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1 Making a Difference everyday nursing Biennial report
2 Table of Contents 1 Chief Nursing Officer s Letter 2 Transformational Leadership Transforming Emergency Care Enhancing Delivery of Care Blending Patient Comfort and Efficiency in New Cardiac Catheterization Suite A New More Therapeutic Inpatient Psychiatric Unit 6 Structural Empowerment Forces of Magnetism Continuously Raising the Bar Groundswell of Support for CNS Contributions Nurses Recognized by Joint Commission 10 Community Involvement Saving a Mother s Life Helping Officer DiPonzio Defy the Odds Saying Thank You to Those Who Have Served our Country Starting Healthy Habits Early Excel Internships Ease Transition to Employment Improvising Amidst Devastation 16 Exemplary Professional Practice Safety is about Culture Comprehensive Program Enhances Safety for Newborns and More Changing our Philosophy and Saving Lives Helping Patients Live Better with Home Dialysis New Videoconferencing Communication Enhances the Healing Process for Surgery Patients Incredible Devotion Making it Possible for a Mother to Attend her Son s Wedding 22 New Knowledge, Innovations and Improvement Using Evidence to Advance the Nursing Profession Wiping out Infection 26 Awarda, Grants, Presentations, Publications and Research Awards Grants Presentations Publications Research Cover photo: Grace Dengler, RN, Clinician I (see page 14)
3 High quality care, exceptional service & compassion Dear Colleagues, It is with great pleasure that I present the Rochester General Hospital 2009/2010 Biennial Nursing Report. It is both an honor and a privilege to work with one of the finest group of professionals, our nurses. They, along with the entire healthcare team, demonstrate a commitment to serve our patients and our community by providing high quality care and exceptional service with compassion. Faced with financial challenges, I made a dramatic change in the nursing leadership structure in 2009, only eight weeks prior to our Magnet redesignation site visit. Building on our shared governance model, the structure was flattened, truly embracing leadership at the front line. The nurses, with the entire healthcare team, demonstrated their ability to work together for a common purpose to provide the highest standards of respect, patient safety, and clinical excellence to our patients, families, and community. During our site visit in March, it was evident to the Magnet Appraisers that our entire team was engaged and focused on outcomes. They witnessed and experienced respect, knowledge, research, quality, collegiality, and collaboration at all levels within the organization and our community. As a result, we were redesignated as a Magnet Hospital in May of 2009, a recognition achieved by less than 7% of all U.S. hospitals, demonstrating our commitment to continue our journey in clinical and nursing excellence. In 2010, we underwent an unannounced Joint Commission survey. Most evident in this survey was the culture and attitude of our nursing team in providing excellent care to our patients. The nurses were recognized for delivering compassionate, individualized care. The surveyors left Rochester General Hospital with best practices they intended to share with others throughout the country. Nursing is both an art and a science. What we do isn t easy it takes dedication and commitment. It is both physically and mentally challenging. Our nurses are passionate about what they do and they continue to raise the bar. At Rochester General Hospital, clinical excellence is more than competence and skill; it s about caring for our patients, each other and our profession. We serve as both a resource and mentor for other organizations. In the following report, you will see highlights of our accomplishments and stories representing both the art and science of nursing. At Rochester General Hospital, we are united by a common purpose and the opportunity to do meaningful and worthwhile work. I am proud of our nurses and the entire healthcare team. They make a difference every day. Cheryl Sheridan BS, RN, MPA, NE-BC Senior Vice President Patient Care Services and Chief Nursing Officer 1
4 transformational leadership An infrastructure to remain dynamic Rochester General Hospital s nurses are empowered to create valuable, positive change through a commitment to collaboration and leading-edge care. As a result of physical and organizational changes throughout the hospital, we ve fostered a sense of belonging that welcomes new voices, boosts morale, enhances performance, and encourages a team approach that benefits our entire organization. Transforming Emergency Care Joelle Marcaida, RN, Clinician III (l) and Christine Fiordeliso, BS, RN, Administrative Clinical Leader (r). The new Emergency Department s thoughtful and expansive layout brings patients closer to medical personnel and vital resources. A better equipped, more collaborative atmosphere in the B. Thomas Golisano Pavilion and Emergency Center has allowed team members to realize efficiencies that were impossible in the previous space. Now we have all the tools, resources and staff we need to do our job effectively, states Michelle Johnson, RN, Clinician III. Nurses played an integral role in the changes, which have resulted in a higher level of care. Patients have noticed. Emergency Department patient satisfaction scores escalated from the single digits to the 90th percentile in A major reason is that patients are seen much more quickly; wait times have been slashed dramatically to approximately 15 minutes. Among the other significant transformations: nursing stations have been replaced with work stations, where nurses, physicians and secretaries function as a team. Rooms are private and spacious with TVs, well-stocked supply carts, and a state-of-the-art monitoring system allowing continuous communication between patients and medical personnel. 2 In the ED, nurses, physicians and secretaries operate as a team. Peter Sichak, RN, Administrative Clinical Leader (l); Bryan Gargano, MD.
5 Enhancing Delivery of Care Laura Stahl, RN, CEN, Clinician III, at computer workstation in a patient room. The new ED demonstrates a significantly higher level of care. The redesign has affected both atmosphere and attitude. We can greet people with a clear conscience, knowing we can help everybody in a timely fashion, says Mary Mahler, BSN, RN, Administrative Clinical Leader. And we re happy because our patients are happy. How can we make this our home? That s the question nurses asked during construction of the 12-bed Sands Family Cardiothoracic Intensive Care Unit (CTICU). Among the answers: Larger patient rooms with windows, wall-mounted computers with bedside labeling systems, ergonomic sinks, hooks on the backs of doors, and bedside carts to store supplies. We help each other as much as possible. Ginny Riggall With everything at the bedside, nurses are in charge of their practice says Ginny Riggall, MS, RN, CCRN, Clinical Nurse Specialist in the CTICU. They are also able to spend more time with their patients, affording them the opportunity to make subtle observations. For example, when nurses recognized that patients were unfamiliar with bedside clocks that displayed military time, they replaced them with standard-time models. The new space with close proximity to the Przysinda Family Foundation Cardiac Catheterization Suite has had the added benefit of encouraging more teamwork between the two units. Nurses communicate more easily and effectively about patient flow, collaborate on order sets and training, and work better as a team to improve outcomes. Relationships have also improved with respiratory therapists, who now round with nurses and midlevels, an arrangement that has strengthened communication. We help each other as much as possible, says Ginny. With better communication, you can offer suggestions and come up with better solutions for the patient. Ginny Riggall MS, RN, CCRN 3
6 Blending Comfort and Efficiency in Cardiac Catheterization 4 Sharon Babicz, BSN, RN, Clinical Leader, Clinician III (above). Renovations, made with recommendations from nurses and patients, have translated into more time at the bedside and higher patient satisfaction. In a high-volume, highly technical environment like Rochester General Hospital s Przysinda Family Foundation Cardiac Catheterization Suite, special attention must be given to the delicate balance between patient comfort and team member efficiency. Using recommendations from both patients and team members during the renovations, the attention paid to even the smallest details down to the paintings on the walls has caused patient satisfaction scores to soar from the single digits to the 90th percentile. The patients come and go from the same room, with the same nurse, so it feels like they re getting one-on-one care, says Aileen Mancini, BSN, RN, Nurse Manager. Nurses are equally appreciative of the new environment. I don t feel as rushed, explains Sharon Babicz, RN, Clinical Leader, Clinician III. I can say, I m going to be your nurse and this is what s going to happen. The patients definitely have less anxiety. During renovations, nurses offered their opinions
7 Suite on what would make waiting and recovery time more pleasant. Now, there are additional rooms that are larger and include solid walls between them to reduce noise and enough space for visitors to sit down. Computers are on wheeled carts instead of fixed to a central station for more accessible information at the bedside. Windows were added for more natural light. Families are able to wait in a nearby room instead of being sent to another floor, allowing physicians to communicate with them more easily in person. The nurses looked at this project not only practically, but emotionally. They really owned it to make it right. Aileen Mancini In addition, because of the more structured assignments, nurses are able to spend more time educating patients throughout their stay, providing a continuity of care that makes both patients and their families feel safer and more valued. The proof is in the numbers the result of extreme dedication and tireless planning on the part of the nursing staff. The nurses looked at this project not only practically, but emotionally, Aileen adds. They really owned it to make it right. A New More Therapeutic Inpatient Psychiatric Unit Nurses and patients were consulted in the design phase of the newly renovated G1, Inpatient Psychiatric Unit. Swathed in soothing colors, the 30-bed unit now boasts big-screen TVs, quicker access to medical charts and computers, cubbies for patients, a locker/coat room for staff near the new guest lounge area, an exam room that doubles as space for family conferences, and a large conference room. As a result of the changes, We re heading toward a more therapeutic milieu, says Lynsay Smith, MS, RN, LMHC, Director of Behavioral Health Acute Care Services. We are now able to provide more patient-centered, individualized treatment options. The unit is participating in a New York State Office of Mental Health learning collaborative, with the focus on reduction of restraint use. In addition, team member training in Dialectical Behavioral Therapy helps patients learn how to regulate emotions and when to use self-soothing techniques. With the additional, space, a comfort room for patients is also being added. By recognizing subtle changes in mental status and therefore providing earlier interventions before behavior escalates, restraint use on the unit decreased by one-third from 2009 to We all worked together to get it done and it s beautiful. Sue Ceretto It all comes down to one thing, says Lynsay: We re being more proactive than reactive. Overall, the unit is now more spacious and filled with light, which enhances both patient and team member experiences. Says Sue Ceretto, RN, Clinician III, We all worked together to get it done and it s beautiful. Sue Ceretto RN, Clinician III 5
8 STRUCTURAL empowerment Demonstrating commitment to the practice and to each other The heart of a Magnet hospital can be found in the role of a nurse in the myriad ways frontline nurses drive improvement through collaboration, communication, ethical decisions, and a deep understanding of what constitutes a strong professional practice. Forces of Magnetism Continuously Essential to the success of Rochester General Hospital s Magnet redesignation process, Magnet Unit Champions from every unit built enthusiasm and guided colleagues through what to expect during a three-day site visit in March And their hard work was duly noted. Magnet Unit Champions enthusiastically exemplify the highest standards of care and commitment. 6
