Consultation and resources
As a nurse at Salem Health, you have access to professional resources to help you provide excellent care. Some of those available for consultation include:
Advanced Practice Nurses (APN/APRN)
Clinical Nurse Specialist (CNS)
Salem Health engages APNs to act as both expert clinical resources for staff, and in the case of the Midwives and NPs to provide direct patient care. The Clinical Nurse Specialist (CNS) group currently includes clinical experts in Critical Care, Geriatrics, Diabetes and Cardiovascular Care. Some programs the CNS group has championed include multiple research projects, NICHE designation, interprofessional rounds, and promoting evidence based practice. Prepared at the graduate level, each CNS functions within a defined area of clinical specialization in the three spheres of influence: 1) patient; 2) nursing staff; and 3) organization/ network. CNSs provide clinical care for individual as well as groups of patients, conduct research and promote evidence-based practice, as well as coach and educate staff to advance professional practice.
Nurse Practitioners (NPs)
Nurse Practitioners (NPs) practice within Women’s and Children’s Services, Palliative Care and Salem Health Medical Group (SHMG). In Women’s and Children’s, Neonatal Nurse Practitioners (NNP) are utilized to provide care in our Women’s and Children’s services. The NNP group collaborates with neonatologists and other providers to provide comprehensive clinical management of neonates and their families. NNPs respond to neonatal emergencies and attend high risk deliveries directing resuscitation. They function as a resource for staff to promote evidence-based care for neonates and their families to integrate medical and nursing care. This includes providing ongoing educational activities for those caring for neonates and their families. NNPs participate in quality improvement and patient safety activities, promoting evidence/research based practice in the NICU.
In Palliative Care, the role of the APN is to alleviate suffering of actual or potential illness by assessing and treating the patient/family based on holistic goals, and supporting and managing complex patient physical, mental, social, and spiritual issues at the end of life. The APN collaborates with the current healthcare team to provide an extra layer of support for patients during their hospitalization and beyond.
SHMG utilizes Family Nurse Practitioners (FNPs) as providers of direct patient care in the Family Medicine Clinics and the Urgent Care Center. FNPs provide general health care and treatment of adult health, pediatric health, gynecology, and minor office procedures.
Certified Nurse Midwives
Certified Nurse Midwives at SHMG provide general antepartum, intrapartum, postpartum and gynecological health care and treatment to essentially normal women, including examination of patients, performance of health histories and physical exams, ordering, interpreting and evaluating diagnostic tests and recording findings.
Care Managers (Nurse and Social Work professionals) provide evidence-based case management and are responsible for care coordination, utilization management and transition planning for patients within the assigned caseload. In collaboration with other members of the health care team, care managers monitor for appropriate utilization of health care resources and support appropriate and compliant reimbursement, utilizing standardized evidence-based criteria to confirm medical necessity for admission and continued stay. In collaboration with the patient, family, and health care team, they facilitate the creation of a transition plan appropriate to the patient’s needs and resources; assess patients for psychosocial and economic disparities relative to their health problems. They assist patients and families in adjusting to episodes of acute and chronic illness; in coping with lifestyle changes precipitated by illness or disability; in participating in restorative health programs; in carrying out discharge recommendations; and in addressing issues of terminality. This team uses a variety of treatment modalities, assists patients and families in the alleviation or resolution of social, financial, and emotional problems related to illness, rehabilitation and on-going access to health care through the care continuum.
Certified Diabetes Educators (CDEs)
Salem Health employs certified diabetes educators across the continuum of care to serve as a resource to nursing staff, providers, and other health care professionals caring for patients with diabetes. Our CDE team consists of a CNS, NPs, Registered nurses, and Registered Dietitians working in Community Health, Primary Care, Emergency Room, Inpatient care areas and the outpatient diabetes education center. The inpatient glycemic management team supports patients during their hospital stay; the Diabetes CNS provides management, consultation, and education for complex inpatients; the Diabetes Navigators provide specialized community case management services; Primary Care clinics include CDEs in their care teams; and the Education Center provides one-on-one and classroom training in blood glucose monitoring,meal planning, and exercise and lifestyle changes to help those with diabetes work toward effective self-management.
