Heart Month:

American Heart Month, observed every February, is dedicated to raising awareness about heart disease, the leading cause of death in the U.S. It encourages people to adopt heart-healthy habits, such as eating nutritious foods, exercising regularly, managing stress, and monitoring blood pressure and cholesterol levels.

From the CDC:

• Heart disease is very common. In the United States, heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups. In 2022, 1 in every 5 deaths in the United States was caused by heart disease.

• High blood pressure is a leading cause of heart disease. Nearly half of U.S. adults have high blood pressure, which puts them at risk for heart disease and stroke. And just 1 in 4 people with high blood pressure has it under control.

• Heart disease is costly. The cost of health care services, medications, and lost productivity from heart disease amounted to $252.2 billion between 2019 and 2020.

Welcome Cindy Jensen ARNP:

Cindy has joined the Tonasket Family Medical Clinic to work alongside Dr. Jex to provide primary care. For the last several years Cindy has worked providing primary care for the VA. Her focus is on adult and geriatric patients. Cindy and her husband previously purchased a home in the area and decided to make the move to Okanogan County full time. The both enjoy working on projects and feel very welcomed by the community.

If you are looking for a primary care provider you can contact the clinic at 486-3119 to make an appointment with Cindy.

We love our acronyms (WLOA):

It can be complicated sorting out the various roles in healthcare. As mentioned above Cindy is an ARNP, but what does that mean? Here is primer:

MD/DO: Physician

• Role: Diagnose and treat illnesses, prescribe medications, perform procedures and surgeries, and oversee patient care.

• Training: Medical school (MD/DO), residency (3-7 years), and optional fellowship for specialization.

ARNP: ADVANCED REGISTERED Nurse Practitioner

• Role: Diagnose and manage illnesses, prescribe medications, perform medical procedures, and provide patient education.

• Training: Bachelor’s and master’s degrees in nursing, with clinical experience.

PA: Physician Assistant

• Role: Work under physician supervision to diagnose illnesses, develop treatment plans, perform minor procedures, and prescribe medications.

• Training: Master’s degree with extensive clinical rotations.

RN: Registered Nurse

• Role: Provide direct patient care, administer medications, monitor vital signs, assist in procedures, and educate patients.

• Training: Associate or bachelor’s degree in nursing (ADN/BSN) and licensure exam (NCLEX-RN).

LPN: Licensed Practical Nurse

• Role: Provide basic nursing care such as monitoring patients, administering medications, and assisting with daily activities under RN supervision.

• Training: One-year nursing program and licensure exam (NCLEX-PN).

CNA: Certified Nursing Assistant

• Role: Assist patients with daily living activities (bathing, feeding, mobility) and provide basic care under RN or LPN supervision.

• Training: Short-term certification program and competency exam.

MA: Medical Assistant

• Role: Perform both administrative (scheduling, medical records) and clinical (taking vitals, drawing blood) duties in healthcare settings.

• Training: Certificate or associate degree program with clinical internship.

RpH: Pharmacist

• Role: Prepare and dispense medications, ensure proper drug use, provide patient counseling, and collaborate with healthcare teams.

• Training: Doctor of Pharmacy (PharmD) degree and licensure.

Pharmacy Technician

• Role: Assist pharmacists in dispensing medications, managing inventory, and handling administrative tasks.

• Training: Certification program or on-the-job training.

Radiologic Technologist (X-ray Tech, MRI Tech, CT Tech, etc.)

• Role: Operate imaging equipment (X-ray, MRI, CT) to help diagnose medical conditions.

• Training: Associate or bachelor’s degree in radiologic technology and certification.

MT/MLT: Laboratory Technologist

• Role: Perform diagnostic tests on blood, tissue, and other samples to assist in disease detection and treatment.

• Training: Bachelor’s degree in medical laboratory science and certification.

RT: Respiratory Therapist

• Role: Treat patients with breathing disorders, manage ventilators, and provide emergency respiratory care.

• Training: Associate or bachelor’s degree in respiratory therapy and licensure.

PT: Physical Therapist

• Role: Help patients recover mobility and manage pain through exercises and rehabilitation techniques.

• Training: Doctor of Physical Therapy (DPT) degree and licensure.

OT: Occupational Therapist

• Role: Assist patients in regaining independence in daily activities after illness or injury.

• Training: Master’s or doctoral degree in occupational therapy and licensure.

SLP: Speech-Language Pathologist

• Role: Diagnose and treat speech, language, and swallowing disorders in patients.

• Training: Master’s degree in speech-language pathology and licensure.

RD: Registered Dietitian

• Role: Develop dietary plans for patients with medical conditions to promote health and recovery.

• Training: Bachelor’s or master’s degree in nutrition/dietetics and licensure.

Speaking of Jobs:

HR sent out a guide to the new job postings and applications process. I’m excited about this update to create a streamlined, uniform process for applicants. Check out the job postings here:

One noteworthy item is the significant progress made over the last year in recruitment and retention. As of the publishing date of this newsletter there are only 8 open positions in the District, and throughout 2024 and 2025 we have reduced the number of temporary/traveling employees.

Road Construction:

The next phase of road construction in Tonasket is scheduled to start on March 10th. This phase will have major impacts to the operations at the hospital, clinic, and outpatient therapies. Our next newsletter will have more information about detours, access, and parking.

