Abby & Kate with hubby, Jerry

The Carvalho’s: Bea, 14, Victor, 10, husband Mauricio, Dr. Daniela

& fur babies, Lola & Pitchuka CST, Norm O.’s daughter Vicky and her cat Gizmo, and

his son, Ben with his dog, Molly

CST, Maria Q’s fur

baby Louie & his

“girlfriend” Minnie

PACU RN, Lindsay C’s darlings:

Cooper (9) & Emma (14) :)

Dr. Christine N.’s adorable

guys, Zac, 3yrs old, husband

JD, and Tai 5 years old :)

Dr. Javan N.’s lovely

sweeties, Pierce, 22 mos &

sister Cressida, 3 mos

CST, Terresa R.’s

“gangsta pups” left to

right: Apollo, Chocolate, &

Zeus

CST, Sheila M.’s cuties from

left to right: Arianna, 7,

Cryprus, 6, & Brook-Lynn, 9

CST, Barbara B.’s grandbabies, Carolina

& Maxwell.

Dr. Tim F’s daughter, Caitlin

riding horse Junior

SPD’s Marilyn (in the red top) C’s

fam, left to right: Mischa, 35,

Michael II, 34, husband Michael,

& Marques, 31

And your editor’s darlings: from left to

right: Cleopatra, Malcolm, & hubby,

Mike :)

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Spotlight on...Patient Care Liaisons, AKA PCL’s

Since its re-implementation this past February, the Patient Care Liaisons have been extremely helpful with diminishing or even elimi-nating the stress that patient families feel during the challenges of facing surgery. The PCL’s role is to increase communication and serve an excellent customer service experience to our patients and their families. Now, four months later, the positive and grateful remarks from all around is evidence that this rebirth of the PCL is both needed and appreciated.

I sat down with our PCL’s to get an idea as to what it’s like to fulfill their role and some of the challenges they face:

Esmeralda Bishop, RN CNOR: “I really feel that having a PCL makes a big difference in

quelling the patient’s family’s stress. Having a live person give updates and be akin to their

needs as they wait, helps them feel more comfortable and at ease. One of the patient’s fami-

ly members actually hugged me and thanked me for being there. I believe it’s that human

connection and that I’m here to help attitude that I bring, that really makes a difference.

As a challenge, it took a bit of getting used to the psychological aspects of this position. It’s

a bit different than my role as an OR nurse, because as a PCL, you are present during the

whole circle of care during their surgical journey. It’s a refreshing and different aspect of

nursing that I thoroughly enjoy.”

Kit Cabebe, RN CNOR: “I enjoy being able to experience that whole circle of care with the

patient and their family. Having been through this experience many years ago with my daughter

(see last holiday issue of I&D for Kit’s story), I know first hand about the anxiety you feel as a

parent. I like being able to comfort the families with my understanding and I’ve even shared my

experience if I believe it will help ease their stress.

Some of the challenges I’ve faced is making sure to keep track of the numerous possible delays

that tend to happen in surgery. Keeping families informed does a lot to ease their worry. Also,

another challenge I’ve come across is that some of the families have some different dynamics

that need to be recognized and possibly addressed so that everyone has the best experience

possible.”

Deirdre Green, RN CNOR: “I absolutely love being able to put the families at ease by being that

concerned and comforting face their looking for. We even have a personal number that they can

call to get in touch with us if they need anything. Also, with the patients, I’ve found that being

there to answer that one last question or address a final concern before surgery is very helpful.

Like Kit, I can also empathize with the experience of having a child go through a surgical proce-

dure and often relate this to the families to help reduce their angst.

The modern day new role of the PCL has been a small yet enjoyable addition to Surgical Services,

and that has led to some adjustments in the way of keeping all of the members involved in the

patient’s care fully informed as they progress through the surgical journey.”

Joan Moret, RN CPN: “I see a real change in stress levels as I continuously connect with

the families throughout the day. I like being able to see the patient throughout all phases of

the journey and that challenges me to hone new and different skills as a nurse. I also like all

the positive feedback the PCLs have received both from parents and staff.”

The challenges of being a PCL are keeping track of possible delays and schedule changes, so I

can keep the patients and their families informed. Providing them with up to date infor-

mation, helps me to deal with their therapeutic needs more effectively. It’s important to be

in the right place at the right time so everyone is more at ease.


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Bea Pugeda was born on February 10, 1948 in Rosario, Cavite, Philippines to the late Rosario Profeta and the late Julio Toledo. She departed this life on February 23, 2016 in San Diego, California. Bea started her nursing career in Newark, New Jersey in 1968. She moved to San Diego, California in 1979 where she continued her career at Rady

Children’s Hospital. During her time at Rady Children’s Hospital, she formed strong bonds and friendships with her co-workers. After 35 years of service she retired in 2014.

Bea was blessed with a loving family who thought the world of her. She married Charlie Pugeda in Jersey City, New

Jersey on March 28, 1971 and they had two children, Nanette Pugeda Courtney and Charles Pugeda, both of whom Bea and Charlie are very proud of. In addition to being survived by her loving husband & children, Bea leaves behind a large family of siblings, cousins, nieces, nephews and godchildren.

