Harlan ARH Hospital Nurse Extern Program offers answers, experience

Photos submitted Amber Howard is currently participating in the Nurse Extern Program at Harlan ARH Hospital, working in med/surg.

Photos submitted Amber Howard is currently participating in the Nurse Extern Program at Harlan ARH Hospital, working in med/surg.

Participating in the Nurse Extern Program at Harlan ARH Hospital, Haley Cook is gaining experience in the emergency room.

Haley Cook and Amber Howard are well on their way to becoming extraordinary nurses at Harlan ARH Hospital, but one of the more critical factors leading to their success was a little surprising — being selected to participate in Appalachian Regional Healthcare’s (ARH) Nurse Extern Program.“I started as a nurse extern in December and by the time I got back to college for the next semester in January, I was a changed person,” said Cook who is a senior at Lindsey Wilson College in Columbia. “I originally thought the medical professionals at the hospital might not take me seriously. I thought of myself as a kid, but it was so different. The nurses were so helpful and kind and the doctors took the time to explain complicated medical procedures to me. I can’t really explain it, but when I got back to Lindsey Wilson I was able to better grasp the information. I felt more confident and everything became more focused and relevant.”Howard agrees the Nurse Extern Program was a cornerstone in her professional development. “It was such a big difference in mastering time management skills and experiencing real life medical challenges. I was more confident because everyone helped me grow and made it clear they had my back.” Howard is currently preparing to “take the biggest test of my life,” the NCLEX exam, which is the final step to becoming a Registered Nurse (RN). She graduated in May from Union College in Barbourville, with a Bachelor’s Degree in Nursing (BSN) and is already working at Harlan ARH Hospital as a nurse with a provisional license. The Kentucky Board of Nursing grants provisional licenses once a nursing student successfully completes all requirements to sit for the exam. With that license, they must work under the direct supervision of a RN.“I always knew I wanted to be a nurse and I always knew I wanted to go to Union College so that part was easy, but when I learned about the Nurse Extern Program with ARH, all the parts of my professional development were complete,” Howard said. Through the ARH Nurse Extern Program, students are provided a job, plus the ability to apply for scholarships covering tuition, books, lab fees and daily living costs. “They make it possible for you to focus on becoming the best nurse you can be,” said Howard.

“I love being at a smaller hospital where I get to experience so many different things,” said Howard. “I knew everyone and everyone knew me since I was from the area. I wasn’t just a student. People would come to me for help and I always knew I could go to others for help. You are never left alone.”

Howard, who loves the outdoors and played on the Union College tennis team, originally thought she wanted to go into obstetrics and gynecology but after her hands-on learning experience at Harlan ARH, she knew she wanted to pursue medical-surgical and pediatrics. “I fell in love with med/surg and it put me on the right path.”

Howard works three 12-hour shifts for three days and is off four days. “It’s really effective,” she explained, “because with med/surg you get to know your patients better because you are with them for three days. The first day you get acquainted and then it’s usually very smooth care. Of course you have some admissions and discharges, but the continuity makes for superior nursing care.”

Cook, on the other hand, is loving her time in the Emergency Room (ER). “It’s fast-paced and certainly keeps you on your toes,” she explained. “I’ve seen a lot. I’ll start 10 to 20 IVs each day and I’m getting so much hands-on experience. I inserted an NG tube (nasogastric tube) the other day. I had only practiced it on a mannequin used in the classroom so this was different. The nurses watching me kept telling me I had it and I believed them. A smaller hospital provides you with so much more hands on experience.”

Starting IVs and NG tubes has been only part of Cook’s experience in the ER. “On my second day, this woman was transported by ambulance to the ER. I got to run and get blood for the patient and witness everyone working as a team to get her stable and ready for helicopter transport to Lexington. My heart was racing and I knew I was in the right place professionally.”

Even though Cook had won a scholarship from Lindsey Wilson, the Nurse Extern Program at Harlan ARH provided additional money toward her education. “You are paid to work as a Nurse Extern so that is helpful,” she said, “and then you have the opportunity for more scholarships. Some of the nurse externs even got free scrubs. Everything adds up.”

