BHB announces road traffic accident statistics for 1 January-31 October 2018

15 November 2018: Bermuda Hospitals Board (BHB) 2018 statistics from 1 January – 31 October show that due to road traffic accidents:

  • 1,459 victims required Emergency Department services
  • 132 victims were admitted to acute care wards
  • 18 victims were admitted to the Intensive Care Unit
  • 8 victims 18 or younger were admitted to the hospital
  • 8 victims were discharged to overseas medical facilities
  • 116 tourists required medical attention

BHB provides a set of posters with these statistics monthly (see below).  Please print them and distribute widely.

BHB RTA posters January to October2018

15 November 2018 Home Page, News

November is Diabetes and Chronic Lung Disease Awareness Month

Bermuda Hospitals Board hosts two free public events

7 November 2018: Bermuda Hospitals Board (BHB) is celebrating World Diabetes Day and World COPD Day, which both fall on Wednesday 14 November, with two free events for the public.

Free health screenings for blood sugar and blood pressure levels, as well as lung function testing for smokers or former heavy smokers over the age of 40, will take place in the King Edward VII Memorial Hospital (KEMH) General Wing lobby from 10am to 1pm.

“Chronic obstructive pulmonary disease, or COPD, is characterised by shortness of breath and difficulty breathing,” said BHB asthma nurse educator Debbie Barboza. “People often do not realise they have the condition and believe it’s a sign of them aging. But if you are over 40 and smoke or used to smoke, you could have COPD. While it is not curable, we can teach you how to stop the disease progressing and how to manage your condition.”

A simple non-invasive breath test is the screening test for COPD and will be offered in the free screening session on Wednesday 14 November.

The public can also learn the science of body weight when BHB locum endocrinologist Dr Amy Freeth delivers her talk: The Dilemma of Weight Loss.

“I’ll explain the science of how we gain weight, and why losing and maintaining weight can be a real challenge,” said Dr Freeth. “I’ll also discuss how medications, surgery, food and mindfulness practices can impact weight and overall health. After the talk attendees should better understand what they can do to become healthier and how their choices impact their health.”

All are invited to the free talk, which will take place on Wednesday 14 November from 6pm to 7pm in The Resource Centre located on the ground floor of the KEMH General Wing.

November is Diabetes and Chronic Lung Disease Awareness Month. Members of the community who have these conditions can work with BHB’s Diabetes, Respiratory, Endocrine and Metabolism (DREAM) Centre team. The fully accredited team provides education, advice and counselling to help people successfully manage their conditions.

Located in the Fairview Court building on the Mid-Atlantic Wellness Institute campus, the team includes: diabetes nurse educators Jane Hope, Verna Eugene and Tammoi Simons; asthma nurse educator Debbie Barboza; clinical dietitians Jessika Quigley and Letitia Rabain; endocrinologist Dr Amy Freeth; and internist Dr Cathryn Siddle.

Anyone who would like more information on the free events or on DREAM Centre services can call 239-2027, or email diabetes.centre@bhb.bm, asthma.centre@bhb.bm or endocrinology@bhb.bm.

Flyers of the public talk and free health screenings can be found below for download and printing. Please distribute widely.

BHB Diabetes and Chronic Lung Disease Awareness month NOV2018

BHB Diabetes Month public talk NOV2018

7 November 2018 Home Page, News

Medical ethics expert focuses on difficult conversations

1 November 2018: Bermuda’s healthcare providers will have the opportunity to learn from a medical ethics expert next week. Dr Christy Simpson, head of the Bioethics Department at Dalhousie University’s Faculty of Medicine, will return to the island to give a series of talks as part of Bermuda Hospitals Board’s (BHB’s) annual Ethics Awareness Week.

This year, Dr Simpson and the BHB Ethics Committee will focus on the difficult conversations that present a challenge for many healthcare professionals.

Dr Christy Simpson and Sita Ingram

Dr Christy Simpson (left) and Sita Ingram

Sita Ingram, Ethics Education Committee chair and clinical director of Allied Health Services at BHB, said: “Healthcare providers are here to diagnose and treat illnesses, but it’s also our duty to make sure our patients understand the reality of their diagnosis, and the risks and benefits of choosing one treatment over another. We need to take their values and beliefs into account, along with their loved ones’ wishes.

“These can be very emotional conversations for everyone involved, especially when the prognosis is not good or the treatment journey is likely to be difficult. The situation can be even tougher when patients aren’t able to make decisions for themselves.”

Dr Simpson said: “In the end we need to support patients and their families through the decision-making process and then support their decisions, whether or not the patient chooses the recommended course of treatment.

“There are steps we can take to prepare for these kinds of conversations and to deal with any issues that arise. There are also ethical considerations, along with tools that can help when making a decision is particularly difficult or there are differing views.”