We all miss you Bea, thank you for your beautiful presence in our lives!

In Memory of

Lourdes T Pugeda February 10, 1948 - February 23, 2016


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Editor’s Message With the sudden deaths of our cherished colleague, Bea and my favorite musician, along with personal family health challenges and loss over these last few months, I was forced to face the unexpected and often fleeting aspects of life. Though within our line of work, we tend to see more than our fair share of despair and misfortune, we still remain subject to the often habitual practice of under appreciating the joyfulness and miraculous beauty of life. But through our loved ones who have passed on, we are reminded to treasure and celebrate ourselves and one other, while we’re still present and able. Despite the mostly solo 60 plus cumulative hours of interviews, photography, design, writing, and editing, I remain dedicated to the creation of our publication for one very blatant reason. It is to tell our story of Surgical Services, to show to the world what it is we do, and to celebrate the greatness of who we are. Thank you all for the honor of being your scribe. :)

A conversation with PACU Leadership, Linda Sparks, RN, BSN, MHA, CPAN

Q: Can you give us a little history as to how you got started in nursing?

A: “I have been a nurse for 36 years. I was 16 years old when I left my small farming village to go to college in Manila. I did not really know what

I was going to be when I grew up. At that time, nursing seemed like the best profession to get into. There were not a lot of job opportunities in the

Philippines back then, so I thought being a nurse could be my ticket to go abroad and start a career. It did not take me a long time to realize that I

was meant to be a nurse after all. This amazing profession has shaped me into who I am today.

In 1983, I was hired from the Philippines and my first job was as a Charge Nurse on the Surgical floor in a little town called Paris, Texas. It was an

incredible learning experience. I learned to lead a team with the same passion and common goal which is to provide excellent care. This position

opened doors for me and paved the way to the Leadership role I am currently in. I married my husband Randy, who is also a nurse and moved to

California in 1989. I have worked at Rady Children’s for 27 years and the past 18 years, I have been the Team Leader/Manager of the PACU.”

Q: What are your primary duties as leadership of PACU & what do you enjoy most about your job?

A: “As a Manager, I am responsible for the entire operational activities of the Pre-op, PACU and the Discharge areas in both OPC and ACP 24/7. I

am also in charge of the Inpatient and Outpatient Sedation, Vascular Access Team and the Pain Management Team. We have 100 members of our

team of PCAs, BAs, LVNs, RNs and Nurse Practitioners. What I enjoy the most about my job is seeing positive patient outcomes. At the end of my

day, I celebrate that our patients received the best care possible because I know that my team gave their all in providing excellent care. I am very

grateful when my day ends without a single critical incident I have to follow up. My team’s success is my success. The other aspect of my job that I

enjoy the most is seeing my team fully engaged and happy. When we start a project or a process change together, it gives me the best satisfaction

when our team members are part of the planning, implementation and the experience. Seeing the progress and the growth of each one of us going

through these change processes is very satisfying to me. Outstanding employee and positive patient outcomes make me feel that my job is worth-

while.”

Q: And finally, what are some of your biggest challenges within your role and what are some areas where you would like to see improvement?

A: “My biggest challenge in my role is staffing. Managing daily operations has many variables we have to balance. There is variability in patient

volume, financial support, staff schedules and high expectations to meet targets. My biggest strength is my phenomenal team. They make it happen

no matter what challenges they face everyday. They are truly my Rock. I could not do my job and achieve the best results without their incredible

support and unbelievable engagement.”

-Thank you Linda for sharing your story :)

Sharon Bennett-

Gandy, MFA, CST,

BS, Editor-in-Chief

Addressing the Goal of the First Case On time Start (FCOS)...

It is our practice within Surgical Services to constantly evaluate our performance as a team and implement ways to improve our efficiency to provide

a better surgical experience for our patients and their families. Upon investigation, one area in need of attention is our ability to begin the first sched-

uled case of the day, on time with no or minimal delays. Surgical Services Medical Director, Dr. Daniela Carvalho and Surgical Services Director,

Bruce Grendell, RN studied our practices and implemented immediate tasks to improve our start times.

Dr. Carvalho noted that by improving our efficiency, we are “ultimately helping with the safety and quality of care of our patients.” One of the ways

we can utilize better efficiency is to check the surgical suite the night before and ascertain that the proper equipment needed for the surgery is pre-

sent. “It helps us to identify if something is missing or in need of repair in adequate time to address the issue, instead of five minutes before the pro-

cedure starts.”

In response to the concerns of some about feeling rushed to meet an on time start parameter, Bruce Grendell, RN said, “Safety always trumps effi-

ciency, and no one should ever risk not doing a particular step to meet the on time start. Sometimes being late is unavoidable, but one should ask

‘What could we have done to prevent being late?’ And once that’s identified, ‘What can we do differently to assure an on time start next time?’

Could we ask the surgeon to come a few minutes earlier to accommodate time with family and patient questions? Can we arrive at our assigned

rooms earlier to ensure the necessary equipment and supplies are present?”

