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Sanoma County chosen spot of all the earth as far as nature is concerned, according to the famed plant wizard Luther Burbank Diverse County, with 1,010,000 acres of land on 1574 miles of scenic roadways, Cinema County is rightfully famed for its agriculture. Did a culture, industry and

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recreation, as well as for the amazingly successful ethnic and economic mixture of its more than 340,000 residents on for the forward looking philosophy of its local governing bodies. Now we invite you to take a closer look at Sanoma County in the eighties with your host, Rich

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McGlinchy. Hello. Glad you could join us for this edition of Sonoma County 80. We're going to be talking to members of the community hospital family. Be talking to David Hughes on the left of your screen. He's the assistant administrator for the community hospital, and we'll also

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be talking to market alderman and cheesy assistant administrator but perfect emerging services. I must get that plate fix you know of, why don't we start off by asking each other what your respective responsibilities. Now you're the assistant administrator from the hospital. You're the assistant administrator Nursing

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Services David Wright. With you, what's your basic responsibilities? My responsibilities are in the answer and support services. I have administrative responsibility for housekeeping engineering dietary, which are the support services and then the Answer Services laboratory and what we call the revenue producing departments central supply in

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those areas of the hospital that bring in the money. Basically, as people know who have watched our program over the years, many hospitals a favorite of mine. I was in order there when I was in high school, believing about Yeah, that was what it was a

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very little hospital to write at Margaret. What did your basically I am missus administrator for nursing services. And as such, I'm responsible for all the nursing services in the acute care settings. This includes the emergency room and the image health services for the county. And I

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collaborate with the assistant director of nursing for psychiatric nursing services. We're gonna chat with David for a little while to get his job. That's what he does up there. We're gonna come back and talk to you a little later. David, with so many hospitals offering services

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in health care, perhaps you could describe some of the programs that make community hospital different. Sure, be glad to our main focus that makes community hospital unique is our interest in education. We are the only teaching hospital in Sonoma County were affiliated with the University of

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California, San Francisco vision of community medicine. And as such, we have a residency program in family practice, which is one of the 20 or so recognized specialties and medicines such as pediatrics, orthopedics, family practices, a board certified specialty. And we have 27 family practice residents at

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our hospital for three years, and then they take their national boards. The family practice, incidentally, and you certainly your family practice visit me out here has made an auspicious record. In past years, you've had some outstanding people there, and the nice thing about people who graduate,

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they're the most of them seem to go to small communities where they really need a physician. Well, that is that the general pattern of the family president. Ah, a lot of our residents do go back to real practice. We have, um, several residents that stay in

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the area and support Community Hospital when they finish their practice and we have several that for one reason or another, go into rural practice and look for towns that don't have a doctor that need a doctor. We've had residents go to Montana and Wyoming and places

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like that. Yeah, and we have no Greg Rosa was one of your graduates. I think nobody Occidental, Arian, Mark bandages no back in Washington or something was one of our people here was in current meal. I think Dr Rudy was a graduate of our program. I

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think back in 1941 still practicing here. There's been a great deal of published about community hospital. New responsibility for the oh, I should say, for the county's acute psychiatric services. What can you tell us about this? Well, in January, we took over what was formerly called

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Oak Crest. We don't call it a crest anymore. We call it psychiatric services. Um, Community Hospital took that over in January, and since then we've hired a new nurse manager Jan Golic's with 15 years experience in psych nursing. She has a master's degree in psych nursing

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from U. C. L. A. We've hired a new medical director, Dr Jedd Weiss, who is reorganized the the M D staff, the psychiatrist staff for better coverage. Um, we've developed policies and procedures. We're changing the focus of care from from a triage milieu, whereby the patients

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would come in for a very short period of time into our acute psych unit and then leave for other places. And we're trying to change that into into a longer length of stay where we can offer some therapy programs in some treatment programs which, prior to

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the hospital taking and over, were not available. Um, as you know, the building is quite old and were extensively remodeling that building. We plan to put several $1000 into the what's called the Crisis Clinic. We call it Psychiatric Emergency Services, formerly called the Crisis Clinic. We're

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remodeling that, and it will be a brand new, very modern unit, and we've put several $1000 into the inpatient unit, and we're continuing to look at ways to remodel and upgrade the physical plant of that building. So there several changes going on. Well, as a matter

