Critical Care

Rebecca Sherron is doing what she always wanted -- serving the community where she lives."I appreciate and enjoy being part of the community I am serving," said the new director of Critical Care Nursingat Carroll County General Hospital. "This hospital is growing, and Ilike the challenge of doing new things. It's exciting when you are changing things for the community."Sherron, who holds one of the hospital's top executive nursing posts, oversees care of acutely ill patients. Sherron had the same responsibilities for seven years at Baltimore County General Hospital.

A 15-member volunteer team of critical-care specialists from the Shock-Trauma Unit in Baltimore is standing by, ready to go into American military hospitals in Germany to handle any casualties from the Persian Gulf.The Shock-Trauma team, which can be mobilized within 24 hours, is one of 25 teams recruited by the Society of Critical Care Medicine from 75 major medical centers across the country for overseas wartime duty, said Dr. T. James Gallagher, the society's president and director of critical care at the University of Florida at Gainesville.

Sending up today's insurance-driven medicine racket is tantamount to shooting fish in a barrel. As the nexus of so many charged themes -- life, death, greed, vanity and a surfeit of litigation -- the hospital seems sent straight from central casting as the ideal institutional symbol for most of our societal ills."

When Debbie Van Orden was named 1995 nurse of the year at North Arundel Hospital, her co-worker and competitor Terry DeVeaux cried."But I wasn't crying because I had lost," DeVeaux said. "I was crying because she was my best friend, and I was so happy for her."This year, it's DeVeaux's turn to enjoy the spotlight. The 42-year-old Pasadena resident won the hospital's nurse of the year honors over 11 other candidates.The critical care nurse and mother of three teen-age boys was awarded a plaque, a dozen roses, and a weekend stay in the Poconos at a reception last week.

Dozens of children hopped, skipped and ran around the conference room in the Rouse building as if it were Chuck E Cheese, but no one seemed to care.The adults -- mostly parents, nurses and doctors -- simply enjoyed the din. After all, these children started life with serious medical problems. Many spent weeks in the hospital while their parents went home to empty nurseries.On Sunday, those families celebrated with doctors and nurses at the Howard County General Hospital Special Care Nursery reunion in the Spear Center.

Acting on their own, or with at least the tacit consent of doctors or families, one in five nurses in intensive care units report that they have deliberately hastened patients' deaths, according to a national survey.But a number of experts said the survey questions were so ambiguous that they were subject to misinterpretation.Instead of revealing critical care units filled with self-appointed angels of death, they said, the nurses' responses revealed their anxieties and confusion about where palliative care ends and euthanasia begins.

Companies that offer health-care services and products more cheaply than hospitals are the fastest-growing segment of the health-care market, analysts say.Encouraged by employers and insurance companies eager to cut costs, those companies also are responsible for increasingly specialized alternatives to hospitals.An estimated 100 health-care companies went public last year in the competition to provide lower-cost care, said William L. Paternotte, managing director of research for Alex. Brown & Sons, which devotes 20 percent of its analysts to the burgeoning field.

The United States will soon be forced to make brutal choices about rationing health care as the costs continue to outpace society's ability to pay for treatments, a Johns Hopkins anesthesiologist told a national conference yesterday.While he did not offer a rationing plan of his own, Dr. Mark C. Rogers said intensive-care physicians may have to curtail "futile attempts at saving lives" and the use of experimental drugs, some of which cost $3,000 per dose, if there is little chance the drugs will work.

The latest nationwide shortage in the field of nursing has seen vacancy rates exceeding 10 percent since 1986. Statistics like that make nurses, including those imported through travel agencies, hot commodities today.In Maryland, the average vacancy rate for budgeted nursing positions in hospitals statewide at the close of 1990 was 11.9 percent, says Richard Wade of the Maryland Hospital Association. That's an improvement over the previous year, when the figure was 12.5 percent, he says."It's nothing dramatic," he adds, "but the figures are inching downward."

Betty C. Cole's daughter didn't ask for a new stereo or a red convertible when she turned 18. Instead, she wanted two legal papers guaranteeing her right to die.The gift seemed a little strange for a healthy college freshman. But Cole, an Annapolis attorney who specializes in estate and trust law, understood her daughter's unusual wish.It was prompted by the plight of Nancy Beth Cruzan, the Missouri woman who has spent nearly a decade lying in a coma after a car crash almost claimed her life.