With our patients’ absolute best interests in mind, we should all take on a positive and proactive approach to achieving success with FCOS, while

always practicing proper safety protocols. Thank you Bruce and Dr. Carvalho for your contributing thoughts to this article. :)


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News & Upcoming Events from PACU Education

contributed by Jennifer Mestman, BSN RN CPN, PACU Clinical Nurse Educator

The PACU has recently started working on Caring for the Caregiver in the department. In addition to the ongoing and already wonderful “Lenny’s Acts of Kindness” run by the PACU TLC committee, we had our first CPR (Compassion,

Peace, Renewal) for the Soul session focusing on Self Care for the Healthcare Professional. Tamera Sayegh and Lisa Thompson, Hospital CPR for the Soul Champions, led the session with a discussion on ways to reduce stress in your daily routine. We plan to continue this throughout the year and hope to help the OR introduce this as well! We also have a PANAC conference planned on June 4th from 9-1 focusing on Caring for the Caregiver. Other PACU Education updates include EPIC Charting Standardization and working to make sure we are all standardized in the way we are charting on our patients. We are also continuing with Hospital-wide Competency training and are kicking off a series on Pain with our awesome Pain NPs and Pain MDs to continue over the summer. We have already started this with an in-service on PCAs/Epidurals given by Denise Givens and Rebecca Bennett, Pain NPs.

Education News We Can Use

Welcome to our new education column. Because our continuous education is an inte-

gral part of Surgical Services and our dedicated educators have so much to share with

us, it was decided that an ongoing education column was in order. Thanks Erin, Jen &

Suzanne for your assistance in making our education page a part of our newsletter!

Our lovely RN educators from left to

right: Erin Walker, CNOR, Jennifer

Mestman, CPN, & Suzanne Simone, CNOR

Last year the hospital developed a Venous

Thromboemboli (VTE) Prevention task force to

address the incidence of VTE in children and

what interventions we could implement to de-

crease this Hospital Acquired Condition. It turns

out that VTE ranks second among these condi-

tions. Dr Billman has stated, “Our experience is

mirrored at the State, and national level. When

we started our journey, I don’t think that anyone

anticipated this result.” (please see graphs)

We have taken great efforts to prevent VTE

from a mechanical and pharmacologic perspective

here at Rady Children’s Hospital. In December of

2015, we initiated a new protocol for Sequential

Compression Devices in surgical services. We set

parameters to provide SCD’s for patient >12 yrs

of age with >4 hours of surgery and >10 yrs of

age with > 4 hours of surgery and going to the

PICU. So far, we have had success in rolling out

this new protocol. We would like to thank the

spine team: Dr. Yaszay, Dr. Newton and Dr. Upas-

ani; the neuro team: Dr. Levy, Dr. Gonda and Dr.

Meltzer; and Dr. Carvalho for their support in

this clinical practice improvement initiative.

Thank you to each and every one of you for your

dedication to the safety of our patients in the

community.

Contributed by OR Educators, Erin Walker, RN CNOR & Suzanne Simone, RN CNOR


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Piecing Together the Surgery Schedule Jigsaw Puzzle with Medical Director of Perioperative

Scheduling, Dr. Alvin Faierman…

The surgery schedule of a busy OR like ours is a jangled ordeal consisting of numerous components. From the un-ending surgeon requests to acquire the best times to fit their schedules, to the constant addition of add-ons and emergent cases, to the constant balance of surgeon block time evaluation, manipulating the surgery schedule to its most successful and efficient state, takes a special hand to say the least.

Recently, I sat down with Dr. Faierman and asked him to enlighten us as to what it takes to keep our OR sched-ule running at it’s best capacity.

Q: As the Medical Director of Scheduling, what are your responsibilities exactly?

A: “I oversee the allocation of surgery block time within the services and the surgeons. I also along with

Dr. Carvalho, monitor the utilization of that time and determine if more or less is needed. Epic reports and distributes the data and together, Dr. Carvalho and I analyze it with the goal of ensuring the schedule operates most effi-ciently.”

Q: That sounds like quite a big undertaking. What types of challenges have you found within your role?

A: “Balancing the needs of the individual surgeons with the needs of the OR is a particular challenge. We try and encourage the surgeons to free up their block time they are sure they won’t use as early as possible, so we can fill those spaces with cases that might fall outside of their scheduled time. For example, if surgeon A has two hours left in his block time and he frees that up, then surgeon B may come along and need to use that time to do a case that he may not want to sit on until his next scheduled block time. Surgeon A is encouraged to free the time, because next week or a month from now or what-ever, he may be the one needing surgeon B’s released block time. It’s a give and take method that works very well within the unpredictability of surgery scheduling. Of course if the block time isn’t released, after a certain time, it expires, and then

we can schedule other cases in it’s place. The only exception is the heart room, because due to the nature of their cases, they have their own call team and their own OR. However, in rare instances, we have asked permission from their surgeons to utilize their room as an add on or trauma room when they are absolutely not going to use it, as in the case if the heart surgeons are out of town.

