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CEN - Certified Emergency Nurse - Dump Information

Vendor : Medical
Exam Code : CEN
Exam Name : Certified Emergency Nurse
Questions and Answers : 71 Q & A
Updated On : February 15, 2019
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CEN Questions and Answers

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CEN Certified Emergency Nurse

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CEN exam Dumps Source : Certified Emergency Nurse

Test Code : CEN
Test Name : Certified Emergency Nurse
Vendor Name : Medical
Q&A : 71 Real Questions

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Medical Certified Emergency Nurse

Morristown scientific core Earns Geriatric Emergency Dept. Award | killexams.com Real Questions and Pass4sure dumps

This post was contributed by a neighborhood member.

Atlantic fitness device's Morristown medical core today introduced it has earned level 2 (silver) Geriatric Emergency department Accreditation (GEDA) from The American school of Emergency Physicians, with assist from The Gary and Mary West fitness Institute and John A. Hartford foundation.

The award recognizes emergency departments that give wonderful take care of older adults. The Sameth Emergency department at Morristown clinical center is the 2nd medical institution within the state to earn this prestigious accreditation.

"The over-65 era is the nation's fastest-starting to be age group, and Morristown medical center is committed to ensuring our ageing sufferers, households and caregivers have access to wonderful clinical care that ensures they're secure and neatly-cared for—inner and outside the walls of our medical institution," spoke of Trish O'Keefe, PhD, RN, President, Morristown medical core. "Morristown medical center is nationally diagnosed for its care of older adults, and we are blissful to had been diagnosed by using The American faculty of Emergency Physicians for our dedication to this affected person population."

Morristown scientific core is domestic to The medicines company Geriatric Emergency department, which has senior-pleasant points including:

  • Volunteers who aid older sufferers within the ED
  • Initiatives to ensure correct treatment reconciliation through an emergency department pharmacist
  • New classes to in the reduction of patient delirium whereas within the emergency branch
  • Non-skid ground, adjustable lights and grab bars
  • access to canes and walkers
  • listening to amplifiers for people that forget their hearing aids, analyzing glasses, and further seating for guests
  • reducing using urinary catheters
  • entry to transportation functions
  • past referral to palliative care when applicable
  • health care provider and nurse practising in caring for the geriatric inhabitants
  • A multi-specialist group together with a board-certified geriatric nurse practitioner, geriatric social worker, committed emergency branch pharmacists with geriatric-selected practising, transitional care nurse and a couple of care managers are focused on improving the take care of the older inhabitants and undertake facts-based practices for most beneficial care.

    furthermore, Morristown medical core's Geriatric assessment core, a part of the David and Joan Powell middle for match aging, provides consultative assessments for older patients with dissimilar scientific and memory issues, simple look after these in negative health and at excessive chance for hospitalization, caregiver suggestions, social work session and greater.

    Atlantic health equipment's match getting older program helps older people and their caregivers discover the fitness care capabilities and neighborhood components that they should live longer, more healthy and more active lives. The application helps our neighborhood obtain tips regarding inner most home care and travelling nurse capabilities, rehabilitation amenities, housing companies, adult day care facilities and hospice care providers.

    "Morristown clinical center's Geriatric Emergency department Accreditation suggests our neighborhood that we now have the clinical group, amenities, and protocols in area to keep our seniors secure and gives peace of intellect to caregivers and households," said Dr. Michael Silverman, vice president and Director of Operations, Emergency drugs, Morristown clinical core.

    about the Geriatric Emergency department Accreditation software

    The GEDA application is the culmination of years of development in emergency care of older adults. In 2014, ACEP together with Society for tutorial Emergency medication, Emergency Nurses affiliation, and American Geriatrics Society, developed and launched geriatric ED instructions, recommending measures starting from including geriatric-pleasant machine to specialized team of workers to extra activities screening for delirium, dementia, and fall risk, amongst different vulnerabilities.

    The voluntary GEDA software, which comprises three degrees corresponding to trauma core designations, provides selected standards and goals for emergency clinicians and directors to goal. The accreditation process provides more than two dozen most suitable practices for geriatric care and the degree of GEDA accreditation executed will depend on how many of these most effective practices an emergency branch is in a position to meet. A stage 2 emergency department need to include lots of these most reliable practices, along with providing inter-disciplinary geriatric education, and having geriatric acceptable machine and supplies attainable.

