Naval Hospital Bremerton Command News
Branch Health Clinic Bangor Sports Medicine (S.M.A.R.T.) Clinic opens Nov. 13
Courtesy of Branch Health Clinic Bangor
The inaugural Sports Medicine And Rehabilitation Team (S.M.A.R.T.) Clinic serving the Navy in the Pacific Northwest will open at Branch Health Clinic Bangor for walk-ins on Tuesday, Nov. 13. The only one of its kind for Sailors in Navy Region Northwest, the BHC Bangor SMART clinic will provide patient-centered care for acute and chronic musculoskeletal problems that are non-surgical and/or pre-surgical to preserve health and maintain readiness. The clinic also has the capability to perform physical therapy, with chiropractic care and occupational therapy services pending. The Sports Medicine provider is Dr. Peter Lundblad, M.D., who is Board certified in Family Medicine and holds a Certificate of Added Qualifications in Sports Medicine (CAQSM), from the American Board of Family Medicine. The BHC Bangor S.M.A.R.T. clinic will provide active duty personnel and their dependents with needed expert musculoskeletal evaluation, diagnosis, and treatment of non-surgical and pre-surgical musculoskeletal problems, including joint injections as needed and surgical referral as required. Eligible beneficiaries include active duty Sailors, Marines, area Coast Guard personnel, Army personnel assigned aboard Navy regional commands, and family members of active duty locally enrolled in TRICARE. Consults can currently be sent to the SMART clinic for eligible beneficiaries. Primary providers can locate the clinic under the name “S Sports Medicine” in the electronic health record system. Active duty personnel with acute injuries (that occurred over the previous 24-48 hours)
are able to walk-in for evaluation and treatment daily at 7:30 a.m. and Mon/Wed/Friday at 1 p.m. beginning November 13, 2012 while active duty family members enrolled to the Branch Health Clinic Bangor care welcome to call for a same day appointment.
Naval Hospital Bremerton Health Promotion Webinar Program preps beneficiaries for a Healthy Holiday
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton’s Health Promotion is starting up an inaugural patient-centered ‘webinar’ program to assist beneficiaries in ‘Holiday Healthy Recipe Makeover’ slated for Nov. 13 and 15. NHB Health Educator Jenni Osborne is hosting the web-transmitted seminar to provide follow-on encouragement, assistance and guidance for patients of Health Promotion. “This is a new tool for us to use to support and help our patients with their life style changes. We’re finding that more and more can attend a seminar or class if there’s the option that they don’t have to come in to the hospital. We set the time, but they can choose the setting. This just provides a great flexibility for everyone,” said Osborne. Health Promotion is using the Department of Defense (DoD) Defense Connect Online (DCO) system to link-up with interested beneficiaries. “We do have some experience with doing this, but this is the first time we have applied using DCO for patient communications. This is an opportunity to try something new and beneficial for our patients who have challenges at times getting to the hospital,” explained Dr. Dan Frederick, NHB Population Health officer. According to Osborne, the goal is to help NHB’s beneficiaries stay energized and active in health and wellness by being connected via the web and avoiding prohibitive obstacles such as driving during inclement weather to and from the hospital. The hope is that the new webinar will give the patients the support they need in their comfort of their own home. “They can also interact by asking questions, sharing ideas, and receive real-time replies and
comments. We’re always trying to find different venues and ways to reach out to our patients. The pilot webinar program means that
they don’t need to deal with rain or snow-related issues to receive the services that we offer. They have the opportunity to connect
with us for this seminar wherever they want whether it’s via their home computer, laptop, tablet, or smart phone,” Osborne said. Those
interested in taking part simply need to be at their computer, or smart phone or tablet at the designated time, open the flyer attached,
click on the appropriate link, click the button near “guest,” type in their name and join the class.
November 13, 2012 at 2:30 p.m.
November 15, 2012 at 4:30 p.m.
“The seminar will feature interactive talk about tasty ways to make a not so healthy holiday treat a bit healthier for the holidays, along with what healthier trades you could make that would not be so tasty,” said Osborne, also asking attending participants to send in success or failure stories and she will pick the best three adventures to read during the class, perhaps including hers when she once cooked the cook book...
“Health Promotion is all about behavioral change and educational change and this computer based virtual reality way allows us to to see if this is yet another way we can provide support to our patients,” commented Janet Mano, NHB Health Promotion Division Head. NHB’s Health Promotion overall mission is to provide quality products and services to every eligible beneficiary concerning health and wellness by
combining involvement, optimal command participation and on-going support for individual health behavior change, health promotion and prevention. Eligible beneficiaries can take advantage of a wide variety of programs offered by NHB’s Health Promotion, including Health Risk Assessment; Injury Prevention; Nutrition; Physical Fitness; Sexual Health and Responsibility; Stress Management; Suicide Prevention; and Preventive Health Assessments; injury prevention; nutritional tips; physical fitness; psychological health with stress management and suicide prevention; tobacco cessation; Alcohol and Drug Abuse Prevention; and weight management.
NHB SARP new Outpatient Program to provide preventive care to those in need
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton’s Substance Abuse Rehabilitation Program (SARP) is following Navy Medicine’s core vision of patient-centered health care by preserving health and maintaining readiness with a new Outpatient Program workshop than began on Oct. 29. According to Operations Specialist Senior Chief Nick Desoto, NHB SARP counselor, NHB’s SARP is enhancing the focus on how service members and their dependents may use and abuse alcohol. The Outpatient Program services will offer assistance in making better, healthier choices for dealing with stressors other than alcohol to active duty, family and retirees who are primarily 18 years and older. “Our goal is to work with those who don’t meet the criteria for higher level of care but will if they continue on in their current way of using alcohol. Our focus is to be preventive in the future, and currently acknowledge any abuse. We want to save families, save Sailors and catch them before they fall,” said Desoto, adding that NHB SARP follows American Society of Addiction Medicine guidelines in providing various levels of treatment, care and continual care. SARP will combine rehabilitation and counseling services, along with substance abuse prevention education. The two-week program with intensive workshops and one-on-one counseling is designed to support the military community with education and support to foster leadership and readiness. “This is really a pre-cautionary measure to avoid dependency and help our service-members be successful in dealing with alcohol,” Desoto said. Desoto notes that the Outpatient Program will
concentrate on binge drinking and other unsuitable or counterproductive behavior that may lead to alcohol dependence. “In turn, the ability to assess those individuals before criteria of dependence will help in achieving overall combat readiness by providing service members the proper education and coping skills to find other outlets besides alcohol and drug abuse,” he said. The Outpatient Program curriculum will be lecture-focused augmented by individual counseling. The workshop is in a group therapeutic environment with one-on-one counseling sessions with a certified drug and alcohol counselor. The Outpatient program also strongly adheres to Navy Medicine’s guiding principles of ‘Ship, Shipmate and Self.’ Ship is in reference to taking care of the mission, patients and those seeking care. Shipmate refers to taking care of each other. When someone starts to veer off course or starts to show signs of trouble, the aim is to render assistance. Self is about taking care of oneself and being strong enough to ask for help and guidance if needed. “When our military members are clear in their thinking and able to manage stress in healthy ways (sans alcohol), then the true committed spirit of the individual is maximized. Man-hours and mission commitments are not compromised by hangovers, alcohol-related incidents, and emergency room visits. Individuals and commands begin to show pride in their movement to a healthier work force,” stated Desoto. Topics range from stress management to the attitude and beliefs of alcohol. The program also integrates information on nutrition, physical readiness, sleep hygiene, and includes referral agents for PTSD, Tobacco Cessation and mental health issues.
“We know that not everyone who drinks has a drinking problem. The challenge of talking to a young Sailor or Marine about a possible drinking problem is that there are some 20-24 year old college counterparts who binge drink, weekend party, and that behavior for the most part is accepted in our culture. A high percentage of service members have been down range, done stressful deployments and arduous work-ups and the thought process for some is that it’s not fair that they would have to face a different standard and bottom line, they think they’re too young to have a problem,” explained Desoto. The word has gone out to every command DAPA that if there is a Sailor that they recognize who needs to be seen and isn’t really sick, this is the perfect workshop class for them to face their potential problem before it gets worse. “The main problem I see is that Sailors and Marines are (still) hesitant to seek treatment because of the underlying stigma that seeking treatment may hinder or stagnate their career. This is not the case. It is highly encouraged to seek help before alcohol abuse leads to trouble that leads to administrative separation,” Desoto said. NHB’s SARP works through commands with high-operational tempo and reoccurring deployments. This brings a challenge for SARP and the command for scheduling. The benefit of the new Outpatient Program is that it is only two weeks and can build the necessary foundation for the service member to return to his/her command with a better perspective on their relationship with alcohol. “Alcohol is a mood-altering chemical that destroys not only the ability to deal with stress, but also alters the way some people think about themselves and their ability to make good, clear choices. This happens while failing to see
that the alcohol, while giving some early relief, is actually causing many of the emotional and mental problems they were experiencing.” said Desoto. NHB’s SARP has continued with the Navy’s de-glamorization campaign on alcohol and the new Outpatient Program is hoped to continue with that process. “Focusing on abstinence and responsible use of alcohol for those who are not diagnosed with alcohol dependence are ways (we’re doing this). SARP is also initiating education related to the true story behind alcohol use which is to teach members that excessive alcohol use creates a neurological disorder which can result in many physical and mental illnesses that can result in death. It’s a serious illness and one that is often overlooked or ignored because of the history of glamorization that is attached to it. Education is key to the arresting of the disease,” said Desoto. There is also a SARP Family Program specifically designed to assist spouses that will commence in January with a weekly lecture series open to the public. Desoto also acknowledged that NHB SARP has been needing outpatient care and family-centric services to deal with dependents of those with addiction issues. We need to educate them to know what they are going through such as dealing with denial, along with learning other skills and teachings,” stressed Desoto. “There has been a great need and now it’s possible to offer the Family Program to those 17 and older,” said Hospital Corpsman 1st Class Morgan Notel, SARP counselor who will lead the SARP Family Program. The mission of NHB’s SARP is to offer help and hope to individuals and their family members affected by alcoholism. SARP has several levels of treatment available to help people recover from the
addiction such as counseling and rehabilitation programs. The choice decided upon depends on the type of addiction and SARP staff members can help guide and assist in making the best decision to help achieve lasting results.
NHB Energy Action Month Raises Energy Awareness
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Naval Hospital Bremerton (NHB) Facilities Management Department Environmental Division staff members presented the National Energy Action Month display on the quarterdeck to educate staff and beneficiaries Oct. 25. “Energy awareness events such as this one teach staff and patients to be vigilant in identifying energy efficiency opportunities and then taking action to save energy,” said Naval Station Everett Resource Conservation Manager John Payne. Payne, a local energy expert, was on hand to instruct interested beneficiaries and staff in learning about energy conservation at home by covering subjects such as ductless air conditioning and properly weather sealing homes. He also gave away informative pamphlets and various memorabilia emblazoned with reminders to remain energy conscious. “The Navy is becoming more focused on conservation and renewable energy sources wherever possible and lowering waste,” said Hospital Corpsman 3rd Class Blake Hite, who volunteered from his normal duties as NHB Simulation Lab Program Manager to assist in raising awareness to dress up as Brite, the Navy energy mascot to help draw attention from passersby. A static display highlighted the different projects being recently conducted by NHB Facilities Management Department in the hospital. The projects included the installation of time clock controls in the quarterdeck and family clinic lobbies which conserve 14 Megawatt hours per year (enough electricity to light two homes); LED parking lot lighting replacing the high pressure sodium fixtures with an expected savings on completion of 103 Megawatt hours per year (enough energy to light 17
homes); and the replacement of the boilers which currently work at 80 percent efficient with four energy efficient Condensing Boilers that work at 95.5 percent efficiency. The expected cost savings to the hospital is 5,500 therms per year (enough energy to heat 16 homes). “Everyone should be diligent about turning off lights and using excess energy, and here at NHB facilities we’re very involved with this. Several divisions of Facilities Management such as operations, engineering, and environmental are actively looking at projects through energy audits and equipment reviews to determine more energy efficient products,” said NHB Energy Manager Robert Mitchell. “Energy conservation is part of the command’s sustainable health care program. The program includes water conservation, chemical reduction, product substitution, and using recyclables. This affects the whole command and the bottom line by reducing the cost to operate the hospital,” Mitchell added. Every incoming staff member also learns about energy conservation at command orientation. NHB Facilities Management Department educates them on the command efforts at improving energy efficiency and how each member can positively impact NHB by curtailing waste of energy resources. According to Hite, the NHB education and training department is also looking to reach out to other departments throughout the hospital to keep energy conservation a focus throughout the year next year. “We want to make people aware and continue to support energy efforts,” said Mitchell. “We continue to look for ways to reduce our energy use and encourage staff members to lend a hand and be involved in energy conservation projects, and if they see something that
can be done more efficiently to let us know.” President Barack Obama signed the name change for the current energy awareness month on the first day of October. The Department of Energy (DOE) requested the change to focus on the need for action to save energy and money for American taxpayers through conservation efforts to build on the President’s Blueprint for a Secure Energy Future according to the DOE website.
Naval Hospital Bremerton Physical Therapy Open House a Command Core Strength
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton’s Physical Therapy (PT) held an open house on Oct. 25 for the rest of the command staff as well as patients with interactive stations, static displays and demonstrations to showcase their department. “Our goal is to increase awareness through the ranks and promote what we do,” said Hospital Corpsman 2nd Class Kyle Hewitt, physical therapy technician, adding some have the existing misconception that all the department does to help patients to apply ice and recommend a massage. In reality, helping to alleviate physical discomfort and mitigate pain are the daily principles that take place in Physical Therapy. “We do so much more and we do it actively with the patient by educating them what is wrong, and provide one-on-one teaching on the steps they need to take to continue whatever their goal may be such as rehabbing from surgery, or lessening a specific pain, or increasing their mobility,” Hewitt said. The primary overarching duty of the PT department is to help patients improve their mobility and function after surgery. The staff evaluates, educates and treats musculoskeletal ailments and disorders, and provides support for referred patients to recover, recuperate and rehabilitate. They also take time to encourage others if interested in the field. “I came to the open house today to get a feel for what physical therapy technicians do on the job. I’m interested in applying for the school and have always wanted to help others in their recovery and rehab. I have had patients ask me questions about their recovery and rehab that I couldn’t answer and had to go and get others to explain. I want to be able to do that
myself and help them in the process,” said Hospitalman Coy Ladwig, currently assigned to the command’s Multi-Service Ward. According to HN Nicole Saldana, the most common musculoskeletal ailments and disorders that they routinely see in PT are associated with the neck, (lower) back, shoulder and knee. “We really see a lot of people, active duty and beneficiaries, with lower back pain. Some of what we do is to explain about good posture and practice core strength exercises. We also use a traction device that is very popular and helps a lot. We teach, treat and apply traction to help with their recovery,” Saldana said. Motivation is a big part of the entire rehabilitation process as well as being a physical therapy technician states HM1 Adam Cerullo. “We need to support and provide positive feedback when our patients are here. Many of them don’t really know how it is they’re suppose to feel and we help them find that out by continually interacting with them during their appointment. For example, if a person can’t stretch and reach by extending a shoulder the way they used to, some will just accept that fact that they have decreasing mobility. We can help them see why that is and if there is anything that has developed that we can fix during a personally-designed rehabilitation program,” said Cerullo. Improving core strength is also stressed to many, if not all, of PT’s patients. Lisa Frerichs, PT staff member technician, shared home exercise program flyers during the open house that provided instructional focus on improving core strength. “For example, if a person has extra pounds, then that can lead to a weak core, weak lower back, and even put the pelvic out of alignment to cause lower back pain. We can devise a series of exercises,
really isometric in design, to start them on a program to help them work on the core strength they need,” Frerichs said. “The bottom line is that we’re here and a great resource to use. Our goal is to help others,” Cerullo said.
Naval Hospital Bremerton 5-2-1-0 Program Promotes Healthier Habits
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Naval Hospital Bremerton (NHB) Health Promotions recently launched the Ready, Set, Go! 5-2-1-0 program to help children and families eat healthier and get more active around the hospital. “I am very excited that our hospital is a partner in this health promoting initiative which is spreading through schools, community, worksites and health care that are all endorsing the 5-2-1-0 message,” said Janet Mano, NHB Health Promotions coordinator. “Essentially, this is a great communication tool for promoting healthy lifestyles. It has been embraced by the American Academy of Pediatrics. In Kitsap County, it is part of the strategic plan for Kitsap County Health Priorities and NHB is a partner in this group.” The numbers correspond to daily reminders of getting five or more servings of fruits and vegetables, no more than two hours of screen recreation time (TV, video games, computers, smart phones, and tablet computers), at least one hour of exercise or active play, and zero sugary drinks. One of the program’s biggest proponents at the hospital is the pediatric department. “We adopted it formally in September, and by formally, I mean we had the displays and prescription pads with our peds logo. Health promotions was instrumental in getting that done,” said NHB Pediatrics Department Head Cmdr. Andrea Donalty. “We do a lot of well visits, and part of the well visit is trying to keep our patients healthy. So, this is a formalized program by which we can give them written information through visual displays and a catchy way to remember those numbers as their goal on a daily basis.” In the pediatrics waiting area, parents can look at
the static displays and read the pamphlets outlining each facet of the 5-2-1-0 program. The pamphlets give parents advice on adopting the guidelines and healthy alternatives. Pediatrics clinic serves beneficiaries between birth to age 21 according to Donalty. Healthy habits being taught by this program are key in promoting a healthy lifestyle into adulthood. “I’ve found the patients in my clinic that I have had face-to-face contact with really like it,” said Donalty. “The parents and our patients both like to hear it from us and those who have already been trying to do something like this at home can further their discussion by giving them more validity to what they are trying to do. It empowers them to say that the doctor is behind me as well.” NHB Health Promotions, in cooperation with NHB Combined Food Services has also put up a display table near the entry way to the command’s Terrace Dining Facility to inform patrons of the program along with signage on each dining table. “We focus on giving good, quality nutrition for every person regardless if you’re staff or a patient. As people come in and see the posters for 5-2-1-0 prior to or as they step into the galley, whether it’s their first time or their hundredth time, they can say, ‘I’m not going to have a soda’ or even though we are mandated to serve the different desserts they’ll decide on a piece of fruit instead of cake or ice cream,” said Culinary Specialist 1st Class (SW/AW) James Hangan, acting leading chief petty officer for NHB Combined Food Services. With half of the 5-2-1-0 program focusing on dietary intake, the hospital dining hall provides their customers with healthy choices. “We have chilled potable water, two percent milk, (even) tea bags for patrons that want to
make hot tea,” said Hangan. The galley also provides a well-stocked salad bar which is used by 85-90 percent of diners according to Hangan. “I think it’s a great program and I’d like to see more of it in the future. It’s good to put nutrition, healthy eating, and exercise in the limelight,” said Hangan.
NHB holds Facilitator Class for ShipShape Program
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton, in conjunction with Naval Base Kitsap Fitness Facilities, held a Shipshape Facilitator Class for the first time on Sept. 28. The ShipShape program is tailored to active duty members who exceed, or are in danger of exceeding, body composition assessment (BCA) standards. The specifically designed program provides active duty personnel with basic information on nutrition, stress management, physical activity and behavior modification techniques to lower and maintain an acceptable body weight within Navy standards. “We offered this class in order to increase the capacity of ShipShape throughout the region and to provide classes at locations and times that are convenient and in synch with their operational requirements. The intention is to build a network of trained professionals including Morale Welfare and Recreation Fitness staff, Naval Hospital Health Promotion staff and command fitness leader who can provide the education and support to active duty personnel and their families to meet goals for healthy weight,” said Janet Mano, NHB Health Promotion division head. Providing integral coordination and teaching of the ShipShape program is Hospital Corpsman 2nd Class Christopher A. Peacher, with experience and background in the program. “I believe my shipmates should be given every opportunity to improve their health and attain fitness standards. I have seen great success of this program and stand by it every step of the way. Yes we all have ups, downs and challenges and fall short sometimes, but with the proper motivation and encouragement, military standards are achievable. I believe I have the right spirit
and attitude to do just that,” said Peacher, a 12-year Navy veteran. “ShipShape is the Navy's official weight management program. While it is not mandatory, it is highly recommended for members who fail to meet weight standards or are in jeopardy of failing. Typically ShipShape Facilitator training is only offered twice a year by Navy & Marine Corps Public Health Center (NMCPHC). The program manager has granted me authority to certify instructors locally in order to increase the capacity of the program in Navy Region Northwest,” added Mano. According to Dr. Steven Heaston, Program Specialist for Clinical Prevention at NMCPHC, the intensive 8-week program, based on the most current scientific evidence for achieving healthy and permanent weight loss also includes follow-up monthly contact over the next six months for support and motivation to continually assist participants in their weight management goals. “Every Navy Military Treatment Facility is mandated to offer ShipShape at least twice a year. Of course, how frequently they do so should depend on the prevalence of overweight beneficiaries in their population and the assumption that a certain percentage of those desire assistance in losing weight and will commit to a long-term group support program,” said Heaston, noting that ShipShape is suggested for members who fail to meet weight standards or are in jeopardy of failing. It is also recommended for adult family members in support of family readiness (OPNAVINST 6110.1J, Nutrition Guide). ShipShape is also an appropriate intervention option for retirees who have a higher than average number of weight-related health problems. NMCPHC has been designated as the lead agency for ShipShape
by Navy Bureau of Medicine and Surgery (BUMED). “As such, we track metrics. While most individuals who lose weight on commercial programs or self-guided programs gain it back within the first year, an individualized program such as ShipShape that provides frequent contact between the instructors and participants can yield good long-term outcomes. For example, from July 2005 to present, an average of 41 percent of active duty Fitness Enhancement Program participants who completed ShipShape were within standards six months after completing the program. The most recent review of Physical Readiness Information Management System (PRIMS) data showed that 80.4 percent of ShipShape participants still on active duty two years after completing ShipShape passed their BCA,” explained Heaston. ShipShape addresses the real-world challenges of getting good nutrition, physical activity, and overcoming psychological barriers, often the most important aspect of weight loss. Fad diets generally don't work long-term. On the other hand, ShipShape can help individuals lose weight and keep it off in a healthy fashion that doesn't deprive them of normal eating and social activities,” added Heaston, also citing that numerous participants have lost over 50 pounds and kept it off. The 50 slots filled almost immediately in the class, with participants from MWR fitness staffs, personal trainer equivalents, and command fitness leaders from Naval Base Kitsap Bangor, NBK Bremerton, Naval Station Everett and Naval Hospital Oak Harbor. Commands participating include Behavioral Health and Education Center Everett, Navy Operational Support Center (NOSC) Everett, NOSC Anchorage, NOSC Helena, Transient
Personnel Unit Puget Sound, Strategic Weapons Facility Pacific (SWFPAC), Navy Region Northwest, Puget Sound Naval Shipyard, Commander Submarine Group (SUBGRP) 9, USS Ford (FFG 54) and USS Maine (SSBN 741). “This entire course is going to be very beneficial in helping with our efforts at the deckplates of supporting our troops,” said Michael Martin, of Naval Base Kitsap MWR fitness staff. “ShipShape instructors provide participants with the knowledge, motivation, and tools to make significant lifestyle changes and to be successful. There are so many barriers these days to people maintaining a healthy weight, including social, personal, ethnic, and environmental factors. ShipShape addresses each of these and helps participants craft a personalized weight loss strategy,” Heaston said. As an ShipShape instructor, Peacher has assisted in facilitating Shipshape in San Diego for the past five years and has witnessed positive results. He has been certified through Cooper Institute in Dietary Guidance, Biomechanics of Resistance Training, Certificates from NMCPHS in (1) Choose Healthy Options for Wellness (CHOW), Health Promotion at the Deck Plates, and ShipShape Facilitators Course. He is also an advocate in using tailored messaging to improve Health Behavior Change and Health Promotion Program. “I want to share my education with my fellow sailors so they can have a healthy and safe Navy career. We all know the right and wrongs, but we tend to forget. This program refreshes our memories and brings us back to basic nutrition and fitness needs. A great value of this program is for the participant to have a understanding of emotional eating instead of eating for nutrition,” Peacher said. Peacher
attests that there are those who think being recognized as “The Biggest Loser” is not a big deal. But for some, using a variety of strategies over a long period of time to improve their health and fitness is worth their weight of gold. “Most students leave inspired and we often get call backs with continued progress years down the road. Staying motivated can be difficult of all of us at times not to relapse into old unhealthy lifestyle choices, such as fast foods, sugary drinks, and a sedentary lifestyle,” Peacher said, adding that those who fail their PRT today could very well be dealing with diabetes tomorrow. More information can be obtained by contacting Janet Mano at Janet.Mano@med.navy.mil or calling NHB’s Health Promotion at (360) 475-4997.
“Beat the Bug – Get Your Flu Shot” as NHB prepares for Seasonal Flu Vaccinations
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton’s Preventive Medicine will start providing annual influenza vaccinations Oct. 6-12, for uniformed service members and eligible beneficiaries. Flu shots for beneficiaries will be given at NHB’s Health and Education Center on Naval Base Kitsap Bangor, 2850 Thresher Ave, on Oct. 6-8, from noon until 5 p.m. and again Oct. 9-12, from 2 p.m. to 7 p.m. More information may be obtained at the Flu Hotline, (360) 315-4469. For updates on Flu Clinic wait times, please call (360) 315-4463 Annual seasonal influenza vaccinations are required for all active duty military personnel, selected Reserves and healthcare workers. Navy Medicine’s seasonal influenza vaccine immunization program is designed to protect Sailors and Marines, mission-essential healthcare personnel, and eligible beneficiaries. “Getting vaccinated helps prevent the loss of work. Flu seasons are unpredictable and can be severe. Over a period of 30 years, between 1976 and 2006, estimates of flu-associated deaths in the United States range from a low of approximately 3,000 to a high of 49,000, according to the Centers for Disease Control and Prevention (CDC). This is why vaccination is the primary form of prevention,” said Lt. Cmdr. David Veenhuis, NHB’s Preventive Medicine Head. According to Veenhuis, immunization is not only the the primary method of reducing seasonal influenza illness but also lessens any associated complications by enhancing force immunity. The seasonal influenza vaccine helps protect vaccinated individuals, as well as protects entire communities by preventing and reducing the spread of the disease.
“Maintaining a clean work environment, good hygiene practices and managing workforce exposure – social distancing, tele-working, sick leave, etc. – are effective methods to reduce the risk of spreading influenza,” Veenhuis said. “Everyone who is at least six months of age should get a flu vaccine this season. It’s especially important for some people to get vaccinated, such as people who are at high risk of developing serious complications like pneumonia if they get sick with the flu, and people who have certain medical conditions including asthma, diabetes and chronic lung disease. People who are 65 years and older need to get the vaccine, as do pregnant women and people who live with or care for others who are a high risk of developing serious complications,” stressed Veenhuis, noting that influenza is not the common cold. Influenza can be a severe to life-threatening disease and getting an annual influenza vaccine immunization (either the traditional shot in the arm or the newer nasal spray vaccine) protects many people from getting the disease or becoming severely ill. As has also been the case in the past, Puget Sound Naval Shipyard will be handled by Branch Health Clinic PSNS, and NHB’s Preventive Medicine team will take care of Naval Base Kitsap Bremerton, NBK Bangor and commands such as Intermediate Maintenance Facility and Naval Facilities Engineering Command Northwest. “We will be scheduling a visit close to their work centers and their fall back will be the beneficiary clinic at the BHEC,” Veenhuis said. Tom Shirk, NHB Infection Control expert, attests that there are also multiple steps that can be done daily to mitigate the potential spread of the flu.