Operation Cerner:

Over the next four months, the team at North Valley will be transitioning to a new Electronic Health Record System: Cerner. This change has been a long time coming, and this upgrade is designed to enhance patient care, improve efficiency, and ensure the safety of your medical information. However, this change involves a lot of behind-the-scenes work for our dedicated staff and may bring noticeable updates for our patients and visitors.

What is an EHR and Why the Change?

An EHR is a digital version of a patient’s paper chart, designed to provide accurate and up-to-date information to healthcare providers. Our new system will replace our current platform, offering improved features like better coordination between care teams, faster access to patient histories, and more secure data management.

This change is part of our commitment to delivering the highest standard of care and staying at the forefront of healthcare technology.

What Staff Are Doing Behind the Scenes

The transition to a new EHR is a significant undertaking. Our staff have been hard at work to ensure a smooth rollout. Here’s a glimpse of what’s involved:

1. Training: All staff, from nurses and doctors to administrative personnel, are participating in extensive training to learn the new system.

2. Data Migration: Patient records are being securely transferred to the new system, ensuring no loss of important medical history.

3. System Testing: Teams are conducting rigorous tests to confirm the system is functioning correctly before it goes live.

Looking Back:

2024 has been a transformative year for NVH, marked by significant building efforts—not just in the literal sense with ongoing construction, but also in strengthening our teams.

This year, we’ve welcomed new nursing leadership in both the Hospital and Extended Care units and filled several key roles across other departments. At the start of 2024, we faced significant staffing challenges, with 24 open positions and a heavy reliance on contract staff (travelers), particularly in nursing.

Through dedication and teamwork, we’ve made steady progress. Over the course of the year, we’ve successfully reduced our open positions to just 12, significantly improving our staffing levels. These strides have also allowed us to reduce our reliance on agency staff—a trend we’re confident will continue as we head into the new year.

This progress reflects our commitment to building a strong, sustainable team that provides the best possible care for our patients and community. We look forward to achieving even greater milestones in the coming months!

Respiratory Season:

In January the Extended Care was in outbreak status for Influenza A. The team has done a fantastic job of following their process for an outbreak, and we are now at the end of the outbreak. Lauri Jones from Okanogan Public Health gave kudos to the team for their prompt reporting, plan in place, and success in preventing further infections. I’d also like to recognize Dr. Di Croce for her timely response and care of our residents.

Across the county, we have high levels of influenza and continuing cases of COVID and RSV, but it is not to late to protect yourself with a vaccine. Ask your primary care provider or local pharmacy.

Extended Care Activities Department:

At North Valley Extended Care, our Activities Department is the heart and soul of our community, tirelessly working to enhance the lives of our residents. This incredible team brings energy, creativity, and compassion to their roles, ensuring every day is filled with opportunities for connection, engagement, and joy.

From themed parties and holiday celebrations to art programs and spa treatments involving manicures and salon treatments, the Activities Department curates a diverse calendar of events that cater to all interests and abilities. Recently, our Thanksgiving meal celebration was a huge success, featuring delicious food. Residents, families, and staff came together to create cherished memories. Families wrote comment cards, including “The staff all went above whatever you could imagine. Helpful, friendly, over and above to make us and the residents feel good. May God bless you all” to “As we enjoyed the Thanksgiving meal, the family chatted about the care and detail involved. The staff chat and look residents in the eye, smile, laugh and just love on them. The home is clean. The meal was delicious! Thank you”.

Understanding the importance of socialization, the team hosts group activities such as games, which include bingo, Yahtzee, and card games. Other group activities involve a multitude of crafts, which are then on display throughout the facility as table centerpieces or hung on the walls for all to enjoy. There are men’s group, women’s group for discussions and group activities that pertain to each. The residents enjoy musical entertainment throughout the month by a variety of volunteers who share their talents with singing groups, including those that bring their instruments and play as they sing. Frequently, the residents are encouraged to join in to supplement vocals. When the weather is cooperative, outdoor activities are a focus and the residents enjoy growing—and eating—their harvests in the garden grown in the courtyard. Throughout the summer there are weekly barbecues in which the residents enjoy their noon meal al fresco. The residents are also treated to group outings to museums or shopping trips. These gatherings foster camaraderie and encourage residents to build meaningful relationships with one another. In addition, the Activities Department will arrange one-on-one visits for residents who may prefer quieter interactions, ensuring everyone feels included and valued.

Shannon, Teresa, Teresa, and Sherry

The Activities Department also impresses with their efforts to assist residents with transportation to medical appointments. Their attention to detail, patience, and kindness make what can be a stressful situation so much easier for residents and their families. Whether it’s coordinating schedules or offering a comforting presence during the trip, this team exemplifies care and compassion every step of the way.

All of this is made possible through the dedication and passion of the Activities Department. The department is made up of assistants Sherry Porter, Shannon Gutzman, Teresa Fast, and led by Teresa Davis. These ladies have worked at the facility for a combined total of 37 years. Their ability to bring smiles to faces, promote wellness, and create a vibrant community is truly inspiring. Whether planning a special event or spending time chatting with a resident, their impact is immeasurable.

We’re incredibly grateful for their hard work and the positive difference they make in the lives of our residents every day. If you’d like to support their efforts, consider volunteering or donating materials for activities. Together, we can continue to make NVEC a wonderful place to live and thrive.

Thank you to our Activities Team – you make life here extraordinary!