9 Raising the Bar The appraisers told us our passion was palpable, remembers Barb Thompson, MS, RN, Magnet Program Co-Director. As ambassadors with a mastery of the 14 Forces of Magnetism and other components of a Magnet organization, they champion the nursing excellence practiced on a daily basis. The Forces of Magnetism are not something that we talk about just to prepare for a redesignation survey they are woven into our culture, says Trish Koops, BSN, RN, CCRN, Magnet Unit Champions Committee Chairperson. It s what we do every day. The Champions used a variety of methods to prepare team members throughout the hospital. For example, a Magnet Jeopardy game had teams of nurses answering potential questions from appraisers, while weekly newsletters publicized performance improvement projects and highlighted nursing accomplishments. On the logistical side, the Champions coordinated transportation needs during the site visit and served as escorts for the appraisers. Team members from all departments joined Cheryl Sheridan, BS, RN, MPA, NE-BC, CNO, in the Twig Auditorium in May 2009 as she received the call from the Commission on Magnet announcing Rochester General Hospital s second Magnet designation. Magnet Unit Champion Jennifer Morath, BSN, RN, CNOR, Clinician IV, recalls continuing the celebration five months later at the American Nurses Credentialing Center 2009 National Magnet Conference, which she attended with 16 colleagues and a nursing student. In nursing school at the time and working at Rochester General Hospital for just two years, Sarah Yaeger, Patient Care Technician on 5200, the Interventional Cardiology Unit, felt enlightened after attending the ANCC 2010 conference. She recalls leaving with a newfound confidence in her ability to blend compassionate patient care with the practical information she was learning in the classroom. We have a very tight-knit group here, and we were reminded at the conference how special that is. Sherri Bernier It was very exciting to see the passion that nurses throughout the country and the world have for their careers, says Sarah, now an RN working full time on Thousands of people were there to show what they do, and how much they care. It was an eye opener that nursing really is one big family. A group of Patient Care Services team members from all levels returned from the three-day event with inspiring stories, suggestions for improvement, and a renewed excitement and energy for the work that they do. Sherri Bernier, LPN II on 6800, the Orthopaedic Surgery Unit, and currently enrolled in an RN program, was one of those fortunate to attend the Magnet conference. Throughout the next week, she shared her experiences with nursing colleagues, physicians and other team members during daily huddles. Sherri explains, We have a very tight-knit group here, and we were reminded at the conference how special that is. The Champions already have started preparations for the next site visit in Still energized, they continue to exemplify the standards that demonstrate their commitment to the practice and each other. It s a journey, says Donna Tydings, MS, RN, CNS-BC, CCRN, Magnet Program Co-Director. We want to sustain the momentum to continuously raise the bar. Sherri Bernier LPN II 7
10 Groundswell of Support for CNS Contributions A new working group meets twice a month to plan and execute the unique and valuable contributions that Clinical Nurse Specialists (CNS), a team of advanced practice nurses, provide to patients, other nurses, and the entire organization. The CNS Group, with 12 members, highlights the versatility, in-depth knowledge and specialized expertise these nurses exhibit in clinical practice, teaching, research, consulting and leadership. Changes are being made and it s affecting patients at the bedside. Maureen Krenzer Maureen Krenzer, MS RN, ACNS-BC, Clinician VI, Clinical Nurse Specialist for Members spent six months compiling a list of needs throughout the hospital, then used their big-picture perspectives to match the appropriate CNS with each need. For example, using simulation equipment, they made it possible for newer nurses to practice the code blue process Maureen Krenzer MS, RN, ACNS-BC Clinical Nurse Specialists are known for their unique and valuable contributions to the entire organization. in non-emergency situations to increase their confidence after orientation. The people we train are able to take the information we ve given them and move ahead with it, says Maureen Krenzer, MS, RN, ACNS-BC, Clinical Nurse Specialist for 2800, General Surgery Unit. Changes are being made and it s affecting patients at the bedside. The Committee has also helped support the push for title and regulatory protection, served as a link to preceptors for CNS graduate students, participated in the change to an electronic medical records system, and created a comprehensive, cross-referenced resource manual for staff nurses needing help on any number of issues. In 2010, the CNS group was consulted to help develop the nursing team members at Newark-Wayne Community Hospital, an affiliate of Rochester General Health System. Members are updating protocols to reflect both sites, using telemedicine
11 equipment to broadcast meetings, and providing professional education. This accomplished group stays current through membership in professional associations (many have published and lectured at the local, state and national levels), and reaches out to the community by offering information and free screenings at health fairs and other public events. Arleen Beck-Miller, BSN, RN, CCRN, Clinician IV, a CNS student preparing to graduate, feels uplifted after every meeting. You see how advanced practice nurses affect the hospital, she explains. I come out and know that this is what I want to do, that I chose the right path. Maureen says she appreciates the groundswell of support as the Committee expands its scope, which will, if all goes as planned, include training in what would become Rochester General Hospital s own simulation lab. We are being appreciated as a united group that can impact every area of the organization. There s more recognition of what a CNS has to offer. Earning Recognition from the Joint Commission Surveyors from the Joint Commission re-accreditation process complimented Rochester General Hospital as being among the best and most cooperative hospitals in the nation when they were here for our recent re-accreditation survey. Most evident in the recent survey was the culture and the attitude of our nursing team in providing excellent care to our patients. Cindy Bileschi And at the end of their intensive five-day visit in November 2010, they took some documents they felt could be useful in establishing best practices at other hospitals, including the Sepsis Screening Tool developed by a multidisciplinary team and the Skin Assessment Flowsheet developed by RGH nurses. Most evident in the recent survey was the culture and the attitude of our nursing team in providing excellent care to our patients, says Cindy Bileschi, BSN, RN, Senior Director, Office of Clinical and Regulatory Compliance. It showed that they are proud of what they re doing. Nurses were recognized for staying current with regulatory standards, implementing changes required for remaining in compliance, and Cindy Bileschi, BSN, RN, and Patty Johns, MPA, RN, CPHQ, help maintain Rochester General Hospital s distinction as one of the nation s best and most cooperative hospitals. delivering compassionate, individualized care. All units use self-assessments and daily tracers to find opportunities for improvement and ensure highquality care at all times not just in preparation for visits from surveyors. They don t have to memorize answers to questions, adds Cindy. This is what they do. 9
12 community involvement 10 Compassion beyond the bedside Rochester General Hospital nurses willingly and generously lend their time, skill and philanthropic resources to make sure patients and their families receive the best care possible in the region and across national borders. Their level of concern for the community and for each other is a daily testament to the power of the human spirit. They provide so much more than treatment. They get involved. Saving a Mother s Life InterVol assists children in a remote village in Belize. In her mid-30s and a mother of five, Cheryl Ritchie had literally dragged herself for two days from her remote village in Belize to wait in line with hundreds of others hoping for medical care. She had been diagnosed with a bad heart valve, and without treatment she had less than a year to live. It s a one-in-a-million chance that this woman is still alive and with her children. Susan Richmond-Austin Dr. Gerry Gacioch, Rochester General Hospital s Division Head of Cardiology, had traveled to Belize with members of the nonprofit international relief agency InterVol, which has a formal partnership Susan Richmond-Austin RN, CCRN, Clinician III with the hospital. He took Ritchie s information and promised that someone would be in touch. She had heard that before, more than once. Out of options, she headed back to her family with no hope for recovery. A few months later, InterVol, along with help from numerous community partners, flew Cheryl and her mother to Rochester for an all-expenses-paid heart valve replacement. They were here for six weeks, in the middle of winter. In addition to the medical and emotional support they provide all patients, nurses went above and beyond to offer comfort in such a foreign environment. They weren t used to the cold, so the nurses bought them sweaters, coats and scarves, recalls Susan Richmond-Austin, RN, CCRN, Clinician III. I took them out to lunch, to a museum. Some of the others took them shopping. They didn t know anybody, and we wanted to make their stay nicer. When it was time for Cheryl to return home, the nurses hosted a luncheon for her at the hospital. It s a one-in-a-million chance that this woman is still alive and with her children, Susan says, We were her last resort, and she was very grateful. The next time InterVol was in Belize, she showed up and volunteered for days. She wanted to give something back. It s just very emotional to be able to help someone like that.
13 Helping Officer DiPonzio The personal connections our nurses make with patients are an essential part of the miraculous journey from near death to a new beginning. Anthony DiPonzio can attest to that. The 23-yearold was a little more than a year into his career with the Rochester Police Department when he was shot in the back of the head by a 14-year-old boy. Though chances for survival were slim, he continues to make an extraordinary recovery. In a journal presented to Anthony after his release from the Surgical Intensive Care Unit, nurses privately documented their thoughts about their high-profile patient s condition and progress. Some offered appreciation for the honor of taking care of him, others called him a hero. I ve got an incredible team that gives 100%, so it s nice to see that this young man is starting to put his life back together. Diana Blauw Anthony continued to receive visits from Rochester General Hospital nurses. He s currently recovering at home. Diana adds: I ve got an incredible team that gives 100 percent, so it s nice to see that this young man is starting to put his life back together. These miracles motivate us to continue to give everything to our patients every day. Antonio Lagares, RN, Clinician I, one of the many SICU nurses who felt honored to care for and develop friendships with Officer DiPonzio. It took a hospital-wide effort to accommodate the outpouring of support from turning over a staff lounge to Anthony s family and colleagues to advocating for Anthony s privacy during his most frustrating days. You d have the district attorney, the county executive, the mayor, and half the police force there, but his needs came first, recalls Diana Blauw, RN, BSN, NE-BC, Nurse Manager, SICU. That s how it is with every patient here. After being transferred to a rehabilitation facility, Wounded Rochester Police Officer, Anthony DiPonzio 11
14 Saying Thank You to Those Who Have Served Our Country 12 I don t think there s a way to describe how it makes you feel, says Hope Monje, BSN, RN-BC, Administrative Clinical Leader, pictured here with Vincent Capriotti, World War II veteran from Honor Flight. Hope has been on two flights so far. It makes me stand a little taller just to be with these men. They were at Arlington Cemetery, getting ready to board the bus, when a couple from overseas approached and asked, Are you a World War II veteran? Sally Sackett, BSN, RN, CPAN, CAPA, Clinician IV, quietly stepped aside so the gentleman she had been accompanying could have his moment. He nodded. The questioning continued: Could my sons take a picture of you? You re the most important thing we ve seen all day. Sally recalls this story as a shining example of why she and other Rochester General Hospital nurses give their time to the national Honor Flight Network, a nonprofit organization that gives World War II veterans a free trip to Washington, D.C. to visit the Memorial and other sites that pay tribute to their sacrifices. The nurse volunteers hold hands, offer tissues, handle logistical challenges, and are there for those who have done so much for so many. In nursing we take care of people every day, says Sally, who now serves in a leadership position as a health coordinator for the organization. But I m doing this because I want to say thank you not because it s my job. Wanting to do even more, she enlisted nurses from the Day of Surgery Unit to help organize a fundraiser for Honor Flight. They raised more than $1,100 at the event, held in December 2010 on Pearl Harbor Day. The entire experience is infectious. It gets in your blood and you just can t stop. Carole Ann Lee During the two-day excursion, a deep sense of trust emerges between the nurses and veterans, some of whom have been homebound for years. They tell us stories they haven t told anybody, notes Carole Ann Lee, RN, Clinician III.
