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Nurse Talk Blog Archive

I Will Remind You | Tribute Song to Those Affected by Alzheimer’s

February 28th, 2012 by Nurse Talk

“When you look at me and say, you see a face without a name, perfect strangers in a frame…Everyday we’ll make new memories and add them to this shelf always to remind you, you are never by yourself.”

This song is a tribute to those affected by Alzheimer’s disease and their families. Half of all proceeds from this song will be donated to the Alzheimer’s Society of Canada to help continue research so one day we can hopefully cure this illness. You can purchase the song on iTunes, CD Baby, Amazon, or on the musician’s website at www.brianasselinmusic.com

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As Court Showdown Nears, Our Healthcare System Still a Mess

February 27th, 2012 by National Nurses United

With the approaching Supreme Court showdown on the President Obama’s 2010 health care law (the Affordable Care Act, modeled, of course, on Mitt Romney’s law in Massachusetts), the U.S. healthcare system remains a dysfunctional mess, as nurses bear witness to every day.

In late March, the Court will devote six hours over three days to oral arguments on the legal challenges to the law — the most time the Court has given a case in 56 years. The testimony will likely be accompanied by a possible record 100 “friend of the court” briefs, Kaiser Health News reported February 16.

While the ACA had some undeniable positive elements, such as permitting young adults up to age 26 to remain on their parents health plan, and a few limitations on insurance industry abuses, such as barring them from denying coverage due to pre-existing conditions, our health care nightmare is far from over.

And, as nurses have reported repeatedly the past year, the economic crisis has great aggravated the suffering with broad declines in health status that are directly linked to job loss, unpayable medical bills, and families having to choose between paying for food, housing, clothing or healthcare.

As to the law itself, despite its name the ACA has done little to actually make healthcare affordable. Out of pocket health costs for families continue to soar largely unabated. Nurses now routinely see patients who have postponed needed care, sometimes even life-saving or life-prolonging care, because of the co-pays and deductibles.

A Commonwealth Fund study in November, comparing the U.S. to other high income countries, found that the U.S. stands out for sick adults having cost and access problems with 27 percent unable to pay medical bills in the past year, compared to from 1 to 14 percent in other countries, and 42 percent skipping doctors visits, recommended care, or not filling prescriptions.

Nationally, premiums have jumped on average 50 percent over the past seven years with more than six in 10 Americans now living in states where their premiums consume a fifth or more of median earnings.

Universal coverage remains a far off dream. Fifty million Americans still have no health coverage. Another 29 million are underinsured, meaning they have massive holes in their health plans, an increase of 80 percent since 2003, according to the journal Health Affairs. The percentage of adults with no health insurance at 17.3 percent in the third quarter of 2011 was the highest on record, up from 14.4 percent just three years earlier, Gallup reported.

On quality, the U.S. continues to fall far behind other nations.

What should have been a shocking, underreported study from the University of Washington last Junefound that more than 80 percent of U.S. counties in free fall on life expectancy compared to nations with the best life expectancies. Some U.S. counties are more than 50 years behind their international counter parts, meaning they have the life expectancy that those nations had in 1957.

One reason for this disturbing news is the regression in death rates for child bearing women. The U.S. ranks just 41st in the world, and it has been getting worse, according to the World Health Organization. The average mortality rate within 42 days of childbirth has actually doubled in two decades, from 6.6 deaths per 100,000 live births in 1987 to 13 deaths per 100,000 in 2007. One reason, a 10 percent cut in federal spending for maternal and child health programs the past seven years.

Those who think giving more handouts to the private insurers and other healthcare corporations will improve these dreadful statistics should think again. The wholesale domination of our health by the same Wall Street types who tanked our economy is exactly what has caused the falling health barometers on access, cost, and quality.

There is an alternative which most of the rest of the world has discovered, a national or single payer system, such as expanding and adequately funding Medicare to cover everyone. Even in other countries where conservative politicians have proposed privatization or sweeping health cuts they are being met with an aroused public unwilling to trade their health systems for the broken model we have here.

Whether the 2010 law is fully or partially thrown out by the courts, repealed in Congress, or fully implemented, the need for real reform, single payer/Medicare for all, will continue to grow. At this point the fight for single payer is being taken up state by state, a movement that we will continue to proudly support.

