Since this time last year, the COVID-19 pandemic has affected virtually every part of our lives and our communities. Arguably, no single profession has been more impacted than nursing and National Nurses Week, May 6-12 is the ideal time to recognize the contributions nurses have made and continue to make. Nursing has often been referred to as a calling, rather than a job and that is very true today.

From nursing homes to hospitals, clinics to schools, nurses across the country have risen to the call, donned personal protective equipment, and provided care and comfort to patients who, due to the COVID-19 restrictions, have found themselves alone, without family or friends for support. In the South Florida area, like the rest of the country, nurses have gone far above and beyond to provide loving comfort to patients who are lonely and scared.
 
In 1974 President Nixon issued a proclamation designating National Nurses Week to be May 6-12, ending on Florence Nightingale’s birthday. Nightingale is known as the founder of modern nursing. While caring for wounded soldiers during the Crimean War in the mid-19th century, she observed more soldiers were dying from illness caused by unsanitary conditions than their battle wounds. Her implementation of improved hygiene practices and better nutrition is credited with saving thousands of lives. Nightingale’s set an example of compassion, commitment to patient care and diligent and thoughtful hospital administration that impacts the profession still. Today, new nurses recite the Nightingale pledge or a variation during their formal pinning ceremony at the conclusion of their training.
               I solemnly pledge myself before God and in the presence of this assembly to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous and will not take or knowingly administer any harmful drug.
 
Fortis College in Cutler Bay offers both an Associate Degree in Nursing (ADN) program and a Practical Nursing (PN) course of study. In both programs, nursing theory guides clinical practice. For those who wish to pursue training to become registered nurses, the comprehensive curriculum of the ADN program provides the knowledge and hands-on clinical skills to prepare students to sit for the NCLEX licensure exam and, after successfully passing the licensing exam, pursue careers as entry-level registered nurses.
 
The Practical Nursing curriculum at Fortis provides the theory, laboratory and clinical experiences to prepare students to sit for the NCLEX practical nursing licensure exam and pursue an entry-level position in Practical Nursing. The clinical portion of the PN nursing curriculum includes hands-on experience providing nursing care to diverse patient populations in hospitals and other health care agencies. In addition, the clinical portion of the PN program will enable the student to observe first-hand the behaviors that are crucial to employability.


According to Jean Seaver, many people think that when nurses graduate from nursing school, they have all the training they need to go into specialty areas – whether working in the recovery room, in surgery, the operating room, or in other capacities. She pointed out, however, "They don’t. They require a lot of advanced training and credentialing to get to those levels for critical care." And Seaver is the one who can help get them there.

Seaver, Associate Vice President of Learning and Development at Broward Health, said her position in the Department of Learning has three components: clinical education programming, which includes clinical training/in-service education to keep practice knowledge and skills up to date, advanced clinical content to prepare nurses and other professionals for roles in the ED and OR; staff education and leadership development through Broward Health Leadership University, for developing future leaders for succession planning; and workforce development, which focuses on maintaining high-quality relationships with Broward Health’s academic partners to provide clinicals and attract new talent for the workforce pipeline.
 
Seaver expanded on those components by saying, for example, that Broward Health operates a virtual, high-fidelity simulation hospital to enable clinical staff to gain more proficiency in certain situations. "We have the caregivers perform through evidence-based, computer-based scenarios with mannequins that are lifelike, so they can get experience managing issues like strokes, cardiac arrest, or internal hemorrhages. This provides a safe environment to gain necessary skills for proficiency."
 
The clinical education function oversees and manages the nurse residency program, which includes considerable clinical training. "If we hire nurses and they want to become an ER nurse or a critical care nurse or an OR nurse, we manage that training for them. A lot of developing nursing skills and competencies are needed to manage the care of acute-care patients across different levels of care in our system."
 