15 Starting Healthy Habits Early Sally Sackett, BSN, RN, CPAN, CAPA, Clinician III, and Carole Ann Lee, RN, Clinician III, give back by volunteering with Honor Flight. That connection has helped volunteer Matthew Barnum, BSN, RN, Clinician III, hold his position at the hospital in higher esteem. We take our medical knowledge for granted because we do it every day, says Matthew. But when you re a volunteer, you really appreciate who you are and what you mean to people. It takes me back to the bedside with a greater respect for myself and what I have to offer. The entire experience is infectious, says Carole Ann, who has since returned as a medical leader and recruited her husband as a guardian. It gets in your blood and you just can t stop. With all the concern these days about childhood obesity, echoed by an acquaintance who teaches sixth grade, Karen Riordan, IABPT, suggested starting a partnership between the Przysinda Family Foundation Cardiac Catheterization Suite and a Rochester elementary school. Knowing the importance of instilling positive habits in children at an early age, I thought, Wouldn t it be great if we brought healthy things to them? she recalls. We were able to go back several times and see the kids grow. The experience not only allowed us to open their eyes to opportunities in the healthcare field, it strengthened our team. Christy Hoover The partnership with Audubon School No. 33 began with a health fair staffed by nurse volunteers. Students in grades four through six moved from one station to the next, sampling fruit smoothies, exercising, and learning ways to make meals more nutritious. Entire families participated in a subsequent career fair, which drew more volunteers from the hospital including nurses, nurse practitioners, Christy Hoover BSN, RN, CVN, Clinician IV dental clinicians, patient care technicians and radiology technicians as well as some of their children, who demonstrated fun and easy ways to incorporate movement into daily activities. During the holidays, nurses from the lab hosted a party for the students and distributed hats and mittens bought with their donations. We were able to go back several times and see the kids grow, says Christy Hoover, BSN, RN, CVN, Clinican IV. The experience not only allowed us to open their eyes to opportunities in the healthcare field, it strengthened our team. 13
16 Excel Internships Ease Transition to Employment Rochester General Hospital s Excel Nursing Internship Program provides nursing students valuable experience before they formally enter the profession. Just ask Amy Koster, RN, Clinician I, whose paid summer internship program allowed her to work as a patient care technician on 6800, Orthopaedic Surgery Unit, where she was assigned a preceptor and learned how to organize care delivery for multiple patients. By the time she started work on the same unit after graduation, I already knew the people, the unit, and the kinds of patients I was going to be caring for, she says. It made the transition so much easier. Upon graduation in spring 2009, 70% of Excel nurse interns who were offered RN positions at the hospital accepted. That number grew to 71% in Candidates in the competitive program must be enrolled in a Registered Nurse degree program and within one year of graduation. Under the mentorship of a professional nurse, interns have the opportunity to establish therapeutic and personal relationships with patients, visitors and other hospital team members, as well as shadow nurses in other departments. Upon graduation in spring 2009, 70% of Excel nurse interns who were offered RN positions at the hospital accepted. That number grew to 71% in Grace Dengler, RN, Clinician I, who spent her 10-week internship on the 5100, Mendick Cardiac Evaluation Unit, chose to shadow nurses in the Medical Intensive Care Unit, the Emergency Department, and the Operating Room. The experience afforded her a view of the continuum of care delivery across various levels. You learn different things from different people, she says. The program also helped Grace, who received the 2010 Outstanding Adult Student Award by the Continuing Education Association of New York, feel more confident in a fast-paced atmosphere: I m now an RN on 5100 and the Excel experience helped me a lot in my transition. Grace Dengler RN, Clinician I
17 Improvising amidst Devastation in Haiti Nurses traveled to Haiti to provide much-needed care after the devastating earthquake in Shari McDonald, BS, RN (left), with a nurse from Haiti. Some of the vivid images Rochester General Hospital nurses brought back with them from the devastation in Haiti, where they voluntarily provided desperately needed medical assistance after the devastating earthquake in 2010, include an infant throwing up worms, burning body limbs, and amputations with hacksaws and no anesthesia. You checked your ego at the door and did what you had to do for the people, says Gloria Berent, MS, RN, CNOR, Director of Nursing for Perioperative Clinical Services. Improvisation was key. Under primitive conditions and with very limited medical equipment, the nurses quickly figured out ways to use ordinary supplies in unconventional ways. Catheter bags were reused as garbage bags, crutches became IV poles, and donated urine cups that were useless without the means to conduct lab tests were turned into pharmaceutical containers. You made the best of the situation, recalls Laura Stahl, RN, CEN, Clinician III. It has made me so much more appreciative of who I am, where I live, and the patients we serve. Shari McDonald The nurse volunteers worked with Haitian nursing students. The students who chose to help without knowing if their own families were alive or dead understood that the nurse volunteers were there only to train and assist, not to take over. They organized supplies, labeling boxes first in Creole and then in English, taught sterilization techniques, and used pantomime and drawings to overcome the language barrier when discussing treatments. They were so appreciative, says Shari McDonald, BS, RN, Emergency Department Nurse Manager. And it has made me so much more appreciative of who I am, where I live, and the patients we serve. Despite the horrors all around, the Haitian people were stoic in their resilience. Their determination and innovation one woman sat in a wheelchair made from a plastic lawn chair and spare wheels inspired those who had come from so far to help out. Gloria remembers that wheelchair: I thought, if they can do that, then we can do this. 15
18 exemplary professional practice 16 Changing the culture to enhance patient outcomes Rochester General Hospital nurses have helped advance quality and patient safety to unprecedented levels of priority. From spearheading innovative efforts that touch every department to focusing on ways a single unit can improve, they demonstrate an autonomy and interdisciplinary competence that takes into account the unique needs of every patient. Kristin Opett BS, RN, MSHA Safety Is about Culture Safety needs to be about culture, not just statistics. Nurses at RGH are helping to drive changes that redefine the organization s approach to quality. Together with the Patient Safety Institute, they are working on collaborative patient safety goals while continuing their focus on assuring regulatory compliance. Their contributions were paramount in initiating Comprehensive Unit-based Safety Programs (CUSPs), forming a Patient Safety Advocacy Team to track standards of care, and launching the hospital s new Institute for Patient Safety and Clinical Excellence. Patient safety is a new and emerging science, says Kristin Opett, BS, RN, MSHA, Senior Leader, Patient Safety Officer. It is truly about continuous improvement. On a three-day observation trip to Johns Hopkins in the summer of 2009, a multidisciplinary team of nurses, physicians and administrators met with a wide range of experts, sat in on unitbased safety team meetings, saw firsthand how the hospital handles adverse situations, and learned ways to restructure broken systems. The Patient Safety Advocacy Team helps prioritize quality and patient safety throughout the hospital. In a sense, everybody was new. There was so much going on, this gave the nurses one less thing to worry about. Kayleigh Fahey Returning home inspired, the group hosted a two-day Safety Summit with a standing-roomonly crowd of more than 650 of its organizational leaders, which led to improvements systemwide. One of the most notable was the launch of Comprehensive Unit Based Safety Programs a national best practice. As an example: CUSPs in 5200, Interventional Cardiology Unit, included nurses collaborating with the Przysinda Family Foundation Cardiac Catheterization Suite on hand- Kayleigh Fahey BSN, RN
19 off reports, training new hires, and leading daily tours to familiarize staff with post-construction layouts all of which boosted nursing team member morale and improved quality of care. As a result, patient satisfaction scores rose. Scores were in the 99th percentile in late 2010, up from the mid-70th percentile earlier in the year. And all nurses, no matter their level of work experience, appreciated the chance to become familiar with the new environment. In a sense, everybody was new, says Kayleigh Fahey, BSN, RN, Administrative Clinical Leader. There was so much going on, this gave the nurses one less thing to worry about. Meanwhile, the Patient Safety Advocacy Team has met monthly to highlight individual department achievements, discuss ways to replicate those successes, address questions, and share detailed reports on safety data none of which is blinded. Adds Bernadette Murphy, BS, RN, Director of Clinical Excellence and Performance Improvement: The idea was that we were going to be truly transparent. Comprehensive Program Enhances Safety for Newborns The idea struck when Lori Houppert, MS, RN, Clinician III, accompanied a new mother to her car after discharge. After watching the woman loosely strap her newborn into the car seat, she pointed out that the straps needed to be much tighter for the baby to be safe. The woman said she lived only five minutes away. With each initiative, nurses have felt a greater sense of empowerment. And boom, they were gone, Lori remembers with a heavy heart. I was almost in tears. I thought, This is ridiculous. We ve got to do something. In response, the Drs. C. Samuel and Jeanne E. Grove Women s Care Unit created a Comprehensive Unitbased Safety Program (CUSP) for car seat use, one of several CUSPs the unit has initiated since (continued) 17
20 18 (continued from previous page) Nurses were trained by a county agency to guide parents on adjusting straps and making sure babies are secure. And every discharge folder includes a brochure listing places that inspect car seats, a service that will be available at Rochester General Hospital the first hospital in the region to offer it after nursing team members complete an upcoming certification process. The unit has been busy with several other CUSPs as well: Reinforcing among team members and patients that hand washing is the best way to Lori Houppert, MS, RN, Clinician III, instructing a mom on safe car seat use. Nurses in the Drs. C. Samuel and Jeanne E. Grove Women s Care Unit created several safety initiatives to take patient care to the highest level. prevent the spread of infection, using teambuilding exercises to point out potentially unsafe conditions, creating triage handoff sheets to improve communication between shifts, and promoting a deeper awareness of sensitive patient information in the busy triage area. With each initiative, nurses have felt a greater sense of empowerment a sense shared by everyone at the consistently packed, multidisciplinary CUSP meetings held monthly. It s always standing room only, says Sarah Miller, BSN, RN, Clinical Leader. They are taking ownership of problems and are involved in the solutions. They are engaged and excited and feel like their voices are being heard. Changing Our Philosophy and Saving Lives SICU Team Members celebrate 500 infection-free days near the end of A prominent sign near the entrance of the Surgical Intensive Care Unit (SICU) not only trumpets the number of days without a central line-associated bacteremia infection, but the pride and dedication behind it. The SICU had logged 515 infection-free days in a row by the end of Such a record comforts nervous families with loved ones who are critically ill and preparing for yet another invasive procedure, according to Meredith Dawes, RN, Clinician I. It s a nice thing for us to share with