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The Secret About Your Parents | Alzheimer’s in the First Person | Barbara Taylor Vaughan

February 26th, 2012 by Barbara Taylor Vaughan

OK buddies, I want to talk about something. Alot of you nice people that read my stories are youngsters, 40 to 60 year olds. Alot of your parents are still alive and may either live in your city or away. I want to tell you all a secret. When you talk to your parents on the phone and say, “Hi mom (or dad), how are you?” And they always answer, “Fine, just fine.” When you say to them, “Are you keeping busy, getting out doing things?” And they answer, “Oh yes, I have plenty to keep me busy.” When you ask them, “Are you lonely? And they answer, “Oh no, I have friends, I’m fine.” When you say to them, “I wish we could visit but we are just so busy,” and they answer, “Oh I know, don’t worry about me, you have your life. Don’t worry about me.” I want to tell you a secret: Your parents are not telling you the whole truth.

Barbara Taylor Vaughan

Barbara Taylor Vaughan

They do get very lonely, they do need help sometimes, they do want to see you. They are your parents, and if you are parents, you know that you never want to hurt your children, or want them to be put out. Us seniors want to be on our own, we want to be independent, but hecky, we miss you. SO, here is my advice, before it is too late, and just because it would be wonderful for you to do, try and see them more. If they dont live in town, go visit them, if you can’t take the whole family, YOU go visit your parents for a few days. Oh how they would love that special visit.

If you can, bring them to your house for a week, let them visit you. If you live close by, make the decision today to take them out for lunch, bring them to your house for dinner, go to the mall with them, to the show. I am sure they would love to see your whole family, but sometimes, remember back to when you were a child, there is nothing like just you and your parent doing something together, just you two.

We want our children to have their life, but we also want to be a part of it. We just don’t want you to feel guilty, so we will never tell you that we are lonely, or that we want you to visit us more often, or that we really would like to come visit you. Please, make the time, yes everyone is busy, and not all of us get along with all of our family members, but do it for you, do it for your children, do it for your parents.

Life is short, and I promise you, it might be difficult and you might think that you can’t do it, but I can tell you, you won’t regret it. It might make you remember that your old mom and dad, they were the ones that loved you first, and the most. No one, no one, loved or loves you more than they did and do. SO, be the one that love them the most in their last days, and tell them, before it’s too late. It is so sad seeing you youngsters at funerals crying, sad, and feeling guilty and telling me you wish you had done or tried to do more, but didn’t. SO do it!

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5 Characteristics of an Excellent Caregiver

February 26th, 2012 by Angil Tarach-Ritchey RN, GCM

Relationships can be tested to the limit when there is a caregiver and care recipient within a family relationship. In a paid caregiving position there are those who have something special within them and those who are just making an income. I think about and meet all types of caregivers on a daily basis.

At my Visiting Angels office, we are always striving to hire the excellent caregiver’s with that something special, rather than someone just looking for a job. It is much easier to control what type of caregiver’s we employ than changing a less than satisfactory family caregiving situation.

Everyone isn’t suited to provide care in a family situation or as a paid position. So what are the characteristics that an excellent caregiver has? I believe there are 5 core qualities an excellent caregiver possesses.

1. EMPATHY

My belief is empathy is the #1 core characteristic of an excellent caregiver. I often question if this is inherent within us or this is something which can be learned?

I tend to believe it’s a lot of inherent and a big mix of environment. I also believe there are degrees of empathy. Some can empathize more than others. If you can totally put yourself in the place of who you are caring for, you will do nothing but provide excellent care.

The question is always – how would I want to be treated and taken care of under these circumstances? If that is the core basis for how you provide care you will provide caring, compassionate, and dignified care with a great attitude.

2. DEPENDABILITY

Someone who is in need of care has lost some degree of independence. They have to be able to depend on the person or people providing assistance to them.

caregiverImagine being unable to obtain your own meal, bathe yourself, get dressed, or go to the bathroom independently. Imagine the feelings involved when you lose that independence and have to ask for help. Imagine having no one to count on when you need them.

It is difficult enough for a person to lose independence without having the added burden of finding someone reliable to help them. When you provide care, it is crucial that you are dependable. So many vulnerable seniors’ lives depend on the assistance and care of another to live a safe and happy life.

3. PATIENCE

Besides children, most care recipients are elderly. As we age, our bodies no longer move the way they used to. Add an injury or physical illness and movement is more difficult, slower and may be painful.

Parts of our bodies may not work at all, such as after a stroke, or with a disease such as advanced Parkinson’s, or arthritis. With an illness of the brain, such as Alzheimer’s, there is memory loss and loss of the ability to process information.

