Dr. Chris Jones (Chief of Staff Tri-Star Medical Center, Nashville) Discusses Elective Surgery, COVID-19, and Fear.

They're starting to open up the country. Little by little and there's been a lot of talk about elective surgeries and I think that that's really kind of a misnomer on some things because I think people think that is just well this is just optional and dirt that that the term is really almost misleading in that sense, because a lot of surgeries of people are putting off because I don't want to go to hostile situations or hospitals were told they could do such a such and your health is. Is it risk of some these things again for the money his wife needed and now has had a hysterectomy because of some serious issues going on me replacements, hip all types of joint replacement. My wife's amputation was an elective surgery. This is something that she had to make the choice to do because they try to save her legs for so long and finally she said you know what this is getting of this is killing and so let's let's clear up what elective surgery is and by doing so I invited a special guest on the show this is Dr. Chris Jones.

He is the chief of staff at Tri-Star Centennial Medical Center in Nashville Tennessee.

We have spent some time at Tri-Star Centennial Medical Center is my wife and we lived in Nashville for many many years were in Montana now but I asked him to come on the show to talk about somebody sick so we have a little bit more education. As caregivers possess part of our journey.

Here's this on the show we want to educate and empower and hopefully were to entertain and speaking of entertaining. We hope that John will be joining us soon, but they have some some significant power outage in Nashville and he is not able to join us for the school. Hopefully it by the end of the this half hour he'll be able to be here with us.

Isa Dr. Jones Venable school of medicine where he did at Johns Hopkins and now you the cheapest after your cardiologist. Thanks for coming on the show.

Thanks for taking some time to come here and talk about this because I know that people are chart of the information is coming so fast and furious people. It's almost like a wall of noise and it's it's good to sit down with the experts insists okay what's going on here. So what I'd like you to do is I would like for you to just jump right into what is elective surgery with the great theater before going to be remitted by the date hereof number seven getting methodologies really are critical methods. I also want to thank you all.

The first, the people that are on the front line you on that and I'm a Panama cardiologist, my third in terms of critical care direct patient care encoded 19 in Nashville. Thankfully we didn't get hit so hard that my services were needed so much. But we got a lot of a first first line nurses and doctors that have no effect. Often themselves in harms way to take care of patient I'm so thankful for all of them elective surgery something that we tackled very early on back in March and W thimble our surgeons and other procedural us together to help us decide what elective surgery education great example hysterectomy on a patient joint replacement that on that on the surface of it. You might say, will you know that can elective surgery but it's not optional and I think the way you framed it is right on. And so when we got our surgeons and proceed altogether. Meet me at about 30 of the room along with our administrative team and we define for our hospital back in March is elective surgery was the surgery that can be delayed for 6 to 8 weeks without harming the patient so you know there's some 60-year-old man who need a knee replacement.

They can wait 6 to 8 week thing and it's really not can be a big guilt for them there some 60-year-old man who needed a replacement and their currently in a wheelchair and can't walk in there and with becoming bedbound and and having muscle atrophy and then having a really really difficult time ever getting back on their feet. They don't have that knee replacement you know any any particular surgery. It is not just the surgery that makes elective or not it's the whole patient. One of the things I really like about the way you share your experience with your life great you that it is not her medical conditions, or the doctor she faked the thought that the entirety of the person is what makes elective surgery really depends not just on the third grade, but how the patient doing the other example that hysterectomy is a great enough. Sometimes people have some minimal symptoms from a from the uterus that that need to come out.

