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This file is provided for reference purposes only. It was current when it was produced, but it is no longer maintained and may now be out of date. Persons with disabilities having difficulty accessing information may contact us for assistance. For reliable, current information on this and other health topics, we recommend consulting the NIH Clinical Center at http://www.cc.nih.gov/.
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CC News: July 1996In This IssueMore efficient procedures goal of demo projectQuerybriefsHeadaches after lumbar puncture--why?Lumbar puncture--what is it?Critical care pharmacist takes top honorSecurity issues on the forefront of NIH concernsNursing staffer recalls CC milestones and landmarksChange is the constant in 40-year career
More efficient procedures goal of demo projectDr. John Gallin, CC director, gave the go-ahead in May to the Office of Human Resources Management to start a process that will create simpler, fairer, and more efficient personnel systems."Because of the nature of what we do here, our personnel needs are unique," explains Dr. Gallin. "Having to conform to regulations created for other agencies often hampers our efforts. As a demonstration project, we can test new ways of handling personnel issues that would make it easier to get our work accomplished." In a memo to all CC staff last month, Dr. Gallin emphasizes that this exercise would focus on streamlining procedures that have long been of concern to staff and managers:
Dr. Gallin has appointed a Demonstration Project Advisory Committee (DAC) to spearhead the process of becoming a DEMO (demonstration)project. Representatives from a cross section of CC departments as well as NIH and HHS make up the membership. Staff from the Office of Human Resources Management (OHRM) will provide technical assistance.
"Our committee must create a proposal and obtain approval from the
Office of Personnel Management before we can be designated as a DEMO project,"
explains Tom Reed, OHRM chief and DAC coordinator. Before submitting a proposal, the DAC plans to seek staff input in a variety of ways. Both an email and website address have been set up. A DEMO project comment box will be located near the B1 cafeteria. Over the next six months, there will be town meetings and presentations to review specific aspects of the proposal. Periodic information bulletins will go to all CC staff to keep everyone up to date on the project's progress.
"Once our proposal is approved, our DEMO project will last five years,"
says Reed. "After that, we can apply for extensions or request that
certain aspects of the project become permanent." "Finding simpler, more efficient ways to conduct our business will serve to enhance the quality of our patient care and clinical research," Dr. Gallin says. "The DEMO project is a way for all of us to achieve these goals." Send email comments to DEMO-CC@ohrm.cc.nih.gov . (by Jan Lipkin)
QueryThe CC has initiated a demonstration project to devise and test more responsive personnel systems. (See previous story.) The committee needs ideas from all CC employees. Send email to DEMO-CC@ohrm.cc.nih.gov or drop a note into the comment box to be located near the B1 cafeteria. The project committee will look at how we are paid, fill positions and retain staff, recognize good work, and improve performance, for example. Which of these areas are most important to you? Would you like to see the committee address other issues?
Tom Lionetti, Nursing Department: "Job security and staff retention
are important issues. Can we ever go back to being sure that our jobs will
be around for awhile? I like where I am and what I do."
Stacy Thomas, Nutrition Department: "Training is important to me.
I'd like to see it easier to obtain training. Also, performance ratings.
Sometimes they seem unfair, although the process has gotten better with
reinvention efforts."
Francis Waterhouse, Clinical Pathology Department: "I'd like to see
emphasis on improving performance and recognizing good work. It is important
for morale with reorganization of the Clinical Center. It would also be
nice for the CC to give staff a chance to take more classes, to keep us
involved in our own improvement so we don't become stagnant and our skills
extinct."
briefsDoppman namedDr. John Doppman, a 34-year veteran of the Clinical Center, has been named acting chief of the Diagnostic Radiology Department.Dr. Andy Dwyer, who had been the department's acting chief for the past two years, will assume duties as acting deputy chief.
"I would like to thank Dr. Dwyer for his dedication and leadership
in this role and for true 'yeoman's duty' in leading the radiology department
through a time of turmoil and change," said Dr. John Gallin, CC director.
Research seminar set for nursesNurses from throughout the U.S. will gather at the Clinical Center July 22-26 to participate in the seminar, Research Training: Developing Nurse Scientists.
The program, sponsored by the CC Nursing Department and the National Institute
of Nursing Research, is designed for nurses with doctorates or doctoral
candidates interested in careers as nurse scientists. The seminar will cover
NIH resources, developing a research program, grant writing, ethical issues,
and disseminating research findings.
Help offered in CC clean upThe CC's clean-up campaign continues this month under the theme "Be considerate." Need help in planning and completing department clean-up projects? Want to report an area that needs attention? Send an email to cc_clean@pop.cc.nih.gov.
Drawing a winnerAndreis Lewis picked a winner, winner of a 28-foot Pearson sailboat, that is. Jerry Swift of Bethesda soon will be hoisting the sails on the boat valued at $19,000. He held the winning ticket in a raffle that benefits the Friends of the Clinical Center, a program that helps CC patients and families with personal emergency financial needs while they participate in medical research here. With them are Meredith Estep of the R&W and Jerry King, Medical Record Department chief and FOCC president.
