Are you a tobacco user? Do you vape? Risk factors with the COVID-19 pandemic

IU Health Social Worker and Tobacco Cessation Counselor Danielle Barwise offers help to patients who vape or are tobacco users. They could be at a higher risk for COVID-19 symptoms.

By IU Health Senior Journalist T.J. Banes, tfender1@iuhealth.org.

Want to quit using? We can help.

That’s the message from IU Health Social Worker and Tobacco Cessation Counselor Danielle Barwise. The research isn’t abundant since the outbreak is fairly new. But studies are beginning to show that tobacco users could be at greater risk when contracting COVID-19, than non-tobacco users, said Barwise.

One study in the New England Journal of Medicine looked at 1,099 patients in China with COVID-19. Of that number 173 had severe symptoms, 16.9 percent of them were current smokers and 5.2 percent had previously smoked. Another recent study evaluated 78 patients who tested positive for COVID-19; 27 percent of those whose condition declined had a history of smoking tobacco. The article attributes several factors to the progression of the disease including age, history of smoking, and respiratory failure. Lung damage or lung vulnerability can further contribute to respiratory distress, as part of the virus.

For the past two years Barwise has been helping IU Health patients quit smoking through tobacco treatment consultations. Physicians, nurses and medical assistants generally refer patients to Barwise. She also takes referrals from IU Health North’s Schwarz Cancer Center. She averages five patients a day, about 140 active patients at any given time.

As part of the counseling Barwise focuses on encouraging patients to make choices that help them regain control over their health. Patients learn that smoking is a behavior and an addiction to nicotine. They are urged to set goals – find reasons to quit, strategize for change, and keep a log of their tobacco use. Patients also receive support in dealing with stress and identifying and coping with triggers for smoking.

“Since the outbreak of COVID-19 I have noticed a small spike in interest from current patients wanting to quit tobacco use,” said Barwise. Patients can call 317-944-Quit or email stoptobacco@iuhealth.org for assistance.

As part of the tobacco cessation program Barwise asks patients a number of questions to gauge their interest in quitting the use of tobacco. She also conducts a carbon monoxide test that provides a baseline of carbon monoxide in the body based on tobacco use. Patients receive resources to help them quit smoking and Barwise follows up with them every two-three weeks, following their progress.

“It’s too soon to know if interest will translate into action but patients are opening up conversations about the virus and how it impacts them. I understand people turn to things like smoking because it’s a coping mechanism during stressful times. I would encourage them to find other ways to cope. If you’ve been looking for an opportunity to quit, this is it.”

Intensive care nurse: “I failed in my attempt not to cry”

This is not something any healthcare practitioner imagines. COVID-19 is their worst-case scenario; it’s their nightmare. Yet they tirelessly give day in and day out – even when they have lives outside the hospital. Here’s how one nurse is coping.

By IU Health Senior Journalist T.J. Banes, tfender1@iuhealth.org

First it’s important to remember that she is human. She’s not SUPER human; she’s human. Second it’s important to remember that she is a nurse – caring for the most critical patients.

Fortunately for Brandie Kopsas-Kingsley she’s not going it alone. She is surrounded by other IU Health professionals who frequently ask: “How are you doing?”

Kopsas-Kingsley is one of the caregivers on the front lines of COVID-19. As a shift coordinator of IU Health University Hospital’s medical intensive care unit and a member of the hospital’s rapid response team she is often one of the last caregivers to look into a patient’s eyes.

It’s a role she doesn’t take lightly. It’s a role that comes with a tremendous amount of responsibility. She once helped organize an honor walk for a patient who chose to become an organ donor and more than once she has been at the bedside of a dying patient consoling family members.

Kopsas-Kingsley began her career at IU Health in 2009 as a unit secretary when she was in nursing school. Her role took her up through the healthcare system – as a certified nursing assistant, a licensed practical nurse, and then a registered nurse. She completed her capstone in the medical intensive care unit and has remained there ever since. Her caregiving role has earned her Daisy Award Nominations and Distinguished Nurse recognition.

