By Jennifer Hill Buehrer LMSW

I’ve been writing this column for almost a year now.  It’s hard to believe, just like it’s hard to believe that we’re still doing all of this.  Sometimes I have amusing insights to share here, and sometimes the subjects are so serious that there’s really no good way to lighten them up.  My goal has been to give a voice to you – what I hear and discuss with you – and to shed light on the things we’re all struggling with through this pandemic.  We’ve dealt with and discussed frustrations, losses, pains, hopes, gratitude… it goes on and on. I do this because I’m a fan of language who naturally needs to emote, and writing is the easiest and most effective way for me to share and try to help.  At the same time, words are not a substitute for real connection, and that’s something that demands pause.

Most of us have been in situations where we encounter platitudes – those expressions that have been used so often that they don’t carry much meaning anymore.  In the world of health care, and sickness, it happens a lot: “God doesn’t give you more than you can handle.”  “Everything happens for a reason.”  “He’s in a better place.”  “Thoughts and prayers.”  The point is words in tough situations should have power.  And when we recite things like these phrases that tend to ring hollow from overuse, it may leave us feeling like we’ve offered something meaningful while leaving the recipient of the platitude feeling even more empty and alone.  It can feel like it’s just a substitute for the effort it takes to really connect. All this is understandable as we desperately search for the right words to comfort people we care about. Even those of us who do this for a living struggle sometimes to offer real, caring dialogue instead of platitudes.

Spoiler alert:  this is one of those more serious topics than some of my other articles.  Last weekend a dear friend of almost 30 years ended his life.  As is often true, it was completely out of the blue.  He was handsome, incredibly talented, and loved by so many people in so many places… but for whatever reason he felt alone, clearly.  He was savvy at keeping in contact with friends, sending creative Christmas and birthday cards that carried all kinds of personal touches.  He had the best singing voice I’ve ever heard and would post videos online sometimes of him singing – especially at the holidays – and friends like me just ate it up.  He lived in North Carolina and I hadn’t seen him since the pandemic began.  I’d been thinking of visiting him this spring… I just hadn’t gotten to telling him that yet.  And of course, I’ll carry that with me forever.  It’s not that I think the anticipation of a visit from me would have rescued him from the depths of his despair.  But maybe the thought that he was on someone’s mind, that his company could be a destination in itself, would have made him pause.  Maybe I could have sensed something in his voice when we talked on the phone.  Making the smallest connection could have made a difference.  I don’t blame myself at all; I just think that when someone comes to mind, I need to let them know that.  The beauty of our technology is that it can make it so easy to do – to shoot a text to someone who’s on your mind or call them from anywhere.

My challenge to you, and to myself, is to stop for a second when tempted to offer an overused phrase to someone in distress and instead try to choose words that mean something – words that come from the heart of the speaker and not from the Book of Platitudes.  You never know what that sincere connection can do for someone.  And ultimately what it can do for you.

Jennifer Buehrer, LMSW is a palliative care social worker at St. Joseph Mercy Ann Arbor.

Behind-the-Scenes Peek at the New IHA & St. Joe’s Livonia Medical Center

LIVONIA – The new IHA & St. Joe’s Livonia Medical Center will open its doors to the public this April. Ahead of the opening though, we want to give colleagues a behind-the-scenes sneak peek of the work taking place. Click through the photos above to see photos of the construction underway inside the new center.

The IHA & St. Joe’s Livonia Medical Center will house a variety of service lines, including primary and specialty care, urgent care, an outpatient pharmacy, ambulatory surgery, outpatient imaging, and more

March 11 is World Kidney Day…

Important Kidney Health Updates from Judith Mayer, MD – Nephrology Associates of Michigan

Newer Dialysis Options for Kidney Health Provide More Freedom, Improved Quality of Life
Patients who either choose not to have a transplant or do not qualify for transplant have the options of doing home dialysis or traditional in-center hemodialysis. Home dialysis includes both peritoneal dialysis and home hemodialysis.

Peritoneal dialysis is a process that removes fluid from the body as well as cleanses the blood and it is done daily. It may be performed manually every few hours throughout the day or via an automated cycler during the nighttime. Since the dialysis is done every day this method is the closest to simulating ordinary kidney function.

Home hemodialysis is performed via an arteriovenous fistula (AVF) or an arteriovenous graft (AVG) or catheter and uses a much smaller machine than is typically used for outpatient dialysis. The dialysis is done three to five days a week, and for shorter periods of time than traditional dialysis. Patients are able to do dialysis on a schedule that is convenient for them.