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of fact, you mention remodeling. There's been a great deal of barley and change at Community Hospital. Um, I guess the best way to Fassbender's What's going on all over? Well, there is extensive remodeling going on inside community Hospital. It's hard to see from the street because

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the building looks the same on the outside. But inside. We have several remodeling project over the last years, which is, I guess, another one of my additional responsibilities as projects. We have recently moved the Department of Nursing Administration Margaret Area into new quarters, newly remodeled quarters,

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and we've expanded the Department of diagnostic imaging. Um, by double. We've doubled the space that they currently had in remodeled it so that we could offer more modern space, better looking space, more functional space for some of our clinical areas. Um, we recently remodeled the Department

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of Admissions, which we've had very good feedback on. I think admissions in a very important area. It's the first area the patient sees when they come in, and it is very modern looking with modular furniture. Very nice. Um, we're about to expand the family practice center,

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which is where our residents have their offices. It's an outpatient clinic. We're adding 10,000 square feet to that building because the volume has justified the expansion of that. We're seeing about 58,000 patients visits a year now in the Family Practice center, which is exceeding all our

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expectations. It is. Well, listen, you know something that's kind of close to my heart, that a play on words either open heart surgery that's going to be starting up there soon. I've been through two of these. So what preparations are being made after they wanted way

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are going to offer open heart surgery, um, to the community beginning in January? We hope currently what's going on is we have taken out of service one operating room, one of the large operating rooms, and we're totally remodeling that to accommodate open heart surgery. There, as

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you know, are a number of regulations pertaining to open heart surgery, and we're preparing one operating for that. We're in the process of remodeling R I C U intensive care unit to accommodate the patients. Post operatively. We'll have what we call a C V I. C.

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U, which is cardiovascular intensive care. We have the heart surgeon already under contract and are working with him trying to meet his needs, and the equipment that he'll need is being purchased in terms of education again. We have hired a full time cardiovascular educator, a nurse

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educator who is on board now full time to educate our nursing staff in the new techniques that they'll need to know in taking care of the patient post operatively. And we are in the process of hiring six Ahrens who will actually be working in the operating

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room. No nurses who are who have the special skills necessary to assist the surgeon in cardiovascular surgery in your hospital publication recently also described a new computer. How's that work? We are in the computer age of Community Hospital. We have purchased a A very large computer

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that initially will do all the financial work for the hospital, the general ledger, the building accounts receivable accounts payable those kinds of data processing functions. It has recently been installed and will be what we call going live means actually being using it October 1st, and I

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think the great the greatest need for computerisation at the hospital right now, in addition to financing is the need for computerized patient registration, and we will be doing that October 1st. We will actually be admitting our patients through the computer and should significantly speed up the

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process well about computers in regard to patient care. Will they also be used for patient care in some way? Not initially. But there certainly is a demand for computers and patient care. This year, the pharmacy has purchased a computer, and they will be doing things like

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Drug Utilization Review and some more esoteric things with their computer. Clinical laboratory is computerized because of their quality assurance and quality control. Needs will be on the computer. And ultimately, within the next few years, we hope to have computers on the nursing units so that they

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can what we call order entry, which they can order drugs from the pharmacy. And they can order lab tests through their terminal and cut down on tremendous amount of time so that nurses are freed up basically to do more patient care. You know, when you were

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talking earlier about some of the unique, uh, properties of Community Hospital, aren't you one of the very few kidney dialysis unit organizations in this area, too? We have on our campus a chronic kidney dialysis unit. It's right next door to the hospital and way have an

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agreement with them. In addition, to that. We do acute care dialysis, which is inside the hospital. And they also do that for us. Way have quite a very active dialysis program. You sure do you have another thing going back? Like I do? Way back. They had

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a 1936 hospital there. Then you had I don't in 1972 56 72 now modernization again. But the the old 36 wing, which would set community hard sitting in hospital a pair and it was a small structure, basically remembered. Only had Ward Ward worried about five orders.