Sometimes they can have life-threatening bleeding and dictations that another great example. Sometimes I can be for because of significant discomfort to sometimes think dictation needs occur because somebody's life is that with all of these surgeries can either be elective or urgent or emergently, depending on the whole patient, not not just the surgery itself will you get like kids getting to their ears and and there's so many different things are going on. You can't just intensely postponed, even if the 16 weeks well were just what were 6 to 8 weeks into this thing now that the other consideration here is that you're exactly right were that far into it and so we grabbed some people that although back in early March of their surgery might've been elected at that point but now it's becoming semi-urgent, urgent and really needing to happen if we been really fortunate here in Nashville that the citizenry banded together and meet. We abided by the social mitigation strategy stayed away from one another and we we flatten the curvy volunteering that expression. Flattening the curves of the health and doesn't get overwhelmed with cavitation. We didn't have that in Nashville we were very lucky and so were now in a position where the hospital volumes are are down, actually, and we have 20 a capacity in the community tended to begin doing elective surgery safely and so we actually started in backup this past Thursday, just four days ago now before you living jumping I got a couple of things are that one address that I want to ask you real quickly with this thing all went down. Here, the Chief of Staff, so you're having this meeting was it like for you we was a kind of surreal that okay where the pandemic here on the Chief of Staff. This major urban hospital here was a kind of surreal well yeah I will therapy myself as a servant leader my job.

I have such a incredibly talented and intelligent medical staff nursing staff administrative team.

My job is to give them opportunity to succeed and so by getting everybody in the room that really was my job getting everybody in their letting go with the herd in a constructive fashion helping guide that conversation and then make a decision back in early March thing. What happened in Italy and in the model forecast for Kenneth the look pretty grim and look like Juergen Anita 1500 bed ad hoc emergency hospital in our music city center there with our governor drew up plans for that.

We were fortunate. We got to help with some of the local decision-making art. Art Centennial did we were really we were concerned that we might be overwhelmed with with cavitation as we are concerned that we might run out of PPE. We were concerned that we might run out of ventilators. There was a really it was a daunting time. I was reminded not that the couple times that Roosevelt said that courage is not the absence of fear that it would a thump but is realizing that something else is more important than that dear Annette, I think we we kept that in our mind as we made our plans and in that meeting that day. Although I thought a lot of people who don't want to stop operating on the patient that are suffering. We also knew that we needed to make sure that we were good words in our community and and make sure that that community was protected and that we can care for all the patient that might need to be careful.

We have a situation that in my area here was really sad. This guy had chest pains and see wouldn't go to the hospital because he was afraid of catching this thing and he died heart attack he died.

And that's that's one of those tragic things you like, come on, come on, you know what and so total of about that fear going to the hospital. Yeah, I think that the relief it may be the key point at the current time in our nation is typically in areas like Montana and the fear going to the hospital at this point is going to be can cause more damage than the viruses of week that you're the greatest thing that I that about my job. It is like you I get to talk to a lot of people I get to hear a lot of stories and I think I'm up to eight stories now from different doctors where they had patient that they told me about that. It put off care and because of that there be some death there been knobs.

Some people that are going out long-term. Health problems because of delays in care.

They're really terribly. Sadly, I will assume you had a great story last week. It was a 33-year-olds on the story he shared it with the local newsweekly asking to graciously greatly but EF 33 his life was eight months pregnant and he had been having not crushing chest pain, and he was afraid to come to the hospital and his pregnant wife finally talked them into it and that he came in and yet not yet have really a life-threatening coronary blockage that was quickly dented and thankfully you cannot get a the perennial effects from it, but he almost the almost made a decision that could have really impacted him his future child and his wife. I was so thankful that he chose to come in the story that you just shared is all too common in week rehearsing terrible to fix the New York City, the incidence of sudden cardiac death.800% 100%, and that that they just totally overwhelmed and so people are unable to make it in Lombardi. Do you think they were thinking when able to make it energy think they were just afraid to go in, or as a combination of both of what we know. Yeah I think that's right as they get that now New York within the different situation than than Montana or Nashville about the nation. Their commitment many parts of their health system Oracle round the people there. They were afraid to go to the hospital. There their healthcare system was also very overwhelmed that it may have been that aid office can get to them in time that you possess all the debt that Mercy ship came in. I mean that the USS comfort or something and they were underutilized and and I think that that fear.

