Show cover of No Bones About It: A NAON Podcast Series

No Bones About It: A NAON Podcast Series

Join bi-monthly episodes with the National Association of Orthopaedic Nurses, and host Bryan Combs in a deep dive into hot topics, best practices and trending research for any nurse working in the field of orthopaedics.


Let’s Optimize This Joint
Matt Lowe, MDiv, MSN, APRN, FNP-C, ONC sat down with Christen Nelson RN, BN, ONC to discuss the value of patient optimization prior to orthopaedic surgeries. Christen has been an orthopaedic nurse for 15 years and is currently the lead orthopaedic nurse navigator at Yale Newhaven Hospital. She explains the importance of patient optimization to identify modifiable risk factures for complications post-surgery. Christen shares more information and how she has received positive feedback from patients on the optimization and nurse navigation processes.
23:16 2/15/24
Bone Health and Osteoporosis
Matt Lowe, MDiv, MSN, APRN, FNP-C, ONC sat down with Claire Gill to discuss bone health, osteoporosis, and menopause. Claire Gill is the CEO of the Bone Health and Osteoporosis Foundation, founder of the National Menopause Foundation and hosts the Bone Talk podcast. She shared that 18-20% percent of the population have osteoporosis, and that for those over the age of 50 - about half of all women and a quarter of all men will break a bone due to osteoporosis in their lifetime. Barriers to bone health care include a lack of access to bone density machines (DEXA) and the cost since many insurance plans do not reimburse it. Claire explained that people may prevent osteoporosis by consuming calcium and vitamin D, as well as doing weight bearing and muscle strengthening exercises to maintain healthy bone mass. She is optimistic about the future of bone health because healthcare professionals are getting more knowledgeable about preventing and treating poor bone health.
27:44 12/14/23
Technological Innovations in Orthopaedic Surgery
Matt Lowe, MDiv, MSN, APRN, FNP-C, ONC, sat down with Dr. Karl Siebuhr to discuss technological innovations in orthopaedic surgery. Dr. Siebuhr is a board-certified orthopaedic surgeon who founded Reconstructive Orthopaedics of Central Florida and uses new technologies in his practice due to their positive impacts on patient outcomes. Dr. Siebuhr provided background of how robotic assisted surgery uses automation and artificial intelligence, but it is still driven by the surgeon. He shared his predictions for the future, including that robotically assisted surgeries will continue to develop and become the standard of care because it reduces costs and complications of orthopaedic surgery.
23:13 10/26/23
Opioid Stewardship & Orthopaedic Surgery
Matt Lowe, MDiv, MSN, APRN, FNP-C, ONC, sat down with Diane Jeselskis, BSN, RN, ONC and Lisa Holtz, RN, MSN, ONC, to discuss their organization’s practice at combating the opioid epidemic. Traditionally, the healthcare system prescribes opioids to patients with a no pain goal, but the practice has led to a high distribution of opioid use has led to a high distribution of opioid prescriptions and poor patient outcomes. According to the CDC, 75% of drug overdoses in 2020 involved opioids. Diane and Lisa discuss other modalities such as nerve blocks, regional and peripheral anesthesia as well as non-narcotic medication like anti-inflammatories and NSAIDs to reduce pain. In addition, we’ll discuss patient situations for cold compression devices, deep breathing, and injectable medication treatments that can be used 2 weeks post- surgery. They’ll discuss multimodal pain management and ERAS (enhanced recovery after surgery) protocols for orthopaedic surgery patients to reduce readmission rates, costs, and length of stay, as well as improve patient satisfaction.   
25:37 8/10/23
43rd Annual Congress Takeaways
The new host of No Bones About it, Matt Lowe, MDiv, MSN, APRN, FNP-C, ONC, sat down with Jessica Carlson, MSN, RN and Michelle Osborne, DNP, RN, NE-BC at NAON's 43rd Annual Congress to discuss their backgrounds, podium, and poster presentations.   Jessica Carlson, MSN, RN presented the podium session “Journeys to Bone and Joint Wellness with Personalized Education and Treatment Pathways” along with her colleagues at the University of Pittsburgh Medical Center. Jessica works with the Center for Bone and Joint Health at UPMC Magee-Womens Hospital to focus on nonoperative whole person wellness through the lens of social determinants of health. This session provided an outline for an innovative, personalized approach to diagnosis, workup and interventions.   Michelle Osborne, DNP, RN, NE-BC is the director of Patient Care Services at Northwell Health and manages the surgical orthopaedic unit at Long Island Jewish Valley Stream Hospital. In 2022, this unit won the NAON Orthopaedic Nursing Excellence (ONE) Award which acknowledges professionalism in nursing practice through demonstration of exemplary care for patients, and achievement in quality outcomes, collaborative interdisciplinary work environments, and professional growth opportunities. Michelle presented the poster titled “Nurses Using a Collaborative Approach to Improve Hospital Length of Stay & Patient Experience on a Surgical Orthopedic Unit”. Michelle explained how the inter-professional team collaborates to optimize patient care and outcomes.
