Hard Work


No one knows what individual is personally responsible for Labor Day but we do know the concept of Labor Day arose out of the Industrial Revolution during an era of 12 hour work days, 7 days a week. 

Adults and children as young as 5 years old worked in extreme conditions. Poor work safety, environmental hazards and unsanitary conditions were the norm. 

Labor unions developed to first protest the poor work conditions. Later people joined to advocate for better pay, less hours, and environmental safety. 

A labor march in New York City on September 5, 1882 was part of the early movement and may be the hallmark date that resulted in what today we call Labor Day. 

On Labor Day 2017, Health Calls recognizes people who work. While categorically recognized as the official end of summer, many people are hard at work on Labor Day as they are every day. 


Service professionals of all kinds dedicate their time and unique talents to get us where we’re going, keep us safe, nurse us back to health, keep us comfortable, warm, and make sure that life as we know it hums on. 

It is during times like now, either directly affected by the devastating aftermath of Hurricane Harvey, have volunteered your time in early recovery efforts, or as a sideline observer, we realize how many dedicated people we are indebted to. 

We are not alone. We are dependent upon each other. We are all part of a village. 

Thank you to all who labor, who work hard every day or have retired after many years of hard work. 

It is because of you that we all enjoy the American Dream.  

12 Steps For Medication Safety Prevent Complications and Repeat Hospital Stays

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Larry came home from the hospital where he was treated for a lung infection. He spent 3 days in the hospital receiving IV antibiotics and recuperating from pneumonia. On the last day he received nebulizer treatments to help clear his lungs.

The morning after Larry was discharged home, his home health nurse came to evaluate Larry. An important part of every health care evaluation is the medication review. The nurse gathered all of Larry’s medications that he had been taking prior to going to the hospital and compared the list from the hospital discharge papers.

What the nurse discovered during the evaluation was that Larry had a change in the dose for three of his medicines and he had 3 new prescriptions. Only 2 prescriptions were filled at the pharmacy. Larry also didn’t use his nebulizer at all since he got home.

Larry has COPD. The nebulizer machine helps put the medicine into the form of a fine mist that will reach to all areas of his lungs to make him breath easier and cough up mucus from the infection. Nebulizer medication may be used in addition to or in place of inhalers.

Some people aren’t able to use inhalers properly and the nebulizer medicine gets to the lungs much more efficiently with the machine. In Larry’s case, he was to use the nebulizer four times a day when he is at home, and if he must be away from home, he can use his inhaler occasionally instead of the nebulizer as it’s more portable. The nebulizer helps open all of Larry’s airways so his lungs can clear the infection.

The medicine for a nebulizer machine comes from the pharmacy. Nebulizer machines come from a medical equipment company and is usually covered under Medicare and other insurances with a doctor’s prescription. In Larry’s case, the hospital sent the prescription to the pharmacy but they didn’t send a prescription for the machine to a medical supply company.

When Larry left the hospital, the nurse who reviewed the doctor’s discharge instructions mentioned that he should continue his breathing treatments. She assumed he had been using the nebulizer before. She did not do a complete medication reconciliation prior to his discharge.

Larry mentally prepared and organized all of his belongings for the return home. The discharge instruction review was done quickly as Larry was ready to get home. He failed to pay attention or recognize the importance of the discharge instructions. Larry missed the important details so that he would get his medication routine right when he returned to the safety and comfort of home.

Medication reconciliation is a process that all medical professionals need to follow in an organized way.  This review helps point out changes between the way the medication was intended to be taken and how the individual is actually taking it. Larry and the nurse, if truly doing a medication reconciliation would have discovered that Larry hasn’t used a nebulizer machine before and the problem would have been fixed before he went home.