“Besides hand washing with soap and water, we encourage everyone who visits our main facility or any branch clinics to use our alcohol-based hand sanitizers. They are phenomenally effective in eliminating the transfer of a virus. We have increased the number of dispensers in NHB so anyone entering and leaving, or waiting by the elevators can use them,” commented Shirk. The CDC notes that influenza is thought to spread mainly from people touching something with influenza viruses on it and then touching their mouth or nose. One of the challenging aspects of flu is that someone who becomes infected can infect others one day before they have symptoms and up to five days after becoming sick. Influenza usually causes mild to severe illness, and uncommonly can lead to death. Symptoms of influenza include fever, headache, extreme tiredness, dry cough, sore throat, chills, runny or stuffy nose and muscle aches. Stomach symptoms such as nausea, vomiting, and diarrhea also can occur but are more common in children than adults. Traditionally, seasonal flu impacts the elderly and the young. General information of seasonal influenza can be found at http://www.cdc.gov/flu/.
What can people do to protect themselves against the flu virus?
Naval Hospital Bremerton follows CDC recommendations to:
- Avoid close contact with people who are sick, when you are sick, and keep your distance from others to protect them from also getting sick.
- If possible, stay home from work, school and errands when you are sick. You will help prevent others from catching your illness.
- Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
- Washing your hands often will help protect you from germs.
- Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his/her eyes, nose or mouth.
Different Influenza Types
- Seasonal flu is a respiratory illness that can be transmitted person to person. Most people have some immunity, and a vaccine is available.
- Novel H1N1 flu is a new influenza virus causing illness in people. This new virus was first detected in the US in April 2009, and has spread too many countries around the world.
- Pandemic flu is virulent human flu that causes a global outbreak, or pandemic, of serious illness. Because there is little natural immunity, the disease can spread easily from person to person.
- Avian flu is caused by influenza viruses that occur naturally among wild birds. Low pathogenic avian flu is common in birds and causes few problems. Highly pathogenic H5N1 is deadline to domestic fowl, can be transmitted from birds to humans, and is deadly to humans. There is virtually no human immunity and human vaccine availability is very limited.
- Bird flu is commonly used to refer to avian flu. Bird flu viruses infect birds, including chickens, other poultry and wild birds such as ducks.
NHB Kicks Off 2012 CFC Campaign
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Naval Hospital Bremerton (NHB) Sailors gathered together on the quarterdeck to celebrate the 2012 Combined Federal Campaign (CFC) Kick Off on Sept 14. “This year’s campaign theme is ‘Impacting Lives, 365’. This reminds us that what we give through CFC helps every day of the year,” said NHB CFC Chairperson Lt. Heather Rosati. “I love [CFC] because it really allows me to know where my money goes and I like that,” said NHB Executive Officer Capt. Maureen Pennington who was presented a CFC campaign coin by Rosati. “I do three different areas. I always do something for the military. For a long time now, I’ve been doing something for animals because I’m a big animal lover, and I also do something for hospitals for children.” The goal for NHB’s contribution to the annual campaign, which runs from Sept 15 through Nov 15, is $67,000. There will be a display on the quarterdeck with a thermometer to represent the progress of the campaign toward reaching that goal according to Rosati. One new feature being touted this year to give donors more options is called Universal Giving. NHB CFC is part of the region campaign, Greater Olympic Peninsula (GOP) CFC, and according to their website (http://gopcfc.org), the Office of Personnel Management has chosen their campaign to conduct a pilot project which will allow donors the opportunity to pledge their donation to any approved CFC agency world-wide. Donations to past NHB CFC campaigns could only be provided to national and international agencies and agencies local to the Greater Olympic Peninsula geographically.
“Through Universal Giving, you have more choices of who to give to,” said Rosati. “You can give through any charity as long as they’re in any CFC campaign throughout the country. For me, being from Massachusetts, I plan to give to a local charity that has impacted my family in Massachusetts.” “To do Universal Giving, you have to go to the website to search for whatever charity you want. An icon will pop up to indicate if that charity is Universal Giving, local, national, or an international charity.” Rosati also highlighted the many tentatively scheduled campaign fundraising events including a fall festival with a dunking booth, yard sale, and hosting the popular, annually hosted Dodgeball tournament that is planned for October. CFC representatives were already hard at work earlier that morning with a donation-only bake sale headed by NHB CFC President for the Fundraising Campaign Committee Hospital Corpsman 1st Class (IDW) Dawn Dillow, assistant division officer for OB/GYN, which resulted in over $400. Along with an ample selection of cookies, brownies, and muffins donated by staff members, healthy options such as fresh fruit and yogurt were offered. “Take time to pitch in and give what you want to give,” said Pennington. “It doesn’t have to be a lot. It’s a great way to make a difference.”
Naval Hospital Bremerton detects, deters, defends with Mock Disaster Drill
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton held a base-wide mock disaster drill on August 16 to train the command on handling an armed intruder and subsequent mass casualties. The scenario tested how Naval Hospital Bremerton and Naval Base Kitsap (NBK) Naval Security Force (NSF) personnel responded to an active shooter inside the military treatment facility. The mock drill also evaluated how NHB staff members initially responded, triaged and treated wounded/injured personnel and coordinated the transport of the injured to appropriate casualty receiving areas. The exercise included additional assessment of NHB’s communication, cooperation and coordination with Harrison Medical Center Bremerton, Commander Navy Region Northwest and civilian/county fire/emergency medical services to transport severely injured patients to the Harrison Emergency Room for treatment. “We utilized this event to evaluate the effectiveness of our command in working with NBK NSF to detect, deter, defend and mitigate an armed, barricaded, hostage, active shooter incident. This wasn’t just a table-top exercise. This was full-blown and all-out, with many people involved in handling their responsibilities step-by-step. Our requirements are to train and practice holding two patient surge exercise per year, with one of them involving an external community agency,” said Terry Lerma, NHB Emergency Management coordinator. The scenario occurred in NHB’s main building where staff members were ambushed by an unknown assailant. Staff members then carried out an evacuation and activated emergency response
procedures to deal with the active shooter/armed intruder. “Our goal was to have the incident evolve rapidly, which meant that immediate response was required. The first NHB Naval Security Force on the scene had to aggressively search, seek and stop the shooter. Until that happened, our rescue efforts were delayed,” Lerma explained. Lerma cited that there is the potential at any time for a catastrophic event, such as an active shooter causing a mass casualty situation on the NHB compound. Planning and training for such a situation to rapidly react and respond to such a threat is part of the overall command readiness. Compiled statistics by Federal Emergency Management Agency show that since Aug. 2011, there were 44 open shooter incidents across the U.S., with seven of those being at Hospitals/clinics. “This planned exercise allowed Naval Hospital Bremerton to maintain required high standards of readiness and stay prepared for emergency conditions be they man-made or natural disaster,” explained Lerma. The mock drill was coordinated not to impact patient flow or interrupt service to any eligible beneficiary seeking medical and health services at the facility. There were three fatalities in the mock exercise, along with 17 simulated mass casualty victims triaged and taken into the emergency room at NHB, with six then sent in ‘critical condition’ to Harrison Medical Center Bremerton . According to Lerma, one of the successful lesson learned in the event was the coordinated liaison with Harrison Medical Center Bremerton. The exercise provided both medical facilities with the opportunity to interact and test their response capabilities and identify opportunities to increase those capabilities. “The communication with
our colleagues at Harrison went extremely well. Once they activated their command center for the exercise, they contacted us and we were good to go with them in relaying information on the patients being transferred their way. That liaison piece had not been there before and it was invaluable,” he said.
Chronic Pain management to Benefit the Beneficiary
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton hosted members of the Navy Comprehensive Pain Management Program (NCPMP) for a fact-finding, brain-storming collaboration visit on August 8 and 9. “The pain management team was here to meet and gather information on program capabilities we have at NHB. We all want to know how to implement better methodology with our stakeholders in all of our departments and clinics to help our beneficiaries,” said Cmdr. Brendan Melody, NHB Director of Administration. According to Capt. Ivan Lesnik, Navy Medicine West NCPMP Lead, the general objectives for this BUMED initiative program are to aid in the restoration of function and relief of pain by broadening access to evidence-based, standardized, multimodal, and interdisciplinary pain care across Navy Medicine, ensuring treatment efficacy through practice guidelines, education, and analysis of treatment outcomes. “There is a crisis in effectiveness in handling pain. The number one issue from beneficiaries and active duty personnel is about pain. Pain is the most common complaint. Its loss of function and it impacts quality of life. We have used the tools that we have but that’s not enough,” explained Lesnik. “Establishing a multidisciplinary approach within the Medical Home environment which is focused on improving the patient's quality of life while training the Medical Home Port team in the various modalities and approaches available is absolutely the right approach. The concept definitely aligns with the integrated and coordinated team care tenants inherent to Patient-centered Medical Home. It will provide the Medical Home teams with multiple alternative treatment options
for managing chronic pain in lieu of a purely pharmacological approach. Patients are inundated with advertisements depicting various medications to use in the treatment of pain, even though there are multiple other options available that can be as equally or more affective,” stated Cmdr. Patricia M Taylor, NHB Deputy Director for Medical Services. The Navy response to improve handling pain capabilities is based on the 2010 National Defense Authorization Act and 2011 Assistant Secretary of Defense for Health Affairs memorandum requiring standardized, comprehensive, multidisciplinary pain management in the Military Health System. “This is really about pushing our care to the deck plates, especially improving access to care with a big emphasis on restoring function and capability. Anything that erodes readiness is a deterrent. The major pain areas continue to be the lower back, joint and shoulder pain for the junior and senior enlisted personnel,” Lesnik said. Lesnik attests that chronic pain is at a current state where it is a disease and economic burden to the entire country. “From the utilization of care standpoint, the most common office visit complaint is chronic pain, which is directly associated with loss of function, quality of life and workdays. Chronic pain impairs readiness and is a common medical evacuation cause,” said Lesnik. Lesnik notes that special emphasis will be placed on improving quality of life and functionality, decreasing pain, increasing patient satisfaction, reducing pain-related costs, lessening limited-duty days, and improving access to care for complex acute, high-risk acute and chronic pain patients. “The vision is readiness through restoration of function and relief of pain. Navy
Medicine’s solution at our military treatment facilities, hospitals and clinics is to have multidisciplinary pain care teams that we call R4 Pain teams. R4 is reference to readiness, restoration of function, relief of pain and research,” Lesnik said, stating that the plan is to have R4 Pain Team and R4 Regional Subspecialty Support team assets available for providing a range of assistance for everything from direct clinical care to reviewing complex cases to embedding with specific specialty areas to help mitigate chronic pain. “Chronic pain really is very patient-specific and requires a thorough assessment of the patient's physical and psycho-social elements to determine the best course of action. The multidisciplinary approach outlined in the Navy Comprehensive Pain Management Program will improve communication between the various disciplines involved in the patient's care and should improve patient participation and health outcomes,” Taylor said.
Native Art Donated To NHB
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton (NHB) accepted two donated pieces of art on Aug. 10 of a locally-renowned artist whose relief sculpture work adorns NHB’s outside featuring classic symbols of the Haida, the indigenous nation of the Pacific Northwest Coast. “On behalf of the skipper, Capt. Culp, and all the staff members, and everyone that walks through these doors, we really thank you,” said Capt. Maureen Pennington, NHB Executive Officer, to the donators, Liz Leske and Ray Leske, during the presentation on the quarterdeck. Liz Leske, along with Claire Toth, Cat Toth, and Casey Toth, contacted NHB to donate an Oliver Tiedeman painting and mask in honor of their parents, Richard C. and Marylou Toth. “They loved Oliver Tiedeman’s work and wanted to share it with as many people as possible. Because Naval Hospital Bremerton incorporated Tiedeman’s art in its buildings, my siblings and I feel this would be a perfect place for the painting and mask to be displayed,” said Liz Leske, a resident of Gig Harbor, Wash. The vertical 72 inch by 36 inch Tiedeman painting depicts a totem pole carving with swirling birds around it and the 10 inch by 12 inch ceremonial mask features two of the predominant color schemes of the Haida – rust and green – dominated by two larger-than-life eye sockets decorated with stripes of color to all points of the compass. Oliver Tiedeman (born Apr. 11, 1919 and died Mar. 23, 1986) was a Tacoma, Wash. Artist who worked professionally in Nisqually and specialized in Northwest Native American art and associated murals. Tiedeman originally crafted the numerous Native American art symbols for NHB in 1977. The symbols combine Haida
representation of the Sun, Moon, Beaver, Raven, Copper, Frog, along with Gunarrh and the Whale, and Sea Monster. Additionally, several features the Haida’s symbolic hand design to signify the healing hand of the physician. “This is the perfect place for this art. We love the artist and it’s amazing how much an artist can add to a place,” said Pennington. There are 58 concrete panels, ranging from 7 feet to 22 feet, done by Tiedeman at NHB. He began to work on the project in 1977, took approximately a year to complete, and was ready when the facility opened on May 7, 1980. Just outside the main entrance to the hospital’s quarterdeck, there are panels of Sun and Moon. Sun was considered brother of the Moon, and Raven (in the lower portion of the Sun panel) was a uniting factor in the Haida mythology. Moon, with Salmon Trout design (on the lower portion of the Moon panel) is utilized as a similar design shape. Moon discovered man and sent down arms or rays, pulling him up into the heavens, where man is seen during the full moon. Sun whisked a chief’s daughter up to his arms, where she discovered was brother to Moon and they both bring light to earth, day and night.
Naval Hospital Bremerton Health Promotion supports Stennis Pre-Deployment Fair
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton’s Health Promotion provided a wide variety of health and wellness information for the USS John C. Stennis (CVN 74) Pre-Deployment Fair held Aug. 7, at Naval Base Kitsap Bremerton. “At the event for the families of the Stennis we were able to do some "on the spot" health promotion as well as market our family focused resources. We had calendars of classes for the Wellness Center. These included prenatal and new parent classes and child car seat installations. Families with children who are new to Washington are particularly interested in the Washington State Car Seat Laws, which require children to be in booster seats until they are 8 years old or 4'9",” said Janet Mano, NHB Health Promotion Division Head. The Stennis Pre-deployment Fair also featured services from such local support group as NBK Fleet and Family Support Program, Morale Welfare and Recreation program, American Red Cross, USO, TRICARE, the Stennis command ombudsman program, Legal office, Public Affairs office, Administration office, Family Readiness Group, as well as ship and shore Pastoral Care staff and chaplains. The Stennis Pre-Deployment Fair was the perfect venue for Health Promotion to share information to the estimated crowd of 400 who showed up for the event. The NBK-Bremerton based carrier and its strike group departs four months early on deployment late this summer to the U.S. Central Command area of responsibility, DOD officials announced at the Pentagon July 16. “We thank Health Promotion and all the other local representatives for their support of our
families and helping to make our deployments easier to handle. This event has been a success. There is a lot of really good, necessary and right information being shared,” said Lt. Cmdr. Rob Wills, Chaplain, Stennis Command Religious Ministry Department. “I’m glad this event was here. I needed to make sure my wife is fully informed of all the resources and services we have available from the ship and with commands ashore like Naval Hospital’s Health Promotion,” said Aviation Ordnanceman Chief Select Matthew Renniger. According to Mano, NHB’s Health Promotion has established strong collaborative relationships with many of Navy Region Northwest commands. This networking has allowed Health Promotion to integrate health and wellness into a wide variety of command and community programs. “For example, this year we have participated in 15 safety events throughout the region. This year we have participated in Ombudsmen meetings, "all hands" meetings with Navy Region Northwest, Naval Base Kitsap (NBK) Bangor, Naval Undersea Warfare Center Keyport and Puget Sound Naval Shipyard (PSNS), and been involved in such events as Military Appreciation Day, NBK Right Spirit campaign and a PSNS ‘Fit Walk,’ to name but a few,” Mano said. The overall mission of Health Promotion is to provide quality products and services to every eligible beneficiary concerning health and wellness by combining involvement, optimal command participation and on-going support for individual health behavior change, health promotion and prevention. Eligible beneficiaries can take advantage of a wide variety of programs offered by NHB’s Health Promotion, including Health Risk Assessment; Injury
Prevention; Nutrition; Physical Fitness; Sexual Health and Responsibility; Stress Management; Suicide Prevention; and Preventive Health Assessments; injury prevention; nutritional tips; physical fitness; psychological health with stress management and suicide prevention; tobacco cessation; Alcohol and Drug Abuse Prevention; and weight management. Mano attests that Health Promotion is a strong advocate of the Navy and Marine Corps Public Health Center philosophy that defines Health and Wellness as “ensuring healthy living through various sources and education by providing tools to assist individuals in gathering helpful information. The mission is to provide quality Health Promotion products and services with a vision of producing a healthy and fit force. Health promotion and wellness, along with healthy living, continues to address prevention, community health promotion and general wellness.” There are numerous classes available at Health Promotion for healthy eating and active lifestyle such as “Stress Workshop” that provides an summary of research on the neuroscience of happiness, including nutrition, sleep and exercise; Nutrition and Weight Management classes such as “Mission Nutrition: 3 day healthy eating and weight management class, and “Intro to Nutrition,” “Diabetes Prevention” and “Heart Healthy Living” Classes. There are also monthly field trips such as the Commissary “Healthy Shopping” tour and Fitness Center tour. The “Bariatric Screening” class includes appointments with a registered NHB dietitian as well as a mental health provider. The “Shipshape” 8-week program is specifically designed to assist active duty members in meeting Department of Navy body
composition standards and spouses are also eligible attend. Naval Hospital Parenting Resources include Childbirth classes that prepare for labor and birth and what to expect during the hospital stay. Choose between three consecutive Wednesday evenings, or a full day Saturday; Lactation class is held the 4th Wednesday evening of each month to help you prepare for breastfeeding. Those interested can contact TRICARE to register for Childbirth and Lactation classes at 800-404-4506. For more information call OB-GYN clinic 475-4209. Baby Basics classes: Great information from New Parent Support and Naval Hospital pediatricians for when the new parent brings the new baby home. Call TRICARE 800-404-4506 to register for Baby Basics or Health Promotion 475-4541 for more information. Car Seat Fittings: Events and appointments through Naval Hospital Health Promotion. Call (360) 475-4541 or e-mail email@example.com to make an appointment. Fleet and Family Program www.navylifepnw.com 866-854-0638 Parenting Classes, family and child counseling, Exceptional Family Member Program, family advocacy, ombudsman program, deployment support. New Parent Support Team: includes home visitation, parent -education and prenatal and postnatal care. For more information, call 360-475-7483 or www.navylifepnw.com www.militaryhomefront.dod.mil. For physical activity, MWR Fitness Centers: www.navylifepnw.com for hours and class schedules. Certified Navy Fitness Specialists will work to develop a safe and effective plan to meet desired/required fitness goals. Family
friendly workout areas are available at NBK Bangor and NBK Bremerton. NBK Bangor 315-2134, NBK Bremerton 476-2231; Naval Hospital 475-4546. The Therapeutic Lifestyle Choices (TLC) classes at NHB offer gentle and safe classes which can be modified for all fitness levels. Wellness Classes include yoga, tai chi and Pilates classes throughout the week. Training is also available for Back Injury Prevention, Office Yoga, Everyday Stretching and Strengthening and Relaxation topics are available on request to Health Promotion. E-mail firstname.lastname@example.org or call 475-4541.
65th MSC Birthday Celebrated At NHB
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Naval Hospital Bremerton (NHB) Medical Service Corps (MSC) association members celebrated the 65th MSC birthday with NHB Sailors and staff at a ceremony on the quarterdeck Aug. 3. “We are a diverse community in the Medical Service Corps. We consist of 31 clinical, administrative, and scientific sub-specialties. At Naval Hospital Bremerton, we have 50 Medical Service Corps officers filling about 17 of those sub-specialties,” said NHB MSC Association President Lt. Jeremy Howell. “What I really want to do today is stop and thank you for the wonderful service you have given to this hospital, to our medical department, and to our Navy. I wish you a very happy birthday,” said NHB Commanding Officer Capt. Christopher Culp. Howell made Culp an honorary MSC for the day and awarded him a NHB MSC association t-shirt. NHB Director for Administration Cmdr. Brendan Melody also awarded Culp an MSC specialty collar device. Guest speaker, Capt. (ret.) R. Gregory Craigmiles, first commanding officer of the Navy Medicine Training Center (NMTC), Fort Sam Houston, Texas, highlighted the diversity of MSC officer careers by going over his 30 year career path. “When someone says they’re in the Medical Corps, you automatically know they’re a physician. When someone says they’re in the Dental Corps, you automatically know they’re a dentist and when somebody says they’re in the Nurse Corps, you know they’re a nurse,” said Craigmiles. “But when somebody says they’re in the Medical Service Corps, it begs a second question always. What do you do in the Medical Service Corps? My career took several digressions that reflect some of the
diversity in the Medical Service Corps. I came in as a medical technologist, then transitioned to information technology, and then finally wound up in education and training.” In addition, NHB MSC posted static displays on the quarterdeck with official birthday messages (from directors of the Medical Service Corps, Medical Corps, Nurse Corps, Dental Corps, and Force Master Chief), a complete listing of all the MSC sub-specialties, and a variety of photos of NHB MSC officers working in the hospital and on deployment. The event closed with a ceremonial cake cutting.
Naval Hospital Bremerton hosts Navy Surgeon General for official visit
By Douglas H. Stutz, NHB Public Affairs
Vice Adm. Matthew L. Nathan, Navy Surgeon General and Chief, Navy Bureau of Medicine and Surgery, visited Naval Hospital Bremerton on August 1 as part of his tour to the Pacific Northwest. Nathan’s visit included meetings with command leadership as well as informal chats with enlisted staff members over lunch in the hospital’s Terrace Dining Room and several All-Hands Calls with the surgeon general in the Ross Auditorium. He also engaged with Capt. Christopher Culp, NHB Commanding Officer in daily grand rounds with residents of NHB’s Puget Sound Medicine Residency program. “It was just Dr. Nathan and Dr. Culp with the residents during that time. He was engaged as a professor of medicine and tutored the residents through a case so expertly that they all were stoked,” said Culp. The All-Hands Admiral Call for enlisted personnel gave the surgeon general a captive audience to discuss a wide variety of topical interests for the assembled staff members. “This is our time to talk and I enjoy mixing it up with Sailors. This is where I can hear your concerns and questions. No one here was forced to join. You volunteered and as such, you represent one percent of our nation who serve in the armed forces,” said Nathan, adding that based on health, physical condition, academics and disciplinary issues, only one in four Americans eligible to join the military are actually qualified at this time. “That’s the lowest percentage in the history of the country. You represent a group of elite Americans. Thank you for your service and thank you for being part of something bigger than yourself.” “As a country and as a Navy, we
are coming off of 10 years of war. As Navy Medicine, we’ve been all in, whether on land, above the sea, below the sea or on the sea. Of all the rates that have gone to Iraq and Afghanistan, over 50 percent of the wounded have been Navy Medicine personnel. Nearly one-third of those killed in action have been Navy Medicine,” continued Nathan. Nathan stated that one reason that Navy Medicine is so engaged is the involvement of the enlisted personnel. “We put more responsibility on you, the enlisted, than other services do on their medical personnel, not to be derogatory to our other services. That’s just the rule. It’s because we came from the sea. We all started as Sailors. Our legacy is 236 years old from wooden ships where those before us had to know their job and 10 others. Your heritage is from the sea. Your responsibility, accountability and demand for professionalism started 236 years ago. That’s why I’m proud of the Navy. And all of you.” Nathan attests that Navy Medicine is more involved than ever before in making lasting positive difference and staying engaged. “The United States Navy is a great ambassador and projector of power. We send our ships and Sailors all over the world. Our number one job is to support the war fighter which we have paid with blood and treasure. Our hospital corpsmen are the most decorated rate in the Navy, because when things get bad and everyone runs out, we run in,” Nathan stated.