    Get the Morristown newsletterSubscribe

    Thanks for your remarks.


    Morristown scientific core second sanatorium in NJ to Earn Prestigious degree 2 Geriatric Emergency branch Accreditation | killexams.com Real Questions and Pass4sure dumps

    MORRISTOWN, NJ – Atlantic health system’s Morristown clinical core nowadays announced it has earned level 2 (silver) Geriatric Emergency branch Accreditation (GEDA) from The American school of Emergency Physicians, with help from The Gary and Mary West fitness Institute and John A. Hartford foundation.

    The award recognizes emergency departments that supply outstanding care for older adults. The Sameth Emergency department at Morristown medical core is the second sanatorium in the state to earn this prestigious accreditation.

    “The over-65 technology is the nation’s quickest-starting to be age community, and Morristown clinical core is dedicated to guaranteeing our ageing patients, households and caregivers have entry to brilliant medical care that ensures they are protected and smartly-cared for—internal and outside the walls of our medical institution,” mentioned Trish O’Keefe, PhD, RN, President, Morristown medical core. “Morristown clinical center is nationally diagnosed for its care of older adults, and we are blissful to had been diagnosed by The American faculty of Emergency Physicians for our dedication to this patient inhabitants.”

    check in for E-news

    Morristown clinical center is domestic to The medicines company Geriatric Emergency branch, which has senior-pleasant points together with:

  • Volunteers who help older sufferers within the ED
  • Initiatives to make sure accurate treatment reconciliation by an emergency branch pharmacist
  • New classes to cut back affected person delirium whereas within the emergency department
  • Non-skid flooring, adjustable lighting fixtures and grab bars
  • entry to canes and walkers
  • listening to amplifiers for those who forget their hearing aids, studying glasses, and additional seating for friends
  • decreasing the use of urinary catheters
  • entry to transportation functions
  • earlier referral to palliative care when applicable
  • general practitioner and nurse working towards in caring for the geriatric inhabitants
  •  A multi-professional team including a board-certified geriatric nurse practitioner, geriatric social worker, dedicated emergency department pharmacists with geriatric-specific training, transitional care nurse and a couple of care managers are focused on improving the care for the older population and adopt facts-based practices for foremost care.

    in addition, Morristown medical core’s Geriatric evaluation core, a part of the David and Joan Powell center for fit growing older, gives consultative assessments for older patients with dissimilar clinical and reminiscence problems, primary care for those in terrible fitness and at high possibility for hospitalization, caregiver tips, social work session and extra.

    Atlantic fitness system’s match getting old program helps older americans and their caregivers locate the fitness care services and community substances that they need to are living longer, more healthy and greater active lives. The software helps our community acquire information involving private home care and journeying nurse capabilities, rehabilitation facilities, housing businesses, adult day care facilities and hospice care providers.

    “Morristown medical center’s Geriatric Emergency branch Accreditation indicates our community that we now have the scientific crew, facilities, and protocols in vicinity to retain our seniors secure and gives peace of mind to caregivers and households,” pointed out Dr. Michael Silverman, vp and Director of Operations, Emergency medicine, Morristown medical middle.

    in regards to the Geriatric Emergency department Accreditation application

    The GEDA software is the end result of years of development in emergency care of older adults. In 2014, ACEP together with Society for tutorial Emergency medication, Emergency Nurses affiliation, and American Geriatrics Society, developed and released geriatric ED instructions, recommending measures starting from including geriatric-pleasant gadget to really expert team of workers to more pursuits screening for delirium, dementia, and fall risk, amongst other vulnerabilities.

    The voluntary GEDA application, which contains three tiers corresponding to trauma center designations, provides certain criteria and dreams for emergency clinicians and administrators to target. The accreditation method offers more than two dozen ultimate practices for geriatric care and the degree of GEDA accreditation accomplished depends upon how many of these foremost practices an emergency department is capable of meet. A level 2 emergency branch have to incorporate lots of these most excellent practices, along with presenting inter-disciplinary geriatric education, and having geriatric appropriate gadget and elements purchasable.