I tell people I said please turn off cable to fix because you know the fear is going to like you said it's going to hurt a lot of people and and and so it you know and yeah your situation to see it out here in Montana was certainly much different than in New York and New Jersey and and New Orleans and some other places but I one of the reasons I had what have you want today so you can help ring that commerce insurance okay look yeah this is scary but we know what to do and here's what we're doing and here's what you can do as a caregiver is a patient that kind of thing. So thank you for that.

The opportunities greatly brought and for the nation of the thing about fear is that it paralyzing and advocate liquid on a year-round podcast where you quoted CS Lewis and I thought it was a great quote in it was it was the one where he talked about living in the atomic agent and you turn it on its head and said it was it like to live in the can. The kind of midnight teenage and what he said in the in the quote was that we should act sensibly and I think one of the yeah and if such a powerful comment right me your fear becomes paralyzing and so what we need to do it is to recognize sure this is a bad time for rest and in for me is probably the biggest challenge we face in my lifetime, but when you talk to you like my grandparents who lived through World War II, or other statement through the things that are also really tragic that the fear can be worse than the situation and so what what I loved about that the quote that he shared with that we really do we need to overcome this fear may need to be sensible and thin right now. We got 20 get plenty of capacity and almost all the hop of the United States to care for people who may have a may be having symptoms that are new and concerning like Painkillers about all the want to know you're with having that we need the help. We do indeed on the way we talk to Dr. Chris Jones, Chief of Staff Tri-Star Centennial Medical Center, Nashville, Tennessee. This is hopefully caregiver hope for the caregiver.com will be right back to join this podcast coming. I really hope is on John Butler and I felt pretty show the caregiver since it began. I like to think that I'm responsible for the explosive growth the shows enjoyed.

I'd like to think that that doesn't necessarily make it so.

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Thanks so much sincerely and remember healthy caregivers make better caregiver. Hope you are here on family talk with Dr. Chris Jones. He is the chief of staff at the Tri-Star Centennial Medical Center in Nashville Tennessee very large hospital. We've had the privilege and pleasure in the also the excruciating town of heaven.

He stated her couple of dives with Gracie over the years, but they do a great job over there and he is just bringing some calm assurance to what were doing as a nation.

Now, as were starting to reopen things people are seeking medical care and one of things I wanted you all to know today is okay what to expect, what are we doing what's going on with elective surgery. What is it really even mean Dr. Jones I wanted to ask you about this thing what I've dubbed as caregiver authority and by that I mean is we as caregivers don't note necessarily the science of what's going on with our loved ones, but we know them and I have long been a proponent of caregivers learning how to better engage with their physicians in someone's you to take a bullet as were doing these things because a lot of people now are organ becoming hidden this way and they got me nervous to go itself I want to help people learn how to prepare for a medical visit of one of things out of. But as the 3P's of dealing with doctors you prepare you.

Be polite what you want to be subservient. Miranda.one tab that was given me a little bit attitude left, I told was a duck it with all due respect us take care of Gracie when you were in junior high school, so let's keep this in perspective here, but the other thing is I want people to be prepared. It's it's a business meeting and you need to be prepared for this going there with some things written down 3 to 5 issues that you want to dress and then the third thing is to stay out of the pharmaceutical conversation, I learned that the hard way to learn everything the hard way but but I want people to to understand that they do have caregiver authority. Let's plan for these meetings. Let's make the most of these things.

You guys are busy. Everything's gonna Start hitting at once.

What are your thoughts on that with caregiver authority. Be prepared for these meetings and so forth. What I think your I totally agree with everything that I think you're right on. You know the what, when I need a patient or a patient in their caregiver. You know, in my mind when I'm with and that person is the most important person that that I'm gonna be dealing with and there more important than me and that that that that that is what good doctors do if they recognize that the person within the room frankly is the boss in my job as the doctors to advise people and then sometimes I need that to be firm with my advisement and they may choose not to take it that's okay I love them anyway. But ultimately it's America, it's a free country and I'm here to advise people and I hope it I couldn't. I can give them choices from which vacancies and intake accordingly so that it meets their goals and and get them moving in a healthy way. You know that the founder of HCA and were part of continual part of a statement stompers senior along with his son, thumper's tenure that thumper senior was famous. He famously said that the patients are not experts on their their medical problem, but their world-class experts on whether or not you care and that ultimately is that you should expect that from your doctor.