16:33 6/5/23
NPs Looking at the Whole Patient: A NAON & AAOHN NP Discussion
We are so excited to sit down with another organization, the American Association of Occupational Health Nurses (AAOHN) for a discussion with two great Nurse Practitioner educators. Our hosts Jennylynn Balmer and Bryan Combs sit down with Kathleen Geier, and A.J. Benham a great team from Jackson Orthopaedic Foundation. The focus for these educators is on advanced practice nursing in primary care settings, and the nursing process in caring for patients. We learn so much about each other, education of NPs as both organizations see a growth of NPs in practice, and the organizations themselves. Make sure to tune in as you’ll take away a new perspective.
46:10 4/26/23
Ortho in the ER
On No Bones About It, Bryan sits down with Chris Hemmer, DNP, ANP-BC, RN, FAANP. Topping the list of patient health issues in the ER are chest pains, abdominal pains, headaches, and MSK conditions such as fractures, dislocations, sprains, back or neck pain. With primary care, back pain or other MSK pain are in the top five for complaints seen in clinics. Chris and Bryan talk about lacking specific ortho training as they began their own careers,  and how an NP may feel that lack of preparedness to assess and treat. The quality of life issues with MSK have changed with an active, aging population -60 is the new 40. There are patients in their 80’s healthy enough to receive knee replacements. With this aging population, there are opportunities and advances for the role of Ortho NPs and really Ortho certified RNs too.  This episode talks all about the resources to seek and the opportunities available with a professional organization.  
28:08 1/30/23
An Orthopaedic Surgeon Breaking Barriers
Orthopaedic Surgery as a specialty has the lowest percentage of female surgeons and has the least diverse representation overall in medicine. We discuss two pipeline programs The Perry Initiative for women and Nth  Dimensions  for minorities in the field of orthopaedics. This month on No Bones About It, NAON sits down with Dr. Toni McLaurin, the Director of Diversity, Equity and Inclusion in the Department of Orthopedic Surgery at NYU School of Medicine. For the 10th year in a row, NYU Langone was designated as a LGBTQ+ Healthcare Equity Leader in recognition of their strong commitment to providing high quality care to individuals marginalized or impacted by health disparities. In addition to her director position, Dr. McLaurin is a Professor of Orthopedic Surgery and Chief of Orthopedic Service at Bellevue Hospital, specializing in orthopaedic trauma and post-traumatic reconstruction. We’ll talk about Dr. McLaurin’s start as the Director of DEI in early 2020 amid the myriad of cultural and diversity issues faced by all.  We’ll touch on reasons orthopaedic surgery lacks diverse medical professionals as well as her own experiences as a surgeon and teacher. 
42:08 12/2/22
Tackling Racial Disparity in Orthopaedic Joint Replacement Surgeries
Our guest, Dr. Mo Halawi, is an Orthopaedic Surgeon at Baylor College of Medicine, an Associate Professor of Orthopaedic Surgery, and Chief Quality Officer for Musculoskeletal Services at Baylor’s St. Luke’s Medical Center. Current surgical databases control for differences in demographic, comorbidity and perioperative factors, but lack data on social determinants of health. Surgical databases play an important role in the patient outcomes following a surgery but many factors nationwide are not captured. Dr. Halawi and colleagues led a series of six studies presenting a comprehensive overview of racial and ethnic health disparities for those receiving joint replacement surgeries. The Baylor team’s findings showed lower outcomes continue to occur among minorities.  Recent data points to the need for greater understanding of the social factors that may impact patient outcomes. Those factors include language, education level, income, transportation or care access, living environment and caregiver support, as well as an assessment of the outcomes from surgery from the patient’s perspective and require interventions to be addressed differently. While disparities occur, there’s hope for the future as Baylor found the two minority groups experiencing the most disparities, Blacks and Hispanics, when analyzed over time and with interventions showed positive trends in terms of procedure utilization, health profiles and outcomes.