     About Atlantic fitness gadget

    Atlantic health device, headquartered in Morristown, N.J., is an built-in health care beginning gadget powered via a staff of more than sixteen,500 crew contributors and 4,800 affiliated physicians dedicated to constructing healthier communities. The system serves a inhabitants of 5 million, with over four hundred websites of care, including six hospitals: Morristown medical center, fail to see scientific center, Newton scientific middle, Chilton scientific core, Hackettstown scientific middle and Goryeb little ones’s medical institution.

    Atlantic health equipment offers take care of the whole continuum of health care wants including 11 urgent care facilities, Atlantic Rehabilitation and Atlantic domestic Care and Hospice. Facilitating the connection between these services on each land and air is the transportation fleet of Atlantic cellular health.

    moreover the employed workforce, Atlantic Alliance, a Clinically built-in community, represents more than 2,500 fitness care suppliers throughout northern and vital NJ. Atlantic fitness system leads the Healthcare Transformation Consortium, a partnership of six regional hospitals and health techniques dedicated to improving access and affordability, and is a founding member of each the PIER Consortium – partners in Innovation, schooling, and research – a streamlined scientific trial gadget so one can extend entry to groundbreaking research throughout six fitness methods in New Jersey and Pennsylvania and AllSpire fitness companions, a consortium of five leading fitness care companies dedicated to serving patients, families and communities in New Jersey, ny, Maryland and Pennsylvania.


    Tufts clinical core emergency branch receives maximum-stage accreditation for care of older adults | killexams.com Real Questions and Pass4sure dumps

    BOSTON (January 28) – Tufts clinical middle announced these days that its Emergency branch (ED) has obtained level 1 Geriatric Emergency branch Accreditation (GEDA) from the American college of Emergency Physicians (ACEP), recognizing the optimum level of excellence in take care of older adults. Fewer than 10 U.S. centers have executed degree 1 Geriatric ED reputation; Tufts MC is the first clinic in New England to get hold of this honor.

    “This optimum-feasible certification degree affirms that our ED possesses the particular strategies, infrastructure and institutional commitment to give superior care to geriatric sufferers,” observed Brien Barnewolt, MD, Chairman and Chief of the branch of Emergency drugs at Tufts scientific core. “Our physicians and nurses have gone through selected, extra practicing for the care of this high chance population, we now have ensured that age-appropriate materials are in vicinity and we have instituted a rigorous ongoing fine software. It basically is a complete, collaborative, multidisciplinary effort right through the ED and across the whole Tufts MC organization to devote the time, components and personnel obligatory to deliver state-of-the-paintings emergency care to this prone affected person population.”

    To achieve stage 1 GEDA accreditation, Tufts MC ED clinicians and directors had been required to fulfill more than two dozen particularly particular standards, desires and gold standard practices for the beginning of elite geriatric care. These consist of proposing geriatric schooling, presenting geriatric-pleasant device and components, recruiting really good group of workers and offering events screenings for delirium, dementia and fall possibility. All of these measures display that the ED adheres to the highest standards of look after older adults. The level of GEDA accreditation earned is subsequently determined by the variety of geriatric greatest practices an ED satisfies.

    “The geriatric inhabitants is both the quickest-becoming community of sufferers making use of emergency services and one of the crucial susceptible affected person populations requiring significant clinical substances,” stated Franklin Friedman, MD, MS, FACEP, the brand new Director of the Geriatric Emergency department at Tufts medical center. “we now have created an geared up, integrated equipment that caters to the very specific scientific, emotional and social wants of geriatric sufferers, and now supply them with a stage of care, carrier and journey that can’t be discovered any place else in New England.”

    reaching stage I Geriatric Emergency department accreditation required numerous hours of training from ED leadership and group of workers in close collaboration with interdisciplinary teams throughout the clinical core, including sanatorium administration, the Departments of Pharmacy, Case administration, Social Work services and guidance services, and the Divisions of Geriatrics, Palliative Care, inner medication and adult basic Care and Trauma and Acute Care surgery, among many others.

    “here is a special affected person inhabitants, with enjoyable pathology and physiology and entertaining care and social requirements,” spoke of Gina Wakelin, RN, Emergency branch knowledgeable building Director at Tufts medical core. “we are committed to featuring the households of our geriatric patients with unique and particular care plans when they're discharged from our Geriatric ED. All too frequently in the us nowadays, geriatric sufferers are sent home after receiving emergency care, with their households left questioning in regards to the subsequent steps. We intention to fix that process.”