In another case, Theresa is at the doctor for a check up and her blood pressure is high today. Theresa is to take a blood pressure medicine three times a day. She understands that she is to take the medicine with each meal. In the doctors office the nurse asks her if she is taking her hydralazine. She answers, “yes”. “When do you take it?”, asks the nurse. “At each meal”, Theresa replies. While the nurse is satisfied with this answer, what is missing is finding out the times she takes it. More digging reveals that Theresa gets up at 11:00 am. She eats and takes her blood pressure medicine at 11:30 when she gets a Meals-on-Wheels delivery and then has soup and a sandwich at 5:00 at which time she takes her pill again. She never eats three meals and is actually only taking two doses a day.

Poorly controlled blood pressure may result in a stroke or heart damage, further affecting Theresa’s health and ability to live independently.

As high as one-third (30%) of all patients find themselves back in the hospital less than a month after a hospital stay.

Medication errors are one of the highest causes of repeat hospitalization stays.

Brown bag medication reviews completed by doctors, nurses, and pharmacists often reveal problems. In a typical program, at least some parts of patient medication schedules are inaccurate. Many people also take duplicate medications because they are taking both the generic and brand name for the prescription. Filling medications at the same pharmacy every time will prevent these errors as pharmacists watch for these type of errors when filling prescriptions.

The bottom line, most important result of any medication review is safety. Patients who continue to take medications inaccurately are more likely to require a return admission to the hospital and possibly experience life-threatening medical harm requiring a stay in an intensive care unit.

How can you prevent medication errors from occurring?

1. Keep a current list of your medications in your wallet.

2. Take all of your medications in a bag with you to each doctor visit. Also, pull out your medication list and review it for accuracy as your pill bottles are reviewed.

3. Update your medication list every time a medicine is changed, added, or stopped.

4. Use one pharmacy to fill all of your prescriptions.

5. Pay attention to instructions provided by your health care provider.

6. Be comfortable asking questions about anything that you don’t understand when explanations are provided for you.

7. Request written directions to take along with you, just in case you forget parts of the instructions.

8. Ask someone to attend all doctors visits with you. Ask your companion to listen, take notes and ask questions during the visit to help you recall information later.

9. Review all the information provided you with your companion after you return home. Take notes about any followup questions you may need to talk about with your health care provider.

10. If you are hospitalized and are returning home, ask your family member or designated driver to be there with you for the discharge paperwork review and to help answer any questions at that time.

11. Don’t let the discharge instructions get buried beneath everything once you return home. It is a busy, hectic process to get reorganized when returning home from the hospital! Reviewing the instructions several times is important. There is so much information to remember, it can be overwhelming. Be kind to yourself and review the notes a few times knowing you are taking good care of yourself.

12. Request Medicare-certified home health agency services upon discharge home to assist you in the transition to home. If services weren’t started right after you leave the hospital, you may call your doctors office and request home health visits. The visiting nurse will assist you in assuring that you are taking medications accurately and provide more training and teaching about your health condition(s), medications, diet and fluid management, pain management, and lifestyle changes that are needed to help you remain healthy and avoid a return trip to the hospital. The nurse will make recommendations for other in-home visits such as Physical Therapy, Occupational Therapy, Speech Therapy, Social work services, and even home health aide services to assist with personal care for a short period as you recuperate at home.

13. Always schedule and keep follow-up health care provider/doctor appointments. An appointment to your health care provider is important to be sure that you are recovering well. Your health care provider may make further adjustments as needed to help you continue to recuperate at home.

These tips will prevent many complications in your health, no matter what the medical diagnosis is. In the end, communication is the key ingredient.

Home Health: A Safe Transition Home

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Home Health is an opportunity to provide care, one patient at a time.

With no distractions, in a patient’s home, nurses and therapists have an opportunity to translate health care instructions into part of a patient’s daily routine.

Sixty percent (60%) of patients have unresolved questions related to their health care at the time of a hospital discharge.

The home health team provides safe transitions to home, providing follow-up care at home following a hospital stay, surgery, illness, or change in condition.

Identify barriers to care in the home.

Ensure doctor’s orders are being followed.

Explain post-hospital care in ways that patients understand.

Evaluate safety and medical needs.

This is the daily impact of a Health Calls home health nurse in a respected team.