Also involved is a large Learning Management System, in which compliance modules are built to meet all types of regulatory compliance at the corporate level. "Healthcare is the most regulated environment you’re going to find, because we have state regulations for licensing, regulatory body standards that include management of biomedical waste, electrical safety issues, patient safety, radiation – there’s a lot of training that has to go on behind the scenes to meet those requirements on an annual basis."
 
In addition to her responsibilities at Broward Health, Seaver serves on the board of the Nursing Consortium of Florida. Previously the board secretary, she is currently president-elect for the next two years, and will serve as president for two more after that. Seaver said, "The Consortium has a mission to educate the public on the purpose and importance of nursing and nursing education, and it also serves as an education forum." She chairs the educational conference planning committee, and said the purpose of the two annual conferences is to connect everybody in South Florida to what’s happening – what they can do together, what the solutions are, and how to share that information. "We are also going to look at other matters , such as how to change our approach to educating nurses, given with what happened with the pandemic challenges."
 
COVID did indeed cause an upheaval in all facets of life, especially the medical field, and Seaver agreed: "Education has been disrupted. We need to find more support for our clinical coaches – provide the new graduate clinical staff more orientation time, more access to simulation to gain more skills." She said Broward Health’s Chief Medical Officer was extremely supportive in the early return of clinical students to the hospital setting to continue their clinical training. They returned earlier than many other hospitals allowed. "By doing that, he enabled us to bring them back to continue training with the appropriate PPE and other safety needs; he understood we have to get the students back to get them prepared to pass their licensing exams so they can be hirable and be a future part of the healthcare team."
 
However, once the students returned, they had to be apprised of the changes. "Medical science was changing by the month. You can see that with the guidance the CDC gave us with COVID precautions. We were constantly updating education materials; it’s a communications methodology to keep people current to enable them to be effective in meeting the mission of Broward Health, which is to provide quality care to the population we serve, and make a difference in this county."
 
Seaver summarized by saying, "I encourage people to go into education. People often want to be clinical nurses, they want to be advanced registered nurse practitioners, but education is the foundation that helps these people to grow and develop. In my department, I’ve hired people who started their careers as nursing assistants; then they went back to school and became an LPN, became an RN, got an associate degree, then got their bachelor’s degree, then their master’s, and then they were educators and moved on to become nurse managers and Chief Nursing Officers. Education is a wonderful opportunity to help and see people grow."


Over the past year, many individuals and families have delayed nonemergent medical care as a result of the COVID-19 pandemic. While hospitals throughout the country suspended some services temporarily at the height of the outbreak, all – including ours at Broward Health – have been operating normally for many months with safeguards implemented to ensure the safety and wellbeing of our patients and visitors. However, it’s becoming more and more clear that Floridians are continuing to postpone regular medical care, and as a physician, I’m concerned.

A recent study from the Robert Wood Johnson Foundation (RWJF) and National Public Radio (NPR) found that among the general U.S. population who reported delaying medical care (20%) due to the COVID-19 pandemic, more than half experienced negative health consequences as a result.
 
If you’ve been postponing medical care – whether routine or for a disease you’ve been diagnosed with – now is the time to reach out to your medical provider and schedule an appointment and get up to date on any screenings, vaccinations, chronic disease management or other services you have gone without this last year. The impacts of continuing to put off the care you need can be substantial, and in some cases even devastating or catastrophic. It is not worth the risk. Your health cannot wait any longer.
 
As a physician, it is natural for me to advocate for regular, preventative care for all patients, but I also understand the concerns about visiting a medical facility during a pandemic. Early in the pandemic, they were warranted. Today, however, they are no longer valid. Your healthcare providers are ready to treat you – safely.
 
Our teams at Broward Health have been working to help ensure all our facilities and medical offices continue to be sanitary and prepared for patient visits. Providing high-quality care that’s safe for all our patients has always been our most important priority as we work every day to fulfill our mission to the community we serve.
 
