experience A natural birth Spooner

Spooner Health
Committe to Excellence.
A natural birth
In this Issue
Every woman has different
expectations in childbirth. Some
mothers want to minimize the pain
as much as possible while others
wish to manage labor and delivery
naturally without pain medication.
No one can predict how the birth
process will unfold or what may be
best for pain control, but it helps to
plan ahead and keep an open mind.
Occupational and
physical therapy
Wound care
End-of-life care
Spooner Health System
| A word from our CEO |
Happy New Year! We have high hopes for 2013 here at
Spooner Health System (SHS), fueled in part by our accomplishments in 2012. Last year was a great year for SHS, and
we are pleased to share several ways we have improved
the care and services we provide to our patients and our
Dr. Patrick McCann’s efforts to deliver faster care to heart
attack patients in our rural area earned him the 2012 Physician STEMI (ST-elevation myocardial infarction) award from
Essentia Health in Duluth. Dr. McCann, who is the Emergency
Room Medical Director at SHS, helped implement a system
in which emergency medical technicians transmit important
EKG information to doctors at the hospital while still in the
field. Doctors like McCann can then interpret the heart data
and make critical decisions about their treatment and, if
necessary, where the patient is to be transported, which
ensures they receive the most appropriate care as quickly
as possible.
Another great example of a commitment to our community’s
health is Kathy Dettle’s certification from the National Alliance of Wound Care (NAWC), which recognizes her ability to
deliver the highest standard in wound care. Dettle, a registered nurse for more than 27 years and Co-director of the
Home Care department at SHS, pursued certification after
seeing a surge in the number of Home Care patients who
needed specialized wound care in our area. The NAWC training helps Dettle bring the latest wound care techniques to
patients close to home.
I encourage you to learn more about these individuals,
among others, and their commitment to the health of our
community in this edition of Spooner Health. In 2013, SHS
remains committed to improving the care and service we
provide to our patients and our community.
Mike Schafer
CEO, Spooner Health System
Therapy helps
patient recover
from a fractured neck
Twice a week, Randy Kabrick walks into Spooner
Health System (SHS) for occupational and physical therapy. That’s no small accomplishment for
a man who suffered a fractured neck less than a year ago.
“I had quadriplegia,” Randy says. “I was paralyzed from the chest down
and lost the use of my hands and legs. It was pretty serious.” Randy
was originally taken by ambulance to Spooner Health System’s emergency room. “I was assessed quickly and appropriately, then air lifted to
the cities for proper care.”
After several weeks at Regions Hospital and several months at Courage
Center in the Twin Cities, he was able to return to his home 12 miles
outside of Spooner. Randy was using a wheelchair and the doctor had
told his family that he was unlikely to ever walk again. But with an
impressive can-do spirit, Randy made the most of the occupational and
physical therapy services offered at SHS and has defied his doctor’s
Understanding occupational and physical therapies
Occupational and physical therapies offer complementary care that can
be combined and coordinated to deliver optimal outcomes, better than
either type of therapy alone. In the Spooner area, only SHS offers both
therapies together.
Randy Kabrick works
with Spooner therapist
Shalla Acker, PT.
Setting goals and helping patients focus on and reach
those targets is a team effort for SHS therapists.
“Physical and occupational therapy work
together to comprehensively address the
entire body,” says Catherine Hewitt, RPT,
Physical Therapist at SHS. Physical therapists
work with patients on mobility, walking,
balance, core strengthening and appropriate
assistive equipment. Occupational therapy
also addresses core strength, especially as
it relates to the function and strength of the
upper body. “As an occupational therapist, I’m
looking primarily at trunk strength as well as
arm and hand function,” says Renita Laakso,
OTR/L, Occupational Therapist with SHS.
Both types of therapy have been essential to
Randy’s recovery.
