Choosing a proxy, formula shortage and celebrating nurses: Seacoast health news
Who do You Trust with Your Life? Who Trusts You with Theirs?
PORTSMOUTH — Choosing a medical power of attorney, also called a proxy, may be one of the most important decisions you’ll ever make. Your proxy is the person who speaks for you when you are unable to speak for yourself. On June 8 from 6:30 to 8 p.m., you can learn about this often misunderstood role in “Who Do You Trust with Your Life? Who Trusts You with Theirs?”
This workshop is Part 2 of the series “Talking About Death Won’t Kill You... And May Help You Live More Joyfully,” the online and in-person series sponsored by the NH Alliance for End of Life Options, Brookhaven Hospice of NH, and the Portsmouth Public Library. It is offered via Zoom and in person at the library. Free and open to all.
This workshop focuses on choosing a health care proxy for ourselves and what is means to be a proxy for others.
Choosing the right proxy is part of completing your advance directive, the legal document spelling out your medical preferences if you are incapacitated. Because we can never imagine all of the scenarios that may befall us, it may be up to our proxy to interpret what we want. You’re entrusting that person to represent you and your wishes, whether or not they agree with them. You’re trusting their ability and willingness to do so, in what can be a high pressure, confusing, emotionally charged environment.
Yet, only about a third of Americans have completed advance directives, meaning they have not named a health care proxy. Others who have an advance directive haven't had good conversations with their proxy and other loved ones about their desires. When the unexpected happens, no one is really prepared. “Who Do You Trust with Your Life? And Who Trusts You with Theirs?”” will help you understand the roles and responsibilities more fully. You’re encouraged to bring your proxy or someone else close to you to the conversation.
Through facilitated discussion in large and small groups we’ll think about the kinds of treatments we may or may not want, considering questions like quality of life versus longevity, what gives us joy, our concerns and our aspirations, and what we might compromise, or not. These same considerations are what we need to know for anyone for whom we are a proxy.
A four-part series, “Talking About Death Won’t Kill You . . .and May Help You Live More Joyfully” covers the profound to the practical, helping demystify and normalize conversations about mortality, death, and what matters most in our lives.
Part 1, “How to Live Forever,” May 25, from 6:30 to 8 p.m. This session offers the opportunity to dig deeper. It’s a way to practice having the conversations with no pressure, judgment, or expectations – and maybe even laugh a little!
Registration is required. Register for online or in person at Portsmouth Public Library, through their website: cityofportsmouth.com/library/death. You may also register by calling the NH Alliance for End of Life Options at 603-728-5557.
This series is supported with a grant from the NH Charitable Foundation. Parts 3 and 4 will be offered in the fall.
Amid U.S. baby formula shortage, Dartmouth Health Children’s pediatricians offer guidance for keeping babies safe, healthy and fed
LEBANON – The United States has experienced a shortage in baby formula for months. Supply chain challenges created by the COVID-19 pandemic were the first major impact on formula manufacturing. A formula recall and related shutdown of a production facility in February have made it even harder for families to access their regular brand—causing them to scramble between in-person and online searches.
This situation is frustrating and scary for many families. Pediatricians with Dartmouth Health Children’s want parents to be empowered with knowledge on how to keep their babies healthy and fed during this crisis. One of the most important things to know is that other brands of formula than what a family usually purchases are perfectly safe and suitable, including generic store brands, says Susanne E. Tanski, MD, MPH, section chief of Pediatrics at Dartmouth Health Children’s. If a specialized prescription formula is needed, your pediatrician can help with obtaining it.
“Nearly all store brands are manufactured by the same company and just labeled for the individual store,” Tanski said. “So any of the store brands are identical and interchangeable by type, for example, by regular, gentle, soy, sensitive or hypoallergenic. The quality and safety standards are strict, so these are safe and comparable to the brand name versions.”
It’s also critical during shortages to resist the urge to hoard formula. The American Academy of Pediatrics recommends purchasing only a 10-14-day supply to lessen demand, and several major retailers already have quantity limits in place. On the same token, “stretching” your supply by adding extra water to the formula, or making your own formula at home, can be dangerous to your baby, says Erik M. Shessler, MD, associate medical director for Dartmouth Health Children’s and chapter president of the New Hampshire Pediatric Society.
“The biggest risk for infants would likely be if families were to dilute the formula they have, which could lead to potentially dangerous salt level imbalances or poor growth,” Shessler says. “Families should also avoid switching to a non-Food and Drug Administration (FDA)-approved brand or using homemade formulas, which have an increased risk for contamination and inappropriate ingredients.”
Dartmouth Health Children’s also recommends the following tips until the formula shortage is resolved:
Follow the “use by” date on formula containers.
Only use infant formula for babies younger than 1 year instead of toddler formula or plant-based milks.
Avoid purchasing formula from international sources (which do not meet FDA standards).
Contact your pediatrician for support anytime you feel you need it.
Five Dartmouth Health nurses win Excellence in Nursing Awards
LEBANON – As the nation celebrates National Nurses Month in May, five nurses employed by Dartmouth Health have been honored for their work with Excellence in Nursing Awards from New Hampshire Magazine and the New Hampshire Nurses Association. These peer-nominated awards recognize the state’s best nurses in 13 categories—those who go above and beyond to comfort, heal and educate.