And so you being prepared being polite and not engaging pharmaceutical. I very much appreciate said that that's all great but I have to say when when I got somebody like you and invite Gracie and remind him know that you know her better than me an idea fooled. Think otherwise.

I think that it is one of the thing.

If, on the caregiver and I'm bringing somebody to the hospital. I want to be worried about several things.

One is I want to be worried that not my loved one may get sick in the hospital. I'm going to be worried that being in a public place can be dangerous.

I'm been worried that I might be separated from my loved one I'm gonna be worried I might get sick myself. I get what I like to do the dress a couple of you know really that the hospitals are organ of the faith with public place within a gap.

Most hospitals are like ours there preparing and what they're doing is they're screening every visitor patient and personnel that comes into the hospital for any potential signs or symptoms of coveted and our hospital. Where were universal masking what that means that every body than the hospital wears a mask, CEO, Chief of Staff environmental services. The nutrition visitors every body weakness at throughout the entire hospital 20 coming all day long yeah that's right you do so mask free zones well week we will place it with the patient in their room and there either by the Velcro with a family date they don't have to wear that father in there but when somebody is an example by going the patient and what we wanted to do at that point is put on a mask if I can. And so there probably delete yet that went with that rule for every body and then their expected bright image there. Right now we we have a new visitor policy, but if somebody has to have a caregiver there were lovely quite a bargain to figure out a way to make that work and were moving actually having one visitor per patient enacting a start this week, but taking don't count for cost and has allowed us to keep our hospital a really safe environment. A place where it is getting a place for transmission of the virus should be a very very low probability of that one of the thing I can say that our hospital. Many hospitals are doing it, which we have all the COBIT virus patient what we call co-ported meeting. They're all in the same location and it separate from the other locations of the hospital so somebody committed to deliver a child is Kennedy a really far away, away from the COBIT patient somebody coming in for heart procedures gonna be a good distance away, etc. if they're trying to take you kind of that has kept our hospital of really safe place what one last thing I should mention is that just like you said earlier you what capabilities you get the benefit of the hospital peak their bed than the court awarded people running up and down the hospital and disheveled that there are some hospitals where that is happened that they can override it. It's not true, and in more than 95% off of the United States. If I took a picture and video the hospital right now it with the pond and orderly in a safe place.

Just like it has for the past many years.we got a run, but I really do appreciate you give me in 10 seconds surprised you the most about this whole thing with the private meeting without people come together towards a common mission and output submitted ahead of their peers. I guess I shouldn't say that I'm not I made you feel really good. Great, great news that Dr. Chris Jones Questar Centennial Medical Center staff put this out of the podcast of the available hope caregiver.com Jones, thank you, thank you very much for taking the time on this and have you back on okay.

Thank you. I really I see this is the way we got more to come. Caregiver.com you ever struggled to trust God when things happen to you.

I'm Gracie Rosenberger, 1983 I experienced a horrific car accident leading 80 surgeries in both legs and became I questioned why God allowed something so brutal to happen to me. But over time the questions changed and I discovered courage to trust God that understanding along with an appreciation for quality prosthetic limbs led me to establish standing with help more than a dozen years we been working with the government of Ghana and West Africa, equipping and training local workers to build and maintain quality prosthetic limbs for their own people on a regular basis. We purchased ship equipment and supplies and with the help of inmates in Tennessee prison.

We also recycle parts from donated lands all gases to point others to Christ.

The source of my help and strength, please visit standing with help.com to learn more and participate in lifting others that standing without.com. I'm Gracie. I am stating without