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Dwight Dial

As he sits in the kitchen of his Lake City farm home, Dwight Dial is surrounded by items that remind him of his loved ones: a barometer his mother passed down to him from Swedish ancestors, photos on the fridge of children and grandchildren, embroidered wall hangings completed by his beloved wife, Jane. It’s a comfortable room in a sprawling farmhouse, but at the moment, it’s quiet. The only sound in the house is Dwight’s voice as he remembers three people he lost within three years.

His father, Gerald, was a tail gunner in a B-17 bomber during World War II in the European theater. He flew 36 missions and was featured in a book written about the “Flying Fortress.” Gerald rarely discussed his experiences with his family, who only came to realize the dangers he had faced when they read the book. “We told each other we’re lucky to be here!” recalls Dwight.

After the war, Gerald returned to the farm and married Alice Ann. Together, they raised seven children and tended the land. When he was 85, a lifetime of smoking resulted in a diagnosis of chronic obstructive pulmonary disease (COPD) and emphysema. In 2009, he began to utilize Community Hospice at Stewart Memorial Community Hospital (SMCH) in Lake City. Hospice is a special kind of care that brings terminally ill patients and their families comfort, support and compassion in a manner that respects and cherishes the dignity and uniqueness of each individual. When cure is no longer possible, hospice can provide highly skilled care to patients and their families in the familiar surroundings of their own home or residence, including nursing homes.

Dwight recalls, “The nurses would come to the house to take care of him. My parents were very private, but I think my folks shared more of their personal lives with them than they did with their children.” He was impressed with the level of care his father received at the hands of the hospice team. “At one point, my father decided to stop going to see his doctor for checkups. The nurses communicated with his physician who then made a housecall. Together they decided to let mom continue to take care of Dad in their home with the help of the hospice nurses. When he passed on December 6, 2013, his last words to mom were ‘I’m glad you kept me at home.’”

In May 2011, Dwight and Jane were visiting their son in Alabama who was preparing for his third tour of duty in Iraq. They were playing with their grandson when Jane suddenly said to Dwight, “Something’s not right inside.” When the couple returned home Jane made an appointment with her primary care provider Nancy Flink, certified physician assistant. Tests revealed that Jane had ovarian cancer. Dr. Marc Miller performed surgery in June and Jane, a long-time Nutrition Services Director at SMCH, began chemotherapy at the hospital that felt like home.

On August 28, 2013 the couple celebrated their anniversary with dinner, margaritas and laughter. Dwight recalls that it was their last meal together. A few days later, Jane was taken to Des Moines to receive care from her oncologist where she stayed until October. When she was able to return to her home, she opted to do the next round of chemotherapy at the Lake City hospital, entering the hospice program at the same time. “Everyone at the hospital worked to make sure Jane was comfortable. The maintenance crew brought a hospital bed, then went and got a new mattress for it, while Bethany Morrow made sure Jane had new sheets and anything else she needed. Friends came to sing Christmas carols for us and later hung Valentine’s cards all over the walls,” says Dwight.

The hospice team helped with bathing Jane and medications. They trained Dwight on how to care for her ileostomy and how to give her nutrients through a port after she was unable to digest food. Dwight pauses for a long moment, “Jane passed away on December 26, 2013, 20 days after her father-in-law. She didn’t want to go before Dad and she didn’t want to go on Christmas day. That morning she said to me, ‘I made it.’” Softly, Dwight continues, “I told her it was okay for her to go, and she went.”

A few months passed and Dwight continued to farm. In June 2014, his mother, Alice Ann was diagnosed with breast cancer. Dr. Miller performed a mastectomy, but the disease had spread into her lymph nodes. “My mother was very strong. She went home and convalesced for a few weeks on her own and then began a series of 29 radiation treatments. After she completed 20, I took her to California to see her sister. When we returned she completed the last nine.”

Before Thanksgiving that year, Alice Ann acquired an infection and was hospitalized for 100 days. Dwight decided to take her home to his house where he could care for her. “The wound nurse showed me how to clean and pack her wound. The hospice nurses were also there to help care for Mom.” Throughout 2015, Alice Ann was in and out of the hospital but on December 5 she returned to the hospital for the final time. She told Dwight, “As soon as I’m well enough, I’m going to go to Shady Oaks.”

She reached that goal on December 9. “The hospice team was involved in mom’s care at the hospital and the nursing home,” says Dwight. “The communication, care and support flow so well from the SMCH hospice team. They bent over backwards to make the process as easy as possible for the family.” Alice Ann passed away on December 31, 2015.