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Oh crap. here he comes Can't I come in the box? You won't fit. You are too fat. I've been eating salad The box isn't big enough. Nonsense, the box is plenty big. You are crushing me! I told you. CAN"T BREATHE!

domain: pet


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Late spring and early summer is a wonderful time to go on vacation almost anywhere. One of the best spots to visit, though, is Scottsdale, Arizona, which is dubbed the “West’s Most Western Town.” It is a beautiful, scenic and historic place with lots of sunshine throughout the year. But visiting after winter but before things heat up too much is the ideal time to experience this stunning landscape. It’s no wonder why millions of people make it their trip destination. When you go to Scottsdale, you can explore the city’s natural beauty. Here are some of the best tips for your trip.
Stay at the Right Place
First and foremost, you will want to stay at the right place when you travel to Scottsdale. There are many Arizona luxury resorts to be found in the city, but perhaps the best is the Hyatt Regency Scottsdale Resort & Spa at Gainey Ranch. It is a family-friendly hotel that is breathtaking and surrounded by the McDowell Mountains. There is a water playground that encompasses nearly three acres and you can enjoy great live music every night of your stay. You can even get a nice massage by visiting the hotel’s spa.
The Saguaro Scottsdale is another well-rated, popular destination. There’s quirky Southwestern style for days at this boutique-style resort. With multiple pools with cabanas, spas, gyms, and fun activities, you’ll never be bored.
You can’t enjoy the sheer beauty of nature in Scottsdale, Arizona without making a stop at Butterfly Wonderland. It is one of the biggest atriums in the United States and is home to thousands of different butterfly species. You can stop at the Butterfly Emergence Gallery to see how a butterfly goes through its metamorphosis and view an amazing movie, Flight of the Butterflies, in 3D.
Fiesta Bowl Museum
If you are a football fan, you will definitely want to make a trip to the Fiesta Bowl Museum while you’re in Scottsdale. It is free and open on weekdays. It features a number of exhibits and memorabilia surrounding the legendary college bowl game. You can see some of the most prestigious college football trophies and all 128 helmets of the CFB teams.
Old Town Scottsdale
Old Town Scottsdale is a place you can visit to do a number of things at once during the day or evening. There are scenic, winding streets to explore, galleries where you can view incredible works of art, food, including a farmer’s market and plenty of shopping. The area is located in the downtown portion of the city and is affectionately known as the Fifth Avenue Shops. If you’re a fan of beer and wine, there are many spots where you can also sample at your leisure.
Scottsdale Arabian Horse Show
If you happen to visit the area in February, visit the Scottsdale Arabian Horse Show. This is a free tour that showcases over 2,000 beautiful Arabian horses and is perfect for anyone who is a horse lover. You can also learn a number of facts about these beautiful, gentle animals. Kids are sure to love the Arabian Horse Show.
Frank Lloyd Wright’s Taliesin West
Since you will already be in the Sonoran Desert while visiting Scottsdale, why not take a trip to Taliesin West? This was the home and architectural school of legendary architect Frank Lloyd Wright. It has since become a popular hotspot for tourists and architectural fans throughout the world. Tours are given daily to give guests a better insight into Wright’s incredible designs and uncanny ability to blend the outdoors with the indoors.
These are some of the best sights to see when you are traveling to Scottsdale. Plan your itinerary now!

