Lacey Buckler, assistant Chief Nursing Executive at UK HealthCare, spoke about how graduating from UK directly impacted her career.

Kentucky native Lacey Buckler pursues nursing excellence at UK

Making the RoundsLacey Buckler, who earned three degrees from the UK College of Nursing, currently serves as an assistant chief nursing executive at UK HealthCare. She has a special interest in working with heart transplant patients at the UK Transplant Center.

How did you go from being a UK graduate to your current position?

I started out as a critical care nurse in the Cardiovascular Intensive Care Unit (ICU) here at UK, spent a couple years working there and then moved into a case management position where I did discharge planning for cardiovascular services. I graduated with a nurse practitioner degree here at UK. Then I worked again with cardiology at that point as an acute nurse practitioner and continued my trajectory to earn my doctoral degree. I moved into the director role for advance practice and also cardiovascular nursing and over the past couple years, moved into a chief assistant nurse role.

What is a typical day like in your position?

There is definitely never a dull moment! UK HealthCare is a very busy academic medical center, and we consistently have a large volume of patients moving through our system. Ensuring my teams have what they need to care for the patients while balancing planning and preparing for what’s coming next is how I spend many of my days.

I also enjoying mentoring emerging leaders within the team and supporting students as they rotate through my areas.

Why did you choose a career in nursing?

I think it’s a passion for taking care of others and seeing the happiness on a patient’s face when they get to leave and they’ve been well taken care of – just being a part of that and being part of their family.

What is the most challenging aspect of your work?

I think healthcare is ever-changing. So right now with the political climate that we’re in, it’s hard to be in healthcare because you don’t know what’s coming down the road from bundled payments and changes in how we take care of patients. So I think just not knowing what the next steps will be makes health care challenging in general.

What is the most fulfilling part of your job?

The most fulfilling part of my job is seeing patients get better. I’m involved with the UK Transplant Program here for heart transplantation, so that’s a huge, neat part of UK HealthCare – seeing those patients get better and going on with their lives with a new chance on life is really an awesome experience.

Do you have a favorite UK memory? 

I have a lot of favorite UK memories. I’m a big basketball fan, so I had the pleasure of being an undergraduate student when Tayshaun Prince shot all the 3’s at the North Carolina game. We had really good seats right behind the bench that my friend and I got in the lottery at Memorial Coliseum.

Originally from Morganfield, Ky., Buckler discusses why helping people throughout the state is so important to her.

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Video, Part 2: Dr. Miller on what you need to know about Pap smears

Pap smears, annual exams and the HPV vaccine are important tools for all women in the fight against cervical cancer. Unfortunately, not enough women in Kentucky take these preventative actions, says UK Markey Cancer Center gynecologic oncologist Dr. Rachel Miller. We sat down with Dr. Miller to discuss how regular check-ups and Pap smears can help prevent advanced cervical cancer.

Watch our interview with Dr. Miller to learn more about cervical cancer prevention, including a breakdown of the latest Pap smear recommendations.

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Whether planning for a baby or entering menopause, every woman deserves a healthcare provider who respects her values, preferences and personal goals.

Certified nurse midwives partner with women for better health

JoAnne Burris, APRN, CNM

Written by JoAnne Burris, advanced practice certified nurse and certified nurse midwife at UK HealthCare.

Whether planning for a baby or entering the stages of menopause, every woman deserves a healthcare provider who respects her values, preferences and personal goals.

The certified nurse midwife offers a range of medical services and expertise to support women throughout the female reproductive lifespan, not just through pregnancy and birth. Firmly grounded in evidence-based science, the certified nurse midwife is trained to put the patient at the center of her healthcare decision-making.

Some pregnant women believe choosing a nurse midwife for prenatal and postnatal care means forgoing the comforts of modern medicine. Nurse midwives are frequently associated with home birth, but according to the American College of Nurse Midwives, 94 percent of nurse midwives in the U.S. attend births in hospitals. Nurse midwives support birth according to the preferences of the mother, whether she desires an epidural or unmedicated birth.

What makes nurse midwifery unique

From supporting a woman during delivery to providing primary care, nurse midwives can be found throughout the spectrum of women’s healthcare. There are a few distinguishing features of midwifery that every prospective patient should consider.