Landstuhl SELRES take top honors in Warrior/leader Competition
By Douglas H. Stutz, NHB Public Affairs
For first time since the Warrior/Leader competition began at Landstuhl Regional Medical Center, Germany in 2006, two Sailors claimed top honors in the event held in late June. Hospital Corpsman 2nd Class Charles W. Setzer II and HM3 Malachi Mansfield, Navy Reservists deployed from Operational Health Support Unit (OHSU) Bremerton to Navy Expeditionary Medical Unit (NEMU) Germany, distinguished themselves in the mental, physical and professional challenge of the Warrior/Leader competition that involved marksmanship, military comportment, and fitness capability. Mansfield was recognized as the LRMC Warrior Award recipient for the 3rd Quarter, Cycle 2012, and Sezter took the LRMC Leader Award. “I viewed the Warrior/Leader Competition as a personal challenge. Since the Navy had never won this event in the past, I wanted to be the first Sailor to succeed. Throughout the process and after the announcement, I wanted this to serve as a morale booster for my fellow Sailors and wanted to set the standard and be a role model for others,” said Setzer. The Reno, Nev. native has been assigned to NEMU 13 for approximately four months. The Warrior/Leader Competition is a tri-service competition conducted by the First Sergeants representing each service that began in 2006. Each service selects both a "Warrior" (pay grade E-3 or E-4) and a "Leader" (pay grade E-5 or E-6) to represent their respective service branch - Army, Navy and Air Force – at LRMC. The 3rd Quarter competition took place June 23, 27 and 28. “I wanted to participate in this competition as a personal challenge. I learned that I
could take on duties and challenges that would bring me out of my comfort zone. This competition brought me out of my comfort zone and also exposed me to new experiences,” Mansfield said. The Greely, Colo. Native. has also been at LRMC for almost four months. Mansfield drills out of Navy Operational Support Center Denver, Colo. with Operational Health Support Unit Bremerton Detachment O and Setzer had just moved to NOSC Springfield, Ore. before his deployment where he was drilling with OHSU Brem Det G. Both Selected Reserves gaining command is NHB. According to Hospital Corpsman Senior Chief (Fleet Marine Force) Jeffrey A. Chunglo, Navy Company First Sergeant/Senior Non-Commissioned Officer in Charge, Deployed Warrior Medical Management Center, all competitors had to qualify on an Army run rifle range. To qualify, they had to score a minimum of 24 points or the maximum of 40. Depending on the range, the size of the targets can be adjusted to simulate a 300 meters range. The actual distance can be a close as 50 meters. They also incorporate different stances - prone, kneeling and standing. “The first day Mansfield ever picked up an M-16A2 rifle was on the morning of the qualifications. He qualified as "Marksman," missing “Sharpshooter” by three points. He distinguished himself with his performance on the rifle range. It is amazing that he was able to handle a weapon, perform initial sight adjustments and qualify without ever handling a weapon before, or without guidance,” said Chunglo, adding that Setzer qualified as “Expert.” The next phase of the competition was a "Presentation Board," akin to a Navy command’s Sailor of the Quarter board. Each
First Sergeant served as a Board member. Chunglo explained that when reporting for the Board, each Warrior/Leader gets graded on their uniform appearance, facing movements and military bearing. They then "formally introduce themselves" to the Board and recite their service specific creed. Following this, they are asked three random questions from each First Sergeant covering their service specific history, traditions, policies, customs, and general knowledge. They are graded on their response and military bearing when addressing each First Sergeant. “Each candidate was asked service-specific questions from a panel of First Sergeants representing the Army, Navy, Marines Corps and Air Force. All questions were randomly asked, directly from their specific service manual. HM3 performed very well at the Presentation Board, scoring well above his competition,” Chunglo said. The final event featured a grueling "Cross Fit" style physical fitness test. Mansfield and Setzer were graded with everyone else on such events as a timed run, a floor to ceiling repetitive rope climb and manhandling a "tire flip.” All events were then computed for overall time. “HM2 Setzer was excellent in all phases of the competition. He scored Expert on the rifle range and finished in the top percentage of the physical fitness challenge. His most noteworthy performance was at the Presentation Board. His performance was graded as perfect from all First Sergeants,” shared Chunglo. Chunglo notes that along with this being the first time that NEMU has ever won this competition, to claim both the Warrior and Leader competition is a definite achievement. “Both of them volunteered for this competition as a personal challenge and to represent the
Navy. They have set the bar very high for the remainder of our deployment and the competitors to follow. I am extremely proud of both of them for volunteering for the competition, yet along winning. They both worked very hard preparing for the competition and are to be commended for a job well done,” Chunglo stated. NEMU Unit 13 consists of 108 active duty and Reserve Sailors deployed for approximately one year to LRMC. While serving as doctors, nurses, medical technicians and other support roles, NEMU integrates seamlessly with other medical servicemembers from the Army and Air Force to help care for the Wounded Warriors who arrive for medical care at LRMC from as far afield as Afghanistan. Since the Global War on Terror began in 2001, LRMC has received and cared for approximately 67,000 Wounded Warriors from downrange. “I have worked in multi-service command in the past, and the command at LRMC has been the best I have ever experienced. I have been able to build relationships that have helped with my personal development. Everyone throughout the command is open and accepting of others and fosters an atmosphere of cooperation. All departments and clinics are integrated and promote the team concept,” said Setzer. “My experiences are extremely valuable. I have been able to broaden my horizons working within a joint command. The most gratifying aspect of performance here at LRMC has been the opportunity to take care of the wounded warriors. Working with wounded warriors has been a humbling experience,” added Mansfield. LRMC is the largest American hospital outside of the United States, and the only American tertiary hospital in Europe. LRMC provide primary care, tertiary care,
hospitalization and treatment for more than 245,000 U.S. military personnel and their families within the European Command. LRMC is also the evacuation and treatment center for all injured U.S. servicemembers and civilians, as well as members of 51 coalition forces serving in Afghanistan, Iraq, as well as Africa Command, Central Command and European Command.
NHB Chiefs Partner Up For Trident Triathlon
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Naval Hospital Bremerton (NHB) Chief Hospital Corpsman (FMF) Noel Gravina, NHB surgical services directorate leading chief petty officer and Chief Hospital Corpsman (SW) Julie Sanchez, NHB human resources leading chief petty officer teamed up to take on the month-long Naval Base Kitsap (NBK) Trident Triathlon challenge in July. “SECNAV (Secretary of the Navy) came out with the 21st Century Sailor initiative and part of that is physical fitness which is very important especially if you’re a corpsman. I came back from deployment last year and I realized how important it is to be physically fit for you to be able to treat patients and move them,” said Gravina. “I’m doing the run and the bike portions of the triathlon challenge. Professionally, this just helps me do my job better and longer because if I’m healthy, I can stay in the Navy longer.” NHB health promotion tailored the challenge to attract a wider audience. “We customized it [at NHB] to be accessible to more people because we want to encourage everyone including beginners to do this great cross training,” said NHB Health Promotion Coordinator Janet Mano. “So, we broke it down into the three different distances to make it go from an introductory level all the way to a much higher level. We also let people do it as a team.” NHB staff members were invited as individuals or teams to complete the following events with corresponding distances according to their fitness level: the Ironman which required swimming 2.4 miles, biking 112 miles, and walking/running 26.2 miles, Half Ironman which halved those required distances, and the Sprint which required swimming half a mile, biking 12.4 miles, and
walking/running 3.1 miles. “They could try a new activity they haven’t done as a beginner…or it might be an incentive for someone to get on a bike for the first time in years. We get in our fitness comfort zones and we wanted to give them a non-competitive motivation to get out of your fitness rut,” said Mano. “Initially, I wanted to do all three [parts of the Ironman] event except I found out I’m not a very good swimmer. So, I asked Chief Sanchez to be my teammate and it worked out really well because now we’re motivating each other,” said Gravina. Sanchez, a highly capable swimmer since childhood, used the side stroke to complete the swim portion for her team. “My physical capabilities stood up to my determination to knock it out in one fell swoop. At lap 50, I thought to myself I’m over half way there, I’ll just keep going and do the whole thing,” said Sanchez about completing the 2.4 mile swim in a single 1 hour and 52 minute session at the NBK Bangor pool on July 21. Gravina has been working out twice a day to make the deadline. He completed the run portion July 24 and is in the home stretch with the biking. “I have about 30 miles left to do on the bike, and I’ve been averaging 18 miles a day,” said Gravina. NHB health promotions is tentatively planning on making this challenge to staff a perennial event. “This was the first year offering it, and I hoping and planning to offer it annually and grow it over the years,” said Mano. “It was actually a lot of fun especially with chief Sanchez. Sometimes, when you don’t have a goal, it gets boring, but when you have a specific goal to achieve then you’re driving toward that,” said Gravina. “I would definitely participate in this again.”
NHB to hold Back-to-School & Sports Physicals Aug 15 & 29
Naval Hospital Bremerton will assist families preparing for the upcoming school year and sports seasons by offering after-hours School/Sports Physicals. The physicals will be available from 5:00 p.m. to 7:00 p.m. on Wednesday, August 15 and Wednesday, August 29, 2012, on the second floor of NHB’s Family Medicine Clinic and is co-sponsored by NHB Family Medicine and Pediatrics, and Branch Health Clinic Bangor Family Medicine clinics. In order to make the visit go smoothly students and parents are asked to come prepared. It is strongly encouraged for parents/students to complete all school/sports physical forms prior to the appointment as this task is tedious and time consuming. If a medication for school form is also required, please have it completed as well. All students under age 18 must be accompanied by their parent or legal guardian. Please wear comfortable clothing for the physical exam. Other required items to bring include your ID card and Immunization Record/shot card. The visit will include the following: visual exam, height/weight, vital signs (blood pressure, pulse, respiration) and the physical examination itself. In order to qualify for the appointment, students must be TRICARE Prime beneficiaries enrolled in Family Medicine at NHB or Bangor, or Pediatrics. To make an appointment, contact TRICARE Regional Appointment Center (TRAC) at 1-800-404-4506 and ask for a Sports/School Physical appointment.
NHB CSADD urges “WAIT 2 TXT,” “TXTING KILLS,” and “DNT TXT”
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Navy Hospital Bremerton (NHB) Coalition of Sailors Against Destructive Decisions (CSADD) members raised awareness for NHB Sailors, staff, and visitors about the dangers of driving while texting as part of their month-long July driver safety campaign on July 17. “We wanted to focus on what we call ‘Wait 2 Text’ which involved putting down the phone and not texting while driving,” said Hospital Corpsman Elizabeth George, CSADD July motor vehicle safety campaign coordinator, of NHB’s Pediatric department. “There are different organizations that have similar campaigns going on that are focused on teenagers. CSADD is for everyone but specifically for Sailors 25 and younger. Our campaign is for those who might be the people most often guilty of texting and driving,” George said. NHB CSADD members collected over 50 signatures during lunchtime from people pledging to keep from texting while driving. Their table featured a static display with facts and statistics of fatalities resulting from texting and driving. Those who made pledges signed a banner and were given a choice of different rings and bracelets with slogans such as “TXTING KILLS” and “DNT TXT.” “You’ve got a group of young Sailors in plain sight encouraging their peers to sign this document that they promise not to text and drive. I think it’s a great idea,” said NHB Command Career Counselor Hospital Corpsman 1st Class (FMF) Jason Corless who signed the banner and received a ring emblazoned with “WAIT 2 TXT.” “It’s pretty awesome that they’re taking ownership and accountability for everything themselves and their
counterparts are doing in the hospital and in the region,” added Corless. The July CSADD motor vehicle safety campaign is based around the acronym SAFETY to highlight the many dangers to Sailors. “SAFETY stands for speeding, alcohol, fatigue, ejection (seatbelts), texting and you, and what you can do to prevent that,” said George. After collecting signatures, CSADD members posted the banner below the CSADD display located at the hospital quarterdeck. The tri-fold display explains the CSADD program, the CSADD Creed, and topics covered by CSADD. Along with raising awareness, the NHB CSADD chapter is tentatively planning events such as paintball, MWR trips, and movie screenings to give NHB Sailors safe and fun activities to participate in. “Our CSADD is doing a phenomenal job. They’ve helped stand up other programs at the Naval Base Kitsap Bangor base and I hope they can be a good contender for chapter of the year,” said Corless. The CSADD program was first implemented Navy-wide on June 18, 2010 by Chief of Naval Personnel Adm. Mark Ferguson.
NHB Volunteers help local church revitalized Pee Wee ballfield
By Douglas H. Stutz, NHB Public Affairs
By helping to build it, they will come. Naval Hospital Bremerton staff volunteered to help construct a foundation/retaining wall for a Pee Wee baseball field at Christ the King Lutheran Church and School in Silverdale on July 14. NHB’s Chief Petty Officer Association, Team 365 and others formed the Saturday morning work party to bolster the area by placing and reinforcing block stones approximately four high around the backstop of the Church ball field. “We had been trying to do this project for quite some time. We’re affiliated with the local Pee Wee Baseball Association and supporting them is something we shared with the community. We appreciate the help from Naval Hospital. It’s just awesome to get the extra support,” said Bruce Babler, Christ the King Lutheran Church and School principal. By reinforcing the foundation and constructing the associated retaining wall, there is now available and sustainable space to add improvements to the field. “The Church can now move onto phase three of their plan. That phase is to build dugouts and bleachers for the ball field and players that use it. This has been a plan in play for the last few years and the volunteers have made it possible,” said Stan Graham, NHB staff member and volunteer-organizer of the event. Graham added that the entire project has resulted in many overlapping, positive contributions for everyone involved. The Church benefits, NHB staff (again) support a community project; the command is recognized as a leader in the community; the Navy is represented with the effort as a way to display a good image, and all those who volunteered have provided a needed service to the little
league (from a safety and comfort perspective). “Volunteering is what I do. I like getting plugged into the community and what better way to do that than by helping out? It’s also very rewarding in its own way by helping others out with a project. It really does show others that as representatives and ambassadors of the Navy, this is what we do. We help not only when deployed overseas, but also at home with our neighbors when needed, such as building this wall that is a lot larger than I thought,” commented Hospital Corpsman 1st Class Christopher Cornish. HM1 Adam Cerullo showed up to volunteer after a long night of duty the day before. “But I made the commitment to be here. As long as I got the energy, I’m good to go. Plus, this church is right in my area and is part of my community,” Cerullo said. “On behalf of Christ the King Lutheran Church (CTK), I want to personally thank those in attendance this past Saturday for all your hard work in building and finishing the retaining wall at CTK! Your efforts really made a huge difference,” Graham said. “We really appreciate the help. Thanks very much to everyone for being here,” said Pastor Ted Lambert of Christ the King Lutheran Church
Puget Sound Family Medicine Residency honors Graduating Class of 2012
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton’s Puget Sound Medicine Residency held the annual Family Medicine Resident Graduation Ceremony on June 29. Four of the Family Medicine third year residents ship out to other duty stations and six Family Medicine first year residents continue on their training at NHB along with six new interns. “This ceremony celebrates the successful completion of one of the hospital’s mission, which is to train the world’s finest family physicians. Their maturity, intense personal drive, compassion and willingness to grow personally and professionally have been hallmarks of their academic achievement. I would put myself and my family under their care,” said Cmdr. Erik Schweitzer, NHB Family Medicine head. The graduating class of Family Medicine Third Year Residents are; Lt. Arriel E. Atienza, Medical Corps, with next duty station with 2nd Marine Division, Fleet Marine Force, Camp Lejeune, N.C.; Lt. Cmdr. William A. Boller, III, Medical Corps, with next duty station at Branch Health Clinic Chinhae, Korea; Lt. Stephen A. Keck, Medical Corps, with next duty station at Naval Hospital Guantanamo Bay, Cuba; Lt. Daniel E. Warren, Medical Corps, with next duty station at Naval Hospital Oak Harbor, Wash.; and Lt. Ramil M. Francisco, Medical Corps. The ceremony was highlighted by having two former commanding officers join in the event as guest speakers, along with the entire event being overseen by two bald eagles taking up residence in the trees along NHB’s shoreline. “It is truly wonderful to be home, greet new family interns and meet with so many friends. The opportunity to be here
is adding life to my years and years to my life being back in the Pacific Northwest. There is no place I’d rather be,” said Rear Admiral William Roberts, Fleet Surgeon, United States Fleet Forces Command and NHB commanding officer from 2003 to 2006. “Nothing is achieved without enthusiasm, hard work and some doubt along the way. Make your place a better place by one or more thing you do. Smile. Have fun. Include your teammates, and remember to say thank you,” shared Roberts. “Congratulations to our graduating residents. You will be challenged as long as others seek freedom and come in harm’s way. I am humbled to be here.” “We find our country at war and you knew that when you came here but still joined. You are to be commended for serving a cause greater than yourself. Your efforts and your dedication, discipline and focus have enabled you to achieve your goal. And with the added gift of leadership comes the gift of influence to inspire others,” Capt. Mark E. Brouker, Navy Medical Center San Diego Chief of Staff, guest speaker and former NHB commanding officer, 2008-2011. Family Medicine First Year Residents continuing their residency programs are Lt. Amelia H. Buttolph, Lt. Casey E. McCann, Lt. John S. Roberts, Lt. Gordon P. Salgado, Lt. Adam D. Voelckers, and Lt. Amelia Wright. The Residency graduation has also included several related events over a week-long period, starting off with the staff versus residents’ softball game, with the staff pounding out a 38-11 win. The week wraps up with the traditional Hail and Farewell ceremonial dinner. The Family Medicine Residency program has long been unique in that the residents train to become family physicians in a community hospital setting such
as NHB. In such an environment, family medicine residents become primary physicians for their patients on all inpatient and outpatient services. Residents also receive additional experience in the Intensive Care Unit and Neonatal ICU at Madigan Army Medical Center and on the Pediatric Wards and Emergency Room at Mary Bridge Children’s Hospital, both in Tacoma, Wash. PSFMR also partners with the University of Washington Family Medicine Network which has been consistently rated the top training program in the country. In addition, PSFMR was rated as the top rotation site by UW medical students. Puget Sound Family Medicine Residency (PSFMR) has a total of 18 residents, usually averaging approximately six per year group. The Family Medicine staff at NHB have received additional training in Faculty Development, with two having completed the two-year (U.S. Army) Madigan Fellowship. PSFMR staff and residents have been recognized by the Uniformed Services Academy of Family Physicians for their research efforts, and they have been published in such noted medical journals as American Family Physician, The Journal of the American Board of Family Medicine, The Journal of Family Medicine and Military Medicine. “I would go in harm’s way and serve anywhere with any of you,” commented Capt. Christopher M. Culp, NHB Commanding Officer to the graduating class. “You will always be Bremerton family physicians. This is where you were trained.”
Newest Navy Doc from Bremerton completes dream at Naval Hospital Bremerton
By Douglas H. Stutz, NHB Public Affairs
For one graduate of Naval Hospital Bremerton’s Family Medicine Residency program on June 29, the journey to become a Navy family physician is completed a short distance from where it initially began 33 years ago. When Lt. Ariel E. Atienza, Medical Corps, officially joins the ranks of NHB’s Puget Sound Family Medicine Residency (PSFMR) graduation class of 2012, he will have come full circle and then some. Atienza was born and raised in Bremerton, Wash., completed Bremerton High School in 1996, and was active in Navy ROTC. After graduating from Cornell majoring in biology, the influence of a Navy town guided him. He served on several ships as a surface warfare officer before deciding to pursue his goal of becoming a physician. “I knew early on I wanted to be a doctor, and I finally decided to do it in the Navy with the associated benefits and programs available. Being a Navy physician in family practice is what I want to do with myself,” said Atienza. “Becoming a physician has been a goal of mine growing up and my parents have been proud supporters throughout,” said Atienza, whose parents, Rosie and Pedro have resided in East Bremerton for over 40 years. “We’re very proud of him,” said Rosie. “Now when someone asks me what my son does, I can say he’s a doctor,” added Pedro. After completing medical school, Atienza then asked for and was selected for the Family Medicine Residency program at NHB, where he became immersed in the three-year program that provides graduate-level medical education for future Navy family physicians, and caring and training in improving the health of all eligible
beneficiaries served through patient-centered care. “Graduate-level medical education here is second to none and is the primary command objective for the Puget Sound Medicine Residency program. We also help continue to execute the demands of mission readiness along with daily general practice. Nowhere else could I have done as much learning and training,” said Atienza. Like most residents, Atienza’s first year was training-centric and becoming immersed with basic medicine in a general practice setting. The first year students learned to become comfortable in dealing with patients on all levels, in-patient and out-patient management, and basic obstetrics and new born care. “The first year curriculum is designed to prepare for any condition as a medical doctor who can then go into the fleet as a general entry level provider. There’s also more training added if someone is going to a sub-surface or aviation assignment,” Atienza said, adding that general practice medicine in a military setting means “being comfortable in seeing and treating a variety of diagnoses and injuries across a patient population of diverse ages and backgrounds. It’s also about knowing one’s own limitations and when to go for help.” Atienza’s second and third years of residency built upon the foundation of his first. His focus on family medicine included becoming more knowledgeable on treatment concepts and procedures, as well as handling more advanced detailed management of medical diagnoses, processes and injuries. “Our training is continually designed to make us competent with the ability to practice medicine wherever we go. We all went beyond our comfort level to finding out how to handle medical problems that
initially we knew nothing about. We learned as much as we could and we were constantly challenged. It was always valuable to have clinical specialists and colleagues available and willing to talk over cases, procedures, diagnoses. We are expected to be proficient. Working, learning and teaching with others in the residency program has helped us all get comfortable with the full scope of family medicine,” Atienza said. PSFMR program at NHB has long been unique in that the residents train to become family physicians in a community hospital setting where they help provide needed medical care to active duty personnel and family members, as well as retirees. In such an environment, family medicine residents become primary physicians for their patients on all inpatient and outpatient services. Residents also receive additional experience in the Intensive Care Unit and Neonatal ICU at Madigan Army Medical Center and on the Pediatric Wards and Emergency Room at Mary Bridge Children’s Hospital, both in Tacoma. PSFMR is also a partner with the University of Washington Family Medicine Network which has been consistently rated the top training program in the country. In addition, PSFMR was rated as the top rotation site by UW medical students. “We have a renowned residency program. We have a nationally recognized program of excellence. We have a quality program with quality residents who depart with high marks and awards to prove it. The quality of interaction with the other residents and staff helps make this is a really good place. The Uniformed Services University of the Health Sciences (USU) has labeled NHB as the best family practice military training site,” explained Atienza.
The NHB Family Medicine staff has a combined total of over four decades of experience in medical education. Additionally, most of the faculty members have also received additional training in Faculty Development and that collective expertise has positively impacted Atienza and the other residents throughout their three years as residents. “Our faculty doesn’t look at teaching as just a job. They think it’s a privilege. They always mentor a little extra, explain a little more and go out of their way to reinforce training on patient care. They have the drive and it rubs off on us,” explained Atienza. Graduating from the residency program is very rewarding. Some say we’re like a tribe. We all have basically the same framework. We started as juniors and had fun and handled the work load. Our focus on medicine also included family and camaraderie. As we continue to learn and progress, we also began to mentor and tutor as we were still being taught. Working with colleagues in this program is part of what makes it special,” Atienza said. The past several months have been a whirlwind for Atienza and his family. In April he completed his Medical Board qualifications. In May he married Tina, his sweetheart. In June, he graduates, completing one full circle as he starts another. “We take off for 2nd Marine Division, Camp Lejeune, N.C. It will be new and exciting. One of the other reasons I joined the Navy is to see the world. I’ve seen about half, so might as well continue to try and see the other half.”
BHC Everett Corpsman Making a Daily Difference on Down Range Deployment
By Douglas H. Stutz, NHB Public Affairs
When the weather warms during May to September in Afghanistan, the war also heats up. With the fighting season commenced in southern Afghanistan, a Branch Health Clinic Everett corpsman is right in the midst helping to care for wounded personnel. Hospital Corpsman 3rd Class (Fleet Marine Force) Anthony M. Juarez is serving right in the midst providing direct medical support to help save the lives of those injured in combat. Juarez is assigned to the Role 3 Multi-National medical facility at Kandahar Air Field, which has earned the title of the world’s busiest military trauma hospital. The 22-year old Bakersfield, Calif. native primary responsibility is to provide emergency care transportation to incoming casualties from the flight line to the Trauma Bay. He also assists with Emergent, Urgent, and Specialty care and works in the Referral Care Center (RCC)/ Emergency Vehicle Operation Casualty Care (EVOCC) section. “I am part of a great team doing great things in a bad place,” said Juarez. An average day for Juarez has his 24-hour shift starting at dawn. It is at this time that the daily job assignments of shift corpsman in charge, flight line leader, primary and secondary driver are assigned. It takes several minutes for the shift to be changed over from the last crew to the next. Maintenance and restock checks are completed on equipment and supplies of the ambulances and Humvees. He then ensures that the consumable supplies on the Referral Care Center (RCC) crash cart are ready for any emergency situation that might arise. The RCC clinic then opens for business at 8 a.m. to process patient flow to the appropriate location and provider. “Throughout the day we will get the call for an incoming patient(s) from the flight line anywhere from an estimated time of arrival
(ETA) of 30 min to right now. In most cases, with only seconds to turn over a patient to a provider or nurse, my crew and I depart to our designated job assignment for the day,” explained Juarez. “If I was (on) shift intensive care, my primary goal is to keep abreast with incoming patients,” continued Juarez. “Once a patient is confirmed inbound, shift I/C then coordinates with the flight line leader and trauma team leader for any possible medical support that will be needed such as providing a litter bearer team or ambulance. Overlapping coordination continues with the team briefed on the incoming patient(s) and the plan of action is generated. Juarez notes that the flight line leader is then in charge once the team has left the hospital compound to await the incoming aircraft. “Even though a plan of action has been generated beforehand, our patients and the combat situations dictate quick and fast flexibility of orders for being directly responsible for ensuring patient and staff safety while providing our services on the flight line.” The primary and secondary drivers ensure effective and safe patient movement from the flight line and provides litter bearing assistance. Juarez has held all of these titles on a frequent rotational basis. After 4 p.m., Juarez and the others in his section remain on call solely for the EVOCC patients that come to the hospital. “But we help whenever and wherever we can. We (also) provide services to the Afghan National Army, Afghan National Police and local nationals who are casualties. We provide the same unbiased care to all who enter our doors,” Juarez added. The escalation of fighting has sharply brought the most difficult aspect of deployment directly into focus for Juarez. According to hospital records for 2010, there were approximately 800 battlefield casualties treated at Kandahar Air Field’s Role 3 from May through September — the traditional
fighting season in Afghanistan —More than half of the cases were U.S. or other NATO troops. The rest were Afghan soldiers and civilians too badly hurt to be cared for at nearby Afghan military or civilian hospitals. Compiled statistics also show that almost half of all battlefield injuries treated at Role 3 are caused by improvised explosive devices. “I have experienced the loss of Marines, Sailors, and Soldiers. The hardest part professionally is accepting the results of the ultimate outcome no matter what and rationalizing in my head that I did everything I could for my patients, even though I may not feel that way personally,” he explained. Memorial Day was a poignant time for Juarez who wrote in memory of fallen Marines and Sailors to commemorate that day. "I will never know you for who you are, but only by who you were. I can't imagine how a parent's grief is generated but I can feel the effects from a distance. I can only ask God in my own ignorance, for blessings on families; to mend them, build them, guide them and love them. Take them and keep them close. For you are our father and at your right hand may justice, peace, and comfort find them in their new beginning. Some gave little, some gave all! May God bless you on a job well done! I salute you!" Juarez is the oldest of five children and was raised by his grandmother, a registered nurse who provided his introduction to medicine. His initial plans were to be a high school history teacher upon graduation from Highland High School, but in 2006 he entered the Navy. Fast forward six years later to a challenging deployment, which has become a maturation platform and notable experience to help him handle the continuous casualties and routine professional and personal needs. “The most enjoyable aspect of this deployment has been the people I have met. The people that I have come to know on this deployment have
really enriched my life beyond any measure I could have ever hoped for,” Juarez said, adding that he has gained added knowledge in himself as well as being a corpsman. “I have learned that no matter what I am faced with, I can overcome. The training and experience over the last few years have given me a great insight of what I am dealing with in my current situation.”
Nurse Corps Lt. recognized with Junior Nurse Corps Excellence Award after promotion
By Douglas H. Stutz, NHB Public Affairs
A newly promoted Navy Nurse Corps lieutenant added to his career development by also being recognized with the inaugural command Junior Nurse Corps Excellence Award on June 21. Lt. Anthony S. Hofer, assigned to Naval Hospital Bremerton’s Multi-Service Ward, began his day by being promoted by Rear Admiral Elizabeth S. Niemyer, Navy Nurse Corps Director and Wounded, Ill and Injured Deputy Chief in front of family and command staff members. “This is a nice opportunity to promote someone during my visit. I’m impressed by Lt. Hofer’s career path which shows we can’t assume someone was a corpsman before. His expertise and leadership bodes well for Navy Nurse Corps,” said Niemyer. Hofer’s first 10 years were spent as a fire controlman, serving aboard USS Mount Whitney (LCC/JCC 20) and USS Blue Ridge (LCC 19). He was commissioned on the 100th birthday of the Navy Nurse Corps (May 13, 2008). “How to top his commissioning? By having the Navy Nurse Corps director being the reenlisting officer is how,” said Capt. Iris Boehnke, NHB Director of Nursing Services. The Junior Nurse Corps Excellence Award managed to out-top the reenlistment. The initial recipient was selected by NHB’s Professional Council of Nursing. “Lt. Hofer was picked due to his professionalism, clinical expertise and bedside clinical leadership,” explained Cmdr. Elizabeth Oakes, NHB Nursing Services Assistant Director. The award citation read, “In recognition of your commitment to nursing excellence and to nursing as a unique discipline and art. Your demonstrated dedication, contribution to the nursing profession, and clinical expertise have made a positive difference in the quality of care provided to our patients and their families.” “When I decided to make the Navy a career,
I was told by a lieutenant that day that one day I would be in charge of people and I would have to decide if I wanted to be a manager who was hard to follow or a leader who people want to follow. I hope I continue to strive to be a leader,” said Hofer. Hofer is part of the Navy Nurse Corps of over 4,000 members, with 2,911 active duty and 1,162 reservists. There are over 60 Navy Nurses stationed at NHB, with approximately a dozen of their members currently forward deployed.
