The Medical Reserve Corps
The MRC Reporter
Newsletter for the Sonoma County Medical Reserve Corps
Volume 5, Issue 1
Summer 2008
In This Issue
Message from the Sonoma County Deputy Health Officer
Q & A: How Does the MRC Program Contact Volunteers?
Cultural Competency and "One Bad Day"
Print This!
MRC Program Updates
Greetings to all!
The six months since the last newsletter have been busy ones! I have highlighted some of the activities that have taken place. Plus, our numbers have grown once again. Since the first of this year we have held two new volunteer orientations (see details below). A BIG welcome to all our new MRC volunteers! We now have a total of 679 MRC volunteers:
- 480 health professionals - 56 physicians, 30 pharmacists, 327 RNs, 26 FNPs and 38 LVNs
- 62 mental health professionals - 20 MFTs, 9 LCSWs, 5 psychologists, and 19 psychiatric technicians
- 137 technical and support staff - 1 EMT, 2 respiratory therapists, 134 community members
March 2008 New Volunteer Orientation for Health Professionals
On March 14th we held our 19th orientation training for new MRC volunteers with medical licensure. For this training we did a targeted recruitment of Licensed Vocational Nurses and added 23 new health professionals to our ranks.
MRC National Leadership Conference
This last April, I attended the 2008 Medical Reserve Corps National Leadership and Training Conference held over four days in Portland, Oregon. The theme of this year's conference was "Prepared Volunteers, Resilient Communities, Strong Nation." This conference was attended by several hundred MRC Unit leaders, national MRC staff, and presenters. (Note: did you know that there are presently a total of 761 MRC units now in existence with over 157,000 MRC volunteers? Want to know more, go to www.medicalreservecorps.gov.) I attended sessions on volunteer management, MRC training core competencies, the role of veterinarians in the MRC, geriatric mental health and emergencies, and the behavioral impacts of disasters to name a few. I met and networked with other MRC Unit Leaders from all over the state of California, as well as from other parts of the country.
If you interested in learning more the content of this conference, visit the www.medicalreservecorps.gov home page. From the left column, select "Resources" and then select "National Conference." Scroll down to "2008 National Conference" links for day 1- day 3. To view photos, on the home page select "Photo Gallery" and then scroll down to "National Leadership and Training Conference," and "2008." Enjoy!
Hospital Auxiliary Teams
We now have two hospital auxiliary teams. In April Sonoma Valley Hospital became the second hospital in the county, along with Palm Drive Hospital, to have an MRC Auxiliary Team. Also in April, the Palm Drive Auxiliary Team attended training where they learned how to do N-95 mask fit testing.
Hospital Emergency Exercises
Twice yearly, in the spring and in the fall, hospitals are required to conduct emergency drills and exercises. Over the last two years, MRC volunteers have been invited to participate in these exercises. Most recently, our hospital auxiliary teams have been involved. This spring's hospital exercise was held on May 20th. At Sonoma Valley Hospital (SVH), MRC auxiliary team members attended a "disaster fair," where they and SVH staff observed a decontamination tent setup, and were trained in the use of Powered Air Purifying Respirator (PAPR) suits, HEPA filter systems, evacuation chairs, N-95 masks, walkie-talkie radios, and hand washing techniques.
At Palm Drive Hospital, MRC auxiliary team members, using the N-95 mask fit testing skills they learned in April, conducted fit testing on Palm Drive staff. Additionally, a few of Marin's Medical Reserve Corps volunteers attended exercises at both these sites got a chance to meet some of our MRC volunteers.
June 2008 New Volunteer Orientation for Mental Health Professionals
On June 6th, we held our first orientation training for new volunteers from the mental health profession. Licensed Clinical Social Workers, Psychologists, Marriage and Family Therapists, and Psychiatric Technicians were invited to attend this training. As a result of this, we now have added 54 mental health professionals to this Medical Reserve Corps. This vital addition to our MRC program fills an important gap in our response to a public health emergency.
First Responder's POD Exercise
On June 17th, several MRC nurses from the Petaluma area participated in an exercise at the Petaluma Fire Station on McDowell Blvd. This exercise was designed to test setting up a point of dispensing (POD) site at a fire station where, in the case of a public health emergency, first responders would receive their prophylactic medicine. Thanks again to all who attended.
Did You Know?