The road to recovery
Randy first started working with occupational
and physical therapists through SHS Home
Care therapy when he was released from
Courage Center. “The in-home therapy was
real nice,” Randy recalls. “They taught me to
cope with things in my house and helped me
manage my pain.”
“There are so many things we take for
granted that are made difficult by an injury
like Randy’s,” says Laakso, who has worked
with Kabrick both at his home and on an
outpatient basis. “When Randy was first at
home he was in a wheelchair and we started
with the basics such as bathing and transfers
from the wheelchair to bed.”
“It’s come back fairly good since I first got
home,” says Randy. “I’ve made quite a bit of
progress.” As Randy’s function improved and
he regained the ability to drive, he switched
to outpatient care.
Attitude matters
Randy continues to see Laakso for his
outpatient occupational therapy and he now
also receives physical therapy at SHS to work
on strength and endurance. “I am on the
treadmill now for up to six minutes and they
have a bike that lets me exercise my legs for
20 minutes,” Randy says.
With Laakso, Randy works on functional
activities. “We work on carrying objects,
bending, reaching and refining fine motor
skills such as writing,” Laakso says. “He
wanted us to simulate picking up a piece
of firewood and chucking it in an outdoor
furnace. It’s quite a different activity from
making a sandwich in the kitchen, but it’s
something he wanted to be able to do
this winter.”
It’s the motivation to make progress and
tackle new challenges that has impressed
his therapists and helped Kabrick make such
a rapid recovery. “Randy is so motivated,”
Laakso says. “I’ve never heard the man say
‘I can’t.’ If I give him a challenging task he
says, ‘I don’t think I’ve done that before.
I’ll give it a try.’”
Randy, in turn, credits the therapists for
keeping his spirits up. “They are a joy to be
around,” he says. “They keep me positive.
With my injury it’s very easy to get down a
little bit sometimes, but I go in and talk with
them and they don’t let me lose focus.”
Goal-oriented teamwork
Setting goals and helping patients focus on
and reach those targets is a team effort for
SHS therapists. “We have care conferences
once a week,” physical therapist Catherine
Hewitt explains. “The occupational therapist,
physical therapist, therapy assistants and
speech therapists discuss our mutual
patients. Together we can address issues in
the whole body and figure out the best plan of
action for our patients.” Goals include physical
milestones, and also life plans. “We help
patients figure out how they can return to work
or whether they should find a new vocation,”
says Laakso. “The goal is to help patients
continue to progress to a higher level.”
For more information on physical and
occupational therapy at Spooner Health
System, call 715-635-1272 or visit
can help with
many conditions
Spooner Health System’s occupational and
physical therapists help patients with a
variety of conditions, from traumatic brain
injury to repetitive hand injuries. Therapy
may be used for rehabilitation in:
rthopedics: total knee replacement;
neck, back, shoulder and sports injuries.
Ë Neurology: dizziness, balance, stroke,
Parkinson’s, multiple sclerosis, traumatic
brain injuries.
Ë Geriatrics: low vision, fall prevention,
home safety.
Ë Chronic pain: headaches, arthritis,
Ë Hand therapy: tennis or golf elbow,
fractures of the upper extremities, carpal
Ë Women’s health: pelvic pain, prenatal and
postpartum care.
Ë Specialized care: lymphedema, wound
care, work-related injuries.
To learn more, call 715-635-1272 or visit
www.spoonerhealthsystem.com | 3
Emergency Room Doctor Patrick McCann, MD
Innovation improves care
for heart attack patients
Patrick McCann, MD, Emergency Room Medical Director at Spooner Health System, was recently honored with
the Physician STEMI Award from Essentia Health in Duluth. The honor recognized his efforts to deliver more
timely care to heart attack patients in our rural Wisconsin communities. Each year the award is given to the
physician, nurse and EMT who have contributed the most to improvements in emergent care of heart attacks.
