Volume 10, Issue 2 n January 26, 2015

www.usuhs.edu

The Official USU Newsletter

Learning to Care for Those in Harm’s Way
Dr. Charles L. Rice, Uniformed 

Services University president 

recently announced the selection 

of Dr. Carol A. Romano as the next 

dean of the Daniel K. Inouye Graduate School of Nursing.

“Dr. Romano’s selection comes 

after an extensive search conducted by a committee chaired by Dr. 

Art Kellermann, dean of the Hébert 

School of Medicine, that produced 

a number of nationally-known 

candidates,” said Rice.

“Dr. Romano emerged as the 

best match for the GSN and for 

the university.” She succeeds Dr. 

Ada Sue Hinshaw, who retired in 

August 2014.

Romano has served as the Associate dean for Academic Affairs 

in the GSN since November 2010. 

Prior to coming to USU, she was 

an active leader within the United States Public Health Service, 

retiring at the rank of rear admiral. Her roles involved strategic 

planning, policy development and 

advising senior government officials and included acting deputy 

surgeon general, acting chief of 

staff OSG, director of the Office 

of Reserve Affairs and chief nurse 

officer of the USPHS. 

Romano also worked for 34 

years at the National Institutes of 

Health Clinical Research Center 

where she served as associate investigator, clinical research nurse, 

educator, director of nursing 

communications and recruitment, 

nursing system specialist, director 

of clinical informatics and quality 

assessment, deputy chief information officer and senior advisor for 

clinical research informatics.

She is recognized as a pioneer in 

nursing informatics for helping to 

design and implement one of the 

first computerized medical information systems in 1976, which 

provided electronic medical orders 

and clinical documentation for 

physicians and nurses in ambulatory and hospital environments. She 

was also co-architect of the world’s 

first graduate curriculum in nursing informatics at the University 

of Maryland School of Nursing.

In addition, Romano served as 

advisor to the World Health Organization on the management of 

manpower and health information 

in developing countries.

She earned a Bachelor of Science, Master of Science and Doctor 

of Philosophy from the School of 

Nursing at the University of Maryland after earning a diploma in 

nursing from the Geisinger Medical Center in Pennsylvania. Romano also completed the Interagency 

Institute for Federal Executives 

at George Washington University and the Harvard University 

Senior Managers in Government 

Program at the Kennedy School of 

Government. She is board certified in nursing informatics and 

as an advanced nurse executive. 

Romano is also a fellow in the 

American Academy of Nursing and 

the American College of Medical 

Informatics.

Sharon Holland

Deputy Vice President for External 

Affairs and Managing Editor

Gwendolyn Smalls

Chief, Media Affairs

Master Sgt. Oshawn Jefferson

NCOIC of VPE and Deputy Chief, 

Media Affairs

Christopher Austin

Editor/Layout Design

MC3 Laura Bailey

Writer and Photographer

Production

Editorial content is edited, prepared 

and provided by the USU Office of 

External Affairs unless otherwise 

indicated. The Pulse staff may 

include or exclude articles based 

upon news value, impact on the 

university and space availability.

Submissions

The Pulse is published 

biweekly on Mondays. The deadline 

for submissions is at 4 p.m. 

Tuesday prior to the publication 

date. Submissions can be sent to 

christopher.austin@usuhs.edu or by 

calling 301-295-3338.

Romano Named New GSN Dean

By Sharon Holland, Deputy Vice President for External Affairs/ Managing Editor

2 the pulse January 26, 2015

courtesy photo

On the cover

Army Lt. Col. (Dr.) Patrick Hickey (right) 

reviews the performance of a team of 

physicians, nurses, and hygienists during a 

simulated ebola case scenario in the mock ebola 

treatment unit (ETU) in Liberia. Learn more 

on pg 4.

courtesy photo
Two Navy enlisted service members at the Uniformed Services 

University received the Sailor of 

the Quarter and Junior Sailor of 

the Quarter awards at USU, Jan. 

16.

Boards with the selected nominees were conducted by Navy 

division leadership, Jan. 9. The 

winners – SOQ Hospital Corpsman 

2nd Class Peter Lam and JSOQ 

Hospital Corpsman 3rd Class 

Christopher Sheard – received a 

round of applause from their peers 

and leaders as the announcement 

was made during the Navy division’s weekly training.