Both peritoneal dialysis and home hemodialysis offer significant advantages over the more traditional hemodialysis, such as:

  • Better control of volume/fluid status
  • Better control of electrolytes such as potassium
  • Patients enjoy a more liberal diet
  • Improved blood pressure control
  • Improved energy level compared to in-center hemodialysis
  • Ability to schedule dialysis at patient’s convenience
  • Both methods offer a much better quality of life

Nikki Fenner Honored for Extraordinary Patient Care, Inspiring Poem

LIVONIA – Nikki Fenner, an RN on 4 West, recently cared for another colleague’s very ill grandmother. The patient had been diagnosed with COVID-19, and was declining quickly. Nikki provided extraordinary patient care to the patient and her family, with Nikki’s colleague noting that her grandmother had been treated with compassion and love in her final hours. For her dedication to caring for patients during this challenging pandemic, Nikki was honored with the BeRemarkable Award.

Nikki was nominated by a colleague, who wrote, “Nikki is a wonder nurse from 4 West and patients and coworkers feel that she deserves to be recognized.  Nikki has received multiple caught caring cards for her excellent care that she gives to her patients and their families.  She will go out of her way to make sure that her patients are safe and getting the correct care that they need.”

The colleague whose grandmother Nikki had cared for also shared, “Nikki updated me all night and made sure grandma didn’t struggle one bit. She sat with her, prayed with her and talked to her… I feel relief that she had amazing nurses and techs taking great care of her.”

Nikki wrote a poem describing her experience as a nurse caring for COVID patients. With her permission, the poem is printed below.

12 Hours
The fear that runs through your body when…
You see a Covid positive lab result on your new admit…
The dread you feel thinking of being exposed…
Or taking the virus home… to your family…
The panic-stricken sensation you get when you…
Watch your patient struggle to breathe…
But know that you have to be strong for them…
Because we are all they have in this hospital…
The hopelessness you endure when you know your patients’ existence on this earth will be ripped away from them… and wonder, do they know…
Yet you stay strong… for the family that will be faciing a tragic loss…
The sadness that consumes you when you…
Watch your patient take their last breath…
The ear-shattering silence in the room as you work with the team to prep the body for family to pay their last respects…
The heaviness in your soul as you lay your patient in a bag…
The shudder that overcomes you with the sound of each notch of the zipper as you zip it up…
The defeat you swallow as you watch the body bag gently follow the contour of the patient’s body… while you continue to pray for them and their family
Knowing… these feelings will be repeated more times than you can handle…

Yet… we come to work with our smiles blazing…
Our best foot forward at all times…
With hopes to make them crack a smile or chuckle…
We may be tattered and torn… But…
It’s just what we do… It is embedded within us…
We ARE the backbones of these hospitals…
Making a difference… 12 hours at a time…

Congratulations, Nikki, and thank you for bringing your heart and soul with you into work each day.

How COVID-19 Vaccines Work

COVID-19 vaccines help our bodies develop immunity to the virus that causes COVID-19 without us having to get the illness. Different types of vaccines work in different ways to offer protection, but with all types of vaccines, the body is left with a supply of “memory” cells that will remember how to fight that virus in the future. 

It typically takes a few weeks after your last dose of vaccine for your body to have the highest level of protection. 

Sometimes after vaccination, the process of building immunity can cause symptoms, such as fever, muscle aches, feeling tired. These symptoms are normal and are a sign that the body is building immunity. 

Types of Vaccines 

Currently, there are two types of COVID-19 vaccines that are authorized for emergency use in the United States. None of these vaccines can give you COVID-19 because they do not contain any live COVID virus. 

mRNA vaccines contain material from the virus that causes COVID-19 that gives our cells instructions for how to make a harmless protein that is unique to the virus. After our cells make copies of the protein, they destroy the genetic material from the vaccine. Our bodies recognize that the protein should not be there and build cells that will remember how to fight the virus that causes COVID-19 if we are infected in the future. (Moderna, Pfizer- BioNTech) 

Vector vaccines contain a weakened version of a live virus — a different virus than the one that causes COVID-19 — that has genetic material from the virus that causes COVID-19 inserted in it (this is called a viral vector). Once the viral vector is inside our cells, the genetic material gives cells instructions to make a protein that is unique to the virus that causes COVID-19. Using these instructions, our cells make copies of the protein. This prompts our bodies to build cells that will remember how to fight that virus if we are infected in the future. (Johnson and Johnson) 

Most COVID-19 Vaccines Require More Than One Shot 

All but one of the COVID-19 vaccines that are currently authorized for emergency use in the United States use two shots. The first shot starts building protection. A second shot a few weeks later is needed to get the most protection the vaccine has to offer. One vaccine (Johnson and Johnson) only needs one shot to provide protection. 