These are some of the examples that would cause someone to move slowly, respond slowly or repeat conversations. It takes a patient person to provide care when we can move and process quickly, but the person we are assisting cannot.

I often see caregivers contribute to loss of independence because of impatience. We are in a hurried society and typically spend our lives in a fast pace. It can be difficult to slow down to the pace of the person we are caring for, but it is crucial in excellent caregiving.

A good rule is to allow a person to do as much as they can for themselves and to avoid doing things for a person they can do for themselves. Doing too much contributes to the loss of physical abilities and increased dependence. It can also damage the dignity of a person and this that is an important part of their mental health and quality of life.

Give the care recipient ample time to comfortably be assisted with their activities of daily living (ADL’s), and to complete as many tasks as possible on their own. If you aren’t patient, you will end up providing more care, not less. Use the time to slow down your hurried life and enjoy the process of caregiving.

Persons with memory loss will repeat questions, and comments. This can be enough to test anyone’s patience when you’ve heard the same question 30 times that day.

Here again, empathy is needed. EVERY single time a person with dementia asks a question, they truly believe it is the very first time they have asked it. You MUST respond as if it’s the first time you heard the question asked.

I cringe when I hear a caregiver tell a care recipient with dementia, “I just told you”, or “don’t you remember?” This vulnerable person affected by this horrible disease truly doesn’t remember you just told them, and they honestly cannot remember.

These responses typically come with a frustrated tone of voice, and sometimes anger. Again, empathy counts! Imagine asking someone a question for the very first time and they respond in an angry voice and scowl, and you know you never asked them before. Rather than getting to this point of frustration, become a pro at redirection!

Sometimes redirection can take awhile to start working because dementia can cause someone to get fixated on something, but the better you get at it, the less your patience will be tested. Direct the care recipient towards something they enjoy, or change the conversation to a joyful time earlier in their life. Photo albums are always helpful in redirection.

If the care recipient is angry and uncooperative, give them space and a bit of time. If they are not in danger of hurting themselves or others, remove yourself from the situation. Give everyone time to breathe and calm down. Wait 15 or 20 minutes and reproach in a calm and loving manner. If the source of the frustration is a task that can be put off, put it off. If it’s something that needs to take place as soon as possible, like changing an incontinence brief, try a different approach.

4. STRENGTH

As I mentioned above, caregiving can be very difficult. Whether you are paid or unpaid, there will be days and times when you feel like you are at your limit.

You may be having a bad day yourself, the care recipient may be having a bad day, or you are just burned out. Times like these call for strength.

You must be strong enough to recognize when you are in need of time off, when you need to adjust care, when you need to dig deep within yourself for patience.

Caregiver’s seem to be in a frequent battle with the outside world regarding advocacy and fighting for services, or through red tape of insurance or healthcare bureaucracy. It takes a lot of patience and strength to advocate for your care recipient.

Recognize what your weaknesses are and when to get additional assistance. If you get frustrated and exhausted it will not only affect you, but it contributes to the person you’re caring for feeling like a burden, and everyone loses.

Take time off, get additional assistance, and again put yourself in a place of empathy. Caregiving is not for sissies!

5. FLEXIBILITY

Caregivers have to be some of the most flexible people I know. Things can change in an instant when you are caring for someone.

Family members can be called home from work, need to get their loved one to the doctor, or hospital. The health situation can fluctuate, and personality and behavior can change on the drop of a dime.

Paid caregivers can lose a client to a hospital admission, have to stay on their shift longer because of a health crisis, or get a new patient at the last minute. There are constant schedule changes and client changes. You must be open to change because whether you like change or not, it will happen.

People who value strict schedules and sticking to a routine have a lot of difficulty in the caregiving role. I have spent my career knowing that as soon as I have my day planned out something is sure to change and I will have to tend to whatever has become the priority. Caregiving is best for people who can adapt quickly and accept change easily.

There are other qualities and characteristics I could talk about, but I believe those stem from the core 5. Being kind and gentle stems from empathy and patience. Obtaining the best healthcare possible is a result of empathy and strength. Keeping the care recipient safe comes from empathy, dependability and strength. Every situation and every caregiving moment spent will require empathy.

Whether you are providing care now or will be in the future, you have to ask yourself if you are able to put yourself in the shoes of the person, or people you care for.

This requires you to be judgment free of their situation and have the ability to understand what it must feel like in their place.