    ###

    About Tufts clinical middle and Floating clinic for infants

    Tufts clinical core is an exceptional, not-for-profit, 415-bed tutorial scientific middle that is home to both a full-service hospital for adults and Floating hospital for babies. simply determined in downtown Boston, the scientific center is the important educating clinic for Tufts university faculty of drugs. The scientific core facets a stage one trauma center with rooftop helipad, the greatest heart transplant middle in New England and a famous analysis application, ranking among the correct 10 % of impartial hospitals to receive federal research funding. a physician community of 1,800 New England satisfactory Care Alliance doctors represents our mighty commitment to fitness within the group. Tufts scientific middle is a founding member of Wellforce. For greater information, discuss with www.tuftsmedicalcenter.org.

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    Morristown Medical Center Earns Geriatric Emergency Dept. Award | killexams.com real questions and Pass4sure dumps

    This post was contributed by a community member.

    Atlantic Health System's Morristown Medical Center today announced it has earned Level 2 (silver) Geriatric Emergency Department Accreditation (GEDA) from The American College of Emergency Physicians, with support from The Gary and Mary West Health Institute and John A. Hartford Foundation.

    The award recognizes emergency departments that provide excellent care for older adults. The Sameth Emergency Department at Morristown Medical Center is the second hospital in the state to earn this prestigious accreditation.

    "The over-65 generation is the nation's fastest-growing age group, and Morristown Medical Center is committed to ensuring our aging patients, families and caregivers have access to high-quality medical care that ensures they are safe and well-cared for—inside and outside the walls of our hospital," said Trish O'Keefe, PhD, RN, President, Morristown Medical Center. "Morristown Medical Center is nationally recognized for its care of older adults, and we are pleased to have been recognized by The American College of Emergency Physicians for our dedication to this patient population."

    Morristown Medical Center is home to The Medicines Company Geriatric Emergency Department, which has senior-friendly features including:

  • Volunteers who assist older patients in the ED
  • Initiatives to ensure accurate medication reconciliation by an emergency department pharmacist
  • New programs to reduce patient delirium while in the emergency department
  • Non-skid flooring, adjustable lighting and grab bars
  • Access to canes and walkers
  • Hearing amplifiers for those who forget their hearing aids, reading glasses, and additional seating for visitors
  • Reducing the use of urinary catheters
  • Access to transportation services
  • Earlier referral to palliative care when appropriate
  • Physician and nurse training in caring for the geriatric population
  • A multi-specialist team including a board-certified geriatric nurse practitioner, geriatric social worker, dedicated emergency department pharmacists with geriatric-specific training, transitional care nurse and several care managers are focused on improving the care for the older population and adopt evidence-based practices for optimal care.

    In addition, Morristown Medical Center's Geriatric Assessment Center, part of the David and Joan Powell Center for Healthy Aging, provides consultative assessments for older patients with multiple medical and memory problems, primary care for those in poor health and at high risk for hospitalization, caregiver guidance, social work consultation and more.

    Atlantic Health System's Healthy Aging Program helps older people and their caregivers find the health care services and community resources that they need to live longer, healthier and more active lives. The program helps our community obtain information regarding private home care and visiting nurse services, rehabilitation facilities, housing organizations, adult day care centers and hospice care providers.

    "Morristown Medical Center's Geriatric Emergency Department Accreditation shows our community that we have the medical team, facilities, and protocols in place to keep our seniors safe and gives peace of mind to caregivers and families," said Dr. Michael Silverman, Vice Chairman and Director of Operations, Emergency Medicine, Morristown Medical Center.

    About the Geriatric Emergency Department Accreditation Program

    The GEDA program is the culmination of years of progress in emergency care of older adults. In 2014, ACEP along with Society for Academic Emergency Medicine, Emergency Nurses Association, and American Geriatrics Society, developed and released geriatric ED guidelines, recommending measures ranging from adding geriatric-friendly equipment to specialized staff to more routine screening for delirium, dementia, and fall risk, among other vulnerabilities.