Dwight is grateful for the care shown to Gerald, Alice Ann and Jane, “Hospice gave my loved ones the ability to live out their last days in dignity and love, surrounded by people who truly cared. They became our family during those very critical days. The sincerity this staff has is unquestionable. For the compassion they have for those that are leaving us and for the caregivers, I cannot thank them enough.”

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When mental health issues become visible, it often happens explosively and tragically. The shootings at Newtown and Virginia Tech, along with countless other deadly crimes, were carried out by mentally unstable individuals. About a year ago, an Iowa veteran dealing with post-traumatic stress disorder was angered by two teens who were horsing around at an Ankeny McDonald’s. He shot and paralyzed one of them.

This is when, like a volcano erupting, mental health explodes across the headlines, only to eventually be replaced by some other disaster or scandal. But, as health care providers well know, the problem not only doesn’t go away, it’s getting worse. In fact, mental health is arguably Iowa’s top public health issue.

Unlike volcanoes, poor mental health and the dangers that can accompany it can be controlled. Where we are failing as both a nation and a state is in providing the right care in the right place at the right time.

Health care providers know this means many of the mentally ill end up in emergency rooms, but perhaps the most tragic evidence of failure are the number of mentally ill inmates in American jails. The National Alliance on Mental Illness estimates that nearly 15 percent of men and 30 percent of women booked into jails have a serious mental health condition. That’s about two million Americans each year.

Here in Iowa, 123,000 people live with serious mental health issues and 80,000 Iowa youths cope with severe emotional disorders. Yet Iowa has fewer psychiatric beds and mental health professionals than nearly every state in the nation.

The idea behind the “deinstitutionalization” of the 1950s and ’60s, and more recently the closing of two Iowa mental health institutes, is that the mentally ill could be helped more humanely while living and being treated in community settings. But the community-based infrastructure was never really put in place or properly supported, so a huge number of those released never got the local help they needed.

Now the price is literally being paid, as Iowans in need of mental health services are churning through emergency rooms and sometimes in jails, places that are costly not only terms of real dollars, but in their inability to properly address an individual’s long-term mental health. Good intentions in the form of deinstitutionalization are not enough, but there are solutions.

This is why during the upcoming legislative session, Iowa hospitals will be advocating for increased behavioral health care access across the continuum to help relieve the systemic bottleneck that has patients languishing in hospital beds or in jails.

Iowa needs a full care continuum in behavioral health that includes sub-acute services, crisis intervention, crisis homes, nursing facility care and community-based services. With that infrastructure in place, more hospital inpatient psychiatric beds will become available for patients who truly need them, while patients needing less intensive care will receive it close to home.

Properly investing in these more efficient and effective resources now will put our state on a path to reduce behavioral health care costs in the long run. Otherwise, reliance on stop-gap measures will continue to extract a high price from both Iowans and Iowa communities.

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In this season of giving, surgical services employees at Mercy Medical Center-Clinton have found a creative solution to give the perfect gift to those in need, while at the same time finding a use for material that would otherwise be thrown away.

“It’s just called ‘blue wrap,'” said Leigh Anne Piper, Mercy’s director of perioperative and cardiac services. “We get it in sheets and use it after our surgical supplies are cleaned and sterilized. The wrap is only used to cover the sterilized supplies until it is time to use them in the operating room.”

The waterproof, plastic mesh material would normally be thrown away after use, according to Piper. “We’ve always looked for something that we could do with it,” Piper said. “It’s such a sturdy fabric that throwing it away seemed wasteful.”

That’s when she presented the surgical services team with an idea and from there, it grew.

“I found online that some people made things with the blue wrap and that’s when I mentioned it to an employee in our department who took the wrap home and tried sewing the material to see how easy it would go together,” said Piper. After that proved successful, the idea for blessing bags took hold.

“We thought that if we could sew these together in a bag, we could fill them with items that could help some of our patients who are homeless or in need of basic supplies,” said Piper.

Once it was determined that the bags could be sewn, Piper and her team arranged a sewing night at Mercy. Employees were invited to bring sewing machines for a work session to put the bags together; 24 employees participated in the session.

Donations for items to place in the bag also generously poured in from departments across Mercy and an assembly line was set up in early December where employees could volunteer over lunch to fill bags. Each blessing bag contains a bottle of water, a blanket, hat, gloves, socks, toiletries, flashlight, food and a reference list to find help if needed. More than 108 bags were created and filled and are now ready to be given to patients in need.