“When the emergency medical technicians
(EMTs) pick up a patient with a suspected
heart attack, they do an EKG in the
ambulance, rather than waiting until the
patient gets to the hospital,” Dr. McCann
says. An EKG, or electrocardiogram, records
the heart’s electrical activity, and the results
help doctors determine where and how that
patient can best be treated.
“That saves time, and with heart attack
patients, minutes count,” notes Jody
Stuenkel, ER/OR Director. “When the
ambulance sends an EKG, we can often have
the helicopter (based in Rice Lake) here and
ready to go to a center with a cath lab and
cardiologist immediately. And the team at the
center can be ready and waiting.”
Dr. McCann adds, “When the EKG indicates
that the patient has had a STEMI (STelevation myocardial infarction) — a type of
heart attack best treated immediately with
angioplasty — it means that they need to go
directly to the cath lab. It changes where and
how that patient is transported.”
A better idea
The innovation that Dr. McCann’s award
honors involves communicating the EKG
results to the hospital. “There’s a piece of
equipment that sends the EKG results ahead
to the hospital by phone or fax. But the cell
coverage is so poor in this part of Wisconsin
that it often fails,” Dr. McCann explains. “It
tries to send it two or three times, and
then stops.”
An EMT in Gordon asked Dr. McCann why
they couldn’t just take a picture of the EKG
with a smartphone and send it by email. As
soon as the ambulance hits an area that has
even minimal cell coverage, the email will be
sent. Dr. McCann agreed it was a great idea,
and with the support and efforts of Richard
Mullvain (STEMI Director for Essentia Health
at St. Mary’s Duluth), implemented it with
the Gordon-Wascott EMTs. Plans are in the
works to put it into practice with the Minong
EMTs, too.
“Richard Mullvain and Essentia Health
have been tremendously supportive of this
project,” says Dr. McCann. “This can get a
patient to the care they need up to an hour or
more sooner, which is remarkable.”
About the award, Dr. McCann says, “It
honors a team concept. It wasn’t even my
idea; I just facilitated it. Gordon-Wascott and
Minong EMS and the receiving hospital are
all integral in making this happen. I am very
proud of the team I work with!”
February is American Heart Month
| Know the signs of heart attack |
It’s important to recognize signs of a heart
attack so you can get help right away. Heed
these signs from the American Heart Association
that a heart attack is happening:
♥ Chest discomfort that lasts more than a
few minutes, or goes away and comes back. It
may feel like uncomfortable pressure, squeezing,
fullness or pain.
♥ Discomfort or pain in other areas of the
upper body, such as one or both arms, the
back, neck, jaw or stomach.
♥ Shortness of breath with or without chest
♥ Other signs may include breaking out in a
cold sweat, nausea or lightheadedness.
“Don’t be afraid to come in and be checked out
with a ‘funny feeling,’” emphasizes Jody Stuenkel,
RN, ER/OR Director. “We’d rather tell someone,
‘Well, it was probably that burrito you had for
supper,’ than to have someone with a heart
attack delay treatment.”
Birth Center
A natural birth
Big brother Ben adores
his baby sister.
guided by expert care
The Family Birth Center offers pain management in the form of
intrathecal injections as well as support techniques to help mothers
manage pain naturally. “Whatever you decide, our staff is here to
support you through the process 100 percent,” says Marilyn Nordquist, RN,
OB Manager and Assistant Director of Patient Care Services. “The doctors are
extremely attentive in being here for their own deliveries, and they are extremely
supportive of what the patient wants.”
Support for natural birth
Katie Eichten, MD, is a family medicine
physician who delivers babies at the Family
Birth Center. She has also had two wonderful
birth experiences as a patient at Spooner
Health System, with the births of her two
youngest children.
“Expecting mothers should consider
their plans for pain management during
pregnancy and discuss options during their
prenatal visits,” Dr. Eichten says. “If you
want to have a natural birth, we will discuss
relaxation techniques and help you get
mentally prepared. It also helps to attend
childbirth classes with your support person
and learn about what to expect during labor.”