The extra scholarship money will come in handy for Cook since she is planning on becoming a nurse practitioner, which will require two additional full-time years in a master’s program. “I can do a lot of the work online,” she said, “but Harlan has been so wonderful about working around my classroom demands. Lindsey Wilson is a three-hour drive from here so I plan on coming home two weekends a month to work the 36 hours and get all kinds of hands-on experience.”

Both Cook and Howard agree they are willing to drive the extra miles to work at Harlan ARH, which they both hope to do after graduation and passing the NCLEX exam. “I’d rather drive the extra 20 to 30 minutes to be somewhere I want to be,” said Cook while Howard nodded her head in agreement.

“Harlan is such a wonderful community and the Nurse Extern Program is the total package,” Howard said. “Give it a thought. You get a job working in your field gaining experience; you have mentors who guide and teach you; you can apply for ARH scholarships, and they are flexible about when you work so you don’t have to compromise study time.”

Harlan ARH Chief Nursing Officer Dee Hughes agrees. “I love the Nurse Extern Program,” she said. “I am part of the effort to create the nursing leaders of tomorrow. I love seeing them work and grow into outstanding professionals. They keep me young with their dreams and hard work. I go to as many of the colleges as I can to encourage nursing students to apply for the program. We want to help them be outstanding nurses who are well trained to take care of our community.”

ARH Stories: Eva “Dee” Hughes

Eva “Dee” Hughes, Community Chief Nursing Officer, Harlan ARH, discusses how ARH employees, “put caring and compassion into practice” both at work and in the community, working as “One Family” dedicated to helping others.

ARH Stories: Alice Lucas

Alice Lucas, Director of Radiology, Whitesburg ARH, discusses how ARH has helped her and her loved ones take the “One Family” promise to a new level.

ARH Stories: Mary Downey

A story of going above and beyond as an ARH nurse from our System Service Excellence Manager.

Tug Valley ARH Nurse Extern Program Offers Answers, Experience

Though Tennisa Pack and Jessica Alfrey both earned their Associate’s degrees in nursing from Southern West Virginia Community and Technical College after following very different paths, they are alike when it comes to how much the Nurse Extern Program at Tug Valley ARH Regional Medical Center helped in their pursuit to becoming registered nurses (RNs). Ironically, after completing their studies, they both landed in the same Intensive Care Unit (ICU) at the hospital, providing highly skilled treatment to some of the most challenging patients.

Alfrey went to Southern directly from high school and knows that she eventually wants to become a Certified Registered Nurse Anesthetists (CRNA). Needless to say, she was thrilled when she was selected to work in the ICU at Tug Valley ARH Regional Medical Center after nabbing one of the hospital’s Nurse Extern slots. “To get into school working toward your CRNA you must have at least two years of critical care experience,” said Alfrey. “A lot of recent graduates aren’t able to be placed in the ICU right out of school, but after my Nurse Extern program experience, I had the basics and am now working in ICU.”

Pack, on the other hand, views her recent completed studies and upcoming sitting for the NCLEX exam, which is the last step in obtaining her RN licensure from the State Board of Nursing, as a long-held dream. “I always knew I wanted to be a nurse,” she said. “I watched my parents take care of their parents. I was probably seven-years-old when my grandmother moved in with us and maybe 13 or 14 when my grandfather began showing signs of Alzheimer’s. My parents showed them such respect that I knew I wanted to do this for others.”

“I became a licensed practical nurse (LPN) in 2001 and worked in a nursing home when my children were young and needed me, so I didn’t get my RN degree then,” she explained. “The children don’t need me as much now because they are 24, 22 and 12. I started my pursuit to becoming an RN in 2015 and completed it in 2017.” Along the way she never lost her nurturing tendencies and was voted “Most Caring” by the other students in her class at Southern.

In January, Pack and Alfrey began as Nurse Externs and, according to both, the experience allowed them to bring everything they were studying into focus. “I’m a very hands on learner,” said Alfrey. “I can read a book front to back and still not know how to do something, but show me or let me do it and I’ve got it. Having the Nurse Extern experience really helped me apply my studies to real life. I can’t say enough about all the nurses and other professionals in the ICU as they always had time to explain anything to me.”

