 Hello, and welcome to this special edition of Quality of Life. I'm your host, Dave Augustine, and we are filming from on location at St. Nicholas Hospital in Sheboygan, Wisconsin. In this episode, we're going to discuss hospital-based care. Joining us in this segment is Sister Anise from the Hospital Sisters Health System. Welcome, Sister. Thank you, Dave. To start off with, could you give us a brief history of the hospital sisters? I certainly can. I'll go way back into, our foundation was in Germany in 1844. So we have been around a long time. In 1875, 21 of our sisters, young German sisters, came to America at the request of the bishop and business people of Illinois, Alton, Illinois at that time. Ultimately, our mother house is now, our headquarters are in Springfield, Illinois. That was 1875. And then in 1890, again, the bishop and the business people of Sheboygan invited sisters to come up. There was no hospital in Sheboygan at that time, and so about five of our sisters came at that time from our mother house in Springfield to found the hospital. However, the hospital was a simple home at that time. They simply rented a home, and that's where they began. Always began with home health. Whenever we've served, it's always started with home, serving people in their homes. Now, St. Nicholas, this year is going to be 125 years old, so that's very exciting. It is very exciting. Very monumental. Yep. And August 4th, coming up, it actually is a big celebration to commemorate that, correct? Yes. Can you give us any, a plan of any, what some of the activities will be during that day? Yes, we can. And we want the community to know that they're certainly included in that we want them to be part of the celebration because they have been part of who we are all these years. There will be many displays around the hospital. There will be a picnic all day for our colleagues, but also the public are being invited to the picnic. There will be big tents out in back in the parking areas, back at the hospital. And of course, we're trusting the Lord will give us beautiful, sunny, dry weather. There will be a mass. The Archbishop, the Steki from Milwaukee, will be here to say mass. And again, that's open to our colleagues, to invited guests, and to any of the Shaborgan people who wish to attend that. And then a picnic will go on after that into the evening. So there'll be many, many fun things, be a tent of health fair so people are able to take advantage of that. There'll be a place for children to learn and to have some fun. What do you think it makes it special as far as faith-based health care? What puts that above the rest? I think the basic element that makes us different, I think, any hospital in our area certainly gives wonderful care. And nobody doubts that. But I think the fact that the sisters came here lovingly and with compassion knowing that they were here to serve the community of Shaborgan, not looking for any remuneration and not making any, what I want to say, any exception. They welcomed all peoples into the walls of St. Nicholas. And I think it's because they brought a deep sense of faith, a deep sense of dedication to the image of Jesus. Jesus healed. And so all through these years we sisters have based our healing ministry on the fact that we dedicate and give care because of the compassion of Jesus. And St. Francis. And St. Francis and St. Clair. Yes. I've also had the privilege of working here and being part of the team. I heard that. In the IT department. So I was more of a supporting cast member if you want to say. But it was still all about and is about patient care. And that's one thing I will say is you will never see a more dedicated group of people to their profession than clinical people who provide patient care. And I think that also comes down to the core values, respect, care, competency and joy. And you can see the people living it, exercising it, whether they're mopping floors to fixing doors to providing patient care, quality patient care. So I also commend you and your mission on that as well. Thank you, Dave. And when we say that to any, I help with orientation of new colleagues is that we are a team. Each and every one of the people, our colleagues out there is essential to make this a total compassionate, loving care for the patients who come. What is it that you think makes St. Nicholas Hospital a special place in this community? Well, I think you said it part of it before because we have very dedicated colleagues. I've come to know many of them in a very deep way, a very special way. And I get to know each of them as they come into the family, St. Nicholas family, as new colleagues. And it's very obvious that their dedication is to care for people, to bring that compassion, to live the values, as you said, of respect, care, competence and joy in whatever area they're serving in. For somebody who would like to enter the healthcare profession, to provide this quality of care, what advice would you have for them? Well, again, to be a giving person, to realize that to reach out to people, there's a cost. But it's well worth it that they're giving people to serve others, brings much joy back to each of us. I think there's a cost as well as commitment and dedication as well with that going into that