Another challenge is to find enough space for new partners within a surgical group, to do cases as well. We are growing, but there are still only a limited number of OR suites and staff to do these cases. And though a 7:30 start is a much preferred time, everyone can’t start then, so we stagger the start times to allow for expansion, but without having everyone start at the same time, because that would leave the later start times under utilized.

And yet another ongoing challenge is when the OR is completely booked and every time frame is in use and then an emer-gent case comes in. Juggling cases around in order to find space to fit in the unexpected can be tough.”

Q: What are some improvements we can make to increase our first case on time starts?

A: “The most effective way is for everyone to hold themselves accountable and assign a reason for a late start time. By re-

cording the why, it makes us all become more diligent in achieving this goal and gives room for improvement. And quite frankly, it’s human nature to be more efficient when we are being watched and recorded. Dr. Carvalho analyzes the reason for the late start and acts accordingly. So if a late start time becomes habitual, that surgeon may lose their block time in an effort to ensure the efficiency of the schedule.”

Q: Dr. Rodarte says that you are the perfect person for your role as Medical Director Scheduler, because of your ability to accurately asses how long most cases will take. That said, what are your final thoughts on keeping our OR schedule running smoothly and on time?

A: “As we expand as an OR, it takes a group effort to ensure an efficient schedule. As long as we all play by the same rules, the system will work. It’s a pet peeve of mine to have valuable time wasted. So if we are all proactive and honest about our block time needed and release time earlier or before it’s forced expiration, we allow its use to someone else and that bene-fits us all.”

Thank you for your contribution Dr. Faierman :)

Dr. Alvin Faierman

and his miniature

Pincher, Mako.

Very adorable!

Heard Around the OR…

Ever been walking by and overheard something amusing? Well, Surgical Services is the perfect place for such incidences. This column is

meant to make you chuckle at some of the crazy words uttered by some anonymous individuals within our department.

-Overheard from a staff member who had successfully fixed a piece of office equipment: “OMG, why do I work here? I’m just too

smart to work here.”

-From an RN commenting on a mandatory meeting: “So in that lateral violence meeting they were in, were they like in full combat

mode for the whole 8 hours?”

-From a supervisor talking to a few staff members: “You didn’t even invite me to my own meeting?”

-Overheard at the front desk: “Why am I calling you when you’re standing right here in front of me?”

-From a rushed RN during a Neuro trauma procedure: “I need an Instagram of the brain right away, no I mean an angiogram.”


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Spotlight On...Anesthesia Technologists

Our Anesthesia Technologists (AT) perform a variety of tasks to assist the surgical team in caring for the patient. While their

main role is to work as the primary assistant to the anesthesiologist, they are also available to the RN circulator as extra trained

personnel within critical and or trauma cases.

During a difficult airway intubation or during the course of anesthetizing an unstable trauma patient, the highly trained anesthesia

tech is a necessary component of the surgery. Competent in a variety of skills such as: rapid sequence intubations, sensitive extu-

bations, placement assistance with CVP’s and Arterial lines, intubation Glidescopes, and transfusion assistance with the hotlines,

Level 1, and Belmont devices, their presence and skill can mean the difference in the care provided by the anesthesiologists and

the rest of the team. In addition, the anesthesia tech is responsible for ordering supplies and turning over the anesthesia equip-

ment between surgical cases, ensuring the proper age related equipment is readily available and maintenance and problem solving

of the anesthesia machines. Along with their duties in the OR, the AT’s also provide service and support to both the ACP and

Sharp MRI suites, and the HEMOC, CT, xRay, and CATH Lab units. Finally, the anesthesia techs conduct numerous meetings with

equipment representatives, all while addressing multiple phone calls throughout the day.

So as you’ve just read, our anesthesia techs have a large amount of daily responsibilities. Yet, though they are always very busy,

they enjoy assisting the anesthesiologists and anticipating what they need, especially during critical times. “I like that they can

rely on me to get them what they need, when they need it.” says Susan W., AST. And PM anesthesia tech Ron M., says “That being

able to help the patients stay calm, and assist the doctors and the RN’s, is what I enjoy most about my job.”

Overall, the anesthesia techs felt that in comparison to other facilities where they’ve worked, our OR doesn’t seem to have

enough supplies or equipment. Frequently used devices such as Dopplers, ultrasounds and Bair huggers are scarce commodities

within our busy OR, and that presents an ongoing daily challenge. Furthermore, our AT’s request that we all keep in mind that

overwhelmingly, anesthesia happens first before the surgical procedure. So in preparation, the techs always need to be informed

of the details (such as age, weight etc.) about the surgical patient, so that the proper age related supplies and equipment are pre-

pared before the commencement of surgery.

Our great, fun group of anesthesia technologists are valuable and trusted members of our Surgical Services unit. They are yet

another critical component, that brings their own specialized and reliable skills to provide our patients the best surgical experi-

ence we can provide. Thanks you guys! You are all absolutely awesome!

Our wonderful anesthesia technologists (AT) from left to

right: Sassa M., Fernando P., Amanda F., AmyRay H. (in

purple hat), Danna M., and lead anesthesia tech, Tony O.