Pack agrees about the help provided in the ICU. “They never seemed rushed or unwilling to take the time with me,” she said. “I could ask them anything!” Pack also feels that being a Nurse Extern in a smaller hospital broadens the experience. “You work with everyone in the hospital and every type of medical discipline. It’s very hands-on. In some of the bigger hospitals, the Nurse Externs just get to observe, but here you are expected and allowed to participate.”

Alfrey says that being a Nurse Extern brings a number of perks. “First, they pay you for the hours you work even though you are learning. I have been able to save most of that money and it will go toward my tuition to complete my BSN and CRNA. I know they are offering scholarships for employees and the children of employees to further their education so I’ll be applying for that too because I am now a RN at the hospital. But most of all, being a Nurse Extern gave me real experience. I wasn’t sure I wanted to be a nurse until my senior year in high school, but this experience completely confirmed my decision. I remember my first ‘code’ (cardiopulmonary arrest), I was applying chest compressions and it was quite the adrenal rush.”

Another thing both newly-minted RNs agree on is the fact that the Chief Nursing Officer, Paula Vaughan, not only knows everyone’s name, but also demonstrates unfailing encouragement. “I never saw her when she didn’t have a smile on her face,” said Alfrey. “She would greet us and encourage us to be our best every day.”

Pack notes that Vaughan is just one of the many reasons she enjoys her work in the ICU at Tug Valley ARH Regional Medical Center. “She is so supportive, but then so is everyone. We are a team caring for the community. I am honored to do this work.”

Vaughan feels that today’s nursing students are some of the best she has seen in her long career. “I’m just so proud of every one of our Nurse Externs, Vaughn said. “They really are the cream of the crop. I already have applicants for the next class and the quality is extraordinary. I love seeing them walk through the door on their first day. It’s great knowing when we hire them full-time we will have the next group of leaders ready for the challenges of providing great medical care.”

The Heart of ARH Patient Care

A variety of new programs are being implemented for frontline nurses at the 11 Appalachian Regional Healthcare (ARH) hospitals to enhance the level of patient care.

“Nurses are the heart of patient care and we want to make sure they have every tool at their disposal to deliver the best possible care,” said Joe Grossman, president and CEO of ARH, about the new initiatives.

“It starts as a dual endeavor,” said Dee Hughes, community chief nursing officer (CCNO) at Harlan ARH Hospital.

“Nurses are the largest employee group as being on the frontline, so they know what is going on first hand. We want to communicate from a leadership point of view, but we also want to hear what they have to say. We are working on improving communication and while it might seem like it should come from the top down, it’s really from the top and around because the key to good communication is providing information awhile listening to our nurses and their experiences.”

Hughes notes that Harlan ARH has always been extremely community focused, but she says things have changed in the area, forcing the healthcare system to view how patients receive care and make adjustments to better serve the community. Loss of jobs, drug addiction and more screening as part of the Affordable Care Act is just the beginning.

According to Hughes, there are a number of initiatives being rolled out system-wide that are reshaping the way care is given. This includes employee training, evaluating the best way to staff and retain top employees, a multi-pronged rewards program, improved communication and solid leadership.

CLICK HERE to read more the full story at HarlanDaily.com. 

Scholarship program announced to attract more doctors to Eastern Kentucky

A Medicaid managed-care provider will donate $180,000 to fund up to 30 scholarships aimed at getting more doctors and nurses to Eastern Kentucky.

WellCare of Kentucky announced the program Monday in Hazard.

The scholarships will be aimed at increasing the number of doctors and nurses in primary care and psychiatry, according to a news release.

CLICK HERE to read more about the scholarship program at Kentucky.com.

Two ARH Hospitals Honored with Hurst Gold Standard of Nursing Awards

Whitesburg ARH Hospital and Tug Valley ARH Regional Medical Center awarded the Hurst Gold Standard of Nursing by Hurst Review Services.

A Family Tradition: 80 Years Experience in One Hospital

Tug Valley ARH Regional Medical Center’s Martin family are featured on EKBTV their nearly 80 years of combined experience at one hospital.