Although this was his first time 

winning the SOQ, it is the second 

time Lam, a Military and Emergency Medicine instructor at USU, has 

been nominated since he joined the 

Navy in 2008. The feelings were all 

too familiar for him, he said. 

Through a series of facing movements followed by the recitation of 

the Navy creed and an oral evaluation of his professional military 

knowledge, Lam’s feelings during 

the board ranged from butterflies 

in his stomach to a more relaxed 

state of mind, he said. 

“Just like anybody else who 

is standing for a board, you’ll be 

nervous at first, but once you try 

to relax, take a deep breath and 

think about it, it shouldn’t be a 

nerve-wracking thing because 

it’s in front of the people that you 

work for,” said Lam, a Los Angeles native who deployed with the 

Marines during Operation Enduring Freedom. “How you conduct 

yourself in front of the first classes 

and the chiefs during a board is 

going to pretty much be the same 

as how you interact with them on a 

daily basis.” 

Professional military bearing is 

something that is expected of all 

sailors at all times, whether or not 

they are standing on a SOQ board, 

he added. But it’s still a competition. 

The JSOQ used the word “nervous” to describe his feelings about 

the board, but with the help of his 

squad leader, Hospital Corpsman 

1st Class Lisa Shumaker, preparation got him through it, he said. 

“After HM1 talked to me a little 

bit, I gained some confidence,” said 

Sheard, a technician at the Family 

Health Clinic and a native of Scranton, Pa. “She guided me through 

the process and we did a couple 

mock boards. Sgt. Spears in the 

clinic helped me study. He would 

ask me questions and I would try 

to answer them.” 

Now that they’ve won the 

awards, new feelings take the place 

of the old ones. 

“It feels good,” said Sheard, who 

joined the Navy in 2011 in search 

of a better job and to make a career 

for himself. “My leadership has 

helped me out a lot. It feels good 

to know that they’re guiding me on 

the right path.”

Being recognized for a job well 

done is meant to feel good. It 

means that someone has been paying attention even when it appears 

no one’s watching, but that’s not 

all. According to the SOQ, winning 

the award does not merely reflect 

on the winner’s accomplishments, 

“So, winning, it is not really for 

yourself,” said Lam, who helped 

run the training lanes during 

Operation Bushmaster 2014. “It 

was kind of a team effort because 

I wasn’t out there by myself. So in 

a sense, winning that award was a 

great reflection of the great camaraderie because if I didn’t have 

camaraderie out there I wouldn’t 

have executed as what it states on 

paper.” 

3 the pulse January 26, 2015

Navy Enlisted Division Reveals SOQ, JSOQ Awardees

by MC3 Laura Bailey, writer and photographer

Hospital Corpsman 3rd Class Christopher 

Sheard, Junior Sailor of the Quarter (right), 

poses for a photograph with Caroline Bouvier 

Kennedy, the 29th U.S. Ambassador of Japan.

courtesy photo

Hospital Corpsman 2nd Class Peter Lam, 

Sailor of the Quarter and an instructor at the 

Uniformed Services University, teaches Basic 

Life Saving skills to Air Force 2nd Lt. Katherine 

Richardson during a training session for staff 

and students at USU Jan. 22. 

(photo by MC3 Laura Bailey)
Lt. Col. (Dr.) Patrick Hickey, 

director for the Masters of Tropical 

Medicine and Hygiene program 

at Uniformed Services University, 

recently returned from Liberia 

and is using his experience to help 

educate residents in disaster and 

outbreak response.

“Our mission was to help prepare Ministry of Health workers 

from the government of Liberia as 

well as non-government organizations responders both from within 

Africa and coming from Europe 

and the United States who were 

going to be working in the Ebola 

treatment units in Liberia,” Hickey 

said. “A lot of the focus of the U.S. 

military is moving away from the 

traditional model of global health 

engagements that were direct care 

for more of a capacity-building and 

training model.” 

Because there being no specific 

treatment for Ebola, medical interventions include intensive supportive care where clinicians draw from 

a broad range of experience in 

clinical management ranging from 

diarrhea, dehydration, dysentery, 

sepsis and malaria, according to 

Hickey.

“I think this experience really 

helped reinforce some of the techniques that I will teach students 

and some of the skill sets I’ll try to 

help develop in them,” Hickey said. 

“So when they’re faced with whatever the next pandemic is they’ll 

be able to broadly draw from those 

same skill sets.”