Vaccines:

Protect yourself and your loved ones by getting the COVID-19 vaccine. Vaccination is a safe and effective way to reduce the risk of severe illness, hospitalization, and complications from the virus. By getting vaccinated, you’re also helping to protect vulnerable members of our community and contributing to a healthier future for everyone. Schedule your COVID-19 vaccine appointment with our clinic today and take an important step toward keeping yourself and our community safe. Call at 486-3191 to book your appointment!

Hospital Foundation:

As we wrap up the multiple-year construction project, one of the most exciting items for staff is the creation of two new rooms for patient care. We will now have an additional ED room and inpatient hospital room, which will help get patients out of the waiting room and into the ED sooner. The additional hospital room will give us extra flexibility, particularly when caring for patients with infectious diseases. These rooms were partially built in 2010 with the new addition but have served as storage over the last 14 years. This project was made possible by the generous donation of $100,000 from the Hospital Foundation.

The Hospital Foundation (North Valley Community Health Association) is holding its annual giving campaign, and if you would like to support future investments in local health care, you can contribute here.

Welcome Kristy Terzi:

Kristy Terzi serves as Chief Nursing Officer at North Valley Hospital District, where she leads a dedicated team of nursing professionals in delivering exceptional patient care. With over 30 years of experience in nursing, Kristy has extensive expertise in bedside nursing, nursing education, and nursing leadership. She is committed to fostering a culture of compassion, collaboration, and continuous improvement. Passionate about the privilege of being a nurse and empowering nursing teams, Kristy collaborates closely with other healthcare leaders to enhance patient outcomes and support the District's goals.

Kristy holds a Bachelor of Science in Nursing from the University of Alaska - Anchorage, along with multiple specialty certifications. She is dedicated to education and actively pursues formal and informal learning opportunities. Her commitment to continuous growth drives her to seek ways to improve processes and communication, thereby enhancing outcomes. The development of a strong clinical team and her dedication to the nursing process are foundational to her role. Community involvement and county-wide collaboration are central to her professional focus. With a strong emphasis on caring for people, her leadership supports both the staff of NVH and the community it serves.

Outside of work, Kristy enjoys her farm and caring for animals with her husband. Their move from Alaska to Tonasket in 2020 was influenced by his familiarity with the region. She cherishes spending time with their four sons and beautiful granddaughter, taking walks to appreciate the area's natural beauty, and quilting, which is her favorite hobby during the fall and winter months.

CT Machine:

The new CT is installed and looking much better than the picture we shared last month. The upgrade from our previous CT scanner at 32 slices to 64 slices significantly enhances diagnostic capabilities. With 64 slices, the scanner provides higher-resolution images, allowing for more detailed visualization of complex structures, such as blood vessels, organs, and soft tissues.

This upgrade reduces scan times, improving patient comfort and throughput, while also enabling better detection of small lesions, improved 3D reconstructions, and more accurate assessments of coronary arteries and other critical areas. Overall, the increased slice count improves diagnostic accuracy, leading to better patient outcomes.

Extended Care Surveyors:

Fresh off the State and Federal Survey for the Hospital Division, the Extended Care is undergoing its annual surprise survey. Nursing home surveyors are trained professionals who conduct regular inspections to ensure that long-term care facilities meet federal and state quality and patient safety regulations. They assess various factors, including staff qualifications, patient care practices, cleanliness, safety protocols, resident rights, and the overall physical environment.

Their goal is to ensure that residents receive high-quality care in a safe and supportive environment. The survey process is important because it helps identify areas for improvement, ensures compliance with standards, and protects vulnerable residents.

We collaborate with surveyors by providing requested documentation, answering questions, and addressing any concerns raised during the inspection. This collaboration enhances the facility's performance and maintains a high standard of care.

Next month, we will summarize any findings and our plans to correct them.

Dry Needling:

Dry needling is a therapeutic technique in which a trained physical therapist inserts small, sterile filament needles into the skin and muscle directly into a muscle trigger point, or concentration of knots within a muscle. 

This technique has proven successful in treating muscle pain and dysfunction, migraine, dental pain, and muscle dysfunction limiting range of motion or strength.  

We are proud to announce that four of our PTs have completed rigorous training and testing to be certified to offer this technique to our patients.  They are getting great results having now treated 55 patients since October. 

Diagnoses have included:  Pain, Bursitis, Muscle Strain, Migraine, Headache not classified as migraine, Nerve Impingement, Sciatica, Patella-Femoral Disorder, and Joint Capsulitis. 

We are happy to be able to offer this service to our community.

Announcements:

• Medicare Open Enrollment

  • Closes on Dec 7th

  • The Office of the Insurance Commissioners provides a free, impartial service called SHIBAs (Statewide Health Insurance Benefit Advisors). These volunteers can help you assess your coverage needs and eligibility and help you enroll. Call 1-888-452-0731 to make an appointment with a SHIBA.

• Nationwide IV Fluid Shortage

  • All Hospitals remain in conservation mode following hurricane-related supply disruptions.

  • At NVH our supply has started to improve and we hope to see continued shipments.

• Hospital Foundation Scholarship Awardees:

  • Charlee Buchert, Karlie Richey, and Kendra Castrejon each were awarded $1000 to continue their education in pursuit of a healthcare career. Congratulations!

• Board Meeting Date Changes

  • Due to holidays and the budget approval schedule the Board Meetings have changed for November and December. The new dates are:

    • November 14 7pm (today!)

