And Now... Highway Proximity and Heart Attack Survival

Two days ago, I wrote a post on how commuting distances could affect your health (Does Commute Time Add to Health Risk?) and today's post is on how living close to a highway may make it harder to recover from a heart attack. Maybe I could start a theme on city and country living. ;-)

Have you ever lived near a highway or a busy roadway? I have and it can be stressful. The noise is constant and while you do (sort of) get used to it, it's always present. I've read of studies where living in this type of environment can contribute to high blood pressure as well as stress and anxiety. But there is a new study, published in the May 7th issue of Circulation, that has found that heart attack survivors who live less than 100 metres (328 feet) from a highway have a 27% higher risk of dying within 10 years of their original heart attack, compared with survivors living at least 1,000 meters away. That risk drops  to 13% for those living between 200 and 1,000 metres(656 to 3,277 feet) from the highway.

The important thing to note is that it wasn't just the noise and stress that was found to be the danger, it was the air quality, as people close to high ways are exposed to more particulate matter pollution.

You can read the full study as Circulation has made it available free to the public:

Residential Proximity to Major Roadway and 10-Year All-Cause Mortality After Myocardial Infarction

Tomorrow is International Nurses Day

Tomorrow, May 12, is International Nurses Day. A few years ago, it became a week of celebrating and appreciating nurses. I wrote about this two years ago, National Nurses Week is Coming Up and I didn't get much of a response. The funny thing is, I didn't think I would.

It seems to me, that unless you have spent a good bit of time in a hospital, it's hard to appreciate what a nurse really does. Just a few days ago, I wrote about five fictional nurses and, sadly, these fictional characters can be what people think nurses are really like.

In 2007, I wrote a post What do nurses really do? It still gets many hits, but I don't know who is reading it. Am I getting the message across? Or am I preaching to the choir when people find the post through Google?

Some people have told me that I have abandoned nursing by going into writing. Have I? Although I no longer work in a clinical situation, I still consider myself to be a nurse. Every year, for the past several years, I've worked at a major world-wide organization based in Montreal, filling in as the occupational nurse while the full time one goes on vacation. One year, it was for five weeks straight. And although I did enjoy the challenge of that type of nursing, I love writing and I'm good at it.

My nursing background is what gives me the knowledge behind my writing. I can feel confident with what I've shared because I have either experienced the situations or I have researched them and I know what to look for.

For sure, there are bad nurses in the profession, just like there are SOME bad teachers, bad computer repair folks, bad store clerks, bad bank tellers.... There are people in every profession who shouldn't be there, but they aren't the norm. There have been times when I've encountered less than stellar nursing care on a ward or unit, where there seemed to be several nurses who shouldn't be there. Again though, this isn't indicative of all of us. In my opinion - and it has been borne out by observation and experience - if there are several bad nurses in one area, one often only has to look at the management that allows the behaviour to continue.

Nurses can come in many forms, from the ones who help deliver a baby to those who help you as your life ends. We are in the schools (This Isn't Your Mother's School Nurse) and in the community. We are your parents, your siblings, your children, your friends. We are everywhere. But we're not always appreciated for what we have to offer.

What is the best way to thank a nurse who has touched you? While the gifts of candy and flowers are always appreciated, the best way to thank a nurse is by letting him or her know how you've been touched and by letting his or her superiors know what a good job has been done. We can be so quick to criticize and to climb the ladder when things go wrong, but it takes just a few moments to praise and to climb that ladder with thanks and kudos. You wouldn't believe the difference it makes.

Does Commute Time Add to Health Risk?

What is your work commute like? If you're like me, it consists of a few steps from your bedroom to your office, but that isn't reality for the vast majority of workers. Most people have to go out to work and that's a given, particularly with jobs that are hands-on.

For many years, the trend in housing has been to spread out away from the city cores. Suburbs blossomed and some people went further out, to live in rural areas, commuting back to the city for work.

MorgueFile.com

To them, the added commute time is the price they are willing to pay to live as far from the city as is possible. But is this such a good idea? Can the long commute be harmful to your health? Some researchers say yes.

A study published in the most recent issue of the American Journal of Preventative Medicine found that longer commuting distances were associated with health risks, such as decreased cardiorespiratory fitness (CRF) and increased weight. There doesn't seem to be a difference if the commute was by car or by public transit, because the basis of is is the lack of physical activity and the time that the commute may take away from a person's ability to participate in some sort of exercise.

The study of over 4,000 people in Texas found, "people who drove longer distances to work reported less frequent participation in moderate to vigorous physical activity and decreased CRF, and had greater BMI, waist circumference, and blood pressure. The association remained when physical activity and CRF were adjusted for, although to a lesser degree for BMI and waist circumference. Those who commuted more than 15 miles to work were less likely to meet recommendations for moderate to vigorous physical activity, and had a higher likelihood of obesity. Commuting distances greater than 10 miles were associated with high blood pressure."