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What what will be done with that? That structure now? Is that still used or not used for patient care? I don't suppose it Now there's there are no patients in that wing anymore. It's an administrative wing. Houses located houses, my Department of houses, Margarets department. We

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have our quality assurance resource management. People are They're basically a business office building, and the patients are in um, for the most part, in the 1972 4 story tower, which is where a patient care takes place. Maybe you're getting back to the subject of a moment

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ago that you open heart surgery? The cardiac surgery, you know. Did you have it? There is really an exciting precept. I know we have 11 of the other local hospital here really just started recently had not very long ago and has been successful. And there's need

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for the unit up there. When? When do they look at the possibility of that being an operation? In coming here? Well, it's it's very exciting for us to be involved in open heart surgery is a very large project. We think we have proven to the community

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that there is a a need for more operating rooms. Do open heart surgery. And we have been contact by a number of agencies there that are interested in us doing their open heart. Uh, surgery. Answer your question. We think that the the education programs and the

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staff and the remodeling will be done by January, and we hope shortly after that to begin our first patient, uh, there a number of education programmes conducted at where they're offered at community Hospital briefly touch on those. Can you, David? Well, in ah, in keeping with

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our education motif and the fact that we are teaching hospital. We offer a number of of education programs and our hospital. We have a very active, very large department of nursing education, I think the largest in Sonoma County, and we offer a number of of ongoing

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programs of interest to the public. Currently is the infant Toddler CPR program. Our nursing educators are offering programs in infant and toddler CPR. If you have a small child or baby at home is it could be a life saving thing to know. And we are offering

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that and you can call the hospital and ask for the Department of Nursing Education, and I'll be happy to sign you up for that. Um, in keeping with the open heart surgery program, we have a number of classes going on right now and in cardiovascular. I

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see you techniques a lot of critical care classes going on and in keeping with the trauma center concept that's going on in cinema canning. We offer a lot of trauma classes. Neuro trauma classes are being taught. Now we have a trauma nurse educator full time at

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the hospital who teaches classes in how to take care of accident victims. Okay, we're going down to the point where were to take a break here with the section, Bring the audience a public service announcement, after which we come back, We're gonna talk to Margaret. Ladies

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and gentlemen, we're talking about community Hospital, a very, very expert medical institution here in Sonoma County. We're talking to David Hughes, the assistant administrator for the Community Hospital, and Margaret Alderman, D, assistant administrator for nursing services. We'll be right back after these important messages. Both. Let

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Child safety seats. The loving connection Welcome back this tradition of Sonoma County. The eighties were talking to members of the community hospital staff talking to David users in the right of your screen and market alderman on the Left ST. We have bit most of our first

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half talking with David. David, you're gonna get arrest Market. Were you there for work? How we know that all the hospitals have nurses. Can you tell me what it is? But I think I really do. But what is it? The nurses actually do? Well. In 1980

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the American Nurses Association produced a document called Nursing a Social Policy Statement, and in that document they defined nursing and the scope of nursing practice. And that definition is one that I think really captures the heart and soul of what nurses do. They define nursing as

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the diagnosis and treatment of human responses to actual or potential health problems. And what that means, if you think about it, is that a nurse is a person who helps on individual live with their health problem. The patient in the hospital who has pain or is

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in traction needs nursing care to help them live with that pain or that traction. And it's the nurse who intervenes to help them cope with a health problem. Very, very good description. Where did you lift that from? Thea American Nurses Association's social policy statement That really

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is. That explains it very well. Why is all this necessary in your Well, I truly believe that if patients did not need nursing care, they wouldn't come to the hospital. The hospital is four nursing care, and otherwise patient could come in and be discharged the same

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day or have a routine procedure done in a doctor's office. But the very reason that they stay in the hospital is because they need nurses. And so nursing has a very important role to play in health care and providing health services to patients. Today, I couldn't

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agree with more. Frankly, I have nothing but the highest compliments of the nurses in your cardiac in up there and also in the other hospital here at Memorial Hospital, for that matter around there Last year, the quality of service in the people involved were outstanding. They

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really were. There's been a lot of publicity of late about a nursing shortage. What does this mean? Well, in 1986 the American Hospital Association did a survey study of 932 hospitals throughout the country, and they found a number of things that are very serious concern, Teoh

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health professionals throughout the country. First, 24% of the hospitals reported that they had a vacancy rate of 15% or more in there are in positions. Secondly, the average hospital in that study was indicating that they took anywhere from 60 to 90 days to recruit and fill

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a vacant position. Third, they found that between the period of 1983 to 1985 there was a 13% reduction in enrollments in schools of nursing across the country. That those fans combined with e problems that we have in the higher acuity of patients because of reimbursement moving

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patients out of the hospital faster. We need more nurses for fewer patients than we ever have before. Given that set of facts, um, the American Hospital Association predicts that by the year 2000 the supply of nurses will be half of what the demand for nurses will