The Bottom Line 

Getting vaccinated is one of many steps you can take to protect yourself and others from COVID-19.  Protection from COVID-19 is critically important because for some people, it can cause severe illness or death. All vaccines have been proven to prevent serious illness, hospitalization and death. It doesn’t matter which vaccine you get, just get vaccinated when it is your turn. 

Stopping a pandemic requires using all the tools available. Vaccines work with your immune system so your body will be ready to fight the virus if you are exposed. Other steps, like masks and physical distancing, help reduce your chance of being exposed to the virus or spreading it to others. Together, COVID-19 vaccination and following CDC’s recommendations to protect yourself and others will offer the best protection from COVID-19. 

Things to Know About COVID-19 Vaccination Following Johnson & Johnson’s EUA 

  1. The U.S. Food and Drug Administration (FDA) has now approved three COVID-19 vaccines for Emergency Use Authorization (EUA). It is the first single-dose vaccine approved for EUA. 
  2. Johnson & Johnson’s single-dose vaccine uses a harmless adenovirus to activate an immune response to the coronavirus spike protein. It shows mild side effects like other vaccines. 
  3. Clinical trials showed a 72 percent efficacy against COVID-19 infection and 86 percent efficacy against severe illness and death in those who received the vaccine. No COVID-19 deaths were reported in those vaccinated during clinical trials. 
  4. It doesn’t matter which vaccine you receive. The most important thing is to get vaccinated when it is your turn. Vaccination is the most effective way to end the COVID-19 pandemic and protect yourself and those you come in contact with. 
  5. As health care professionals, we have the responsibility to continue to be leaders in our communities. Please encourage everyone to get educated about the vaccine’s safety and get vaccinated when supplies are available to them. Also, remind the people in your life of the importance of wearing with a mask, washing hands often, avoiding crowds and staying at least 6 feet away from others.  

St. Joseph Mercy Chelsea announces opening of the 2021 Chelsea Farmers Market

Online orders begin April 1, Wednesday and Saturday outdoor markets begin May 1

CHELSEA, Mich. (March 1, 2021) – This spring, St. Joseph Mercy Chelsea will once again host the annual Chelsea Farmers Market.  The farmers market brings high-quality food and artisan products to the Chelsea community.  It offers seasonal vegetables and fruit of all types, meat and poultry, eggs, honey, maple syrup, coffee, a wide variety of breads and bakery items, herbs, hand-crafted artisan products such as jewelry, birdhouses, body care and pottery. Organic and naturally-grown offerings are also available.

“More than just another chance to grab food, the farmers market promotes healthy living and builds a sense of community,” said Emily Griswold, the Chelsea Farmers Market manager.  “Servicing the surrounding towns and villages, our market safely brings together friends and neighbors from the 5 Healthy Towns — Chelsea, Dexter, Grass Lake, Manchester and Stockbridge — to stock up on nutritious food and support local businesses.”

Beginning in April, online orders can be made at, Monday thru Thursday, from 7 a.m. to 7 p.m.  Online orders can be picked up on Saturdays in April, November and December, from 10 a.m. to noon, at the 5H Foundation Office, located at 14800 E. Old US 12 Hwy in Chelsea.  The remainder of the season (May – October) online order pick-ups can be made at the Saturday market location, Palmer Commons, from 10 a.m. to noon.

In-person outdoor markets will also be available on Wednesdays and Saturdays, beginning May 1.  Similar to last year, a number of safety protocols will be in place at each outdoor market.  This includes required masking for all patrons, physical distancing, designated and clearly marked entrance and exit points, and products will only be handled by vendors.

Outdoor Market Wednesday

Where: Chelsea State Bank, 1010 S. Main St., near the corner of Old US 12 and M-52.

When: Each Wednesday from 1 – 5 p.m. through the end of October.

Outdoor Market Saturday

Where: Palmer Commons, 222 S. Main St. in Chelsea

When: Each Saturday from 8 a.m. – 1 p.m. through the end of October.

The market is supported in part by the Supplemental Nutrition Assistance Program, which allows Bridge Cards to be used in exchange for Bridge Card Tokens to purchase food items.  The market also participates in the Double Up Food Bucks program, which matches every dollar of SNAP with a FREE dollar to be spent on fresh fruits and vegetables.

The farmers market is a program of St. Joseph Mercy Chelsea.  It is sponsored by the hospital and The Chelsea Friends and Family Wellness Coalition, and is a member of the Chelsea Area Chamber of Commerce and The Five Healthy Towns Foundation.