    • December 19 7pm

Congressman Dan Newhouse and TFMC Team

Congressman Dan Newhouse Visit:

On 10/16 Congressman Newhouse visited North Valley Hospital and Extended Care. Newhouse met with representatives from the hospital, clinic, and nursing home to ask how he could better represent our rural interests in Washington, DC. The conversation focused on workforce development, reimbursement rates, telehealth, and infrastructure investment.

Thank you, Congressman Newhouse, for your continued interest and advocacy for rural healthcare.

CT Installation:

This month, we are installing a new CT, drastically improving image quality as we upgrade to a 64-slice-capable machine. During the de-installation and installation, the Radiology team will use a mobile unit to ensure we maintain access to this critical diagnostic tool during the project.

The GE Technician is hard at work.

IV Saline Shortage:

As you may have heard in the news, Hurricane Helene flooded the Baxter manufacturing plant, which produces a large portion of the US’s IV saline solution. It will take time to bring the plant back to full production, and like every other hospital, our supplies are running low. We are getting a small amount of fluids from our distributor, but until our supply returns to normal levels, we are conserving as much fluid as possible. Most patients won’t notice any impact, but we have paused elective procedures and are working to be judicious in our saline use.

Medicare Open Enrollment:

Medicare Open Enrollment started on 10/15, and for seniors, the decision to enroll in Traditional Medicare or Medicare Advantage can have implications for costs and access to care. As you make this decision, we would encourage you to learn the pros and cons of each type of plan and be mindful of any sales pitch that sounds too good to be true. The Office of the Insurance Commissioners provides a free, impartial service called SHIBAs (Statewide Health Insurance Benefit Advisors). These volunteers can help you assess your coverage needs and eligibility and help you enroll. Call 1-888-452-0731 to make an appointment with a SHIBA.

In memory of Shane Pyper:

Earlier this month our Radiology Manager Shane Pyper, passed away in a car accident. Shane’s leadership, dedication, and kindness made a lasting impact on both the Radiology Department and our entire hospital community. This is a significant loss for all of us and we join his family in grieving and remembrance.

Road Construction:

It got a little harder to get to our campus, but for the most part, we are getting acclimated to the detours and traffic changes. If you are coming to the hospital, use caution and, in particular, watch for pedestrians along the detour route and by the ambulance’s bay.

Department of Health, CMS, and Fire/Life Safety Survey:

On August 6th a group of surveyors arrived to conduct a surprise inspection of Hospital and outpatient clinics. The surveyors were conducting both the state survey and the federal Centers for Medicare & Medicaid Services (CMS) survey. The surveyors were here for two and half days and spent time touring the facility, interviewing staff, observing, reviewing documentation, and inspecting the facility.

The surveyors reviewed their preliminary findings in an exit interview on August 8th, and emailed a Statement of Deficiencies on August 15th. The surveyors found 12 deficiencies for the Federal survey, and an additional 2 items that were state specific. The Fire Marshal identified 13 items for correction.

To give the you an example of the types of items here are a few of the deficiencies:

CMS/State:

• The Med Staff Bylaws are overdue for review

• An expired medication was found in a crash cart

• We did not have a policy to provide emergency contraception for a sexual assault victim

• A drainline on an ice machine was dirty

• We failed to document vital signs following a blood transfusion

Fire Marshal:

• Sprinkler heads found to be dirty or missing an escutcheon

• An improperly mounted fire extinguisher was found

• Several offices had electrical multi prong adapters in use, and a construction worker had run an extension cord under a door

• A sprinkler head had items within 18 inches of it, and some sprinkler pipes had data cables touching them

• Penetrations were observed in walls or smoke barriers

On August 22nd we submitted a Plan of Corrections to both fix the noted issues and also how to prevent them from occurring in the future. The surveyor team approved our Plan of Corrections and the Fire Marshal conducted a return survey on September 10th to review the corrections to ensure the fixes have been completed.

We strive to be transparent about the work we do and acknowledge that despite our efforts we have areas to continue to improve. Our goal is perfection, but this survey results are very typical and the deficiencies are easily corrected.

If you are interested in learning more about what the surveyor look for the Department of Health provides a list of the common deficiencies.

Flu Season:

As we enter flu season, it's more important than ever to protect yourself and your loved ones by getting vaccinated. The flu vaccine is a safe and effective way to reduce your risk of serious illness, and it helps protect those around you, especially the most vulnerable. Make sure to schedule your flu shot soon and stay healthy this season!

Oroville Farmers’ Market:

This Saturday is a healthcare-themed market day, and we will be representing NVH from 9-1. If you are in the area come stop by and say hello!

Public Hospital Districts:

As we visit with our friends and neighbors at community events like the Farmers’ Markets, one topic that comes up frequently is the lack of understanding about who and what we are. Some residents think we are affiliated with Confluence Health or just focused on Tonasket, but the reality is that we are an independent special purpose district, much like a school district. We serve everyone in our district, including Loomis, Oroville, Havillah, Tonasket, Chesaw, and Wauconda.

As a public hospital district, our mission is to ensure that the residents of our community have access to essential healthcare services, regardless of their location or financial situation. Established by the people we serve, we are a governmental organization funded through local taxes and patient revenues. This allows us to provide a wide range of medical services, from emergency care to routine checkups, and to operate hospitals, clinics, and long-term care facilities that address the unique health needs of our region. We are governed by an elected board of commissioners who represent the interests of our community, ensuring that we remain focused on providing high-quality, accessible care.