The reasons for choosing natural birth are
different for every mother, and may include:
 Avoiding introducing pain medications to
mom and baby.
 Being able to walk and move freely
during labor.
 Wanting to feel everything and be actively
involved in labor/delivery.
 Hoping to speed the labor/delivery
process because mom can feel when to
push during contractions.
 Achieving a sense of euphoria and release
of endorphins that happens naturally
with birth.
“The support system for mothers delivering
naturally at the Family Birth Center is
incredible,” Dr. Eichten says. The nursing
staff assists mothers with an array of labor
techniques including breathing patterns,
movement during labor, different laboring
positions, use of an exercise ball, massage,
soothing music and visualization. One-to-one
nursing care makes it possible for excellent
personal care.
“We are fortunate to have a certified doula,
Marguerite Stroede, on our nursing staff,”
says Nordquist. A doula is someone specially
trained to provide assistance and support
during the labor process. “Many moms
appreciate her help and support through
labor and delivery. And, since she is not
able to be there for every birth, we’ve had
her provide education to other OB nursing
staff so all our moms can benefit from
Marguerite’s training and expertise.”
“Labor hurts, but you can do it; billions of
women have done this,” Dr. Eichten says.
“But if the plan changes, no one should ever
feel like they failed. Bringing a baby into the
world is amazing and miraculous, however
it happens!”
Intermittent and continuous fetal monitoring
can be used to keep track of the baby’s
vital signs in labor. With intermittent fetal
monitoring, the mother can move around
between monitoring sessions, which can help
promote the progression of labor. “If needed,
we use continuous fetal monitoring to keep
a closer eye on the baby’s vital signs,”
Dr. Eichten explains. “The safety of mom
and baby is always our greatest concern.”
Easing your pain
The Family Birth Center offers medical pain
management to make your birth experience
as comfortable as possible. Our certified
registered nurse anesthetists (CRNAs) can
administer an intrathecal anesthetic, which
is an injection of medication through a fine
needle into the spinal area. The intrathecal
injection usually lasts about four hours, and
a second dose can be given if needed.
An intrathecal injection is similar to an
epidural; both cause numbness from the
upper abdomen down. The big difference:
An epidural drips medication into a tiny tube
in the back, and the patient may need to
stay in bed. With an intrathecal injection, the
patient may be able to move around with
assistance because the medication is not
being continuously administered.
To learn more about pain management
options, talk to your doctor.
Lactation consultant
Marguerite Stroede is also a certified lactation
counselor and is available in the Family Birth
Center to provide education and breastfeeding
assistance for moms during their hospital stay
or when they return home.
www.spoonerhealthsystem.com | 5
High-tech wound care
that s’ close to h me
Most minor wounds, like a paper cut or a knee
scrape, heal well enough on their own. For
patients with more serious wounds and an
underlying health condition — such as diabetes, circulation problems or immune disorders — the body may need
some additional help to heal itself.
Thanks to Spooner Health System’s Wound Care Program, led
by Kathy Dettle, RN, Co-director of Home Care and a wound care
certified (WCC) specialist, these patients have access to specialized
wound care expertise and the latest in wound care products. And it’s
all very close to home.
A new path to healing
After Joyce Peterson had an abscess removed following back surgery
earlier this year, her incision began to expand and a deep infection
developed. With her doctor based in Eau Claire, Joyce would have
needed to remain hospitalized more than 80 miles from home.
Fortunately, there was another solution: She was admitted to the
swing bed program at Spooner Health System with a “wound vac.”
This innovative technique uses a sealed wound dressing connected
to a vacuum pump. The seal protects the wound from outside
bacteria, while the vacuum extracts drainage to prevent germs
from accumulating.
“When Joyce came to us,” recalls Dettle, “she was quite ill. The
infection required intravenous antibiotics three times a day, and her
incision needed more than a basic dressing.” Dettle, who regularly
attends industry events to learn about the latest in wound care
products, worked with Joyce’s surgeon and SHS’s nursing staff to
coordinate care.