New decision on restored leaveDid the furlough leave you with more leave than you can use? HHS has OK'd a plan so that annual leave restored as a result of the Dec. 18, 1995-Jan. 6, 1996, furlough can be donated to federal employees approved as leave recipients in the Voluntary Leave Transfer Program.
The department waives for this use only its requirement that all current
accrued leave be exhausted before using the restored leave, explains Warren
Moyer, CC management analyst.
Renovation completePharmacy Department's ambulatory pharmacy section on the first floor near the main elevators had a top-to-bottom renovation recently that offers a comfortable and spacious waiting area for patients and efficient work space for staff. Three windows are now available for dispensing medications. Behind the scenes, staff work in a galley-type preparation section that puts ordering and storage areas in easy reach.
Contact CCC for help in patient edCC staff who would like to inform patients about protocols, procedures, medications, and unit policies can contact Clinical Center Communications for expert help in creating publications to meet those informational and educational needs. Call Wendy Schubert at 594-5792 for details.
Leave the driving to someone elseWant to earn $44 a month? Consider Transhare, a program that offers a subsidy to staffers who opt for public or van-pool transportation. It's an option for employees willing to surrender any NIH parking permits, off-campus parking access cards, and sticker numbers.
NIH will throw in free parking for commuters from the Shady Grove or New
Carrollton metro stations. For details, call 402-RIDE.
Special deliveryFifth graders from Farmland Elementary in Rockville brought their original opera, "Chat Room Virus," to the 14th floor assembly hall stage last month in a special presentation for CC pediatric patients. The students, dubbed La Clevique Kids Opera Company, wrote, composed and sang, as well as handled all phases of the production.
Koop award recipientLaura Chisholm received the C. Everett Koop Award as the PHS reserve junior officer of the year. Making the presentation were Dick Zimmerman, vice president-Navy section, Reserve Officers Association, and Acting Surgeon General Audrey Manley. Chisholm, nurse manager on 10 West, an outpatient cancer care clinic, served five months as interim chief for the former cancer nursing service.
CC staffers receive NIH Director's AwardsDr. Harold Varmus, NIH director, presented top NIH and PHS awards to six CC staffers in ceremonies last month. NIH Director's Awards went to Jean M. Harris, Nursing Department nurse specialist in quality assurance, and to a Medical Record Department administrative group. Cdr. Carol A. Romano, director of Nursing Department's clinical systems and research support, received the PHS Commissioned Corps' Meritorious Service Medal.Harris was cited for her "exceptional initiative and leadership, with impact on quality management in coordinating accreditation review in the Clinical Center and the workforce diversity program." A group award went to Jennifer Bayless, deputy director of the Medical Record Department; Kimberley J. Jarema and Karen K. Phillips, medical record administration specialists; and Jon W. McKeeby, computer specialist. The award recognized their "outstanding administrative support in the development and expansion of intramural research protocol data management services."
Romano's medal recognized her "contributions to the PHS toward improving
the quality and efficiency of management and delivery of health-care services
through creative use of information technology." Earning PHS Unit Commendations were Cdr. Sara L. Bergerson, Cdr. Denise B. Ford, Lt. Melissa A. Zafonte, Cdr. Naomi Ballard, Lcdr. Laura Chisholm, Lcdr. Florentino Merced-Galindez, Lcdr. Jeanne Odom, Lt. Kathy Dilorenzo, Lt. Linda Ludy, Lt. Michelle Manimbo, Ltjg. Rose McConnell, Lt. Susan Orsega, Ltjg. Helen Owens, Lt. Karen Vorsteg, Lt. Keysha Ross, Cdr. Maureen S. Leser, Capt. Patti A. Riggs, Ltjg. Kelly M. Stevens, Lcdr. Jean R. King, and Cdr. Nancy G. Sebring.
Clarence W. Jackson, Jr., supervisory procurement analyst, office of procurement
management, NIH Office of the Director, earned a Director's Award "in
recognition of outstanding contributions to the Clinical Center's small
purchasing operations."
Headaches after lumbar punctures--why?Who develops headaches after a lumbar puncture and why do they get them? Those were the questions a team of CC nurses asked in a recently completed clinical study. It's important to know because "cerebrospinal fluid is like liquid gold in a research hospital because of the information it provides," points out Christopher Geyer, principal investigator for the study that looked at physical and mental factors common among patients developing headaches after the procedure. He and the research team work on 3B North, a unit for NIAAA patients. Lumbar punctures are one of the most frequently performed procedures required in alcohol-dependency studies because they offer a way to determine how the brain's chemical neurotransmitters work. But, as many as 60 percent of patients who undergo the procedure develop headaches. "The headaches cause significant discomfort for the patients, and can also mean longer hospital stays and delays in diagnostic and research studies while the pain is being treated," he says. After following 212 patients between 1992 and 1995, the research team found that certain traits do relate to the headaches, including:
Determining before the procedure the physical and psychological aspects that seem to be common in patients who develop the headaches allows the health-care team to begin assessment and treatment early, which could minimize chances of getting headaches in some patients and perhaps stemming them altogether in others. "In explaining the procedure to patients, we unwittingly set them up to anticipate headaches," Geyer says.
