Steve Horner

It is with great sadness that I share with you the passing of our dear volunteer and friend, Steve Horner. He passed with great dignity, in his home surrounded by his family and those who love him.

Please keep his family and everyone here at Children’s in your thoughts as we grieve the loss of a truly special soul.

Funeral services for Mr. Horner will be held on Saturday, November 22 at 11 a.m. at the Church of Holy Innocents, 681 Prospect Avenue, West Orange. A reception will follow at the Cranford Hotel, One South Union Ave, Cranford.

Condolence cards may be sent to the family at 209 Holly Street, Cranford, New Jersey, 07016.

A Precious Gift

I know that I have written about random acts of kindness in one of my first blogs but something happened this weekend that brought it all home again. The daughter of our long time volunteer, Steve Horner, called this weekend and asked Janet Weston, Director of Volunteers, and I to come say our goodbyes.

Steve has given over 8,500 hours to the hospital over his 20 years of volunteering. He was recently honored by NJBiz by being named the 2008 volunteer of the year. Steve worked mostly in the school program on our inpatient unit, but he was always available to help where he was needed.

Being invited into a family's grief, before the family member passes away, is a tremendously personal and generous thing for the family to do. Steve’s family made it very clear to me as I sat in their home that his life, after he retired and especially after his wife, Aurelia, died three years ago, was dedicated to spending time volunteering with our children.

Aurelia was also a volunteer, who encouraged Steve to donate his time to our children. As we sat with Steve and reminisced, his daughter grabbed one of two cards that was on the bureau in his bedroom. She told me that this card had arrived last week and was from Jackie Jones in our dietary department. His daughter went on to explain that Steve would come home and tell stories about all of us, but especially Jackie. He had a soft spot for her and the stories would be about - how she had given him a hug, or told him a story - things that I know Jackie never thought would be worth retelling to your family but she brought him tremendous joy. His daughter showed me how the card "sang" when you pushed the button and how much it had meant to him to get this card at home.

As I left that night, I was so thankful for the chance to have time with Steve and his family. Steve’s daughter reminded me how the little things we do make such a difference in people’s lives – in ways we may never imagine.

While I know Steve will join his dear wife Aurelia soon, he has given me a tremendous gift to remind us no matter how small the gesture is, showing that random act of kindness defines who we are as people and could add so much to someone's day.

Guest Blogger - Nursing at Children's Specialized Hospital

Guest blogging is Karen DeWitt, Ed.D, RN, CNAA, Vice President Patient Care

I have the distinct honor of being the first guest blogger on Amy’s blog. And what else would I talk about than my twenty years experience nursing and working here at Children’s Specialized Hospital.

During my time at Children’s Specialized, nursing staff has always demonstrated compassion and competence with our patients and families. Our staff continue to deliver great clinical care as evidenced by our outstanding outcomes. Creativity and innovation have been the hallmark of our practice. When I started my career at Children's Specialized I was the Director of Nursing/Pre Admissions Coordinator and backup weekend supervisor who on off hours was expected to go into a dark room and develop stat x-ray films. Not an easy feat!

Here are a few changes I have noticed over the past two decades:

The professionalism of rehabilitation nurses has grown tremendously. There is now a certification in this specialty (CRRN), demonstrating expertise to nursing peers, CARF and the public. I am proud of the CRRNs we have on staff and urge our RNs to consider obtaining this certification.

Children’s Specialized developed a clinical ladder fifteen years before the practice became popular. Nurses who want to remain at the bedside can do so while achieving promotions and salary increases.

Another addition over the past twenty years is the position of restorative nursing assistants in long term care and rehab , This valuable position was added to facilitate bedside carry over of therapeutic interventions.

Nurses have become vital, participating members of our program teams. Like all great programs, this has been an evolutionary process. Nurses are assigned to teams and nursing representatives participate in patient care meetings and also the team program development meetings. At both meetings, nurses have a voice in program planning.

The Staff Nurse Advisory Committee was established as an additional way to involve staff nurses in decision making. It was initiated to address the rapid growth of change in rehab care and provide me with direct feedback from staff, which has guided me many times in decision making. Nurses are active on the Nursing Practice Committee which now utilizes evidence based research to establish best practices.

Nursing in Long Term Care has really grown as a service and is as large as our inpatient rehab program. All of our nursing assistants are now certified, demonstrating their special qualifications to care for this population. Last year, Judy Potter became the LTC Administrator / Nursing Administrator for both LTC sites. Mountainside LTC no longer has to share the Director of Nursing with Inpatient Rehab. Judy rounds with the staff on a regular schedule to keep in touch with their needs.

Opportunities have expanded for nursing staff to work in the outpatient settings with the addition of Pediatric Practice, Medical Day Care and new outpatient sites.