 

Nurses in home health provide a highly skilled, broad range of nursing skills including chronic disease management, use astute assessment skills to identify potentially critical acute changes early,  fall risk assessment and interventions, medication management, complex wound care, and patient teaching for complex health needs and disability care.

Home health nurses are respected by the physician providers they work with. Home health nurses find rewards working in an interdisciplinary team alongside the physical therapist, occupational therapist, speech therapist, social worker, and home health aide to help maximize the patient’s abilities.

The entire team are the eyes and ears in the home, identifying and treating potentially health changes events EARLY before they become critical events. Patients will have better outcomes because the clinical team detects problems early and then intervene to prevent complications. These early solutions increase patient satisfaction and reduces medical costs by avoiding a hospital readmission.

 

 

Excellence. Integrity. Quality.

By the way, Health Calls is hiring RN’s. Looking for the best to serve Reading and Berks County.

Call 610-927-3166 or email MRadwanski@healthcallshomehealth.com for more information. FAX resume to 610-927-3164.

 

There’s Value In Connecting With The Good Times

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A couple of years ago, I attended a meeting in Chicago. During some down time, I had the pleasure of exploring the Impressionist exhibit at the Art Institute of Chicago. While I was enjoying this beautiful collection, I was distracted by all of the people who walked in front of my view, and hurriedly took pictures of the art with their phones, and moved on to do the same with the next masterpiece rather than really looking at it and enjoying it. Will they remember how well light was captured at the various times of year in Monet’s Haystacks of Wheat?

What if, in every day life, we looked at life through borrowed eyes or with a sense of Christmas wonder? What if we spent more time with our happy memories?

In meditation, a suggestion is to focus on a memory of a place that brings a sense of peace in order to center on the meditation activity. I usually go to one of two places: the beach, or a quaint cottage I stayed at with my sisters. I hear the trickling of soothing water from the lake. It was peaceful, beautiful and I was so content and happy. Good place to go mentally for centering and happiness. I thought about this while reading an article that reminds us to Live in the Moment.

There’s value in regularly connecting with “the good times”.

As recently shared in the white paper, Dementia Caregiving Guide, spending time talking with Mom (who has Alzheimer’s) about a memory of a happy time with Dad is emotional validation. Life stories, memories from daily life, celebrations, vacations and special trips, and all positive connection of this kind with family and friend is well spent.

What emotion or experience does this picture create for you? Consider asking your parent if they ever saw a beautiful field of sunflowers like this. Where was it at? What were they doing that day? What other happy memories does it bring? What happens when you ask your child or grandchild about the photo? How many colors do they see? Who lives with those flowers? Ask them to tell you a story about the sunflowers. Do they make you happy?

 

Do you ever experience post-vacation blues? Feel overwhelmed and let down with that morp speed experience of ‘back to work’ after a much needed break? Bring some momentos home and print one, or several photos from the trip and keep them at your desk to keep the scenery, activity, scents, smells, and sounds alive. You work hard so you can play hard, so relive and savor it!

Do you wonder how you will manage dealing with your Mom’s new cancer diagnosis with the treatments and appointment schedule when you are trying to balance a full time job, a family, and a home? How about that time you overcame your fear of heights?

Write the story down, tell others about how you challenged yourself, both physically and mentally training for the hike you took and how you felt reaching the summit. Remembering how you overcame your fears will embolden you to pull together your resources and increase your confidence to deal with the current crisis. Remember that you researched and asked others for help while prepping for the hike. You need to do that with this challenge too, so you don’t burn yourself out.

One way to share your story is to write it down. Not a diary with gossipy type of memorabilia, but a journal in which you record the day to day events that have importance in your life. Record vacations, the one lined memorable or remarkable, startling phrases that your children or grandchildren have said. Take special care to note things you are grateful for, generosity others have shown you, things you have done to pay it forward, thoughts you have had while quietly taking a walk. The thoughts and things you record may be valuable and memorable to your family in the future. There are many approaches to journals including Journalling apps, and guided book journals. On-line journalling prompt sites are helpful to start the thought process.

