Nurses Helping Nurses

Being part of the nursing blog community can be fun and interesting. Although my blog is usually geared towards the general public, I do get many student nurses and new nurses who visit to see what I'm writing about.

A couple of weeks ago, I was approached by an online nursing site and asked if I would share some tips for new nurses for a round up post. Sure - I like doing things like that so I gave her four tips that I thought were particularly important. They ended up being in this post, 101 Nursing Tips From the Experts. I wish I'd known or taken heed of some of those suggestions all those years ago, that's for sure.

The list of contributors is impressive. Some names are familiar, while others are new to me, so I'm off to check them out. After all, I'm still learning too, even after all these years.

Light Therapy or Talk Therapy for SAD

It's that time of year again in the northern hemisphere - talk about seasonal affective disorder, or SAD.

What is SAD? Much of how we feel comes from the amount of daylight we experience, experts believe. So in the fall, as daylight hours shorten and night hours are longer, we see less sunlight. Some people go to work in the dark and come home in the dark. There may be days when they only see sunlight through their office window - if they have one. It's believed that in some people, this lack of sunlight causes SAD. And one remedy for this is to use light therapy - exposure to special lights of specific wavelengths to combat the lack of natural light.

SAD lights are commercially available in various shapes and forms, from large standing ones to portable folding ones, usually promoted as great for travel or to bring to your office. But do they work? A new (small) study published today in the American Journal of Psychiatry shows that while the lights may be helpful, they may not be as effective over the long-term in battling SAD as "talk therapy," or cognitive behavioral therapy (CBT).

The light therapy works, the researchers agree, but the problem behind using light therapy is the need for continuous use for it to be effective. Users need to use the light every day for a set number of minutes per day, and if they stop, their SAD symptoms reappear or worsen. The researchers also point out that there can be problems with ensuring that the light therapy is always available. People may not be able to purchase portable units or be in environments where they can use lights. Talk therapy, on the other hand, doesn't require special equipment or adaptation.

The study looked at 177 people with SAD over the course of two winters. The group was  divided into light therapy and CBT subgroups. By the end of the second winter, more people who used light therapy experienced a return of their SAD symptoms than did those who used CBT. But, only 30% of the light therapy group were still using their lights that second winter.

"Light therapy is a palliative treatment, like blood pressure medication, that requires you to keep using the treatment for it to be effective," lead author Kelly Rohan said in a news release. "Adhering to the light therapy prescription upon waking for 30 minutes to an hour every day for up to five months in dark states can be burdensome," she said. 

Light therapy does work for many people, but it must be used consistently. If that isn't possible, perhaps CBT is the better option.

Never Far From My Mind

This blog is an important part of my work identity. I post about interesting health topics and news about nursing issues - and yet sometimes I let it sit untouched for a few months at a time. And I feel guilty when that happens.

Sometimes I wonder why I allow that to happen. It's not that I don't think about the blog because I do. Many mornings when I sit at my computer to start my work day (which can be as early as 4:30 a.m., as today), I have the best of intentions to post that day, but it doesn't happen.

What is the point of a blog like this? When I began it over eight years ago, it was to bring attention to my work, my ability to write about health issues in a friendly and engaging way. It was to build a brand, in a way. And it worked. I developed a great following of readers and I get many on-ofs, people who find this blog because they are looking for a specific issue. Clients have also found me through the blog and I've sent potential clients here so they can see my unedited writing style.

A lot has happened since I posted my first piece in 2007. My husband and I sold our big house in the suburbs and we moved back into the city proper. I fell (on moving day!) and dislocated my shoulder, which put me out of commission working clinically. Up until then, I'd still been working part-time for a while as a clinical resource nurse. My full-time freelance career took off, and I'm doing what I love.

I have two "anchor clients," non-profit organizations for whom I write site content, among other things. And I have many clients who use my services to write for online or print journals, online content, newsletters, and more. Oh, and don't forget my book, Just the Right Dose! That was a major accomplishment and I'm proud of it.