What do you think? Do you agree? Or is this just an excuse and these people may  not have exercised anyway? When we lived in a suburb off the island of Montreal, it could take my husband anywhere from 30 to 60 minutes to get home, by car, from work. Yet, he still went to the gym almost every day. Now that we've moved back into the city proper, his commute is about 15 minutes, maybe 20 and he still goes to the gym almost every day.

I think there could be some merit in this. If you're a parent of young children and you already spend a lot of time away from them at work and with your commute, you may not have time for individual exercise. However, how about doing activities with the family? This way, you could get your physical activity and family time in together.

Canadian Health Care, Healthcare Access & Health Insurance, Part 1

On the first day of this blogathon, I asked people for suggestions on blog topics. Friend and colleague Jennifer Fink (Blogging 'Bout Boys) suggested that I write from the Canadian perspective of health care, healthcare access and insurance. So here I am. It's a touchy subject for many, so I'll see if I can explain how I see it without stoking any flames. There is a lot to cover, more than can be done in one blog post. So this is part 1 - a basic explanation of how the system works.

I have seen many sides of the Canadian healthcare system, from being a patient, a parent of a patient, a child of a patient, a nurse, and an administrator within a nursing department. While I know the system isn't perfect, I wouldn't give it up for anything.

from MorgueFile.com

Because of my work online, I interact with many Americans, of all socioeconomic and education levels. I've watched many discussions go on about the perils of socialized medicine and much misinformation that is spread because people don't know the facts but they believe they do. Unfortunately, spreading misinformation does everyone a disservice, everyone.

The Canadian medical system is national health insurance system run by the provinces and territories. The federal government, located in Ottawa, Ontario, distributes funds to the provinces. While medical care falls under provincial jurisdiction, there are some rules that the provinces must follow as per federal guidelines, the Canada Health Act. The provinces may add to the services. For example, a province may decide to have a drug insurance plan to ensure that all residents are guaranteed a minimum of medication availability.

Why Medicare Isn't "Free"

Canadians - and people in other parts of the world - often refer to Canadian health care as free. It's not. Our tax dollars pay for it, federally and provincially. We pay for it every day.

There is abuse to the system. People from other countries have been known to come to take advantage of the health system. Before the province of Quebec required photos on their Medicare cards, there were thousands of people who had fake ones or ill-gotten ones in their possession. People lent their cards to friends who needed to go to an emergency room or clinic. This added up to millions of dollars being stolen from the Canadian tax payer. When the cards became photo ID cards, the number of applied for cards dropped dramatically, said Medicare officials.

What Medicare Provides

Medicare allows Canadians and landed immigrants the right to see a doctor or healthcare professional in a hospital, clinic, or office without having to pay for it. Certain types of visits are not covered by the system though - there are limitations. If you have been hired for a new job and your employer wants a pre-employment physical - this is not covered by Medicare; the doctor must be paid as he or she cannot charge the system for this service. If you are travelling and you need vaccinations, this isn't covered. Many extras provided in a doctor's office aren't covered by the system either; each province is a bit different.

However, a yearly physical is covered. Blood tests done in a hospital and provincially approved clinics are covered, blood tests done in private labs aren't. Specialized nuclear testing in a hospital is covered, not in a private clinic. Physiotherapy in a hospital or healthcare facility is covered; physiotherapy in a private clinic is not - and so on.

The goal is to ensure that everyone is covered by a certain level of care. This doesn't always work as intended, unfortunately, as waiting lists for the publicly provided services can be staggering at times.

If you have been injured or are ill and you go to an emergency department or walk-in clinic, you must have your health insurance card with you. If you don't, you must pay for the services rendered, even if you can prove that you are a Canadian and a resident of the province. If this happens, you must apply to your health insurance board for reimbursement.

Glitches in the System

Ideally, the system was supposed to provide equal access to medical care across the country. But one of the drawbacks to the program and provincial control is associated with how much the provinces pay their healthcare professionals. A doctor in British Columbia gets paid more per patient visit than does a doctor in Quebec. Therefore, a Quebec resident who must see a doctor in BC may be required to pay an amount in addition to the fees the doctors claim from the Quebec health board.

Other glitches aren't as minor. Waiting lists are long for some procedures. Some parts of the country don't have certain types of specialists or equipment. While these are not acceptable, particularly for life-threatening issues, these aren't limited to Canada. I have heard from many Americans about waiting lists for specialists that are months' long. I've heard from others that they must travel to other parts of their state to be able to see a certain type of expert. In countries as big as ours, this need to travel, as frustrating and painful as it may be, is often inevitable.

Nurses are overworked and underpaid. This is a story, again, not unique to Canada. There is a nursing shortage - again, not unique to Canada. There are more and more demands on the available resources - need I repeat about it not being unique to Canada?

The Canadian system is far from perfect and we are working on trying to find solutions.

My next post on this topic will talk about how we work private insurance in with our national health insurance.