  • Emphasis on education. Nurse midwives counsel patients on a variety of health topics, from contraception to nutrition to breastfeeding. Rather than giving advice, the nurse midwife offers reliable information and encourages women to make individualized decisions. Consistent with this philosophy, patients acquire knowledge so they can make informed decisions and feel confident about their care.
  • Partnership. Nurse midwifery services are provided in partnership with women and their families in order to empower women to determine their individualized journeys to motherhood. In addition to working in partnership with women, they work in close collaboration with obstetricians, anesthesiologists and neonatologists as a part of an integrated healthcare team.
  • Birth is normal. For healthy, low-risk women, interventions during birth are usually unnecessary. A hallmark of nurse midwifery care is non-intervention in the absence of complications. While nurse midwives are experts in normal birth, they are highly trained to detect complications and will collaborate with physicians when necessary.
  • Founded on evidence-based science. Certified nurse midwives are registered nurses who have earned a master’s of science in nursing with an additional certification in midwifery. They are licensed professionals capable of attending births, writing prescriptions, conducting annual exams and providing birth control counseling as a part of their wide spectrum of healthcare services.

Nurse midwives empower women to take control of their health and birth experience. This sense of control can be a positive influence on the entire family unit. Midwifery is a beautiful healthcare partnership designed to help women realize their potential to be a force for optimal health and wellness.

If you are interested in nurse midwife services, talk to your OB-GYN.

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Gardner and Jon Wes Adams

Twin brothers’ rare heart condition sparks unique research opportunity

In 2015, identical twins Gardner and Jon Wes Adams, then in their mid-20s, both nearly died when their hearts suddenly stopped beating. The incidents happened months apart, but the cause was the same: Brugada syndrome, a rare congenital heart rhythm disorder.

Jon Wes’ heart stopped first while he was running at The Arboretum at UK. Bystander CPR kept him alive until emergency medical personnel arrived. At the UK Gill Heart Institute, doctors ran a battery of tests to determine why this healthy, physically fit young man went into sudden cardiac arrest.

As soon as the results indicated Brugada syndrome, the care team knew they needed to test Gardner, since he has the exact same genes as his twin brother. They weren’t surprised to find that he had the syndrome, too.

Understanding the role of genetics

By that time, Jon Wes had received an implantable cardioverter defibrillator (ICD) that could detect abnormal heart rhythms and provide an electrical shock to restore a normal heartbeat and prevent cardiac arrest. Gardner and the doctors decided that he should receive an ICD, too. While sudden cardiac arrest in Brugada syndrome is uncommon, the chances seem greater if it’s happened to a family member, especially one with identical genetic material.

Only months later, Gardner’s heart stopped while he was running, and the ICD saved his life.

This unusual clinical case – genetically identical twins with a rare heart condition – prompted one of their doctors, heart rhythm specialist Samy-Claude Elayi, to seek a greater understanding of Brugada. Genetic testing revealed a specific mutation behind the condition in Jon Wes and Gardner. The mutation causes the membrane of the heart cells to stop conducting the electrical current that powers the heart. It turned out that their non-twin brother and their father also had the mutation, but no symptoms. Elayi wanted to know why the condition was presenting so differently in family members with the same genetic mutation.

With support from a high-impact pilot award from the UK Center for Clinical and Translational Science, Elayi and a multidisciplinary group of researchers are trying to find answers. The team includes Brian Delisle, PhD, associate professor of physiology and a recognized expert in the field of the basic mechanisms of congenital cardiac arrhythmias; Mark Farman, PhD, associate director of UK HealthCare Genomics and professor of plant pathology; and Jonathan Satin, PhD, professor of physiology. The case inverts the oft-quoted paradigm of “bench to bedside,” a reference to the trajectory of science that starts in the lab and then progress to patient care.

“This is a really fantastic opportunity because we have different members from a single family from whom we can get cells,” Elayi said. “We are trying to do a specific analysis of how what is really going on with this family and this gene because this disease is still very poorly understood.”

Testing blood cells

The research team is looking at cells from Jon Wes and his non-twin brother, as well as the rest of the family, with the hypothesis that there will be differences in each of them. Blood samples were sent to collaborators at the Stanford Cardiovascular Institute, where the blood cells are being transformed into inducible pluripotent stem cells (iPSC) – cells that can become any type of cell in body. The iPSCs will then be sent back to UK, where Satin will make them into heart cells that the team can study.

The team hopes to make a certain type of cardiomyocyte, or heart muscle cell, that few labs have been able to create. If they can do it, it would be a major advancement of this science at UK. They also hope that better knowledge of the genetic factors of Brugada could advance precision medicine in the field.

“This case is at the intersection of developmental biology, functional biology and molecular biology,” Delisle said. “Hopefully we can use this approach of reprogramming patient cells into stem cells to better understand their heart condition. And it could be a platform for understanding other types of congenital arrhythmias.”

