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Everyday, Renown salutes its more than 150 active military and veterans on staff. Becca Gilbert, a Renown trauma nurse, is an example of the many outstanding service members at Renown who are serving both their country and their community. Becca Gilbert, BSN, RN, wears many uniforms. When she’s not wearing scrubs in her role as a trauma nurse in the intensive care unit of Renown Regional Medical Center, she’s wearing fatigues as a first lieutenant in the Nevada Air National Guard. “Service is huge,” says Becca Gilbert, RN, of her role in the Air Guard. “It’s something that is ingrained in me and a big part of who I am as a person. I find a lot of pride in being a part of something that is bigger than what is going on in my world.” Renown Health was named one of 15 recipients across the nation — and the only health system in the U.S. — for the Department of Defense’s highest employer award, the Secretary of Defense Employer Support Freedom Award, for exceptional support of its military employees. The Employer Support of the Guard and Reserves and Renown held a ceremony June 29 to recognize the award and to honor representatives of Renown who currently serve in the Guard and Reserves. With her Air Guard background, Gilbert is preassigned veteran patients at the Renown ICU. She says she’s able to relate to the veterans and their families and create a quick bond with them. “I’ve been assigned patients who are guard members with traumatic injuries — it’s good but hard,” Gilbert explains. “But I really love working with patients who are veterans.” Gilbert’s first career was as a veterinarian technician. Then enlisted in the Nevada Air National Guard in August 2008 — following in her father’s footsteps — and trained to serve as an EMT. While she was a medic, she went to nursing school for her second bachelor’s degree and was able to commission as an officer after graduation. Serving Our Community Gilbert says her work in the guard offers benefits that help with her job responsibilities at Renown, where she’s worked for four years. “At Renown, we are really a team and rely on each other to make sure there are good outcomes,” she says. “In the guard, officers are often put in charge, which teaches you a lot of things — organization, decision making and thinking of others. I think all of those things go hand-in-hand with my role as a nurse, especially in the ICU. People in the guard count on you as an officer and leader, and that is really important in the ICU when patients are counting on you for a positive outcome.” Gilbert’s responsibilities in the guard vary, including training for disaster relief missions and ensuring service members are fit and healthy enough to perform their jobs. “Training is a large part of the military — trauma training, physical fitness training and staying current on certifications,” she says. Locally she also leads the Self Aid Buddy Care program, a United States Air Force program that encompasses basic life support and limb-saving techniques to help wounded or injured personnel survive in medical emergencies until medical help is available. With the guard, Gilbert has also been involved in a bleeding-control program for volunteers in the community. She teaches community groups how to stop bleeding if they are a bystander to a car accident or other type of event, and is working with Renown trauma surgeon Marty Bain, M.D. to implement the program at Renown as well. Making a Difference Abroad In January, Gilbert was presented with an opportunity through the Nevada Guard State Partnership Program to travel outside the United States to the Kingdom of Tonga in the South Pacific and work at the Women and Children Crisis Centre, which assists families who are dealing with domestic violence. Gilbert praised the women who work at the center for their efforts towards change, as she says domestic violence is common in Tonga. “The women who work at the Women and Children Crisis Centre are pioneers,” she says. “They are trying to make changes by documenting what is going on and providing statistics to the lords and kings of Tonga. Some of it still isn’t accepted, but they continue to help the women and children of Tonga. They are helping so many people.” Renown Health salutes Gilbert for her tireless service to her country and her community here at home.