Check out this video from the Association of Public Hospital Districts that explains the work we do: What is a Public Hospital District?

Happy Environmental Services Week:

As we celebrate Environmental Services Week, we want to recognize and honor the hard work of our Environmental Services team. These dedicated professionals play an essential role in ensuring that our hospital and nursing home remain safe, clean, and welcoming for everyone. Their behind-the-scenes efforts make a big difference in protecting the health and well-being of our patients, residents, and staff. We are deeply grateful for their commitment to maintaining a healthy environment, and we encourage everyone to join us in celebrating this amazing team!

We didn't quite get the whole team together, but here is most of us!

Nursing Home Facility Assessment:

Every year we conduct a Facility Assessment for North Valley Extended Care. This document (a breezy 29 pages) outlines the care we provide, the residents we care for, the resources and tools we need, and the staff required to conduct that work. Historically, the Facility Assessment had been prepared each year by a small group of NVEC employees, but a recent CMS rule now requires a broad audience to participate and engage in the process of creating the Facility Assessment.

This change has been a great opportunity to connect with residents, families, front-line employees, and our Board of Commissioners on the great work we do in the nursing home. We are proud of our 5-Star rating and the feedback throughout the process has been overwhelmingly positive.

Although we’ve completed the document for 2024, it will require updates and before you know it we will get started on the 2025 version.

Immunization Awareness Month:

August is National Immunization Awareness month which raises awareness about the importance for people of all ages to get recommended vaccines throughout their lifetime. In 1796, an English doctor named Edward Jenner developed the first vaccine when he noticed that milkmaids who had been exposed to cowpox appeared to be immune to smallpox. His techniques were not up to today’s standards, but he started the learning process which led to modern day vaccines. Vaccine development has come a long way since then and has expanded as new scientific discoveries have been made. Although no vaccine is 100% effective, vaccines have proven to be one of the most successful & cost-effective public health tools to help prevent serious illness. Not only do they protect the person receiving the vaccine, they also keep diseases from spreading to other people. 

Here are some common vaccines recommended for adults:

• Shingrix is the most recent vaccine for shingles.  It was released in 2017 and requires 2 doses for the best protection.  People who had the previous version of the shingles vaccine, Zostavax, should get both doses of Shingrix for maximum protection.  The CDC recommends this vaccine routinely for people over the age of 50. If you are unsure which vaccine you had for shingles, talk to your doctor or pharmacist and they can help you determine if you should have this vaccine.

• RSV is a vaccine that is now recommended for people over the age of 60 who are at increased risk for severe respiratory illness. This includes people with chronic conditions like lung disease, heart disease, those who live in a nursing home or other long term care facility and those with other chronic conditions.  This vaccine is a 1 dose vaccine.  Your doctor or pharmacist can help you determine if this vaccine is recommended for you.

The CDC also recommends everyone over the age of 6 months get a flu shot every year.  People over the age of 65 are eligible to get the high-dose flu vaccine but if that is not available it is fine to get a regular flu vaccine. In addition, there is also a new 2024-2025 COVID vaccine that will be available this fall and it is recommended that everyone over 6 months of age get this updated vaccine. 

For up-to-date information on recommended vaccines, visit CDC.gov/vaccines/schedules/index.html

Wound Care:

The wound clinic at NVH treats complex and non-healing wounds with a referral from a primary care provider. These types of wounds may be caused by injury, disease, or poor blood supply. Our clinic combines advanced clinical tools with traditional practices to provide exceptional wound healing.

The wound clinic will work with each patient to develop an individualized treatment plan to aid with wound healing.

In addition to traditional wound treatments, our wound clinic, when appropriate, can utilize:

• Advanced Dressings

• Non-selective and Conservative Sharp Debridement

• Skin graft substitutes / Allografts

• Negative Wound Pressure Therapy/Wound Vacs

• Compression therapy

• Biological debridement

This service continues to grow as our team’s reputation for great outcomes brings patients from throughout the region. Hopefully you won’t need treatment for a complex wound, but if you do, its’s great to have this team at North Valley.

Community Events:

Look for the NVH Booth at upcoming events. We had a lot of fun at Oroville’s National Night Out last week, and we will be at the Tonasket Tiger Tail Gate and Garlic Festival later in the month.

Our Dietitian Frano is a staple at the Tonasket Farmers Market. Stop by and say hi!

Rural Excellence Award:

For the second year in a row North Valley Hospital is proud to announce its selection as one of 13 hospitals honored by the Washington State Hospital Association (WSHA) for the Critical Access Hospital Achievement of Quality Excellence program. This prestigious recognition underscores our unwavering commitment to delivering exceptional healthcare services and improving patient outcomes.

The WSHA recognized these hospitals for their exemplary performance in key areas of healthcare quality improvement, including sepsis management, workplace violence prevention, diagnostic excellence, and addressing health disparities. The honored hospitals were selected based on their comprehensive reporting and adherence to quality measures that ensure the highest standards of care.

North Valley Hospital remains dedicated to advancing healthcare quality and will continue to implement innovative strategies to meet the evolving needs of our patients. We are grateful for the support of our community and the hard work of our staff, which made this achievement possible.

Noreen Olma & Kim Jacobs:

Retirements are bittersweet! Noreen Olma, Lab Manager and Kim Jacobs, Safety Officer both retired this summer. Both Noreen and Kim worked at NVH over 30 years.