This alarming trend is a threat to the overall health and wellness of our community and in the entire state of Florida, which is home to a large population of seniors. In fact, according to the Centers for Medicare and Medicaid Services, nearly a quarter of Medicare beneficiaries forewent any medical care for up to six months last year. In the particular case of aging adults, the importance of routine medical care cannot be overstated. Providers can only deliver world-class healthcare services to patients when able to see their patients.
 
I realize during this time, many people have turned to the convenience of virtual care, which has provided a great interim solution to address healthcare needs. However, it cannot take the place of seeing a physician face to face. Physical visits in the office are necessary to provide the highest quality of care in many specialties, especially when treating the most critical and chronic conditions. I also cannot overstress the need for an annual physical with your primary care physician in preventing disease and protecting your health and quality of life.
 
As we start to return to normalcy and plan reunions with the people we’ve missed, I encourage you to make plans to reunite with your medical provider. I assure you, they will be happy to welcome you back.


Important Facts During Better Hearing & Speech Month – May 2021

Learning and education begins long before a child enters a classroom. From the very first time you speak to your infant (“I’m your mom” and “Daddy’s been waiting to meet you”), your baby is listening and learning language. In fact, your baby is listening to the world for almost an entire year before she or he utters her or his first word. If all parts of the hearing system are not functioning properly, delays in speech and language are likely to occur.
 
Hearing loss is the most common disorder present at birth, but unlike other disorders, hearing loss is invisible and frequently goes undetected until age 2, later if the hearing loss is less severe or in only one ear. Even mild hearing losses and hearing loss in one ear can affect speech, language, listening skills, and educational performance. For this reason, KIDZ Medical Services began the First Sounds Newborn Hearing Screening Program in 1999, long before it became mandated by law.
 
Babies can’t tell us if they are not hearing well. Prior to the introduction of newborn hearing screening programs in Florida, the average age of identification of hearing loss was 14 months or greater. Since the initiation of the newborn hearing screening, the average age of confirmation of hearing loss has decreased to 2-3 months of age.
 
The Importance of Newborn Screening
The later a hearing problem is detected, the more difficult it will be to overcome these delays. That is why it is so important to have your newborn’s hearing screened at birth and to follow up with a pediatric audiologist if your newborn doesn’t pass this screening. The audiologist will conduct further testing to determine how your baby is hearing, whether or not there is a problem, and if so, whether it is temporary or permanent. Delaying the newborn hearing screening can delay a diagnosis and treatment if a hearing loss exists. If your baby wasn’t born in a hospital, talk to your pediatrician about where you can go to have your baby’s hearing screened, or visit a pediatric audiologist in your area.
 
Newborn hearing screening is only the first step in early detection of hearing loss. Hearing can change at any time as your child grows. Additionally, any baby who has spent time in the Neonatal Intensive Care Unit, has a blood relative with hearing loss that occurred in early childhood, or has any type of malformation in their head or ear may be at slightly higher risk for developing hearing loss. These babies should be monitored periodically by a pediatric audiologist to ensure that no changes in hearing are detected.
 
Signs of a Potential Hearing Issue
Parents and other family members are usually the first to suspect that their baby or child may have a hearing problem. Some signs to look for are:
• Lack of awareness or inconsistent responses to sounds by 6 months of age
• Does not respond when you call his/her name at 7 months to 1 year
• Does not point to familiar objects by 15 months
• Does not follow simple directions by 1-2 years
• Does not say 6 – 20 words by 18 months
• Does not put two words together by 24 months (“want juice,” “daddy go”)
• Pulling or scratching at ears
• Difficulty in school at any age
 
Parents should never take a “wait and see” position, but should see a licensed audiologist immediately to discuss any question or concern about hearing, speech or language development or educational performance.
 
Even if your child is diagnosed with a permanent hearing loss, today there are many opportunities for a complete and fulfilling life. Children are perfect the way they are, and allied health professionals can help them achieve their best. There are many resources and support for children and families so that your child can lead a normal and healthy life and achieve all their goals, hopes and dreams.