“When you join the healthcare field, you commit to being a lifelong learner. We are constantly searching for ways to improve our practice, provide better care, and raise up the nursing profession,” said Kopsas-Kingsley. “That said, the amount of information and evidence that we’re processing daily is profound. We’ve spent a lot of time learning and asking new questions.”

The COVID-19 pandemic has added a new layer to her role as a nurse. For the health and safety of patients and staff, IU Health has temporarily restricted visitors. That took on new meaning for Kopsas-Kingsley recently when she made the phone call to a family en route to visit a young patient.

“It was something I’ll never forget. Our unit provided lifesaving care to this patient who succumbed to the disease process. The team worked extremely hard to provide the best care possible in a difficult situation,” said Kopsas-Kingsley. She is close to her coworkers and said they rely on each other for support. In a group picture taken during “Nursing Week” last year, they are all smiling. “Our unit is accustomed to medical alerts and end-of-life scenarios, but the current environment imposes new obstacles.”

With no family by the patient’s side, Kopsas-Kingsley made the call. The family put her on speaker in their car and discussed the next steps.

“It’s always difficult to have these conversations. Never in a million years does someone wake up and hope they get to have these discussions. As I heard the family members weep, I provided comfort and support. I failed in my attempt not to cry but I was able to say, ‘we are profoundly sorry for your loss.’”

And at the end of her shift, Kopsas-Kingsley goes home to her grandmother, her husband, Tommie and their two children Amelia, 6 and Aristotle, 3.

Their home is busy. Amelia is in Kindergarten and participates in Greek School and Girl Scouts. They are in the midst of potty training Aristotle who is in preschool. Her husband is a stay-at-home dad so the children have been accustomed to some social distancing, keeping busy with various educational activities. As a wife and mother, Kopsas-Kingsley finds peace in simple things – making blanket forts and walking in the woods with her family, caring for her plants and eating pancakes on a Sunday morning.

She knows that the next day she will return to work and will again face the fear of the pandemic.

The medical intensive care and medical progressive care units at IU Health have hosted COVID-19 simulations and debriefs so that all staff members can practice proper isolation techniques and have time to ask questions, voice concerns and provide recommendations. Kopsas-Kingsley has worked with groups to help identify specific patient needs and work through emergency response plans.

Whens she sees social media posts by hospital workers that read: “We stay here for you; stay home for us,” it hits its mark with her.

“I think about how best to respond when someone says, ‘everyone is overreacting.’ My main concern is how can I can respond without getting angry or insulting because then people won’t listen,” said Kopsas-Kingsley. Here’s her message:

  • COVID spreads very easily and a lot of children and young adults don’t show symptoms, therefore this is not a time to have sleepovers and parties.
  • When you don’t quarantine or take this seriously, you are putting others at risk – especially frontline responders.
  • This is not a drill. They are seriously shutting down the world. Once it’s out we can’t reel it back in.
  • If you know someone with health problems such as asthma, COPD, cancer or diabetes, think about how much they matter to you.

“We’ve had a lot of candid conversations at the hospital about how we feel and what we fear. We see things happening around the world and even in our country,” said Kopsas-Kingsley. “If we do not support each other and provide an environment where we can be honest and vulnerable, then we aren’t going to make it. Adaptability and resiliency are essential.”

Social worker helps cancer patients navigate their diagnosis and healing

Diane Monceski has worked at IU Health for 16 years dedicating her career in social work to helping cancer patients at IU Health Simon Cancer Center.

By IU Health Senior Journalist T.J. Banes, tfender1@iuhealth.org

It’s no coincidence that Diane Monceski enjoys working puzzles – Sudoku, Criptoquip, and Jigsaw.

“My role feels so natural. It’s like a puzzle – trying to help someone navigate the way, to help them hold the pieces together,” said Monceski. “We see people with a lot of different circumstances and I think I’m pretty good at appreciating where they are.”

Monceski’s career in social work started 16 years ago at IU Health Methodist Hospital working with pulmonary and oncology patients. Monceski knew early on she wanted to focus on caring for oncology patients.

In 2012 she moved to IU Health Simon Cancer Center where she joins two other social workers – Janet Hoyer and Melissa Renbarger. Their focus is to provide assistance with counseling, lodging, transportation, family support, financial/insurance, and legal aid. They also encourage patients to focus on their own strength, abilities and interests.