“This project really demonstrates how we serve our faith-based Mission at Mercy,” said Amy Berentes, vice president of patient care, adding “not only do we provide care to those who come to us, but this project demonstrates how we live our faith and extend our care and compassion to those in need. The added benefit is that we are being good stewards of our resources, finding a meaningful use for material that would have otherwise gone to the landfill. I am proud of everyone who participated in any way in this project.”

Piper admits that it exceeded her expectations on how well the idea for the project took off and how inspired employees were to help. “As an organization, we live our mission every day in what we do, but it was absolutely heartwarming to see how everyone wanted to help. I am so proud to work at Mercy.”

The bags will be provided to any patient that any employee feels may need one. Piper credits her surgical services department and the entire Mercy team for the assistance in this project.  “I have had many colleagues tell me that they are excited to be a part of the project and really feel that these bags may make a difference in someone’s life.”

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(From time to time, the blog features recipients of the IHA Iowa Hospital Heroes Award. These outstanding hospital employees come from across the state and work at hospitals of every size. They exemplify the courage, caring and community focus that are the hallmarks of the hospital mission in Iowa.)

A hero is admired for outstanding achievements and noble qualities. This is true for Pharmacist Michele Birdsell from Henry County Health Center (HCHC) in Mount Pleasant, who is our hero both inside the health center and out in our community.

An HCHC pharmacist since 1996, Michele has positively impacted the lives of patients, staff and students for 20 years. Her actions, attitude and day-to-day concern for our patients are evidence of the passion she has for others. When Michele says “my patients,” she really means it, it’s not just a mantra.

The impact she makes does not stop with her patients. Michele spends a tremendous amount of time, talent and energy as a preceptor for pharmacy students from the University of Iowa and Drake University. In 2011, she was named University of Iowa Hospital Pharmacy Preceptor of the Year. One member of HCHC’s medical staff said, “Michele’s critical thinking skills are second to none. She goes above and beyond to pass her knowledge on to others by being a preceptor to pharmacy students and providing education to staff.”

Michele has been described by colleagues as a shining example of selflessness, caring and compassion. She does whatever is necessary to ensure that patients receive their needed medication in a timely manner, even when that means responding in the middle of the night, in inclement weather or when she’s not on call.

Outside of HCHC, Michele shows her commitment to the community by serving on the local business and professional women’s group. Within that organization she mentors young women to become professionals and supports scholarship efforts. She is also an active participant with the American Cancer Society and has volunteered for more than 10 years with HCHC’s Relay for Life team, helping with fundraisers and volunteering at the event.

Maya Angelou once said, “A hero is any person really intent on making this a better place for all people.” Michele Birdsell is a true Hospital Hero as her numerous contributions have made HCHC and the surrounding communities in Henry County a better place for us all.

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A month-long stay in the UnityPoint Health-Allen Hospital neonatal intensive care unit (NICU) wasn’t easy on premature twins Brayden and Bentley. It wasn’t easy on their parents, Maja and Josh Etringer.

And it wasn’t easy on a new big sister, when it’s best for 2-year olds to stay home.

“Having one child at home who needed me. Being here and separating myself. I complained, I cried,” said Maja Etringer. “But everyone was supportive. They didn’t judge me.”

Maja and Josh asked aloud if everything was going to be OK. They wondered if they were doing the right thing.

Allen Hospital neonatologist Dr. Pankaj Nagaraj provided the necessary expertise to help sick newborns grow, thrive and eventually go home for the first time. He also provided comfort for a family in distress.

Dr. Pankaj Nagaraj

“I had conversations with him that I maybe wouldn’t have with another doctor – maybe others wouldn’t have time, there are other babies,” Maja added. “He listened to every single thing I said, I asked silly questions but he answered every single one of them. He gave reassurance that everything will be OK.”

Brayden and Bentley returned to Allen Hospital for the annual NICU reunion as healthy seven-month olds. Dr. Nagaraj was happy to catch up, although it wasn’t the first time he was updated on their progress since discharge.

“I called his cell phone at 9:30 one night because the twins had just got their first shots and our pediatrician had told us to go to the emergency room,” said Maja. “I called Dr. Nagaraj, he walked me through it and I was able to sleep. Who else does that? I called his cell phone at 9:30 at night to ask a question.”

As happy as families are to see nurses and doctors they spent such critical time with in the past, the NICU staff beams at the sight of babies they got to know so well.

That’s the sense of community that develops in the NICU, and the Etringer family is appreciative of all that Dr. Nagaraj does to help keep precious newborns in need of careful supervision close to home.

“We’re lucky to have him as a doctor. It’s almost like having a big city doctor here in the Cedar Valley,” Josh said. “Dr. Nagaraj’s presence, just who he is makes you feel calm and less stressed.”

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