Branch Health Clinic Bangor ribbon-cutting reopens renovated facility
By Douglas H. Stutz, NHB Public Affairs
Branch Health Clinic Bangor officially reopened on June 14 with a traditional ribbon-cutting ceremony after going through a major 17-month facility upgrade. The complete renovation has revamped and remodeled the facility. “We made it! 17 months ago we broke ground before this day. There are two reasons to hold this ribbon cutting. One (reason) is to reflect on all we have gone through to reach this point, and it’s been a lot. There’s been noise, electrical outages, a number of moves, even emus to deal with. We did it with class, style, and professionalism. We have been flexible, dedicated and shown perseverance not only by our staff, but also by our patients. Through all the disruptions, our beneficiaries still think we’re the best,” said Cmdr. Christian Wallis, BHC Bangor Officer in Charge. The clinic now has a well-organized 21st century layout with additional exams rooms, as well as associated medical and dental services in close proximity resulting in greatly improve patient flow. “The previous layout had become cumbersome as all of our medical and dental services have expanded over the years. Our new layout provides staff and patients with a better design that automatically improves patient flow throughout the clinic. We also have improved patient care and our clinic staff can now operate as efficiently and effectively as possible,” said Wallis. The new interior design is more than just cosmetically appealing with a consistent visual appearance throughout all spaces. The renovation conducted an architectural re-design of the entire health clinic based on the concepts of Medical Home to completely improve patient and provider flow while upgrading facility services. The recapitalized of 2.8 miles of square footage allowed an increase of clinical space including additional exam
rooms, a second optometry eye lane and a four man audio booth. The redistribution of provider staff and reengineering of work flow processes to accommodate two-part physical exams reduced patient wait times by more than 50 percent while increasing patient throughput by 25 percent. The increase in clinical space has also allowed the implementation of a new Sports Medicine and Rehabilitation Team (SMART) clinic to provide comprehensive treatment and management of musculoskeletal injuries within the family medicine clinic. “This was an important project because it helps take care of our people; our Sailors on the waterfront and their family,” said Capt. Pat Rios, Navy Facilities Northwest Commanding Officer. “There is usually nothing worse to an engineer than an occupied renovation, especially a medical center. But this project worked out very well.” According to Wallis, the clinic renovation was handled in four phases for a cost of $7.4 million and resulted in little or no degradation in services. Additionally, due to the detailed planning, coordinating and communication between three organizations working together on the projects, the renovation was completed three months ahead of schedule. The effective planning of the clinic helped maintain a 94 percent customer satisfaction rating and 99 percent access to care rating while being upgraded. “Usually during a ground breaking ribbon cutting ceremony there are guest speakers, but we are all ‘guest-thankers’ today. What a remarkable achievement it was to continue through dealing with everything from jackhammers to emus during the renovation project to provide for our patients and keep morale high,” said Capt. Christopher Culp, Naval Hospital Bremerton Commanding Officer. “We planned it to minimize as much as possible the impact on patient services. We had no impact on access to care for our enrolled
population. Our beneficiaries still received the high quality, customer-friendly care that our clinic provides,” said Wallis. Wallis noted effective management ensured the clinic’s 11 Dentists, six Hygienists and three Specialists achieved a 98 percent Dental Readiness Index, 68 percent Dental Health Index and 99 percent access to care rate while exceeding BUMED production targets by 8 percent all during three moves during the renovation. Effective space management has also factored in to allowing Submarine Group 9 Medical and Strategic Weapons Facility Pacific and Marine Corps Security Force Battalion medical personnel to comfortably co-exist within the clinic. "This renovation was worth the minor inconveniences to our patients and staff. We've gained a first-class facility to deliver world-class patient-centered medical and dental care,” said Capt. Scott R. Peck, NHB Director for Primary Care and Branch Clinics “The final reason we held this ribbon cutting is that it builds our future. The renovation is over and now behind us. Our next great thing, whatever it might be, is coming and we are well prepared for it,” Wallis said.
NHB Comptroller and Management Analyst Honored
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Navy Medicine honored members of Naval Hospital Bremerton’s (NHB) Resource Management and Comptroller directorate with top honors on June 6. NHB Director of Resource Management/Comptroller Robert Tufts was awarded Bureau of Medicine (BUMED) Civilian Comptroller of the Year and NHB Management Analyst Sabrina Weber-Cornwell was awarded Data Quality Manager of the Year for Navy Medicine (NAVMED) West at the 2012 Navy Medicine Audit Readiness Training Symposium at the Nation Conference Center in Lansdowne, Va. Vice Adm. Matthew Nathan, U.S. Navy Surgeon General, and Chief, U.S. Navy Bureau of Medicine and Surgery, presented them with their awards. “The award is recognition of the hard work of my staff. Any leader knows that you don’t achieve anything without your staff’s backing,” said Tufts. “I’m still in shock,” said Weber-Cornwell. “It feels good to be recognized.” Tufts expertly executed a $101 million budget and closed fiscal year 2011 at managing nearly 100 percent obligation of that budget, the highest rate in command history and second highest in Navy medicine according to the award nomination form. “We provide a fairly economical product. Part of what we are doing is providing resources that our nurses, physicians, corpsmen are able to deploy into warzones without a hospital for the Navy to support our Marines and Sailors,” said Tufts. NHB Resource Management and Comptroller directorate consists of approximately 25 staff members handling accounting, budgeting, travel, civilian payroll, civilian human resources, data quality, and uniform business office duties. Tufts and his staff are responsible for overseeing an annual budget between $83-101 million excluding military compensation.
“We have the duty to advise the command leadership on proposed expenditures of funds and proposed contracts and whether we will be able to absorb those costs currently or in the future. We also advise on financial policies, regulations, and laws to make sure we don’t break any,” said Tufts. In addition to the hospital, the directorate is responsible for maintaining the branch health clinics at Puget Sound Naval Shipyard (PSNS), Everett, and Bangor. “$83 million dollars is the base we get every year. The extra $17-18 million is for special projects like the renovation of the Bangor clinic or the renovation currently going on at the PSNS clinic, or when the elevators or boilers need replacing,” said Tufts. Tufts attests that the staff works tirelessly to help keep the hospital running at its optimal efficiency with available resources to bring the best available care to beneficiaries. “In addition to providing good, quality medical care, we are also taking care of the paperwork and trying to be good stewards of the taxpayer’s money,” said Tufts. “We try not to waste funds and we do things responsibly.” Weber-Cornwell plays a vital role in the process by ensuring data is correct, complete, and valid in making sure resources are being allocated where needed. “I do data quality, MEPRS (Medical Expense Performance Reporting), and EAS (Expense Assignment System) processing. What I deal with in my MEPRS/EAS role is the labor files, the financial files, and the workload files out of CHCS (Composite Health Care System),” said Weber-Cornwell. Among her many noteworthy achievements according to her nomination form, Weber-Cornwell was recently hand-selected by the NAVMED West Data Quality Manager to assist in the testing and evaluation of several reporting methodologies to the Navy Medicine Data Quality Program. Her assistance was key in the successful implementation of these
reports which greatly enhanced Navy Medicine’s reporting capabilities. “Changes happen so quickly. It seems like a moving target when you’re trying to find the right metric,” said Weber-Cornwell. “I’ll continue doing what I do internal within the command or with external requests. I’m always available to help and I like being the ‘go to’ person.” One of the new changes facing the directorate will be an annual Department of Defense-wide financial audit by a Certified Public Accounting (CPA) firm for Generally Accepted Accounting Principles (GAAP) compliance. The directorate is preparing for this evolution which tentatively takes effect fiscal year 2014, according to Tufts.
NHB Chiefs Welcome Home Wounded Warrior
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton’s Chief Mess gave a heartfelt reception to welcome back one of their own at Seattle Tacoma (SEATAC) International Airport on June 10. Hospital Corpsman Chief Holly Crabtree, rehabilitating after being severely wounded by a enemy sniper while supporting operations in Iraq in April 2010, was greeted with a hero’s welcome. The event was arranged by NHB Command Master Chief Frank Dominguez and Hospital Corpsman Master Chief Tom Countryman, and closely coordinated with Port of Seattle Aviation Security, Port of Seattle Police Department and the Transportation Security Administration. “We’ve been looking forward for her arrival all week. It is just a honor to assist to welcome Chief Crabtree. We’re blessed to have her home. It’s hard not to be emotional about this, because usually when we render honors, it’s for those who have fallen,” said Port of Seattle Sgt. Doug Newman, Office of Professional Accountability, and the 2011 Navy Reserve Sailor of the Year of Navy Reserve National Security Forces, Naval Base Kitsap,Wash. As the U.S. Airways flight was taxiing into place after landing, Port of Seattle Fire Department gave ceremonial twin water cannon shots across the plane brow. Once the plane door opened, Master Chiefs Dominguez and Countryman accompanied family of Crabtree onto the plane to greet her and escort her into the terminal. Once inside SEATAC, the NHB chief petty officers stood in formation and rendered salutes, followed by shared smiles and warm applause by Port of Seattle staff members and fellow passengers. “This is completely unexpected and so awesome. What’s up my brothers and sisters!” acknowledged Crabtree to her Chief’s Mess. “Holly will remember this event for the rest of her life and know that you all have her back here in the
Pacific Northwest. It was truly an honor welcoming one of our own home from the battle field. I continue to be awed with the character of the mess and you all show its true strength every day. I will cherish today's moment for the rest of my life,” said Dominguez. “We are so pleased and happy to be able to do this,” added Deborah Miller, Port of Seattle Aviation Security Supervisor. Crabtree, a Port Angeles, Wash. native, was accompanied on the inbound flight from Florida with Leah, her daughter, and is transferring to NHB. She sustained injuries on patrol with Army Civil Affairs attached to Special Operations task Force West near Ar Ramadi in Iraq’s Anbar Province. Despite undergoing therapy during her lengthy rehabilitation process, it hasn’t held her back. Crabtree has participated in Wounded Warrior Games 2011, thrown out the first pitch at a University of South Florida baseball game, and shared greeting with members of the New Orleans Saints. There were also several former shipmates of Crabtree in attendance from her time on USS Abraham Lincoln (CVN 72) when homeported at Naval Station Everett. Along with Countryman were retired Hospital Corpsman Master Chief Bee Rose, and Lt. Jeremy Howell, acting Department of Administration head. “We were on a first name basis as young corpsmen from 2001 to 2004. Holly was a operating room technician and I was a general service corpsman. We also were at Independent Duty Corpsman school together, and I last saw her when I was commissioned in 2008. I’m very happy to be able to take part in welcoming her here,” Howell said. “This has been without a doubt one of the coolest events I’ve ever been part of in all my time serving in the Navy. Like all of us, I’m glad and honored to be here to welcome one of our own home,” said HMC Michael Mussett, Leading Chief Petty Officer of Nursing Services.
NHB Operational Symposium shares Deployment Experiences
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton held an Operational Symposium on June 8, to share personal shipboard and shore-based deployment information, experiences and lessons. The Operational forum has become a quarterly event originally created and coordinated by NHB Navy Nurse Corps staff to give recent returnees from deployment the opportunity to share their "story" in word and picture. Under the guidance and arrangement of Cmdr. Christine Ward, Pediatric Nurse Practitioner and clinic manager, and Operational Symposium coordinator, the program has expanded over the last 12 months to allow all staff members the ability to share their ship and shore experience. “I wanted to give all staff members of our deploying platforms a chance to celebrate with others upon their return. I believe in the spirit of morale building, of esprit de corps, and inspiring enthusiasm for the duty that is before us,” said Ward. The symposium is open to all staff members. According to Ward, every staff member can attend the event. Civilians can learn and support active duty staff, as well as add their insight or even share their own past experience(s). But the real hope is attracting busy active duty staff members to the event to pick up specific details and descriptive particulars from first-hand experiences from those returned on deployment. “They will be better prepared when the baton is passed to them by learning about what works and what doesn’t, and all the good, bad and the ugly of deployments. These will be the main themes with each speaker giving it their own twist. Those attending will also find a ready personal reference and a point-of-contact to ask more questions,” said Ward. The symposium presented two polar-opposite examples of a ship and a shore deployment. Hospital Corpsman Chief Shawn Kenney spoke on his Individual Augmentee assignment to
Afghanistan and Lt. Cmdr. Kevin Gue, former NHB Multi-Service Ward and Intensive Care Unit head nurse and now Senior Nurse Officer assigned to USS John C. Stennis (CVN 74) shared his recent deployment to the Western Pacific, Indian Ocean and Arabian Gulf. Gue focused his deployment talk as part of the Stennis Medical Department from July 25, 2011 to March 2, 2012. “We were gone for 221 days and the entire deployment was one of the best I’ve ever been on. We were really a small hospital on a small floating city,” said Gue, a 26-year Navy veteran. Gue was part of a team of seven providers, one psychologist, one physical therapist, one radiological health officer, one anesthesiologist, and approximately 35-40 hospital corpsmen. Compiled statistics helped to tell a portion of Gue’s story – the Stennis Medical department, augmented by medical personnel from Carrier Air Wing Nine, treated 3,600 sick call patients and 2,745 acute care cases; handled 2,855 physical exams; conducted 410 surgeries, and coordinated 2,515 physical therapy appointments. “Being a medical officer on a ship is career enhancing, not only because there are few billets. But also due to the amount of training we did, which was a lot with many different departments. I also worked with our preventive medicine team, medical readiness team, and our battle dressing stations and repair lockers for general quarters,” Gue said, noting that the long days on station supporting Operation Enduring Freedom also took them to great port calls like Singapore. HMC Kenney’s deployment was well beyond the horizon from Gue’s in landlocked Afghanistan in 2011-12 with 3rd Battalion, 7th Marines, Kilo Company. Assigned to Forward Operating Base Inkerman in the volatile southern part of the country, Kenney provided medical support as the sole provider for approximately several hundred
Marines, 50-100 Afghan National Army personnel and the local populace. “Being an independent duty corpsman, I got orders to go as soon as I checked in to NHB,” Kenney related. “There was three months of training out of (Marine Air Ground Task Force Training Command) 29 Palms, including a month in the desert under actual conditions to simulate where we were going down range.” Kenney ran Kilo Company’s Battalion Aid Station. He tailored the site to fit his ability and those of two additional corpsmen assigned. Besides the daily norm of sick calls and preventive medicine duties, he went along with vehicle and foot patrols outside the wire and dealt with a lot of trauma cases mostly for the locals and ANA. “There were such injuries as open fractures and chest wounds that I took care of. We did what we could and stabilized them to the best of our ability,” he said. Kenney attests that the FOB was really just like camping out for seven straight months. But in a hostile environment. “Our Marines could go without water and food, but by God, we had a gym,” he noted, stressing that the weight lifting helped deal with the needs for carrying, at minimum, 40 pounds of gear when on foot patrols. Kenney’s recollections of his time there include proud and sad memories. There was pride in seeing his corpsmen, HM3 Vincent Arreola and HN Garrett McDonald, attain their Fleet Marine Force qualifications, and there is solemn remembrance for two Marines that were killed in action, Cpl. Chris Singer, and Sgt. Joe D’Augustine. The best day? When his relief, HMC Gil Garcia, also from NHB, showed up to relieve him. “When Gil arrived and I did the turn-over with him, that was the happiest day of my life,” Kenney said. From the extremes associated with haze-gray underway to IA boots-on-the-ground, the symposium was deemed a success and continued on a NHB educational
tradition. “I attended last year and it was very good. It’s nice having a continuous educational event that brings together staff. During any deployment, there are always lessons learned. This symposium gave us a real opportunity to share the experiences of our current and former staff,” said Capt. Mark Turner, NHB Executive Officer.
Naval Hospital Bremerton personnel depart for Pacific Partnership 2012
By Douglas H. Stutz, NHB Public Affairs
Throughout the week of April 16-20, approximately 40 staff members from Naval Hospital Bremerton have departed to report for Pacific Partnership 2012. Pacific Partnership 2012 (PP12), the largest annual humanitarian and civic action (HCA) mission in the Asia-Pacific region, will begin May 1, and include engagements with the host nations of Indonesia, Philippines, Vietnam and Cambodia. Hospital Corpsman 3rd Class Priscilla Sanchez of NHB’s Emergency Room is one of NHB’s doctors, nurses, hospital corpsmen and support staff augmenting the multi-specialized team of preventive medicine, veterinarians and medical, dental and engineering personnel embarking on board hospital ship USNS Mercy (T-AH 19) for the mission that is expected to last approximately four and a half months. When Sanchez found out she was selected to go on Pacific Partnership 2012, she was more than ready. “I’m excited and ready for my first deployment. I volunteered for this mission and am happy to help and give back to others. We will see, meet and work with different cultures and different countries. Just being able to share in the diversity will be a great opportunity all its own,” Sanchez said, a San Antonio, Texas native, who besides providing her ER technician skill when needed also plans on getting as many at-sea qualifications as she can during the anticipated four-month journey. As has been the case in the past, medical and dental projects in each country are tailored to the requests of the host nation based on needs in the areas of public health and preventive medicine, veterinary care, optometry
and ophthalmology, dental, adult and pediatric medicine, immunizations, nutritional counseling, biomedical repair and medical environmental assessments. Medical subject matter expert exchanges are designed to build capacity for host and partner nation providers to better understand respective cultural and provider practices. In addition, Pacific Partnership deploys with an engineering team made up of members of the Naval Construction Force (Seabees) to construct and repair projects requested by the host nations. “You will travel to countries you’ve never been, meet people you will never forget, and for years afterwards, you will have that feeling of satisfaction of doing why you chose to be part of Navy Medicine in the first place,” shared Capt. Christopher Culp, NHB Commanding Officer, leading the command to bid farewell to the departing staff members. Mercy is slated to set sail in early May from San Diego for the annual HCA mission, which is sponsored by the U.S. Pacific Fleet and began in 2006 as a result of the 2004 Indonesian tsunami that ravaged the Banda Aceh area of Sumatra. PP 2012 will also be the first deployment for Culinary Specialist 3rd Class Tyler Ney. “Everyone departing from here seems to be looking forward to it. Every single person I’ve talked to who has been on the deployment says it’s a great opportunity to visit places that most of us would never deploy to, let alone have a chance to go on any other kind of trip. I’ve got my camera packed, per family request. I’m ready to make the most of this, see as much as I can and lend a hand when needed,” said Ney. At the invitation of the host nations, military and civilian professionals from Australia, Canada, Chile, Japan, Malaysia, Peru, Netherlands, New Zealand,
Singapore, Republic of Korea, Thailand and the United States, along with non-government organizations (NGO) and international agencies, will partner to execute tailored HCA projects and subject matter expert exchanges. These HCA projects and events, coordinated at the request of each host nation, will employ the collaborative capabilities of all participants in medical, dental, veterinary, public health services, engineering and disaster response activities that will help to increase confidence, capability and preparedness of host and partner nations to respond to natural disasters and crisis. Now in its seventh year, Pacific Partnership 2012 has collaborated with partner nations, NGOs and host nation counterparts to focus on sustainability projects on a range of topics from basic first aid, preventative health and hygiene, and women’s health; beach and seawall corrosion, and maintenance of fisheries; and combined animal and public health campaigns. Host nations that ensure they are equipped with sustainable programs that prepare for and support emergency relief efforts align with a broader goal for maintaining a stable and secure Pacific region. For Leah, age 6, and Guyland, age 7, seeing their dad, Information Systems Technician 2nd Class Guyland Charles ready his seabag along with others, it became a lot clearer that their father was leaving on an extended business trip. “I think my son is having a harder time in dealing with this than anyone else,” said Charles. “We’ll miss him, but I like the fact that if I got to share him with others, he’s going on a humanitarian mission to help others,” said Mrs. Alicia Charles. In addition to aiding the health, security, and improvement of disaster response capabilities of the host nations, the
partnerships forged through Pacific Partnership missions help to ensure that the international community is better prepared to synchronize and function together as a coordinated force when disaster strikes.
NHB OR Staff Recognized for 'Earth Day Every Day' Efforts
By Douglas H. Stutz, NHB Public Affairs
The inaugural NHB Sustainability Award certificate was accepted by Cmdr. Fran Slonski, Main Operating Room (OR) department head along with Kevin Stevenson Main OR nurse. "Sustainability refers to "the ability to meet present needs without compromising the ability of future generations to meet their needs" and Stevenson has been the driving force of the Main OR team," said Robert E. Mitchell, NHB environmental manager and sustainability program manager."He has helped to coordinate the overall environmental awareness efforts that has reduced the amount of solid waste leaving the Main OR, increased recycling outflow and advocated product substitution as a sound economic practice." According to complied figures by NHB's Environmental department, Main OR surgical savings from recycling efforts for just three weeks in 2011 was $11,508. Projected 2012 savings for the entire year in the Main OR by recycling and usage of remanufactured items is estimated to be at $172,614. "We really just started, but we're going to save a ton of cash continuing to do what we do now," said Stevenson. "We worked closely with our Environmental department and brought in Stryker Sustainability Solutions to coordinate and accommodate the ambitious sustainability plans that was envisioned we could implement. Without them, this would not have happened. We wouldn't be handling paper, plastic and any medical supplies as properly as we do now." One such sustainability plan put into place by the Main OR staff involved medical supplies involved in laparoscopic usage during a procedure. Much is disposable and not reusable. But the instrumentation
once used is recyclable. Plastic parts can be grinded and/or melted down; metal components of copper and steel can be separated, recovered and reused. "Due to our case load, we might use a dozen specific devices a day and instead of them now ending up in a landfill, each is recycled," said Stevenson. "It's really all about changing habits. It is habit transfer and keeping people from falling back into former ways of handling waste product," said Jayson Ayers, Stryker Sustainability Solutions representative. "Kevin is a champion of the cause because he has shared his awareness and discipline with those he works with. As former military, we know that service members tend to pick up on new instructions quickly and follow through. The efforts here at NHB are really great," said Ayers. The Main OR used to throw away three, 30-gallon bags of garbage per total joint surgery case. Now they recycle three, 30-gallon bags of plastic and have just one 15-gallon bag that is now thrown away. "It's a significant reduction in waste stream to the landfill," said Stevenson. "It's really an incremental amount of waste product, and we're staying on top of the process because it's easy to take for granted. We even recycle the instrument wrappings to use again." Compiled statistics at NHB show that the ongoing environmental awareness campaign of recycling is working. Recycled material (in tons) of paper and paperboard went from 52.25 in 2010 to 55 in 2011; plastic went from 15.53 in 2010 to 15.75; construction debris went from 2.55 in 2010 to 3.66 in 2011; metals and aluminum cans went from 1.90 in 2010 to 2.12 and batteries showed an increase from 0.43 in 2010 to 0.88 in 2011. Concurrently, and as a direct result of the command's
overall recycle efforts, trash disposed (in tons) fell from 198.50 in 2010 to 190.19 in 2011. Overall, average solid waste disposed by hospital staff per day fell from 1.18 pound to 1.12 lb. per day. "Our goal for 2012 solid waste disposal per person, per day, is one pound or under," said Ramon Calantas, NHB environmental technician. "We think that by continually being actively aware and getting as many people involved as we can, that we can achieve that." "Earth Day is every day for us, but we also wanted to use this annual recognition of Earth Day as a perfect opportunity to educate our staff and beneficiaries on our sustainability programs in the hospital and how everyone can help," said Mitchell. "Our real mission is to shed some light on what goes on behind the scenes such as continuing to find ways to effectively reduce our bio waste outflow and soiled water reduction. We are recycling a lot more products now than ever before and the dividends to our local environment and savings in funding are getting better." There were Earth Day displays showing other "green" processes at NHB, as the command has continually raised awareness through environmentally sound practices, energy progress and environmental stewardship. Success stories include: installing Big Belly Solar Trash Compactors, which use solar energy to compact refuse. The containers hold up to five times normal capacity, saving on pickup and disposal costs, and reducing pollution produced during pickup and transport; implementing Daylight Harvesting in the Family Clinic, where refractive film bends light upward to reflect off of the ceiling into the room. Overhead lighting can be reduced or turned off on bright days; adding LED Parking Lot Lighting, resulting in
improved visibility and security at night, as well as an expected savings of enough energy to light 17 homes. NHB has also installed Restroom Occupancy Sensors Occupancy sensors in all NHB and Family Clinic restrooms for an expected energy savings of enough energy to light 4 homes. Time clock controls for lobby lighting have been installed in the hospital quarterdeck and Family Clinic lobbies, which automatically turn lights off during the day and on at nightfall. The expected energy savings is enough electricity to light 10 homes. The installation of condensing boilers with 95.5 percent efficiency will replace the existing boilers with 80 percent efficiency and are expected to save enough energy to heat 16 homes.