If the person has advanced Alzheimer’s, take yourself to the place it would be like when they were healthy and then started to realize they couldn’t remember things, or lost their way. Understand how it felt to receive the diagnosis of Alzheimer’s, knowing there is no cure and your abilities will most likely diminish. Think about what it would be like to have a stranger bathe or dress you.

If you can do those things, you will always provide care that is of the best quality possible. If you cannot, I recommend alternative care for a family member or another choice of career.

Care recipients deserve no less than the best we have to offer.

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

 

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In My Day…Grandma’s Used Almonds for Everything | Lynn Ruth Miller

February 25th, 2012 by Lynn Ruth Miller

Almonds for Everything

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You know, my grandma didn’t believe in drugs. She believed in nuts. She used almonds for everything. She would slip them into everything she fed us just to be sure they did their job. We found them in salads, desserts, candy, and even our underwear. She said they got rid of warts.

I grew up during the depression. And, we spent the little money we had on food, not beauty products. When we saw a wrinkle in the mirror, we just gave up hope. But not my grandma. She made a paste of milk, almonds and rosebuds and smeared it on her face every night. She looked looked like the ghost of the apocalypse but she smelled like Almond Roca. And my grandpa loved sweets.

She had 18 children, not counting the 4 miscarriages and she wasn’t even Catholic. She wasn’t very careful either.

When grandpa lost his hair, she made a paste of gooseberry juice and almond oil. It made his scalp soft as a baby’s bottom. I think that’s why he wore a diaper on his head. He said it was to protect him from a chill. I guess you had to be there.

My aunt Hazel had teenage anemia and my grandma fed her almonds to build her up. It must have worked because she went from a 32A to a 36D in one summer and eloped with Uncle Jack in the fall.

Every night, grandma mixed almond oil with milk and made us drink it before we went to bed. She said it kept things moving. I thought that was why she and Grandpa changed neighborhoods so much but Mama said it was because of the bill collectors.

If we coughed, Grandma mixed a bubbly drink with powdered almonds and orange juice. Nowadays we use decongestants and antihistimines, but they’re not as much fun. If you drank enough of Grandma’s mimosas your cough vanished and so did your ability to stand up.

We always thought Grandma’s remedies cured a multitude of sins. But, I think they encouraged them. What else explains those 18 kids?

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Creating Positive Employee Morale Is Up to You

February 24th, 2012 by Stephanie Staples

One bad egg can spoil the bunch. And it’s not just eggs, is it?!

One colleague on a rampage, one employee stuck in a rut, one subordinate contaminating the minds of others – sadly, it happens all too frequently. And it matters – a lot!

To create quality practice environments, everyone needs to play full on so that we can have our best foot forward for our:

• Teams to function effectively.

• Facilities to run efficiently.

• Patients to be treated with dignity.

• Selves to be able to function with excellence.

We needn’t look further than the last, and possibly most important question, on the hallowed HCAPHPS* scores, to give us our cue. The patient is asked what is their ‘Likelihood to Recommend’. Patients can choose from the following answers: never, sometimes, usually, and always. Of course, always is the answer we are ‘always’ looking for. It is no exaggeration that our jobs may depend on it.

Think about your own experience in a hospital when you were not a caregiver but a patient or family member. You expected expertly delivered and safe care. You expected accurate diagnosis and timely treatment. But beyond that, what you notice is the manners in which the staff carry themselves, conduct themselves and treat you, your family and each other.

With that in mind, here are a few ideas for you to consider:

The truly toxic people must go. Period. Keep them and you will risk losing the great people instead. If this is your situation and you are not a manager, bring this to your manager. A file must be started, discipline must be taken and after 3 strikes – you’re out. Tough love must prevail here.

Find a way for different departments/wards to connect. Work to break down silos. An ‘us/them’ environment is potential for disaster. Even starting with a few people connecting will make a big difference. It’s a lot harder to be mad at people you like.

Find the fun, the funny. The facility that plays together delivers great care together. Patients can see and feel this spirit. Look for ways to pro-actively lighten up a hard job.

Appreciate someone at work everyday. Have a stack of blank note cards, or kindness tokens or stickers and use them daily to let someone know that they made your day easy or better. It could be a Doc who respected your suggestion, a colleague who complimented you or a patient who was very brave during a tough treatment or one who told you a funny story. It’s interesting – I don’t know anyone who is too old for a sticker!