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be. We'll figure that. Ask him, if you will. That you just mentioned is the fact that 13% less enrollments now to study nursing, when when the lead is greater and the numbers going down, a very serious statistics say it is. You've been a nurse for quite

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a while. Did you stay in nursing? What do you really like about? I love nursing? I've been a nurse for 20 years, and I hope to be a nurse for at least another 20. Um, there are a number of really a number of things that I

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love about nursing. First of all, its variety is endless. It offers opportunities. Teoh Healthcare professionals that really other health professions don't. For instance, in clinical nursing, a nurse can specialize in cardiovascular nursing, in pediatrics, in oncology, nursing in medical nursing and surgical nursing whatever. So there's

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lots of different specialties within nursing the nurse can choose. There's lots of settings that a nurse can choose. She can work in an acute care hospital. She can work in a clinic, work out in public health in a school in a doctor's office, the lots of

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different places a nurse can practice and again within the clinical setting, there's lots of levels of responsibility that a nurse can assume she can be a clinical nurse. Ah, nurse practitioner, miners, a NASA tous, a nurse midwife. There is an endless opportunity to choose different specializations

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and levels of responsibility over and above that. Nurses can become educators, um, and go on to be academic people who teach in schools of nursing, they can be scientists and nurse researchers who produce the theory base and the science of nursing. Um, nurses can be managers

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or administrators on, and it's even happening now that nurses can be politicians. It's an endless opportunity to be challenged, to stimulate yourself, to grow and learn over and above that. Working with people is, um, of treasure of a reward in and of itself. That's really difficult

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to verbalize how significant it is when a patient says, thank you for helping me through a very tough period of time. Uh, one of the best known politicians who was former nurses are third district supervisor cover. There's a long, long time. I remember, uh, what is

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Community Hospital done to respond to this general problem. Well, because the nursing shortage is really what we call a multi various problem, there is no single cause off the problem. We're doing a number of different things. Teoh deal with the issues. We're doing some things at

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the hospital wide level, and we're also doing something specifically in the Department of Nursing, and I'll just mention a few of those hospital wide. We have developed a recruitment and retention committee, um, which will be looking at those issues or concerns that nurses and other employees

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in the hospital half. In addition, we are looking at instituting an employee award system through the hospital, and that should be coming up within the next month or two. In nursing, we're looking at decentralizing the level of decision making to the individual units so that the

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clinical nurses who are practicing on the units have the ability to make quick decisions about things that affect their practice on a day to day basis. Um, we have expanded the Department of Education to support the nurses with staff development and educational programs, so those were

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just a few of the things kind of escaping rapidly. A couple got you one of the things that Victor's very faster than you recently went to Switzerland and the winter present a paper at a conference. Now, first of all, tell us about this was an international

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congress of physicians who meet annually in Switzerland. And the topic of the conference was cardiovascular gerontology and a colleague of mine at the University of Southern California who was an assistant professor of nursing there. And I collaborated on a paper together, which we submitted and was

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accepted to the conference s. So we went to Switzerland to present our paper on management models of care of the elderly in acute care hospitals. I must be paper. Uh, nurses usually do this more and more. This is happening as nursing advances the education base of

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the nurses. In practice, we are doing more research. We're doing more academic paper presentations and more of the professional responsibilities for educating and influencing health policy than ever before. We just have one moment left to us, and the one thing I did want to ask you

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quickly. That's a subject. It bears a lot more than a quick response. But we don't have the time, but you have a doctoral degree in nursing and are certified by the American Nurses Association. Basically, what does that mean? My doctoral degree is a degree research degree

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in my substantive area of expertise, which is nursing administration. But the doctoral degree allows me to be an independent nurse researcher and to produce research work that develops the science base of nursing, from which we practice the credential. The certification in Nursing Advanced Administration is a

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certification from the American Nurses Association, which, um, standardizes the body of knowledge in a specific area or content area. Mind being advanced nursing administration degrees, you should be very proud of. Thank you. Thanks very much for being part of the program. David. Thank you. My pleasure.

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Yeah, it's always a pleasure to me to have people from Community Hospital because I have a great deal of respect for the picture institution. Saved my life a few times. I think thats enough reason to respect it. My name is rich. McGlinchey programs and attorneys will

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be back next week. We'll have another members in the county have a family or related a teacher. It's our community hospital. Until then, good luck to each and every one of you