A side part of my success is I get many emails from nurses who want to get into writing. I love helping them if I can. I don't mind responding by email, giving them a quick run down of how I got to where I am today, along with some advice. I do have a pet peeve though. Would you believe that the majority of those who write to me to ask for information or advice don't even bother to acknowledge that I responded? Nothing. It's not everyone. I've gotten some delightful thank you notes back. Sadly though, they are in the minority. A very small minority.

Some of my fellow writers have gotten pretty upset about that lack of courtesy and no longer offer advice when asked. They charge a consulting fee. I understand their point of view; I don't agree with it, but I understand it. Anyway, that was a little side track rant. ;-)

So, what was the point of this post? A sort of welcome back to myself, I think. It's time to get back on the blogging track. When I see that certain blog posts are read regularly, despite how long ago they were written, and when I get email from people telling me that they learned something important because of one of my posts, I know that this blog is important. It has good information. So here we go again, after another short hiatus, we're back!

Named a top 50 nursing blog

It's always nice to be recognized. Every so often, I get a message from a website or organization that tells me that my blog has been recognized as a valuable resource, either for nurses or for the general public. That means people are reading it - and they like the information I've been posting. Sometimes they even give me a cool badge that I put on my blog for a while. ;-)

I received an email this morning, telling me that Marijke: Nurse turned writer was listed in 50 Top Nursing Blogs, over at Top RN to BSN. What I like about these lists is they introduce me to blogs I don't know about. While there are some that are already familiar to me, it's always fun to discover new ones. And these lists help other people find me, so it's a win-win situation.

Do you have a favorite list of blogs that you turn to when you're looking for new blogs to follow? 

What The Nurse Writer Is Up To These Days

Busy, busy! Posts have been slow because my work life has been keeping me busy. Here's a quick fly-by post to explain what's been happening for those who have been asking:

I am still the Director of Content over at Sepsis Alliance (part-time), an organization that is dedicated to educating the public and healthcare professionals about sepsis. It's frightening how few people know about sepsis, yet it touches so many lives.

In addition to working with SA, this past May, I started working with the Partnership for Palliative Care as their Content Strategist (also part-time). As a nurse who worked in hospice nurse, this particular organization is doing work that I strongly believe in. It also has the same challenges that Sepsis Alliance has in some ways. The word "sepsis" is not known by many in North America and many who have heard the word don't know what it means. "Palliative care" faces the same issue. Not many people know exactly what it is. They may confuse it with "hospice," which isn't really correct. Hospice is end-of-life care, while palliative care is supportive care that can - and should - be given to anyone who has a life-threatening or serious illness or condition, to help them live as good a life as possible. Palliative care is also given at end-of-life, but it's not solely about end-of-life care.

I've been also been actively marketing my book, Just the Right Dose: Your Smart Guide to Prescription Medicines & How to Take Them Safely. It's a long-term project, trying to get this book in front of people who may need it - which is really just about anyone! I'm hoping that this book will be the first in a series; I have other ideas in mind. But first, we need to get this book out there. It's gotten great feedback from healthcare professionals and people who know little about medicine and health-related issues. If you take any type of medicines, I encourage you to have a look at the book. And if you have read the book, please consider leaving a review on Amazon.com or .ca. The more reviews there, the more visible it gets when people look for certain types of books.


And then there's my regular writing. I've been writing some articles, paid blog posts, and more.

If you have any ideas you would like to see me cover in this blog, leave it in the comments, and I'll see what I can do. I want to write about topics that you are curious about.

The oldest working nurse in US gets a surprise birthday party

Many nurses can't wait until they get to retirement age. Some even leave before that magical age, usually either 60 or 65 years old. But every so often, we hear about a nurse who really doesn't want to leave the profession. He or she enjoys it and likes going to work, making a difference in the lives of their patients and their families.

What is the oldest age you've ever heard of when it comes to a nurse who is still actively working? Seventy? Eighty? How about 90?

On May 8, 2015, Florence "SeeSee" Rigney celebrated her 90th birthday - while she was at work. She is the oldest working nurse in the U.S. today. Rigney works two days per week at Tacoma General Hospital in Washington, where she sets up the operating room. She only gave up direct patient care two years ago, when she was 88.