Jon Wes and Dr. Elayi have taken their story into the community to talk with students about CPR and heart health. Check out a video of a recent visit they made to Lexington’s School for the Creative and Performing Arts.

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Watch: Dr. Rachel Miller discusses the HPV vaccine, cervical cancer prevention

We sat down with Dr. Rachel Miller, a gynecologic oncologist at the UK Markey Cancer Center, to discuss the HPV vaccine and why it’s so important in preventing cervical cancer. HPV, or the human papillomavirus, causes almost all cases of cervical cancer, but the vaccine can protect young men and women against the disease.

Watch our interview with Dr. Miller to learn more about the HPV vaccine and why she recommends it.

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Pictured: UK Pastoral Care interns. The UK Pastoral Care internship program began in 1967, and to this day, helps present and future chaplains understand how to care for patients.

UK Pastoral Care interns practice providing compassion for all

When Mark Dunn arrives at UK Albert B. Chandler Hospital for his shift as a hospital chaplain, he heads to the Emergency Department to check on the trauma cases from the night before. He may offer support to a family in the midst of the chaos that often accompanies trauma, making sure the right information gets to the right staff member. The sense of calm he brings to the situation frees up the medical staff to focus solely on saving lives.

Once Dunn feels comfortable leaving the ED, he walks to the 10th floor and starts making his way down, floor by floor, unit by unit, repeating the process of being a presence for people in need of a sounding board, helping them to make sense of a devastating diagnosis, or provide a prayer, if requested.

Although quiet and unassuming, Dunn thrives on the connections he makes with people. He has a soothing voice and gentle demeanor, but perhaps his strongest skill is that he is a good listener, all traits he didn’t realize he possessed until he joined UK’s Association for Clinical Pastoral Education (ACPE) internship program.

ACPE helps develop pastoral growth

ACPE was established in 1967 and is among the founding accredited Clinical Pastoral Education centers. Rev. Joe Alverson is currently the director of UK Pastoral Care and helped grow its educational program.

In 2013, Rev. Dr. Cam Holzer was hired as ACPE supervisor and clinical pastoral educator, and she worked to revive the program so new CPE students could learn and serve within a larger, more seasoned chaplaincy team. Holzer says the internship program is designed to facilitate personal, pastoral and professional growth.

The internship is 400 hours of training: 100 hours of class time and 300 hours of direct service. Each intern is mentored by staff chaplains and is assigned to specific floors or clinical areas of UK HealthCare, serving as the primary chaplain for their areas. Once an intern is equipped to carry an on-call pager, they may be called to a variety of urgent pastoral situations.

“They learn the skill of showing up and making themselves available,” Holzer said. “There is no way to know what it is they are getting called to; they have to listen, care, trust their intuition and grow in more effective communication to learn what that person needs and how to help provide it. It could be a prayer, to mostly listen or the person may need to have someone there with them and talk very little or not at all.”

Teaching chaplains the power of listening

For some students, the clinical internship is a requirement of their Masters of Divinity degree and for others, it is an elective. Seasoned clergy and lay persons also take CPE to deepen their pastoral care capacity. The program is open to persons of all faiths and backgrounds, and ages range from 25 to 75.

“When I interviewed for the internship, I was nervous because I don’t like talking about myself,” Dunn said. “I had no experience and didn’t even understand the chaplain’s role in a hospital. Over the course of the internship, I learned I was a people person and enjoy talking with others. I learned how to listen, to meet people where they are, one on one, in depth, to be the presence they need at that moment in their life”

After completing the internship in 2014, Dunn served for a while as a PRN (relief staff) chaplain at UK HealthCare. He then completed a one-year chaplain residency at Norton Hospital in Louisville, and soon afterward Dunn made his way back to UK HealthCare, hired full-time in 2016.

Students who complete CPE internships usually go on to be PRN chaplains, full-time hospital chaplains or pastor churches. Sometimes they work in nursing homes and social care settings. Students will have developed a capacity to more deeply hear and help others in different settings for the rest of their lives.

“Interns learn more about the art of spiritual assessment, the ability to open their heart and listen, paying close attention to learn what is uniquely going on with the person before them, whether it be the patient, a family member, or UK staff. They learn from their own emotions and experiences how to honor and respect others in their feelings,” Holzer said.

“The hope would be that they develop their own way of being more fully in the world, and more attentive, compassionate and effective in their ministry.”

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  • UK Pastoral Care provides 24/7 support to patients, families and staff at UK HealthCare who are dealing with spiritual and emotional challenges.
  • Read the story of one UK chaplain who was in a severe bicycling accident but used her experience to enhance her role as a chaplain when she returned to work.
When Jennifer Thomas, a nurse at UK HealthCare, injured her knee, her work became nearly impossible. But an orthopaedic clinical trial offered hope.