The anesthesia workroom

Sassa M., AT and Raul B., AT PM anesthesia techs, Susan W.

and Ron M.


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A Hearty Welcome to… Rokesha “KiKi” Wimberly, CST Traveler

Sara Eckerman, RN Traveler Mary Kerlavage, SPD Traveler

Christina Pruess, RN Traveler Jenisa Parilla, SPD Traveler

Welcome back to Kelly Longley, RN Vivian Rodriguez, PCA PACU Traveler

Welcome back to Cheryl Sosa, BA Heidi Hafliger, CST Core staff

Tariq Merchant, CST Traveler Sassa Mauga, AST Core Staff

Kimberly Burns, RN Core staff Cheree Bowen SPD Traveler

Matthew Thompson, SPD Traveler Jenn Johnson, RN PACU Traveler

Marc Petrie, RN Traveler Brittany Kepner-Card, RN PACU Traveler

Tami Schmidt, RN PACU Traveler Jen Katz, RN PACU Traveler

And A Sad Goodbye :( sniff! & Well Wishes to…

Kate Davenport, MD who completed her fellowship and moved on to an attending job in Arizona

Ginger Frieze, CST who moved on to pursue an opportunity in Texas

Katelyn Harris, RN who moved back east to be closer to her family in New Jersey

Janelle Dela Vina, RN, NP who accepted a nurse practitioner position at UCSD

Gary & Julienne Johnson, RN’s (our favorite married travelers are leaving us for now, but they plan to come back! :)

Sara Eckerman, RN who will be leaving us at the end of her assignment this June :(

MD’s Take On It…with Anesthesiologist & Chief of Staff, Andrew Zimmerman, MD

Q: How long have you been Anesthesiologist?

A: “I’ve been an anesthesiologist, including my residency time, for 29 years, 17 of those have been here at Rady.”

Q: Can you tell us about your additional job as Chief of Staff?

A: “Yes, since January this year, I’ve been in the second, two year portion of the Chief of Staff posi-tion. It’s turns out to be a total of six years, with the first two years being a Chief of Staff elect, then two years where I am now and then a final two years as past Chief of Staff.”

Q: And what are your responsibilities as Chief of Staff?

A: “I oversee and represent our medical staff to the hospital administration. Any matters involving things like credentials, or behavior issues for example, I’m the one at the top level to deal with it. I also sit on the hospital’s Board of Directors as representation of our hospital’s physicians.”

Q: Wow, that sounds like a big job, which leads me to ask what kinds of notable challenges have you faced in this position?

A: “One of my biggest challenges, is that though I’m representing the physicians, sometimes their needs may not be in an exact alignment with the hospital, making my next action somewhat difficult. However, I always keep in mind that my role is to represent the doctor first and foremost. Another challenge is having to close the resulting gap that arises when a physician has a need for cer-tain equipment that may not necessarily fit into the requirements of the hospital capital budget.”

Q: Any other thoughts you’d like to add?

A: “I enjoy this position, because since I’m in the “trenches” everyday as a practicing pediatric anesthesiologist, I hear and experi-ence things I otherwise would not, and I’m often able to enlighten the hospital administration to the actual truth. My “inside ear” has been instrumental in helping to educate and assist, especially with issues concerning Surgical Services. I also like utilizing the rela-tionships I’ve formed within administration to benefit any of the personnel who haven’t been able to get the desirable results they’ve been seeking. Sometimes I’m in the position to bypass all of the red tape and help them come to a satisfying resolution. It’s a great feeling to be able to help out in that way.”

-Thanks for contributing your thoughts Dr. Zimmerman :)


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PACU TLC Committee…what’s it all about, you ask? The committee was formed in 2007 and imme-

diately the goal was to name the committee. Are we going to be the Sunshine Committee, the

Birthday gang, the PACU Encouragers? We asked the staff to submit suggestions and there was a

resounding winner. Thus began the TLC Committee.

Participation in the committee is completely voluntary. For a yearly contribution, birthday gift

cards/lunches are given, special holiday treats/seasonal treats are handed out, and we also recog-

nize new babies with a gift card, and loss of an immediate family member with a plant and card.

Surgeries, sicknesses, and other family losses are also recognized with a card.

Throughout the years, dues have changed, members have changed and options of how to partici-

pate have changed. Through it all, the objective has always been the same…find ways to show the

staff that they are valued, celebrated and supported. That is what we are all about.

Contributed by Kerry Barthel, RN, CPN, CPAN

The Tender Loving Care Committee, AKA TLC

Spring TLC Updates -Contributed by Aeoni Williamson PACU RN, CPN

This spring has been fun and fast moving for the TLC busy bees. They have been buzzing away making gifts for their members. In

recent months, TLC have given out chocolate covered pretzels for Valentine’s Day as well as chap sticks handmade by Lisa Staples,

CST and lotion to the team. The birthday potluck was delicious as always.