Dartmouth Health winners, by award category, are:
Advanced Practice Nursing: Sandra J. McDonald, MSN, APRN, Dartmouth Hitchcock Medical Center (DHMC)
Front Line Nursing Leader: Ivy M. Park, BSN, RN, MEDSURG-BC, OCN, DHMC
Pediatric Nursing: Jennifer A. Orbeso, DNP, RN, DHMC
Psychiatric and Mental Health Nursing: Christina M. Favero, RN, DHMC
Senior Nursing Leader: Amy W. Matthews, DNP, RN, CENP, Cheshire Medical Center
Award winners will be featured in the June edition of New Hampshire Magazine and celebrated during the face-to-face 2022 Excellence in Nursing Awards Reception in Manchester, N.H., as part of National Nurses Month. DHMC and Clinics Chief Nursing Officer, Karen F. Clements, BSN, MSB, MHCDS, RN, FACHE, is the keynote speaker for the event.
“DHMC nurses are truly extraordinary. I am very proud to see four of our nurses receive this professional recognition from their peers,” said Clements. “To have so many award winners after such a challenging year is a testament to the exceptionally high caliber of nursing professionals in our organization.”
“At Cheshire, Amy has been key in messaging the transition to a regional referral center for nursing,” said Cheshire’s CEO and President Don Caruso, MD, MPH. “She has clearly enabled the common vision and communicated it. As a result, we are meeting our goal of taking patients from outside our primary and secondary catchment areas. This is happening with an engaged nursing staff.”
Sandra J. McDonald, MSN, APRN, of Contoocook, N.H., is recognized for excellence in advanced practice nursing. As the team lead for Neurocritical Care advanced practice providers at DHMC in Lebanon, McDonald advocates for advancement in the workplace and lifts up her colleagues through her positive attitude and leadership by example. McDonald is actively involved in DHMC’s Advanced Practice Provider fellowship program, providing didactic and clinical opportunities to critical care APP fellows and mentorship to Neurology APP fellows.
“We take care of people with complex neurological diseases and I find that incredibly interesting. But what gives me the greatest joy is the people: the patients, their families and friends, and my colleagues. We are given the honor of caring for people in their most vulnerable state and personalizing that for each patient is very important to me,” said McDonald.
Ivy M. Park, BSN, RN, MEDSURG-BC, OCN, of Enfield, N.H., is recognized for front line nursing leadership. Park is the Unit Nurse Manager for 1 West, Hematology Oncology Inpatient Unit, part of Dartmouth Cancer Center’s Norris Cotton Cancer Center Pavilion in Lebanon.
“I do this work because it’s an opportunity to make a difference in somebody's life. Our patients are motivated and passionate about healing and often have a renewed outlook on life. We save lives every day and I love the feeling of partnership that emerges with our patients. I think the compassionate part of being an oncology nurse is passed on from generation to generation. Whomever comes to 1 West will get excellent, compassionate care. We receive great feedback about our care from traveling nurses and ancillary staff who come to our floor. I am so lucky to be part of this team,” says Park.
Jennifer A. Orbeso, DNP, RN, of Lebanon, N.H., is recognized for excellence in pediatric nursing. Orbeso is a clinical nurse in the Neonatal Intensive Care Unit (NICU) at the Children’s Hospital at Dartmouth Hitchcock Medical Center and the nursing diversity and inclusion specialist in the Office of Nursing Support. As a clinical nurse she is an advocate of primary nursing, which allows the nurse to care for infants and their families in an extended period of time while they are hospitalized. As the nursing diversity and inclusion specialist in the Office of Nursing Support, Orbeso works in partnership with different stakeholders to ensure diversity, equity, inclusion and belonging (DEIB) in DHMC and Clinic’s workforce.
“The biggest misconception about my role as a Clinical Nurse is that working with neonates primarily involves changing diapers. I can tell you, there’s so much happening during developmental diapering. It is a time where you cultivate trust, where you address neonatal pain and discomfort and much, much, more. In DEIB, I want people to know that it is not enough to articulate diversity and inclusion, my job as a specialist is to make sure there is a tangible understanding of the staff’s value and to demonstrate it in our policy and priority programs,” says Orbeso.
Christina M. Favero, RN, of North Walpole, N.H., is recognized for excellence in psychiatric and mental health nursing. As a clinical nurse in the Emergency Department, Favero cares for high acuity psychiatric patients by providing crisis intervention for patients with suicidal ideation, anxiety, depression, substance use disorders, and other mental health diagnoses and conditions.
“I am most proud of the ability to use humor and therapeutic listening when working with patients. This facilitates trust and empowers patients to actively participate in their own care through self-efficacy and accountability,” said Favero.
Amy W. Matthews, DNP, RN, CENP, of Peterborough, N.H., serves as chief nursing officer and vice president of Patient Care Services at Dartmouth Health member Cheshire Medical Center in Keene. She has been a registered nurse since 1985 and joined the Cheshire nursing staff in 2000. She currently serves on the executive team, and provides nursing leadership at Cheshire. She's passionate about keeping health care local and being actively engaged in the community. Matthews also serves on the New Hampshire Nurses Association and the Monadnock United Way Boards of Directors.
“I am grateful to serve a team striving for excellence that is characterized by compassion, respect and the best possible outcomes for our patients, our communities and each other,” said Matthews.
To learn more about the Excellence in Nursing Awards visit www.nhmagazine.com/excellence-in-nursing.
This article originally appeared on Portsmouth Herald: Choosing a proxy, formula shortage and celebrating nurses: Seacoast health news