Dr Simpson will lead continuing medical education lectures for local healthcare providers next Monday to Thursday (5-8 November). Details are available on the BHB website at bermudahospitals.bm by clicking on CME Events under Quick Links. Following the lectures, Dr Simpson, the Ethics Committee and BHB staff will participate in two days of workshops.

According to Dr Simpson, one thing everyone can do to make these kinds of situations a little easier is to consider completing an advance directive and choosing a healthcare agent.

“Thinking about what you would want and discussing it with your loved ones ahead of time can ease some of the stress in a very stressful situation,” Dr Simpson said. “In a case where you aren’t able to make your own decisions, an advance directive can take the burden off your loved ones’ shoulders and potentially prevent family turmoil because you’ve made many of the hardest decisions in advance.”

Members of the Ethics Committee will be available in the Acute Care Wing lobby at King Edward VII Memorial Hospital (KEMH) from 12pm to 2pm on Monday 5 November to talk about advance directives, ethical dilemmas, difficult conversations and decision making with members of the public who stop by. The Committee provides medical ethics consultations to healthcare providers, patients and the public by calling 291-HOPE (4673) or emailing ethics@bhb.bm.

Ethics information, tools and advance directive booklets are available at bermudahospitals.bm by searching ‘ethics’.

The BHB Ethics Committee comprises about 20 members, including clinical, administrative and community representatives. The Committee promotes awareness of ethical concerns at both KEMH and the Mid-Atlantic Wellness Institute, endorses medical ethics education, provides an ethics consultation service and produces guidelines on prominent issues that can help healthcare professionals consider all aspects of controversial decisions. The Committee also reviews medical research proposals on request and reviews hospital policies to ensure they are ethically sound.

BHB’s Ethics Committee maintains a close relationship with Dalhousie University’s Department of Bioethics, which provides assistance and training in ethical matters.

Featured photo credit: Monkey Business Images/Shutterstock.com

1 November 2018 Home Page, News

Walk-in Mammography Day on Thursday

23 October 2018: Bermuda Hospitals Board (BHB) is celebrating Breast Cancer Awareness month this week with a walk-in mammography day this Thursday 25 October. If you are over the age of 40 and have not had your mammogram this year, come and celebrate with us. We are accepting new and returning patients.

Please note the following:

BHB’s Mammography Department follows the guidelines of the American College of Radiology (ACR). This includes the age at which persons should have mammograms and the frequency with which they should be conducted. The guidelines stipulate the following:

  • Women aged 40 to 82 should get mammograms every year
  • Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer
  • All women should be familiar with the known benefits, limitations and potential harms linked to breast cancer screening
  • Women should know how their breasts normally look and feel, and report any changes to a healthcare provider right away
  • Women with a family history, genetic tendency or certain other factors should, in addition to a mammogram, be screened with MRI. Very few women fall into this category.
  • Talk with a healthcare provider about your risk for breast cancer and the best screening plan for you.

To learn about fun ways the BHB mammography team is marking Breast Cancer Awareness Month, follow us on Facebook at www.facebook.com/BermudaHospitals/

23 October 2018 Home Page, News

BHB Road Traffic Accident Statistics from 1 January to 30 September

18 October 2018: Bermuda Hospitals Board road traffic accident statistics for the period 1 January 2018 – 31 August 2018, shows the following:

1,350 victims required the Emergency Department

98 victims were admitted to the Acute Care Wing

17 victims were admitted to the Intensive Care Unit

8 victims 18 or younger were admitted to the hospital and,

8 victims were discharged to an overseas medical facility, following road traffic accidents.

95 road traffic accident victims were tourists

Posters with these statistics are available in the link below.

BHB Road Traffic Accident posters to September2018

18 October 2018 News

Mental health poetry competition launched for young people

3 October 2018: Bermuda Hospitals Board today announces the launch of a poetry competition ahead of Mental Health Awareness Week in October. Young people between the ages of 12 and 18 are being invited to write poems of up to 26 lines for the theme ‘Mental Health and Young People in a Changing World’. The poetry competition is free to enter, and there will be gift certificate prizes.

The competition opens today and the deadline is Tuesday 16 October 2018. Winners will be announced on Friday 19 October at the launch of the MindFrame PhotoVoice Exhibition at the Bermuda Society of Arts, an exhibition of photographs and art by people who use services at the Mid-Atlantic Wellness Institute.

Natasha Lisa Kalloo, Registered Mental Health Nurse in Child & Adolescent Services and member of the Mental Health Awareness Week Committee, comments: “The theme is Mental Health and Young People in a Changing World. During Mental Health Awareness Week we will talk about a number of issues impacting young people, but we wanted our young people in Bermuda to have a voice too. This poetry competition gives a creative way for them to speak about life in their own words and how it impacts their mental health – what makes them happy, sad, anxious, or depressed, for example and how they manage these emotions.