“I’m so surprised by how fast the wound is healing with the wound
vac,” says Joyce. “It’s so much faster than with regular dressing, it’s
like a miracle.”
Dettle first became interested in wound care as a result of her work
as Spooner Health System’s Co-director of Home Care. “There tends
to be a lot of wound care involved in our home care services — so in a
way, it became a specialty of mine whether I liked it or not,” she says
with a laugh. As Dettle began to learn more about new wound care
techniques, she decided to pursue certification, and in 2011
she became certified by the National Alliance of Wound Care.
Dettle currently leads a wound care team that is focused on
providing the best wound care services to our community. But she
emphasizes that their success is due in large part to the team
approach throughout the facility. Other members of the team include
a physician, physical therapist, education director, assistant director
of patient care services, purchasing director, dietitian and director
of quality.
A growing need
The need for specialized wound care has been steadily growing
in the United States, especially among patients with diabetes or
vascular problems such as peripheral artery disease. “We see a
tremendous opportunity to care for these patients, especially those
whose physicians are outside our area,” says Marilyn Nordquist, RN,
Assistant Director of Patient Care at Spooner Health System. “Many
of them don’t really need to be hospitalized but still need regular
attention to their wounds. Thanks to Kathy’s expertise, we’re able to
offer them specialized care that’s close to home.”
“My surgeon in Eau Claire is very satisfied with my progress,” Joyce
says, “and the staff here at Spooner Health System are wonderful.
Even the ladies from environmental services who clean my room are
so friendly and caring — they always have smiles on their faces and
you can tell that they love what they do.”
Currently available to inpatients and home care patients, Spooner
Health System’s Wound Care Program will soon expand to the
outpatient community. “We’re currently looking for an area that
we can set up as a formal outpatient facility for wound care,” says
Nordquist. “There’s a real need among patients who don’t require
hospitalization and don’t qualify for home services, but who still need
specialized wound care — and want to stay here in our community.”
Joyce Peterson, with
her husband Roger, found
relief thanks to Spooner
Health System’s Wound
Care Program.
Genuine caring
End-of-life care
at the end of life
For a time in summer 2012, Kathleen Cutshall
and her specially trained dog, Attie, were regulars
in and around Spooner Health System (SHS).
Kathleen’s mother, Marjorie, was receiving end-of-life care
at SHS, and Kathleen was spending night and day at her
mother’s side.
“When we went the end-of-life route I stayed at the hospital like at a
hotel,” says Kathleen, who lives in the San Francisco Bay area. “We felt
very embraced by the people at the hospital. There was an incredible
feeling of support and of making me, my dad and my mom comfortable.
One of the nurses brought blueberries and another brought my mom a
Bible on tape.”
It’s that spirit of accommodation and assistance that SHS strives to offer
patients and their loved ones through end-of-life care, providing medical
expertise and emotional support during an intensely personal and
distressing time.
The role of end-of-life care
The circumstances under which medical care becomes end-of-life care
depends on the patient’s condition, responsiveness to treatment and
the family’s and patient’s decisions. “In a typical case the physician
has determined that the patient isn’t going to survive their health crisis
and it’s only a matter of weeks, not months, until the patient will die,”
explains Diane Neste, CSW, social worker at SHS. “We take care of the
patient and the family during that time.”
A special room with a couch, recliner and mini fridge is designed to be
comfortable for the patient and his or her family members. “Families
can be here and be involved as much as they want to be,” Neste says.
Nurses are on hand around the clock to tend to the skilled nursing
needs of patients. A physician is also available to touch base with
patients and their families and address any issues or concerns. Neste,
as a social worker, offers information and assistance. “I talk with the
family about what happens next, the logistics of death, but sometimes
I simply sit with people, bring them coffee or water,” she says. “All
of the staff members are really good listeners. We all try to provide
opportunities to listen and give support.”