23:22 10/7/22
NPs and Musculoskeletal Health: A Foundation for Wellness
In this episode Bryan talks with NAON Member, Roz Puleo, ONP-C, FNP-BC, RCEP about her experience as a Nurse Practitioner working in an outpatient sports medicine setting. The number of Orthopaedic NPs in the area of Sports Medicine and overall musculoskeletal health continue to increase. Sports medicine should be looked at as a more comprehensive arc for a person leading an active lifestyle, not just about athletics. Orthopaedic care for a sports medicine issue goes beyond resuming the sporting activity and touching psychological or emotional wellness, return to work and even physical adjustments through rehabilitation. The role of orthopaedics keeps people moving, building on the foundation to overall wellness. Looking ahead to new opportunities in orthopaedics, we talk with Roz about NP sports medicine care in the outpatient setting. NPs have greater acceptance, more autonomy and overall better ownership of primary care. She shares experiences at her clinic that show less referrals out of the clinic to orthopaedics since implementing the NP role onsite, improved patient satisfaction and outcomes, increased comfort and trust, and improved patient education.
34:03 8/5/22
QI Projects: Driving the Quality of Orthopaedic Care
Bryan sits down with Jillian Knudsen, RN, MSN, CMSRN, ONC, CNL, CPHQ and Laura C. Arkin, MSN, APRN-CNS, ONC, ONC-A, CCNS, FCNS; two NAON Orthopaedic nurses leading the way with QI projects. Have you asked yourself how to get started with a process improvement? Our experts provide their tips for starting a QI project from types of tests, methodologies, resource allocation or even as simply as diving into the care of a patient population. Many have asked, “Why do we do it this way?” So did Laura and Jillian and in our discussion they share strategies for identifying a clinical problem or process issue to building upon process improvements in stages. As you listen, embrace looking at processes to make changes to improve care for patients or improve nursing practice.
36:23 6/3/22
A NAON Overview of Justice, Equity, Diversity and Inclusion (JEDI) in Orthopaedics
NAON had the pleasure of speaking with Erica Taylor, MD, MBA, FAAOS, FAOA Founder and CEO of the Orthopaedic Diversity Leadership Consortium and Dr. Fred Brown, DNP, RN, CENP Director of Generalist Education to explore Justice, Equity, Diversity and Inclusion (JEDI) principles from their experiences within the field of orthopaedics. Dr. Taylor is  an Assistant Professor of Orthopaedic Surgery at Duke University School of Medicine, Chief of Surgery at Duke Raleigh Hospital, Associate Chief Medical Officer of Diversity, Equity, and Inclusion at Duke PDC and Vice Chair of Diversity, Duke Orthopaedics.  Dr. Brown is an Assistant Professor for Adult Health and Gerontological Nursing at Rush University College of Nursing.   In this first discussion on JEDI, NAON starts the conversation with an overview into program components through education. Our guests consider the action behind learning and a need to do more listening. Our guests discuss teaching JEDI principles within organizations to promote initiatives. It’s their belief a key step to engaging in conversation on JEDI in any organization starts through forming genuine, authentic co-worker relationships. Our guests talk about creating value perception and providing equitable care through diversity in the workforce. We’ll dig into quality improvement projects and how social determinants of health play a huge role in patient reported outcomes. We hope you join the NAON JEDI conversation.
41:02 4/6/22
Nurse Liability with Electronic Health Records (EHRs)
NAON sits down with Georgia Reiner, Senior Risk Specialist from Nurses Service Organization to discuss nurse liability with electronic health records. Electronic health records (EHRs) create the digital version of a patient’s paper chart with a holistic focus on the patient’s health going way beyond the standard clinical data. An EHR system is built to share information with other providers so that all clinicians involved in a patient’s care have access to necessary records in a timely manner.  Documenting electronically streamlines provider workflow, yet the risk issues for nurses are similar as those with paper records. Tune in to this high level view of nurse risk to educate yourself on best practices, as well as basic steps to take to mitigate your risk level. We are talking about issues facing orthopaedic nurses, but this episode broadly applies to all nurses. Be sure to subscribe, rate and review No Bones About It: A NAON Podcast so you don’t miss an episode in 2022.