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Learn more about a Renown Health nurse who formed a nonprofit to help other families through loss. After the unexpected loss of her young husband, a Renown Health nurse turned her grief into helping other families navigate the loss of a family member. Jen Walker, RN, MSN, director of clinical excellence, lost her high school sweetheart and husband of eight years when he passed away in October 2015, while their two boys, age 7 and 9, lost their father. Walker, a nurse at Renown since 2003, was overwhelmed by the outpouring of support she received from the Reno community. It inspired her to want to help others in the same situation. “After Travis passed, the community did some amazing things for me,” Walker says. “I got really motivated to do the same thing and to give back, so that’s when I came up with starting The Journey Within.” The Journey Within organization provides support and resources for young families who have lost a close family member. Before officially starting her organization, Walker used some of the money she received after her husband passed and personally donated to three families. And with the help of four board members, Jen officially started The Journey Within in February 2017, and they have helped six families so far. One of the board members is her sister, Anny Goff. “She thought of creating this foundation in the darkest time of her family’s life,” Goff says. “She knew there would be other families that would need help and support and immediately wanted to help others. It showed incredible strength and courage to keep moving forward.” Nursing Careers at Renown Health Nurses at Renown Health demonstrate a commitment to patients and their families through the integration of care, clinical expertise, education, evidence-based practice and the pursuit of quality patient outcomes. Learn more about our mission, vision and values and the benefits of a career in nursing at Renown Health today. Explore Nursing at Renown Walker’s organization supports families through financial donations, which she funds through two yearly fundraisers. The Travy Tourney is a golf tournament held in memory of Travis, and the “Let’s Toast to Travis Fundraiser” event raffles prizes and merchandise. Along with financial support, The Journey Within helps families connect with other community resources, such as counseling and grief therapy services. Walker hopes to expand her nonprofit’s fundraising and support for families beyond the Reno-Tahoe community. Because of her outstanding work at Renown and in the community, Walker recently received a 20 Under 40 award from the Reno-Tahoe Young Professionals Network. She has also received a Women of Achievement award, a Leader of the Quarter award and has been nominated four times for Northern Nevada Nurses of Achievement. “She is strong and resilient and cares a lot about people,” says Jen Richards, chief nursing officer, acute care services. “She never settles for the status quo and is always pushing our team to do better.” In navigating her own loss and starting a nonprofit to give back, Walker has learned a lot about the community. “I’ve gained a tremendous amount of respect for the community as a whole, but especially for the young community,” she says. “Seeing the young people in the community who have been willing to give back and live really selflessly has been amazing to me.” As someone who lost her husband, helping young families who have gone through the loss of a close loved one can hit close to home for Walker, but that doesn’t stop her — it fuels her. “That’s one of the hardest parts about doing this — it takes you back a little bit,” she says. “But it’s just a very good reminder of ‘why.’ Because when I get to talk with these families, I realize that now I am that person who is there to listen. I just want them to know that they’re talking to someone who’s been through something similar.”

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Registered Nurse Tori Tembey (left) shared how her co-worker and fellow RN Jennifer Payne helped a patient with his pet's end-of-life arrangements. "It was such a selfless act that Jennifer took the time to do this for the patient.” Tembey says. Pets become members of our own family, and when they are ill or at the end of their lives, it can be devastating for their owners. During a hospital stay, a Renown patient was faced with the difficult decision to euthanize their terminally ill pet. A Renown registered nurse stepped in to help in some pretty remarkable ways. Back in high school, Jennifer Payne wanted to be a veterinarian. She worked in a veterinary hospital and planned to attend veterinary school, but struggled with some of the situations she faced. “I have a lot of compassion for animals,” Payne explains. “And some of the things I saw while working at the vet — like people bringing in their cat saying, ‘I’m moving, you need to put this cat down’ — wasn’t OK with me, and wasn’t what I wanted to do.” She changed course and went into nursing, but recently drew upon her early experiences working with pets and their owners to help a Renown patient in an extraordinary way. Payne now works in the trauma intensive care unit at Renown Regional Medical Center, where she recently observed a county animal control officer visiting a patient. The patient was visibly upset — they learned their dog was terminally ill and in poor health, and a veterinarian was recommending euthanasia. The patient had lost another dog just before Christmas. The patient hoped to have his ill dog similarly cremated, but animal control does not perform cremation. “I overheard all of this and thought, ‘this is the most horrible thing I’ve ever heard,’” Payne says. She offered to pick up the dog, have him cremated and bring the ashes to the patient. She also took up a collection with her Renown colleagues to pay for the cremation. The next day — her day off — Payne and her young daughter picked up the ashes and brought them to the patient at the hospital. “He couldn’t even talk because he was crying so much,” Payne says. “He said ‘I can’t thank you enough for all you’ve done. You’re a wonderful person.’ There was a friend in the room who asked what my daughter’s name was, and I said ‘Estelle.’ The friend said, ‘Estelle, your mother is an angel.’” Payne, who has a golden retriever of her own, says she knows what it’s like to have “fur babies,” and she could see how important this dog was to the patient. “It was great to be able to do this for him,” she says. Renown salutes nurses like Jennifer Payne, who are making a genuine difference everyday in the lives of patients and in the community.