domain: geography


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One of the first Magi RP Sites to hit the web. Create your own character within an alternate world based off the home of Aladdin, Alibaba, Morgiana, and Sinbad, the King of the Seven Seas! Conquer Dungeons and receive the power of Djinn, and maybe so
Shinobi of Lore is a play-by-post role-playing game set in a custom universe based on the Naruto series. Create a custom shinobi, join one of the villages and become a legend worthy of stories to come!
We are a group of growtopia players who create games or projects out of the game. Feel free to browse our games or get in with the community!
Free forum : We love The Legend of Zelda series and strive to create the perfect place for Zelda fans and gamers!
The forums of project eon.. A place where you can see updates, Chat with friends, make new posts, create guides, finding the latest client.
Naruto rpg which takes place in the Clan war era. Allowing you to create and fill major roles in a universe where Hashirama and Madara never existed.
SoFaC is a science-fantasy community where you can create and play your own story, set within a richly detailed universe. This is the SoFaC discussion community.
A complex gaming network, Team Rage and Task Force 51 have come together as one to create a new wave of gaming in NOLA.
Join the first English role-playing forum on the web! Create your own original character to roam around Ikebukuro or apply for a canon character to role-play as. Either way, you'll definitely have a f
The purpose of this forum is to create an open source community that is focused on fabricating the best headphones for as little money as possible using free time.
Free forum : Rebellious Rewind is a forum attempting to create a dynamic economy and environment in which everyone's actions have the potential to affect the lore of the site. Uses some Mechanics from Shadow of Mordor, but is not based on it.
Create your own Super hero or Super villain. Save the universe or conquer it. The choice is yours in Marvel Unlimited.
TEA is an open prompt role play site where you create the story, the world, and the rules of your thread. No limits and everything comes form your imagination.
The greatest Naruto RP forum of its era. Create characters, build families, raise villages, and make legends in battle. The Shinobi world is in your control join now and you can introduce your ideal character.
Free forum : This is a text based roleplay where you create a character then live and fight within the jedi order.
Medieval Roleplay where you can create your own Kingdom, explore Dungeons, and do quests for your King.
Here we role-play and work together to create epic stories.
Free forum : A play-by-post forum rpg, the God's Game is a creative strategy game. You start with a 'Maker' Character of a specific domain and allowed to create within the void.
Progress Through Self Destruction. A movement to change how social media works within music and create a new outlet for creativity and collaborations.
Free forum : For all your roleplaying needs. Roleplay anything you wish. Create your own account and jump in! We roleplay from humans, shifters, animals. . . You name it
A roleplay site for people to create stories together.
Just a place for me to mess around and create layouts to get exprience =]
The all-time BBWFL, otherwise known as, Beanie Babies World Football League. Create your own team today!
Become a shinobi from any nation at Naruto RP Legends. Create your own clan or become part of an already existing one, learn jutsus, and become a world famous ninja.
Umineko: No Naku Koro Ni is based on Manga/Visual Novel/Anime series. It's going to be sorta like a MMO in a forum. Create your Original Character and have fun.
A casual D&D experience that aims to create a fun environment to play at your leisure and allow for adventures among friends new and old.
Taylor connect is great, but there is always drama, so why not create this!
Ecalphri is a rising upstart in online role playing chat sites. Create your own character and adventure with others as you travel around the world of Ecalphri and do virtually anything.

domain: entertainment


"You can never have enough pass rushers," Smith said. "We want to get more pressure on the quarterback this season."
Although North Carolina State's Mario Williams is destined to be a top five pick, there are three other defensive ends who could be on the board when the Bears are on the clock with the 26th selection.
The Bears have already shown interest in Florida State DE/LB Kamerion Wimbley at the Seminoles pro day last month. Despite missing three games with a knee injury, he finished with 7.5 sacks as a senior. At six-foot-4, 248-pounds Wimbley ran the 40 in 4.63 seconds at the NFL Combine.
Penn State's Tamba Hali is not considered a great pass rusher despite 11 sacks last season, but the 275-pound native of Liberia has enough size to be an every-down player and should be a late first- or early second-round pick. The problem is he reminds some of Haynes for more than coming from the same college. Hali lacks speed, which is something Smith craves off the edge and has led to a diminished role for Haynes.
North Carolina State's Manny Lawson might be best suited to play the rush linebacker position in a 3-4 defense because he weighs just 241 pounds, but he's 6-foot-5, so he could grow into a full-time defensive end, and he runs a 4.46-second 40-yard dash.
If the Bears decide to address defensive end outside of the first round, there's also potential value later in the draft.
Tennessee's Parys Haralson is undersized for an every-down defensive end at 6-1 and 253 pounds, but he could make an immediate impact as a situational pass rusher in the second or third round.
Purdue's Ray Edwards had a disappointing junior campaign for the Boilermakers, which saw him start the first six games of the season, only to become part of a rotation. Even with part time reps in the second half of the season, he still finished with 5.5 sacks.
The Bears are likely to address defensive end at some point in the draft. With Alex Brown and Adewale Ogunleye coming off Pro Bowl alternates seasons, it would seem to make more sense to wait until the second day to address the perceived need.


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description of the Claude and Mary Tidd fonds on Archives Canada
Search multi-level description available on the Yukon Archives' Archives Descriptive Database
Collection of Claude Tidd's photographs on the Yukon Archives'
The virtual exhibit on the history of the Mounted Police in Canada is available on the Virtual Museum of Canada site.
Archives Canada for more virtual exhibits and descriptions of records in archives

domain: library


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Mark Twain National Forest
|Mark Twain National Forest|
IUCN category VI (protected area with sustainable use of natural resources)
A kayaker on the St. Francis River at Silver Mines Recreation Area in the Mark Twain National Forest
|Nearest city||Rolla, MO|
|Area||1,491,840 acres (6,037.3 km2)|
|Established||September 11, 1939|
|Governing body||U.S. Forest Service|
Mark Twain National Forest (MTNF) is a U.S. National Forest located in the southern half of Missouri. MTNF was established on September 11, 1939. It is named for author Mark Twain, a Missouri native. The MTNF covers 1,491,840 acres (6,037.3 km2), 78,000 acres (320 km2) of which are Wilderness, and National Scenic River area. MTNF spans 29 counties and represents 11% of all forested land in Missouri. MTNF is divided into six distinct ranger districts: Ava-Cassville-Willow Springs, Eleven Point, Houston-Rolla-Cedar Creek, Poplar Bluff, Potosi-Fredericktown, and the Salem. The six ranger districts actually comprise nine overall unique tracts of forests. Its headquarters are in Rolla, Missouri.
Some unique features of the Mark Twain include Greer Spring, which is the largest spring on National Forest land and part of the Eleven Point National Scenic River, and pumps an average of 214 million gallons of water per day into the river. The public can also visit the Glade Top Trail National Scenic Byway, which offers views of over 30 miles (48 km) to the Boston Mountains in Arkansas. The 350-mile Ozark Trail system winds through much of the National Forest.
In the 1870s, citizens of southern Missouri began an era of extensive logging of the state's native oak, hickory, and pine forests. Lumber mills were commonplace, but by the 1920s they had disappeared, along with much of the state's native forests. Thus, in 1939 President Franklin D. Roosevelt signed the MTNF into existence. In March 1933, he also created the Emergency Conservation Work Act, better known as the Civilian Conservation Corps (CCC). In the area that would later become Mark Twain National Forest, hundreds of young men at over fifty CCC sites worked at building roads and planting hundreds of acres of pine to preserve and enhance the natural resources of southern Missouri. Many of their contributions can still be visited and enjoyed today.
Although it is far from being the largest National Forest in acreage, Mark Twain National Forest is located in more counties than any other. As of September 30, 2007, its 1,490,862 acres (2,329.47 sq mi, or 6,033.3 km²) were spread over parts of 29 counties in southern and central Missouri.
|Sainte Genevieve County||10,254||4,150|
|Saint Francois County||673||272|
- "Land Areas of the National Forest System". U.S. Forest Service. January 2012. Retrieved June 24, 2012.
- "The National Forests of the United States". ForestHistory.org. Retrieved July 20, 2012.
- Table 6 - NFS Acreage by State, Congressional District and County - United States Forest Service - September 30, 2007
|Wikimedia Commons has media related to Mark Twain National Forest.|
- "Mark Twain National Forest". USDA Forest Service. Retrieved February 6, 2006.


