Protect Your Family Against Accidental Poisoning or Unsafe Use of Opiod and Other Prescription Medicines

Protect your family. Keep medications safely locked up and away.

The Washington Post reported this week that Poison Control Centers receive 32 calls a day about children exposed to opiates. While the number of exposures has decreased in the past 6 years, there is still need to protect unaware families of the possible risk to children and family members taking prescription pain medications and other drugs inappropriately, leading to poisoning and possible death.

The Center for Disease Control (CDC) recommends storing and locking medications up and away, out of the reach of children.

Important safety tips include:

1. Never leave medicines or vitamins out on a kitchen counter or at a sick child’s bedside, even if you have to give the medicine again in a few hours.

2. Always relock the safety cap on a medicine bottle. If it has a locking cap that turns, twist it until you hear the “click” or until you can’t twist anymore.

3. Tell children what medicine is and why you must be the one to give it to them. Never tell children medicine is candy so they’ll take it, even if your child doesn’t like to take his or her medicine.

4. Remind babysitters, houseguests, and visitors to keep purses, bags, or coats that have medicines in them up and away and out of sight when they’re in your home.

5. Get rid of expired or unused medications using recommended methods as outlined by Consumer Reports:

  • Return unused medications to your pharmacy. Many pharmacies have take-back programs or drop off bins for safe disposal.
  • Drop off unused meds during National Prescription Drug Take Back Day  on Saturday, April 29.
  • Mail medication to a collection site.
  • Use a self-service disposal kiosk at Walgreens and other participating sites.

Celebrate Certified Nurses!

Certified nurses are recognized for the value they bring to their specialty area of practice. On Sunday, March 19, we celebrate Certified Nurses Day.

The American Board of Nursing Specialties (ABNS), the organization that represents nearly a half million certified nurses states:

Specialty nursing certification is THE standard by which the public recognizes quality nursing care. With the increasingly complex patient/client needs within the current healthcare delivery system, care needs are best met when registered nurses, certified in specialty practice, provide nursing care.

Health Calls Home Health Agency Nurse Manager Cindy Dey, BSN RN CRRN, became certified in Rehabilitation Nursing in 1991. Cindy loves rehab nursing and teaching. She started her career working in neurotrauma at an Acute Rehabilitation Hospital. From the beginning, Cindy enjoyed working with patients and their families who needed to be independent with care in order to take their disabled family member out of the building on the grounds or even off-site for a therapeutic day pass, and to ultimately bring them home at discharge. Cindy became proficient and specialized in rehabilitation nursing knowledge and practice, taking the time to really focus on her patients – people suffering from head trauma.

When asked about her career choices, Cindy says,   “I took my career path seriously and wanted to be as proficient as possible with caring for Neurotrauma patients. In order to be certified, you must be experienced by working in rehabilitation for an extended period, and pass a written exam. The definition of rehabilitation nursing has grown and expanded over the years, and its principles of collaborative effort and team work are essential with nursing as a whole. Rehabilitation Nursing focuses on returning patients back to living optimal functional lives, although for some people it is a new normal. The goal is to get patients and the family unit to a functional, independent, active lifestyle. Rehab nurses focus on the whole person and not their  disability. It is something that I have a passion for, it has been the basis for my career in Home Health Nursing and also during my time teaching as an adjunct clinical nursing instructor.”

Cindy’s road to certification unfolded after her inpatient rehabilitation nursing job was completed. While many nurses become certified when working in an inpatient rehabilitation nursing setting, Cindy became certified once she found a home as a home health nurse. Since Rehabilitation Nursing is a specialty area practiced in many settings, Cindy was able to find so much relevance in her home health setting.

Today, Cindy is the On Call and Weekend Nurse Manager for Health Calls Home Health Agency, located in Wyomissing, PA. This job is a combination of many positions. Cindy is responsible for the after hour and weekend management of the agency. She takes all incoming telephone calls, which she proudly says come directly to her, as Health Calls does not have an answering service. “Our patients, nurses, therapists, referral sources, and the community get to talk to a live person, which is rare today.”

Cindy believes her firm rehab background has been very beneficial in Home Health Nursing. Traditional, site-based Rehabilitation Nursing teaches patients and their families about adapting and caring for themselves, or loved one, their health issues,  as well as preventing new problems.

“In a rehab facility there are no unusual structural obstacles or throw rugs, there are large spaces to lay out supplies for treatments and wound care, wide doorways, elevated toilets and handicapped safety railings, no stair cases or narrow hallways to navigate, to either get into your home or to get to your bed.”