    The voluntary GEDA program, which includes three levels similar to trauma center designations, provides specific criteria and goals for emergency clinicians and administrators to target. The accreditation process provides more than two dozen best practices for geriatric care and the level of GEDA accreditation achieved depends upon how many of these best practices an emergency department is able to meet. A Level 2 emergency department must incorporate many of these best practices, along with providing inter-disciplinary geriatric education, and having geriatric appropriate equipment and supplies available.

    Get the Morristown newsletterSubscribe

    Thanks for your feedback.


    Morristown Medical Center Second Hospital in NJ to Earn Prestigious Level 2 Geriatric Emergency Department Accreditation | killexams.com real questions and Pass4sure dumps

    MORRISTOWN, NJ – Atlantic Health System’s Morristown Medical Center today announced it has earned Level 2 (silver) Geriatric Emergency Department Accreditation (GEDA) from The American College of Emergency Physicians, with support from The Gary and Mary West Health Institute and John A. Hartford Foundation.

    The award recognizes emergency departments that provide excellent care for older adults. The Sameth Emergency Department at Morristown Medical Center is the second hospital in the state to earn this prestigious accreditation.

    “The over-65 generation is the nation’s fastest-growing age group, and Morristown Medical Center is committed to ensuring our aging patients, families and caregivers have access to high-quality medical care that ensures they are safe and well-cared for—inside and outside the walls of our hospital,” said Trish O’Keefe, PhD, RN, President, Morristown Medical Center. “Morristown Medical Center is nationally recognized for its care of older adults, and we are pleased to have been recognized by The American College of Emergency Physicians for our dedication to this patient population.”

    Sign Up for E-News

    Morristown Medical Center is home to The Medicines Company Geriatric Emergency Department, which has senior-friendly features including:

  • Volunteers who assist older patients in the ED
  • Initiatives to ensure accurate medication reconciliation by an emergency department pharmacist
  • New programs to reduce patient delirium while in the emergency department
  • Non-skid flooring, adjustable lighting and grab bars
  • Access to canes and walkers
  • Hearing amplifiers for those who forget their hearing aids, reading glasses, and additional seating for visitors
  • Reducing the use of urinary catheters
  • Access to transportation services
  • Earlier referral to palliative care when appropriate
  • Physician and nurse training in caring for the geriatric population
  •  A multi-specialist team including a board-certified geriatric nurse practitioner, geriatric social worker, dedicated emergency department pharmacists with geriatric-specific training, transitional care nurse and several care managers are focused on improving the care for the older population and adopt evidence-based practices for optimal care.

    In addition, Morristown Medical Center’s Geriatric Assessment Center, part of the David and Joan Powell Center for Healthy Aging, provides consultative assessments for older patients with multiple medical and memory problems, primary care for those in poor health and at high risk for hospitalization, caregiver guidance, social work consultation and more.

    Atlantic Health System’s Healthy Aging Program helps older people and their caregivers find the health care services and community resources that they need to live longer, healthier and more active lives. The program helps our community obtain information regarding private home care and visiting nurse services, rehabilitation facilities, housing organizations, adult day care centers and hospice care providers.

    “Morristown Medical Center’s Geriatric Emergency Department Accreditation shows our community that we have the medical team, facilities, and protocols in place to keep our seniors safe and gives peace of mind to caregivers and families,” said Dr. Michael Silverman, Vice Chairman and Director of Operations, Emergency Medicine, Morristown Medical Center.

    About the Geriatric Emergency Department Accreditation Program

    The GEDA program is the culmination of years of progress in emergency care of older adults. In 2014, ACEP along with Society for Academic Emergency Medicine, Emergency Nurses Association, and American Geriatrics Society, developed and released geriatric ED guidelines, recommending measures ranging from adding geriatric-friendly equipment to specialized staff to more routine screening for delirium, dementia, and fall risk, among other vulnerabilities.

    The voluntary GEDA program, which includes three levels similar to trauma center designations, provides specific criteria and goals for emergency clinicians and administrators to target. The accreditation process provides more than two dozen best practices for geriatric care and the level of GEDA accreditation achieved depends upon how many of these best practices an emergency department is able to meet. A Level 2 emergency department must incorporate many of these best practices, along with providing inter-disciplinary geriatric education, and having geriatric appropriate equipment and supplies available.