Like a family
“It was a very intense time,” says Kathleen. “My dad would come in the
mornings to be with mom and give Attie and me a break, but otherwise,
I was there night and day. And everybody was so sweet and so nice. They
did become like family.” From the culinary staff who would ask about
her mom when Kathleen got her morning oatmeal to the cleaning staff,
the nurses, the nurse manager, the social worker, the nursing home
activities assistant, the physician and the hospice chaplain, Kathleen
felt she received true caring and real individual attention.
Attie offers comfort and
unconditional love
“CPL” Attie is a therapy dog who works with Kathleen Cutshall,
L.C.S.W., providing canine-assisted therapy to active duty service
members, military veterans and their families in California. But when
Kathleen’s mother, Marjorie, went into end-of-life care at Spooner
Health System, Attie’s ability to provide comfort and comic relief
was brought home. “She’s a crazy dog and an unrelenting kisser,”
Kathleen says. “But Attie was also a great comfort to my mom and
was really soothing to everybody. People recognized her on the street,
and patients would ask us into their rooms.”
The night Marjorie died, Attie wouldn’t leave her side. “We didn’t know
my mom was going to die then, but I tried to call Attie over to the
couch with me and she wouldn’t leave my mom’s side,” Kathleen recalls.
“They let my biggest coping mechanism, Attie, stay with me and
my mom,” Kathleen says. “They had complete acceptance for
where we were emotionally. Because it was my mom and because
I have been a hospice social worker, I was very demanding. I told
them that I was aware I was demanding and the nurses said, ‘This
is your mother, we feel you’re advocating for your mother.’”
The physician, Dr. Mark Van Etten, was also willing to listen to and
address Kathleen’s concerns. “He was willing to problem solve
with me,” Kathleen says. “Most doctors don’t come in and just sit
and talk, but he ended up spending hours with us over the course
of our weeks at the hospital.”
Kathleen and her mother also took advantage of the spiritual care
offered. “The hospice chaplain said a really wonderful prayer with
my mom,” Kathleen recalls. “It was very brief, but it was a comfort
to me and to her.”
www.spoonerhealthsystem.com | 7
819 Ash Street
Spooner, WI 54801
| Upcoming Education |
All classes and groups are FREE unless
otherwise noted.
Aphasia Support Group
First Thursday of the month, 10 to 11:30 a.m.
Trinity Lutheran Church, Spooner
For more information, call 715-635-1272.
Expectant Parent Class
Feb. 4 and 11 or April 22 and 29, 6 to 9 p.m.
For more information or to register, call 715-635-1211.
| Table of Contents ... | winter
Therapy helps patient recover from a fractured neck.............................
Innovation improves care for heart attack patients
A natural birth experience guided by expert care
High-tech wound care that’s close to home
Genuine caring at the end of life
............................... p4
................................ p5
....................................... p6
.................................................... p7
new therapist!
Danae Herwick is a new full-time physical therapist with Spooner Health
System. Danae recently earned her doctor of physical therapy certification from
Andrews University in Michigan. She brings experience in neurological, pediatric
and manual therapies, and particularly enjoys working with a range of patients
to draw upon her varied skills and education. Danae looks forward to practicing
in a rural setting, as she was raised and currently resides in rural Milltown. In
her spare time, she enjoys outdoor activities, relaxing with her many pets and
trying to keep up with her nephews.
This publication does not constitute professional medical advice. Although it is intended to be accurate, neither the publisher nor any other party assumes liability for loss or damage
due to reliance on this material. If you have a medical question, consult your medical professional. Websites not belonging to this organization are provided for information only. No
endorsement is implied. Images may be from one or more of these sources: ©Fotolia, ©Thinkstock, ©iStock, © 2013 BlueSpire Strategic Marketing | bluespiremarketing.com