“There is no entry fee, and we want to encourage individual as well as school entries. We hope schools will see this competition as a way to talk about mental health and how it impacts their students, and that writing poetry is a way for them to communicate thoughts, feelings and events that may be challenging.”

Mental Health Awareness Week Poetry Competition Rules

Mental Health Awareness Week Poetry Competition flyer

3 October 2018 Home Page, News

King Edward VII Memorial Hospital is on Snapchat and under pink lights

1 October 2018: Bermuda Hospitals Board (BHB) is celebrating Breast Cancer Awareness Month this October with events and awareness campaigns organised by the Mammography Department.

BHB is expecting a social media buzz on Snapchat today with the Mammography Department filter and the main entrance of the Acute Care Wing will be under a pink glow commencing tonight and running for the entire month.

“BHB started offering mammography services in 1992 and since then have never wavered in our commitment to provide mammograms for all who need it,” said BHB Senior Imaging Technologist Terricca Smith.

“The pink entrance lighting shows the public that we continue to be dedicated to providing breast cancer education and testing. Research shows that early detection of breast cancer greatly improves survival rates, so we are eager for women to have regular mammograms,” she said.

BHB’s Mammography Department follows the guidelines of the American College of Radiology (ACR) which includes the age at which persons should have mammograms and the frequency with which they should be conducted. The guidelines stipulate the following:

  • Women aged 40 to 82 should get mammograms every year;
  • Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer;
  • All women should be familiar with the known benefits, limitations and potential harms linked to breast cancer screening;
  • Women should know how their breasts normally look and feel and report any changes to a healthcare provider right away;
  • Women with a family history, genetic tendency or certain other factors, should in addition to a mammogram, be screened with MRI. (Very few women fall into this category);
  • Talk with a healthcare provider about your risk for breast cancer and the best screening plan for you.

The Mammography Department has allotted Thursday 25 October from 9am to 12pm as walk-in Mammogram Day. Individuals who meet the requirements above, set out by the ACR, can attend the department for a screening without an appointment.

To learn about other interesting things going on and opportunities to win prizes from the BHB mammography team during the month, follow us on Facebook: www.facebook.com/BermudaHospitals/

1 October 2018 Home Page, News

Q&A with Myrian Balitian-Dill on the right of nurse practitioners to prescribe medications

24 September 2018: A question and answer interview with Bermuda Hospitals Board nurse practitioner Myrian Balitian-Dill.

BHB Nurse Practitioner Myrian Balitian-Dill

1. When did you become a nurse practitioner (NP)?

I completed my post-Master NP diploma and successfully passed my Board exam in August 2012.  I transitioned into my NP role in BHB in Jan 2013 in Cardiology.

  1. How long did it take?

As I already had my Master’s Degree (University of Toronto), it took about 20 months to complete the requirements for the Post Masters Nurse Practitioner Diploma (University of Toronto).

  1. Why didn’t you decide to become a physician?

I was already a seasoned nurse and I was helping patients make impactful changes in their lives by teaching them about their disease, counselling them on how to incorporate healthy habits, assisting them with their medications, and helping them manage their disease at home.  My goal was to build on my experience and incorporate more critical and diagnostic thinking into my practice to better assist my patients.  It was not my intent to shift my focus from a nursing perspective to medicine, but rather to advance nursing practice.  As nurses, our focus is to optimize the health/function of our patients through health promotion and disease prevention.

  1. Is your degree in a certain specialty?

There are several clinical streams you can choose to be as a Nurse Practitioner—Primary Care, Adult, Pediatric, Anesthesia.  Except for the Anesthetic stream, you can choose a sub-specialty to practice in.  For example, I am an Adult NP with a sub-specialty in cardiology.

  1. Are there other NPs in Bermuda?

Yes, and the Nursing Council recently registered two new Bermudian  Nurse Practitioners .6. Do you have any idea how many NPs are on island? Are you the only one at BHB?

I am the only one employed in a nurse practitioner capacity at BHB.  There are five registered with the Bermuda Nursing Council, but I am unaware how many are employed as nurse practitioners.

  1. Where is this designation popular?

Nurse Practitioners started in the United States and Canada to address the physician shortage, particularly in rural and outreach areas in the early 20th Century.  There are now about 248,000 NP’s in the United States and over 5,000 NP’s in Canada.  The role is gaining momentum and popularity globally with many jurisdictions investing and creating advanced practice nursing roles.  Global healthcare needs—such as an aging population, the insurgence of non-communicable diseases, coupled with the positive outcomes associated with NP care, have really propelled NP’s as a solution to our healthcare crisis.