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We've known Jon Stewart was coming back to television. We knew it'd be on Apple TV Plus. And now we know what the new show will be called.
The Trouble With Jon Stewart will premiere this fall — Apple isn't saying exactly when — and already has been signed up for multiple seasons of the hourlong show. Each episode will tackle a single issue — a "problem," as the name implies (though there could certainly be a problem with Stewart himself) "that are currently part of the national conversation." They'll also touch on Stewart's advocacy work, which opens the doors to health care for military vets, as well as animal rights.
Apple also says that there will be a companion podcast "to continue the discussion." (No word on whether it'll be exclusive to Apple Podcasts or somehow only available to Apple TV+ subscribers, or if it'll be more broadly available as well.)
Stewart will host the show and also serve as executive producer.
Apple TV+ also is home to other original series like The Morning Show, and the awards darling Ted Lasso.
Apple TV+ is the all-original streaming service from Apple. It's available for $4.99 a month, though you'll get it for free for a year if you buy a new Mac, iPhone or iPod. Apple TV is available on every major streaming platform, including Roku, Amazon Fire TV, Google TV, Apple TV, and on the web.
Get the latest updates, reviews and unmissable series to watch and more!
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domain: news


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In his nationally syndicated column, Cal Thomas points to the critical role of ultrasound in empowering pregnant women to make an informed pregnancy decision. In his column, he cites a Care Net survey of the impact of ultrasound on a woman's pregnancy decision. Thomas writes,
A 2005 survey by Care Net, a network of about 1,000 antiabortion pregnancy centers in the United States and Canada, based in Sterling, Va., found that "72 percent of women who were initially 'strong leaning' toward abortion decided to carry their pregnancies to term after seeing a sonogram." That isn't depriving a woman of her "choice." It is providing more information so that her choice will be fully informed.

domain: medical


My client, a major Oil and Gas Service company, has an excellent opportunity for a Design Draughter to join the engineering team on a permanent basis. This opportunity offers the successful candidate an opportunity to work with one of the leaders in this field.
Working in a busy engineering drawing office of a major service company: Produce engineering documents such as drawings, technical illustrations, ensuring they are completed to required standard within timescales Covering full range of mechanical components including components such as skids and frames as well as schematics and some electrical. Reviewing as-built equipment to allow improvements in design, manufacture, assembly and operation in the field Participate in briefings/debriefings, report reviews, design reviews and costing Provide support to Engineering, Manufacturing, Service, Sales & Service Departments Aberdeen and elsewhere
Candidate: Competent in the use of Autocad Experience in a Design Office in Engineering Environment Experience of working to established processes and standards relating to the Oil and Gas Industry Able to work on own initiative with little supervision Be self motivated and a strong team player Produce accurate work of consistent high quality and quantity
For more information or to discuss this position further please email Richie at firstname.lastname@example.org or call 01506 517215
Job Reference: RW/16143
Closing Date: 09-Nov-2012


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McClain was a former Illinois assistant and state champion high school coach.
John Groce has Illinois in it to the end so often that he’ll soon land a big fish.
Illinois’ athletic department ranks in the lower one-third of the Big Ten in donor contributions.
They say where there’s smoke, there’s fire.
Kansas State rewarded basketball coach Bruce Weber for winning a share of the school’s first conference championship in 36 years with a raise and a one-year contract extension Wednesday.
Throughout all the brimstone, my mind kept sparking back to a thought that’s been in my head for weeks: The Fighting Illni and Weber’s Kansas State Wildcats have no business meeting in the NCAA Tournament this season. And here’s to hoping that they don’t.
Jim Larranaga’s team has had a banner season, but they’ll likely have to beat Duke for a second time this season — this time with Ryan Kelly — to reinforce their potential to go deep in the NCAA Tournament.
Bruce Weber isn’t on the sidelines in Champaign any longer. But that hardly means the guy can’t still stir up the Illini faithful.
He’s off in Kansas now. But, not unlike the coach who preceded him in Champaign, it’ll be a long time before Bruce Weber is forgotten at the University of Illinois.
Former Illinois coach Bruce Weber has been hired to replace Frank Martin at Kansas State, sources told CBSSports.com.
On Thursday, the bad case of Illini indigestion was finally relieved when Ohio University’s John Groce was announced as the 17th men’s head coach in Illinois history during a press conference at Assembly Hall in Champaign.
John Groce has been hired as the new men’s basketball coach for Illinois.
Butler’s Brad Stevens will not be taking over as Illini basketball coach.
Weber led the Salukis to two NCAA Tournaments from 1998-2003 before moving on to the University of Illinois, where he coached until he was fired March 9.
It’s difficult enough to hire the right basketball coach at Illinois, without choosing to limit the field of candidates beforehand.
With Bruce Weber’s Illinois tenure in the rear-view mirror, multiple names have begun to surface as a potential replacement.
Instead of making a brief statement in support of his friend, Izzo opted on Friday to instead unspool an inappropriate – and inaccurate – rant against Illinois athletic director Mike Thomas.
In an interview on The Mully & Hanley Show on 670 The Score, Thomas simply said he had no comment, after Izzo ripped him Friday at the Big Ten Tournament.
After addressing the game, Izzo set aside time to specifically address Illinois’ decision to fire Bruce Weber. And wow, he had a lot to say.
With Bruce Weber officially out the door, here are nine possible Illini head coaching candidates.


ZQTG08 dc linear actuator/ max loading capacity 6000N for solar
They are perfect for the applications such as solar panel tracking,
door and vent controllers and household floor washers.
- The DC linear actuator transfers the rotational output of its motor
to the final straight-line actuation movement via gear trains or
lead screw arrangements, both of which seem to be involved into our
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- The straight-line motion is used to run a huge number of different
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- The linear actuator can be powered with either 24VDC or 36VDC to
obtain maximally the loading capacity as much as 6000N. It can
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- This model of DC linear actuator has been updated both in
workmanships and key components like windings, ball bearings and
gear sets to prolong its life.


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The fabulous North Country Theatre Company return with their latest production, Gift of Stones by Jim Crace.
Adapted for the stage and directed by Nobby Dimon
The village of flint knappers is safe, self satisfied, and inward looking, but a stray arrow, an amputation, and a wild woman from the salt sea marshes bring murder, mystery and cataclysmic change. Narrated by a one armed story teller and his daughter, in a language as pared down and flinty as their tools and weapons, Jim Crace’s award-winning historical novel is brought to the stage by the company whose brilliant adaptations have ranged from the hilarious 39 Steps to the scary The Rocking Horse Winner, and most recently the deeply moving A Month in the Country.
We are offering a discount of £2 if you also book a seat for ‘Falcon’s Malteser’ (discount automatically applied at checkout but not applicable to dine-out tickets).
|FOOL (Friend of the Old Laundry)||£14|


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Results tagged with 'employment'
Published Aug. 6, 2016
Two years ago this week, Donna Jones was one of hundreds of workers at the Cargill Inc. beef slaughterhouse told their services would no longer be needed. Enter Employ Milwaukee to help her and 438 other displaced Cargill workers, Milwaukee Neighborhood News Service reports.
Published June 7, 2016
StandEatDrink Hospitality Group, the owners of MOVIDA in Walker's Point, as well as the forthcoming Hotel Madrid and Yokohama 1910, will host a job fair for qualified candidates on Monday, June 13.
Published May 25, 2016
A Common Council ordinance has been drafted that would significantly reinforce the city's ability to put unemployed or underemployed people to work, while also better ensuring economic opportunities for small and locally-owned businesses.
Published April 6, 2016
Milwaukee Neighborhood News Service reports that America Works, a nationwide organization that connects job seekers and employers, recently held its first large-scale job fair in Milwaukee's central city on March 30.
Published Dec. 1, 2015
Fifteen thousand Wisconsinites kicked off food stamps right before the holidays because of a new state work requirement law. Sounds heartless, right? Unless you actually look at the reason the people were bounced out of the program.
View the other 7 articles
Piles of red circled job classified ads sits on the table. Musty smell of old newspapers linger in the air. The computer has browsers opened to LinkedIn and local newspaper employment postings. Books about resumes and social media presence littered the living room. My head dizzy with tho...
Republicans agree that cutting taxes (especially the top brackets) is the best way to stimulate job creation and thus reduce unemployment. But are they right? Let's consider three major sectors of employment: manufacturing, services and government.
Manufacturing: Advances in automation and robo...
I'm fairly new to our fair city, and so many parts of the area excite me, but I have to say I'm more than a little amped at the upcoming week of events to honor those who work downtown. Sorry, I guess that's Downtown.
I have enjoyed working and walking Downtown, we eat at the Waterfront D...
Write a blog now!