Medical Laboratory Professionals to be recognized all week at Naval Hospital Bremerton
By Douglas H. Stutz, NHB Public Affairs
"Laboratory Professionals Get Results!" will be the theme at Naval Hospital Bremerton during April 22-28 to recognize and honor Laboratory Department staff members throughout National Medical Laboratory Professionals week. “The focus is on allowing our staff to relax and celebrate the practice of their profession through fellowship,” said Lt. Cmdr. Todd. J. Tetreault, NHB Laboratory Manager. Weeklong events include the traditional cake cutting with the Capt. Christopher Culp, NHB Commanding Officer on Monday, a special pizza luncheon on Tuesday, a Laboratory Scavenger Hunt on Wednesday; an ice cream social on Thursday, and a Lab Coat Design Contest on Friday. “We do what we do as a great team not as a group of individuals. Using the entire week to recognize that is just a great way to say thank you to everyone,” said Hospital Corpsman 2nd Class Diana Rodriguez, Laboratory/Clinical Pathology technician. “There really is a lot of planned activities week that’s all interactive. We got raffles, pot-lucks, even lab coat designing. It should be fun and a nice way to recognize everyone here for what we do on a regular, daily basis, which is help care for all of our patients,” said HM2 Melissa Couture, Laboratory/Clinical Pathology technician. The behind the scenes responsibilities of the entire lab continually bring timely results that benefit and impact direct patient care. The approximately 25 active duty personnel and 12 civilians manning NHB’s Lab conducted more than 720,000 tests in the last 12 months, with another 250,000 processed for performance at military and civilian reference
laboratories. “The testing performed in the Laboratory forms the basis for more than 70 percent of patient diagnoses. As the world gets ever more complex, healthcare professionals need to work closely with the Laboratory that can deliver complex results that are unobtainable in most other clinical settings. The accuracy and quality of our labor directly affects the ability of the organization to provide effective and timely care to our patients,” said Tetreault. There is never any real down time in the laboratory. Laboratory personnel continually work around the clock to support the Emergency Room and all inpatient clinics and departments. The Lab is open to beneficiaries for specimen collection and drop-off Monday through Friday from 7 a.m. to 8 p.m. and on Saturday from 8 to 12 a.m. “Most of what we do is unseen by our patients, but it all helps provide the results they need when they come in for their appointment. We are a large part of patient care. I personally know the value of the lab because my mom in her battle against cancer always had to have a lot of lab testing done. I think that’s the main reason why I do what I do here. It’s because of what she went through. I know the importance ensuring lab tests are taken, handled and delivered in a correct and timely manner,” said Rodriguez. Besides obtaining and receiving patient samples (everything from blood to tissue) and processing them, areas of specialty include; Phlebotomy (the act or practice of opening a vein by incision or puncture to remove blood as a therapeutic treatment); Chemistry (the study of the chemical processes in living organisms); Urinalysis (an examination of the urine to determine the general health of the body and, specifically, kidney function);
Hematology (the study of the nature, function, and diseases of the blood and of blood-forming organs.); Microbiology (the branch of biology dealing with the structure, function, uses, and modes of existence of microscopic organisms); Serology (The science that deals with the properties and reactions of serums, especially blood serum); Histology (the branch of biology dealing with the study of tissues); Cytology (the study of the microscopic appearance of cells, esp. for the diagnosis of abnormalities and malignancies); Pathology (the science or the study of the origin, nature, and clinical course of diseases) and managing the Blood Bank (packed red blood cells or plasma is typed, processed, and stored for future use in transfusion). Enlisted personnel assigned to the Lab are comprised of advanced medical laboratory technicians, histopathology technicians, and cytology technicians, throughout five locations. Besides the majority working in NHB's main lab, they are also at Branch Health Clinic Puget Sound Naval Shipyard, BHC Bangor, BHC Everett, and Madigan Army Medical Center Armed Services Blood Bank Center. The list of all the specific jobs/duties/responsibilities handled by the Med Lab technicians includes; collecting blood or body fluids from patients; accessioning patient samples to allow automated equipment and Laboratory information systems to analyze, interpret, and result provider ordered testing; processing patient samples to allow ordered tests to occur; perform testing in Chemistry, Hematology, Urinalysis, Coagulation, Microbiology, Immunohematology (Blood Banking), Serology, Histology, and Cytology; Collating and verifying testing results; Certifying the authenticity of results and
release them to the health care providers; Conducting Quality Control and Quality Assurance Initiatives to ensure the continued accuracy and precision of reported results; Maintaining equipment in every area listed above; and taking part in continuing education efforts to grow professionally. Tetreault attests the Lab doesn’t provide a service to get results, but rather they provide a service as a result of a focused and directed need. “Knowing that the support we provide helps providers deliver quality care to our beneficiaries is gratifying,” he said. NHB's Laboratory has also been fully accredited by the College of American Pathologists (CAP), American Society for Clinical Pathology (ASCP) and American Association of Blood Banks (AABB). It is also licensed and the Food and Drug Administration (FDA).
2012 Services to the Armed Forces Award presented to NHB ARC Chairperson
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton’s American Red Cross volunteer chairperson was presented the 2012 Services to the Armed Forces Award on April 18. Joyce Berry was selected by the American Red Cross Volunteer Recognition Awards Committee and feted at the Burke Museum in Seattle, and a Volunteer Appreciation Event at the Bremerton West Sound Red Cross office that gave many NHB volunteers the opportunity to join in the recognition. “I was completely overwhelmed. We don’t do what we do as volunteers for the recognition. We’re here to assist those in need. But it is nice to be acknowledged for all of the work we do here. I am really touched by all of this,” said Berry. “Congratulations, Joyce! We appreciate you, and all you do for Red Cross and NHB. Thank you for your service,” said Karen McKay Bevers, West Sound Director for American Red Cross Serving King and Kitsap Counties. “We are all honored and pleased for her,” said Maria Landro, NHB volunteer Family Practice Nurse. The Services to the Armed Forces Award recognizes an American Red Cross volunteer in a direct service, management, or leadership position who has made a measurable impact serving the American Red Cross, military customers and community by strengthening or improving services to the military and their family members. “As an ambassador for the Red Cross, we all recognize your valuable and measurable contributions,” said Ivy Davis Zolle, American Red Cross Regional Director of Volunteer Services. American Red Cross volunteers at NHB gave over 10,000 hours of service in 2011.
The volunteers contribute time as doctors, nurses, outpatient and inpatient record assistants, patient advisors, customer service representatives, and have handled duties in such areas as Health Promotion, Dermatology, Mental Health, Pediatric, Orthopedic, OB/GYN, Labor/Delivery, Ophthalmology, Urology, Dental, Ambulatory Procedure, Pharmacy, Laboratory, Quality Management, Professional Affairs, Patient Services, Physical Therapy, Fitness Center, Staff Education and Training, Emergency Room, Family Medicine, Internal Medicine, Family Centered Care, and Referral Management. “I am very fortunate to have such dedicated volunteers. I definitely could not function without them,” said Berry, noting that many volunteers go above and beyond to provide needed hours. “We appreciate everyone for their effort.”
NHB holds Holocaust Days of Remembrance ceremony
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton’s Diversity Council held a special recognition observance for Holocaust, Days of Remembrance on April 17. The theme of this year’s event was “Choosing to Act: Stories of Rescue,” highlighted by a very personal narrative and historical retrospective shared by keynote speaker Mr. Sheldon Balberman, from the Washington State Holocaust Education Resource Center. Balberman is a second generation son of Polish survivors from the Nazi persecution during World War Two. “The subject is a little bit difficult for me because it’s about my family and my emotions are real,” said Balberman, who addresses schools and specific groups five or six times a year educating audiences on the Holocaust. With vivid details and visual aids, Balberman took assembled staff members 73 years back into the past, to Strykow, a tiny village in central Poland in 1939. He told how his mother, Shaindel Kuttas, was then a young 21-year old who was herded away by the Nazis to varied ghettos, then to toil in fields until the day came when she joined 79 others in a cramped railway cattle-car to be taken to Majdanek concentration camp. “There was death inside that car. Someone said to her to fight, so she clawed and fought her way to the top over others so she could breathe. Only three survived during that ride out more than 80,” related Balberman. His mother’s personal odyssey continued on a harrowing journey. She ended up at the infamous Auschwitz-Birkenau and Ravensbrueck concentration camps before being finally liberated in Germany by the Russians while on a death march from Ravensbrueck back into Germany. “The death march was in mid-January during winter.
They had no shoes and were all exhausted and ill. If any stopped to rest they were shot down by the Nazi guards,” Balberman said. It was one horror after another. Auschwitz-Birkenau was where the notorious Joseph Mengele, dubbed the ‘angel of death,’ selected 400,000 persons for death and conducted grotesque experiments. “Every morning my mother and others had to parade before him and have him decide life or death. Dawn to dusk they had to work. Women were so desperate that some of them would prick their fingers to draw blood in order to rub color in their cheeks to try to make themselves more attractive to their tormentor,” said Balberman. His mother faced death by execution on three different occasions. One time was due to being punished for stealing a piece of bread. She was made to knee forward, arms outstretched, holding a brick in each hand, with a rifle pointed at her head. If she dropped her arms, she would be shot. It was only because the guard took pity on her that she lived because he deemed that she was still strong enough to work. The only link, the sole memoir that Balberman’s mother had of her family from that time was a yellowed photograph showing 48 relatives taken in 1934 that was then forwarded on to an uncle in Canada. Only five of that group survived the Holocaust. “My mother always stressed the need to “never give up” and “never forget,” said Balberman, stressing that notion applies to anyone. Balberman’s father Sender was also a victim of the time, with a tortuous trail similar in hardships but still different than his future wife. Following the Nazi blitzkrieg of Poland in 1939, Sender smuggled himself and his oldest brother (Moishe) across the border into Russia. He was ultimately arrested for not having any
identification and was sent to a Siberian labor camp. There he spent three years working daily in sub-human conditions, often being forced to work outdoors as a lumberjack with minimum clothing in minus 50 degree weather. “He was a guest under Joseph Stalin, then-leader of the Soviet Union. The difference between a Nazi concentration camp and a Soviet labor camp was that the Nazi camps were expressly built to kill people. The Soviets camps wanted to work them to death, in horrendous conditions,” Balberman explained. While many fellow prisoners died, Sender found a will to live and overcame horrendous conditions of disease, severe cold and grossly unsanitary conditions. Sender was finally liberated from the labor camp when the Free Polish Army came searching for Polish citizens to fight the Nazis. He and his older brother were the only survivors of his family. His parents met after the war’s end in 1948 in Munich. They knew each other from growing up in the same village but never had a romantic interest back then. But that was another lifetime long ago. They courted for several weeks. Then Balberman’s mother took the initiative. Shaindel proposed to Sender. She immigrated to Canada and he followed. Historical evidence on the Holocaust shows that approximately six million European Jews that were persecuted and exterminated during the Nazi Germany reign of terror from 1933 to 1945 didn’t follow Balberman’s parents. Adolf Hitler, leader of the Nazi party, exploited anti-Semitic feelings during his rise to power and then ordered what he termed a “final solution to the Jewish question.” Most Jews in countries like Poland that were overrun by the Nazis became victims of the Holocaust. “The one who does not
remember history is bound to live it through again,” said Balberman, quoting Spanish-born U.S. philosopher George Santayana. “It is up to us all that anytime we see anyone stereotyped we speak up because that’s a cause for concern. If it is not you today, it could be tomorrow.”
Medical and Dental Readiness more than just a weekend drill with OHSU NHB
By Douglas H. Stutz, NHB Public Affairs
As in weekends past and those to follow, Operational Health Support Unit (OHSU) Naval Hospital Bremerton (NHB) provided important medical and dental screening requirements for Navy Reservists on April 14-15. The examinations are not only an annual responsibility to ensure all Navy Reservist personnel are fit for deployment, but the physical exams are potentially even more imperative due to the announced shift of manpower requirements for future Individual Augmentee (IA) responsibilities next year. According to Adm. Mark Ferguson, vice Chief of Naval Operations, there will be a wholesale shift concerning IA manning needs. The recently-announced plan is to have Navy Reserves filling all billets in 2013, an estimated 3,800 number of ‘core mission only’ IA assignments (there are approximately 9,000 IA billets currently handled by Sailors, over half by active duty personnel). “Our goal is to achieve and maintain our medical and dental readiness to a level at least 95 percent of our total Navy Reservist force. We serve a fairly large region in Reserve Component Command Northwest, with NHB as the hub. NHB is right in the middle of a large Pacific Northwest regional concentration of submarine, surface and air assets. All of us on the Navy Medicine Team, including nurses, hospital corpsmen and medical/dental providers have to help ensure all of our Navy Reservist assets are up to date and ready to deploy if and when called upon,” said Capt. Harry Ward, OHSU Bremerton Senior Medical Executive, and Physician Specialist/Professor of Medicine at the Geffen School of Medicine at UCLA.
“Taking care of our own is what we do. As such, we simply have to have medically and dentally ready forces. Our reserve detachments back up and support many of our local commands in this area, and we bring reservist medical providers in from all over the region. We want to reach out and touch everyone and not be constrained by geography in any way when asked to support. One of the latest messages from Adm. Nathan, our Navy Surgeon General, said that to maintain our fighting forces, our Navy Reserves have to continue to be a critical part and continue to contribute a lot,” said Ward, who has served in Navy Reserves for over 20 years, with three deployments. He has been in Operation Desert Storm in 1991, Operation Enduring Freedom in Afghanistan for 2006, as well as Landstuhl Regional Medical Center in Germany during 2009. Ward’s experience in Desert Storm further solidifies his emphasis on having medical and dental readiness up to date. According to Ward, during Desert Storm, nearly 40 percent of Navy Reservists were deemed not qualified for active duty due to dental issues with periodontal disease. Capt. William Creed, OHSU Reserve Liaison Officer (RLO) and head Dental Officer, also remembers well Desert Storm, as well as before. “Historically, all of our efforts before that time were lax. We were recalling reservists who were not medically or dentally qualified. Now it’s much different. My main job is to coordinate the dental readiness for the whole region with all the Navy Operational Support Centers (NOSC) and Reserve Commands (REDCOMS),” said Creed, a Vancouver, Wash. resident. Cmdr. Tim Labrosse, RLO and Reserve dentist, estimates that he and his dental team monthly
provide an average of 70 to 80 screenings to Selected Reservists. “I can average eight to ten dental examinations an hour. Every Sailor I see is an important asset for us. My goal when they come in for the screening is to assess them for deployment and make sure they won’t have emergency dental needs, if and when they deploy. Nothing is more costly than sending a person in and out of an IA assignment for dental care. There’s lost manpower hours, logistical expenditures, and travel costs. It all adds up. Before a Sailor departs from here, they will know what category they are concerning their dental readiness,” said Labrosse. There are four classifications for Dental Readiness. Class 1. Patients not requiring dental treatment or reevaluation within 12 months. Class 2. Patients who have oral conditions that, if not treated or followed up, have the potential but are not expected to result in dental emergencies within 12 months. Class 3. Patients who have oral conditions that if not treated are expected to result in dental emergencies within 12 months. Patients should be placed in Class 3 when there are questions in determining classification between Class 2 and Class 3. Class 4. Patients who require dental examinations. This includes patients who require annual or other required dental examinations and patients whose dental classifications are unknown. “Dental readiness is just an example of waking up to the need for healthy fighting forces ready to be part of the ‘edge of the sword.’ As part of those forces, we want to continue to contribute and maintain continuity and leadership with the large amount of Navy Reservists in the Pacific Northwest and throughout the western states,” Ward said. OHSU Bremerton is currently handling medical and dental
readiness screenings for 18 detachments with approximately 900 total personnel stationed in North Dakota, South Dakota, Colorado, Utah, Wyoming, Montana, Idaho, Oregon, Washington, and Alaska. There are Navy Reserve centers in such places as Sioux Falls S.D., Fargo, N.D., Fort Carson and Denver Colo., Cheyenne, Wyo., Billings and Helena, Mont., Pocatello, Idaho, Central Point, Ore. Tacoma, Bangor, and Everett, Wash. and Fort Richardson, Alaska. There are also corpsmen coming to NHB from farther afield out of Minnesota and Texas (Current compiled official Navy figures from April 2, 2012, list the total number of U.S. Navy Reserve component as 64,118). One innovative means to handle medical and dental readiness in the vast, mostly rural area is by sending a traveling team of core Navy medical staff to specific Navy Operational Support Centers. “Our training team is made up of physician/providers, nurse practitioners, and dental officers to go out and handle medical and dental needs all over the 15 state regional commands. Many of our Navy Reserve centers are scattered over large areas of geiography, so it’s value added to do all we can to keep that readiness up to date by going to the detachments, rather than having their personnel come to us,” said Ward. “The work never stops. It can take a lot of time to arrange logistics throughout our region to support Navy Medicine West, even as far away as Okinawa and Guam,” said Ward. Another important part of OHSU’s overall mission is to backup and assist NHB and BUMED by providing doctors, nurses, hospital corpsmen and technician support. “Whoever and whatever the CNO or Surgeon General needs, we will put out a message for support and operationally start
looking at whom we have available,” Ward said. “What we have now in Navy Medicine and the Navy, as a whole, is a truly integrated service. It used to be that reservists were just backfill for some positions, but we are now integrated across the board. Camaraderie has really greatly improved since the first Gulf War,” Ward said.
New and Innovative NHB Materials Exchange Site
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton’s innovative internal website for reusing, recycling and reducing waste of office supplies and furnishings has caught on over the first quarter of 2012. “This is an original cost-savings 'green' concept that also encourages good stewardship of government resources by reusing, recycling, and reducing waste (cost) of office supplies and furnishings. The site was launched in December 2011 and we are already realizing savings and waste reduction for the command,” said Phyllis D. Slayton, Command Evaluation Officer and creator and designer of the new site. Instead of automatically purchasing new items, the new NHB Materials Exchange Site acts as a "Virtual Warehouse" that is available for all staff members. They can easily post or search for "available" items or list a "wanted" item. According to Slayton, approximately 50 staff members have utilized the site, and there has been several thousands of dollars saved. “It might not seem like much, but it’s a definite start,” she said. “The office supply and furnishings re-use and recycle concept had been in the back of my mind for a long time. We've never really had a method here at NHB to make those items easily accessible to staff. We would end up having used material either shipped off to DRMO (Defense Reutilization and Marketing Offices) or sent to the recycling bins. The site is for the benefit of the command and all staff members. This concept really is a unique cost-savings and waste reduction tool that can be easily reproduced at any MTF or other organization with available collaboration software like SharePoint,” Slayton explained. According to Slayton, the need for some way to reuse and recycle office supplies and
furnishings became even more evident during last fall's Space Utilization moves. “Many people had to pack up their offices and downsize to move. Some staff members were even getting rid of good office items such as file folders, staplers, binders, and paper punches. I couldn't stand it! Office furniture was being sent by the load to DRMO that could have been potentially been used by others. Being a good steward of government resources, coupled with budget constraints, it just seemed like an ineffective way to do business,” Slayton said. Slayton then started looking for a possible physical location to store the excess items but it quickly became evident that space was at a premium. It also became just as quickly apparent that no one was really interested in taking on the additional task of managing the materials. “In the beginning it almost became a non-starter, but I don't give up easily,” said Slayton, labeled as tenacious by her father at age eight when determined to complete a specific task. This case was no different. Without the feasible option of having enough storage space available, Slayton then hit upon the perfect alternative of using a centralized computer-based program to reach staff members. “It came to me; why not go "virtual warehouse" with a SharePoint site? Our staff members are able to keep any item in their own area for a little longer and see if someone else wanted or needed it. The timing was right with our staff becoming more comfortable using and understanding the SharePoint computer program,” she said. With some help from some savvy co-worker-friends, Slayton constructed the site and made it as user-friendly and easy to navigate as possible, along with a database to capture all transactions and estimated
value of items. The sites rules are basic; materials must be the property of the U.S. government. No personal items are allowed and any item listed is not for personal or home use. Any material to be posted must be handled appropriately beforehand with no authorized removal from walls, fixtures or other clinic and department areas without official consent. The material(s) to be posted must still be in good usable condition. No hazardous or damaged material will be accepted. For any computer equipment items, staff will need to coordinate with NHB’s Information Management Department. Each item listed on the site features detailed information on the condition, quality and quantity, along with contact information. “If you build it, they will come. And they did. I've gotten many compliments on the site, with exclamations of "this is so cool," and "why didn't anyone think of this before?" and "what a great 'green' concept",” Slayton said, who was also invited to become a member of the new NHB Environmental Management System Green Team, which identifies opportunities to improve environmental stewardship and sustainable practices, help prioritize opportunities, and to promote and implement selected opportunities.
NHB stresses Pharmaceutical Prescriptions Cost-Saving options
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton (NHB) is stressing several cost-saving options to all beneficiaries for pharmacy prescription drugs.
The TRICARE home delivery and NHB Pharmacy offer two economical alternatives for patients as well as the Department of Defense. NHB Pharmacy refills are free to beneficiaries and have no co-pay requirements. Home deliveries for generic prescription drugs are also free to beneficiaries.
The home delivery option will also save time for beneficiaries as well as money. TRICARE Management Activity notes that by using home delivery, beneficiaries avoid having to travel to and from the hospital, search for a parking spot once there, wait for the prescription to be filled, and even potentially take time off from work to pick up the refill.
Copayments for some TRICARE Pharmacy home delivery medications have been reduced to zero since October, 2011. Generic formulary drugs purchased through home delivery that used to cost $3 for a 90-day supply have dropped to zero. Additional changes to TRICARE pharmacy copayments in place include; generic formulary drugs purchased at civilian retail pharmacies were raised from $3 to $5; brand name formulary drugs from civilian retail pharmacies went from $9 to $12; and non-formulary medications went from $22 to $25 in both civilian retail and home delivery. Brand name formulary drugs purchased through the Home Delivery will have the same $9 copayment.
Copayments for prescriptions filled through Home Delivery cover up to a 90-day supply if the prescriber writes the prescription
to be filled for a 90-day supply, but only a 30-day supply purchased at a retail pharmacy.
Home Delivery offers convenient and free automatic prescription refills that can be shipped to any address in the U.S. or Fleet and Army Post Offices overseas. To sign up for home delivery for your pharmacy refills, click here: www.tricare.mil/homedelivery or dial 877-782-8731.
Switch regular prescription medications filled in the TRICARE Retail Network to Home Delivery and start saving.Home Delivery and MTF pharmacies offer the best value for beneficiaries, the Department of Defense (DoD), and taxpayers.
The October, 2011 change was the first since 2002 for some copayments for prescription medications covered .,by the TRICARE Pharmacy benefit and action is a companion to the President's 2012 budget and independent of the FY12 National Defense Authorization Act.
One of the busiest locations at NHB is the Pharmacy. On its busiest weekdays, NHB's Outpatient Pharmacy handles and processes over 2,100 prescriptions and the staff continually strive to lessen the wait time for all eligible beneficiaries despite operational and deployment commitments that have resulted in decreased manpower assets.
For general questions, please contact Express Scripts at 1-877-363-1303 Non-Network costs vary by plan. For more on the new copays
Frequently asked Questions, Search "Walgreens" http://www.tricare.mil/faqs/search.aspx
NHB holds 119th Birthday Celebration for Navy Chief Petty Officers
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton celebrated the 119th birthday of U.S. Navy Chief Petty Officers on March 30, by remembering those currently deployed and honoring those who have given the ultimate sacrifice to their country. Hospital Corpsman Chief Shawn Kenney, HMC Keith Davis, HMC Gilberto Garcia, and HMC Juan Guedea of NHB are forward deployed to various locales, and Navy-wide, from March 2002 to the present, there have been 35 chief petty officers lost supporting Operation Iraqi Freedom, Operation New Dawn, and Operation Enduring Freedom. "It was on April 1, 1893 that Navy General Order 409 of February 25, 1893, established the rate of chief petty officer. The legacy lives on 119 years later with the 38 current staff members who wear the anchors on their uniform, with the approximately 30 retired staff members who have worn the anchors on the cloth of our nation, and with those who will advance to the rank of Navy chief petty officer," said Operations Specialist Chief Adrian Alegria, Substance Abuse Rehabilitation Program counselor and master of ceremony of the birthday. "We all know the old saying that if you want something done in the Navy, get a chief to do it. I would add that chiefs are also the repository of pride, standards and integrity. They continue to set those standards and the standards of honor and what it means to serve," said Capt. Christopher Culp, NHB Commanding Officer. Logistics Specialist Senior Chief Edward Lange, acting NHB Command Master Chief, read birthday wishes from Master Chief Petty Officer of the Navy Rick D. West, retired HMC Steve Jackson shared the birthday
message from Force Master Chief S.E. Boss and HMC Noel Gravina presented the Chief Petty Officer Creed. Information Systems Technician Chief Jennifer Clem then explained to assembled staff members, beneficiaries and friends that it is always customary at Navy birthday celebrations to cut a traditional cake in celebration of the birth of the specific organization. "The chiefs are no exception to the rule. The traditional cake cutting is done by our oldest and youngest Sailor. I'm proud to introduce Aviation Maintenance Administrationman Master Chief Angela Mattison-Lindbom, who enlisted in the Navy in 1984 and made chief in 1995. Our youngest chief is HMC Philip Nacionales, who enlisted in the Navy in 1996 and made chief in 2011," said Clem. "Our oldest chief passes a piece of sliced cake first to the younger, signifying the passing of experience and knowledge from the old to the young of our organization, and also further emphasizing the fact that we care for our young Sailors before we look to our own needs." Nacionales, current Senior Enlisted Leader at Branch Health Clinic Everett took some good-natured ribbing from enlisting in the Navy the year after AZCM Mattison-Lindbom became a chief. "But being involved in this ceremony is an overwhelming experience. When I made chief, I realized that it wasn't all about me. Being a chief is being part of something much bigger. It is an honor and privilege. This event just keeps that feeling going," he said. Also present for the birthday celebration was retired Boatswain Chief Jerry Irvine, who served his nation for 21 years, on nine different ships, with three tours in Vietnam, including River Section 523 in the Mekong River Delta, and River Section 521 near
Hue City, and Retired Storekeeper Chief Gene Hanson, with a Navy career of 22 years that spanned three decades with involvement in World War Two, the Korean War and Vietnam War. "After this is over, I think we both can take early liberty, if our wives let us," said Irvine. On the eve of the 119th birthday, Cmdr. Doug Stephens, Branch Health Clinic Everett, David R. Ray Health Center Officer-in-Charge, shared a bit of Navy history with his staff, "This is a true story. Fleet Admiral William F. "Bull" Halsey was one of our greatest Sailors. On one occasion, he was piped aboard a ship and through sideboys. One of the sideboy's was a chief petty officer. When passing the chief, Fleet Admiral Halsey winked at the chief, then continued on his way. When Fleet Admiral Halsey was asked why he winked at the chief, the Admiral stated, "Son, because I know chiefs got me where I am today." "From the time that I have been in the Navy, I have been told 3 objectives of the chief petty officer: To train and guide junior officers, to develop them into leaders; To train and develop our subordinates into future leaders; and to utilize all fellow CPO's experience and wisdom, in addition to technical expertise, when trying to solve problems and achieve the command's mission. Thank you to all the chiefs that have helped me along the way to a wonderful and satisfying career. Happy birthday chiefs!" said Stephens.