Read More About Caring for the Whole Family: Renown Nurse Helps Patient with Ailing Pet

Alzheimer’s disease is not normal forgetfulness as we age. Instead, it is a specific form of mental decline. And according to the Alzheimer’s Association it accounts for nearly 80 percent all dementia cases. Natasa Dragicevic, MD, PhD., behavioral neurologist and Alzheimer’s disease specialist with Renown Institute for Neurosciences, weighs in on diagnosing it and the importance of early medical action. How to Diagnose Alzheimer’s Disease In general, the signs of Alzheimer’s disease occur slowly, getting worse over time. For example, forgetfulness is a daily search – for shoes, keys and other misplaced items. Not only is memory affected, but also speech patterns and behavior. There is no single test for Alzheimer’s disease. “Specifically, a neurologist should be the one to diagnose Alzheimer’s disease given differences in presentation,” clarifies Dr. Dragicevic. “And ideally a behavioral neurologist (Alzheimer’s sub-specialist) will be managing the treatment,” she adds. Brain Imaging Diagnosing Alzheimer’s disease involves multiple approaches and medical providers. In short, medical history is reviewed along with a physical exam, lab tests and other diagnostic testing. “A medical workup includes a variety of tests. These include MRI and other brain imaging, as well as neurological and psychological testing. Furthermore, a lumbar puncture is performed to look for markers of the disease,” she states. What Causes Alzheimer’s disease? Although no one knows the cause, researchers think many factors play a role. Uncontrollable risk factors include your genetics and having a family member with the disease. However, the controllable risk factors include: reducing the risk of head injury and keeping your heart healthy. It’s important to realize that high blood pressure, high cholesterol, stroke and diabetes play a role in brain health. Blood loss to the brain causes vascular dementia, leading to long-term blood vessel damage. Symptoms of Alzheimer’s disease Generally speaking, the signs of this disease differ in each person. Yet noticeable behaviors include: • Losing the way to familiar places • Forgetting to pay bills • Trouble finding the right words when talking • Repeating questions • General confusion • Social withdrawal Alzheimer’s Disease – Benefits of Early Diagnosis Equally important, spotting Alzheimer’s disease early allows more time to benefit from medications and possible clinical trials. Likewise, nutrition and exercise changes can be made, increasing blood flow to the body, and perhaps delaying symptoms. Early diagnosis also allows for personal health decisions and quality-of-life conversations to take place.   According to the Alzheimer’s Association, these benefits include: 1. Medical advantage 2. Emotional and social comfort 3. Time to plan ahead 4. Cost savings A Brain Supporting Lifestyle “At the present time, treatment is limited,” explains Dr. Dragicevic. “Usually Alzheimer’s is a progressive ongoing disease – any management at this time is purely symptomatic.” However, she states the following lifestyle changes can help support brain health: • New hobbies such as painting, pottery, music classes or learning a new language • Crosswords, puzzles and playing games, such as Scrabble • Brain challenging mobile apps, such as Luminosity • 30-45 minutes of mild to moderate physical activity per day, such as walking • Eating a Mediterranean diet (primarily plant based foods)