cost because it does take time and devotion because even one of the things I said, well, vacation, I'm out of here, no, that doesn't work. People need help, people need care. That's what our mission is and that's what we do no matter what. Absolutely. And we have wonderful dedicated colleagues who are willing to go the extra mile or take that extra shift when necessary. Okay. Any final thoughts about the 125 anniversary or St. Nicholas Hospital or care in general? Well, my final thought is that I'm so grateful to be able to be part of it yet, to be part of the mission here, to represent our hospital sisters group and to see, again, the wonderful work that our sisters began many years ago going forward very beautifully with many, many colleagues here who have the same spirit and the same compassion and dedication. I know the retreats that you have down at the mother house in Springfield absolutely reflect that, so I was able to attend one of those well and I totally enjoyed myself and learned a lot. Well, that's good. And you're welcome there any time. You know that. Thank you. Sister, I'd like to thank you for joining us in this segment. It's been an honor talking to you and hearing your thoughts on St. Nicholas Hospital. Thank you, Dave, for inviting me. Okay. When we return, we'll be coming to you from one of the patient care units at St. Nicholas Hospital. We're coming to you now from one of the nursing units at St. Nicholas Hospital. Joining us to talk about the care units at St. Nicholas Hospital is Mary Shiller, who's an RN. Welcome, Mary. Thank you. Thanks. I'm glad to be here. What is your role currently at St. Nicholas, Mary? My current role is I work as the oncology clinical nurse educator, not only here at St. Nicholas Hospital, but I also work for our other three hospitals in the Eastern Wisconsin division, so St. Vincent Hospital in Green Bay, St. Mary's Hospital in Green Bay, and St. Clair and O'Connell Falls. And so as the nurse educator, my role is primarily to do education, orientation, and competencies with our nurses who are going to care for our cancer patients. That sounds like a huge role. It is a big job, but one that I enjoy very much. How long have you been in the healthcare field? I began working at St. Nicholas Hospital 37 years ago. At the time, I was a nursing assistant. We were back at the old St. Nicholas Hospital on Huron Avenue, so I began there, and then I was still in college at the time, and then after I graduated from college, I passed my state boards, became an RN, and we had moved to the new hospital, so the rest of my career has been here. And the rest is history. Yes. As far as that goes, good for you. St. Nicholas Hospital is obviously part of the hospital sisters, and it's a faith-based care that it gives, and it's also this year's 125 years of existence. What's your thought of being part of an organization like that? It's really exciting to be a part of an organization that has been around for that long. And I think the reason it has been around for that length of time is because people really believe and work to accomplish our mission, which is to reveal and embody Christ's healing love for all people through our high-quality Franciscan healthcare ministry. Okay. As we're coming to everybody from a nursing care unit, what is the major function that a nursing care unit provides? Well, we have a number of nursing care units throughout the hospital, and our medical surgical unit would of course be our biggest unit, so those have a wide variety of patients with medical diagnosis, cancer diabetes, pneumonia, strokes, those sorts of things, as well as any surgical procedures. And then our other inpatient units would be our intensive care unit, our women's and infants unit, and then we have many outpatient nursing care units throughout the hospital too. Certainly our one-day surgery area, our GI lab, the emergency room, et cetera. As well as also the surgery center is part of St. Nicholas Hospital. And we can't forget our home health and hospice. I mean, it's not a nursing unit in the walls of the hospital, but certainly if you think about it, that's really where our sisters back in 1990 began their ministry because they serviced many people in their homes in the Sheboygan community, and that continues to this day. With all the disciplines that go on in the hospital, of the different types of services, can an individual work in multiple care units, or do they have to have special certifications in each? It depends. There are areas of the hospital where we require additional training. In the area that I work, for instance, in cancer, we only allow certain nurses to administer chemotherapy who've demonstrated some additional competencies and have had some additional training in that area. Or in the emergency room or the intensive care unit, they need to have advanced cardiac life support training. So yes. But we do have several colleagues that work in multiple units. Some people like that variety, and we certainly encourage that. Okay, wonderful. What's a typical day in a nursing care unit? I don't know if there is such a thing, but... I would say there's not a typical day, but I'll just give you a day shift on the medical surgical unit. Okay, very good. It begins at 6.45 in the