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The online classifieds website has been acquired by Impresa Capital, the majority shareholder in the Durban-based Ignition Group.
Online transacting on classifieds sites for South Africans could become safer with the local launch of a dedicated escrow service. The service, dubbed Shepherd, is supported by Standard Bank and is designed to facilitate safer online trades as it eliminates the
Wi-Fi networks, rather than those operated by mobile communications companies, will eventually be the predominant way that South Africans connect to the Internet, according to Alan Knott-Craig, the
Online advertisements promising to rehabilitate indebted consumers’ credit records for a fee are often scams, credit bureau TransUnion said on Monday. These advertisements could be found on online classified websites such as Gumtree and OLX, fraud specialist Gayle Mower
President Jacob Zuma was put up for sale in a tongue-in-cheek advert on classifieds website Gumtree, The Star reported on Monday. The advert was posted by “Average Joe” on Thursday but disappeared soon afterwards, the publication reported. It featured Zuma’s picture, with the price set as “negotiable”
I have often warned people about free classified websites like Gumtree because they are a breeding ground for scams and fraudsters out to deprive you of your money and your possessions. I’ve never been successfully scammed on
When classified advertising specialist Junk Mail Publishing was founded in 1992, few people had heard of the Internet. Seventeen years…

domain: finance


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welcome to the best extraordinary casual guide of Hello Neighbor alpha 4 games,In this guide of Hello Neighbor alpha 4 you will find various traps and walk troughs, Moreover , in this guide you will discover how to complete all appreciated Neighbor alpha 4 games levels in the most least complex way .
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-------------------- Table of Contents : -------------------- - Hello Neighbor : Item and Distraction Guide - How To Reach Hello Neighbor alpha 4 game Ending - Hello Neighbor : Complete Alpha 4 Guide - Hello Neighbor Guide To Breaking And Entering - Hello Neighbor : Learning the Controls and Getting Into the House - How To Reach The Hello Neighbor Ending


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Workshop teaches gardening for health
Dee Pigneguy is hoping to inspire more people to take up a healthier way of life through her Gardening for Health workshop at the Dig It! Royal Oak Organic Garden.
There’s still time to book a place at the February 24 event.
She says on the whole people now have too much ready-made ‘‘fake food’’ handed to them on a plate.
‘‘When people go to the supermarket now it is just refined sugar, refined sugar, refined sugar,’’ she says.
Pigneguy says people need to head back to their roots and back to the garden, to remember the way things used to be.
‘‘People need to look to food as the answer to good health.’’

domain: agronomy


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The Kansas Wesleyan University Foundation has announced a pair of new board members, as Jandrea Blumanhourst ’89 and Jenell Hulse join the group of esteemed leaders. The appointments took effect July 1.
Hulse, the construction division manager and a commercial loan officer at Bank VI, hails from nearby Lindsborg. A 2018 graduate of Kansas State, she is active in both Salina and Lindsborg. Hulse is a co-chair of Svensk Hyllningsfest, president of the American Legion Auxiliary and a former president of the Salina Noon Rotary Club. Both of Hulse’s parents attended KWU.
Blumanhourst, who resides in Wichita, brings 33 years of accounting experience to the board. She graduated from KWU in 1989 with a degree in accounting and went on to earn a Master’s in Professional Accountancy from Wichita State. She has served on several boards, most recently for the Wichita Chamber Chorale.
A full list of the KWU Foundation’s Board of Directors appears below:
Chair: Bob Meyer ’73
Vice Chair: Gus Applequist ’14
Treasurer: Tom Wilbur
Secretary: Cathy Doubrava
Mike Baumberger ’96
Jandrea Blumanhourst ’89
David Branda ’76
Steve Scofield ’65
“Jenell and Jandrea bring a tremendous amount of financial experience to our foundation board,” said Ken Oliver, KWUF administrator and the university’s executive vice president for advancement and university operations. “They join a distinguished group of leaders and achievers, whose wisdom and insight has sent the university’s endowment to never-before-reached heights. We are fortunate to benefit from this group’s knowledge.”
The Kansas Wesleyan Foundation was established to be an auxiliary association for the financial aid and assistance of Kansas Wesleyan University. It operates an endowment in excess of $45 million.


Logan led troops in Germany, worked in D.C.
MADISON – Lieutenant Colonel John Logan’s military career led him to serve in Germany and work with various command agencies in Washington D.C.
“When I graduated from college, I was commissioned as a Second Lieutenant (2/LT) in the Army Transportation Corps. I reported for active duty at Fort Eustis, Va. to attend the Transportation Officers Orientation Course on Oct. 16, 1962 — the week of the Cuban Missile Crisis,” Logan said.
Logan’s next assignment was to a medium truck company in Mannheim, Germany. During this three-year tour, he served as platoon leader, battalion personnel officer and company commander.
“When I left active duty in 1965, I joined the Alabama National Guard for two years with assignments as a Signal Officer,” he said. “I transferred to the Army Reserve, completed the Transportation Advanced Course, and the Command and General Staff College.”
From this point, Logan held various active duty assignments with the Defense Logistics Agency (DLA) and served on the staff of the commanding general of the Military Transportation Management Command (MTMC) in Washington D.C.
Logan retired with the rank of Lieutenant Colonel.
In civilian employment, Logan worked with Teledyne Brown Engineering from 1966 until his retirement in 2005 as Director of Human Resources.
“My wife Lois and I moved from southeast Huntsville to Madison in 2000,” he said. “We really enjoy the community.”
He attended Florence State College (now the University of North Alabama) and received a bachelor’s degree in business administration. With Southeastern Institute of Technology, Logan earned a master’s degree in organizational development.
“My wife and I have three daughters: Andrea who lives in Atlanta; and Pamela and Elizabeth, who live in Denver. Our three grandchildren are Logan, 25, Freeman, 21, and Lyla, 11,” he said.
“I do annual volunteer work raising funds for families with children with cancer,” Logan said. “I golf regularly and am an avid University of Alabama football fan.”


