Category: Newsletter

Conquering Enormous Obstacles, a Young Mother Becomes a Certified Nursing Assistant

Since she was little, Tiana Albino has wanted to be a pediatrician, and she was determined not to let anything get in the way of her dreams. Giving birth to a son at age 19 and becoming homeless seemed like big obstacles, but Tiana wasn’t giving up so easily.

And thanks to The New Jewish Home’s Geriatrics Career Development program (GCD), she’s on her way.

Tiana’s plan was to start her career by studying to be a nurse, and after high school she enrolled in the nursing program at Bronx Community College. During her second year there, her son Prince was born. “I stopped going to school to take care of my baby and myself, physically and mentally,” she said. Tiana and her boyfriend Masika then lost their housing, and moved to North Carolina to live with Masika’s father. She didn’t work or go to school for two years.

When the family returned to New York, Tiana wanted to find a way to regain her momentum. She spoke to a career counselor and asserted that she wanted to work in medicine. That’s how she found out about GCD.

Tiana applied to GCD’s Young Adult Program, for young people ages 18-24 who are out-of-school, unemployed, and facing multiple barriers. It’s a free three-month program that engages, trains and supports participants so they can begin meaningful health care careers. She was accepted into the Home Health Aide program, but had to pass up the opportunity because she couldn’t find a babysitter for her son. She was disappointed, but she kept in close touch with Casey Linder, manager of the program.

After several months, Tiana was able to find daycare for her son and was ready to start GCD. She applied again and Casey interviewed her over the phone. Then, the COVID-19 pandemic changed everything. Tiana learned that she could study to become a certified nursing assistant (CNA) instead of a home health aide, and that the classes were online. She was accepted and started her classes.

“I was extremely excited but also tired,” she said. Her family was living in a homeless shelter, and her son was a busy, curious toddler. It wasn’t easy for her to attend classes, but, she said, “I made sure every day I was on-time and participated. Everybody knew Prince because he would be on the screen smiling or wanting to say hello.” Sometimes the internet connection in the shelter was bad, and Tiana had to sit in her car during her classes. When she was late because her life was so stressful, she called Casey to apologize. “I explained to her what had happened, and she just listened to all my problems and didn’t judge me. That’s the one thing I wanted, for somebody to listen and understand.”

After months of on-line classes, Tiana finally had an opportunity to interact with nursing home residents during the clinical phase of the program. “It was great to be able to meet the patients, but I was nervous — I wasn’t sure I was ready to help care for residents. Casey reassured me. I took vital signs, changed residents, and gave partial bed baths.” The residents made her feel welcome. “They wanted me to talk to them. I braided the hair of one resident. There was one resident I sat with every day for 5 or 10 minutes, and she gets so excited every time she sees me. These people feel like my family. They always want me to come back.”

After each experience working with residents, Tiana and the other participants met with Casey to talk about their experiences — the ups and downs.

“I’m so grateful to Casey for believing in me and giving me a second chance,” Tiana said. “It is hard being a mom, and people tell you that your life is over because I decided to have my baby boy at 19. I wanted to prove everybody wrong.”

And Tiana did. “I finished my online class with a score of 90 and passed my clinicals and aced my written and skills exam through really hard work and dedication,” she said proudly. “I officially became a CNA.”

“The program gave Tiana the opportunity to confirm that health care is what she’s really interested in and gave her a launching pad,” Casey said. “She got hands-on experience and valuable interactions with peers, residents and nursing staff. It was affirming to her that she’s on the right path.”

Tiana and her fellow participants in the GCD Young Adult program had a graduation ceremony in November. Only six graduates were able to attend, and the event was low-key — with a graduation playlist providing background music, they ate a catered lunch and received their certificates. Each shared a lasting memory from their program experience, and the pride they felt in their achievement was palpable. “We could have just been sitting in an empty room and it still would have felt meaningful,” Casey said. “They know that they’ve accomplished something important. I know they are especially proud of the fact that they did this in such a unique way, unlike any other cohort, which really distinguishes them as a group.”

Having earned her CNA license, Tiana has not given up on her dream of being a pediatrician. “This is a stepping stone for me,” she said. “When I work with the elderly, I know I need to provide extra care because they are fragile. Though my ultimate goal is to work with kids, I know working with different populations will help me. I’m not going to stop here, though, I want to be an LPN, an RN, and ultimately a pediatrician.”

She has a message for single moms like herself: “If you have a dream, don’t give up, don’t listen to the negative people in your life. Focus on those who will motivate you, and want you to work harder than ever. You may not know me, but I believe in you, so don’t ever give up.”