morning. People gather, and we do a safety huddle. Talk about what types of patients are on the floor, what our top priorities should be. Then they go and get a bedside handoff report from the night shift. We do those right in the patient room. We include the patient in them so that we can verify all kinds of safety concerns there. Then they begin their work day, whether that means giving treatments, taking vital signs, making rounds with the physicians, providing the care that needs to be done. Nurses obviously spend a lot of their time educating our patients, teaching them about their disease processes, their medications, other treatments, those types of things. That'll continue for the rest of their shift, and then they'll do a handoff at near 3 o'clock in the afternoon to the next shift that's coming in. Nice. What's the favorite part of your role? The favorite part of my role is working with new graduates, those people who are beginning their nursing career, and helping them learn and see their enthusiasm about nursing as a career. We just have some really great new nurses who are going to carry on nursing care when some of us retire someday. That's probably my favorite part. Now you kind of touch upon retiring or whatever, but being in the healthcare industry, lots of dedication, lots of devotion when it comes to that. Do you have any advice for people who are looking to get into the healthcare field? I would highly encourage it. There are many, many job opportunities going to be there for a long time. We know that baby boomers are aging. As people live longer, they have more healthcare needs. The other thing I think about healthcare is there's so many different avenues that people can explore, so it's not something that you go into it. Maybe with the idea that I want to do this for my nursing career, you might change that five times during your nursing career or more, and that's great. There's lots of opportunities. Final thoughts. How does it feel to be part of St. Nicholas Hospital and its tradition? It's very exciting. Like I said, I've been here for 37 years. I think St. Nicholas is a bit unique when I compare it to some of our other hospitals. We do have a lot of employees with a lot of longevity, and I think that says something about the family atmosphere, the dedication to our mission, and carrying on what the sisters began back in 1890. Mary, I'd like to thank you for taking time out of your busy day for joining us and talking about St. Nicholas Hospital and your role. You're welcome. Thank you. When we come back, we'll be coming to you from the emergency department. Joining us now is Tom Barr, RN in the ED department at St. Nicholas Hospital. Tom, welcome. Good. Thank you, Dave. How long have you been with St. Nicholas Hospital? This time around, I've been here 31 years. 31 years? Yes. So you were at the old location? Correct. I started in 1977 at the old ED. The old ED, the old building, which was originally built in 1890 or around then. We were in there for how long? What was the year when we moved over to the new building? 1979. We moved over here to the new building. What are some of the changes you've seen since then as far as expansions and remodeling? We've done quite an extensive remodeling here probably within the last eight years. In fact, eight years ago, the emergency department was just rebuilt. This was all added onto. We had an eight-room ED. Now it's 12. We've expanded the size of the rooms, the number of the rooms, the amount of services that we offer. Okay. I know the nursing care units underwent some modifications as well. Fourth floor has also expanded. It has seen a few transitions. That's now where the main hospital beds are. Originally every floor, second, third, fourth, and fifth had rooms. They still all have rooms, but they, as insurance progressed and fewer people stayed longer, some of those areas got closed down, so now they're mostly on fourth floor. But that was extensively remodeled probably about 15 years ago. How many licensed beds does St. Nicholas have? That I'm not sure of. I think they're licensed for 100 and some, but we're staffed for about 60 to 80, I believe. 60 to 80? Census pretty much stays around there. This last year, it's been staying pretty much up. It's been pretty full. There are times when it drops down to 20, 30, but then it seems in a day or two it will fill the place up again. With the ED, what level of incidents are you certified or equipped to handle? St. X ED is certified to a level three. Which is? By the state's level, actually it's the national levels. There's levels one, two, three, and four. Level one being something like freighter, that's a full service, full access. Every specialty, every physician, 24-7. Level two, you have almost all the specialties, but there's some of them are on call and they could have to be there in half an hour. Level three, less, but you have most specialties or you have specialties on call, and that's what we're certified to right now. What are some of the changes you've seen over the past years as far as advancements or increase of services or capabilities? This documentation starting, I mean we've all known paper charts and charting originally was all done by hand and now it's all electronic changes in just