Watch this video to see the surprise birthday bash Rigney's coworkers threw for her.




Nurses? How old do you plan to be when you retire?

My interview on RadioMD.com

I'm working to promote my book in as many ways as I can (did you buy it yet? :-) ) so I agreed to be on HealthyTalk over at RadioMD. I was invited for two 10-minute sessions, which were done live yesterday.

If you'd like to hear them, the links to the recordings are here:


How to take your prescription drugs safely


and


Questions to ask your pharmacist



I think they went rather well.

If you have any questions about the book or the topic, feel free to leave them here and I'll do my best to answer them.

You can also visit JustTheRightDose.com, where there is more information about the book.

A Quicker, Possibly Better Measurement of Frailty Before Surgery

Young or old, one of the biggest concerns about having surgery is how well you are going to do after. Surgery is meant to cure a problem or to improve quality of life, but the outcome isn't always what we may hope for. While some people breeze through post-operative recovery, others struggle and have set backs. In some cases, the surgery and its effects start a downward spiral that is hard to stop.

Seniors are frequently considered to be at risk for surgical complications. Many have other medical problems, may be taking prescription medications, and may not have a support system at home to help them when they recover. However, it's not just seniors who can be at risk for post-surgery difficulties - young adults can be just as well.

Frailty tests are meant to help physicians understand which patients are at highest risk for complications after surgery. The most common test is the Fried Frailty Criteria.  "Frail means they don't have the physiologic reserve to bounce back after the operation, so they start down a path that they may not easy recover from," coauthor Kenneth Ogan, MD, said in a press release.

This assessment looks at five distinct features: shrinking (has the patient had any unexplained or unintentional weight loss of 10 or more pounds over the past year), grip strength, exhaustion (how tired is the patient?), activity level, and walking speed (how quickly can the patient walk 15 feet?). The assessment can take about 10 minutes to complete.

A study just published in the Journal of the American College of Surgeons looked patients who had major abdominal surgery and the researchers examined if there was a better way to assess the patients that was also less time consuming.

Of the 351 patients in the study, 36.7% of them had experienced a post-operative complication within 30 days of the surgery. Almost 25% were minor complications, but just over 14% were major, such as wound infections, pneumonia, and stroke. Some died.

The researchers went back and to see what the prediction would be if the testers had used just two of the five frailty factors, grip strength and weight loss. They found that the prediction results of post-surgery outcomes were the same using the two assessments as with the full five-point assessment.

The researchers then added two other factors (the patients' physical status for anesthesia and hemoglobin levels in the blood), and the ability to predict complications was better than with just the frailty test.

The advantage to this finding is that the preoperative testing for just two frailty factors, plus the physical status and blood tests cuts down the testing time to less than a minute, the researchers said. In addition, if there are issues like poor grip strength and weight loss, it might be possible to address these problems before surgery, perhaps reducing the risk of complications after.

Medicine errors at home: all too common, especially for children

It's a common event in many households - a child has an ear infection and has to take antibiotics. A family member has an injury and needs to take analgesics, pain relievers. In other families, someone has a chronic illness that requires regular prescription drugs. Medicines are a part of modern life. They keep us alive and they make life more liveable for millions of people.

According to an article in Family Practice Management, in any given week, four out of five Americans take either a prescription drug, an over-the-counter (OTC) medicine, or a dietary or herbal supplement. That's a lot of people. The article goes on to say that nearly 1/3 of American adults take five or more drugs. But if you think about it, that's not too surprising. Let's say our friend Mr. Johnson has type 2 diabetes, arthritis, and hypertension. He may take one or two prescription meds for each condition - and then on top of it, he may have other medicines to take occasionally if he had an infection or some other short-term health problem. That's easily five or more medicines at one time.

Any time you take a prescription drug, there's room for error - if you take more than one, the chances of making mistakes multiply.