Life after Ostomy Surgery

A new collaboration between The New Jewish Home and White Plains Hospital is providing hope and help for patients recovering from ostomy surgery. 

When patients wake up from ostomy surgery, they are dealing with all the usual post-surgery issues — weakness, pain, and disorientation — plus “the reality that they are confronting a total change to their lifestyle, both physical and psychological,” according to Tina Nardi, ET Ostomy Specialist. She should know: As one of the pioneers in ostomy care, she has been counseling patients for more than 40 years. She was recently brought in to train the nursing staff at The New Jewish Home’s Sarah Neuman campus under a new partnership with White Plains Hospital designed to provide seamless care from surgery to rehab to discharge home.

Ostomy surgery, Nardi explains, is most often indicated when a life-threatening illness, such as cancer, ulcerative colitis or inflammatory bowel disease affects the digestive or urinary system. During surgery, bodily wastes are rerouted from the usual path to an external abdominal opening called a stoma. The stoma is then fitted with a pouch to catch the waste. “Patients are coming to grips with the fact that their body image has changed,” says Nardi. “They now have a pouching system to cope with elimination of body waste, which they have to learn to manage. They worry about leakage and odors and about getting back to work, their social life, their diet, intimacy.” 

While patients receive some counseling in the hospital, their stay is often not long enough to learn to deal with all the physical and emotional issues surrounding their ostomy. As part of the collaboration with White Plains Hospital, patients are discharged to Sarah Neuman’s rehabilitation program, a state-of-the-art facility recognized for its excellence in restoring patients’ independence. Here, they may spend an average of 3-4 weeks regaining overall strength while learning how to physically manage their ostomy and to adjust psychologically. Length of stay varies due to protocols unique to the pandemic, and also due to other comorbidities that each client may present. “The goal,” according to Nadine Hall, Assistant Director of Nursing at Sarah Neuman, “is to be totally rehabilitated and equipped to function and cope once they go home.”

“Patient education begins on Day One and covers every aspect of ostomy care and coping,” according to Hall. Patients learn about the many products now on the market that make it easier to deal with issues like leakage and odors. There is an evaluation of patients’ physical ability to provide self-care as well as a psychological evaluation. Some patients are very knowledgeable; they will give you instructions on how to care for their stoma. Others don’t even want to look at it or touch it.” Each patient gets individualized care tailored to their needs. “You have to know your patients. What will work with one will not work with another, so we try to see where they are in the process and let them know we are here for you. We have to be matter-of-fact and tell them this is not something you should be embarrassed about. We explain that many people have learned to lead normal lives with their ostomies and that we are dedicated to providing them with the resources they may need.” That includes referrals to support groups, training of family members and other caregivers and referrals to agencies that provide assistance once patients are discharged home.

While all Licensed Practical Nurses (LPNs) and Registered Nurses (RNs) get basic training in ostomy care in their regular training, the specialized, in-depth education they received from Nardi has strengthened their skills and broadened their knowledge. All the nurses who went through the training received a certificate of training in the management of patients who have undergone ostomy surgery. The nurses also have the option to further pursue wound ostomy care as a specialty if they choose to do so. Central to the training was exposure to the vast world of modern ostomy products designed to give patients greater physical and psychological comfort. “It’s like going to a shoe store: one size does not fit all,” says Nardi, who conducted the nine-session training over Zoom. “I shared pictures of different kinds of stomas and how to use different appliances and accessory products.” Nardi is the first to acknowledge that having a stoma — something that more than 700,000 Americans live with — is never easy. But, she reflects, “when I started out in the 1960s, people would leave the hospital with no education, and in terms of products, there was so little available. Thank God to be living in this age, when there is a growing number of trained personnel and so many great modern products available to make living with ostomies easier.”

Helping Frail Cardiac Patients Get Well, Go Home and Stay Home

Marlene Konopolsky, who runs the Social Work Transitions program on our Westchester campus, provides expert care from the moment patients arrive for heart rehabilitation to three months after they are discharged home. “I’m essentially their care navigator for the next 12 weeks.”

A clinical social worker who has additional training in congestive heart failure, Marlene works with frail, chronically ill patients with various cardiac conditions who were admitted for short-stay rehabilitation. With the goal to reduce emergency room visits and re-hospitalizations, Marlene provides education and monitoring to help stabilize this medically complex group of patients. She has become an invaluable one-stop resource for these cardiac patients and their families, guiding them throughout their stay and during their transition back home.