instrumentation, what we have available from that standpoint. There's just much more technology involved, much more computer based, everything. Is that a good thing or a bad thing? Yes. Lots more to learn. At one time you didn't need to know as much, you needed to know a lot to work in the ED, but now you need to know even more. It is very technologically involved. Okay, but I think one of the benefits of that is you're connected with pretty much the flow of that patient wherever they've been as far as their medical record. Correct. That has helped immensely in the last year or two with care everywhere, any other hospital that also has the same sort of medical records that we have, the EPIC system, we can access those records. We've got agreements with all those hospitals, so if you're a patient here we can access your records from freighter to vice versa. So it saves a lot of copying and sending records back and forth and can we get this record, can we get that record, that sort of thing. This is St. Nicholas Hospital's 125th year anniversary in existence, August 4th we have coming up a huge celebration to celebrate that part of the hospital sisters. As a faith based organization, how do you think that contributes to the quality and level of care provided here? I think it provides a much higher quality of care. People don't work here just for the paycheck. They work here because they really want to work here. It may not be the absolute top of the scale pay area, maybe not the absolute best top of the run place to work, but most people here that work here see it as a calling as opposed to just a job. Through the years of transition, has the amount of staff members pretty much stayed constant or has it grown? Staffing has actually gone down over the years with the number of patients we see going up. Emergency departments, we're very much busier than we've ever been in the past. Our staffing levels have stayed fairly close to the same. If anything, we've actually had to go down some with more like ancillary personnel. Number of nurses has increased a little bit. How does ED traffic in the types of cases you see in the town like a shaboy can compare to the larger cities like Chicago, Milwaukee? I see a lot of people at E&A conventions, state conventions, federal, national conventions, and we talk like ED nurses do, they always talk. It's always interesting to talk to people from big cities who say, well, we've got a knife and gun club and we see this and we see shootings and we see murders. I can talk to them and say, well, how many people's hands have you seen caught in a corn picker or when's the last time you saw somebody's arm come out of a enameling oven from, say, a coal or something like that, not that that's ever happened. Those sort of things. A lot of industrial type things at times, we see farm accidents here and they say, well, you don't see any shootings and I says you've never been deer hunting in Wisconsin, have you? They say they shoot at each other all the time. Any final thoughts about St. Nicholas Hospital existence and history? Just that it is a great place to work. It's a great faith-based organization, patience. Our goal has always been to provide the best care anywhere and the staff reflect that. Okay. Tom, I'd like to thank you for taking time out of your day to talk with us about St. Nicholas Hospital and its history. Thank you. Thank you. When we return, we'll be talking with St. Nicholas Hospital CEO, Andy Begnell. Joining us is St. Nicholas Hospital president and CEO, Andy Begnell. Andy, welcome to the show and thank you for joining us. Thank you for having me. We're coming to you from the St. Francis Healing Garden here at St. Nicholas Hospital and Andy, why don't you give us a little bit of a history. How long have you been in healthcare? I've been in healthcare for going on 20 years now and I graduate with my master's degree in healthcare administration from St. Ambrose University in Davenport, Iowa. Okay. How long have you been with St. Nicholas Hospital and HSHS? I've been with St. Nicholas Hospital in this position serving for the past five and a half years and during that time with hospital sister cell system as well. Nice. The stages that St. Nicholas has been through along with all the other healthcare institutions, it has definitely changed from when we started 125 years ago. Absolutely. Can you go through some of the changes that you have seen how St. Nicholas Hospital has adjusted and as far as where do you see the future going? Yeah. As you know, we've been serving this community for the past 125 years and obviously during that time many, many changes have happened not only in the Sheboygan area and the community proper, but also in healthcare. When we first started we actually operated out of a small home just right up the street from where we stand today and obviously as those years progressed we have really adjusted with the times. Healthcare has obviously seen a lot of change during that time. Back in the 60s we had the enactment of Medicare which was a big deal and so the healthcare industry adapted to that as well and as you know we've also grown pretty substantially in our market here in Sheboygan the last couple, three years with the Accountable Care Organizations that are forming