Their dedication and passion have been truly inspiring, and it's hard to imagine my time here without their presence.

Noreen and Kim have been pillars of strength and support, making a significant impact on all of us. Noreen's unwavering commitment and Kim's boundless energy have shaped the very essence of our work environment. Their contributions have been invaluable.

As Noreen prepares for her well-deserved retirement, celebrated her last week with us, and Kim, who embarks on her retirement journey next month, it is hard to picture NVH without their guiding presence. Best of luck to both of you and enjoy retirement!

Construction Update:

As progress continues on the our HVAC construction, the team has moved onto the first floor in the St. Martin’s Building and Hospital. For patients and visitors this phase of work will be the most disruptive as access to MRI and x-ray require alternative routes. Patients in the ED and hospital floor may experience construction noise and increased traffic, but the crews are striving to be low impact.

Hot Conditions and Dehydration:

Staying Safe and Hydrated

As temperatures rise during the summer months or in hot climates, the risk of dehydration increases significantly. Dehydration occurs when the body loses more fluids than it takes in, disrupting the balance of salts and sugars in the body, which can affect the way it functions.

Understanding Dehydration

Dehydration can range from mild to severe, and its symptoms can vary accordingly. Mild dehydration might cause dry mouth, thirst, and decreased urine output. As dehydration progresses, symptoms can include:

• Dizziness or light-headedness

• Dry skin that doesn’t bounce back when you pinch it

• Rapid heartbeat and breathing

• Lack of energy or confusion

• Fainting

In severe cases, dehydration can lead to heat exhaustion or heatstroke, both of which require immediate medical attention.

Causes of Dehydration in Hot Conditions

When exposed to hot conditions, the body tries to cool itself through sweating. Sweating results in a significant loss of water and electrolytes, such as sodium and potassium, which are essential for normal bodily functions. Factors that can exacerbate dehydration in hot weather include:

• Physical Activity: Engaging in strenuous activities increases sweat production, leading to higher fluid loss.

• Inadequate Fluid Intake: Not drinking enough water to replenish lost fluids can quickly lead to dehydration.

• Clothing: Wearing heavy or non-breathable clothing can trap heat and increase sweating.

• Alcohol and Caffeine: These substances can increase fluid loss through urination.

Preventing Dehydration

To prevent dehydration in hot conditions, it's essential to maintain an adequate intake of fluids. Here are some tips to stay hydrated:

1. Drink Plenty of Water: Aim to drink at lot of water and drink even more if you are active or spending extended periods in the heat.

2. Consume Electrolytes: Include drinks that contain electrolytes, especially during and after exercise. Sports drinks, coconut water, and oral rehydration solutions are good options.

3. Eat Hydrating Foods: Incorporate fruits and vegetables with high water content into your diet, such as watermelon, cucumbers, oranges, and strawberries.

4. Avoid Dehydrating Beverages: Limit the intake of alcohol and caffeinated drinks, as they can contribute to fluid loss.

5. Take Breaks in the Shade: If you’re outdoors, take regular breaks in shaded or cool areas to help regulate your body temperature.

6. Wear Appropriate Clothing: Choose light, breathable fabrics that allow your body to cool more effectively.

Recognizing and Treating Dehydration

Early recognition of dehydration symptoms can prevent more severe health issues. If you or someone else shows signs of moderate to severe dehydration, it is crucial to:

• Stop Physical Activity: Rest in a cool, shaded place.

• Rehydrate: Drink water or an oral rehydration solution slowly. Avoid chugging large amounts quickly, as it can cause stomach upset.

• Seek Medical Attention: If symptoms worsen or do not improve, seek medical help immediately.

Sports Physicals:

Cover your kids' ears, but the end of summer is fast approaching. With the fall sports seasons just around the corner, it is time to start thinking about Sports Physicals. The Tonasket Family Medical Clinic has walk-in availability starting this week on Thursdays and Fridays until August 30th. Call 486-3191 for more information.

Welcome:

Thank you for reading the first edition of our newsletter. If you found us through the website, Facebook, or a printed copy, please consider subscribing at www.nvhospital.org to get updates right to your inbox.

We hope this platform will allow us to provide updates and insights into the work of NVH and topics impacting the health and well-being of our communities.

Construction Update:

Background:

A large portion of the hospital services are located in the 1952 St. Martin’s Building. It is the brick building directly north of the main entrance, and from the exterior, it is hard to tell it is a separate building. Much of the infrastructure is original from the 50’s and in desperate need for an update. Several years ago, we began the design and planning phases to upgrade the heating and cooling on all three floors. The work directly impacts the kitchen, surgery, outpatient clinics, lab, radiology, scheduling and billing.

This project will ensure we can keep using the space with less risk of the frequent heating and cooling issues we have had in the building. It is always a major investment in allowing us to meet upcoming energy savings requirements as part of the Clean Building Act.

In addition to upgrading the HVAC we are using the opportunity to add additional clinical space in the ER and hospital floor. These rooms were designed to be built-out later but have been used as storage. The additional rooms will allow us to see more patients and reduce crowding.

Wayne Verbeck, President of North Valley Community Health Association, aka the Hospital Foundation, presents Adam Tibbs, NVH BOC President, a check for $100k. The funds raised by the Hospital Foundation will be allocated to the completion of two critical projects within North Valley Hospital: Emergency Department Room 1 and Acute Care 110.