Start where you are, with what you have, and start now. If you wait for all the stars to line up to start improving your practice environment – you may be waiting a long time. Things are not expected to be perfect but they can definitely be better tomorrow than they were today. Even if no one notices, even if you think it doesn’t matter, even if you are nervous to begin. Please – you start, you take the lead, you make a difference and watch the slow but steady changes that follow to create an institution that people will want to recommend, always.

*HCAHPS stands for Hospital Consumer Assessment of Healthcare Providers and Systems, an instrument to measure patient perceptions of care that publicly reports hospital performance (quality of care as perceived by patients).

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Nurses’ Health Study Recruits “Next Generation”

February 23rd, 2012 by Nurse Talk
Nurses Health Survey 3

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From the dangers of tobacco and trans fats to the benefits of physical activity and whole grains, much of what we know about health today is thanks to the Nurses’ Health Study.

Researchers are recruiting 100,000 nurses and nursing students to join the long-running Nurses’ Health Study and expand its landmark research on women’s health.

Female RNs, LPNs, and nursing students between the ages of 20 and 46 who live in the U.S. or Canada are eligible to join the study. More than 25,000 have signed up already, and recruitment will stay open until the goal of 100,000 participants is reached.

Researchers hope to engage a highly diverse group of women in the “next generation” of the study. For the first time, nursing students are eligible to enroll.

In order to make participation as convenient as possible for busy women, participants can join online and complete the study’s surveys through a secure website, http://www.nhs3.org/.

More than 250,000 nurses have participated in the study since the 1970s. By completing confidential lifestyle surveys, they have helped advance medical knowledge about nutrition, exercise, cancer, heart disease, and many other conditions.

“Nurses were originally recruited for their expertise in accurately reporting health data,” explains Dr. Walter Willett, the study’s lead researcher and Chair of the Nutrition Department at Harvard School of Public Health in Boston, Mass. “Their involvement has been invaluable, and their dedication is remarkable—an astounding 90% of them are still enrolled, decades later! The new group, NHS3, will allow us understand how today’s lifestyle and environment affect a woman’s health in the future.”

Nurses enrolled in the earlier studies are encouraging their daughters and younger colleagues to join. “My mom started filling out surveys when the study began,” one nurse recently commented on the NHS3 Facebook page (www.facebook.com/NHS3.org). “I am so proud to be part of this study and see what it has done.”

NURSES’ HEALTH STUDIES

Started in 1976 and expanded in 1989, the Nurses’ Health Studies have led to many important insights on women’s health, including cancer prevention, cardiovascular disease, and diabetes. Most importantly, these studies showed that diet, physical activity, and other lifestyle factors can powerfully promote better health. www.nhs3.org

SOURCE: Nurses Health Study 3

CONTACT: Laura Anatale Tardiff, +1-617-525-0353, nhs3@channing.harvard.edu

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Ban Viagra…? Plus, Deborah Burger with an NNU Update and Andrew McGuire on Single Payer in California | February 25, 2012 | Show 437

February 22nd, 2012 by Nurse Talk

The show begins…

“Dan as you know, we try to shy away from controversy but sometimes a gal just has to speak up. I must comment on the recent congressional hearings on contraception. First of all—I thought that train left the station in the 70′s! And can we talk? The expert panel assembled consisted of all males! “Where’s the beef?” as our old friend Clara Peller used to say in the famous Wendy’s commercial. Without going into further detail, we wondered what it would be like—if the shoe were on the other foot—so to speak. You know, the deck being stacked to fall the other way?”

AS LUCK would have it—a little research provided us with the perfect opportunity to share just that kind of breaking news. Listen this Saturday as California State Senator Janelle Jones introduces groundbreaking legislation (Senate Bill SB 1240) that moves to criminalize the very dangerous Viagra. That’s right—Viagra. The all-woman senate panel that drafted this bill says there is mountains of evidence that Viagra should be banned! Don’t miss Senator Jones on Nurse Talk!

AND…we have an update on the very active nurses from National Nurses United. Deborah Burger always brings life and humanity to the critical healthcare issues in our country.

We’ll check in with our friend Andrew McGuire. Andrew is the Executive Director of California One Care. Cal One Care envisions a health care system where every child and every adult receives the health care they need, when they need it, and at a cost that is affordable. We align fully with that vision and we’ll check in with Andrew about the campaign and let our listeners know how they can get involved.

AND OF course where would we be with out a little laughter? We’ll have another edition of “In My Day” with comedian Lynn Ruth Miller, Golden Bed Pan Award, Phobia of the Week and some email questions and calls.

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