Orthopaedic clinical trial helps UK nurse regain mobility

Working as a bedside nurse requires extensive physical effort – pushing wheelchairs, twisting and lifting, and standing for long periods. Jennifer Thomas, who’s been a nurse at UK HealthCare for six years, can attest to this. In fact, it was while assisting a patient from a wheelchair that she badly injured her knee.

“The pain was excruciating – a sharp, stabbing burn,” Thomas said. “It was constant regardless of sitting or walking. My sleep was interrupted due to the discomfort, stairs were next to impossible to navigate and playing with my newborn grandbabies – be it pushing a stroller or carrying them from room to room – was difficult at best.”

The injury also made it difficult to do her job as a pre-op nurse. Sometimes she’d be walking into a patient’s room when her knee would give out, causing her to fall. She had trouble standing for the long enough to assist with epidurals and nerve blocks, and her knee would swell after long days.

Thomas cycled through the standard treatment options: cortisone shots, physical therapy and two surgeries. These treatments required time off work and extended periods of rest, but they didn’t provide relief. The only way to reduce the pain was to stay off her knee and keep her feet elevated.

Participating in a clinical trial

In November 2015, a year after her original injury, Thomas was referred to Dr. Christian Lattermann, director of UK’s Center for Cartilage Repair and Restoration in UK Orthopaedic Surgery & Sports Medicine. In order to fix Thomas’ injury, Lattermann need to perform a cartilage transplant. Unfortunately, many patients who undergo this type of procedure experience muscle weakness afterward. To combat this problem, Lattermann, along with co-principal investigator Caitlin Whale, are leading a clinical trial to investigate how muscle stimulation using a device called the Phoenix Device could improve muscle strength following surgery.

“Weakness in the thigh musculature after this procedure is a big problem that we have not been able to improve,” Lattermann said. “[The Phoenix Study] is a way to find better techniques to treat this weakness.”

Thomas was eligible to participate in the clinical trial. First, Thomas’ strength and functional performance were measured. She then underwent an osteochondral allograft, a surgical procedure where a living piece of cartilage and bone from a cadaver is implanted in the knee. After surgery, Thomas had nine weeks of rest. Within days of surgery, she began a home treatment program, and a couple of weeks after surgery, she began participating in physical therapy. After completing the 12-week home treatment, Thomas’ strength and function were measured, and then again at six months and one year.

Lattermann’s team is still collecting data for this study, which will help them evaluate post-surgical treatment programs and how muscle stimulation can improve recovery.

“The basis for any clinical treatment has to be evidence-based research, and that’s what we’re doing here,” Lattermann said. “Our goal is for every patient being seen clinically to be enrolled into a research study or register as a research participant.”

Meeting her goals

After 12 months of treatment, Thomas feels she’s achieved the goals set out at her first appointment, even if she’s not exactly where she was before the injury.

“I am not 100 percent, but I understand Dr. Lattermann never promised or expected 100 percent,” she said. “I believe we met the goals he had hoped we would achieve. There are still some things I can’t do and some things I will never be able to do again. Aside from those few downfalls, I can walk, play with my grandchildren, stroll in a park or mall, get around my house, wear normal shoes and boots. I can live my live without falling to the ground, limping and enduring horrid pain.”

This was Thomas’ first time participating in research, an experience she describes as extremely positive. She felt comforted by the fact that she would leave each appointment with a plan of care and established treatment goals.

“I’ve had a lot of experiences with a lot of surgeons, and there’s no one like Dr. Lattermann,” Thomas said. “I can’t begin to express the gratitude I have for him and his team.”

Thomas now works as a nurse case manager, which is less strenuous for her knee. She says her own experience as both a patient and research participant have made her better at her job.

“I’m thrilled to be in the position I am and honored to be able to continue nursing,” she said. “I have yet another experience I can share with my patients. Understanding and personal knowledge are among the best gifts a nurse can share with her patients.”

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If you feel especially lethargic or depressed during winter, you may suffer from Seasonal Affective Disorder, or SAD. Here's what to do about it.

Here’s what you can do about Seasonal Affective Disorder, or SAD

With daylight in short supply, you may find yourself feeling lethargic, craving carbohydrates and going to bed earlier. Rather than dismissing those feelings as the winter continues, you may be suffering from Seasonal Affective Disorder (SAD).