Public Defibrillators - Are They Helpful?

There has been a push to put automated external defibrillators (AEDs) in many public spaces, particularly arenas, gyms, schools, and just about any place where there may be physical exertion, large gatherings, or many floors that may make it difficult for EMTs to reach a patient in a timely manner. Some businesses have also purchased AEDs for their employees or guests/visitors, but are these AEDs really any good?

I thought about this last summer when I was filling in as an occupational health nurse at a major organization. There was an AED in the medical office, along with a few other life-saving pieces of equipment. Interestingly, it's not a given that a nurse knows how to  use one of the AEDs, but when I took a CPR renewal course a few years ago, the EMT graciously took a few extra moments to show me one and how it worked.

As a nurse, I've done CPR many times and I've reacted in many emergencies, but how you react in a hospital situation, where you have back up all around you, and how you react in the outside world are really two different things. I learned this many years ago when I had to help give CPR to a person who had collapsed on the street on a Halloween night, as she was taking her son out trick-or-treating. I never found out if she survived. I doubt it.

I remember how ill at ease I felt. It was as if I had forgotten all my training. Doing CPR in the street was much more difficult than doing it in the hospital. I was shocked at how ill prepared I felt and I have never forgotten it. The event happened over 25 years ago - I was pregnant with my oldest child.

As I took over the medical office for several weeks, I double checked my area and I looked to see if the AED was charged. I had to check to see if the charge light was on and if it was, we were ok. But, it occurred to me to wonder if anyone is checking the AEDs that are placed in so many public places now. We have rules about checking fire extinguishers and alarms, but are there rules for AEDs. Last week, I learned, apparently not.

According to this article from CBC, Defibrillators in public buildings need more upkeep, there is a problem with not only batteries running out, but machines not functioning properly at all. If this is the case, then it might be best not to have them at all. In my opinion, it is more dangerous to believe you have life saving equipment on hand that doesn't work rather than none at all.

AEDs do have their place. Statistics show that if CPR and an AED are used within the first three minutes following the heart stopping, there is a 75% chance of survival. So, what to do? Do you have any solutions as to how to ensure the AEDs are maintained properly?

Add on info:

In 2010, the American Heart Association updated its CPR guidelines to a much simpler way of doing things. You can read about it here: New CPR Guidelines.

5 Fictional Nurses

Today is 5 of your..... a theme for the Blogathon 2012 participants. It originally was supposed to be about movies, books, or some other type of influence that got you on your way to blogging or that gave you ideas. But, since I couldn't think of anything, I decided to list five fictional nurses that I have enjoyed "meeting" over the years.

Cherry Ames

The first fictional nurse I knew was Cherry Ames. I had several Cherry Ames books that I read, alongside my Nancy Drew books. I wasn't a Cherry Ames wannabe, but I did enjoy reading about her adventures. How many roles could a nurse really take on? If you were Cherry - many.

Look! You can still buy the books, written by Helen Wells.

Amazon link

Sorry folks - I'm a Kindle devotee, but really, some books just should not be ebooks and Cherry Ames books fall in that category.

Jill Danko

Doesn't ring a bell? Jill Danko was a nurse on a show in the 70s called The Rookies. She wasn't a major character; she was the wife of one of the police officers, but she was popular and Kate Jackson, who played Jill, ended up getting quite a bit of screen time.

Major Margaret Houlihan

Played by Loretta Swit in the hit sitcom M*A*S*H, Major Margaret Houlihan was a different breed of nurse. No nonsense, tough, but if you watched the show regularly, you would see that she did have a heart that she guarded very carefully. I think every female nurse should have a little of Hot Lips Houlihan in her. She knew her stuff and she backed up her nurses 100 percent.

Carol Hathaway

A newer name, newer than Jill Danko anyway. Carol Hathaway was a nurse at ER's County General Hospital and was the envy of many women as she became Doug Ross's lover. And who was Doug Ross - he was played by George Clooney.

Nurse Jackie 

I have a confession to make. I've never watched one episode of Nurse Jackie. Not my fault though - I don't get the network that runs the show. I've heard a lot about her so I figured the list should include her. She does belong on my list - I've heard enough about her!

What fictional nurses do you remember?

Sunday - Relaxing? How Do You Relax?

A big part of being healthy is knowing how to relax. Do you know how to relax?

Taking time for yourself is important, but in today's busy world, how many of us really do take that time to slow down? What do you like to do and wish you had more time for?

I love to quilt. Yes, I made this one, and many more. Did I mention I love to quilt? ;-) To me, hand quilting is very soothing. I can do it while I'm watching television, listening to music, listening to an audiobook or just while I'm pondering life. All is good. Until I jab the needle in my finger, as I did the other day. A small poke is ok, a jab is not. Ouch. But, aside from those few jabs, while I am quilting, I am in my happy place.

I also like to read - and napping is always good. ;-)

Would you like to share what makes you happy, what makes you take time for yourself?