     About Atlantic Health System

    Atlantic Health System, headquartered in Morristown, N.J., is an integrated health care delivery system powered by a workforce of more than 16,500 team members and 4,800 affiliated physicians dedicated to building healthier communities. The system serves a population of five million, with over 400 sites of care, including six hospitals: Morristown Medical Center, Overlook Medical Center, Newton Medical Center, Chilton Medical Center, Hackettstown Medical Center and Goryeb Children’s Hospital.

    Atlantic Health System provides care for the full continuum of health care needs including 11 urgent care centers, Atlantic Rehabilitation and Atlantic Home Care and Hospice. Facilitating the connection between these services on both land and air is the transportation fleet of Atlantic Mobile Health.

    In addition to the employed workforce, Atlantic Alliance, a Clinically Integrated Network, represents more than 2,500 health care providers throughout northern and central NJ. Atlantic Health System leads the Healthcare Transformation Consortium, a partnership of six regional hospitals and health systems dedicated to improving access and affordability, and is a founding member of both the PIER Consortium – Partners in Innovation, Education, and Research – a streamlined clinical trial system that will expand access to groundbreaking research across six health systems in New Jersey and Pennsylvania and AllSpire Health Partners, a consortium of five leading health care organizations dedicated to serving patients, families and communities in New Jersey, New York, Maryland and Pennsylvania.


    Mount Carmel doctor sidestepped pharmacists, persuaded nurses, sources say | killexams.com real questions and Pass4sure dumps

    Sidestepping pharmacists and persuading nurses to follow his orders are among the actions used by Dr. William Husel to prescribe lethal doses of pain medication for dozens of patients while working the night shift at Mount Carmel West hospital's intensive-care unit, sources told The Dispatch.

    Staff members who worked in the ICU in the past five years said Husel often would give emergency orders for the powerful opioid fentanyl or some other painkiller. Those emergency orders, meant to be used in certain urgent situations, would allow him to bypass a pharmacist's pre-approval, giving the medical staff access to drugs stored in a Pyxis machine, or secure cabinet, on the ICU floor.

    Husel sometimes would tell families agonizing over removing a loved one from a ventilator that he would ease the patient's suffering with pain medication, but he didn’t tell the families he was prescribing potentially lethal dosages, family members said.

    Other times, the doctor would just order the large doses of opioids without informing families or consulting with anyone else in the hospital, families have said in lawsuits.

    If he was challenged by nurses or pharmacists over his prescriptions for pain medication, the doctor often would tout his residency work as an anesthesiologist at the Cleveland Clinic, then offer long medical explanations to justify his decisions, the staff members said.

    The Dispatch talked to three people who have worked at the hospital and another who is close to the hospital. They did not want to be named because they feared backlash from Mount Carmel or former co-workers.

    They say Husel's behavior went undetected for nearly four years because of hospital policies that were loose enough to allow Husel to work around them and go unchecked.

    Mount Carmel Health System said the first formal complaint about Husel was filed on Oct. 25, and an internal investigation is reviewing whether administrators should have known about his actions sooner.

    The system said in a Friday statement that it has more work to do and has engaged independent experts to strengthen processes to keep patients safe. "The industry-standard safety measures in place were not sufficient to prevent the events that have occurred," the statement said.

    Among recent changes, it said, are the changing of limits on the amounts of specific medications available for emergency override through the automated pharmacy dispensing system.

    Other actions include a new protocol to set maximum dosages for pain medication in the electronic medical-record system; a new escalation policy for deviations in pain-medication protocols, increased education on end-of-life care and a review of hospital culture to determine needed changes.

    Mount Carmel fired the 43-year-old Husel, of Liberty Township, on Dec. 5. The health system has said Husel ordered excessive doses of pain medication for 34 near-death patients. All of the patients died, but Mount Carmel has said it does not believe the drugs caused six of the deaths.

    All but one of the patients identified in the investigation died at Mount Carmel West. One died at Mount Carmel St. Ann's hospital.

    Several hospital sources have confirmed that Dr. Larry Swanner, the hospital's vice president of medical affairs, has been placed on leave. And the health system recently fired its pharmacy director, Janet Whittey, according to attorneys representing victims.

