No Bones About It: A NAON Podcast Series provides a deep-dive into hot topics and trending research within the field of orthopaedics. Featuring interviews with industry experts and current NAON members, each episode aims to address best practices in an easy, on-the-go format. The NAON Podcast Series will release on a bi-monthly schedule.
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No Bones About It Host
NAON Board Director, Matt Lowe, MDiv, MSN, APRN, FNP-C, ONC, an Advanced Practice Nurse and owner of Renewal Primary Care, hosts the podcast episodes.
2024 Episodes
February 2024: Let's Optimize This Joint
Matt Lowe, MDiv, MSN, APRN, FNP-C, ONC sat down with Christen Nelson RN, BSN, 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.
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2023 Episodes
December 2023: 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.
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October 2023: 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.
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August 2023: 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 opiontinued 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.
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June 2023: 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.
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April 2023: 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.
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January 2023: 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.
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2022 Episodes
December 2022: 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.
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October 2022: 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.
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August 2022: 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 really should be viewed as a comprehensive arc for those leading active lifestyles, not just about athletic pursuits. Orthopaedic care for a sports medicine issue goes beyond resuming the sporting activity and touches psychological or emotional wellness, return to work and even physical adjustments through rehabilitation. The role of orthopaedics keeps people moving, and builds a 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.
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June 2022: 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.
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April 2022: 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.
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February 2022: 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.
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