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There are a lot of impressive titles you can use to describe Stephanie Kruse: entrepreneur, marketer, philanthropist, leader, adventurer, nurse. And now with her planned gift to the Renown Health Nursing Excellence Endowment, she can add one more to the list: a member of the Renown Legacy Society – a group of visionary supporters who have chosen to make a lasting commitment to the future health and wellbeing of northern Nevadans. This generous planned gift comes on the heels of a significant cash gift made to the Nursing Education Fund last summer. Stephanie is an inspiring example of someone who has dedicated her life to helping others. The daughter of a nurse and a retired nurse herself, Stephanie knows the hard work, selflessness and dedication it takes to create a successful business and community. As Chair of the Renown Health Foundation Board of Directors, she also understands the importance of attracting and retaining nurses within a healthcare system. As a way to contribute to a cause near and dear to her heart, she decided to include the Renown Nursing Excellence Endowment as a beneficiary of her retirement plans. “I wanted to honor the memory of my mother, who was a registered nurse in a small-town hospital in Iowa.,” said Stephanie. “I was always very conscious of her passion for providing great care to her patients, and I wanted to provide funding for others interested in nursing.” Across the nation, health systems are facing a shortage of nurses and nursing-related professionals. Renown is proactively implementing programs to build our pipeline of potential future nurses and keep those already in the field. Stephanie’s generous gift will help the endowment provide programs such as training, scholarships, loan repayment and professional development to increase retention and recruitment of prospective nurses. “As nurses, we are entrusted with our patients’ lives,” said Melodie Osborn, Chief Nurse Executive at Renown Health. “We have the privilege of caring for people in their most vulnerable time and helping those who cannot help themselves. Stephanie’s generous gift to the Nursing Excellence Endowment Fund will help us develop new nurses for the future so we can continue to provide care to those in need for generations to come.” No Stranger to Healthcare Long before she found herself leading the Renown Health Foundation Board, Stephanie learned the ins and outs of healthcare. She graduated from nursing school and became a part-time nurse in a Sioux Falls, South Dakota nursing home while attending Augustana College to obtain a degree in journalism and a minor in theater. As part of her journalism program, Stephanie completed an internship in the public relations department of a Sioux Falls hospital, and that led to her accepting a position as director of public relations at a sister hospital. She later was recruited by Saint Mary's Hospital and moved to Reno to be the director of marketing in 1981. She stayed at Saint Mary's for almost 10 years before starting her own company in pursuit of her passion for marketing strategy. Since launching her brand, Stephanie has grown KPS3 to a multi-million-dollar firm with more than 60 staff members. Somehow, she is still able to find time to serve on six (!) volunteer boards, most of which are dedicated to improving access to better health and human services. “I have a soft spot in my heart for organizations who strive against all odds to help those with the greatest needs,” said Stephanie.

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At Renown Health, we often discuss the importance of both healthcare – how we treat people when they are sick or injured – and health – how we keep people well in their mind, body and spirit. This conversation is as important for the patients we serve as it is for our healthcare providers.   It’s well known that the medical field can impose challenging and even unhealthy expectations for healthcare workers. Long hours and physically and emotionally demanding work can lead to burnout. Yet, until recently, these issues were rarely discussed openly. Because the role of healthcare providers is to care for other people, they may feel uncomfortable asking for help themselves. The good news is that more and more physicians and professional associations are talking about burnout. Hospitals are also taking action to address concerns like mental and emotional fatigue. We need our workforce to be healthy in mind, body and spirit. That’s why we support our team by educating them on the warning signs of burnout. Renown Health also trains management-level employees to care for those who need help. We encourage employees to talk openly about these challenges and encourage them to access the many services available to our employees that can help them live well. Caring for people is central to Renown Health’s mission. We believe this applies to both our patients and our teammates.

