check out our new foster dog

When Oscar died at the beginning of the week, we decided that we would foster bounced greyhounds while the adoption groups searched for a forever home. Although we weren't planning on starting right away, this sweetie needed a home fast, so we took in to the fold while the adoption group does their magic.

His name is Chance

Handwashing

How often do you wash your hands? Are you fanatical and wash them more frequently than you need to? Do you only wash them when you really have to? Or do you wash them as often as necessary, but not obsessively?

When I was a student nurse, we learned the proper techniques for hand washing and, of course, the whole bit about how often and when to wash. It’s amazing though, how many people don’t wash their hands properly or often enough.

I have been reading about the debate as to whether people should be using the so-called antibacterial hand washes. I use them and I do encourage my kids to use them in certain situations. For example, my son was working in a store where he would work the cash. We all know that money can be very dirty, so I think that the use of a hand sanitizer when working at a cash is a good idea. When out shopping and handling lots of things and then eating in a fast food cart, I think that’s another great use for a hand sanitizer. But they shouldn’t replace hand washing, in my opinion.

A lot of the actual cleaning is in the movement and action of washing, the running of water and the friction caused by rubbing your hands together. From what I’ve seen, people who use hand sanitizers tend to just rub their hands together and not do the hand washing movement that is needed.

A good hand washing technique is simple, but it can’t be rushed:

- Make your hands wet with warm running water.
- Using soap, rub your hands together, making sure that your fingers rub into the areas between the fingers of the opposite hand. This should take at least 10 to 15 seconds, minimum.
Wash the top of your hands, not just the inside (palms) and don’t forget the thumbs. Apparently, they are often forgotten. Also, remember to clean under your nails and to let the water run under as well.
- Rinse your hands well and then dry with a clean towel.

If you are using a hand sanitizer, you can use the same motions of rubbing your hands together, in between your fingers and remembering the tops of your hands and your thumbs.

We all know that hand washing is important to stay healthy and to prevent the spread of infection, but do we all know how important it is? It’s been documented in the medical literature that the spread of illness drops drastically when proper hand washing is observed. From an anecdotal point of view, when I was just graduating from nursing, I worked in post-partum and nursery. The rules were incredibly strict about hand washing when you were in the newborn nursery. Pretty well every time you turned around, you had to wash your hands. The entire time I was there, I didn’t catch one cold, one virus, one illness. Nothing. It was the healthiest time ever in my life. My hands were raw and red, but I was healthy. :-)

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Grief

Grief is a funny thing. We all react differently to the death of a loved family member or pet. Although I had worked in medicine in acute care, we often didn’t have time to think about how people reacted to a death but when I worked in palliative care, it was part of the job.

I’ve long been interested in death and how different cultures think about it and treat it. Back in college, I recall taking a humanities course called Death and Dying, so my interest went back pretty far. But it’s not really something people like to talk about so it’s hard sometimes to be interested in a topic that’s taboo for many.

Our family has experienced several deaths in the past four years or so. My husband’s father passed away after a three-week illness, our golden retriever died of cancer, my brother took his life, our last two guinea pigs left us and then, on Monday, my heart dog – Oscar – died. I know that the death of a guinea pig isn’t on the same level as the death of a brother, but it’s a loss. To me, it’s another soul that has left this earth and it’s a soul that my children loved, so their pain at losing an animal hurts my heart.

The house is a lot quieter these days. I listen for Oscar’s tags, the click-click of his nails on the floor, the thud as he jumps down off my son’s bed. I remember when Rox died (our golden), I often saw him out of the corner of my eye. I haven’t had that with Oscar yet. I often felt comforted by those imaged visions of Rox so I wonder why I’m not experiencing it with Oscar. Maybe it’s too soon. Or maybe it won’t happen.

Oscar was a funny dog – he loved flowers. One time when he got loose, I caught him because he had stopped to smell some flowers. Silly dog. So, now there is a big bouquet of beautiful flowers in the window sill where he’d go and show the neighbourhood how scary and frightening he looked. Silly dog. I miss him.

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Medication errors

I was reading an article on errors in hospitals and it reminded me of how easy it is to make mistakes. It is very easy.

Doctors and nurses are quite overwhelmed a lot of the time. The patients in the hospital now are sicker than patients 20 years ago; I know that sounds odd, but it’s true. Many of the patients we had 20 years ago are now being treated on an out-patient basis or their stays in hospital are much shorter than they might have been back then. Patients are living longer with more serious illnesses and treatments and therapies are getting more complicated.

Of course, a mistake can never be excused – mistakes shouldn’t happen. The problem is, when you’re dealing with humans, they are going to happen. In most professions, an error is found and corrected, most people are none the wiser. But if a healthcare professional errs, it’s a life we’re talking about.

The general public can help protect themselves in some ways too. When I was working in the hospital, it always amazed me how people would trustingly take a cup full of pills and just pop them down without any comment. I wanted them to look at their pills, to learn what they were taking, what the pills looked like, what their names were, and what they did. When a patient questioned why they were getting a blue pill instead of the usual orange one, I didn’t just tell them to take it, I’d either answer the question (dosage change, drug company change, etc), or I’d take the pill and say, “hold on, I’ll double check for you.” I wanted the patients to know what they were taking. I know that not all nurses do that; I know of some nurses who would just brush it off, but I like to hope that they’re in the very small minority.

Pharmacists can make errors too. We had that happen when my oldest son was a baby. He was given 10 times the dose of antibiotics he should have received. It’s only because of my nursing training and the knowledge that I knew it was wrong, so we went back to the pharmacy and had it corrected. But, considering the dose he was given, he could have been killed. Thank God I was able to pick up on it.

The worst part of that situation was that the pharmacist never acknowledged or apologized for the error. Another pharmacist on duty gave us the right dosage, but despite going up the chain, to the very top, I never got an apology. That’s all I wanted.

So, you as the general public, what can you do? When your doctor gives you a prescription, ask what the paper says, have the medical-ese translated for you. Clarify with the doctor how many times a day, what dosage, what medication, and for how long. That way, if there is a problem with the prescription at the pharmacy level, you know what you were told. When you pick up your prescription, check the label to make sure it matches what you were told at the doctor’s. If it doesn’t, ask for an explanation. It could be a perfectly reasonable explanation or it could be an error. And then it’s your turn. Make sure you take the medication as directed and only as directed. And, *finish* the prescription, even if you feel absolutely wonderful after only a few days.

Here are some tips for reading prescriptions:

QD means every day.
BID means twice a day.
TID means three times a day.
QID means four times a day.

Now, QID does not mean, normally, that it has to be every six hours, just four fairly evenly spread out times in the day. In the hospital, would often be 6 a.m., noon, 6 pm and bed time. But, double check with the pharmacist to be sure.

Q1H means every hour
Q2H means every 2 hours
Q3H means every 3 hours, and so on.
QHS means at bed time

Mistakes shouldn’t happen, but we know that they do. So, we all need to do our part to prevent them or catch them when they do happen.