Palliative Care Team
The palliative care team consists of doctors, nurse practitioners, nurses, social workers, medical ethicist, and chaplains who care for people in the hospital when a chronic or serious illness is causing them pain, symptoms or distress. This team provides care on a consultative basis and work with patients and families by managing physical and emotional symptoms caused by disease or therapy; helping families have difficult conversations; and coordinating communication with members of the care team.
Palliative care helps patients understand treatment options, what resources are needed to leave the hospital, or how to get things organized at home. The Palliative Care team believes in caring for the whole person— body, mind and spirit and understands that each person is a unique combination of history, values, preferences and needs. Palliative care provides that extra layer of support for patients who are facing a serious illness to alleviate physical, emotional, and spiritual suffering. Some patients may choose to move from palliative care to hospice care, but most leave the hospital feeling well enough to live their lives and pursue additional therapies as needed.
Rapid Response Team
Salem Health has a Rapid Response Team, comprised of an expert ICU RN and an expert RT, who are available to respond to calls for help in triaging patients whose clinical condition is deteriorating, and who respond to all Code Blue activations. This team can escalate level of care as needed and activate recovery protocols to assist in caring with the patient. Condition H Response is a component of the rapid response system, and was initiated in order to encourage patients and families to partner together with care givers to address patient’s needs. Education is provided on admission to patients and families as to how the Rapid Response Team is a part of their support system while in the hospital, and may be activated any time there is concern over a patient’s condition. Explanations include how to ask for the team as well as how to contact the team themselves if need be.
Wound and Ostomy Nurses
Nationally board certified in wound and ostomy management, these specialized nurses provide consultation at the request of medical staff to assist with management decisions in the care of persons with chronic wounds and fistulas. The WOCN provides pre and post ostomy education/counseling to the patient facing extensive bowel or bladder surgery and daily education immediate post operatively while hospitalized. Patient consults are available in an outpatient clinic as needs arise. As an expert resource, WOCN’s also provide formal and informal education to nursing staff to improve staff knowledge and skill and to advance patient care.
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Our three hospitalist teams of physicians engage in clinical care, teaching, research and leadership in the field of general Hospital Medicine. They routinely care for unassigned, hospitalized medical patients, working with the primary care physicians of these patients. Most hospitalists also co-manage inpatients with a wide variety of medical co-morbidities along with medical and surgical subspecialists and are often the integral care team members and leaders of quality initiatives.
The Medical Ethicist is available to assist with difficulties involving interpretation of advance directives/POLST forms, surrogate decision making for incapable patients, clarification of medico-legal-ethical issues, and anything else that may raise ethical concerns. This resource is open to everyone, staff and patients alike. You can reach the ethicist during normal business hours by paging through the switchboard. Pages after hours are acceptable, but may not be answered until the next business day.
Professional Development Specialists
The PDS team are master’s prepared nurses who are experts in the development, delivery and evaluation of clinical education and professional development activities. Each PDS at Salem Health is assigned a clinical specialty, including emergency services, perinatal, perioperative, adult health, critical care, service line/ancillary departments and rehabilitation. One PDS also functions in a housewide capacity designing programs for education that crosses many or all clinical units and departments. PDSs provide education consultation to each inpatient unit, coordinate new graduate residency/ internship programs, coordinate and educate preceptors, and provide CNA certification and education. They help units provide competency assessment, annual education programs, and work on projects to coordinate any education needed.
Kaizen Clinical Nurse Consultants and Kaizen Specialists
Kaizen Clinical Nurse Consultants and Kaizen Specialists support the achievement of organizational goals through the use of Kaizen methodologies. They promote continuous improvement culture by building spirit, capability and shared learning among staff, physicians and volunteers. The Kaizen staff also lead and facilitate process improvement indicatives that improve patient quality and safety, waste elimination, financial performance, reduction in variation of care, and improve provider/patient experience.