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Immunizations (vaccines) save the lives of thousands of children and adults annually, protecting us from illnesses that can lead to disease, hospital stays, life-long complications and even death. Not only do immunizations protect the persons receiving the vaccine, but through herd immunity, vaccines protect children that are unable to get vaccines due to illness or age and our elderly community members whose immunities may have declined. Vanessa Slots, M.D., offers insight on the importance of immunizations. Immunizations Your Child Needs (and when) Birth to 6 Months Hepatitis B: Shortly after birth, first vaccine dose Diphtheria, Tetanus, and Pertussis (DTaP), Polio, Haemophilus Influenza (HiB), Pneumonia, Hepatitis B and Rotavirus: Ages 2, 4 and 6 months, boosters and vaccines One Year to 18 Months MMR and Varicella (chickenpox) vaccine: Age 1, first vaccine dose Hepatitis A, HiB and Pneumonia: Age 1, booster DTaP: 15 months, fourth vaccine dose Hepatitis, second dose: 18 months Flu Vaccine: 6 months and older, annually* *In the year after receiving their first dose, an infant will need a booster one month later. Four Years Old MMRV, DTaP and Polio, final dose: Four years of age Pre-Teen and Beyond Tdap and Meningitis: Before starting middle school, children receive these vaccines. They are also old enough to start the HPV vaccine, an essential vaccine for all young adults to protect against cancer, genital warts and cervical dysplasia.

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

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Has a male in your life been affected by depression? It could be your father, husband, or son. Or maybe your brother, a friend – or even, your co-worker. They all have one thing in common, they’re men and they may not always be able recognize when they need help. Here’s how you can support the men in your life by understanding their unique signs of depression. Dr. Coard, Ed.D., Psychologist with Renown Behavioral Health, weighs in on the topic of depression and the warning signs. More than 6 million men are diagnosed with depression each year, and surprisingly, depression in men can differ from women. The signs of depression are not easily recognized and it’s common for men to be in denial about what they’re going through. They can demonstrate anger and aggression instead of sadness – making it difficult for loved ones, or even their providers, to recognize. Behavioral Signs of Depression in Men High levels of the hormone cortisol are released during stressful situations affecting the neurotransmitter, serotonin (a feel good hormone), contributing to depression. You can identify depression or suicidal tendencies by paying close attention to the following behavioral changes: Anger, irritability, or aggression Avoiding family or social situations Losing interest in family responsibilities, passions and hobbies Lack of sex drive Becoming controlling/abusive in relationships Risk-taking behavior such as; unsafe sex, overspending or gambling Not being able to concentrate or remember details Excessive drinking or drug use Having frequent thoughts about death Talking about suicide Attempting suicide Factors That Lead to Depression in Men Life Events Work stress or long-term unemployment can be huge contributing factors relating to depression. This type of life event can be overwhelming, making it impossible for a man to cope. Changes in Relationships The loss of a relationship can be a significant contributing factor to the emergence of depressive symptoms and past experienced physical, sexual, or emotionally abusive relationships. With this in mind, counseling can often help individual to overcome this type of trauma. Grief and Loss Overwhelming sadness due to the loss of a loved one can trigger depression. Although normal, each person goes through their own grieving period. For example, normal responses to death are insomnia, poor appetite and loss of interest in activities. Pay attention if grief seems prolonged or out of the ordinary. Health Problems In particular, depression coexists with medical conditions. As men age, this can be passed off as normal aging, but it could be more serious. In addition, illnesses such as thyroid disorders, Addison’s disease and liver disease can cause depressive symptoms. Diabetes, cancer, heart disease, or Parkinson’s disease can affect any age, thus triggering or worsening depression. Some older men also feel like they may be suffering from dementia because of difficulties with memory this may be a symptom of depression. A trip to the doctor may be in order to help alleviate concern and worry. Depression in Men and Suicide Frequently the emotional pain occurring with depression can distort a man’s ability to see a solution beyond suicide. Individuals with depression become very rigid and constricted in the way they solve problems. The statistics below speak for themselves, helping us understand the need to reach out to those who need our support. Male suicide rates are on rising – men die by suicide 3.53 times more often than women, accounting for 70% of all suicides. Sadly, every day 129 men commit suicide. White males accounted for 69.67% of suicide deaths in 2017. In 2017, firearms accounted for 50.57% of all suicide deaths. Middle aged Men who are middle aged have the highest suicide rates. 40% of those identifying as transgender have attempted suicide in their lifetime. Males who are guy or transgendered are at an increased risk for suicide attempts, especially before age 25. Veterans often suffer from post-traumatic stress disorder (PTSD) and depression, and are more likely to act on a suicide plan. How You Can Help Now that you can identify some of the warning signs of depression, here’s how you can help: Talk about your concern and communicate that you’re there to help him. Let him know depression is a medical condition and will usually get better with treatment. Suggest professional help from a Primary Care Provider, Psychologist or Therapist. Help set up appointments and offer to accompany him – let him make the decision, but make it clear you’re there for him, no matter what he decides. If you feel he is in a dire or life-threatening situation, contact 911. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Call the Veteran’s Crisis Line at 1-800-273-TALK (1-800-273-8255) and press “1”