“On the contrary, when patients are at home, they learn to adapt, navigate and work around pets, large pieces of furniture, and many obstacles. They learn how to care for themselves and regain their independence. The goals of Rehab Nursing and Home Health Nursing are the same: assessing, treating, assisting, teaching, and guiding patients in the transition back home, which is often a time of crisis. In all settings, rehabilitation nurses help patients and families make a paradigm shift and adapt from a time of dependence and illness to independence and wellness, or to manage with chronic illness, with the assistance of family or with the help of community services. We teach patients and families how to navigate through real life circumstances, and how to adapt to them, as well as who to reach out to in case of a problem”.

Cindy uses her specialty practice each day. Her typical day includes:

  • responding to critical vital signs in home tele-monitoring units the agency employs with patients with cardiac and respiratory problems,
  • taking calls from patients who are having medical problems,
  • responding to patient and family concerns and questions,
  • talking patients through medication schedule or dose questions,
  • trouble shooting medical problems or symptoms, and
  • problem-solving complex home care equipment with patients and families on the telephone.

Twenty-three years ago, Cindy met her husband, who had recently immigrated to the U.S. from Germany, on a blind date that her cousin set up. Cindy and Stefan have been married for 20 years and have three children: Summer, Jeremiah, and Danielle. Cindy’s 85 year-old mother also lives with the family. Cindy describes herself as chronically early; she hates to be late for anything. She is also a huge history buff and loves to travel. Cindy is the only child of a third generation dairy farmer and a self-professed country kind of girl. She graduated from Widener University.

S.A.F.E.: Be Informed, Be Empowered, Be Prepared

Patient Safety Awareness Week #PSAW2017

Most patients have taken care of their personal needs in a certain way most of their adult lives. When frailty occurs, or a person needs home health following an illness or surgery, the rehab team will often recommend personal care support for a period of time. That’s when  Health Calls Provides C.N.A. support to help with personal care until the patient is strong enough to do so safely and independently again. Cindy Babula, Certified Nurse Assistant suggests the following acronym to the patients she supports :

S. it
A. lways
F. or
E. very thing.

Frail or weak patients need time and patience to to do things safely. Of course, they may not need to do ALL things from a sitting position. Sitting to button a shirt, for example, allows time to conserve energy or catch one’s breath after showering. Many patients take pride in reminding Cindy when they have ideas of ways that she or they might do something in a safer way.

TOUCHE! Cindy says. It’s a give-and-take when each of us, patient AND a caring caregiver, puts SAFETY FIRST!

Cindy says a patient once pointed out a sleeping cat in their path as they were walking towards her bathroom; it was not a “stuffed animal,” but rather a living, shallow-breathing, deaf cat who would have to be picked up so the two could safely traverse the room.

Safety takes team work.

Here are more #SAFETYFIRST2017 ideas from the Centers for Disease Control:




The Answer Lies Within The Collective “Us”

My father-in-law celebrated his 90th birthday on Saturday. As I watched the 4 generations have fun together, I was struck by how much technology has changed in his lifetime while the basics of our needs and our nature as humans remains constant. Let me explain.

Some 50 years ago, my favorite cartoon as a kid was the “Jetsons”. and 30 years before that, when my father-in-law was 5, he and his family gathered around the radio on Sunday nights to listen to stories on the radio. For me the Jetsons was mind-boggling, as it was science fiction. To consider that one day cars would not only drive themselves, but fly the passenger from one place to the next was amazing to me. We are basically “there”, as MTT develops a wheelchair that drives itself, and  I watched my 20-month old grand-niece “Facetime” with her aunt who was 160 miles away but technologically with us during the birthday party.

Barry P. Chaiken, MD, MPH recently wrote an article in which he states:

The rapid expansion and evolution of medical knowledge makes it impossible for any single healthcare professional to assimilate and retain the up-to-date information necessary to properly treat patients”

– See more at:

We find ourselves dealing with mind-blowing technology in health care. As consumers, providers, and advocates for our loved ones who need health care, the reality of today’s science can cure one and be terminal for another. We all must face our mortal as well as technological limitations. Basics of communication and relationship management are key.

As mortals, clinicians (doctors, nurses, therapists, researchers) must work very hard to stay on top of the game. We must increasingly rely on and trust the expertise of our team members who know more about pieces of the equation than we may personally know. We can accomplish the best plan for each individual entrusted in our care when we consider the collective “Us“.

As family members and caregivers, we expect better, in fact the best plan of care for those we care for and about. Since I read the Chaiken article, I have given a lot of thought he presented that compares health care team members to musicians of an orchestra.