Lastly, "volunteering offers healthy rewards!" So says Kaiser Permanente in their Spring 2008 newsletter. David Sobel, MD and medical director for Kaiser's Health Education is quoted as saying:
"True well-being is achieved when we feel connected to something beyond ourselves…Evidence suggests that a regular regimen of helping others may be as important to our health as regular exercise and proper nutrition. To add to the physical benefits, there's a phenomenon called 'helpers's high,' which leads to a sensation of sudden warmth, a surge of energy, and a feeling of extreme pleasure immediately after helping."
Plus, according to this article, "a 2003 study by the Institute for Social Research found that a pattern of giving may extend your lifespan. Over the course of the five-year study, seniors who reached out to family and friends reduced their odds of an early death by nearly 60% compared to those who didn't lend a helping hand."
So, keep on volunteering, it is good for you, it is good for our community, and might even help you live longer!
Regards,
Gabrielle C. Trubach, MA
MRC Coordinator, Public Health Preparedness
Message from the Sonoma County Deputy Health Officer
By Leigh Hall, MD, Deputy Health Officer, Public Health Preparedness
New Deputy Health Officer
I am pleased to introduce Mark Netherda, MD, as the new Deputy Health Officer for Sonoma County. Mark has been a long-time public health physician in the County's HIV/AIDS clinic so he knows the County well. He was chosen from over 20 applicants after an extensive nationwide search. I know both the staff at Public Health and the volunteers in the MRC are going to very much enjoy having him as part of the team.
I am retiring to move on to other things beyond the world of medicine and public health (and to become a member of the MRC!). I am very proud of the almost 700-member MRC we have built over the last few years, and, in particular, the work that Gabrielle and other PH staff have done to recruit, train and encourage all of you. Many of you have already contributed greatly to the community through the MRC, and I know Sonoma County is far ahead of most other counties in preparing for a public health emergency because of all of you. Your willingness to step forward and get prepared is very much appreciated by us at Public Health.
I know the MRC will grow and flourish over the years, and I look forward to watching it happen as one of its members. Thank you for all your help.
Q & A: How Does the MRC Program Contact Volunteers?
By Gabrielle C. Trubach, MA, MRC Coordinator, Public Health Preparedness
Q. How does the program get in touch with me?
A. On a regular basis we send you email messages with things like:
A web link to invitations to attend our volunteer trainings, conferences, events and exercises. The email messages come from either DHS-MRC@sonoma-county.org (our MRC email address) or from phtraining@sonoma-county.org (the Public Health training email address).
A web link to our online newsletter.
A direct connection to the Public Health Department (via email!).
Using email is cost efficient and allows us to quickly communicate with over 80 percent of our volunteers!
Q. How will you contact me in an emergency?
A. For emergency notification and deployment:
We use TENS (Telephone Emergency Notification System), an automated telephone system to contact you in an emergency.
You will receive an automated call with pre-recorded message that uses all your phone numbers (home, work, cell). So please keep us updated on your contact information.
When you listen to the automated call, you will have a chance to repeat the message, unless you are listening to the message on your answering machine.
The recorded message starts as soon as you - or your answering machine - pick up. A message will be left if your machine answers.
Each phone number is automatically called twice.
New! This system can now get through to caller ID-blocked phone numbers. Here is what your phone will display in the caller ID window: "So Co EMR Alert." Please make note of this display if you have a caller ID blocked phone.
Also, please note: we hold notification drills 1 to 2 times a year using home phone numbers only!
Q. What will this call sound like?
A. An emergency notification call sounds like this:
First you will hear a greeting: "This is Sonoma County Public Health with a message for the Medical Reserve Corps."
Because it is automated it may sound like a solicitation, but, DON'T HANG UP UNTIL YOU ARE SURE!
Here is a summary of what you will hear during this message:
- Date of call
- Time of call
- Situation information and instructions
- Where to report
- What to bring
- Any other pertinent information and/or instructions
MRC Survey Results
By Gabrielle C. Trubach, MA, MRC Coordinator, Public Health Preparedness
In the Winter 2007 edition of this newsletter, we asked you to take our Volunteer Survey, either online or by filling out and returning the paper survey to us. 136 of you (out of our 602 MRC volunteers as of December 2007), or 23 percent, responded. Here are a few highlights from this survey:
The survey respondents are ready to go! Over 94 percent of 132 respondents are "willing and able to respond to a local public health emergency call-up."- They are also flexible in their location assignments, responding that they are "willing to staff" a variety of dispensing sites, including high school or veterans halls, fire stations, special needs medical shelters, or health facilities.