  1. In other jurisdictions do NPs prescribe medication?

Yes, but there is still a lot of variability.  In the United States alone, the NP’s prescriptive authority is determined state by state.  Some states allow full prescribing authority—which allows NP to prescribe independently without physician oversight and can include controlled substances, such as narcotics.  In other states, there is no prescriptive privilege at all.

  1. You have been an NP for several years, what did you have to do to get this right in Bermuda?

Our legislation in Bermuda permits NP’s to prescribe “under the authority of a medical practitioner”.  This means that NP’s must have a collaborative relationship with an over-seeing physician.  It took several years to articulate the conditions of this collaborative relationship to enact it and allow NP’s to prescribe.   The practice is restrictive but it is a starting point.

  1. Can you explain the right to us? Does it have limitations i.e. / can physicians prescribe in instances where you cannot?

NP prescribing in Bermuda is restrictive.  It means I can prescribe from a list that pertains to the management of my patients.  For example, many of my patients suffer from chronic conditions such as diabetes, hypertension and heart disease.  So, the list that I can prescribe from reflects classes of medications that help manage those disease entities.

NP’s who work in other clinical areas will have a list that is reflective of their practice.  As NP practice grows, so will the list—with an inevitable shift to open prescription.  But I am getting ahead of myself.

  1. Now that you can prescribe you are essentially on equal footing with physicians?

It is not so much about “equal footing” but rather making the system more efficient.  If the NP can prescribe evidence-based therapy at point of care, why do we need to wait for another practitioner (physician) to prescribe that therapy?

NP’s are registered nurses with an expanded scope of practice which includes diagnosing, ordering and interpreting tests, as well as prescribing and performing certain procedures.  The role has overlapping skillsets with our physician partners.

According to the Institute of Medicine, practitioners should work to their full scope of their training.  It makes the system more efficient and cost-effective. This is the direction we need to go in order to address our healthcare crisis.

24 September 2018 News

Bermuda Hospitals Board Nurse Practitioner Obtains the Right to Write Prescriptions

24 September 2018: Bermuda Hospitals Board (BHB) Nurse Practitioner Myrian Balitian-Dill is one of only a handful of registered nurses who have attained nurse practitioner designation in Bermuda. She is now the first to be granted authority to write prescriptions locally. Mrs Balitian-Dill received the news from the Bermuda Pharmacy Council on 31 August 2018.

Mrs Balitian-Dill is the only nurse practitioner at BHB. On obtaining her qualification she moved into a nurse practitioner role in the hospital’s Cardiology Department. In November 2016 she transitioned to help set up a new service at BHB, the Patient-Centred Medical Home. The small dynamic team of this service also includes a physician medical director, a staff nurse and an office administrator. The setting provided the ideal environment for Mrs Balitian-Dill to be afforded the right to prescribe as Bermuda legislation dictates that prescribing rights can be granted to nurse practitioners “under the authority of a medical practitioner”.

The new development is the result of several years of collaboration to ensure all the necessary regulatory documents were in place. Mrs Balitian-Dill is pleased with the move and sees it as a starting point and an important way to help reduce health care costs.

While the permission only exists under the direct supervision of a physician, Mrs Balitian-Dill explains the benefit.

“I believe it makes the system more efficient,” said Mrs Balitian-Dill. “If the nurse practitioner can prescribe evidence-based therapy at point of care, why do we need to wait for another practitioner (physician) to prescribe that therapy?”

“I applaud the path Myrian has taken in her nursing career,” said BHB Chief of Nursing Judy Richardson. “Myrian is passionate about advancing nursing practice in Bermuda. Her work with the Patient Centered Medical Home is yielding positive results. Early evidence shows improved health of clinic patients who had frequently used other services.

Our Clinical Services Plan identified the need for a more diverse workforce which includes more advanced practice nurses like Mrs. Balitian-Dill.”

BHB CEO Venetta Symonds said: “We welcome this move by the Pharmacy Council and are proud of Myrian’s accomplishments and her dedication to provide our patients with the best possible care.”

Editor’s note:

The Patient-Centred Medical Home is an outpatient clinic within BHB created to provide a more coordinated, comprehensive, and patient-centred approach to care to un-insured and under-insured patients who also have chronic medical conditions.  The service is available by referral.

24 September 2018 Home Page, News

Bermuda Hospitals Board announces Road Traffic Accident Statistics for the period 1 January – 31 August 2018

20 September 2018: Bermuda Hospitals Board road traffic accident statistics for the period 1 January 2018 – 31 August 2018, shows the following:

1,224 victims required the Emergency Department

92 victims were admitted to the Acute Care Wing

15 victims were admitted to the Intensive Care Unit

6 victims 18 or younger were admitted to the hospital and,

8 victims were discharged to an overseas medical facility, following road traffic accidents.

86 road traffic accident victims were tourists

20 September 2018 Home Page, News