“We’re here to try to help people overcome any barriers to their care,” said Monceski, who grew up in Illinois and received her undergraduate degree from Illinois State University and her master’s degree from IUPUI. She was recently the recipient of the Maynard K. Hine Award recognizing individual alumni who have made significant contributions in support of the IUPUI campus and its alumni program. She is married to Dan, the mother to a daughter Kristin, and a son Michael. She also has three grandsons.

“I chose social work because I always felt reducing stress was an important part of health. If I could help people reduce stress while going through medical issues that would be help them get more out of their health care,” said Monceski. “I’ve always been really interested in body mind connection. As I researched careers I found social workers were the ones who did that.”

March is “Social Work Month,” a time to recognize people like Monceski as part of a healthcare team. This year marks the 65th
anniversary of the National Association of Social Workers with a theme, “Social Workers: Generations Strong.”

The social work team receives referrals from doctors, nurses, and other caregivers. The needs range helping secure lodging for out-of-town patients, to providing emotional support for family members.

“The thing I like the best is you get to connect with people at an overwhelming time and we can’t fix everything but we can make it better,” said Monceski. “We are able to help people chip away at that pile of things that are going on – ‘What am I going to do about my job, my health, my kids?’ Each time they overcome a barrier it gives them hope to get through it. The other thing I like about my job is the caliber people we work with. Doctors, nurses and the entire staff is so passionate about our patients and you can tell everyone who works here wants to be here and the patients see it too.”

Angels within us give healthcare heroes a boost

“We’re gonna take care of one another and get through this.” Sweet treats, notes of support and caring gestures help nurses, physicians, techs and everyone on the front lines in the fight against COVID-19.

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

In a time of deep distress within our homes and hospitals, it’s easy to let fear rule our thoughts. But these are also the times when our better angels come out to provide comfort and care.

If the COVID-19 public health crisis has exposed weaknesses in some institutions of government, it has revealed the strength and spirit of our communities, our healthcare heroes and the nation as a whole.

That strength has played out within IU Health as team members rally to provide lifesaving medical care in the face of a virus that threatens our physical and mental well-being.

We want to share with you stories of good – displays of kindness and compassion extended to our teams on the front lines by patients, businesses and fellow team members. Following are just a few:

A giant sign installed with permission over the weekend greets team members and patients at IU Health West Hospital. The colorful sign, erected free as a gesture of appreciation by a Brownsburg yard sign owner, reads simply “Heroes Work Here.”

On a smaller scale, but no less important, Allison Foltz, a nurse in the emergency department at Riley Hospital for Children at IU Health, shared a note she received from a teenage cancer patient who came into the hospital recently suffering from fever.

“She talked about how she knew when she was starting to feel a fever coming on, that she would probably have to come to the hospital and wanted to do something to thank everyone in the ED for all of our hard work right now,” Foltz said.

“She made a card thanking the staff and was just overall very appreciative and uplifting. It was definitely a small act of kindness that made a big difference.”

The note reads in part: “Thank you all for doing what you do. I understand how stressful your jobs can be, especially right now. We appreciate how hard you all are working!”

Foltz said she planned to post that card in the ED for all to see as a reminder of the sometimes unspoken appreciation patients and their families have for hospital staff.

Meanwhile, over at IU Health Methodist Hospital, the ED team was treated to macarons from the Macaron Bar on Mass Ave. in Downtown Indianapolis last Wednesday.

Nurse practitioner Bridget Thorne tweeted out photos and a thank-you: “Huge thanks to Macaron Bar Indianapolis for donating macarons to our Methodist ED staff today! Thanks for supporting our frontline workers!

In another “sweet moment,” Riley PICU nurse Kelsi Lawless brought in decorated cake pops courtesy of local baker Stephanie Stucky.

“Small and big things. It all counts, so very much,” Lawless said, adding that Stucky donated the pops, decorated with images of scrubs, heroes, Riley, face masks, toilet paper … you get the idea.

“The Riley PICU wants to thank you for spreading sweetness during a time where it’s very much needed,” Lawless posted on Facebook, tagging Stucky. “Your kind heart and talent is much appreciated, and we will be sure to share the love with all the wonderful people here!”