Nursing: The Challenges Are Worth The Rewards

Carolyn Jones’s day as an RN starts with a 20-30 minute drive from her Perry County home to Hazard ARH Regional Medical Center. Her commute allows her to view the beautiful scenery and mountains that are so much a part of the personality of her community. “It’s not a bad commute,” she says. “I enjoy the time.”

But when she gets to work it’s non-stop. “I’m pretty much on my feet all day, except for when I‘m charting or doing orders. Nursing is a physical job, but it’s also so rewarding. I like helping people,” says Jones, who works 12-hour shifts rotating from a three to four-day work week every other week. “The longer hours have worked well over the years since her husband works the night shift at Hazard Community and Technical College allowing him to care for their 14-year old daughter, the youngest of their three children, while Carolyn works.

“My boys are now grown and married, but my 14-year-old daughter is into everything—soccer, cheerleading, scholastic goals. It takes both of us.” “But the different shifts and ARH’s ability to support me has allowed me to steadily improve my skills and position. Everyone who wants opportunity to grow can do it at ARH.”

When Jones started her career at ARH she was a certified nursing assistant (CNA). In five years she moved into a nursing clerk position, and soon found herself going full-time for her RN licensure. “That was a very challenging time because I had two boys in high school, a younger daughter. I was working full time and going to school full time. I just kept telling myself ‘it can be done’ and we got it accomplished.”

Jones says her time as a CNA gave her an advantage over many of her younger classmates because she went in knowing the basics very well. Her work as a nursing clerk gave her needed insight into procedures, paperwork and how units run. “I just had to put it all together, once I started learning the more skilled aspects of nursing in school.”

She notes she had mentors from work while she went to school, and that allowed her to “learn more quickly and feel more confident. If you want to grow professionally, ARH will give you the opportunity along with support.”

On a rainy January 2017 morning, Jones clocked in for her 7:00 am to 7:00 pm shift and, as usual, had around five patients. The first half hour of her shift is a time when night nurses exchange information and brief day nurses about patients. From there, the day morphs quickly into patient needs, discharges and new admits coming mostly from the ER

“I’m on a med/surg, telemetry floor, so we get all kinds of cases,” she explained. “We have a lot of cardiology and then we have a lot of geriatrics. Nothing stays the same.” Jones says she feels very confident that her patients are getting top-notch nursing care. “When I went to school at Hazard Community and Technical College, the professors in the nursing program were excellent. It was almost one-on-one and they knew us personally and helped us everyday. I just loved them, and much of that is why I love nursing now.”

Back in 1990, when Jones first began working at ARH, she did not have the advantage of tuition reimbursement through ARH, like it exists today, or with student loan repayment, which is also currently available. “I paid for every dime myself, so it’s really great we have these programs. Maybe that will encourage more students to go into nursing.”

With the added programs available, Jones says she would consider getting her Master’s degree, which would take an additional three years. “With additional degrees, I would improve my retirement as well as having more income when my daughter goes to college,” she said.

Retirement is “a long way off,” she admits, “but I can actually imagine it now.” “I’d like a little trip to Destin, FL, sitting on the beach, but who knows!”

Jones thinks the new ARH Visa Rewards Card, which provides employees with monetary rewards for certain milestones or achievements throughout the year, will be a great way to let the employees know their hard work is appreciated. “We all need a little acknowledgement, and the new ARH Visa card does just that by rewarding great work.”

She also likes the concept that she can refer an RN to be hired at any ARH facility and be rewarded $2,000 for the referral once that nurse is hired. “That would go a long way in getting me to the beach” she laughed. “I’m going to look around for referrals.”

As her day comes to a close, Jones admits that one of the absolute best aspects of her job is the team she works with. “They are absolutely the best. Everyone is experienced and if you find you have a problem with coding or something, people are there to help you find the right answers.”

She also acknowledges that, while every job has challenges, she is very grateful for the benefits offered through her ARH employment. “I’m proud to be able to provide for my family, not only with a paycheck, but also with health insurance and other perks. It’s a great package, which cuts down on worry and allows me to provide great nursing care at Hazard ARH.”