Transport, Triage, and Treat Training with NHB Mass Casualty Exercise
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton held a mass casualty exercise on March 21 to test after-hours responding capabilities of limited staff on duty. The exercise, held in conjunction with force protection exercise Solid Curtain/Citadel Shield 2012, and in cooperation with Naval Base Kitsap and Command Navy Region Northwest Fire/Emergency Medical Services, focused on how those on duty could handle a scenario involving multiple casualties in need of immediate medical assistance. "We plan and practice several mass casualty drills a year and for this one, we wanted to see how our weekend and after hours staff would respond if they were suddenly surged due to an influx of multiple injured patients. In such a scenario, they're going to be the only ones for about the first hour. They need to know how to deal with all that's needed during that time," said Terry Lerma, NHB Emergency Preparedness Coordinator. The exercise scenario involved a vehicle accident on Naval Base Kitsap Bremerton. A passenger van swerved to avoid a pedestrian, tipped over and rolled down and embankment into a second occupied motor vehicle, causing 12 people to sustain various injuries. NBK Bremerton Federal Fire Department initially responded with NHB helping to handle the surge of multiple patients needing medical treatment. "As always, when an actual emergency happens, it won't be at our convenience. It will be when we least expect it and we have to ready. Planning and training to prepare for that actual emergency will give us the experience needed to be able to handle whatever needs to be done,"
said Lerma. On any given-weekend and after normal working hours, there are duty personnel in such areas as Operating Room, Emergency Department, Nursing Services, and Clinical Support Services. The objectives of the exercise were to primarily stress the capabilities of the emergency department and main operating room with the patient surge, and assess the ability of the after-hour staff to respond, triage, treat and/or transport injured patients to appropriate treatment areas. The exercise also tested the collective communication capability of the staff on duty. "The communication during the exercise was good. Our Emergency Department did really well. The turn-over and interface with the Fire Department delivering the incoming casualties was very good, as was the triaging and transferring of some of the injured to the Operating Room and Multi-Service Ward," said Lerma. According to Lerma, one of the top three After Action Report items after any emergency exercise is always about internal communications. This mass casualty exercise gave the command the opportunity to activate the alternate hospital command center (HCC) and iron out information-sharing and various means of informing staff, patients and beneficiaries. "We primarily used landlines, but also had our command radios on hand for the exercise. Our command duty officer relayed on-time input and updates to the HCC which was valuable," Lerma Said. "This exercise was valuable. It allowed us to talk things through, especially regarding communication," said Russ Kent, NHB Facilities Management Department head and HCC Operations Section Chief. Of prime importance to the HCC during any emergency is ensuring that the timely and accurate
word gets out to staff on reporting to assigned places of duty. During an after-hours emergency event, the duty section has the immediate responsibility as other staff members are notified to augment the caring for casualties. "We do have several ways to quickly recall additional clinical support and every emergency exercise can pose a different scenario. If we're dealing with an earthquake, that could impact our network connectivity and we might have to use other means. If we're handling a number of casualties from a automobile accident, then we can use our internal pager system. We will use the best methods available to get the word out to staff if they need to immediately report to the hospital. Social media also gives us several options that we will utilize," said Capt. Mark Turner, NHB Executive Officer and HCC Incident Commander. "I would say this training is very valuable especially for the emergency medical technicians and firefighters. They were the ones who went through and practiced their training. I learned the importance of triaging. We don't normally see these kinds of cases on a day to day basis so being able to do it in a drill makes you more aware The hospital staff was very professional. They treated me like I was an actual patient and I was impressed," said Hospital Corpsman Andrew Colbeck, of Branch Health Clinic Puget Sound Naval Shipyard. "There are always three priorities in any emergency," explained Lerma. "There is life safety of the sick and injured as well as the safety of our own staff; incident stabilization that in a mass casualty scenario we treat every patient; and property conservation/business continuity where we still provide services to care for other patients when dealing with mass casualty
casualties. We did all of those today." Naval Hospital Bremerton is part of Bureau of Navy Medicine and Surgery, a global healthcare network of 63,000 Navy medical personnel around the world who provide high quality health care to more than one million eligible beneficiaries. Navy Medicine personnel deploy with Sailors and Marines worldwide, providing critical mission support aboard ship, in the air, under the sea and on the battlefield.
Certified Nurses recognized at Naval Hospital Bremerton
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton recognized Certified Nurses Day on March 19 by acknowledging the professional credibility, achievement and improved patient care of staff members with nursing certification. "It takes a lot of work, dedication and commitment to become a Certified Nurse," said Capt. Iris Boehnke, Naval Hospital Bremerton (NHB) Director of Nursing Services, noting that there are 64 nurses at NHB out of 169 who have achieved their certification. "We have almost 38 percent of our staff certified, which is almost double the national average of less than 20 percent." Lt. Cmdr Cherri Vilhauer was specifically honored for holding the longest certification tenure of 22 years as an Operating Room Nurse, and Cmdr. Thecly Scott for holding the most certifications with four in Electronic Fetal Monitoring, Inpatient Obstetrics, Nurse Midwife, and Women's Health nurse Practitioner. "I extend congratulations to everyone who has gone above and beyond for their certification. We all benefit, especially our patients. Certified Nurses improve on our overall quality, safety and patient care," said Capt. Christopher Culp, NHB Commanding Officer. The date is testimony to the enduring legacy of Margretta "Gretta" Madden Styles, Doctor of Education, Registered Nurse and Fellowship of American Academy Nursing (1903-2005). March 19 is Styles' birthday, and she became known as the 'Mother of Nurse Credentialing' and a visionary scholar who made an international impact on the nursing profession. "Today is Certified Nurses Day! I owe a lot to the nurses that got me where I am today. The thousands of certified nurses in the
U.S. today and the growing role of certification in contributing to better patient outcomes are a lasting testament to Styles legacy. So, have a great day and thank you for everything that you do every day," exclaimed Cmdr. Doug Stephens Officer-in-Charge of The David R. Ray Health Center at Naval Branch Health Center Everett. According to Lt. Cmdr. David J. McIntire, NHB Critical Care department head, Registered Nurse, BSN (Bachelor's of Science in Nursing), CCRN (adult critical care nursing), board certification of nurses plays an increasingly important role in the assurance of high standards of care for patients and their loved ones. Nursing, like health care in general has become increasingly complex. While a registered nurse license provides entry to general nursing practice, the knowledge-intensive requirements of modern nursing require extensive education, as well as a strong personal commitment to excellence by the nurse. "Becoming a certified nurse is proof you know your profession and certification in specific fields varies but not by much," said Lt. Cmdr. Geoffrey Plant, of NHB's Family Medicine and board certified in medical-surgical nursing. Plant achieved his certification approximately 10 years ago, which has to be renewed every five years. The initial eligibility criteria in Plant's field requires a nurse to hold a current, active registered nurse (RN) license within a state or territory of the U.S. or the professional, legally recognized equivalent in another country; have practiced the equivalent of two years full-time as an RN; have a minimum of 2,000 hours of clinical practice in the specialty area of medical-surgical nursing within the last three years; and have completed 30 hours of
continuing education in medical-surgical nursing within the last three years. "After putting in the hard work, then electing to get tested on your knowledge and competency and then passing the test really proves in an objective way that you know your job," Plant said. There are 28 certifications in specific nursing fields held by staff members at NHB, including Adult Clinical Nurse Specialist, Adult Registered Nurse Practitioner, Ambulatory Perianesthesia Nurse, Case Management, Critical Care Nurse, Electronic Fetal Monitoring, Emergency Room Nursing, Family Nurse Practitioner, Gastroenterology Nurse, Infection Control and Epidemiology, Inpatient Obstetrics, Lactation Consultant, Lactation Educator, Legal Nurse Consultant, Maternal Newborn Nursing, Medical-Surgical Nurse, Neonatal Intensive Care Nurse, Nurse Midwife, Occupational Health Nurse Specialist, Operating Room Nurse, Pediatric Emergency Nurse, Pediatric Nurse Practitioner, Post Anesthesia Care Nursing, Professional in Healthcare Quality, Professional in Utilization Review, Registered Nurse Anesthetists, Women's Health Nurse Practitioner and Wound Ostomy Continence Nurse.
NHB Crews into Shape
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Multiple teams from Naval Hospital Bremerton (NHB) are taking part in the month-long 12th annual "Crews Into Shape" challenge, running from Mar. 4-31. "The goal for "Crews Into Shape" is overall health improvement by getting people to eat more fruits and vegetables and stay physically active throughout the week," said NHB Health Promotions Hospital Corpsman 2nd Class Holly Dean. Crews consist of 2-10 members registered online with a crew leader and crew name. No weigh-in is required and each member sets their own weight loss, maintenance, or gain goal. Points are accumulated for things such as eating fruits and vegetables, physical activities, and goal attainment. "As a group, we're trying to get higher Physical Readiness Test scores than last year," said NHB Orthopedics Leading Petty Officer Hospital Corpsman 1st Class Elizabeth Ramos, co-captain for the "Boneheads" team. "My personal goal is to run the PRT instead of doing my usual cardio event, the bike." The "Crews Into Shape" challenge runs concurrently with National Nutrition Month and is sponsored annually by the Navy and Marine Corps Public Health Center (NMCPHC). The challenge is open for all DoD employees. To counter busy work schedules, some NHB crews have found creative and effective means of fulfilling their daily exercise and diet goals and raising awareness with health education. "This week's activity is a Juice Friday where we are sampling a spinach, kale, carrot, and apple juice that I made at home this morning. Juicing unlocks the nutrients in the veggies and fruits and is a great way to get the health benefits from the produce. Other plans for our team included Salad Friday and
Smoothie Friday, as well as walking lunches," said Peggy Hall, NHB clinical staff support and crew leader for the "Quality Matters" team from NHB Quality Management which she also led in last year's challenge. Taking the steps instead of the elevator for cardiovascular exercise is one method a number of teams are incorporating into their daily routine. One of the most frequent traveled routes in the main hospital is from the sub-level basement to the third floor. There are 98 steps in that route. "Mondays, Wednesdays, and Fridays we walk the stairs from the sub-level to the flight above the Seventh floor. We do it at least two times a day and we try to increase it on Wednesdays to three," said Ramos. "Also, one of our crew members is a command fitness leader (CFL) and some of our techs go whenever she leads a fitness enhancement program session [after hours]." At the recent Secretary of the Navy call, the Honorable Ray Mabus announced 21st century Sailor and Marine initiatives with the intent to maximize personal readiness, build resiliency and produce a combat effective force. "Crews Into Shape" correlates to the physical fitness needed to make those initiative possible "I think it gets overlooked, but physical fitness is one of the most important things. It's important for taxpayers to see a Sailor and feel proud about their appearance in uniform," said NHB Optometry Leading Petty Officer Hospital Corpsman 1st Class Chad Pilkington and CFL. "I don't think it's good for them to see us in uniform and only think we're well fed. I want them to see that we're healthy and we take pride in our uniform and represent it well. [Crews Into Shape] is a tool and incentive to get Sailors into that healthy frame of mind." "People make poor
choices everyday and one thing I would like to see them get out of this challenge is greater awareness to help them know where they are and where they should be to maintain their optimal level of health," said Dean. Dean notes that one dynamic "Crews Into Shape" introduces to some participants is an alternative for those who have tried to get healthier alone to now have a group effort to help them stay in shape and eat right. "The great thing about having other people with similar goals is that you have someone else holding you accountable other than just yourself. When it's just you, it's easier to slip up and not eat enough of the healthy foods throughout the day or skip a day of working out," said Dean. "It's vitally important even if you have an exercise plan. If you've got somebody expecting you to be there and keeping you on track, it's going to work. We didn't score the most points [last year], but we became more aware and had fun. It's not necessarily just about eating right and physical fitness, but it's also the camaraderie with your team members. The most challenging thing about this program is getting people to join especially the ones that would benefit the most," echoed Hall. "Thanks to a strong network of command health promoters, we have had an amazing turnout in the local area for the Navy Marine Corps Public Health Center's "Crews Into Shape" challenge. Navy Region Northwest has the strongest representation of any region navy wide," said Janet Mano, NHB Health Promotion coordinator. There are 13 teams at Naval Hospital, with an additional five teams at Naval Branch Health Clinic Everett, and another 85 throughout the greater region, including teams from Command Navy Region Northwest Safety, Naval Base Kitsap,
Operational Health Support Unit Bremerton, Puget Sound Naval Shipyard and Intermediate Maintenance Facility, Naval Station Everett, Naval Undersea Warfare Center Keyport, and Naval Air Station Oak Harbor.
NHB Corpman Awarded Purple Heart and Commendation Medals
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Hospital corpsmen assigned to Naval Hospital Bremerton's Pediatric Clinic are honing their essential skills thanks their leading petty officer with extensive credentials. Hospital Corpsman 3rd Class (Fleet Marine Force) Tony Carlton has accumulated amble experience from being deployed with the Marine Corps, as evidenced by receiving the Purple Heart, Navy and Marine Corps Commendation with Combat Distinguishing Device, and Navy and Marine Corps Achievement medals. Carlton has been training clinic corpsmen since arriving eight months ago to perform more than just basic medical procedures to prepare them when their turn comes to deploy. "I've done a couple classes on combat patient assessment because you never know when these guys will get pulled into a deployment. If they deploy with our Marine Corps they'll be expected to know this," said Carlton, noting that he also goes over the Fleet Marine Force manual as added preparation for his junior corpsmen. "You won't know what you're going to do [during a situation] unless you know it so well that it becomes an automatic motor function," added Carlton, a Clintwood, Virginia native. "He's just a really good LPO. Sharing his experience and teaching those of us who haven't been deployed yet has been really valuable in our overall training," said Hospitalman Monica Navarro, of NHB's Pediatric Clinic. Carlton received his Purple Heart medal for injuries sustained while assigned as Senior Line Corpsman for Weapons Company, 3rd Battalion, 7th Marines, Regimental Combat Team 2, 1st Marine Division Forward operating in the southern Afghanistan
Helmand Province area of Southern Musa Qu'lah in support of Operation Enduring Freedom in Afghanistan. In the middle of the day on Jun. 19, 2010, a seven ton truck carrying seven Marines was moving at the company command post when it struck an improvised explosive device (IED). "I was sitting behind the wheel [of a truck], not having slept in a couple days. I was working with a gunnery sergeant when we see a truck coming over this hill. There was a corporal ground-guiding the truck and they didn't know we weren't doing that," said Carlton, explaining that ground-guiding refers to a Marine in front of a vehicle within a area that has heavy foot traffic providing the driver with an extra pair of eyes to assist in maneuvering in that area. "We went over yelling to get back in the vehicle and quit ground guiding. The Marines couldn't hear us over the diesel motor and about this time we hear 'boom.' It was a huge IED. It took the front end off of the seven ton and blew the wheel off," related Carlton, sustaining injuries along with all the Marines around the blast-site. According to the citation for his Navy and Marine Corps Commendation Medal, Carlton went into action immediately after the explosion to triage the injured Marines and provide care to the most severely wounded. He stabilized them and enabled others to render aid. "Throughout this time his actions were consistent with a first class medical provider, invariably saving lives," the citation read. The most serious injuries were urgent casualties with potential internal bleeding and blown pupils. There were also two more Marines diagnosed as priority medical evacuations with grade III concussions (The classic and the most severe
form) and possible broken bones, and three other medical evacuations due to blast effects. "I guess at the time I didn't realize I was as bad off as I was until my adrenalin started going down," said Carlton, who sustained a grade III concussion from the blast. "I was able to do my job even though I was having difficulty concentrating because I was running on autopilot." Carlton attributes his first responder ability in that situation to his extensive training, which he continues to stress to his corpsmen. A Pediatric Clinic co-worker has even posted a slightly over-stated congratulatory note on Carlton's deployment and mentioned that he had sustained multiple injuries. That was somewhat over-blown. No pun intended. "I wasn't blown up that many times. I was involved in several accidents, and there were explosions on the ground and inside the trucks. I've had several concussions due to a blast wave and my left ear is hard of hearing. But other than being knocked out or knocked around I'm okay," Carlton said. In addition to his heroic actions, as senior line corpsman, Carlton had the responsibility of ensuring all line corpsman were ready for operations. He organized and operated the forward Company Casualty Collection Point (CCP), and during combat operations, he established procedures and guidelines that ensured timely and accurate diagnosis and treatment of all patients arriving to the CCP. He treated 237 Marines during 10 days of sustained combat operations. He also conducted 133 Military Acute Concussion Exams (MACE) which were a result from IEDs or indirect incoming fire. He properly categorized them, treated and after diagnosis, transferred them to the appropriate level of care. He also handled over 10 other Marines for
typical sick-call ailments ranging from trench foot to heat exhaustion. He received his awards in Aug. 2011. "I never thought I'd be awarded the Purple Heart," said Carlton who originally enlisted to become a SEAL. "When I joined the Navy, I joined to be something more than ordinary. I never thought I'd be a Navy corpsman with the Marine Corps and see as much and do as much as I did."
NHB Medical Services continue during Force Protection Exercise on Mar 22/23
By NHB Public Affairs
Naval Hospital Bremerton will continue with daily operations during Solid Curtain-Citadel Shield 2012, an annual Navy-wide Force
Protection Exercise designed to enhance the training and readiness of security personnel to respond to threats to installations and
NHB will participate in Solid Curtain-Citadel Shield 2012, commencing approximately 9 a.m. the morning of Thursday, March 22, and continuing through Saturday morning, March 24. Delays in accessing the bases are expected during this timeframe.
While there will be no impact on Military Treatment Facility emergency and acute services at NHB, patients should anticipate potentially long wait time at the main gate. In the event of an actual emergency during the exercise when time is of the essence, patients should call 911 or go immediately to the nearest civilian medical facility for care. Emergency room visits are a TRICARE-covered benefit.
Outpatient clinic schedules for March 22-23 have been revised to ensure patient access to emergent, urgent, and acute care. Inpatient, surgical and emergency services will not be interrupted.
There will be an Independent Duty Corpsman assigned to the NHB Main Gate area to assess those beneficiaries arriving for an appointment to timely facilitate their base access.
Access to Naval Branch Health Clinic Bangor will only be through Naval Base Kitsap Bangor Trident (main) Gate. Civilian beneficiaries who regularly utilize NBHC Bangor are recommended to seek treatment at
NHB or the most conveniently located civilian medical facility.
All beneficiaries are strongly encouraged to utilize outpatient services such as the NHB Main Pharmacy and Drive-Through Pharmacy either before or after Exercise Solid Curtain-Citadel Shield.
Exercise Solid Curtain-Citadel Shield is not in response to any specific threat, but is a regularly scheduled exercise designed to enhance the readiness of Naval Security Forces.
NBHC Everett Medical Services during Solid Curtain-Citadel Shield 2012.
NBHC Everett will also be participating in Solid Curtain-Citadel Shield 2012 as a tenant command of Naval Station Everett. The clinic's participation will commence at approximately 8:30 the morning of Thursday, March 22, continuing through Saturday morning. Daily operations will continue on Thursday March 22, however, all clinic operations will be curtailed on Friday, March 23, due Naval Station Everett's closure and the clinic's participation in a mass casualty exercise. All patients presenting to the clinic on Thursday, March 22, must enter the base through the North Gate and are strongly encouraged to get any prescription refills prior to Friday, March 23, since they will not have access to the base.
National Patient Safety Week kickoff highlights Safe Patient Care at NHB
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton officially commenced National Patient Safety Week of Mar. 4-10 with a kickoff celebration on Mar. 5.
The annual week-long event focuses on enhancing, improving and increasing awareness on a wide range of patient-related safety topics for beneficiaries, staff and command visitors.
"By engaging our staff and engaging our patients with such tools as these at work and at home, we'll make where we work and live that much safer. The more we know about our health and safety, the better off we will be. "Be aware for safe care" is our theme this year. We want to ensure that we have safe patient care every day," said Cmdr. Sarah Butler, NHB Quality Management department head.
Butler shared that some things patients can do to "Be aware for safe care" include; seeking information and questions; keeping track of their family (medical) history; knowing and writing down personal health care history; exploring healthcare options and selecting a hospital, doctor and pharmacy that fit their needs; choosing a family or friend as a health care advocate; following up on test results; and evaluating their environment (at home, work, away) to assess (any) risk of falling.
The kickoff ceremony also included NHB's Quality Management staff re-launching the Staff Safety Handbook campaign. "We've always meant to have this program in place and this kickoff gives us the perfect opportunity to pass on to everyone that this booklet is a great all-around training tool," Butler said, noting that
the basic safety tips in the pocket-sized books are also a convenient way to teach and share with others in the departments and
"We'll put these handbooks to good use in ICU (Intensive Care Unit) to help increase our readiness in patient safety," said Hospitalman Gregory Anderson, of NHB's ICU/Critical Care.
The most visual and popular event throughout the week was the "Patient Safety Seek and Find" static and interactive display on the quarterdeck, where anyone could check their situational awareness (SA) for patient safety. The display featured a bed-ridden manikin patient, with associated medical and hospital props that may or may not be conducive to proper patient care. The goal was for each participant to try and find the 15 errors associated with the display.
"This display is for everyone, but especially our staff. We're hoping to get as many staff members involved as we can throughout the week and increase their awareness. Our overall goal is for everyone to take a moment to try and see how many things they can find in the display that put the patient at risk," said Mayda Schaefer, Patient Safety Analyst, adding that this is the eighth consecutive year NHB has highlighted National Patient Safety Week with a kickoff ceremony.
Butler stressed that patients and family are a key part of the healthcare team. "We want them to realize there are good questions for their good health that they should address and discuss with their doctor, nurse and pharmacist every time we see them during a visit. "What is my main problem?" "What do I need to do?" "Why is it important for me to do this?" All these are legitimate questions that are in their right to ask," said
Butler also shared NHB'S usage of the Department of Defense Patient Safety Program theme of TEAM UP to actively promote getting patients involved as partners with their healthcare team.
"T is for 'team together.' E is for 'educate yourself.' A is for 'ask questions.' M is for 'manage your medications.' U is for understand changes in the game plan.' P is for provide perspective," Butler said.
According to Butler, the 2012 National Patient Safety Goals for hospital staff and leaders will focus improving identifying patients correctly such as using at least 2-ways to identifying the patient; improving staff communications by getting important test results to the right staff person on time; improving infection prevention with such measures as advocating hand-cleansing guidelines; using medication safely by labeling medicines and medication containers not already labeled; and identifying patient safety risks correctly by identifying any patient who may be at risk for committing suicide.
There were also learning lads organized by NHB's risk manager, patient safety expert and others."We're highlighting one week for something we do year-round, but we feel the added emphasis is important not only for our patients, but also for our staff," said Butler.
NHB Corpsman recognized at American Red Cross 'Real Heroes' event
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
A hospital corpsman from Naval Hospital Bremerton was recognized by the American Red Cross serving King and Kitsap Counties as
their recipient of the 2011 Military award on March 1.
Hospital Corpsman 1st Class Marvin Belanio was honored for his life-saving efforts at rendering emergency first aid on an airline flight at the 13th Annual Real Heroes Breakfast that drew a packed-crowd of civic and community leaders.
"I'm surprised and humbled by being recognized for doing something that any corpsman would have done in such a situation," said Belanio, Leading Petty Officer for NHB's Bio Medical Repair division.
Belanio was returning last May to NHB from a fiscal logistics symposium in Maryland aboard a Delta Airlines flight. Just as he put his headphones on and began to relax for the five hour flight, he heard a thump on the plane's floor. Looking ahead a few rows, he spotted a gentleman lying on the floor. The fellow passenger had collapsed, and just as Belanio started towards the man, the flight crew was calling for assistance from a doctor, or anybody with medical experience. A quick look around confirmed to Belanio that he was the only one qualified to handle the situation.
"I might have actually felt more than heard the thump of the passenger falling. The gentleman fell face first and obviously medical assistance was immediately needed. When I reached him, I noticed he had a pallid color and wasn't breathing. There was commotion and flustered people around him. Some wanted to move
him, but I quickly took charge. The last thing we wanted to do in such a situation is move anyone in such a condition because there
could be some type of spine injury. Especially with the kind of force he had to incur landing the way he did."
"I didn't see the passenger go down but I did notice that HM1 Belanio jumped out of his seat right away to render assistance. It was 'Corpsman Up!' and there he was. While everyone else was looking around for someone to step up, that's exactly what he did. He told the flight attendants, "I'm a Navy Corpsman and I can help him," said Lt. j. g. Rachel Smith, NHB Assistant Department Head for Materiel Management, who was also on the flight and sitting three rows behind Belanio.
Once Belanio had maneuvered into position to reach and handle the downed patient, he swiftly carried out a rapid assessment and administered cardiopulmonary resuscitation (CPR) that resuscitated the passenger. "I did the 'look-listen-feel' and received no response. I started the CPR which got his breathing back," Belanio said.
For the remainder of the flight, Belanio continued to assess and monitor the passenger.
Upon arriving in Seattle, Belanio briefed the emergency responders waiting to take over, was personally thanked by the flight crew and passengers, and was later awarded a free flight and bottle of champagne from Delta Airlines.
"HM1 Belanio has experience in combat caring for Marines and Sailors. He's a stand-up guy who always does the right thing. He has earned the right to be called 'doc' by his Marines, which is the highest honor for a hospital corpsman. What he did on that flight to help
just showed why he is a 'doc', said Smith.
"I really don't consider myself a hero, but my wife Michelle does tell our two-year old that 'daddy is a hero,' and it is pleasing that she thinks that. My parents are also very happy and proud," said Belanio, a Wash. native and 13-year Navy veteran, with a background in emergency care. Belanio has served two tours in Iraq with Marine units as well as taught trauma support courses such as Tactical Combat Casualty Care (TCCC) training.
"Basic life support is something all corpsmen know. It's what we do. I think that all of us in uniform who are making such sacrifices to care for others are the real heroes. A hero is just someone at the right place at the right time to make an effort to help when needed," said Belanio.
The American Red Cross Real Heroes Breakfast celebrates extraordinary acts of courage and compassion by Kitsap County and North Mason County heroes, with those honored being chosen from hundreds of applications by a selection committee. Each Real Hero from the greater Kitsap Peninsula had a special tribute for their respective acts of heroism which included such as areas as; Good Samaritan, Animal Rescue, Call to Action, Law Enforcement, Fire Rescue, Good Neighbor, Medical, Preparedness, Water Rescue and Military.
NHB Celebrates Black History Month
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Naval Hospital Bremerton (NHB) Diversity Council celebrated Black History month on the quarterdeck with staff and patients Feb.
29. NHB Commanding Officer Capt. Christopher Culp helped kick off the ceremony by recounting how he was personally motivated by Master
Chief Boatswain's Mate Carl Brashear, (the first African-American to qualify and serve as a master diver in the Navy) who was his
patient for 10 years in Naval Medical Center Portsmouth.
"We are collectively better for the contributions of every person present," said Culp. "That means the more diverse we are, the more diverse our experiences, the more contributions we'll have going forward. Today, we recognize and pay tribute to the contributions of African-Americans of the nation and the Navy."
The celebration continued with a recital of Maya Angelou's poem, 'Still I Rise' by X-Ray Technician Hospital Corpsman 2nd Class (SW/AW) Rosalyn Dupree, and the reading by diversity council members of an article highlighting the myriad inventions and innovations developed by African-Americans.
Next, the Naval Branch Health Clinic (NBHC) Bangor Diversity Dance Group led by Hospital Corpsman 2nd Class (SW) Jason Span excited the crowd with an energetic modern dance recital.
NHB Chaplain Lt. Martie Johnson followed up by honoring the first African-American Navy Officers known as the Golden 13.
"They were trained as officers at Great Lakes and this was done before civil rights which was [a] huge [accomplishment]. This was 1944, not 1964," said Johnson. "In the Navy, before WWII, the only rates you
were eligible for if you were black were CS (culinary specialist) or SH (ship's serviceman). Back then, they were called messmen
Assistant Department Head for Labor and Delivery Lt. Jenique Keys recounted her experiences as an African-American female naval officer and discussed the history of pioneering African-American female naval officers.
"My parents paved the way for my journey. They both served with an accumulated service of almost 45 years on active duty between the two of them. I look to them as my heroes," said Keys.