Let’s all take a few minutes to share your war stories or fond memories while nursing at CSH. Does anyone remember the Craig bed?

I’m sure there are many of you who have a fond memory or two. Please do not mention patients by name…

What did you do on your summer vacation?

I remember as a child this was always the first assignment during the first week of school.

Depending on the grade level, it was very fun to write an essay or to bring in show and tell from summer vacation. My proudest memory was when I brought in a pearl that I got out of an oyster in Maine. There was a stand where you picked out an oyster, the "magic man" put sand in the oyster and when he opened it there was a pearl.

As I have been going to different sites I have heard wonderful things. Janet Giordano's (PCC/NB) daughter was on the chanmpionship softball team whom won the Babe Ruth World Series 12 U (& under) girls fast pitch softball tournament. Shona Donegan (Dir Speech/Hearing) rode her bike to Montreal. Jill Rebuth (FPl) is having twins!

What did you do on your summer vacation? A trip? A personal goal completed? Maybe we could share the stories on the blog or Friday night at the Beach ball.

Welcome Fall but I truly hope you had a great summer.

Drive Time Songs to Sing Along With

What song makes you turn the music up real load and sing a long? This week while driving I noticed that a certain song came on and I immediately turned it up and started singing out loud.
I always have the radio or CDs on in the car but I hadn't noticed that there are some songs that immediately I turn up, while others just go unnoticed in the background.

So to end the summer I thought I would ask you - what songs make you sing out loud?

There are many for me but this particular one was "What I like about you" and I know one of my colleagues on Senior Leadership will know who it is by but I know it makes me break out in a smile.

How about you?

Where did summer go?

I can't believe it is the middle of August already. Today was supposed to be my beach day off; the first Friday of play at the beach with no agenda. It is 2 pm and I am just now getting there. How does that happen? As a child I remember the biggest decision of the day being where I was going to ride my bike and which friend I would play with. How come as adults we get filled with responsibilities - errands, just one more email.

Senior Leadership has been teasing, but seriously concerned that I didn't take that week off this summer I had planned to. Part of it is I truly love what I do and always feel like there is more to do. For those chronic TOP day forfeiters - you know that you hear from me every September if you are over the maximum to be carried over. We all need to take time and rejuvenate; sometimes it is just harder to do than other times. Of course then I look at our kids - kids who have been in accidents who come to inpatient. You never know what is going to happen in life and it is so very important to nurture your soul as well as provide nurturing to everyone around you.

Are there tricks that you use to refresh that others could benefit from?Would love to hear and learn from you. In the meantime, I am going for a swim in the ocean.Amy

Adapting to the Changes in Health Care

Thank you all for your very helpful thoughts and suggestions. It was hard for me not to jump in and respond but I really believed it was important for you all to debate the relative merits of the suggestions that were put forward. As I explained previously, this is not an issue of not having a plan or even having the wrong plan, there are things that happen that are completely out of our control. Much like life, it is how you adjust to those changes that are unexpected that often define both our personal and professional success.

We will be making changes immediately to address the things we can address, contractual changes, keeping our appointments filled, redoubling our efforts on cancellations, aggressively hiring additional therapist, seeking additional long term care beds to address the kids who end up "stuck" in inpatient awaiting a bed - a whole host of things. We have all been giving our best and we need to continue that over the last five months of the year to close the $700K budget gap we find ourselves in. Senior Leadership is committed to continuing to look at every possibility to create savings, while still maintaining the quality of care and work environment that is so important to all of us.

You can see the passion in the many responses to the blog - people protecting their areas while offering up others. Many of you have written to me off line and made other suggestions. I am not going to respond individually to each of the suggestions that were made but know each suggestion was fully examined and considered. Some things we couldn’t change for safety reasons, others for equity, and others because we thought it wasn't the right thing to do for the organization.

The strategic planning process that we did in 2001 led to all of the great success we have had to date. It was a thoughtful plan of growth, balanced with getting our financial house in order. At key points we took stock of the plan, decided not to move forward on some projects and to move faster on others. The Board of Directors has charged us to build on that success and craft the vision for the next 3 to 5 years. We will present to them a strategic plan in September that will set the map for the future.

Having said that, much of the changes that will come before us will not be what is in that plan but things that are done to us by others. The bottom line is that health care is changing every day. These changes will be imposed upon us through regulatory, customer or payer demands. The key for us will be how agile we are in adapting to the changing environment. Paramount in all of our efforts is the desire to continue to provide high quality services to our children, have a good work environment for each of us to work in and that the organization remain financially viable.
I am asking you be part of solving the challenges we find ourselves with both short term and long term. We all have to be rowing our oars in the same direction. We will continue to examine the work we do - all of it. Continuing look for ways to do things better, smarter and constantly reviewing what businesses we are in and why we are in them. This is an organization of tremendous talent and heart.

We will get there - together.