“I’ll make sure they have all their medication,” Marlene said. “If they need transportation I’ll make those arrangements. I get involved with various agencies if the patient needs Medicaid, counseling services, legal help, advanced directives, or access to doctors.” She’ll even take on housing issues. “If a patient’s condition worsens at home, in most instances, we are able to bring the patient back to our facility instead of the hospital.”

How the Program Works

When patients with cardiac conditions are admitted after a hospitalization, the staff determines whether they are appropriate for the Social Work Transitions program. Marlene is involved in their care plan and makes sure their needs are met. She arranges and plans for their discharge, making sure they get all the equipment they need and coordinates their home care. She makes contact with the patient’s primary care physician as well as the cardiologist to ensure that an appointment is made within a week following discharge. While Marlene previously made home visits; these days she is more likely to drop in via phone or FaceTime.

The Patient Experience

Raymond Piedmont was a Social Work Transitions patient last year. He has been treated at The New Jewish Home’s Westchester campus several times, and his last discharge was in October 2019. “I had been laid up so long I forgot how to walk,” he said. “The people there were absolutely wonderful. Without them I wouldn’t have been able to do the things I’m doing now. I can walk without a cane.”

Marlene was there for him throughout his stay and beyond. “She would pop in once in a while to ask, do you have any questions? Is anything I can do for you? Whenever there was a care team meeting with the doctors, Marlene would be there.”

After Ray’s discharge, Marlene came to his home several times. “She asked specific questions — do you need this? Are you able to do that? Are you getting around? are you climbing stairs? She was assessing my situation, even without me having to say anything.”

Over the past few months, Marlene has worked with post-COVID patients who received rehabilitation therapy. One of her patients, Vinicia Rosario, was recently discharged. “She was with us from the beginning, and she was very attentive,” said Vinizia’s granddaughter, Cindy Hidalgo. “She answered all our questions. Marlene keeps us in the loop about everything in regard to my grandmother’s care. She said, ‘I’m your eyes and ears and voice when the team is meeting, since family members can’t be there.’ She held our hands and guided us through the entire recovery journey.”

Marlene is very accessible to patients and families. They can depend on her if an issue arises. “Families are so overwhelmed when they bring a patient home from the nursing home, it’s reassuring to know they can just pick up the phone and connect with me,” she said.

Just recently, she relates, she discharged a patient on Saturday and readmitted her on Sunday. “I spent a lot of time on the case with the patient’s niece, guiding her through the process of readmission and providing emotional support,” Marlene said.

Even on weekends, patients in the Social Work Transitions Program and their families can count on Marlene to be there for them. Thanks to this unique program, these patients have access to the expertise of a caring social worker whose commitment to them doesn’t end when they leave The New Jewish Home.

Photo: Patient Vinicia Rosario, front row second from the left and Social Worker Marlene Konopolsky to her right with the patient’s care team and family upon discharge home

Enhancing Care Through Deep Knowing

Mrs. L., a resident at Sarah Neuman, The New Jewish Home’s Westchester campus, was visited regularly by her husband. “He came religiously every day to help walk with her and care for her,” according to Miriam Levi, Assistant Administrator. “So it ripped him apart when we closed our doors in March because of COVID-19.” But, thanks to a person-directed care model, adopted six years ago by The New Jewish Home, Mr. L. was able to maintain frequent contact with his wife during the pandemic even though he couldn’t visit like he used to.  “The staff worked out a way he could come to a fence in the garden and see her, and he could call every day and be comforted by the fact that he was talking to someone who really knows his wife — her habits, likes and dislikes. That’s a big plus for residents and families.”

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Making Spiritual Connections During COVID-19

Residents and patients at The New Jewish Home have always appreciated chaplaincy visits. During the pandemic, however, these visits evolved to provide deep emotional and spiritual care to meet the needs of our older adult clients. Each year, in conjunction with the Jewish Theological Seminary, The New Jewish Home helps train chaplains by hosting students in our Clinical Pastoral Education Program (CPE). We are one of the few nursing homes in the country to offer training to chaplain interns, and the only one accredited in New York State by the Association for Clinical Pastoral Education as a training site for this crucial work.

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What’s Next After 51 Days on a Ventilator? A Dedicated Team of Rehabilitation Therapists

Larry Kelly is probably one of the best-known COVID-19 survivors in New York City. Larry, who retired a few years ago as the assistant principal of a high school in Harlem, contracted COVID-19 while performing in a dinner theater in Fair Lawn, NJ. The whole cast of the play got sick. A New York Times profile of Larry, published in July, reported on the 51 days he spent on a ventilator in a drug-induced coma, first at Mount Sinai Morningside and then at Mount Sinai Beth Israel Hospital, before he arrived at The New Jewish Home.

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