Vol. 21 •Issue 12 • Page 10
Successes of Sleep
New Categories Highlight ADVANCE’s National Sleep Achievement Awards
We here at ADVANCE don’t like routine. That’s why we expanded our sixth annual National Sleep Achievement Awards.
This year, along with best facility, we included two new categories: best manager and best technologist.
More winners mean more chances to share your success stories. Congrats to all!
Diana Chesnut, RRT, RPSGT, defines the compassionate health care provider.
To really understand what her patients go through, she once wore continuous positive airway pressure to bed every night for three months straight. The tech at Wilson Memorial
Hospital in Sidney, Ohio, even tried multiple interfaces to gain first-hand knowledge about the plusses and minuses of each.
“It made a difference,” Chesnut said of the experiment.
Beforehand, “I was pushing them,” the 50-year-old admitted. But afterward, she truly understood how patients battled to get used to CPAP, and she had a new appreciation for the skill needed to work with them.
In addition, Chesnut has become the go-to tech for working with pediatrics—an often tricky population. Prior to her arrival, the Wilson staff struggled to deal with children in the sleep lab. Chesnut’s calm, detail-orientated demeanor changed that.
“Diana has instilled in the sleep team that the way to properly ensure the patient has the necessary education and best chance of maintaining compliance is by spending time with each one to allay fears and provide the highest possible level of comfort,” wrote Steve Brabbin, BS, RRT, director of cardiopulmonary services, in his nominating essay.
“Her efforts have spilled over to the entire staff, and as a result, we have seen a higher success rate with pediatric and special needs patients.”
Chesnut takes her keen eye for children’s sleep issues beyond the hospital, serving as the liaison to schools in the county. She regularly meets with counselors and teachers to explain the warning signs of common sleep disorders.
For her latest project, she composed a document that soon will be in the hands of all the teachers in the area. It will help educators identify sleep problems so they can work with their students to establish good sleep habits.
Although Chesnut is passionate about sleep medicine today, her health care career started elsewhere.
She worked as a respiratory therapist in the NICU and PICU for 30 years and then settled into mini-retirement. One day about five years ago, her old boss asked her to come back to help in the sleep department.
Her current co-workers couldn’t be happier about her decision to accept the offer. “Diana Chesnut represents what all sleep technicians should embody,” Brabbin said.
Ed Payne, RPSGT, remembers when CPAP machines matched the size of an oxygen concentrator. Much has changed in his 24 years in sleep medicine but not his dedication to the field or output of innovative ideas.
Payne and a pulmonologist colleague opened a freestanding sleep center in 1984—a venture rarely heard of at the time. He eventually co-founded United Sleep Medicine in 1998.
The company started with four employees; now it has 100. Headquartered in Charlotte, N.C., United Sleep Medicine owns nine centers and has management service agreements with 23 others.
In total, the facilities average 1,100 sleep studies a month, with Payne chipping in a sizable amount of his expertise to keep things running smoothly. Over the course of his career, he figures he has performed and scored more than 60,000 polysomnograms.
“Believe it or not, I still like scoring records and looking at data,” said Payne, vice president and technical director, with a laugh.
The 45-year-old pushes to have the whole process—consult, sleep study and follow-up—completed in one to two weeks. Payne, however, doesn’t achieve this quick turnaround time by managing by intimidation.
“I try to find quality people and put them in positions where they will excel,” he explained. “I’m not better than them. I don’t micromanage. I let them do what they think is best and support them.”
Charlotte Ramirez, RPSGT, has worked with Payne for nearly 10 years and attributes much of her career success to him.
“He has mentored many of us and molded us into regional managers,” wrote the assistant technical director in her nomination. “I have been able to grow professionally and climb the ladder due to his guidance.”
When not educating co-workers or streamlining care, Payne—an avid golfer and hunter—lectures at regional and national sleep meetings and strives to help an underserved population.
Patients without insurance or with inadequate funds can make small monthly payments to defray the cost of services. They can also get equipment at cost or gratis, depending on their
“Ed is very caring and would give you the shirt off his back,” Ramirez added. “He truly is a wonderful leader.”
Area specialists in university settings don’t always send their high-acuity patients to their own institutions for sleep studies. Often, they refer them to the Alexian Brothers Medical Center’s Sleep Health Center in Elk Grove Village, Ill.
“We do a darn good job,” boasted Denise M. Anderson, RPSGT, clinical supervisor.
Roughly 60 percent of the center’s patients have diseases or conditions that require a special touch, including Duchenne’s muscular dystrophy, spina bifida, multiple sclerosis, myasthenia gravis and complex sleep apnea.
Anderson recalled one occasion where her staff treated an autistic 8-year-old boy with Down syndrome. They dutifully took care of not only him (the hookup took four hours), but also his parents and his service dog.
“I will remember that experience until I die,” she said.
At Alexian Brothers, specialized attention starts even before a patient comes through the door. Clerical staff spend at least 10 to 15 minutes on the phone with the patient or a family member to pinpoint special needs so the entire sleep team can be fully prepared when the individual arrives for the appointment.
From there, education becomes a key facet at the 10-bed center.
“We try to assess how much they understand about why they’re here,” said Archana Patel-Szadowski, RPSGT. “At other labs, staff may give them a video to watch and that’s it.”
Individualized scheduling is part of the care package. Patients arrive 90 minutes apart to allow adequate time for education, taking vital signs and just getting to know each other.
“This is not a cookie-cutter lab where everyone arrives at 8 p.m. or 8:30 p.m. and is in bed by 10 p.m.,” Anderson said.
On the staffing end, day and evening/night scorers put in one Saturday a month working with MSLTs, MWTs and late sleepers. They also pick up an occasional evening or night shift and may split a 12-hour shift to provide help during times of high census, a co-worker’s illness or special situations.
Beyond this extra effort, the techs—two-thirds of whom are RPSGTs—should be commended for their increased skill sets, said Kelli DeBerry, CRT, RCP, director of respiratory care and the Sleep Health Center.
Staff regularly use a lift to transfer non-ambulatory patients between the wheelchair and the bed—a job not generally handled by sleep techs.
“I’m so proud of them you don’t even know,” DeBerry said.
About the Contest
ADVANCE solicited nominations from readers around the country for the best sleep facility, sleep tech and sleep manager. Short-answer essays describing how participants have demonstrated excellence in sleep medicine helped our judges pick the winners. The best facility received a $1,000 cash prize; best tech and manager earned $500 each.
Judges for the National Sleep Achievement Awards were: Maria E. Dimi, MBA, RRT, administrative director of respiratory care and neurodiagnostics at Saint Barnabas Medical Center, Livingston, N.J.; Craig A. Muri, RPSGT, REEGT, clinical director of the Sleep Wellness Institute, West Allis, Wis.; and Stacia Sailer, MD, medical director of the UMass Memorial Sleep Disorders Center, Worcester, Mass. All were winners in last year’s competition.
Sleepmate Congratulates all the winners.
Mike Bederka, managing editor, can be reached at firstname.lastname@example.org.