The Military Medical Humanitarian Assistance Course, one 

of the programs Hickey directs, 

educates medical providers in 

recognizing the major causes of 

mortality among at-risk populations during complex humanitarian emergencies. 

During one recent offering of the 

MMHAC at USU, residents were 

educated in techniques to handle 

malnutrition, diarrhea and dehydration, and disease outbreaks 

through use of didactic lectures 

and scenarios.

The challenges for residents in 

the scenarios presented included 

limited communication barriars 

when relaying treatment information. Many of the techniques 

presented by instructors were 

meant to be streamlined so that 

they would be easily communicated across cultures. 

During the diarrhea and dehydration scenarios, residents were 

given educational tools—measuring spoons with instructions printed on them for the preparation of 

oral rehydration solution—to help 

convey treatments in a way that 

could reach across language barriers.

Instructors for the disease 

outbreak scenario tasked students 

with treating an outbreak with 

limited amounts of vaccine so as to 

develop a way to prioritize resources while taking into account other 

factors such as geography, logistics 

channels and security.

Professor Uses Experience to Educate on 

Outbreak Response

by Christopher Austin, editor/layout design

4 the pulse January 26, 2015

Lt. Col. Hickey (left) recently returned from Liberia where he helped train Ministry of Health 

workers and non-government personnel in techniques for handling Ebola. He uses this experience 

to help train residents in the Military Medical Humanitarian Assistance Course (MMHAC) at 

Uniformed Services University. (photo by Christopher Austin)

Residents at the MMHAC were presented with 

different oral rehydration solution mixtures 

that they were able to sample. The green 

measuring spoons feature instructions for how 

to make a simple solution out of water, sugar 

and salt. (photo by Christopher Austin)
Tips for Losing Weight in The New Year

by Christopher Austin, editor/layout design

5 the pulse January 26, 2015

With the new year come New 

Year’s resolutions and a popular 

one is to lose weight. There are 

healthy and unhealthy ways to do 

it, though, and Air Force Maj. (Dr.) 

Christopher Bunt, assistant professor in the Department of Family 

Medicine has some advice.

The chief piece of advice that 

Bunt offered is the importance of 

remaining focused on the actions 

taken to lose weight. 

“Think about one thing you 

could cut from your diet, or one 

thing you could cut back on,” he 

said. “So people say, ‘well, I drink 

lots of Diet Pepsi or Diet Coke.’ 

How many? ‘Ten a day.’ Maybe you 

could cut back and you could do 

five, or three, or two, or one.

“If I’m more specific about it, I 

think people are able to focus on 

it. The hardest thing is when we 

doctors say ‘you need to eat better 

or exercise more.’ We’re not giving 

them specific guidance. If I’m able 

to give them specific guidance, 

I’ve found that patients are able to 

understand that, they’re willing to 

buy in and they’re then successful.”

Exercise plays an important role 

as well, and similar to dieting, it 

should be focused on specifics. The 

Sports Medicine Patient Advisor

by Pierre Rouzier, M.D., suggests 

beginning a routine of physical 

activity that can become an enjoyable part of life, is affordable, and 

fit into a schedule. Those looking to 

lose weight must also be mindful of 

realistic activity programs.

“You need to build into whatever 

you’re doing,” Bunt said. “If you 

go from sedentary to trying to run 

a marathon, it’s not going to go 

well.”

A physician might prescribe an 

exercise program much like a prescription for medication. It comes 

with instructions like what the 

exercise is, how much needs to be 

done and how often.

“I’m trying to meet [patients] 

more where they like,” Bunt said. 

“If I’m telling you that you need to 

run and you’re like ‘I hate running,’ 

then it’s a waste of my time to tell 

you that and a waste of your time 

to tell you. But if I say ‘what do you 

like to do for exercise?’ ‘well I like 

walking,’ or ‘I like cycling,’ great, 

let’s work out something that’s 

walking-based or let’s work out 

something that’s cycling based.”

The Patient Advisor suggests 

many ways to start exercising effectively without a prescription, some 

of which are easy to include into 

busy schedules like going on walks, 

taking the stairs instead of the 

escalator or elevator, or walking to 

do errands. 

Exercise should be a gradual 

progression from low activity at 

first, to higher later on. The goal is 

to gradually increase breathing and 

heart rate so that the body becomes 

better equipped to endure more 

strain. For example; going from 

exercising once per week to three 

times a week, going from half-hour 

walks to hour ones, or starting with 

lifting small weights and progress 

to larger ones.