"Their path was paved by other people especially my mother. She served 20 years as an active duty enlisted African-American woman in the Navy…and I'm sure she still gives thanks to those who came before her."
The ceremony closed with a benediction by NHB Chaplain LCDR Timothy May and a cake cutting ceremony. Immediately after the ceremony, diversity council members served the audience in attendance plates of traditional African-American foods.
NHB Promotes Children's Dental Health Month
By MC1 (SW) Charlemagne Obana, NHB Assistant Public Affairs
Naval Hospital Bremerton (NHB) oral surgery technicians visited nearby Jackson Park Elementary to promote Children's Dental Health Month on Feb. 28. "It was good to see the kids enjoying our presentation. They were raising their hands and asking questions which means that they had an interest in learning more and telling us their own stories about their experiences with the dentist or brushing and flossing," said Oral Surgery Leading Petty Officer Hospital Corpsman 2nd Class (SW) Jeremiah Hays. The NHB staff members taught a classroom full of first graders the importance of brushing all surfaces of their teeth and flossing properly with visual aides and props.In addition, the surgical technicians shared with the children the consequences of poor dental health. "Dental health is extremely important to children because it's as kids that we tend to form our habits," said Surgical Technologist Hospital Corpsman 3rd Class Dustin Ragsdale. "It's a lot easier to form good habits when you're learning everything than try to undo bad habits." "As someone who has worked in dental, I've seen people who have not had the best dental care before their time in the Navy. They come in and need fillings or teeth removed not necessarily because of neglect on their part, but they weren't taught good habits early on," said Hays. According to the oral surgery staff members, one of the easiest things a parent can do to improve their child's oral health is to be good example by letting their children watch them brush and floss regularly. Also, parents should supervise their children directly as they brush and floss to make sure their child's technique is correct. Each student received an oral care package
consisting of items such as toothbrushes, toothpaste, dental floss, and stickers. NHB oral surgery department is also tentatively planning to celebrate the Children's Dental Health Month in March with informative static displays on the quarterdeck.
TRICARE SERVICE CENTER RELOCATED
Naval Hospital Bremerton's TRICARE Service Center has relocated from the main hospital's Family Practice wing to nearby Building 14. The move is designed to improve internal communications between TRICARE and NHB's Referral Management Center and Enrollment specialists by combining all services in one location. "This will primarily be a seamless move and there should be no impact on our customers," said Renee Proctor-Brown, RN, BSN, Clinical Liaison Nurse and TRICARE Manager. Building 14 is located in Mt. Adams Parking Lot, across the foot bridge from the Third Floor of the main hospital. NHB's TRICARE Service Center offers walk-in service to provide assistance to service members, retirees and family members on enrollment with Naval Hospital Bremerton, authorizations and referrals in the community; claim issues; and benefit information. Walk-ins are seen from 7:30 a.m. to 4:30 p.m. According to Proctor-Brown, the five staff members of NHB TRICARE Service Center help approximately 50 to 60 walk-ins per day. "This move will be great for all of us. By being co-located, it will make both of our jobs much easier," said Diane Polizzi, Referral Management department head. Polizzi notes that the move will positively impact patients by improving the timeliness of services. "This will certainly speed up handling consults and getting the proper authorization for our patients," she said. Along with the walk-in service available at NHB, beneficiaries can contact the TRICARE Regional Appointment Center (TRAC) 1-800-404-4506 and TriWest Healthcare Alliance Beneficiary Services at 1-888-874-9378.
From Kitsap to Kabul - NHB Physician handling role of CMO for ISAF
By Douglas H. Stutz, NHB Public Affairs
The program director for NHB's Puget Sound Family Medicine Residency has taken his expertise from Kitsap to Kabul. Cmdr. David Congdon departed in September when the tasking order came for a senior family physician to deploy to Afghanistan. He is currently Chief Medical Officer for the headquarters of International Security Assistance Force (ISAF) in Kabul. Congdon is filling a NATO billet with a small team of one physician assistant, a Navy chief petty officer, one hospital corpsman and two U.S. Army medics. "My team provides basic routine care, emergent care and trauma stabilization and I advise the base commanding officer on all things medical. I (also) do preventive medicine assessment for the camp and track epidemiology for the camp," said Congdon. Congdon, an Oak Harbor, Wash. native with 24 years of active duty service is the only physician at ISAF and thus handles every illness and trauma. "We've had several emergency situations requiring quick stabilization and transport to higher echelons of care," he said. Although most of his responsibility is to ISAF personnel, Congdon has also ventured into Kabul to render assistance when needed. "We recently traveled to a local orphanage and delivered school supplies, toys and clothing. The kids were great. They were super polite and knew a little English. Like all kids, they laugh at the same silly stuff that our kids laugh at." The Kabul-based ISAF Headquarters serves as the operational command for the NATO-led mission. It interacts with the Afghan government, as well as with governmental and non-governmental organizations
present in the country to assist with reconstruction, and supports the work of United Nations Assistance Mission in Afghanistan (UNAMA). ISAF Headquarters are also distinct from the Headquarters for the Regional Command Capital (RCC), also located in the Afghan capital. At the ISAF Headquarters level, there are approximately 50 contributing nations with more than 2,200 service members to make up the headquarters and its support personnel. "The NATO environment is quite different. There are so many different countries represented on the base, and I'm speaking a little Italian and French every chance I get," said Congdon. The shape and size of ISAF Headquarters has continued to evolve as the mission progresses, with the size of each nation's contribution to the Headquarters changing over time. Congdon's main responsibility from a medical perspective is to provide care and ensure the camp continues to operate. To that ongoing goal, engaging in preventive medicine duties helps keep the focus on the prevention of disease that is intricate in maintaining force readiness for ISAF personnel throughout the camp. "I have done a fair amount of preventive medicine such as inspections of dining facilities and providing education on how to limit the spread of viruses. We have so many different nations represented here at headquarters, and getting everyone to the same level of hygiene awareness is a challenge. Poor hygiene is a major threat to military operations and is the single most important duty we do. Some of the specific things I have worked on include proper hand-washing, limiting virus spread and even how to cough correctly," Congdon said. Congdon's medical clinic is also his bunk-room, living area, classroom, and impromptu
dining facility. "Our small medical team and I all live together in the same place we work. We basically live, work, and eat 24 hours, seven days a week together. There are no days off, no weekends, no holidays and no escape," he said. "But I am able to hit the gym regularly which is very good fo r the morale." Deployment conditions notwithstanding, Congdon and his team also are carrying out their duties in the midst of a typical harsh Afghan winter. "The weather is super cold. The temperature gets down to zero and night and in the mid-20s during the day. It's currently snowing and this is our fifth snowstorm of the winter," said Congdon. Congdon notes that his expertise goes beyond handling duties as the primary and only provider. As the resident medical expert for headquarters, his insightful recommendations are also heeded in the ongoing decision making process in ISAF's daily mission. "The overall leadership atmosphere here is excellent and my boss, Col. Curtis Winstead, U.S. Air Force, is superb. I've met a lot of great people over here. There are plenty of foreign military and civilians all here attempting to assist Afghanistan in becoming a more self-reliant country. I am certainly proud that I am able to be in a supportive role in all of this and will not soon forget this experience." Before Congdon headed down range, his leadership propelled NHB's graduate medical education (GME) residency program to continue to set lofty standards. The GME residency program received the singular honor of being granted five year accreditation instead of the traditional three by the Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committee (RRC) for Family Medicine. "I couldn't be more proud of the
residency and our hospital! This was a major victory for the command and great recognition for the high quality of education here throughout the hospital," said Congdon. Congdon noted that one of ACGME's main concerns before granting the five year accreditation was how NHB's internal process would ensure that the necessary teaching/tutoring and mentoring would being consistently accomplished during a time with so many staff members heading on extended deployments. "We made sure our residents aren't abandoned if anyone heads down range," explained Congdon, who was confident that the program would continue on during his deployment. "Our permanent civilian faculty members are fully vested to provide top-notch training and teaching in addition to our active duty faculty." As has been the case with others before him, once Congdon returns from Afghanistan, he can share his experience and insight with residents and physicians alike, thus continuing his role in advising and assessing.
NHB support for Great American Spit Out Campaign Exposes Smokeless Tobacco Dangers
By Douglas H. Stutz, NHB Public Affairs
The Great American Spit Out (GASpO) campaign was recognized Navy-wide on February 23, but is always year-round at Naval Hospital Bremerton (NHB). The Department of Defense event is part of 'Quit Tobacco—Make Everyone Proud,' an on-going educational campaign tailored specifically for the U.S. military to give up tobacco products. "Smokeless tobacco is dangerous and has definite health risks," said Patrick W. Graves, Naval Hospital Bremerton Tobacco Cessation Facilitator. "Any time any person puts any kind of smokeless tobacco into their mouth, they become exposed to such health threats as oral cancer, pancreatic cancer, esophagus cancer, stomach cancer and colon cancer. We encourage anyone who uses smokeless tobacco to just give it up for the day." "It's time for me to quit. I have finally realized that I don't need it. This is the right choice for my overall health," said Logistics Specialist Senior Chief Edward Lange, Medical Services Leading Chief Petty Officer. Lange counts himself as one of many who has attempted to quit, only to restart and then try again. "It's only been nine days for me this time. I've tried before, so maybe the third time is a charm," said Lange. Graves notes that smokeless tobacco has 28 cancer-causing carcinogens. The dip is a super concentrated form of nicotine, equal to 3.5 packs of cigarettes. "That makes it all the more addictive," he said DoD data shows that smokeless tobacco is used by 19 percent of 18- to 24-year-old military males, which is approximately twice the national average. "But it's seems so much harder to quit in our older populations," Graves said.
"Just like alcohol used to be, no one thinks it's cool to be a quitter. But once you quit you're really glad because you get rid of the baggage that went along with something that is self-destructive," Graves said. Graves acknowledges that there are success stories. He estimates that almost 50 percent of serious quitters, people who make the commitment and take the necessary steps, do quit the habit. "But for those who give a half-effort and expect and hope just a pill or some patches will do all the work, the odds are less than 25 percent," he said. "Having the guts to start is important. Having more guts to succeed is also needed," Lange said.
Naval Hospital Bremerton hosts Commander Navy Medicine West
By Douglas H. Stutz, NHB Public Affairs
Rear Admiral C. Forrest Faison III, Commander Navy Medicine West and Naval Medical Center San Diego visited Naval Hospital Bremerton and Branch Health Clinics at Naval Base Kitsap, Puget Sound Naval Shipyard and Naval Station Everett, February 14 and 15. Faison also called upon Naval Hospital Oak Harbor. Faison used his time to meet and greet many staff members throughout his visit as well as hold discussions with command leadership. During several Admirals' Calls, Faison shared the guidance of Navy Surgeon General Vice Adm. Matt Nathan along with his observations of leading approximately 13,000 civilian and military staff members scattered across 15 time zones from Arizona in the American Southwest to the island of Diego Garcia in the Indian Ocean. "If you don't remember anything about this admiral's call, remember these two words; thank You. Thank you so much for the difference you make. You are there to answer the call and carry on the tradition of care and compassion that dates back to the founding of our nation," said Faison. Faison noted that by every conceivable measure that is looked at, NHB staff is helping to lead the way in such areas as training, patient care, and optimizing resources. "NHB is making a real difference in time of need with efficient and effective practices across the board. Quality care has never been better," he said. Echoing the recent guidance by the Navy's Surgeon General, Faison reinforced the three guiding principles - Ship, Shipmate and Self - of leadership expectations to all staff members. "The Ship is our mission, which is taking care of people.
We have been at war for 10 years and Navy Medicine has been in the middle. How we move forward after these 10 years of war to continue our mission is a challenge. Keeping our skills refreshed and our training updated is important. Our mission will continue and we will continue to do the best we can. But we have had a very high operational tempo and that has created some shortages in some clinics in our hospitals. It has been a balancing act taking care of patients when deployed and at home. By continuing to train at home, we continue to be well-prepared to serve when deployed," said Faison. Faison noted that one vital aspect of medical training for both Navy Nurses and Hospital Corpsmen is that they need to continue to treat and care for patients at home before they are sent down-range. Taking care of patients here is important not only to help them out, but it give our corpsmen the skills and expertise to be well-prepared to deploy. Same for our nurses. He or she shouldn't need to be learning fluid management and ventilating care on the fly working on a critical patient in a tent in Afghanistan. That is not what we do. Our people are first responders. There are no runny noses and ear aches in Kandahar. We're there to care for the sick and injured and save lives. That's what we do, and we do it well." Addressing the topic of Shipmates, Faison stressed the importance of watching out for one another. "During this time of war, the longest our nation has been through, we have had staff members see horrific and gruesome stuff when deployed. What keeps me up at night is worrying about a corpsman who hasn't asked for help because they don't want to be seen going to Mental Health. Be attuned. Look out for each other. Our ability to help each other is as critical as
taking care of our patients," he said. Lastly, Faison touched on Self. "We also need to look at ourselves and ensure we are taking care of ourselves. We need to have a balanced approach to our lives and we have the resources to help anyone anyway we can with career, skill enhancement and training. Taking care of Self also means advancing in rate, something that NHB has done a great job with, by helping their Sailors pass their advancement exams. Self also refers to not becoming a Physical Fitness Assessment casualty. PFA is 100 percent avoidable." Faison wrapped up his two-way admiral call and discussion with staff members by sharing his sincere thanks for all they do. "We are unlike any healthcare organization in the world for one simple reason; everyone we care for is someone who has volunteered and sacrificed to serve our country and defend our freedom. With great challenges comes great opportunity. I have no doubt we are up to the challenge. By providing guidance, initiative, and support to our staff, we can meet those challenges. Thank you on behalf of all that you care for. You make me so proud."
Gone but Never Forgotten - NBHC Everett Remembers Clinic Namesake
By Douglas H. Stutz, NHB Public Affairs
Naval Branch Health Clinic Everett formally recognized the Medal of Honor recipient and namesake of their clinic on Feb. 15. Hospital Corpsman 2nd Class David R. Ray, who would have turned 67 on Feb 14, was remembered with a birthday celebration attended by all hands as well as several distinguished guests. The event also included staff members sharing comments from Ray's family and another hospital corpsman who served alongside Ray during the Vietnam War. Ray was awarded the Congressional Medal of Honor (posthumously) for his actions during the Vietnam War at Phu Loc 6 near An Hoa in Quang Nam Province, Republic of Vietnam, on March 19, 1969. NBHC Everett, commissioned in 2002, is located within the David R. Ray Health Center. "We really decided to do this ceremony for several reasons but primarily because it's the right thing to do. Sharing what Ray did is something that a number of our more seasoned petty officers can relate to. They have deployed like Ray did and have been in the action. But we also have younger corpsmen that have yet to deploy and this clinic is their initial command experience. They need to know and understand that Ray's legacy defines who we are," said Cmdr. Doug Stephens, NBHC Everett Officer in Charge. Rear Admiral C. Forrest Faison III, Commander Navy Medicine West and Naval Medical Center San Diego, addressed the assembled staff of NBHC Everett during part of his tour of Pacific Northwest Navy hospitals and clinics and stressed that by their actions they were continuing to follow in Ray's footsteps. "We do stand on the shoulders of giants,
much like Petty Officer Ray. All of you are following with that tradition," said Faison. NBHC Everett Command Master Chief Martin Aquino read heartfelt correspondence from Ray's sister, Mary Don Bixby, Friends of Fondren Library Executive Director at Rice University "I wish that I could be with you today. One of my fondest memories is attending the opening ceremony for the Health Center. We were treated with such respect and warmth during our visit, and we returned home with the knowledge that my brother had been honored by an exceptional group of U. S. Navy personnel who had chosen to name the Health Center for him. His love of his country and his dedication to his work as a corpsman led him to give his life to save the lives of others. Every day I am in awe of his heroism. It is hard to believe that Bobby, as we called him, would have turned 67 on Feb. 14. Thank you for honoring my brother in this special way. Even though we've never met, you can be assured that you are often in my thoughts," wrote Bixby. Hospital Corpsman 2nd Class Krystal Wasson also shared a personal letter, one penned 43 years ago in Quang Nam Province by Ray's friend Hospital Corpsman Tommy Vickers to his family. The letter was received by Mr. and Mrs. Tom Vickers from their son the day before the Rays were notified on their son being killed in action. It read, in part, "I guess you know by now that Bob Ray got killed last night. They (Vietcong) ran over An Hoa. This is the story I got from a Marine he (Ray) patched up. "They started when one got through the wire and pulled a satchel charge under a hutch. When it went off everyone ran outside. They started mowing them down as they ran out. Bob got hit, but was still treating
wounded when he was hit the second time. I hope this isn't true, but this Marine said he and Bob were real close. After his mother has calmed down, tell her this little Marine said Bob knew his job and was doing it. He fixed my arm. Then he stated to cry. He said that the enemy was all over them, plus rockets and mortars as thick as flies." Vickers worked late in the night and well into the next day helping to treat and care for mass casualties. By 6:30 a.m. (on Mar. 20), six more choppers from An Hoa landed. Vickers still could not locate his friend and began asking Marines from Ray's outfit if they knew his status. "Everyone said he had been hit, but no one knew how bad. Then this one kid told me what happened. I couldn't work. All I could do was sit and stare," wrote Vickers. In addition to Ray, 10 Marines died in the battle. "This ceremony is a poignant and powerful reminder of who we are," said Capt. Christopher Culp, Naval Hospital Bremerton Commanding Officer. "For conspicuous gallantry and intrepidity at the risk of his life above and beyond the call of duty while serving as a HM2 with Battery D, 2d Battalion, at Phu Loc 6, near An Hoa. During the early morning hours, an estimated battalion-sized enemy force launched a determined assault against the battery's position, and succeeded in effecting a penetration of the barbed-wire perimeter. The initial burst of enemy fire caused numerous casualties among the marines who had immediately manned their howitzers during the rocket and mortar attack. Undaunted by the intense hostile fire, HM2 Ray moved from parapet to parapet, rendering emergency medical treatment to the wounded. Although seriously wounded himself while administering first aid to a
marine casualty, he refused medical aid and continued his lifesaving efforts. While he was bandaging and attempting to comfort another wounded marine, HM2 Ray was forced to battle two enemy soldiers who attacked his position, personally killing one and wounding the other. Rapidly losing his strength as a result of his severe wounds, he nonetheless managed to move through the hail of enemy fire to other casualties. Once again, he was faced with the intense fire of oncoming enemy troops and, despite the grave personal danger and insurmountable odds, succeeded in treating the wounded and holding off the enemy until he ran out of ammunition, at which time he sustained fatal wounds. HM2 Ray's final act of heroism was to protect the patient he was treating. He threw himself upon the wounded marine, thus saving the man's life when an enemy grenade exploded nearby. By his determined and persevering actions, courageous spirit, and selfless devotion to the welfare of his marine comrades, HM2 Ray served to inspire the men of Battery D to heroic efforts in defeating the enemy. His conduct throughout was in keeping with the finest traditions of the U.S. Naval Service."
NHB ACLS Program Trains To Save Lives
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Naval Hospital Bremerton (NHB) staff education and training department (SETD) conducted Advanced Cardiac Life Support (ACLS) at Naval Base Kitsap (NBK) Bangor Behavior Health and Education Center (BHEC) Feb. 16-17. "ACLS is a requirement for me as an independent duty corpsmen (IDC) and I've been qualified since 2006 when I went to IDC school," said Emergency Department Leading Chief Petty Officer Chief Hospital Corpsman (SS/SW/AW) Allen Truhn. "The way everything was run here, it was a relaxing setting with great instructors. The facilities at the BHEC also made it very easy to learn in." "The training is required for the majority of nurses and doctors at NHB. It isn't required for most hospital corpsmen, but it sets them a step above the rest of their peers," said ACLS Program Manager Hospital Corpsman 2nd Class (SW) Timothy Poole. "They'll know exactly what to do in case of a code even if doctors or nurses aren't there. Since they've been trained, they can lead the scenario." "A code is a cardiac-related emergency. Anything ranging from a patient coming in with chest pain, where we assume it is cardiac-related until proven otherwise, to cardiac arrest or a stroke," said Truhn. "This training is mission critical so I just want to thank everyone that is a part of the team at NHB because they're the reason why this program is so successful," said ACLS Program Director Cmdr Fran Slonski. "Also, we are lucky we have the BHEC because it allows people to get away from their jobs so they can concentrate on their training." The curriculum consists of classroom training in basic life support (BLS), respiratory emergencies, stroke, and cardiac emergencies which is
taught by video, instructors, and scenarios. The instructors are primarily hospital corpsmen, nurses and doctors from NHB. "I really liked the practice sessions to do the hands-on since it got to mix the students together. In my group there were students with experience levels from a hospital corpsman taking the class for the very first time to a civilian anesthesiologist who was actually a retired Navy who has been doing ACLS probably since the early 1980's," said Truhn. The final tests include a written exam with 50 questions which requires a minimum score of 84 percent to pass and a mega-code scenario usually consisting of a group of six students evaluated by an instructor. ACLS is usually held quarterly unless there is a situation that requires additional classes according to Poole. One of the additional classes is held in June when the new family medicine interns arrive at NHB. Most incoming medical professionals arriving at NHB are already certified in ACLS which requires renewal every two years. "If their certification has lapsed, they need to recertify because technically they cannot practice medicine without it. That's why when the new intern college doctors get here, we hold class for them so they can re-qualify as part of their check-in," said Poole. The curriculum, guidelines, and testing material are supplied by the Military Training Network (MTN) which is standard for all branches. Changes to the guidelines are made every five years, and NHB changed over to the 2010 guidelines on Sept. 2011. "For corpsmen taking the course for the first time, I strongly encourage them to take the EKG course and the pre-ACLS course. That will get them the base knowledge they need in order to go in to get the ACLS qualification," said Truhn.
"There is a lot of new information and there is an assumption of knowledge prior to coming to the [ACLS] course." For enrollment into the ACLS course, contact HM2 Poole at NHB SETD (360)475-4146.
Preventative Medical Screenings at NHB a complete team effort
By Douglas H. Stutz, NHB Public Affairs
Naval Hospital Bremerton continued to improve upon patient centered care by holding the 2nd Captain's Cup HEDIS Challenge for clinical quality based on Healthcare Effectiveness Data and Information Set (HEDIS) metrics. NHB Medical Home Port teams used HEDIS metrics to inform, coordinate and schedule preventative breast, cervical, and colorectal cancer screenings and diabetes maintenance and management for beneficiaries. According to Dr. Dan Frederick, NHB Population Health Officer, the goal of the challenge was to motivate all the staff members of Medical Home Port teams to engage their patients in the preventive medical screenings process. By educating and reminding patients about annual screenings and checkups, Medical Home Port teams have the ability to diagnose and treat any potential health issue early rather than later. "We thought that by borrowing the term 'Captain's Cup' from our Navy sports colleagues we could capture the competitive spirit of involvement and increase health screenings which benefits our patients in the long run. We have been very pleased with the improvement in our command's overall HEDIS metrics as result of the response by our staff," said Frederick. "Everyone who put forth the effort has worked hard to improve the overall care of their patients. Point of care intervention, which occurs while our patients are here for any reason, is a critical pathway of involving our staff with the arranging preventive screenings." "HEDIS metrics is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of health care and medical service," said Aimee
Aldendorf, Health Educator. The competition lasted eight weeks with honors going to the top Medical Home Port team for compiling the highest composite score of patient screenings. Team Two, lead by LCDR Gray Dawson, Family Medicine physician and Maria Millsap, Primary Care nurse, claimed the top composite score and received their award from the Commanding Officer, CAPT Christopher Culp. Recognition also went to the team that demonstrated the greatest improvement from the inaugural challenge held last year. Team Four showed the greatest improvement, with honorable mention to Team Three. "Everything done help to make a positive difference in caring for our patients. Thanks to everyone for their contributions," said Culp. "This is definitely a team award. Everyone has worked together to make this happen and to change our processes for the better," said Dawson. Aldendorf noted that NHB had all primary care providers and support staff use Carepoint, the Military Health System (MHS) population health tool, which provides a listing of patients in need of preventive screening. "The health care providers then encourage their support staff to assist in calling patients and arranging necessary studies for each beneficiary," Aldendorf said. "We not only inform a patient of their need to come in for a screening, but we can also identify those who are in for a appointment to use that opportunity to get whatever screening or additional checkup is overdue," added Aldendorf. "It really is our patients who benefit from having our Medical Home Port teams contact them to come in for the screenings. It certainly helps us treat any disease by catching it early," said CDR Cynthia Kuehner, Family Medicine Department Head. Five Medical Home Port teams at
NHB, along with one at Naval Branch Health Clinic Bangor and NBHC Everett participated in this event. Each healthcare team is made up of approximately 25 staff members of primary care managers (PCM), registered nurses (RN), and hospital corpsmen and/or medical assistants. Additional physicians/providers are also part of the team to fill in during absences. NHB's primary care services transitioned last year from an individual patient/provider model to a standardized primary care team model that provides better access, continuity, wellness, and disease management for patients. The HEDIS metrics helps with standardizing primary care services, enhancing access and continuity between the patient, his/her primary care provider and their primary care team. Even the patient's family is added as part of the overall team. The partnership between NHB staff and an individual patient enrolled to a Medical Home Port team completely focuses on sustaining and enhancing wellness, along with delivery of comprehensive health care services, based on the patient needs before they visit the hospital, during their time at NHB, and afterwards during recovery. "Bottom line, their work really makes our jobs much easier," added CAPT David Murphy, Director for Medical Services.
NHB support an ongoing legacy for Operation Iraqi Freedom and Operation New Dawn
By Douglas H. Stutz, NHB Public Affairs
With 2011 wrapped up, so has the deployment of Naval Hospital Bremerton personnel to Iraq. From the onset of Operation Iraqi Freedom in 2003 to the final days of Operation New Dawn in 2011, Naval Hospital Bremerton staff members continually deployed for medical support inside and out of Iraq. From the cities along the Euphrates River in rural Anbar Province to Basra on the Al Faw Peninsula, from the northern urban enclave of Mosul to Baghdad's Green Zone and Sadr City and many places in between, NHB doctors, nurses, hospital corpsmen, and support staff were there. They embedded with various units that included 1st Medical Battalion, Special Warfare Group Iraq, 20th Seabee Readiness Group, Civil Affairs, Warrior Transition Team, 1st Marine Expeditionary Forces, 3d Marine Air Wing, 1st Marine Logistic Group and 1st Force Service Support Group. NHB sent nearly 300 staff members to augment Fleet Hospital Eight at Naval Base Rota Spain in early 2003 to gear up for Operation Iraqi Freedom, and also deployed approximately 200 additional staff members to help run Expeditionary Medical Facility Kuwait that rendered support to the ground mission just north of the Kuwaiti border inside Iraq through 2011. NHB staff members were directly involved in assisting with caring for the almost 4,500 American troop fatalities and the approximately 32,000 service men and women wounded throughout OIF and OND. Yet the nine years for many NHB staff members, some who did multiple deployments, produced more than simple statistics and accumulated data. The time spent brought many to the forefront of their chosen Navy Medicine
profession, in ways that forever remain etched in their professional bearing and personal mindset.