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Flu shots don’t just protect those who get vaccinated; they protect everyone, including your family and the community. As we continue navigating the COVID-19 (coronavirus) pandemic, Renown Health infection prevention expert Whitney Robinson explains how getting your flu shot is vital for staying healthy. 5 Ways to Schedule Your Flu Shot Call Us! 775-982-5000 Urgent Care Appointments Renown Pharmacy Vaccinations Make an Appointment via MyChart Need a Doctor? Find One Now Reasons to get the flu shot Chills, body aches, fever, congestion; getting the flu isn’t fun. But in addition to protecting yourself with a flu shot, you’re helping reduce flu cases and hospitalizations, Whitney said. Flu shots are currently available at pharmacies throughout the Reno area. Whitney says the ideal time to get your flu shot is September through October, but remain relevant throughout the winter months as it only takes two weeks for the antibodies to develop in your body. This timing allows the vaccine to provide the strongest protection during the length of flu season. Who needs a flu shot? Almost everyone. The Centers for Disease Control and Prevention recommends the yearly flu shot for everyone six months of age and older. Equally, they consider it the first and most crucial step in protecting against the flu virus.

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The Benefits of Being Clutter-Free Gives you a better sense of well-being. Did you know procrastination is linked to clutter? According to a recent study clutter problems led to less life satisfaction, especially among older adults. Helps you lose weight. Constantly being in cluttered room, office or car can be stressful. All the undone cleaning tasks in the back of your of mind cause stress, which is linked to obesity. Promotes mental health. Having clutter around can make you feel anxious or overwhelmed. This prevents you from truly relaxing or focusing. Saves you money. It’s not a secret that money worries cause stress. According to a Journal of Consumer Research study, you’re more likely to make a purchase when you’re sitting in a messy room compared to a tidy room. Clutter-Free Tips Start with a plan. Make a list of your clutter-improvement priorities and the tasks needed to accomplish each one. Focus on one section of your home per week, so you don’t get overwhelmed. In fact, organizational expert Peter Walsh suggests starting with the easiest room first to gain momentum. Conversely, "The Life-Changing Magic of Tidying Up" author Marie Kondo suggests organizing by category (for example clothing or books). Experiment with an organizing plan that appeals to you. There are also many helpful on-line calendars you can use as a starting point. Delegate when you can. Include your children and spouse into your plan. Is uncle Bob an electrician? Then get him to swap out your eyesore of a ceiling fan or update an old light fixture. Of course it’s ok to outsource the duties - such as window cleaning or painting - if your budget allows. Buy less. The less you purchase the less you need to store, clean, keep track of, organize or dust. Seems simple, right? Not for everyone. On average we are bombarded with over 4,000 marketing messages a day, not to mention FOMO (Fear Of Missing Out) when we see our friends posting about their newest toys on their social media feeds. Focus on quality over quantity. When in doubt, throw it out. Still on the fence about what to throw away? Use these declutter decision-making guide questions to help you. Organize Your Health Along with taking care of your surroundings, make a commitment to get up to date on your health checkup and screenings. Preventing an illness is a bargain compared to the cost of a chronic disease. It's also a good idea to go through all of your medications and check the expiration date. Remember to properly dispose of medications. DO NOT flush medications down the drain or toilet, unless the label indicates it is safe to do so.

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