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A History of the County of Worcester: Volume 3. Originally published by Victoria County History, London, 1913.
This free content was digitised by double rekeying. All rights reserved.
Herefortune, Hereforda (ix cent.); Herefordtun-juxta-Avene (x cent.); Herferthun (xi cent.); Herfortune (xii cent.); Hervertun (xiii cent.); Hervyngton (xv cent.).
The parish of Harvington lies on the eastern boundary of the county. It is divided from Warwickshire by a tributary of the River Avon, (fn. 1) forming the greater part of the eastern and northern boundaries of the parish. The Avon itself bounds it on the south and east, while one of its tributaries, flowing south-east, forms the western boundary. There is a ferry across the Avon in the extreme south of the parish.
The area of Harvington is 1,310 acres, (fn. 2) of which 780 are arable, 383 permanent grass and 2 acres are woodland. (fn. 3) The village of Harvington stands at a height of some 100 ft. to 150 ft. above the ordnance datum. To the north-west the land rises slightly, attaining near the northern border a height of 200 ft. The soil is sand, with a subsoil of gravel and Keuper Marl, and the chief crops are wheat, barley and beans.
Harvington village spreads over a series of steep and irregular slopes, the houses being scattered along several by-roads. The roads run between banks and hedges, and the country is wooded close to the village. (fn. 4) The church stands prominently on a ridge at the meeting of three roads, the rectory in wooded ground on the west at the foot of the hill. In the village are several houses of 15th and 16th-century date, the half-timber work being well preserved.
Adjoining the churchyard on the south-east is Harvington Manor, a fine two-storied house of stone and half-timber, dating in part from the 14th century, but much altered by the insertion, probably in the 17th century, of new floors and partitions. The floors throughout appear to be hung up by iron straps to the tie-beams of the roof principals. The original arrangement of the plan seems to have consisted of a large open hall on the north with a two-storied block of buildings on the south. The position of the original screens is marked by a passage across the house, and the present door on the east is a later opening. The walls of the ground story are of stonerubble masonry, the first floor being of half-timber construction. The roof is covered with stone slates. Two of the original window openings with their moulded oak mullions still remain. The entrance doorway at the north-east of the original hall still retains its moulded frame and door of oak. To the north of the entrance is a central newel stair, probably of later date, leading to the loft over this portion of the house. A little to the north of the house, immediately adjoining the churchyard on the east, is a fine pigeon-house of rubble masonry lined internally with stone cells and having a ridge roof covered externally with stone slates. This is probably contemporary with the house, and is an extremely fine example. In the garden of the rectory, an old house with modern additions, are portions of early 14th-century tracery, removed from the east window of the church at the time of its restoration.
The village contains a reading room, opened in 1887.
There is a wharf on the Avon and to the north of the village a disused gravel-pit. There is a sand-pit in the north-west of the parish.
In 1868 there was a curious old custom still observed at Harvington; the children used to go round to all the houses on St. Thomas's Day and St. Valentine's Day repeating a doggerel rhyme as follows (fn. 5) :—
'Wissal, wassail, through the town,
If you've got any apples throw them down,
Up with the stocking and down with the shoe,
If you've got no apples money will do.'
Thomas James, head master of Rugby School, was presented in 1797 to the rectory of Harvington, where he died in 1804. (fn. 8)
A bronze celt was found in the ditch which divides Harvington from Warwickshire. (fn. 9)
The following place-names occur in the 17th century: Harfordes, Mowes, the Meere, Hingle, Bitton, Portway Peece, Haynes Close, and Sherrowes. (fn. 10) Wistanes Brycge, Heopanhylle, Hunighommesstreote, Caersawealla are places mentioned on the boundaries of Harvington in an Anglo-Saxon charter. (fn. 11)
In 799 Balthun Abbot of Kempsey gave to King Coenwulf of Mercia, in return for privileges for his house, 12 'manentes' at 'Hereford.' (fn. 12) At the beginning of the 9th century Deneberht, Bishop of Worcester (798–822), gave 2 cassates of land at HARVINGTON to Eanswyth for her life on condition that if she survived him it should pass to the church of Worcester after her death. (fn. 13) Harvington is included in King Edgar's spurious charter of 964, granting the hundred of Oswaldslow to the church (fn. 14) of Worcester. At the date of the Domesday Survey Harvington, which then included Wiburgestoke, was held by the monks of Worcester. (fn. 15) In 1207 they let it at a farm of 24 marks and 12 quarters of oats to the men of the vill for twelve years. (fn. 16) This lease was renewed in 1230 for ten years. (fn. 17) In 1240 the annual money rents from the manor amounted to £2 14s. 10d. (fn. 18) In 1254 the prior leased the manor to Simon de Wauton, afterwards Bishop of Norwich. (fn. 19)
At about this time John D'Abitot made an exchange with the monks of Worcester of 4 acres of land for a part of a messuage in Harvington, and a case (fn. 20) in which this John appears was taken at the Worcester Eyre of 1254. Roger de Pershore and Marchia his wife complained to the judges that on the Thursday before St. Peter ad Vincula last certain strangers had stolen away Maud their daughter and abandoned her at Harvington, where John D'Abitot kept her at his house against her will. John D'Abitot, however, denied any fault of his. On the Thursday he was leaving his courtyard at Harvington, when he heard a great noise, and on looking for the cause beheld a monk and some Welshmen dragging along an unwilling girl who made a great outcry. Seeing D'Abitot her captors fled and she, left alone, begged him for shelter. This he willingly gave her till she could return to her own friends. The girl confirmed the story; so the parents, who had sued the rescuer for 100s., went disappointed away.
In the Taxation of 1291 Harvington was included with Cleeve Prior. (fn. 21) After the dissolution of the priory in 1540 (fn. 22) the manor of Harvington was granted to the Dean and Chapter of Worcester in 1542, (fn. 23) and was confirmed to them in 1609. (fn. 24) On 23 June 1641 they granted it to Kempe Harward for three lives, but in 1652 the commissioners for the sale of the dean and chapter lands sold it to Thomas Bound. (fn. 25) He still held in 1658, (fn. 26) but at the Restoration the manor was recovered by the dean and chapter, (fn. 27) and remained with them until 1859, (fn. 28) when it was taken over by the Ecclesiastical Commissioners. In 1862 the commissioners sold to the trustees of the Duc D'Aumale the reversion of certain leasehold land and the lord's interest in some copyhold land and a fishery in the Avon. (fn. 29) This estate has since passed with Bishampton Manor (q.v.) to Sir Charles Swinfen Eady.
At the date of the Domesday Survey there was a mill at Harvington which was worth 10s. a year. (fn. 30) This mill was granted by David, Prior of Worcester (1143–5), to William Rupe at a yearly rent of 17s. and 30 'stiches' of eels, (fn. 31) and in 1212 was the subject of a lawsuit between Thomas Rupe and his wife Joan and Richard and Hugh Sandford and their wives Maud and Olivia. It was finally settled by Thomas Rupe acknowledging the right of the Sandfords to the mill, while they yielded to him certain lands which were part of his mother's dowry. (fn. 32) In 1294–5 an agreement was made between William Lench and Alice his wife, on the one hand, and Henry de Chester, John his son and Henry Austyn on the other, (fn. 33) concerning mills in Harvington, which may have been those acquired by the prior and convent from Henry Austyn of Sandford in 1311. (fn. 34) After the dissolution of the priory both these mills passed to the dean and chapter, who sold them to George Willoughby in 1549–50. (fn. 35) In 1818 cornmills at Harvington were advertised for sale, a paper-mill there being at that time held under a lease for thirty years by a Mr. Phillips. (fn. 36) There is still a mill in the parish to the south of the village, and near it is a weir which is said to have been repaired with fragments and even some of the statues from Evesham Abbey. (fn. 37)
The church of ST. JAMES consists of a chancel measuring internally 32 ft. by 20½ ft., south vestry, nave 25 ft. by 40 ft., north porch, and west tower 9 ft. by 9½ ft. The earliest existing remains belong to the 12th century or earlier, and the church at that date was considerably smaller than the present building, the nave being about 16 ft. wide. The extreme height of the early nave, the west wall of which is still clearly visible, would even suggest a pre-Conquest date, but the earliest detail, that of the tower (which has been rebuilt in recent years), is of the first quarter of the 12th century. Early in the 14th century the whole church was rebuilt, with the exception of the tower, and enlarged to its present dimensions. The east window was replaced by a modern one at a recent restoration, and the tower was largely restored and crowned with a modern timber spire.
The three-light east window is modern, replacing a 14th-century window, the remains of which are in the vicarage garden. On either side of the chancel are three single-light windows, of 14th-century date, with trefoiled heads. At the east end of the south wall is a curious 14th-century piscina with a trefoiled head and an abnormal development of the cusps into a thin stone shelf. There is no sedile, but the sill of the south-east window was originally carried down to form a seat. The north door to the chancel and the pointed chancel arch of two chamfered orders both date from the 14th century.
In the east wall of the nave is a small image bracket and at the east end of both north and south walls appear the sockets for the rood beam. The nave is lit by four 14th-century windows, each of two lights with traceried heads, and though all are of similar detail the eastern one in the south wall is of notably finer design. There are 14th-century north and south doors to the nave, the latter blocked, with chamfered jambs and heads and labels with curiously mitred drips. The north porch is modern. The circular tub-font at the west end of the nave is of doubtful date. The west wall of the nave bears clear traces of the earlier church, the line of the nave walls and the pitch of the roof being quite distinct. There is also a blocked-up square door which must originally have opened on to a western gallery and above this is a small round-headed window, originally external.
The door between tower and nave is of late 12th-century date with a plain slightly pointed arch of two square orders and chamfered capitals. The early 12th-century west window is a single deeply splayed light with a round head. The original belfry windows in the second stage of the tower are of two roundheaded lights, the mullion taking the form of a column. The broach spire, added in 1855, is covered with oak shingles. On the west wall of the nave are two monuments, to Thomas Ferriman, who died in 1619, and to Thomas his son, both rectors of the church.
The belfry contains a peal of tubular bells.
The plate consists of a chalice without marks, of late 17th-century design, a plated salver and a pewter flagon.
The registers before 1812 are as follows: (i) baptisms from 1573 to 1733, burials 1570 to 1731, marriages 1570 to 1729 (1633 to 1660 missing); (ii) baptisms from 1653 to 1690, burials 1653 to 1687, marriages 1678 to 1687 in a dilapidated minute book; (iii) baptisms and burials from 1734 to 1812, marriages 1734 to 1752; (iv) marriages from 1755 to 1812.
There is a Baptist chapel in the parish with 160 sittings, erected in 1886.
According to the register of Worcester Priory, Deneberht, Bishop of Worcester, gave the church of Harvington to the priory at the same time as he gave the manor. (fn. 38)
The prior and convent were the patrons until the Dissolution. (fn. 39) After the dissolution of the priory the advowson was granted to the Dean and Chapter of Worcester in 1542 (fn. 40) and confirmed to them in 1609. (fn. 41) The dean and chapter have made the presentations (fn. 42) ever since, and are still the patrons of the church of Harvington.
A cottage at Harvington given for the maintenance of lights in the church was valued at 3s. 4d. at the time of the dissolution of the chantries. (fn. 43)
The eleemosynary charities are regulated by a scheme of the Charity Commissioners 6 May 1884. They comprise the charities of (1) William Chaunce (fn. 44) and others, trust fund, £120 consols, representing the gifts of various donors mentioned on the church table; (2) Mrs Lydia Ward, gift in 1841, trust fund, £22 7s. 4d. consols, and (3) Mrs. John Marshall, gift in 1857, trust fund, £26 18s. 7d. consols. The several sums of stock are held by the official trustees, producing £4 4s. 8d. yearly, of which in 1909 £2 4s. 8d. was distributed in coal and £2 was paid as bonuses to clothing and boot clubs.
In 1887 the Rev. Arthur Henry WinningtonIngram, by his will proved at London 16 April, bequeathed £100, now £100 consols, with the official trustees, the annual dividend of £2 10s. to be applied in memory of Mrs. WinningtonIngram in adornment of the churchyard with trees, shrubs and flowers and in maintaining the churchyard in beautiful order.
A reading room with site was by deed dated 3 September 1887 conveyed to trustees by Mrs. Winnington-Ingram in memory of her husband, the Rev. Arthur Henry Winnington-Ingram, for the use of the parishioners.