    Whittey could not be reached, and Swanner did not return several messages seeking comment.

    Mount Carmel has placed a total of 23 employees on paid leave, including pharmacists, nurses and managers. Its Friday statement said this is standard procedure in the investigative process and not meant to imply blame.

    In recent years, the hospital redistributed doctors to staff more day shifts, which are busier, said two doctors who worked in the ICU in the past five years.

    New doctors performing residencies as part of their training were taken off overnight shifts in 2013, Mount Carmel said, because weekly resident hours were capped at 80.

    That meant Husel often was the only doctor in the ICU during large stretches at night, hospital staff members said. 

    Mount Carmel said best practice is to have a critical-care doctor in the unit 24 hours a day, and Husel served in that clinical-coverage role.

    Fentanyl is commonly stored in 50 microgram bottles, and nurses and pharmacists from large area hospitals in Cleveland, Cincinnati and Columbus said that any nurse should question why more than two bottles are being opened.

    If Husel ordered 1,000 micrograms, as he is accused of doing for James “Nick” Timmons, that meant a nurse would have had to open 20 bottles.

    Pharmacists also were supposed to retroactively approve any emergency doses that Husel ordered and review their appropriateness, the doctors who worked at Mount Carmel have said.

    It is unclear what protocol was in place during Husel’s time in the ICU and whether it was followed, including an audit or accounting of how much medication was being dispersed.

    It is also unclear why pharmacists required to approve the drugs and nurses who administer them may not have spoken up.

    The Dispatch tried to reach out to several nurses and pharmacists named in wrongful-death lawsuits, and they declined to comment or couldn't be reached.

    Each patient who died under Husel’s care would have originally been assigned another Mount Carmel doctor when they were admitted, as is normal procedure for hospitals. Those doctors would have had access to the patient charts before signing the death certificates.

    The Dispatch reviewed death certificates of 11 patients named in lawsuits. Of those, only one had fentanyl or other drugs listed as a possible cause of death. The Dispatch reached out to the other doctors who treated the patients and signed the death certificates, but they either declined to comment or couldn’t be reached.

    Timmons, who died Oct. 24, was the only Husel patient identified to date for whom an autopsy was performed by the Franklin County coroner. The coroner listed the cause of death as cocaine and fentanyl.

    The coroner's report did not say whether Timmons used fentanyl or if it was given to him in the hospital. An attorney for Timmons' family provided medication records that show he was given 1,000 micrograms of fentanyl, 10 milligrams of the opioid Dilaudid and two 10-milligram doses of the sedative Versed — all ordered by Husel — in the minutes before his death.

    The coroner did not return calls seeking comment.

    Husel was first hired by Mount Carmel in 2013 as an internal medicine doctor in the ICU, but during his five-plus years in that department he was not board certified, unlike an estimated 85 percent of physicians working in the U.S. 

    Officials at three national medical certification organizations all said Husel is not currently certified nor has he ever been certified with their boards or associations.

    Board certifications are not required by the Ohio State Medical Board to practice medicine. But they serve as proof that a physician has additional expertise in a particular specialty or sub-specialty in a medical practice.

    .

    Some hospitals have independently made the decision to require board certification for staff privileges. Mount Carmel said Husel's efforts toward getting credentialed were consistent with their bylaws, but it did not provide details.

    The health system went public about its investigation on Jan. 14, the same day the first wrongful-death lawsuit was filed against Mount Carmel, Husel and others.

    Following the initial Oct. 25 complaint, a second complaint against Husel was filed Nov. 19 and a third on Nov. 21, the day Husel was removed from patient care.

    In the weeks after the first complaint was filed, the health system acknowledged, Husel overdosed three patients. Lawyers said one happened Nov. 20, after the second complaint, and involved a 2,000-microgram dose of fentanyl and 10 milligrams of Versed.

    Husel’s medical license has been suspended, and an investigation has been launched by Columbus police and Franklin County Prosecutor Ron O'Brien. Husel faces at least 14 lawsuits.

    jviviano@dispatch.com

    @JoAnneViviano

    lsullivan@dispatch.com

    @DispatchSully

    mwagner@dispatch.com

    @MikeWagner48



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    Medical CEN Exam (Certified Emergency Nurse) Detailed Information



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