The Successes of Sleep

Vol. 17 •Issue 5 • Page 54
The Successes of Sleep

New categories highlight ADVANCE’s National Sleep Achievement Awards

We here at ADVANCE do not like routine. That is why we rebranded and 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 means more chances to share your success stories. Congrats to all!

Best tech

Most sleep techs have compassion for their patients, but Diana Chesnut, RRT, RPSGT, titrates her empathy up a notch.

To really understand what people experience, she once wore a continuous positive airway pressure mask 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.

Afterward, she truly understood how CPAP can take some getting used to and had a new appreciation for the art of working with patients.

In fact, Chesnut has become the go-to tech for working with pediatrics — an often tricky population.

Prior to her arrival, Wilson struggled to deal with children in its 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, yet misdiagnosed, sleep disorders.

For her latest project, she composed a letter that soon will be in the hands of all the teachers in the area. It will help educators identify sleep issues as well as establish good sleep habits.

Obviously, Chesnut is passionate about sleep medicine. Her health care career, however, started elsewhere.

She worked as a respiratory therapist in the NICU and PICU for 30 years and then went into mini-retirement. One day about five years ago, Chesnut’s old boss asked her to come back to help the sleep department.

Her current co-workers could not be happier about the move. “Diana Chesnut represents what all sleep technicians should embody,” Brabbin said.

Best manager

Ed Payne, RPSGT, remembers when CPAP matched the size of an oxygen concentrator. Much has changed in his 24 years in sleep, but not his dedication to the field or output of innovative ideas.

Along with a pulmonologist colleague, Payne opened a freestanding sleep center in 1984 — a feat 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 is in management service agreements with 23 others.

In total, they average 1,100 sleep studies a month, with Payne chipping in a sizable amount of his expertise. Over the course of his career, 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, does not achieve this quick turnaround time by managing by intimidation.

“I try to find quality people and put them in positions where they will excel,” Payne 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 close to 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 his underserved population.

Those patients without insurance or adequate funds can make small monthly payments for services. They also receive equipment at cost or gratis, depending on their circumstances. “We need to give back to the community,” he said.

“Ed is very caring and would give you the shirt off his back,” Ramirez added. “He truly is a wonderful leader.”

Best facility

Area specialists in university settings often do not send high-acuity patients to their own institutions for sleep studies. Instead, they refer them to the Alexian Brothers Medical Center’s Sleep Health Center in Elk Grove Village, Ill.

“We do such a darn good job,” boasts Denise M. Anderson, RPSGT, clinical supervisor.

Roughly 60 percent of their patients have diseases or conditions that require a special touch, including Duchenne’s muscular dystrophy, spina bifida, multiple sclerosis, myasthenia gravis, and those pre/post-organ transplants.

Anderson recalled one occasion where her staff treated an autistic 8-year-old boy with Down syndrome. Not only did they dutifully care for him (the hookup took four hours), they also accommodated the child’s parents and his service dog.

“I will remember that experience until I die,” she said.

Such specialized attention starts before the patient even comes through their doors. The clerical staff spends at least 10 to 15 minutes on the phone with the patient or family member. They find out about special needs so the rest of the sleep team can be fully prepared when the individual arrives for the appointment.

From there, education becomes a key part of the process 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, they may give them a video to watch, and that’s it.”

Unique scheduling for both the patients and the employees comes with such dedicated care.

Patients are staggered 90 minutes apart to allow extra 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. and 8:30 p.m. and is in bed by 10 p.m.,” Anderson said.

On the staffing end, their day and evening/night scorers also contribute to the department by putting in one Saturday a month working with MSLTs, MWTs, and late sleepers. They also pick up an occasional evening or night and may split a 12-hour shift to provide help during times of high census, sick coverage, or for 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.

They regularly work with a device 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.

Mike Bederka is managing editor of ADVANCE for Respiratory Care Practitioners. He can be reached at [email protected].