Basic goal underscores quality control techniques
 
“Clean is better than dirty,” according to certified indoor environmentalist and licensed mold assessor, Mike Tebor, ASCS, CIE. Now on the surface that may sound like a descriptive oversimplification of indoor air quality control, particularly during a once in a century pandemic; but straight-talking Mike Tebor, founder and co-owner of Air Duct Aseptics (ADA) a company with a 30+ year history of specializing in indoor air quality control, claims that the simple mantra is the basis for his company mission. “We clean and contain mold (which generates musty odors), bacteria, dead skin flakes and other dangerous contaminants found in air conditioning systems as a vital measure to protect families and patients from the dangers of unclean indoor air,” he said. It is also where “simple” ends in his industry.
 
The technology and techniques behind accomplishing that is where the rubber meets the road. ADA uses experienced, certified, and skilled professionals to identify problem sources, correct problems at the source and validate the results. Tebor conducted college level air conditioning and psychometric studies and had microbiological expertise from his previous career in quality control, sanitation and manufacturing roles at major beverage companies. He has maintained his recertification and licensing to qualify as an expert in HVAC systems and mold remediation, so he knows his way around achieving safe, cleanliness guidelines in both residential and health care facilities.
 
In addition to health benefits, clean air conditioning systems will save money. The U.S. Department of Energy reports that 25 to 40 percent of the energy used for heating or cooling a home is wasted. Contaminants, toxins and dirt from normal use require heating and cooling systems to work harder and shorten the life of your system.
 
When an HVAC system is clean, it doesn’t have to work as hard to maintain the desired temperature. As a result, less energy is used, leading to improved cost-effectiveness.
 
According to Tebor, finding and collecting contaminants found in miles of hospital and medical office AC duct systems is not confined to fiberglass, sheet metal and cooling coils which can block /restrict air flow increasing major electrical costs and consumer discomfort. Just as important, ADA removes and contains microbials (prevalent in Florida’s humid, hurricane-prone climate) which can trigger nasal congestion, respiratory problems, asthma attacks and skin irritation; not to mention the microscopic hazards of some mold speciates which can be potentially fatal in operating suites and Critical Care units. The company works with hospitals during construction, remodeling, high infection rate experiences and everyday operations to provide the safest methods to clear ductwork and contain residue.
 
Throughout his career, consumer awareness and government regulation of infection rates has heightened the importance of on-going maintenance of air filtration and data-driven results validation. Safety first is standard operating procedure along with strict adherence to National Air Duct Cleaners Association (NADCA) guidelines to ensure the highest safety and quality standards.
 
In contrast to the common adage, Tebor explains that indeed What you can’t see CAN hurt you. In fact, inspecting and cleaning HVAC duct work is just the beginning. In order to avoid spreading minute particles not visible to the naked eye which can contaminate the hospital indoor air quality, ADA uses HEPA filters to contain the micro-organisms that pollute the indoor environment. Also, in order to prevent and extend the sanitation process, ADA uses technology such as ultraviolet lights in strategic mold prone areas in conjunction with the sanitation process to kill biological viruses, bacteria, mold and musty odors and inhibit future growth, with a specific focus on specialty treatment units. The ultraviolet light produces an electromagnetic energy that can scramble the DNA of mold and bacterial follicles on surfaces and in the air to address contamination. In order to be effective, ultraviolet light must have direct contact within a specified distance and duration (similar to sunlight). Licensed mold assessors and certified Indoor environmental credentials, both held by Tebor, are essential in the safe handling of ultraviolet light techniques.
 
Since 1990, Tebor has led the company with his wife. Petrina, a co-owner whose HVAC hygiene field career was inspired because her asthmatic condition was adversely impacted by mold, is also a certified indoor environmentalist and licensed mold remediator and Class A air conditioning contractor. The company is headquartered in Pompano Beach and services the state of Florida with staffing and resources including a dozen mobile units.
 
Any initial inquiries can take advantage of a free consultation with ADA to discuss appropriate treatments.