To learn more about what to expect each week at the farmers market, please e-mail, visit the website at or visit the Chelsea Farmers Market Facebook page.  For local businesses interested in becoming a vendor, please visit

Beam with SJMHS Colleague Signatures Now Sits in New IHA & St. Joe’s Livonia Medical Center

LIVONIA – Last year, we hosted a structural beam onsite and invited all SJMHS colleagues to sign it. Colleagues filled the beam with words of encouragement, expressions of pride in their work or department, and general well wishes. IHA and Schoolcraft College, who are partners in this project, also hosted the beam at their sites for signatures. The beam was then installed during a beam-raising ceremony in the new IHA & St. Joe’s Livonia Medical Center.

A year has passed, and construction of the new center is nearing its close. The beam is now displayed at the top of a stairwell on the south side of the building, intentionally left exposed so that people can see the signatures.

The Livonia Medical Center will open this April. The 124,000 square foot facility will house a variety of service lines, including primary and specialty care, urgent care, an outpatient pharmacy, ambulatory surgery, outpatient imaging, and more.

Thank you to all who took the time last year to make your mark on the new center. We will share more information about the Livonia Medical Center in coming weeks.

March is National Nutrition Month®

March is National Nutrition Month (NNM), an annual campaign created by the Academy of Nutrition and Dietetics (AND). This year’s theme is “Personalize Your Plate.” During the month of March, our Trinity Health Registered Dietitian Nutritionists make a special effort to engage our colleagues, community and family members with making informed food choices and developing healthful eating and exercise habits. You are encouraged to seek the guidance of a Registered Dietitian Nutritionist (RDN), who can tailor a healthful eating plan to meet your specific, individual needs. Everyone is unique with different bodies, goals, backgrounds and tastes. Personalizing your plate is what we do best.

RDNs can show people how to use MyPlate, which provides practical, consumer-friendly tips to follow the key recommendations of the Dietary Guidelines. MyPlate recommends visualizing your plate as nutrient-rich sections with one quarter reserved for grains, another with protein-rich foods and the remaining half with fruits and vegetables along with a serving of low-fat or fat-free dairy.

We encourage you to take the “What’s on Your Plate?” quiz. The quick self-assessment provides tailored resources based on answers to a series of simple questions on current eating habits. The results page will provide a snapshot of how you are doing in meeting food group recommendations.

You can also give the “MyPlate Plan” a try.

In addition, the second Wednesday of March is Registered Dietitian Nutritionist Day, an annual celebration of the dedication of RDNs as the leading advocates for advancing the nutritional status of Americans and people around the world. This year’s observance will be March 10.

Colleagues, the COVID Vaccine, and HIPAA

As the vaccination roll-out is well underway for our colleagues and community members, this is a great time for some important privacy reminders.

  • When receiving a COVID vaccine, colleagues are considered patients. This means they should be afforded the same privacy protections under HIPAA as all other patients.
  • Receiving a COVID vaccine is not mandatory for colleagues which is different from flu vaccine.
  • A colleague must complete a Trinity Health release form in order for the organization to share their photo that was taken while getting a vaccine.
  • There are many community members cycling through our COVID vaccination clinics. It is very likely that the colleagues working the clinics will see people they know. Receiving a vaccination at a community clinic is considered protected health information (PHI) which should not be shared with others for personal purposes.
  • If a colleague or community member shares that they received their vaccine in a personal capacity, this is not considered PHI. 
  • If you learn that a colleague or community member received a vaccine while working in the clinic or providing care, this is PHI and should not be disclosed.

Is this a HIPAA violation?

  • A coworker at lunch tells you that she did not have any side effects after getting her second vaccination. You share that information with your mother to calm her fears about getting the vaccine.

Answer: No, this is not a HIPAA violation. The information was not learned during the course of your job. It was shared by the coworker presumably as part of a friendship. The coworker is free to share any of her own medical information with anyone she chooses.

  • In the COVID vaccination clinic one colleague loudly asks another colleague what time Dr. Jane Doe came in for her vaccine.

Answer: Yes, this is a HIPAA violation.  Everyone in the clinic heard that Dr. Jane Doe had an appointment and received her vaccination. Even though the doctor is a colleague, she is a patient for purposes of receiving the vaccination and the fact that she received a vaccination would be considered PHI. The colleague should have gotten up and quietly asked for the information so it couldn’t be heard by everyone in the room to protect the information.

  • While registering patients at the COVID vaccination clinic a colleague sees her neighbor. The colleague goes home and tells her husband that their neighbor Nick received his vaccine today.

Answer: Yes, this is HIPAA violation. This is PHI which should not be disclosed without authorization from the patient.

Another important reminder is to check MyChart or follow your RHM’s procedure for obtaining COVID test results. Personal use of the electronic health record outside of MyChart is not allowed. It is also never appropriate to check test results for another person, unless you’re a member of the patient’s care team or have a legitimate business reason to do so.  We appreciate your commitment to the privacy of our patients.