DR. ROBIN MARIE SMITH, DVM, age 52, died at Northwest Hospital Center, Inc., Randallstown, MD, on Friday, January 16, 2009 with close friends and family attending. She was born February 21, 1956 at WRAMC, D.C., to John and Viola Wilkinson and graduated with honors from the University of Missouri-Columbia College of Veterinary Medicine in 1986. Dr. Smith had a successful career in veterinary emergency/critical care and her close friends remember Robin as one of the kindest and most professional doctors who ever cared for animals.

Dr. Marc Applestein, a urologist on staff at Howard County General Hospital, has been named president of the professional staff. Dr. Jonathan S. Fish, an internist, was named vice president, and Dr. Francis S. Chuidian, a specialist in pulmonary disease and critical care, was named secretary/treasurer. Applestein joined the hospital's professional staff in 1988. He graduated cum laude from Duke University with a bachelor of science, and from the University of Maryland with a doctorate in medicine.

The Baltimore Washington Medical Center has nearly doubled its size with the completion of a $117 million expansion that will accommodate more critical care patients and increase space for its outpatient services, at a time when the hospital has seen an increase in the demand for health care. And as part of the expansion, for the first time since the 1960s the hospital will be a designated birthing center. A labor and delivery unit is expected to open in the fall. (Although the hospital doesn't currently have a delivery unit, about 20 to 25 women give birth each year at the hospital through its emergency department, according to hospital officials.

The Baltimore Washington Medical Center has nearly doubled its size with the completion of a $117 million expansion that will accommodate more critical care patients and increase space for its outpatient services, at a time when the hospital has seen an increase in the demand for health care. And as part of the expansion, for the first time since the 1960s the hospital will be a designated birthing center. A labor and delivery unit is expected to open in the fall. (Although the hospital doesn't currently have a delivery unit, about 20 to 25 women give birth each year at the hospital through its emergency department, according to hospital officials.

In the office of Dr. Elizabeth "Betsy" Hunt, words attributed to Louisa May Alcott hang on the wall: "I am not afraid of storms for I have learned how to sail my ship." For Hunt, or "Dr. Betsy," as she likes to be called, her storms are pediatric emergencies and her ship is simulation. As early as 1980, Hunt was preparing for emergency situations, either as captain of the safety patrol squad or as a lifeguard at the local pool. By simulating bus accidents and heart attacks, she recognized the value of a plan.

Shock Trauma team to help quake victims Three doctors, a nurse and an engineer from Maryland Shock Trauma Center plan to travel to China today to help treat victims of the May 12 earthquake that devastated the central part of the country. The team plans to help doctors at West China Hospital, a huge, modern facility in Chengdu - about 50 miles from the quake's epicenter - where more than 2,000 quake victims have been treated. Dr. Thomas Scalea, Shock Trauma's physician in chief, said he and his colleagues offered to help soon after the earthquake struck.

*James M. Culhane is the new chair of pharmaceutical sciences at the College of Notre Dame of Maryland's new School of Pharmacy. He began his job Sunday. Culhane was an associate professor in the Department of Pharmaceutical Sciences at Wilkes University's Nesbitt School of Pharmacy for the past 10 years. Culhane, who holds a doctorate in pharmacology and toxicology from West Virginia University's School of Medicine and a bachelor's degree in chemistry from Washington and Jefferson College, has received many honors and awards, including the 2007 Carpenter Award for Excellence in Teaching.

Baltimore : Johns Hopkins Physician named 1 of most influential A Johns Hopkins physician whose research focuses on improving patient care - including the use lof airline-style checklists in critical care units - has been named to this year's list of Time magazine's 100 most influential people. Dr. Peter Pronovost, a professor of anesthesiology and critical care, was cited for his efforts to improve the way medical care is delivered to patients around the world. This year, Provonost's work drew headlines when federal regulators told Michigan hospitals to stop providing him with data while they reviewed whether his studies technically violated informed consent rules.

A Florida corporation that provides pediatric physician and nursing services to 32 states, including Maryland, agreed yesterday to pay $25 million to settle claims the company billed the federal government for critical care for infants who were not critically ill. Rod J. Rosenstein, U.S. attorney for Maryland, said in a statement that Pediatrix Medical Group Inc. of Sunrise, Fla., had "upcoded" reimbursement claims to the government under the Medicaid program...

Baltimoresun.com's tax-advice column features three experts from the Hunt Valley accounting firm SC&H Group answering questions about preparing your return every Monday until April 17. To be included in the following weeks, please use the form at the right side of this page to submit your questions. Jane Bortz, Sparks: In 2005, I had less income and more deductions than usual. The results were a bottom-line deficit, even after including my [self-employment] tax. The [self-employment] tax was $1,802.