The total project cost is over $7M, with funding coming from several areas:

• $100,000 donation from the Hospital Foundation

• $1M grant from USDA

• $775,000 grant from the Department of Commerce

• $5M bond funded from Hospital operations and existing tax revenue
  

Status:

Last month, we hit an exciting milestone by placing the three HVAC units on the roof. It was a significant undertaking, and we wanted to thank our neighbors again for all of the disruption and inconvenience caused by the crane and road closure.

This week, work began on the first floor of the St. Martins building. This represents the final phase, and the project is scheduled to be wrapped up by the end of October.

Men’s Health Month

June is Men's Health Month, aiming to raise awareness of common health issues and encourage early detection and treatment among men. This observance highlights the importance of regular health check-ups, healthy lifestyle choices, and seeking help when needed. Men's Health Month provides an opportunity to promote overall well-being and educate men on the significance of prioritizing their health. With a focus on preventive care and healthy habits, this month serves as a reminder for men to take charge of their health and make informed decisions for a better quality of life.

The first step is making an appointment with your primary care provider.

Well-Being Survey:

Thriving Together North Central Washington is a CMS and state-funded organization focusing on improving health within Okanogan, Chelan, Grant, and Douglas counties. We have partnered with Thriving Together on several initiatives, including the drug disposal kiosk, the behavioral health program, and vocational training programs.

A few weeks ago, Thriving Together launched a Well-Being Survey (available here) which runs through the end of July. We are working with Thriving Together to promote participation in the survey, and we will also strive to support the subsequent efforts to improve the health of our communities. If you have not participate yet, please make your voice heard!

This data helps guide NVH and all of the organizations that play a role in health to prioritize our efforts and better serve our community.

Congrats NAC Class!

Ten students completed the NAC course lead by Rochelle Allen. Pictured (L-R) Ashton Roberts, Hailey Smither, Rosemary Luna, Daisy Martinez, Jasmine Valdez, Rochelle Allen -NAC instructor, Terika Brasher, Genifer Lariza, Emma Lou Brasher, Eva Houlihan, Emma Arbogast

The most recent cohort of ten nursing assistant students graduated in May. This program is a great way for the participants to kickstart a career in healthcare. Our next class for CNA’s starts next week, but if you or someone you know is interested in a future class stay tuned.

Stephanie Steinman, BOC Pos. 4 At Large, and Jerry Bradley, BOC Pos. 2, were sworn in at the December 21, 2023 Board Meeting. This is Commissioner Steinman's first term and Commissioner Bradley's second. OCPHD#4 Commissioners serve 6 year terms.

The Washington Hospital Association recognized North Valley Hospital with the Achievement of Quality Excellence for 2023.

Thank you to our care team for their excellent work!

CMS has updated their Nursing Home Ranks and has awarded North Valley Extended Care a 5-Star Rating.

Read more about the ratings CMS Ratings.

Great work EC Team!

At the June 2022 regular meeting of the BOC, the OCPHD#4 Board of Commissioners approved the purchase of the new Senographe Pristina™ by GE mammography system. The new equipment was installed in August, just in time for October Breast Cancer Awareness Month. The integrated 3D system sets the bar for diagnositc confidence and performance. The ergonomic design helps to improve the overall patient and technologist experience. North Valley Hospital mammography technologists, Michelle Beattie and Brenna Beltrami, are highly trained professionals who aim to provide a comfortable experience for their customers. To schedule a screening mammogram, call 509-486-3124.

The following article appeared in the Spring edition of the NVH Newsletter. It discusses the history of Respiratory Care, reflections from Ken's career, and a highlight of his recent accomplishment.

A History of Respiratory Care – Nationally and Here at North Valley Hospital

By Phil Gleason:

For many of us, when we think of the health care provided by North Valley Hospital, we think of doctors and nurses. Rarely do we recall the ancillary staff that the doctors and nurses depend on for diagnosis, treatments, and to implement the plan of care. Respiratory Care is relatively new to the collection of ancillary departments, with its infancy traced back to “oxygen orderlies”, or the staff managing the potentially dangerous tanks of O2 in the early days. And O2 is a drug, and training individuals in its safe administration would have value. Thus begins the training for what is to become the field of respiratory care.

In Chicago, 1943, Dr. Edwin R. Levine began an “inhalation therapy” program using on the job trainees to assist with post-surgical patients. In 1946, a group of Dr. Levine’s students and others formed the “Inhalation Therapy Association” (ITA) and the first hospital-based department was formed.

The ITA evolved considerably into what is now the AARC (American Association of Respiratory Care), with the standards of care of a respiratory therapist much more defined. In 1960 the American Registry of Inhalation Therapists (ARIT) was formed, leading to a formal credential process for those in the field. This credentialing body evolved into the National Board for Respiratory Care (NBRC.) The NBRC developed two main levels of training and college education standards: certified respiratory technician (CRT) and registered respiratory therapist (RRT). CRTs are similar to LPNs in educational requirements, RRTs are similar to RNs.

Ken Radford, our Respiratory Therapist here at North Valley Hospital, was born in Seattle in 1956, the youngest of 5 boys.