and the Affordable Care Act that's happening right now. We've adjusted very well with the changes as we have over the past 125 years. Sure. It seems like healthcare in general but especially hospitals, you're in between two areas. One is what the insurance companies will be so you're getting beat up on that side. You've got the providers or the suppliers of healthcare or the prices are keep going up so I'm sure you have a huge challenge all the time. Absolutely. What we've really seen over the past few years is a higher level of integration with our medical staff obviously as the community has seen we've seen greater partnerships evolve from that. Prevea Health is one of our physician partners as you've seen and obviously we're working very closely, much more closely as a system of care versus one standalone hospital operating in a system. Definitely. I think you hit on the key there is partnership because I did get to work at St. Nick and back then it was more of a here are the physicians and it was more of a referral back and forth where you can actually see the integration coming in which makes things more efficient and a more pleasant place to go for your healthcare. How much of a role do you think the faith-based part of it has increased healthcare? A huge role. Obviously when we started 125 years ago the sisters were invited to the Sheboygan community to serve in the capacity that we serve in today and that obviously remains very, very strong in what we do in bringing spiritual healing healthcare to the community that we serve. So I think there's a very important role and aspect that that type of care plays in serving the community that we have. Now St. Nick, obviously you're St. Nicholas, you always tend to call it St. Nick at least. Yeah. You've been through a lot as far as changes you've partnered with, you know, your physician staffs more. You have increased services, you know, as far as what you offer to the community for healthcare. If you had to look into your crystal ball, what would you say it would look like in, let's say, five, ten years from now? Yeah. I think we'll continue to see a decrease in the amount of inpatient utilization for healthcare services. You've seen that over the years in which you have 15 years ago, we probably had a hundred inpatients in our hospital today. We average a census inpatient-wise about 25. 25. And on the outpatient side of the business, we've actually increased. So much more of the services that we provide are on the outpatient side. We'll also see an increase in preventative care that we offer the community as well. And obviously our goal is to keep people healthy and out of the hospital. Right. So we'll see that. That's another reason for this serious quality of life is to what can you do in a proactive manner to stay healthy versus, you know, when you get down to the, oh boy, you're at the final stages or so, whichever. Right. You know, and I think a lot of what you see happening in the census is the advances in care, technology, the compassion, everybody working more as a team. I think you see that turnaround. Absolutely. Absolutely. Compared to years ago, you'd be as normal procedure. It would be in the hospital for a week. Now it's one day surgery. Right. If that. So how does the surgery center fit into all of this? The surgery center is a very important aspect. Obviously for us, it was important that we worked very closely in developing that surgery center back in 2008. And as you are aware, we actually, that began as a partnership with our medical staff. And as time went on, we realized that we were much more stronger together in terms of how we operated that more integrated into the work that we do in the hospital versus standalone. So it's a very efficient center, but it's also a different setting, more appropriate for outpatient surgeries than what we have in the hospital. And I think this actually comes around to when I started with our first segment with Sister Anise, is it's about patient care and physicians. And as I said, the clinical people, that is a dedicated group of people to their missions. They want to care for people. They don't want to have to worry about businesses or where's the next thing going to come from. They just want to take care of people, provide services and do their mission as well. Correct. So any final thoughts as far as St. Nicholas Hospital? August 4th is the new anniversary, 125-year-old birthday. I suppose things are, the buzz is coming around here getting exciting? Yeah, very exciting. I would encourage all of the viewers that are viewing this program to come out on August 4th and enjoy the day with us. It's an important day for us, obviously. And we look forward to celebrating another 125 years well into the future. Excellent. What time do the festivities start before we wrap? Roughly around 4 o'clock, 4 to 7.30. You'll see a lot of activities start and we're really looking forward to a great day. Excellent. Well, Andy, I'd like to thank you for coming on to the show and sharing some history of St. Nicholas. So this concludes our show for Quality of Life. If you have any questions or have any information, please contact us through our website at www.wscsjboykin.com. For Quality of Life, I'm Dave Auguste. Thank you for watching.