This year they have added some fun events that they have hosted. TLC happy hour at Casa Machado was a success. The partici-

pants enjoyed tacos and drinks while watching planes land and take off from Montgomery Field. A sneak peek into the next upcom-

ing events for TLC is hiking at Torrey Pines and an end of Summer Bon Fire. Stay tuned for more fun and exciting things from TLC.

Lennie’s “Acts of Kindness” has been a huge success. Sadly it is coming to an end. Since January, Lennie’s cart has been out serving

healthy grab and go snacks. In January, it was coffee and tea, and cider in February. Then it was all things green in March, and mini

cupcakes in April. Lennie’s last “Acts of Kindness” was In & Out Burgers, this May. Thank you so much to Lennie and her generosity

for making this happen.


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Our Surgical Services Employees of the Month

Surgical Services strives to promote a positive culture among our staff members. The Magnet and Professional Development

Council feels that it is important to recognize staff that make a personal effort to "go above and beyond" the call of duty to

accomplish and support the organization's goals and values. As an active member of the Council, I am honored to lead the Em-

ployee of the Month Recognition Program for Surgical Services. Nominations are submitted from representatives of the PACU

and OR/Anesthesia/SPD Kudos programs, Patient Experience Feedback from Parents, Daisy RN Awards, High Five awards

from Nursing Students, CARES and Good Catch Awards. Each month, all members of the Surgical Services’ Shared Decision

Making Councils sends in their votes. One employee is chosen, honored and recognized. Our winner’s picture is posted on the

Employee of the Month Board and receives a personal certificate of recognition.

After a long day of work, I always feel a little better when I walk past our Employee of the Month board. I am reminded how

lucky I am to work with such talented and caring professionals. Please help us congratulate our winners from 2015 and help

nominate deserving staff for 2016. Submissions can be in the form of any award program we already have in place (Kudos,

CARES, Daisy, Good Catch, etc ...).

Our Employee of the Month Board is a small way of recognizing YOU and your hard work everyday.

With Gratitude,

Leo Frutiz, BSN, RN, CNOR

Magnet Champion

And Just In Case We Wish to Do A Little More…

Fresh Start is recruiting PACU and Discharge RN’s for Saturday, July 16th.

Celine Nigro, Medical Director says that we will have one of the biggest schedules to date with 15 patients from Ethiopia,

Palestine, Pakistan and China. Several of the cases will be stage one microtia with Brucker and Meta, as well as a Cohen case

and a Ferdowsmakan case.

We will need both phase 1 and phase 2 nurses to help us care for patients. Shifts begin around 0730 and we will likely be

working all day. You can sign up for 4 or more hours and kind of pick your start time.

Please consider signing up for 4 hours, we really need your expertise and skills!

You can sign up by going to the Fresh Start website, if you have questions please see either Linda Sparks or me.

Contributed by Terese LaPlante, RN CPN


15

Our R.O.S.A. Picture Page... Photos taken & contributed by Gayle Gyles, Neurosurgical

CST Coordinator– Thanks G!

From left to right: Shari Mulligan, RN CNOR

& RN Neuro coordinator, Erin Walker RN,

CNOR & Gayle G., CST Neuro coordinator Sharon B. Gandy, CST & Gayle G.,

CST

Neurosurgeon Dr. Michael Levy &

Gayle G., CST

Neurosurgeon & Rosa robot

expert, Dr. David Gonda

Precise positioning is required for use of the ROSA The exact location of the

desired area is determined...

And the surgery commences

through just a small hole leading

into the brain.

Neurosurgery fellow, Dr. Mark Calayag & Dr. Gonda at work with ROSA

The ROSA guides Dr. Gonda’s hand as he makes the drill hole to penetrate the skull.


16

Dear Appy...

Recognitions & Accomplishments

Toneya Jackson, BSN, RN, CPN won the Nurse Leader of Excellence Award & Meher Jamadar, MA, RN, CAPA was awarded the

Nurse of Excellence for Surgical Group. Well, it makes sense that both of these awardees would come from the excellent Surgical

Services team. Congrats ladies!

Please join me in congratulating Miss Nora Tando RN, CPN for her 35 years of Outstanding Service at Rady Children’s Hospital. She has been a valuable member of our Surgical Ser-vices team since 1999.

“Nora was amazing, she kept us up to date with what is going on” . Another parent’s feedback “ Nora was outstand-ing and gave excellent care”.

Patient Care Liason, Esmeralda Bishop, RN CNOR

shares her experience with us : “I found a dusty, for-

gotten box that was full of Gameboy units, but none of

them had any game cartridges. After several attempts,

I finally was given permission to do with them what I

wanted. What I wanted, was to see the “obsolete” units

be utilized in some way. After calling many suppliers, I

finally located a company who agreed to give both credit

for trading some of the old units and to donate game

cartridges for the remaining ones. Now, many of our

pediatric patients are soothed and occupied during their

surgery wait. And it cost nothing more than a fair bit of

perseverance and dedication and taking that one little

extra step to assure our patients have a more pleasant

surgical journey.”

Surgical Services poster

board, crafted by Creative

Art Director, Christine C.

below, won 1st place at this

year’s Team Rady contest.