Growing up in Central Seattle provided an ethnic diversity to his childhood; “A really cool upbringing.” He graduated from Franklin High School in 1975, which provided a rich interracial experience. Ken continued his education at Seattle Central Community College taking a variety of classes including welding, music, and accounting. Still looking for direction, an older brother, Ric, a Respiratory Therapy Department head, suggested Ken consider becoming an RT. Ken thought that was a good idea “until I figure out what I want to be when I grow up”. After 40 years in the field, jokingly Ken says, “I guess I never grew up.” In any case, Ken entered the respiratory therapy program at Seattle Central Community College.

Ken began his career working at Northgate Hospital in North Seattle in 1981. A year later (as was the requirement back then) he took and passed his certification exam in 1982. A few years later that facility was purchased by Northwest Hospital. Ken gained about 15 years of high-quality experience in those facilities, including much of his time spent in very active ICUs, where taking care of 2-4 ventilator patients per shift was common. While still working at Northwest Hospital, he and Corina started dating. They soon got married, lived in Mountlake Terrace and had two kids.

They later moved to Wenatchee and had another child. Because pay was better in Seattle, Ken continued to work at NW Hospital. Working three days a week, he would stay at his mom’s, and commute back to Wenatchee. Ken would joke: “I was 35 years old, married, three kids, two dogs, and a cat and owned my own home, but I still lived with my mom.”

Looking to eliminate the commute, Ken checked out a job in Chelan. While at the hospital, he heard of a similar job via the same company at the Tonasket Hospital. “Where’s Tonasket,” he remembers asking.

Ken and Corina decided to make the move to a more rural existence. He was hired as a “rent-a-tech” in the hospital. John Barnhart, was working at NVH at the time. The two of them split the week.
Ken later did homecare for a while, but when Barnhart wasn’t available, the Hospital would call Ken. He would have to tell them he wasn’t available. Later arrangements lead to Ken’s return to NVH. The company Ken worked for got bought out and they stopped providing therapists. Ken went to administration and said, “I’m out of a job and you’re out of a therapist, do you want to hire me,” which they did. When Barnhart left the area, Ken picked up the slack and began call 24/7. For a while RT call was done by the nurse anesthetist, but Ken is again on call 24/7.

“That must have been difficult during this pandemic?” I asked. I saw an expression cross Ken’s face that I’ve seen on other’s when asked about Covid’s impact on them. It is as if language cannot convey their emotion. It’s difficult for them to articulate the feeling when all the hospital beds are full, every gurney in the ER holds a patient, and another car pulls up with someone gasping for breath.

“The pandemic changed everything,” he said. For example, “how safe was it to give nebulized treatments?” Would the aerosol spray the virus throughout the room? Policies and procedures had to be written. Then there were patients who didn’t take the pandemic seriously, who didn’t believe it was real or who refused to take precautions. Ken saw it as a health care issue. When the Delta hit, it got worse. There were really sick individuals who needed intubation and ICU care. But every hospital in the state was full. “We had to up our game. We had to re-think everything and adapt.” Ken credits the hospital administration for setting up a task force to handle this volatile, fluctuating, and dangerous situation. Complementing the task force, Ken says he felt safer in a Covid room than he did walking into Walmart.

After talking with Ken, one is impressed with how much he really enjoys his work. During the years as a CRT in a rural setting, there were few online learning options, and with family and other commitments, completing the requirements to sit for a Registry exam was difficult. But, after four decades of working in the profession, Ken was able to go back to school online and take the classes required to be eligible to sit for the Registered Respiratory Therapist (RRT) exams. This credential required an additional 60 hours of coursework, passage of a four-hour "Therapist Multiple Choice Exam" followed by a Clinical Simulation Test covering chronic airways disease, trauma, cardiovascular, med/surg, pediatric, and neonatal clinical situations. Given his knowledge, experience, and years working in the profession, Ken wanted to obtain the right initials behind his name to better reflect it. He now holds those credentials and is working on a handbook of Respiratory Care for nurses.

A lot of small critical access hospitals don’t have an RT department. It goes without saying; we should acknowledge the importance and heroics of this profession during these difficult and challenging times.

In March the Hospital and Extended Care received new training platforms that provide hands-on CPR practice with feedback to the student to improve our skills. Working in a small facility we (thankfully) do not have as many opportunities to provide this lifesaving care, but when we do we want to be as prepared as possible.

In addition to the student feedback about the quality of CPR being performed, a benefit is the ability to access the training more frequently and on-demand instead of waiting for an annual class.

Vicki Lewis was elected to serve on the Board of Commissioners and formally takes office on January 1st. Vicki has worked in multiple healthcare roles in both military and civilian settings and maintains her RN license.

Welcome Vicki!

The Hospital Foundation recognizes the hard work of all NVH employees with yard signs, banners, and newspaper advertisements. During a difficult year our community is thankful for the work we do.

The NVH Lab has purchased a COVID PCR Analyzer which will significantly improve our ability to quickly and accurately identify COVID positive patients.

On December 15th NVH recieved the first batch of COVID-19 Vaccine in Okanogan County. Starting the next day we vaccinated any elgible healthcare worker, first reponder, or nursing home resident regardless of organization.

In the first two weeks we have vaccinated 500 people, and are awaiting approval from the Department of Health to move forward with the next phase.

The Tonasket Family Medical Clinic remodel of the Verbek building is complete. Dr. Jex and Dr. Dawson are seeing patients in the new space and are happy to be able to have more room.

We are accepting patients now and would love to schedule you for flu shots, check-ups, or to establish a new primary care physician.