January 8th, 2011 by CodeBlog in Better Health Network, Interviews, True Stories
Tags: Certified Nursing Assistant, CNA, CodeBlog, Director Of Nursing, DON, Nursing Care, Nursing Profession, Skilled Nursing Facility, SNF
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“NurseExec” is the director of nursing (DON) at a 120-bed skilled nursing facility (SNF) that has a 50/50 mix of patients needing short-term rehab and long-term care.
After working in the OR as a circulator nurse, she started out as a charge nurse in her current building, which entailed pushing a med cart and taking care of 20 patients. After nine months, she was promoted to Risk Manager and three years later became the DON.
She starts her day at 7am by rounding on nursing units, consulting with unit managers on clinical issues, and dealing with grievances and employee issues. She checks in with the charge nurses and certified nursing assistants (CNAs), checks shower rooms and utility rooms. Then it’s off to Morning Standup with department heads, followed by clinical rounds with the interdisciplinary team to discuss new admissions, new orders, and a report for the last 24 hours. Most days this is all followed with other meetings, lasting until 11am or so.
The afternoon is filled with reports, employee issues, clinical and education issues, pharmacy issues, and another rounding of patients. She typically ends her day at 4pm.
What do you like about your job?
Every day is a different set of challenges. I have great benefits and a wonderful team to work with.
What frustrates you about your job?
People who know the right thing to do, yet don’t do it. Makes me crazy! Read more »
*This blog post was originally published at code blog - tales of a nurse*
January 7th, 2011 by Bryan Vartabedian, M.D. in Better Health Network, Humor, Opinion, True Stories
Tags: 33 Charts, AMA, American Medical Association, Doctor Patient Relationship, Doctor's Feelings, Doctor's Lifestyle, Doctor's Personal Life, Doctor's Viewpoint, Doctors Not On Duty, Doctors Seeing Patients, Doctors' Privacy, Dr. Bryan Vartabedian, Family Medicine, In Real Life, IRL, Medical Humor, Patients Seeing Doctors After Hours, Pediatrics, Physician Behavior, Physician Visibility In Public, Privacy Settings For Doctors, Social Media, Work-Life Balance
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In the movie “The Sixth Sense,” there was that kid who saw dead people. I’m like that. But I see patients and their parents instead. They’re all around me.
They’re watching at the grocery store when my kids act up. We meet during anniversary dinners, at Christmas Eve service, and on the treadmill at the Y. I bump into parents when buying personal effects and even during the early morning coffee run in my oldest sweats. I see patients.
The follow-up dialog between the parents might go something like this:
Dad: “Marge, don’t you think Billy’s colitis might be better managed by a doctor capable of pulling himself together?”
Mom: “Don’t be ridiculous, Frank. DrV’s bedhead has nothing to do with his ability to care for Billy. And besides, I’ve heard that he can intubate the terminal ileum in under 10 minutes.”
It’s not that I necessarily mind being seen in the wild. I’m pretty comfortable in my own skin, even when it’s glistening after a workout. I’m bothered more by the fact that patients may be repulsed by my occasional bedraggled appearance. If I knew they were good with it, I might be less caught up with the whole matter. Read more »
*This blog post was originally published at 33 Charts*
January 6th, 2011 by admin in Research, True Stories
Tags: Cancer Treatment, Center for Advancing Health, CFAH, comparative effectiveness research, Doctor-Patient Communication, Dr. Jessie Gruman, Empowered Patients, Healthcare Decisions, Medical Innovations, Medical Research, New Developments in Medicine, Oncology, Patient Empowerment, Patient-Doctor Partnership, Public Awareness, Shared Decision-Making
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This is a guest post from Dr. Jessie Gruman.
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More Can Also Be Less: We Need A More Complete Public Discussion About Comparative Effectiveness Research
When the public turns its attention to medical effectiveness research, a discussion often follows about how this research might restrict access to new medical innovations. But this focus obscures the vital role that effectiveness research will play in evaluating current medical and surgical care.
I am now slogging through chemotherapy for stomach cancer, probably the result of high doses of radiation for Hodgkin lymphoma in the early 1970s, which was the standard treatment until long-term side effects (heart problems, additional cancers) emerged in the late 80s. So I am especially attuned to the need for research that tracks the short and long-term effectiveness — and dangers — of treatments.
Choosing a surgeon this September to remove my tumor shone a bright light for me on the need for research that evaluates current practices. Two of the three surgeons I consulted wanted to follow “standard treatment procedures” and leave a six-centimeter, cancer-free margin around my tumor. This would mean taking my whole stomach out, because of its anatomy and arterial supply.
The third surgeon began our consultation by stating that her aim would be to preserve as much of my stomach as possible because of the difference in quality of life between having even part of one’s stomach versus none. If at all possible, she wanted to spare me life without a stomach.
But what about the six-centimeter margin? “There isn’t really much evidence to support that standard,” she said. “This issue came up and was discussed at a national guidelines meeting earlier in the week. No one seemed to know where it came from. We have a gastric cancer registry at this hospital going back to the mid 1990s and we haven’t seen support for it there, either. A smaller margin is not associated with an increased risk of recurrence.” Read more »
January 2nd, 2011 by Shadowfax in Better Health Network, True Stories
Tags: Adriamycin, Breast Cancer, Breast Cancer Screening, Breast Self-Exam, Caringbridge, Chemotherapy, Cytoxan, Dr. Liam Yore, ED, Emergency Department, Emergency Medicine, Emergency Room, ER, HER2 Positive, Herceptin, Infiltrating Ductal Carcinoma, Mastectomy, Movin' Meat, Oncology, Preventive Health, Preventive Medicine, Radiation, Shadowfax, St. Baldrick's Foundation, Taxol, Triple Negative Breast Tumor
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This year has been a weird one for me and cancer. In the ER, we see cancer patients pretty infrequently. The occasional chemotherapy with fever, but that’s about it. I think the oncologists try hard to keep the patients out of the ER — to everybody’s benefit.
But this year, I’ve had a weird rash of cases where I’ve made primary diagnoses of cancer in the ER — several times over and over and over again. In ten years I don’t think I’ve made as many cancer diagnoses as I have this year alone. Just very strange.
Unfortunately, it came home to roost. My wife was diagnosed with breast cancer last week. Read more »
*This blog post was originally published at Movin' Meat*
January 2nd, 2011 by Nicholas Genes, M.D., Ph.D. in Better Health Network, True Stories
Tags: Blogborygmi, Doctors and Social Media, Doctors On Twitter, Dr. Guido Majno, Dr. Nicholas Genes, Dr. Thomas Peebles, Healthcare Social Media, Medicine and Social Media
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This year I learned about the death of two physicians that were pretty important to me.
The first was my pathology teacher, Dr. Guido Majno. In addition to being a tremendously kind and curious person, he and his wife wrote the best textbook I’ve ever read.
The second death was that of my pediatrician growing up, Dr. Thomas Peebles. Funny, although he followed me from birth to high school, my family never knew about his incredible research background. We learned it in the many obituaries.
It’s worth reflecting on their accomplishments and the manner in which they conducted their lives and practice — especially in this era, when doctors are encouraged to develop their social media presence and be proactive about online reviews.
Would they have used these new tools? Would they even have needed them? Would they have found the idea of trading links to medical stories on Twitter to be interesting? Stimulating? Or maybe distressing or distasteful?
I never thought to ask them.
*This blog post was originally published at Blogborygmi*