- Survey respondents are generous with their volunteer time. Nearly 60 percent of 130 respondents agreed to "travel out of Sonoma County" to serve in a neighboring county.
- They are interested in training to help them be better prepared. When asked about their interest in specialized training, the topics of Start Triage and Building Personal Emergency Go-kits were top choices.
- And survey respondents are pleased with their MRC experience, with most rating their "satisfaction with the MRC program" as "satisfactory" or "very satisfactory."
Thanks to everyone who participated in this survey. The complete survey results are available here (pdf).
PODs 101
By Ann Baechler, RN, MSN, Public Health Preparedness
What are PODs?
Points of Dispensing, or PODs, are defined as the physical locations where medication or vaccination would be administered to the general population in response to a public health emergency. Potential PODs are situated in a variety of locations around Sonoma County, like veterans halls, senior high school gymnasiums, and other appropriate public facilities.
The location and number of PODs that might be opened would depend on the nature of the emergency situation. These decisions will be made by our Public Health Officer.
The types of PODs may include:
- Mass dispensing sites to assist with dispensing to the general public.
- A specialized dispensing site to assist with dispensing to post office employees for an anthrax exposure.
- Selected fire stations around the county to assist with dispensing to first responders.
POD Roles and Positions
In response to a public health emergency, you may be called up to fill a role in any one these various PODs. We will attempt to match up your licensure or skill set with the POD position, however, you may be asked to fill other positions as needed.
These positions at a POD include:
- Entrance staff/greeters
- Patient Educators
- Line Monitors
- Triage Staff
First Aid Staff- Help Desk Staff
- Traffic Controllers
- Safety Officers
- Counseling Team
- Clinical Screeners
- Medication Dispensers
- Runners
- Exit Staff
Typical tasks at a POD include:
- Receiving the Strategic National Stockpile (SNS) supplies/medications
- Assisting with set up of the POD
- Receiving Just in Time Training (JIT)
- Greeting/administrative tasks
Triage/routing symptomatic people to appropriate sites- Orienting/educating public about the event and the medications
- Clinical screening for allergies and any medical problems
- Dispensing appropriate medication/vaccine and providing follow up instructions
- Providing mental health support to those who are distressed
- Assisting with break down of the POD
For those of you who have already participated in one of our exercises, you are familiar with the above information. If you are NEW to the MRC or haven't had an opportunity to participate in one our exercises, I encourage you to do so! Please be sure your contact information is up to date so we know how to reach you.
Lastly, to see what it might be like to perform POD duty, check out the POD Game online at http://www.thepodgame.com/play.html.
Thank you so much for volunteering your time with the Medical Reserve Corps!
Planning for a Pandemic
By Kim Caldewey, PA, Public Health Preparedness, Program Planning Analyst
Sonoma County Public Health is Planning for a Pandemic
It has been 12 years since the highly pathogenic H5N1 virus was isolated from one farm goose in Guangdong, China. Since then, 385 laboratory-confirmed human cases of H5N1 influenza (aka: avian flu), from 15 countries on 3 continents, have been reported to the World Health Organization (WHO). Of those who have contracted the virus from sick birds, 243 have perished - a mortality rate of over 60 percent.
So far H5N1 is not easily transmitted from human to human, but just a small genetic mutation could mean that the Avian Flu could become a worldwide human epidemic, a pandemic. The global public health community has been working in an unprecedented collaborative effort to understand the nature of this deadly virus to mount a worldwide effort to mitigate its impact.
In Sonoma County the Public Health Preparedness unit, together with specially trained microbiologists in the Public Health laboratory, and in coordination with the California Department of Public Health, are developing strategies to respond to a pandemic threat. The Medical Reserve Corps is an important element in Sonoma's pandemic influenza plan.
The Centers for Disease Control (CDC) and the Department of Health and Human Services require all county health departments to develop a written Pandemic Influenza Plan that is integrated into the counties' emergency operations plans. Sonoma County's plan proposes specific response activities for each of the six World Health Organization's Pan Flu Phases (see www.PandemicFlu.gov).
Key Features of the Sonoma County Plan
- Notification of healthcare and community partners to alert them to an impending health emergency.
- Communication with the public about the pandemic on a variety of topics such as how to avoid the flu, how to take care of a sick person, where to get emergency medical care and similar messages.
- Implementation of a number of social distancing strategies to minimize transmission of the virus. These would include dismissing students from school and prohibiting large social gatherings. For example, the Governor of California plans to order the dismissal of students from schools at the first confirmed case in North America.
