Always a lesson in every situation...

I haven't blogged in some time. I would like to think it's due to the fact that I am so busy with juggling several jobs, raising a teenage daughter, planning a wedding (and getting married!), assisting my new in-laws with their move and other, numerous time-sucking things I have been doing this summer. But perhaps it is laziness in part; not taking time to put my thoughts down on issues that matter to me. Well, today that changed - well at least in part. These are not my words, but those of a friend and fellow blogger. I had to share simply because I was struck by the emotion of the words (the story was not new to me) and the renewal of the call many of us have answered in following a career in healthcare.

I invite you his blog and read about Pip, the flying squirrel.

Because of Pip: Taking Action

Hard pill to swallow???

For many Americans sweet dreams are not obtainable. They complain of poor sleep everyday - or more appropriately every night. The elderly are much more likely to report sleep problems. Due to a myriad of reasons, most physiologic sleep is altered and they find themselves up at night when they should be getting restorative sleep. For that reason the use of sleep aids has increased...and so have the consequences. Many drugs leave patients with 'hangover' effects impairing judgment and physical mobility long into the daylight hours after taking these prescription sleep aids - especially long-acting formulas. For the elderly this can be especially dangerous leading to increased risk for severe injuries related to falls, mismanagement of medications and other accidents. Some hospitals have reduced the use of such medications in hopes of reducing confusion, falls and other sequelae (especially in the elderly). In the hospital setting, patients often do not recover from untoward events. 

Cascade Iatrogenesis is a series of adverse events triggered by an initial medical or nursing intervention initiating a cascade of decline. It often results in a poor outcomes for the patient or inability to return to pre-illness level of functioning and is preventable. Many of these events are precipitated by medications - either a new medication, too many medications (polypharmacy) drug-drug interactions, over-sedation, so on and so on...
As for the use of sleep aids, especially in the acute care setting, it cannot be overstated - we must be vigilant and cautious when utilizing these or any medications in the elderly patient. Having an a lower dose option may be helpful, however we should really be considering alternatives rather than adding one more pill to the the medication soup

See the following:
Wall Street Journal: Citing Dangers, FDA Requires Lower Doses for Certain Insomnia Drugs http://online.wsj.com/article/SB10001424127887324081704578233652166139618.html?mod=dist_smartbrief 
National Sleep Foundation: http://www.sleepfoundation.org/article/sleep-related-problems/sleep-aids-and-insomnia

Reaching out one story at a time...CodeSTEMI Series Unveiled

Lights, camera, action...CodeSTEMI series premiered at EMSToday in Baltimore, MD.

Despite sophisticated systems of care, numerous education outreach programs and the focus on being heart smart, cardio-embolic events remain the number one killers among men and women. As EMS and hospital systems across the country continue to build collaborative systems of care that aim at improving timely recognition and intervention of cardiovascular events such as STEMI and cardiac arrests, one trio is documenting the journey for various emergency medical systems across the nation. The result... an incredible documentary-style collection of real life stories of successes and challenges in developing high-performing cardiac systems of care. The first episode premiered last night at a special viewing sponsored by PhysioControl at the EMSToday Expo Showroom. The response was positive, leaving viewers anxious for more.

I encourage you to check out the first full episode: Rural STEMI System of Care: Sioux Falls

The CodeSTEMI team:

Host: Tom Bouthillet, Fire Captain/Paramedic
Executive Producer: Ted Setla
Second Camera: Chris Eldridge

CodeSTEMI TV

Nurse guilty of doing her job

Recently a nurse in Arizona was fired from a very large medical center and is "under investigation" with the State Board of Nursing for doing her job. In question is the very core of nursing practice: patient advocacy and education. Her story can be found on many nursing blogs and twitter - I have provided a link to one of the blogs below.

The nursing community is pulling together to help support her and bring media attention to her unfair situation. Read her story and you be the judge...

The Nerdy Nurse 
Arizona Nurse Has License Threatened By Doctor After Providing Patient Education