“It’s like this progress,” Bunt 

said. “Like with anything, if you 

take small bites, you start working 

through things and you’ll be able to 

handle it.”

Guidelines to Maintain Your Exercise Program

According to The Sports Medicine Patient Advisor by Pierre Rouzier, M.D., Third Addition

•	 Avoid setting your expectations too high, start slowly and build your stamina gradually.

•	 Find a friend to exercise with.

•	 Avoid being competetive. Try to improve on your last effort instead of comparing yourself with 

someone else.

•	 Recover completely from illness before resuming exercise. Then start with less exercise and increase 

the amount you do gradually to avoid injury.

•	 Remember that exercise needs to be continued throughout your life. Don’t try to be too intense. 

Enjoy getting healthy and have fun!
Uniformed Services University has begun training 

residents in the I-PASS 

handoff bundle, a verbal 

handoff process developed at Boston Children’s 

Hospital along with USU, 

Walter Reed National Military Medical Center, and 

nine civilian hospitals, to 

form a standardized patient handoff process that 

reduces patient injuries as 

a result of caregiver miscommunication. 

The verbal mnemonic, 

I-PASS – which stands 

for Illness severity, Patient summary, Action list, 

Situational awareness and 

contingency planning, and 

Synthesis by receiver – has resulted in a 30 percent reduction in injuries due to medical errors at the 

participating institutions, according to a study published in the New 

England Journal of Medicine.

The initial project was focused 

on the pediatric wards of the participating hospitals.

One of the co-investigators was 

Army Maj. (Dr.) Jennifer Hepps, 

assistant professor of Pediatrics at 

USU. She was also responsible for 

helping to create a video intended to help educate residents and 

interns on I-PASS and why it is 

important.

“We got a mandate from General 

Clark at the hospital to say ‘let’s 

disseminate I-PASS across the 

entire hospital,’ which was great,” 

Hepps said. “We’re in that process 

right now, trying to modify the curriculum for the other disciplines— 

nursing, ancillary staff, and other 

sub-specialties like surgery, anesthesia, and internal medicine.

“Since the study came out, 

everybody sees that there seems to 

be some good effect to standardizing handoff and having a rigorous 

process for transitioning care of 

patients at the shift changes.”

The three-hour orientation introducing the system occurs during 

residency retreats and initial intern 

orientations. There is also an informative video developed by the 

combined efforts of the university 

and WRNMMC that is available 

on the graduate medical education 

page on the hospital intranet.

The video features Army Col. 

(Dr.) Clifton Yu, director of graduate medical education at WRNMMC and one of the lead investigators in the project, going over the 

benefits of I-PASS and how it seeks 

to combat factors that lead to miscommunication in patient handoff 

like lack of protected space and 

time, tangential conversation, and 

no effort to avoid interruptions. 

When taught, I-PASS combined 

with seven of the communication 

techniques taught in TeamSTEPPS, 

or Team Strategies and Tools to 

Enhance Performance and Patient 

Safety, a team training curriculum 

also followed by caregivers.

I-PASS shares simularities with 

the technique Situation, Background, Assessment, and Recommendation (SBAR), which is taught 

already in TeamSTEPPS.

“SBAR was developed by the 

TeamSTEPPS folks for very discrete transitions such as if you’re 

coming back from a sedated procedure,” Hepps said. “Part of the education is really when to use SBAR 

for updating team-members on 

status changes or brief transition 

within the hospital and when do 

you use I-PASS for big transitions 

of care from one unit to another or 

one team to another.”

Hepps hopes that I-PASS will 

some day be commonly used to 

ensure the safety of patients in 

hospitals across the country.

6 the pulse January 26, 2015

New Handoff Bundle Being Taught to Residents

by Christopher Austin, editor/layout design

The University produced a video to help instruct residents on the I-PASS system and shows scenarios with 

actors featuring poor communication choices such as checking phones while performing a handoff. 

courtesy photo
Final Frame

7 the pulse January 26, 2015

Sailors from Walter Reed National Military Medical Center and the Uniformed Services University of the 

Health Sciences take the Active Duty Chief Petty Officer Advancement Exam at USU, Jan. 15, 2015. Sailors from 

WRNMMC and USU account for more than 170 out of 17,000 sailors fleet-wide who are eligible for advancement 

to E-7 this cycle. (photo by MC3 Laura Bailey)