44:03 2/4/22
Orthopaedic Nursing: Oh, The Place You May Go
The roles of orthopaedic RN and NP nurses have evolved greatly into so many areas of healthcare. We’ll talk with Alena Ann Groves, DNP, FNP-C, ONP-C and Sally H. Pearson, DNP, FNP, ONC . These very busy orthopaedic nurses are the perfect example for this discussion. They both serve a variety of nursing roles from teaching nursing students, to performing athlete physicals or providing care at student health centers to running specialty osteoporosis clinics and even to providing musculoskeletal care for employees of a manufacturing facility. They talk about the changes to both in patient care and the growth extending to outpatient care. Orthopaedic NPs are treating non-surgical issues and improving patient care in many communities. They’ll discuss how orthopaedic NPs now treat patients for chronic musculoskeletal conditions offers tips for opening your own clinics within your organizations. They’ll discuss where they see orthopaedic nursing in the future, and the opportunities for continued advancement with orthopaedic expertise. Listen in to hear about their path and to reflect on your own orthopaedic journey.
30:02 12/3/21
Take Your Orthopaedic Unit to the Next Level
In this episode, NAON talks with Zach Perpetua, MSN, RN, CMSRN, CNL and Michelle Parks, BSN, RN, ONC from UPMC Passavant on their journey to obtain an Orthopaedic Center of Excellence designation. UPMC has established a center of excellence in several specific specialties, including for total joint replacement in July of 2019 and renewed in 2020. The UPMC Orthopaedic Unit began their journey in 2017 with 2 ONCs and a commitment to increasing more staff certified nurses. It is well documented in literature that certified nurses improve patient outcomes and quality of care. Certification also provides an avenue for nursing professional development and leadership roles within their organizations. The UPMC Passavant Hospital Foundation provided grant money to support the unit in their staff ONC certification process, including the expense of study materials, ONC exam costs, NAON memberships for each certificant, and coordination of study group sessions.  Through this support, all of the UPMC nurses that joined the initiative received certification.
35:08 10/1/21
Orthopaedic Surgical Mission Trips
In this episode, we speak with NAON Members, Bonnie Rae Koski, RN, MSN, CIC, ONC and Karen Mitchell, BSN, RN to learn more about their experiences with Operation Walk. Operation Walk is a volunteer medical humanitarian organization that provides the gift of mobility through life-changing joint replacement surgeries at no cost to those in need in the U.S. and globally. Through Operation Walk Carolinas, Bonnie, Karen and a dedicated team of hardworking healthcare professionals travel yearly to international locations. They share their philosophy on extending their work life commitment to take care of those in the community- globally. We’ll hear about the blessing each feel when they see the positive impact on someone’s mobility. It’s an amazing experience to hear personal stories of how a more functional life impacts family members and even villages. Through their trips, they have learned to use different assessments, a variety of pain medications and adjust surgical procedures as circumstances warrant. All for the language of smiles and hugs to change the life of one person at a time.
46:48 8/2/21
TJA Orthopaedic Travel Surgery
Bundled payments to reduce costs and improve outcomes aren’t a new concept in orthopaedics. We’re discussing a new innovation in orthopaedic care- employers using a bundled system to directly purchase health care for their employees. Travel for surgery, will we see more of this in the future? In this episode of the No Bones About It, host Bryan Combs discusses the University Hospitals Orthopaedic Travel Surgery program with Kelly Anne McCrone, BSN, ONC, Rita Hall, MSN CNS, Erica Sevinsky, RN, ONC.  Helping to meet the demands of employers and insurers with a move toward value based care, University Hospitals along with other health care systems in the Employers Centers of Excellence Network operate as sites for outpatient procedures.  Our guests share the background and the advance preparations involved for a travel surgery. They also share the requirements needed to become a surgical center of excellence.
33:33 5/13/21
The Nurse Scientist
Are you someone interested in the why? Do you have a sense of inquiry? This episode is a fascinating discussion with one of our premier Nurse Scientists, Sandra Siedlecki, PhD, Rn, APRN-CNS, FAAN from Cleveland Clinic Hospital System. She shares with host Bryan Combs the unique role she plays in a clinical setting advancing the care of patients.
28:34 4/9/21
Let’s Talk ONCB Certification
Do you have questions about orthopaedic certification? In episode 1, NAON host Bryan Combs, PhD, CRNP, FNP-BC, CNL, ATC talks with the Dorothy Pietrowski, MSN, RN, ONC®, ONP-C® and Matt Price, MSN, RN, CNP, ONP-C®, RNFA from the Orthopaedic Nurses Certification Board (ONCB). We’re exploring the value of certification to an RN, the certification exam, mentorship, and hearing about a day in the life of an ONC.
29:42 2/17/21