Knowing the symptoms

SAD is a type of depression that occurs as daylight wanes in late fall and often continues until early spring. Symptoms of SAD include:

  • Loss of interest or pleasure in activities.
  • Social withdrawal.
  • Sensitivity to rejection.
  • Irritability and anxiety.
  • Guilt and hopelessness.
  • Fatigue or low energy levels.
  • Decreased sex drive.
  • Decreased ability to concentrate.
  • Trouble thinking clearly.
  • Weight gain.
  • Physical problems, such as headaches.

Understanding SAD

Anyone can get SAD, but it is more common in women, people between the ages of 15 and 55 (the risk goes down as you age) and those who live farther from the equator. Experts are unsure of what causes SAD, though they think it might be connected to the lack of sunlight upsetting sleep-wake patterns, or the short days affecting a brain chemical called serotonin. Melatonin, a sleep-related hormone, also has been linked to SAD.

If you’re experiencing any of the symptoms of SAD, it is important to see a healthcare professional who can help you sort through the cause of your depression and discuss treatment. He or she can also check for other possibilities such as low thyroid, which can present similar symptoms. A mental health assessment may be performed to get a better idea of how you feel and how your depression is affecting your ability to think, reason and remember.

Tips for treatment

Treatment for SAD often consists of light therapy, spending more time outside, psychotherapy and antidepressants. Remember, people rarely “snap out of” a depression, but there are things you can do yourself to help relieve symptoms:

  • Set realistic goals. Don’t take on too much. Break large tasks into small ones, set priorities and do what we can as we can.
  • Try to be around other people. Being around others usually makes you feel better.
  • Do things that make you feel better. Going to a movie or taking part in religious, social or other activities may help. Doing something nice for someone else can also help you feel better.
  • Get regular exercise.
  • Eat healthy, well-balanced meals.
  • Stay away from alcohol and drugs. These can make depression worse.
  • Delay big decisions until the depression has lifted.

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Help the Markey Cancer Center #TurnUpRupp this Saturday!

It’s time for the Big Blue Nation to get excited! The UK Markey Cancer Center is sponsoring the Wildcats’ basketball game against Kansas this Saturday and we want you to #TurnUpRupp to help us break the Guinness World Record for indoor crowd noise.

We know BBN has the loudest fans. Now let’s prove it!

This Making the Rounds features Dr. Gerhard Hildebrandt, division chief of hematology and blood and marrow transplantation at the UK Markey Cancer Center.

Meet Dr. Gerhard Hildebrandt, hematologist: ‘We’re here to help’

Making the RoundsIn this week’s edition of Making the Rounds, we’re joined by Dr. Gerhard Hildebrandt, division chief of hematology and blood and marrow transplantation at the UK Markey Cancer Center. Dr. Hildebrandt moved to the United States in 2009 after earning his medical degree in Germany.

What kinds of cancer do you treat?

We treat cancers of the blood and lymph system. We treat leukemia, we treat lymphoma, we treat multiple myeoma. We do treat benign disorders of the blood, like clotting disorders and bleeding disorders, but my special focus is in malignant hematology, which is really cancer of the blood and lymph system, and also bone marrow transplantation.

What do you most enjoy about your specialty?

I think that the chance to offer something, which, in a horrific moment in a patient’s life, can bring light – it’s just very satisfying. The other thing is, I do not fix and disconnect with the patients. I think in our field there are long-lasting relationships with the patients, and this is a thing which makes it unique and very exciting for me.

What do you want potential patients to know about you?

What I want them to know is that not only me, but our entire team really, really cares for them. And that we really spend the time they need. There’s no rush. My favorite slogan is always, “There’s no rushing medicine.” See, we do not rush patients in and out – that’s not what we’re here for. We’re here to help.

How would your friends and family describe you?

Ambitious, hardworking – maybe overly hardworking. But on the other side I’m very childish. You know, fun-loving.

Describe your ideal weekend.

I’d spend it with my kids. I usually take my son for swimming, and we usually have a movie night on one of those days where we watch a movie with the kids and try to spend some time with them.

Where is your favorite place you’ve traveled?

I think it’s Botswana. I did two trips to Botswana. I went on a cruise, and then I slept in the wild with no cellphone, no guns, no weapons. It was very interesting to sleep there and hear the animals close by with no fences.

What do you enjoy about living in Lexington?

It’s a very livable town. Very nice, very friendly. I like downtown. I think there are quite a few good restaurants and places to get a drink once and a while. It’s very green. Where I live I can bike through the backstreets, so that’s good.

Take a look at our video interview with Dr. Hildebrandt below. He speaks about what makes working Markey so unique.

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