- Coordination of a response to care for an increase in sick patients at hospitals, clinics, skilled nursing facilities and county alternate care sites. The medical, mental health and support staff components of the Medical Reserve Corps would be essential for success in this effort.
- Organization of a mass vaccination campaign in the event that an effective vaccine has been developed and distributed. Our plan calls for the inoculation of all 489,000 residents of Sonoma County within a few days and we'll need hundreds of medical personnel to accomplish that goal, another critical role for all MRC volunteers.
The prospects of a pandemic infectious disease are daunting, but our efforts to prepare for such an emergency will help us be ready for whatever hazard may occur. The Medical Reserve Corps of Sonoma County is a cornerstone of our preparedness planning. Please visit our website to find out more: http://www.sonoma-county.org/pandemicflu
Cultural Competency and "One Bad Day"
By Stephen Rios, LCSW, Training and Education Coordinator, Public Health Preparedness
As a Medical Reserve Corps volunteer, during a public health emergency you will be working with diverse individuals and groups. "Cultural Competency" is a hallmark characteristic that enables you to be more effective and provide a higher level of care for our community.
Consider this: "One Bad Day" (a true story)
Recently, a Mexican-American male named Jose, was delivering a presentation at a nurses conference. During his presentation he shared a story he called "One Bad Day," in which he detailed his experiences at a local hospital. He described how he went to see his doctor about the severe pain he was experiencing, but he was told that he would first have to see an intake worker and then a nurse about his medical concerns. Jose replied: "I am in a lot of pain. I just need to see my doctor!" He was then told to wait for an appointment, which further frustrated and disappointed him. Jose then told the conference audience: "That was the worst care I ever received! They were rude and didn't get me a doctor even though I was in a lot of pain. I was so frustrated with that hospital." (He went on to name the hospital.)
Later that week, Jose learned that staff from that same hospital were in attendance at his presentation and had reported being offended and baffled that someone could say such negative remarks about the care provided at their hospital. This staff had avoided Jose the day of the conference.
If you were a staff from that hospital what would you have done?
Consider these three easy steps towards "Cultural Competency" that could have improved Jose's experience:
1. Take time to observe - Notice what types of experiences that people from diverse groups are having (e.g., language barriers, physical impairments, problems filling out forms etc.) then take steps towards improving their experiences.
2. Live the life of... - Put yourself in another's shoes. For example, how would you feel if you were in pain and felt that you were being discounted? Could you blame Jose for feeling the way he did after such a negative experience? Seek to understand others perspectives and needs which could differ from your own.
3. Take a journey - Learn about other cultures. For example, live a couple of days in another county and attempt to accomplish simple, everyday tasks. How successful are you in locating resources and communicating with others? Did you accomplish your tasks, or change your priorities when challenges arose?
If I were staff from the hospital where he received his care, I would approach Jose with a pen and paper and say:
"Jose, I heard you describe a very unpleasant experience and I would like to hear more about it. Please sit with me and tell me what happened. I want to take your comments back to the hospital so we can improve. The way you were treated is not how our hospital typically operates and we owe you an apology and a promise that your experience will be a better one when you come again. Here is the phone number for a patient's advocate, so if you have any problems you can quickly get attention. Please accept my apologies for you uncomfortable experience."
The moral of the story is to avoid personalizing, then discounting, others' accounts of negative experiences. Whether they are true or not, we need to investigate people's accounts of negative experiences in order to better understand their perceptions. Defensiveness usually creates a "lose-lose" situation: we don't learn practices of giving more effective care, or to improve the experiences for people like Jose.
To learn more about how you can become more culturally competent visit: http://www11.georgetown.edu/research/gucchd/nccc/foundations/frameworks.html
MRC Volunteer "Cancellation Policy"
Whenever possible, we ask that you give us at least 24 hours notice if, for any reason, you find that you are unable to keep a staffing commitment. This is especially important when signed up for flu shot clinics and community presentations. It is not only us that are counting on your participation, but, so are our community planning partners.
If you need to cancel, please call 707-565-4427 or email DHS-MRC@sonoma-county.org.
Thank you!
Update Your Profile
Has your contact information changed recently? Please to let us know how to reach you by completing our online "Update Your Profile" form at www.sonoma-county.org/mrc.
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For more information, please contact:
Sonoma County Medical Reserve Corps
625 5th Street
Santa Rosa, CA 95404
Phone: 707-565-4427