There is, in fact, too much complexity in health care for any ONE of us to know; to be the SOLE person responsible, and have the intellectual property and resources to carry off the plan of care. Instead, we must work together on the patient’s behalf. If the patient is surrounded by a symphony of experts, in concert of one another, we have a chance of success. As health professionals, we must recognize that we cannot act alone.

Political views aside, I find irony that our president stated this week that “Nobody knew health care could be so complicated”. Welcome to health care, Mr. President. You may not have known but many do. There are no easy decisions. Health care reform is far more complex than any of us realized. Life (and life-changing decisions) is not black and white. There are many shades of grey in between, that color and shape the right course of action for each person entrusted in our care.

imageAs care coordinators, family caregivers and advocates, we must see ourselves as the conductor, with the baton. You have permission. Take up the baton. The baton communicates and directs the movement of the music. As an advocate, use your baton to identify your loved one’s wishes, facilitate communication between and among health care team members and ask the hard questions to move the care along. The goal will be “what is best, in this situation, with the facts before us”. You alone will not have all of the answers. The answer lies in the symphony.


Safety Tip Sunday: What To Do With Symptoms of Heart Failure


The Mayo Clinic ‘s Guide on Heart Failure recommends that if a person experiences any of the following symptoms, that you seek emergency treatment if you experience any of the following:

Chest pain
Fainting or severe weakness
Rapid or irregular heartbeat associated with shortness of breath, chest pain or fainting
Sudden, severe shortness of breath and coughing up pink, foamy mucus

The diagram below breaks things down into a simple to follow traffic light signal guide (green light- things are fine; Yellow light- I have warning signs…I better beware; Red light- I need to stop and take action, I’m in trouble and I need help now).


Talk to your health care provider. Symptoms of heart failure can be treated to prevent a life-threatening event. Long term treatment solutions include medication, diet and lifestyle modifications, fluid balance management, and self-care monitoring. Follow your healthcare providers recommendations for a safe and healthy outlook!

Social Work: A Model For Calm in Often Stormy Conditions

I recently asked Lillian Chinicci, MSW LSW what piece of advice about life she would offer to others.

It is never too late to achieve your goals.   I was 53 when I lost my husband.  My children were married and out on their own.  I decided to go back to school.  I earned my bachelor’s degree in Social Work and then continued on to earn a Masters degree  in Social Work.  My license to practice Social Work in Pennsylvania is very important to me, ” Lillian said.

Lillian has been Health Calls Clinical Social Worker for 5 1/2 years and says she loves her job helping Health Calls patients.  “It feels good to make a positive difference in the lives of patients and their families, when I can. ” Lillian realizes that not everyone is ready for the weighty decisions that her work forces people to face about living situations, getting additional help at home or making potentially life-altering changes. Lillian is a patient and wise clinician who knows that the impact of her visits may not be measured immediately; many that she advises will hold off enacting on her counsel to some point in the future.

One of the many agencies that Lillian refers families to is Berks Encore. Lillian says one of many services is the legal services available at Berks Encore. Legal Aid is very helpful for families who cannot afford an attorney but have legal needs. There are qualifying financial guidelines for the pro bono services to prepare simple wills and power of attorney documents, but the staff at Berks Encore are very helpful in determining qualifications. Lillian also recommends the volunteer grocery shopping services that Redner’s Market and Berks Encore have partnered to provide to those in need of the service throughout the Berks County community.

Lillian is a role model with a giving heart and service to others. She volunteers for a local hospice agency, offering friendly visits to patients at the end of life, so they are not alone. Lillian is also a role model at Health Calls Home Health Agency. She deals with difficult family dynamics with grace and a serene calm. She is gifted at helping patients and their families identify needs and focuses on what is best for the well-being of the patient. Lillian keeps conversations positive and finds common ground to help families find agreement in stressful situations and makes referrals to the appropriate community service to help them.

Lillian lives with her 7 year old Persian cat, Enzo.  She has a son, Robert, who just retired from the Navy, after 20 years of service.  He served on Submarines.  Her step-daughter is a Veterinary Technician.  She  has 7 grandchildren, ranging from ages 15 months to 23 years old. Lillian’s  mother is 91 years old and lives alone in her own home, in Lancaster County.  Lillian also assists her weekly with grocery shopping, picking up prescriptions, and doctor’s appointment.  

Lillian recently overcame a fear that she is proud of. She always had a fear of driving long distances to unfamiliar places since she gets lost easily. She has overcome that fear and has traveled to Virginia and Connecticut to visit her son and his family in recent years.