If you're a parent, giving medicine to a child, you know how easy it is to make a mistake. The journal Pediatrics, published a study last year that found that outside of the hospital environment, every eight minutes in the U.S., a child under the age of six years old is subjected to a drug error. One every eight minutes. The study looked at a period of 10 years. Almost 700,000 children had medication errors - 25 of the children died. Almost 2,000 were admitted to critical care units.

The most common drug error at home is dosage - the amount of the drug given or taken, according to that last study. Dosing mistakes like giving too much of a medicine or not enough. If you're giving or taking a liquid medicine, dosing errors usually come from incorrect measuring. Someone may use a tablespoon instead of a teaspoon or the other way around. Kitchen spoons aren't specific enough for medicines either, so the dose isn't precise. If parents or other caregivers are giving medicines to children, one caregiver may give a dose not realizing another already gave it.

Other common errors involve:

• Chewing or breaking a pill or capsule that shouldn't be chewed or broken. This is a common mistake. Many pills shouldn't be broken because they have a special coating on them to prevent the medicine from being absorbed in the body too early in the digestive process.
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• Taking at the wrong time. Some pills must be taken with food, others on an empty stomach. Taking them incorrectly will affect how they are absorbed and how effective they are. And taking some pills on an empty stomach can cause serious irritation, leading to other problems.
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• Missing doses. Forgetting to take medicine is a common problem and just about everyone who has ever taken a prescription drug has forgotten a dose from time to time. 
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• Misunderstanding directions. Taking medicines can be stressful. You're not feeling well when you've gone to the doctor or nurse practitioner. You may feel rushed or you may not think to review the prescription - this can lead to misunderstanding the instructions. Unfortunately, this is more common than people realize.

Prescription and over-the-counter drugs are serious products and while we may take them every day, it's really important not to ever take them for granted. Mistakes happen and they happen every day. So know your prescription and how it should be taken. If you have any questions about any drugs you take, ask your pharmacist. Your pharmacist is your best resource when it comes to medications - it's his or her specialty.

Just the Right Dose - Helping people understand their prescription drugs

Prescription drugs are an important part of life for millions of people. Some drugs are literally lifesaving, while others make life more comfortable. But these medications have become so commonplace and easily available that they might not be taken as seriously as they should be. And that is very dangerous.

When I began working as a nurse, I was often surprised at how little some of my patients knew about their prescription drugs. When taking a nursing history (an intake interview of sorts), we would ask about what drugs the patients took at home, how they took them, and so on. So many patients would say something like, "oh, I take that little white pill for my diabetes - well, just a half of one really because I don't need to take the full one all the time." Other patients would bring in their medicine bottles, but with several prescriptions in one bottle, all mixed up. Sometimes, I would be handed bottles of expired drugs. I was even told a few times to "look at my records," when I asked about prescriptions.

It wasn't unusual for some of my patients to be there because they had not taken their drugs properly. Often, it was that they didn't take their medications as frequently as they should have, but others took too many pills or didn't follow the instructions. Some combined medicines that shouldn't have been combined, others took pills on an empty stomach rather than with food, causing damage. The stories were endless.

Why did so many people not know anything about their pills? Some of it goes back to "doctor knows best," and not feeling they needed to question their prescriptions. And I believe that part of it goes back to just not realizing how important this information and knowledge is.

Last month, I wrote a blog post about prescription drug use in North America and the errors that occur because patients don't understand their medicines properly (Over 200 Billion Dollars For Prescription Meds in U.S. Alone). I found that information as I was doing research for my new book, Just the Right Dose: Your Smart Guide to Prescription Drugs & How to Take Them Safely.

The book, now available at Amazon and Kobo, covers topics such as how to read a prescription (What do those abbreviations really mean?), how to take or give medicines - including tips for people who have trouble swallowing pills, why certain pills should never be broken or crushed, why over-the-counter drugs should be used as carefully as prescription drugs, and more.

Who should read this book? Anyone who takes prescription drugs and anyone who gives them to someone else - such as a parent who has to give medicines to a child, or a family caregiver, looking after a parent or sibling.

To learn more about the book please visit JustTheRightDose.com. You can also go directly to Amazon or Kobo to purchase it.