Lawless finished her post with this quote adapted from Theodore Roosevelt: “Do what you can, with what you have, where you are (and with a 6-foot minimum distance).” 💚

Vern Farnum, director of spiritual care and chaplaincy for the IU Health Academic Healthcare Center, shared an interaction he witnessed last week that touched his heart.

“An ICU staff nurse went into her manager’s office and told her she was going down to buy her a cup of coffee. She said to the manager, ‘All I need to know is what type of coffee do you want.’ She then turned and said, ‘You’ve got our backs, and we have yours. We’re gonna take care of one another and get through this.’ When I looked back at the manager, her eyes were filled with tears.”

And this from Uptown Café in Indianapolis:

“Thank you to all the healthcare heroes who are tirelessly answering the call to help the sick … And a special thanks to the IU Health Methodist Hospital nurses pictured here. We appreciate you more than you know! Hope you enjoyed the cinnamon rolls baked especially for you.”

Kelly Sego, program manager for corporate communications at IU Health, shared a note received on St. Patrick’s Day, printed on notebook paper and decorated with a shamrock: “Dear Riley Staff, thank you for all you are doing during this stressful time.” It was signed simply, Lauren.

We’ll have more examples of people reaching out to support our healthcare heroes, including a tea party for Riley social workers, in the days ahead. For now, here’s one way Riley palliative care physician Adam Hill and his team are dealing with stress:

“We just had an end of the day ‘80s dance party in our office,” Dr. Hill tweeted last week. “That’s how you fight healthcare distress and provide team self-care.”

Nurse’s weight loss – Started with a warning sign and ended with a heavy decision

She was at a volleyball game when her face became flushed and her heart rate elevated. It wasn’t just the excitement of watching her daughter playing on the court. Paula Kramer was headed toward serious health issues.

By IU Health Senior Journalist T.J. Banes, tfender1@iuhealth.org

Looking back Paula Kramer recalls clues that she was embarrassed by her weight. There’s the clue that when she went to visit her husband at his sports bar she asked him to meet her outside in the parking lot. There’s also the clue that she nervously stood in line when her family visited an amusement park – fearing that she couldn’t be safely secured into the ride. And there’s the clue that she may have opted for a nursing desk job rather than work at the bedside.

As she eyes a milestone birthday in June – turning 50 – Kramer no longer feels that anxiety. In fact, she says she is thankful she made a big decision in the past year. Under the care of IU Health Dr. Nicole Lee, she underwent gastric sleeve surgery. The procedure, also known as a “sleeve gastrectomy” reduces the size of the stomach by surgically removing about 80 percent of the stomach. Before surgery, patients spend up to six months in supervised weight loss that includes sessions with health professionals such a psychological testing and nutrition.

“I had tried other weight loss programs and diets. I’d lose 30 pounds and gain right back and then some,” said Kramer, who has been an IU Health nurse for six years. “Dr. Lee was amazing at explaining everything to me. She told me this wasn’t a magic fix; it’s a weight loss tool and it’s up to me how I use it. This just gave me the tools to succeed.”

Married to Larry Kramer and the mother to three children Sylvie, 16, Gabi, 18, and Ethan, 13, Kramer said she began gaining weight in her 20s. At her height she weighed 264 pounds. Now, eight months post surgery, she weighs 169 pounds.

The wake up call came when she was sitting in the bleachers at her daughter’s volleyball game.

“We were in tournament time and they were undefeated. I always get a little flushed at the games with all the excitement, but this time it was different,” said Kramer. She looked down at her Apple watch and her heart rate was 140. “I could feel my heart pounding and someone mentioned my face was red hot.” A few days later she checked her heart rate again after she had been sitting quietly at her desk and it was again 140.

“My mom was overweight. She passed away at the age of 70 and I knew the risk factors,” said Kramer. By the time she decided to have gastric sleeve surgery she was on medication for high blood pressure, cholesterol and a heart condition, was diagnosed as pre diabetic and had sleep apnea. “My kids are still young. I was scared,” said Kramer. “I just adore Dr. Lee. I was scared about my health and I was scared if I made this big decision. She understood my concerns and coached me through the whole thing.”

