Appalachian Regional Healthcare Performs First Same-Day-Home Hip Replacement in the ARH System

This month, Hazard ARH Regional Medical Center successfully executed the first same-day-home hip replacement performed in the ARH system.

Traditional hip replacement surgeries involve making a sizeable incision along the patient’s hip, up to ten inches, in order to replace a painful hip joint. Same-day-home hip replacement is a similar procedure but performed through a much smaller incision. The surgeon also avoids cutting or detaching any muscles during the procedure, resulting in less tissue injury, less blood loss, and a faster return to everyday activity.

Dr. Ryan Shephard, the ARH orthopedic surgeon who performed the procedure, says that not every patient is suited to same-day-home hip replacement. Ensuring that the patient has adequate care once they’re home recovering and providing extensive patient education before the procedure are just some of the vital prerequisites.

Hazard ARH Regional Medical Center is proud to offer this minimally invasive surgical technique for hip replacement patients who meet the criteria


Above article was published November 7, 2019 – Special To The Hazard Herald

Nicole Vanhoose: Putting everything together to go from CNA to RN

Hundreds of patients have been cared for by Nicole Vanhoose, a registered nurse (RN) in Hazard ARH Regional Medical Center’s Oncology Medical Surgical unit. Nonetheless, there is one individual she remembers with perfect clarity.

“He had leukemia,” she said. “He was going to be an in-patient, stuck inside the hospital for at least a month. After a couple of weeks, he was going stir-crazy. I knew I had to do something to help him cope, which in turn would allow him to heal and respond to the treatment.”

Part of the reason she remembers this particular patient so well is because he was emblematic of most patients from eastern Kentucky. “Like so many others who live in this area, he needed to see the mountains and to breathe fresh air. He was basically alone and staring at the walls. Time was dragging. When you get a diagnosis like leukemia, your world is suddenly turned upside down. One minute you’re thinking about getting someone to soccer practice and suddenly all that falls away and you are totally focused on your health. Most of the time you need treatment immediately, but just because you have to stop everything doesn’t mean everyone around you needs to stop everything too. Oftentimes, someone still needs to get to soccer. I knew his family couldn’t stay or even visit him during that month of treatment. He was sick, alone, and without fresh air.”

So Vanhoose, who has worked as an RN for ARH for over 11 years, began problem solving how she might get this patient some fresh air. “Windows weren’t enough,” she said, “so IV poles and tubes were packed up and off we went. I rolled him outdoors every day after that. When he could look up and see the sky and feel the air on his face, it was magic. I like to think that was almost as beneficial as the cancer treatments.”

“He came back to the unit just recently. He’s doing fine and is cancer-free. It was a great feeling for all of us,” she continued, referring to her teammates who deal with cancer diagnoses every day. “It’s not an easy unit. Oftentimes you are the last person they see as they take their last breath. It’s important work. I left once and worked rehabilitation in home health, but I knew this was where I was supposed to be and I came back pretty quickly.”

Vanhoose is currently the nurse manager in charge of the oncology unit where she works. She says it is very important that everyone on her team feels like family. “I grew up here. This is where I became who I am and it was because of an incredible nurse manager who mentored me. I love the fact that I now have her job and am able to pay it forward, just as she did.”

Neither of Vanhoose’s parents had the privilege of graduating high school, so when she earned her diploma from Knott Central High School, she had her eye on being the first to go to college. “I knew I wanted to go into nursing because we had cared for my grandmother after she was diagnosed with Alzheimer’s. She was bed-bound and then she fell and broke her hip. Soon it was hospice, but I remember what a difference excellent nursing care made to my grandmother, during that last period in her life.”

Vanhoose may have known all along that she wanted to be a nurse, but she never imagined the path she would take to make that dream a reality. “Because of a low ACT score, I didn’t get accepted into the nursing program at Hazard Community & Technical College. I was pretty discouraged,” she said. “But I had completed everything I needed for my Certified Nurse Assistant (CNA) training while in high school, so I thought I’d work hard and figure out next steps.” While figuring the next step, she never took her eyes off her dream.

Vanhoose began her career at Hazard ARH Regional Medical Center as a CNA. “I did what I had to do to get into school to become a Licensed Practical Nurse (LPN). I completed that training and worked at ARH for five years as an LPN. Even though I wasn’t where I wanted to eventually be, I was still caring for patients and I was learning all along the way.”

While working as an LPN, Vanhoose was accepted into an RN program and realized her dream of becoming a registered nurse. But she didn’t stop there.

“I have always prized education. I’m a life-long learner and ARH has made it possible for me to work, support my family, and pursue my dreams,” she said. In July, Vanhoose will secure her Bachelor of Science in Nursing (BSN) degree from Chamberlain College and will have officially gone from starting as a CNA to becoming a BSN.

Vanhoose is grateful for all the obstacles she has had to overcome. “I have two children and I hope I am modeling for them how to take a situation that may be initially discouraging and turn it around into something positive. I want them to know and believe that you can do anything if you really want to.”

Vanhoose also knows the already difficult route to her dream of being a BSN would have been much more difficult without the support of her employer, Appalachian Regional Healthcare (ARH). “They worked with me every step of the way,” she said. “Especially my manager, who would accommodate my schedule and figure out ways I could go to school and still work full- time. “For a long time, I went to school Monday through Thursday and then I’d work the weekends. If a test came up at a difficult time, she would work it out for me.”

Today, as one of the nursing leaders at Hazard ARH, Vanhoose is making a difference in the lives of those who now work on her team. “I want to them to know that I understand,” she said. “I never stop talking about the student loan repayment program that pays $300 a month to students pursuing higher education in healthcare. I explain that we have a Nurse Extern program that pays $10 an hour and you can work just about any time you want. It also provides excellent training to go along with what is being taught in school. You can find a mentor. ARH has a scholarship program in addition to student loan repayment. If you want an education beyond high school, you can have it here.”

In addition to setting an extraordinary example for her children, Vanhoose also wants everyone on her team to know they have a champion in her. “I am visible, with an open door policy,” she explained. “I want to know what you want and what you need. Even if it isn’t more education, I want to know how I can make it better for you and in turn, I know each individual will deliver better patient care. It’s a family atmosphere and everyone pitches in. If I need to be here on a weekend, then I’ll be here, but so will my team.”

It is not surprising that Vanhoose’s team maintains one of the highest staff retention rates in all of ARH’s 13 facilities.

People often ask why Vanhoose felt the need to gain more education after attaining her goal of becoming an RN, but she says that is a no-brainer. “Finishing my college degree absolutely allowed me to put all the pieces of my personal puzzle together. It has finished me, in a good way.”

One class assignment really stands out in her mind, illustrating why education is of such value. “I knew I could go in and take a health assessment. I had years of experience. I was pretty cocky actually, but my professor made me take a video of me taking the assessment and then had me look and find what I could improve. It was so eye opening, because I could improve on just about everything. It wasn’t that I took a poor assessment, but today I take much better ones!”

Vanhoose doesn’t talk about her personal next steps, other than thinking about taking her children to Washington DC for an educational trip and helping Hazard ARH’s oncology department be the best place to work in the system. “I have all the tools I need to make a difference in the lives of my team, my children, and my patients. I’m settled,” she said. “And, I always have the opportunity to go out and see the mountains and feel the air on my face.”


Above article was published November 7, 2019 – Special To The Hazard Herald