Christine Cadwallader, Ad-

ministrative Associate B* to

the Operating Room Director,

has received her Bachelor’s degree in Software Engineer-ing. Congrats Christine!

Denise Jones, Supply

Chain Operator, has re-

ceived her Bachelor’s in Health Information Sys-tems. Congrats Denise!

Gary, one of our Plant

Operation Maintenance

(POM), team members

helped us resolve a

leaky soap dispenser

that was causing a

safety issue. Thanks

Gary!

I just found out I have to work in a specialized service I’ve never worked in, because the RN and Tech coordinators are out with the flu for 2 weeks! I’ve never done those types of complex surgeries and everybody knows the surgeons in that group are very particular as to who does their cases. Maybe I should just put in my notice now, instead of getting yelled at every day. -Signed not good enough for this!!

Dear Not Good Enough For This,

First off all, Dear Appy doubts that it is true you’re not good enough, you did receive formal training for this type of work, yes? But you could use a thicker skin, especially since you’re considering quitting your job and being homeless on the streets. Are you going to give up when someone throws a quarter in your face and calls you a bum? I recommend you keep your day job, so Dear Appy has 3 suggestions for you: A) You could just stand there and refuse to pass any instruments or retrieve any supplies until they get the hint and start being nice. However, you’ll probably just get fired and we’ve already determined you’re not cut out to be a bum. Or B) Just grin and bear it, after all, you just have to work with them, not marry them (unless they're good look-ing and then that might be a consideration ;) Or Dear Appy’s best suggestion, C) Be proactive and learn all you

can about the procedures, be open to suggestions and bring an eager, enthusiastic attitude. Before long, they’ll forget all about their old regulars and start requesting you instead. :) Good Luck!

PACU RN, Sheri Sterniolo & her

husband, Frank, RN recently

welcomed a baby boy. Congrats

guys!


17

PACU RN, Amy looks quite

regal in “my” chair. :) That’s

ENT surgeon, Dr. Jerry in the

far back. Even he’s admiring

her queenly pose.

Matt, CST & Matt, RN

stopped in to pay their

respects to Bea.

Norm, CST & Ashley, RN on her

last day in the OR before heading

to CVICU as a new grad. :)

Admin Assistant, Emely

getting flowers from her

husband. :)

RN’s Julienne & Gary sport their

Rady wear at Epcot Disneyworld.

OR director, Bruce, RN

poses with Mirabelle, CST

(right) and her daughter

Perrian.

PACU BA, Jenean enjoys the

get well hearts she received

once she returned back to

work following a brief illness.

A little lounge happiness, I

just had to get a picture of:

front row, Kathleen, RN & Gary,

RN, 2nd row: John, CST & Luz,

CST and Leland, CST in the

far back

PACU RN’s, left to right:

Julia, Lindsay, & Lisa

Nothing like a good yoga pose to limber up

during a long surgery, Dr. Christine & James

of Neuro monitoring.

Randy, RN and

Dr. Kate on her

last day.

Humberto, SSA (front),

left to right: Jesse, SSA,

Danna, AT & Big A, SSA

Barb, CST with Elaine, SPD. I keep

telling her she doesn’t have to hide

any more, they’ve given up on the

fugitive search :) Just kidding!

Daniella, RN, Ginger, CST on

her last day, with Norm, CST

Katelyn, RN on her last day

before heading back east. Marilyn, SPD & Big A, SSA– again! :) Terresa, CST & her

soon to arrive baby

girl. :)

Norm, CST & Alice,

RN. Our Norm is just

so loving! :)

OPC fun & eats!

18

Myrna, RN & recent RN

grad Ashley on her last

day.

Celso, SSA & Joe, PCA

Happy Admin Day!

Dr. Kate Davenport’s last day,

w/ Kelly, RN & Marianna, BA

on the far right.

Lilia, PCA & Celso, SPD

Tena, RN is testing out the

Surgical Theatre navigation

system.

Ortho tech, Skee & Amory,

CST.

Courtney, RN, Dr. Andy &

Katelyn, RN @ Kate’s fare-

well party.

Lucy, PCA at the ACP surgery

information desk. Look at that

friendly smile! :)

Neurosurgery in progress! Isn’t this a lovely duo?

:) Robert, CST & Big A,

SSA on the right.

Our wonderful group of

SSA’s left to right: Celso,

Roy, Big A, Diane, & Enrique

:)

Tena is proud to show off her

purple socks, while Amory, CST

and the anesthesia doc, admire

her pose, or maybe they’re ac-

tually in awe of her fashionable

footwear? :)

Supply Chain operator,

Martin, celebrates his

birthday with Rohn, CST

& April, SPD

Sarah RN, and Lisa,

CST

Angie, RDA & Dr. Leary

hard at work. :)

Marilyn, SPD pauses to

“strike a pose” :)

Tita, RN and Dr. Andy in

quite an interesting pose.