Surgery was July 24, 2019. Since then she has dropped from a size 22 to a size 12. “It’s weird to go to a normal store to shop for clothes. I haven’t done that since I was in my 20s,” said Kramer.

And now, she’s noticing the little things that she couldn’t do before – like crossing her legs, confidently climbing on that roller coaster, and taking in workouts with her daughters at the gym.

“I feel better. I feel healthier and I feel more confident,” said Kramer. “People who haven’t seen me for awhile take notice and that’s so encouraging.”

Process Established for Donations and New Suppliers

Indiana University Health Supply Chain team is dedicated to ensuring we are well-equipped to respond to the COVID-19 crisis. This includes proactively investigating alternate sources of critical products, including accepting donations from private or public sources.

IU Health Supply Chain will be reviewing all offers, but are primarily accepting the following categories:

  • Respiratory Mask including industrial N95 and N99
  • Facial and Eye Protection
  • Hand Sanitizer with 70% alcohol content
  • General Personal Protective Apparel (PPE)
  • Disinfectants

Prospective suppliers and donors of these critical products will be asked to complete the appropriate form below, so we can best understand the opportunity that is being presented. Completion of all questions will allow IU Health to respond most efficiently and effectively. All email inquiries or completed forms should be submitted to COVID-19.Supplies@iuhealth.org.

Please expect a response to your completed form within two (2) business days.

  • Supplier Form
  • Donor Form

If the donor cannot submit via email, they can contact the Supply Chain Customer Service at 317.962.SERV (7378) with the information.

Please do not drop off supply donations at IU Health facilities. All offers of supplies and donations need to be submitted for evaluation first, using the form above. IU Health will reach out to coordinate obtaining the supplies after review of the form.

IU Health White Memorial has achieved the Pathway to Excellence Designation

Indiana University Health White Memorial joins a premier group of organizations that have received Pathway to Excellence® designation from the American Nurses Credentialing Center (ANCC).

The Pathway designation is a global credential that highlights IU Health White Memorial’s commitment to creating a healthy work environment where nurses feel empowered and valued. IU Health White Memorial ‘s nurses are an integral part of the healthcare team, with a voice in policy and practice. Pathway nurses are engaged, resulting in higher job satisfaction, reduced turnover, improved safety and better patient outcomes.

As a Pathway organization, IU Health White Memorial leads the effort to enhance quality of care, patient and nursing safety and the future of healthcare delivery.

“We are proud to achieve this prestigious accreditation. Our staff has worked tirelessly to achieve this certification and it reflects our dedication to excellent patient care and services,” said Renea Smith, MSN, RN, chief nursing officer for IU Health White Memorial. “In awarding us Pathways to Excellence designation, ANNC has provided us with the opportunity to celebrate the exceptional care we provide to our patients and our commitment to the well-being of our community.”

IU Health Arnett NICU earns Level III accreditation

The Maternal and Child Health Division at the Indiana State Department of Health has granted a Three-Year accreditation to Indiana University Health Arnett Hospital as an Obstetrics Level of Care III and Neonatal Level of Care III. To achieve a Level III accreditation, IU Health Arnett must be equipped to care for complex maternal medical conditions and obstetric complications as well as infants requiring neonatal intensive care. In addition, they must be equipped and prepared to stabilize and transfer maternal and neonatal patients to the level of care appropriate to their medical condition.

Being granted a Level III care program, IU Health Arnett Hospital is committed to maintaining levels of excellence in the delivery of comprehensive, patient-centered, multidisciplinary care resulting in high-quality care for women and newborns. Patients receiving care at IU Health Arnett Hospital have access to onsite 24/7 care for obstetrics and neonatology services that include highly skilled obstetricians, midwives, neonatologists, neonatal nurse practitioners, certified registered nurse anesthetists, lactation consultants and skilled nursing and support staff.

“We are proud to achieve this prestigious accreditation. Our staff has worked tirelessly to achieve this certification,” said Abhay Singhal, MD, medical director and neonatologist with IU Health Arnett. “We are proud to work with the Indiana State Department of Health to ensure safe and high quality care is delivered to women and newborns”