At the Beginning - "I don't recall exactly when I knew that Fleet Hospital Eight would play a major role, but soon after 9/11, we knew something was ramping up," recalled retired Hospital Corpsman Chief Steven C. Jackson, who deployed from March to September 2003 as leading chief petty officer for Fleet Hospital Eight Surgical Services. "We were materially ready thanks to good preparation and training, but we had no idea what to expect or how it would affect our own lives." Naval Hospital Bremerton received orders February 2003 to staff, ready and deploy personnel to stand up and support a 116-bed Expeditionary Medical Facility (EMF) to Rota, Spain, in support of Operations Enduring/Iraqi Freedom (OEF/OIF) and possible future contingencies. The Operational Readiness Department coordinated all logistics to marshal, ready and deploy 274-personnel from NHB as well as from nine other gaining commands around the country to form Fleet Hospital Eight. "Our first group set up the EMF on a vacant lot next to the flight line and by mid-deployment we had built the 250-bed fleet hospital in tent city," said retired Hospital Corpsman Senior Chief Timothy D. Stewart, who was assigned to Inpatient Services as the ward leading chief petty officer. "It seems like so long ago, and we probably weren't prepared for what was to be done. My fellow corpsmen drove stakes and erected a quality structure and cared for our wounded warriors to the best of their abilities. It was a pleasure to serve with them as they did all the hard stuff." Stewart noted that they treated almost 1,700 patients with 78 hospital corpsmen running seven wards and worked port to
starboard (12 hours on, 12 hours off) shifts nearly the entire time deployed in 2003. "I was extremely proud of how well my corpsmen completed their duties. We received accolades from the Soldiers and Marines we were treating," he said. Jackson attests to the mettle and resolve of the fleet hospital staff to deal with the influx of incoming injured from the battlefield. "I cannot recall a time in my life when I've been more proud of the Navy and being a corpsman. Having such an outstanding team to work with inspired me beyond words. Watching my corpsmen perform flawlessly and without complaint, often working long hours without a break, sometimes with no end in sight, literally brought a tear to my eye," said Jackson. Jackson also came away with high regard for the rest of the medical team at the fleet hospital. "Seeing some of the 'miracles' performed by our surgeons and nurses was truly memorable. They handled facial reconstructions, avulsed limbs, severe eye injuries and more. And watching our junior corpsmen step up to effectively and efficiently handle the support challenge turned them quickly into seasoned professionals," Jackson said.
In-Country Iraq - When Lt. Roger Williams arrived in Baghdad's Green Zone in 2007, his initial thoughts of being in a safe and secure area were quickly tested. "I was actually doing the tourist thing, thinking I was completely safe. I was swimming with my Army counterpart in what had been renamed 'Liberty Pool,' one of Saddam's former personal-use only pools, when my buddy said that it had been a while since any rocket or mortar attack had happened. I thought he was kidding and not five minutes later, we heard incoming rounds landing all over the place. That was really my
'welcome to Baghdad' moment," said Williams, working at NHB's Operating Room. The occasional shelling actually never abated when Williams was there, and it became part of the almost unreal aspect of deployment. "The attacks added to the surreal aspect of being there. Some would hunker down and others would go about their business as best and safely as they could and just dealt with it," he said. Williams worked as a perioperative nurse attached to Forward Surgical Team assisting with the 28th Combat Support Hospital in the Green Zone, helping care for troops, contractors, and Iraqi's. "We operated on all who needed us," he said. The surreal gave way to heartrending - There were two vivid and equally tragic reminders of the war at hand. Army Capt. Maria Ines Ortiz was killed on July 10 during a mortar attack on the Green Zone. She was the first Army nurse killed by hostile fire since the Vietnam War. The attack also killed two other people and wounded 18 more. "It was very sad. I had met her. I knew her. She was on the way from the Emergency Room to the Operating Room when we lost her," said Williams, who also deployed with Fleet Hospital Eight four years earlier. "We were all devastated. Lt. Cmdr. Amy White, our current Emergency Medicine division officer, worked with her in the Intensive Care Unit." Ortiz was one of many that Williams and others worked to save. Most of those wounded in Iraq did make it out for further treatment. Advances in training, experience, equipment and technology has brought the survival rate of battlefield casualties up dramatically - some estimates as high as 98 percent - compared to former wars. Another colleague drove up one day in a Humvee filled with casualties from a sniper attack. A local Iraqi
mother was wailing in shock over her two young daughters who both had been shot and in immediate need of medical care. "We could see that one of the daughters was already dead. I couldn't even begin to imagine the grief the mom was experiencing. That tragic incident really stood out about the horrors of war," said Williams, a father with daughters and one son of his own. "I had two tours in Iraq," remembered Hospital Corpsman Chief Nathan W. Sims, former Leading Chief Petty Officer for Operational Readiness Department. "The first time I was with 1st Battalion 5th Marines at Ar Ramadi in al-Anbar province, from February to August 2005. Things were pretty bad at the time. We took mortars and rockets almost daily. We had several large Vehicle Born Improvised Explosive Devices and lots of contact with the enemy. We were busy doing all we could. We lost 15 Marines and one great corpsman, HM2 Cesar "Cid" Baez. Cid was an inspiration to everyone that he served with." Baez, from Pomona, Calif., died as a result of enemy small arms fire while conducting combat operations. As was the case in wars past, medical advances were made under battlefield conditions that have enabled Navy hospital corpsmen like Sims to deal with the wounded as never before. Compiled BUMED statistics show that casualties today have a 90 percent and higher chance of surviving, a quantum leap even from the first Gulf War over a dozen years earlier. One medical advancement carried out during OIF was improving upon the personal protective body armor. "I saw up close body armor saving a life," Sims said. "We had one round stopped by it. The bullet almost went all the way through a protective plate on one of our Marine.
It didn't enter his body, but he did end up getting a huge bruise. We'll take that any day over the alternative." Self-applied Combat Application Tourniquets to stem blood loss were implemented during urban warfare and roadside bombing attacks. "The CAT tourniquets are a good fallback to help stop bleeding, especially for all Marines on patrol," said Sims, noting that there was also medical care advances made using new technology in surgery that help to prevent infection. Sims deployed again in 2008 to Al Asad with Naval Mobile Construction Battalion (NMCB) 17 and noticed improvement with treating the wounded and getting them out of harm's way. "We used to have undersized vehicles that a litter wouldn't fit into," said Sims. "When we got the Mine Resistant Ambush Protected (MRAP) armored vehicle, it was a vast improvement. A litter could fit inside with stable protection when transporting injured personnel." "Even with all the advanced technology that has been added, the number one asset we had in Iraq to save lives was our hospital corpsmen," Sims stressed. "It's the training that every corpsman goes through and knowing the basic ABCs (airway, breathing, circulation) for saving lives out there on patrol." Training and experience trumps all in caring for troops, yet the ability to provide medical assistance to Iraqi civilians was also vital to the success for many missions, commented HMC Emiliano Rabor. Rabor served as part of the Al Anbar Provincial Military Transition Team 2007-2008. "There were times we provided more medical care when on patrol than anything else. Medical care was considered a blessing where we were. We treated so many civilian cases. Showing compassion and care to the medical
needs of local Iraqis allowed us to gain some mutual respect and cultural understanding," said Rabor. "When I went back for the second time, there really was an improvement in the climate and the lives of the Iraqi people," recalled Sims, noting the difference between his initial and following tour. "It was a whole different world the second time around. I believe that the sacrifices made by all who have served in Iraq have meaning. We have all helped the Iraqi people by improving their quality of life and making sure that they don't live in a constant state of fear."
Towards the End - Hospital Corpsman Master Chief Tom Countryman's one-year deployment from 2010 through 2011 as command master chief at Expeditionary Medical Facility Kuwait covered a time when the drawdown of troops in Iraq went from 90,000 to 50,000. The war-time violence abated some but didn't completely diminish. "It didn't mean that our work load got any easier, and it didn't mean we just stopped doing what needed to be done. We continued to provide urgent and emergent expeditionary medicine and primary care, as well as combat force health sustainment. Those were our main missions," Countryman explained. EMF Kuwait served as a Level III hospital with top-notch resources for emergency room needs, surgery requirements, Intensive Care calls, clinical providers on call, and vital laboratory and blood bank concerns. "One of the goals I reminded our Sailors was to continue to get better than they were when they came here. My primary personal goal was the same as any other CMC that has ever been on deployment, and that was to take care of our troops and get every one of them home safely. That goes double for our patients,"
Currently - Hospital Corpsman 2nd Class (Fleet Marine Force) Andrew L. Chase brought back his experience to handle NHB's Tactical Combat Casualty Care (TCCC) training as program manager and lead instructor. "TCCC is the course that will help save lives on the battlefield. It's our duty to take what we know and share with our units in the field," said Chase Chase modified and enhanced the course to ensure than once hospital corpsmen are deployed with a Marine Corps unit, they are ready to handle first responder care for wounded on the field of battle and prevent loss of life. TCCC is now required within 90 days of members deploying. "The bottom line is that you fight like you train," Chase flatly stated. "Our training will have our deployers confidently and aggressively assess and treat our wounded brothers and sisters in Afghanistan and the world over." Chase brings knowledge gained the hard way - from the battlefields in Western Iraq to urban warfare in Baghdad. He deployed with Regimental Combat Team 1, 1st Marine Division from Dec. 2007 to Jan. 2009. He went originally to Fallujah, Iraq, but then found himself relocating from one hot spot to another. Along with running daily convoy ops with the Regimental Combat Team and working the Rear Area Security, he was a combat replacement for multiple Marine battalions carrying out standard operations that included mounted/dismounted patrols, and sweeping for Improvised Explosive Devices and weapon caches. He also got in a mission with a Navy SEAL team and spent a few months embedded with a Military Transition Team training the fledgling Iraqi Army. His duties included the battle of Sadr City to
helping track High Value Targets in Diyalah. He also trained several Iraqi doctors on treating combat trauma and the necessary clinical care afterwards, as well as six Iraqi Army medics. He finished up his time in Iraq working out of Ramadi. The support missions for OIF and OND are completed, but as is the case with the rest of BUMED, Naval Hospital Bremerton continues to support ongoing contingency operations. A total of 63 staff members have deployed in 2011, with approximately 25 currently serving in Afghanistan.
NHB Runners leg out year with 'Yukon Do It' Marathon
By Douglas H. Stutz, NHB Public Affairs
There were approximately 120 full marathoners and 300 half marathoners who ran the second annual Yukon Do It Marathon and Half Marathon on Dec 31. Along with 80-plus additional 5K runners, the 500 participants used the last day of 2011to close out the year with a picturesque run along a sizable stretch of Port Orchard's waterfront. "This is a fast and scenic course and is quickly becoming known for both in the running community," said Tony Seabolt, race director of Narrows Bridge Running Club/Route 16 Running and Walking, Gig Harbor. Organizers billed the run 'as a perfect opportunity to join other crazy runners for one last hoorah before the year ends.' Ninety percent of the race course afforded continuous views of the Olympic Mountains, Puget Sound Naval Shipyard, Seattle, and occasional glimpses through the clouds of Mount Rainier and the Cascades. Seabolt noted that the half marathon offered a personal record-type course with a negative elevation gain and almost all of it relatively flat. The course started at South Kitsap High School, wound down onto Beach Drive and continued on along the waterfront to Manchester State Park and back. Those who ran the full marathon continued on to Yukon Bay before retracing back. "Manchester State Park could not house any more than about 200 runners so we came to downtown (high school) due to parking. But also the course is a double out and back for the marathon because the Southworth bridge is under construction," explained Seabolt. As runners mingled and meandered before the start, one question that was posed and commented on was, "which came first, the full or half marathon?" Certainly the historical
relevance of the initial marathon that has expanded from being highlighted and commemorated in the modern Olympic Games to year-round weekend offerings lends credence to the notion that the marathon came first. But even back at the beginning, didn't the runner have to complete a half before finishing the full to deliver his message? The 26.2 mile marathon legend can be traced back to 490 BC to Marathon, the famous plain about 25 miles northeast of Athens, Greece. It was there that an Athenian force of about 11,000 under Miltiades prevailed in victory over 20,000 Persians. Miltiades then dispatched the runner Pheidippides to reach Athens as quickly as possible to report their victory in case Athens might surrender prematurely to the Persian fleet assuming their land army had already lost. On reaching Athens, Pheidippides delivered the message, collapsed and died. The current acceptable distance of the marathon waffled back and forth between the first Olympic games of Athens in 1896 of 24.85 miles and 26.56 in the Antwerp games of 1920, finally deciding on 26.2 from the London 1908 games. As much as the full marathon presents a challenging athletic event, so does undertaking the completion of the half marathon. The half doesn't have quite the mystical allure of the full, but Runner's World magazine attests that the half has grown in popularity so much that it has been the fastest growing race distance since 2003 in the U.S. According to Running USA, U.S. half-marathons have continued to increase in popularity, increasing from 1.1 million finishers in 2009 to nearly 1.4 million finishers in 2010, a record 24 percent annual increase. Complied statistics also show that there are more half marathons, such as the second
running this year of the Poulsbo full and half and the Yukon Do it, being added to run calendars every year. This year's recently held popular Seattle Marathon had 2,600 for the full and almost 7,500 for the half. The mileage distance of the half is a demanding length for many. But for the uninitiated, 13.1 isn't some numerical answer to a statistical problem, although it sometimes seems like it past the 10K almost half-way point on a hilly course (see Seattle Marathon); and 13.1 isn't an alliteration to some religious scripture tract, although it can certainly feel like it during specific portions of a challenging course (see Poulsbo Marathon); and 13.1 isn't some obscure radio station fading in and out on some remote FM frequency, although that fading in and out bit is relative to some (see Tacoma City Marathon). "Watching people finish and the satisfaction on their faces at their accomplishment is gratifying," said Seabolt, who also coordinated donations from participants for Backpacks for Kids in Port Orchard. The coordination and organization of all needed logistics, communications, and course details can if not overly difficult, at least time-consuming. "When you love running and the community, it's easy. There are a lot of details to cover to manage 500 runners, and hopefully next year, we double that," Seabolt said. "We're really hoping to make the Yukon Do It a marquee event for the city of Port Orchard and the community. Hopefully this will become a great event and raise a lot of awareness and money for local charities for years to come."
TCCC prepares NHB Corpsmen for Combat Environment
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Naval Hospital Bremerton (NHB) Staff Education and Training Department Sailors conducted a highly refined and improved Tactical Combat Casualty Care (TCCC) Nov. 14-18 at Naval Base Kitsap (NBK) Bangor Behavior Health and Education Center (BHEC). "We're giving deploying corpsmen training in treating traumatic injuries in a combat environment," said TCCC Instructor Hospital Corpsman 3rd Class (FMF) Bryan Thude. "They're being given tools to keep themselves and their patients safer." The TCCC instructors added elements of realism by attending a course in fabricating simulated improvised explosive devices (IED) at Joint Base Fort Lewis-McCord. "We went down to Fort Lewis for a day class in order to learn how to effectively and safely put together IED simulators," said Thude. "I think it adds to the realism and opens up the students eyes more." The weeklong training culminated in the 25 students running through a final course simulation that reflected a scenario which might play out in the battle space. "Now, we incorporate tactical maneuvers and IED simulators. We have new staff members who have returned from battle in Afghanistan who are instructing students on applying techniques learned doing the job while being forward deployed," said Hospital Corpsman 2nd Class (FMF) Andy Chase, TCCC lead instructor. "The instructors themselves have gone through more training. We've completed the Operational Expeditionary Medical Skills (OEMS) course. In addition, we implemented physical training throughout the course because as a corpsman, you have to be stronger than the ones you have to provide care for." "It's one of the best TCCC
courses I've been to," said Hospital Corpsman 3rd Class (FMF) Brian Brock. "This was more hands-on so you get idea about what you're doing instead of it being verbalized." During the final scenario, the TCCC instructors emphasized the importance of situational awareness in the battle space and the significance of maintaining communications with those around them. "We're really trying to teach the students to not only be tenacious but to understand that they have to endure all endeavors to keep that patient alive," said Chase. "I've never seen explosions at TCCC before which is good since they can really throw you off your game in combat. It's good for people who haven't been over there to get the idea. It was a good experience," said Brock. "Our goal with this training is to send our deploying corpsmen over into the battle space well prepared and confident in their skills," said Chase. By that measure, the NHB's TCCC instructors have been highly successful judging from the positive reactions of the students after completing the final simulation. "It's a very good course with seasoned instructors who know what they're talking about. I'm really impressed with how they put it together," said Chief Hospital Corpsman (SW) Gil Garcia who is anticipating his first deployment to Afghanistan with 1st Marine Division in early 2012. "This training will no doubt come into play with where I'm going and hopefully help me save lives."
Great American Smokeout at NHB
By MC1(SW) Charlemagne Obana, NHB Assistant Public Affairs
Naval Hospital Bremerton (NHB) Health Promotions staff and Substance Abuse Rehabilitation Program (SARP) team members joined forces to educate and encourage Sailors and civilians to quit smoking during the Great American Smokeout Nov. 17. "The theme this year is 'Walk Away For A Day' to try to spur people to just try it for a day to see that for 24 hours you can have success," said Patrick Graves, NHB's tobacco cessation facilitator. "How challenging would it be to quit for a lifetime?" The day started off with a celebration breakfast with recent inductees to the nicotine-free life dining and sharing their stories of dependence and their affirmations to quit. "I smoked my last cigarette on Apr. 2 and it put me on my knees," said Curt Jones, a retired Army sergeant 1st class who stopped smoking after 52 years with assistance from NHB's smoking cessation program. "I've felt better [since I quit]. I cough very seldom, my wheezing is pretty much gone, my tongue is no longer coated, but because I have emphysema, I'm still terribly short of breath." Following the breakfast, Graves met with a classroom of Outpatient Crisis Intervention Program (OCIP) students to educate them about the smoking cessation program at the hospital. Recently, SARP moved from Naval Base Kitsap (NBK) Bangor Behavior Health and Education Center (BHEC) to NHB's 7th floor which has given Graves more opportunities to educate Sailors about the tobacco cessation assistance provided by the hospital. "We've started to approach at each point we can intervene and educate people to let them know that tobacco addiction is something we want them to think about," said Graves.
"They need to be deliberate and intentional with their actions and choices that they make. Smoking is an unhealthy decision that may not affect them right now, but it will in the future. There is an addiction going on here and we can help you break that cycle." The team took to the halls of the hospital with a cart brimming with promotional items and rewards for health providers to share in the message of the healthy tobacco-free life. NHB Health Promotion Coordinator Janet Mano dressed as a six-foot tall cigarette butt and followed Graves around to family medicine, pediatrics, and OB/GYN to engage the hospital staff, patients, and visitors to encourage them to stop and to let the friends and family members they know who smoke to quit. "If you tried to quit smoking and you didn't have success, try again," said Graves. "Be honest with yourself about why you failed in the past and this time be more deliberate, intentional, and mindful in your approach to quitting. You will have a higher success rate. I beat this drum day in and day out." "I hope I never smoke again," said Jones. "I'm 62 now, and I want to live as long as I can. I'd like to live to see my grand children grow up."
City of Port Orchard Police Dept. reaches out to one of their own with NHB's help
By Douglas H. Stutz, NHB Public Affairs
When the City of Port Orchard Police Department needed quick help to find out how to contact one of their officers wounded from an Improvised Explosive Device in Afghanistan, they knew Naval Hospital Bremerton was the place to call. Staff Sergeant Robert McFann of the City of Port Orchard Police Department, and former Navy master-at-arms first class petty officer, sustained injuries at the end of October while supporting contingency operations on deployment in Afghanistan. "As soon as we found out he's been injured, we immediately set out to contact and let him know that we're here for him and that he has people caring. We're family," said Bill Schaibly, Community Police Officer and retired Navy master chief, who directly contacted NHB's Hospital Corpsman Master Chief Tom Countryman for assistance and guidance on how to locate and contact McFann. As soon as Countryman got the request, he passed it on to NHB's Patient Administration. Hospital Corpsman 1st Class Dana Jones, HM3 Angel Gilbert and Michael Hall used their knowledge to collectively provide the timely linkup to enable the department to get in touch with one of their own. Jones used her considerable knowhow as NHB's Fleet Liaison as well as a recent medical evacuation coordinator in Afghanistan to commence the tracking requirements. Jones knew to begin via Landstuhl Regional Medical Center in Germany, the conduit for all injured coming out of Afghanistan. "I know how the patient services there works and enough about the ins and outs of the command," explained Jones, who ended up contacting outpatient services at
LRMC and then finally locating the correct barracks where McFann was. "It's what we do. It really didn't seem like a difficult task for us because we know what to do. But it can be hard for those who don't really know where to start or who to contact." "That's why Jones and the rest are here. I just asked for their support and then stepped out the way to let them work their magic to help those in need," said Countryman. The injured officer was flown out of Afghanistan to Germany on Nov. 2, and the call from home was established a day later. "Try to put yourself in his place. Wounded, away from his shipmates, and in a hospital setting a long ways from home. It's nice to receive a long-distance call from home. We let him know we're tracking and he's on our radar," Schaibly said. "We sincerely appreciate all the help to help us track the movement in-theater of our officer, The staff at Naval Hospital Bremerton was extremely helpful," City of Port Orchard Chief of Police Alan L. Townsend said.
NHB CPOA recognized for Volunteer Work
By Douglas H. Stutz, NHB Public Affairs
Certificates of Appreciation were presented to nine members of Naval Hospital Bremerton Chief Petty Officer Association (CPOA) on Nov. 8 for their volunteer support of the recently held Veterans Stand down on Sept. 13. Kitsap County Commissioner Charlotte Garrido and Kitsap Veterans Assistance Program coordinator Leif Bentson presented the Certificates of Appreciation to Hospital Corpsman Senior Chief Michael Hess, Hospital Corpsman Chief Christopher Newcomber, HMC Ernesto Oliveros, HMC Neilrose Gervacio, HMC Julie Sanchez, HMC Gilbert Garcia, HMC Keith Davis, Information Systems Technician Jennifer Clem and Personnel Specialist Chief James McCormack. "One of my favorite words is 'volunteer.' We wanted to come to Naval Hospital Bremerton to thank those who helped out," Garrido said. "Our community wouldn't be anything without the commitment of such volunteers as we're recognizing here. Volunteers go above and beyond their regular work by donating time, service and heart to help out and make a difference. What they did was really invaluable to us here in Kitsap County." "Getting members of Chief Petty Officer Association involved is a sure way that any project will get done. That's what Navy Chiefs do; they get it done," commented Capt. Christopher Culp, Naval Hospital Bremerton Commanding Officer. The Fall 2011 Veterans Stand down was held at the Kitsap County Fairgrounds and provided several hundred veterans and family members a range of services and information, including free haircuts and groceries, clothes, financial help, housing, foreclosure information, Veterans Affairs health care
enrollment, legal counseling, and lunch. NHB's chiefs primarily took part in the preparation, setup, serving of the food service for the event. "This was a great opportunity for us to help support of local veterans. We did the prep work, feeding and tear down for lunch," said Davis. "I saw younger veterans and family members and veterans from the Vietnam era. I also got to meet with one of our World War II veterans who was at the battle for Okinawa. Getting to talk with him was the highlight of my time," Davis said. "Volunteering to help is just the right thing to do. We're a service organization. It's our duty to help others. The veterans there are who we're going to be. It's up to us to help take care of them," explained Newcomer. "We are proud of the many veterans we have in our county and we also know that all of them do not have an easy life. The stand-down gave those in need the access to many helpful services," said Garrido. Kitsap County Commissioner Charlotte Garrido is the chair of the Kitsap Board of County Commissioners, where she and the two other commissioners oversee several county departments and the county's $300 million dollar budget. Leif Bentsen is the coordinator for Kitsap County Veterans Assistance Program. Leif is also a veteran, having served in the Army from 1965 through 1968, including 13 months in-country in Vietnam.
A Veterans Day Legacy - Gone but Never Forgotten
By Douglas H. Stutz, NHB Public Affairs
Veterans Day this year falls on a unique numerical twist of time in our history; 11-11-11. That's an aggregate trio, hat trick, and three-pointer all of the same. Unfortunately, one of our local veterans, William Frampton Ballinger, didn't make it to 11-11-11. It wasn't without trying, as he did in most things. Ballinger is one of many American veterans who made 11-11-11 the symbolic date what it is - a date set aside to honor and remember those who gave their all, and then some, for their country in time or war. Ballinger was 85 when he passed away. I didn't really know him, but I knew of him and others like him; men (and women) who had fought and survived through the Second World War, the Korean War and the Vietnam War. Those three wars gave Ballinger his own trio, hat trick, and three-pointer of a sort that is a woven part of our nation's military history during those trying times. His obituary reads like a primer of our country's involvement in deadly engagements scattered across the globe. Ballinger participated in five beachhead landings in 1944 onto the Philippine Archipelago during the Pacific Campaign of WWII. He helped liberate those islands, charged with carrying out forward observer duties for artillery. When the Korean War broke out in 1950, Ballinger was back. He took part in the Inchon Landing, evaded capture by Chinese Communist forces and even found himself swept away down the freezing waters of the Yalu River, all while serving again as a forward observer. The 1960s took him from the frozen Korean Peninsula to Can Tho, in South Vietnam's Mekong Delta. He was again back in the thick of it, operating a communications center with the Signal
Corps during the Tet Offensive of 1968. Ballinger wore the cloth of our nation in a career that spanned four decades. Those of us following stand on his shoulders, as well as those of the many other veterans living in Kitsap-area communities. Like a number of others, Ballinger chose to reside and retire in one of those communities. Yet there were many who didn't return. According to the National Archive, 38 Kitsap residents died during the Vietnam War, 15 were lost in the Korean War, and WWII took the lives of 218 residents. During his final week, surrounded by family and attentive staff of the Naval Hospital Bremerton's Intensive Care Unit, he even found time to meet and greet a visiting group of Seattle Seahawk Sea Gals. He and his family had been following the team's fortunes since 1979. If anything, the cheerleaders came away from the impromptu meeting more moved than Ballinger, who was visibly touched by their surprise showing. Being able to spend some time, share a smile, and take images with the ailing combat veteran made their collective day. "The caring, compassion and dignity by all the entire staff at Naval Hospital to Bill was very special to us," said Alvina, married to Bill for approximately 58 years. In 1918, on the eleventh hour of the eleventh day in the eleventh month, America joined in with other countries to celebrate the signing of an armistice to end of the First World War. That date a year later became Armistice Day in the U.S. to remember those who fought and sacrificed during the four long years of WWI. In 1954 the day became formally known as Veterans Day, the annual remembrance for America to honor approximately 25 million citizen-Soldier, Sailor, Airmen and Marine.
Ballinger was born on Feb. 17, 1926 and died on Oct. 30, 2011. Up until the end, his honor, courage and commitment continued to be evident to all, traits that are really the epitome of 11-11-11. Which is why we remember.
Designed and Coded by IT2(AW) Robert M. Stepp, Naval Hospital Bremerton Information Management Department
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