Knox's Blog

I think the world can be divided into two distinct categories.  There are the people who like surprises and those people who hate surprises. Whichever side you line up on—life is full of surprises, right? It’s like the philosopher Forrest Gump once said, “Life is like a box of chocolates, you never know what you’re going to get.” And, as hard as some of us try to control everything that happens around us, the unexpected realities of life are never far away.

About a year ago my daughter, Leah, adopted an adorable and playful cat, which she named Bowtie Kitty, from a friend who was no longer able to care for the animal.  Leah was very excited about the addition of her new furry family member, and did all the things that you are supposed to do in order to care for a new pet.  She bought all sorts of cat toys, treats and accoutrements from the local pet shop, and made a wonderful home for her new feline friend.

After a few months, when she had the available funds, Leah scheduled an appointment with the local vet for Bowtie Kitty to get all her needed shots and to get spayed.  (Truth be told, Leah could have had the cat spayed a month earlier but used the money to go see The Band Perry in concert.) So you can imagine Leah’s shock when, on that initial visit, the veterinarian informed Leah that she would be unable to perform the routine surgery that morning.  Bowtie Kitty was, indeed, pregnant. Yep—kittens! Surprise!

This story got me thinking about a few key truths as they relate to healthcare.  It’s no secret that working in healthcare is full of surprises.  Understanding how to remain flexible and thoughtfully work through constantly changing scenarios at work and in life is an invaluable skill set to posses.  In fact, remaining flexible is a non-negotiable when caring for people.  You and I are in ideal positions to continually re-examine the system; we can help minimize unexpected outcomes that put patient health in jeopardy and simultaneously put the cost of care out of the reach of many patients.

At first glance, my daughter’s cat story, although unexpected, still has a cute and cuddly ending— kittens. And, even though it’s a lot of work to find homes for all of the kittens, the story still has a happy ending.  But, I don’t want to be Pollyannaish either; in many instances, the outcomes for animals like these kittens are not as pleasant—outcomes like cruelty, abuse, abandonment or even being euthanized.  It’s no secret that we are not always guaranteed a happy ending when we are faced with medical “surprises,” personally or professionally. We have been given the noble task of caring for people as patients and their family’s wrestle through life-altering challenges.

What do you think? Do you like surprises? What are things that we can do to help us remain flexible (and diligent) in our jobs?

I recently saw an article in the Ashburn Patch titled, “Inova Plans Bedside Wedding for Dying Patient’s Daughter,” and knew I should probably pull out the tissues before reading further. And I was right, for once again, our Inova team pulled together to make it possible for a patient dying from pancreatic cancer with only days to live, to see his only daughter get married.

Mr. Bill Malone had been a patient on the oncology unit at ILH for quite a while. During his time there, the staff had gotten to know not only Mr. Malone, but the entire family, including his wife, Francie, their daughter, Dori, and Dori’s fiancé, Jim O’Sullivan. The nurses, techs and physicians enjoyed hearing about the wedding plans for Dori and Jim that were to take place on June 4th. After Mr. Malone’s latest stint in the hospital, which lasted more than a month, he was released to a rehab facility. Unfortunately though, he contracted pneumonia and was readmitted in May. The staff then had the sad task of informing the family that Mr. Malone would not live to see the wedding.

They brainstormed, came up with a plan and asked the family if they would consider a hospital wedding. In two days, the team learned how to be wedding planners. April Brown, PCD, and Kathy Wright, Oncology Clinical Specialist, with help from Selena Brown, RN, and Beth Guzzetta, Clin Tech, organized and decorated.  Gloria Andrzejewki, RN, brought champagne for the couple, balloons and wedding bells. Amanda Korn, RN, sang a Shania Twain song, “From This Moment,” Najat Chemlali from Food Services ordered a wedding cake and hors d’oeuvres for the reception and Charlene Martin from Community Affairs took photos.

I mentioned before that we are so much more then our job titles. Charlene works in Community Affairs and fills in as a photographer, but she also pitched in to help Virginia Moore of chaplaincy services on this special wedding day. During the “I now present to you husband and wife” portion of the ceremony, Charlene and others witnessed a near comatose man raise his hands and clap three times. There wasn’t a dry eye in the room.

It is a spiritual axiom that when we give, we receive way more than that which we gave. Amanda Korn, who was Mr. Malone’s primary oncology nurse for the last seven or so years, said that this event was her most rewarding day as a nurse. Amanda said it was awesome to see all the disciplines come together to pitch in and help in any way they could.

And that’s what our Inova teams do so well every day. I’ve heard similar stories over the years and am always grateful for the reminder of the lessons learned with each one. Our best caregivers (and we are all caregivers) know that we don’t just take care of a patient; we take care of the entire family – physically, mentally and spiritually. Thanks to this team, Dori could have her father at her wedding and provide him with the knowledge that he could now leave this place knowing all is well. Bill Malone passed the next day.

Last week was certainly an informative one. Many of you learned about Vision 2015 through Employee Updates. I sat in the Employee Updates at our hospitals and I was impressed by the questions and dialogue.  Vision 2015 will be part of an ongoing dialogue, so I urge you to continue to be part of the conversation.  Several folks asked to see the Vision 2015 videos again. We will be posting links to the videos on InovaNET this week – I’ll be sure to share the link with you on this blog.

I’ve been making an extra effort to hear from colleagues through rounding.  Last week I took part in rounds at Inova Heart and Vascular Institute on the Fairfax Campus. The Inova Heart and Vascular Institute is an important, differentiating service that we provide as leader’s in cardiac care for the Washington, DC area.

(L - R): Phyllis Harris, Jo Ann Ramos, Knox, & Lindsey Busenberg

Sincere thanks to my colleagues for sharing candid feedback – that’s the only way we will truly engage each other in making the system better for our patients and each other.

I hope you have a good, and productive week!

Last week was incredibly hot here in Northern Virginia, but luckily I had several meetings this week that kept me out of the heat. One of the first meetings focused on ways Inova can improve patient care through innovative practices and new technologies. I met with our clinical leadership about how we can reinvent our patient care model to ensure we take an interdisciplinary approach and we remain patient focused. All of these discussions were in alignment with our overall Vision 2015 strategy.

Front Row (L-R): Susan Magnotti, Dottie Hernly, Maria Cahafeiro-Cava, Jessica Davis, Neena Mungal, Pat Harris; Back Row (L-R): Sung Kim, Judith Rush, Christine Candio, Knox Singleton, Marie Lynn, Priscilla Yekeh, Awilda Hahn

Knox Singleton and Chris Candio, CEO, IAH recently met with hospital staff.

I also had the opportunity to spend time rounding at Inova Alexandria Hospital and met with the local staff. Engaging in rounds always reminds me of how dedicated the members of our Inova family are to helping improve the patient care experience. I want to personally thank our colleagues at IAH for telling me about your role at Inova and providing ideas about how we can continue to improve our patient care model.

I want to congratulate Ilcias Vargas, Cardio Invasive Specialist at Inova Alexandria Hospital, for entering the closest answer in the “Guess My Weight”contest earlier this year.

Ilcias Vargas, Cardio Invasive Specialist, "Guess My Weight" Winner!

Despite the heat, I am continuing my exercise regimen at the gym. Once it gets a bit cooler, I will try to move my exercise regimen outdoors. I am inspired by some of the recent posts shared on Inova’s Fit For Spring page – if you haven’t yet signed up, be sure to do so!