One traditional theory of why so many patients develop the headaches has
been the "leakage theory," he adds. Bed rest following the lumbar puncture has been a standard of care designed to prevent the headaches. "But, all bed rest seems to accomplish is to postpone the headache," Geyer notes. The next phase of the study will examine the role of patient mood, bed rest, and the interaction of certain brain chemicals. "Low levels of the neurotransmitter serotonin are associated with alcohol dependency because it plays a role in impulse control and craving," he says. "Low levels of serotonin may alter levels of substance P, a neuropeptide found in plasma and spinal fluid that relates to sensitivity to pain. Determining how these chemical factors relate to developing the headaches could lead to a simple blood test to identify who is at risk. Working with Geyer on the project were CC nurses Nancy Harnett, Susan Squires, Ruth Auslander, Ann Turk, Barbara Bowens, Marie Vangeyten, Mary Anne Hannaman, and Beth Price, along with Dr. David T. George, NIAAA.
Geyer, who received Nursing Department's research award in ceremonies last
month, has presented the study's findings at local, national, and international
nursing conferences. (by Sara Byars)
Lumbar puncture--What is it?Physicians use a procedure called a lumbar puncture to draw samples of cerebrospinal fluid. After a local anesthetic, a small needle is inserted through the lower back, between spinal disks, and into the interior of the spine called the epidural space. The epidural space serves as pipeline for the cerebrospinal fluid, the body's only fluid that carries neurotransmitters throughout the spinal cord and brain. The fluid constantly bathes and protects the brain and the body can generate between 20 and 24 cc of new fluid an hour.
The lumbar puncture is an important diagnostic test, allowing physicians
to check for infections and measure levels of glucose, protein, and neurotransmitters
such as serotonin and dopamine. Some patients develop severe headaches after
undergoing the procedure.
Nursing staffer recalls CC milestones and landmarksMargaret Blake measures her 30 years, six months, and 14 days at the Clinical Center in milestones."I've seen all the additions. Each new development meant a major change," says the Nursing Department administrative officer who retired this spring. "And I've worked with six nursing chiefs." "Way back when, workers were closely supervised. Now, there's more independence. I've appreciated that." A landmark from way back when is a casualty of progress she'd like to see returned. "The pools out front. Some patients believed that the water healed them. When the pools are back, this will truly feel like the Clinical Center again."
A Charleston, S.C., native, Blake came to Washington for a visit and never
left. "I have always looked for ways to move up. I went back to school. I got an A.A. degree and just kept going. I ended up with a B.S. in business administration." Credit son John-who earned a degree in computer science-for that. "I knew I wanted him to go to college and told him he was going if I had to sit there and hold his hand," she recalls, laughing.
Blake plans to devote some of her retirement time to continue a much-loved
hobby, traveling.
Change is the constant in 40-year careerJames Browne quotes baseball great Satchel Paige when describing his philosophy of life: "Don't walk in front of me. I may not follow. Don't walk behind. I may not lead. Walk beside me and be my friend."Browne walked the Clinical Center's tangle of hallways for nearly 40 years before retiring, gathering friends with each step. "I've seen all the changes," says Browne, an audiovisual specialist in the Nursing Department since the early 1970s. "The building is nice and bright today. It used to be hospital green throughout." But there's one bottom line he says has never wavered. "Patient care has always been good here. And so have our supervisors." Browne, a Washington native and Navy veteran, first came to the Clinical Center in 1957 to work in the operating room. Moving to Nursing Department's education and training section 16 years later, the gregarious Browne found a niche that suited him well. "There's no AV equipment I can't operate," he says, laughing. "Staff members always called on me to help." And help has been a two-way street. "I truly thank the staff members who helped me when I've had health problems. Members of the Nursing Department feel like part of my family." Department members hosted a retirement party for Browne that highlighted his affection for the Redskins. "I've been a football fan since I was six years old." Co-workers' gifts included scads of Redskins memorabilia, a letter from the team coach, an autographed football, and photographs of team members.
"I'm not gonna do anything," may be what Browne claims as his
retirement plans, but don't count on it. There're grandchildren to visit.
And, he hopes to do volunteer work here. "I always enjoyed my work
at the Clinical Center. Helping others."
Security issues on the forefront of NIH concernsSecurity issues have remained in the forefront for federal workers since last year's bombing of the Alfred P. Murrah Federal Building in Oklahoma City.
That tragedy prompted a presidential mandate that all federal agencies scrutinize
their security measures to assure compliance with the Justice Department's
new government-wide standards.
Comments? webmaster@cc.nih.gov
National Institutes of Health (NIH) Warren Grant Magnuson Clinical Center (CC) Bethesda, Maryland 20892 Last modified 7/16/96
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