There’s so much love

there :)

Those heart room folks know

how to party! :) Alice, RN

front & center, then Dr. An-

thony (right), Jessica, RN

(left), & in the back: Tita, RN

(right), Courtney, RN, Mitch,

CST, and Katelyn, RN

Discharge RN’s Julie, AKA,

“VIP” & Jen. SSA’s Jesse & Humberto

The OPC dental mascot

19

“Sincere THANKS to our outstanding Registration Team at ACP

and OPC! They are such an efficient, welcoming and gracious

group! Our Perioperative Services Department runs smoothly be-

cause of their diligence and attention to detail on a daily basis!”

-Suzanne Masters, RN

Upon doing discharge phone calls we received great feed-back from two different families whose children have autism:

“Great! I want to thank everyone who cared for him in

such a patient and kind way. Great job!”

“Great! He got a new toy that helped focus his attention

somewhere else. Thank you all for doing such a good job

with him. He has autism and I always worry.”

-Thank you all for making a difference each and every day! Contributed by Shay Glevy, RN, BSN, CAPA, CPAN PACU Supervisor

To all of Pre-op staff and Dr. Pransky:

“Utmost professionalism from beginning to end. The

staff allows peace of mind and provide parents with

enough instructions + easy explaining to uneasy parents

such as myself. We are blessed to have our child in your

care. Keep up the great work.”

-Kudos from a patient’s family

This is what families are saying about you on our post-op calls!

“Very good, thank you for what you do!”

“You are so wonderful...priceless, you ALL are

genuine and caring . You go above and beyond. I

cannot say enough. We’ve been here many times

and each time is wonderful.”

“We love the care our daughter received! You

guys are wonderful!”

-Thank you all for all you do and for putting pa-tients first! Contributed by Shay Glevy, RN, BSN, CAPA, CPAN PACU Supervisor

“Our surgeon, Dr. Carvalho was excellent!!!! Explained every-

thing and answered all of our questions. Very helpful. Nurses

and staff from beginning to end were superb!!! Thank you!”

-Kudos from a patient’s family

“Our child’s day nurse was very

helpful and gentle to a scared 4

year old. She made us feel we

were the most important patient

even though she had many.

Again, I thank God in Christ for

her!”

“Our child’s night nurse was very

kind and helpful even very late

at night. He was very gentle

with my 4 year old. I praise the

Lord and Jesus Christ for this

kind man.”

-Kudos from a patient’s parent

“I want to send out Kudos to our PCL’s. They help out so much in the waiting

room , with working as a team with the info desk and our volunteers. They

make the flow easier and the waiting room so nice and calm. Joan, Friday was

awesome and thanks for assisting with a parent concern about a call they hadn’t

received. Kit made things so peaceful by helping take parents to PACU while I

checked in parents. Esmeralda, thank you for following up with parents around

the waiting room. And Deirdre who helped with a parent being stressed about

procedure time change.”

You ladies rock!!!!!!!!!!!!!!!!!!

-Contributed by Lucy Mendoza, PCA

Post-op call comments from parents:

“Amazing experience from Registration to Discharge and your follow up phone call. All staff are phenomenal. Excellent service. “

“I was very impressed. Staff were super friendly, they made sure our child was comfortable. Very pleased with the whole experience

and thank you for the phone call to check on us, I appreciate it very much.”

“Love it! Completely different in Florida. We liked the pager, the wagon in pre-op. It was very comforting for our child. Great experi-

ence.”

“Great service, BIG 10, Big thumbs up.”

“Great, loved the map pagers, etc.”

“Everyone was amazing! Thank you so much.”

“You are all amazing. Everyone was so comforting and kind and kept us informed to make it the best possible experience.”

20

“Sharon. Awesome job on the newsletter "Incisions Decisions". It was fun to read and left me feeling a part of something bigger than myself. You are such a great tech and an amazing person. Thank you for taking the time to create this quarterly newsletter. Thank you also for the superb care you provide our patients. You are a special person doing a beautiful job at work and helping to create a great work environment with a culture of caring and understanding. Thank you. I am honored to work with you and grateful for your dedication. All the best,”

Lester Machado, MD

“Super happy doctor is treating son, more than satisfied. Dr.Pransky is the best

I've ever seen.”

-From Patient Experience Survey

Hello all!

Here is a comment from a parent that demonstrates what an awesome job you do each

and every day:

“Above EXCELLENT- each person we encountered was above excellent!!!”

That pretty much sums it up! Thanks for working so hard!

-Contributed by Toneya Jackson, RN BSN CPN

“The doctor was outstanding and let us take as much time as

needed to ask questions.”


“The doctors were very considerate and taking time

to make sure we were ok before he went in there.

The nurses were very nice, staff in waiting room was

very informative and even the security guard. Would

not change a thing.

-From Patient Experience Survey”

“Everyone was at eyes view and they all

were just wonderful with children and

worked well together and everything was

amazing.”


“Their organization, how easy it is to follow everything,

watch progress, check on you frequently, if you can't be

with your kid at least you know what's going on.”


“Everything was outstanding, especially the

nurses. They were very caring and reduced

my son's anxiety.”


rady children's surgical services newsletter

Health & Medicine