Writers from my hometown just recreated our area’s rich history in a sight and sound extravaganza. Reading, Pa. has experienced tremendous financial loss as manufacturers have relocated elsewhere over the past 30 years. Reading Railroad was also once the largest corporation in the United States. The area’s history is rich, but we mourn who we were and are dismayed by the tougher and rougher times. In an article written about the multimedia performance, This is Reading, the author writes that the story created “a piece of art in a city that has fault lines”. The good news is that there are many strong and good-hearted, generous people who work hard every day to enhance the quality of lives in our town. New manufacturers and small business are finding their way. The People’s Chronicles is a local non-profit of story tellers with a mission to create a richer community through our local stories, told by people who created or experienced them.

Mike Little, Health Calls Owner and CEO was born and raised in Nitro, WV. Each year, Health Calls celebrates West Virginia Day. This is the birthday of the state (June 20) and commemorates the state’s succession from Virginia. It’s not our state holiday, but we respect and celebrate with him because it’s part of our synergistic unique company culture. We hear about differences in the way of life through his stories and we are richer from the experience. You and your loved ones, mine as well: we all have fault lines. With our storytelling, all the wrinkles and faulted lines, meaning…purpose…and community are created.

Carpe Diem. Be. Present. Tell stories. Keep a journal. Express gratitude. Pay attention to cues (the smell of pine, the crackle of the fireplace, the taste of salted caramel, the melody playing in the restaurant) that bring you to a happy memory and tell the remembered story. You and I each have a unique story. Tell it! Encourage your loved ones, people you work with, those you care for to tell their story, the memories of today and yesterday. Keep them in the present, happy and alive.

Alzheimer’s drug may be promising treatment for traumatic brain injury


There is some promising research results for treatment of patients with traumatic brain injury. Treatment for Traumatic Brain Injury (TBI) is often elusive. While it's a major cause of disability and death, finding treatment with medications has generally failed. A new study found that memantine, a drug that is used to treat dementia associated with Alzheimer's disease, may be a promising therapy.

The study examined the effect of the drug on blood levels of neuron­specific enolase (NSE), a marker of neuronal damage. The blood level was significantly reduced by day 7 of treatment.

In addition, the Glasgow Coma Scale (GCS) is commonly used after a brain injury to describe the level of consciousness in a person following a traumatic brain injury. There were marked improvements in traumatic brain injury patients GCS by day 3 of treatment in the study.

Source:
http://newsroom.wiley.com/press­release/journal­clinical­pharmacology/ alzheimers­drug­may­help­treat­traumatic­brain­injury

Enjoy the Fruits of Summer

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Summertime is a great opportunity is to enjoy access to fresh food. Here in Berks County, locally grown food is abundant and available at area farmer’s markets and stands. A complete listing of seasonal and year-round markets and stands is available here.

The Penn Street Market is held in Reading every Thursday this summer from 10-2. The Food Trust is also at the Penn Street Market providing interactive demonstrations and food samples throughout the day. The Antietam Valley Farmers Market , is held in Carsonia Park on Saturday’s from 8:00-12:00 year round. West Reading also hosts an open air market on Sundays May through October in the 500 block of Penn Ave. from 9:00 am – 1:00 pm.

Purchase some fresh food and follow these suggestions to get your family to eat more fresh meat, fruits and vegetables, and less pre-packaged, processed foods. Try  “rebranding ” delicious veggies as this article suggests.

  1. Describe the food in an indulgent, decadent way. As an example, “Juicy, luscious sweet cherries” sounds appealing and appetizing.
  2. Have fun competing to find the prettiest, smallest, largest fresh veggies to take home to try.
  3. Label food in a healthy positive way rather than a restrictive manner. “Suzie Sweet Pea” has had a way into the bellies of more children than simply telling kids the sweet peas are good for them.
  4. Go head to head in a friendly cook-off competition with family and friends for the most flavorful recipe. Invite others to taste test and name the winner of a Veggie Cook-off competition.
  5. Get the most of the experience, be mindful while enjoying the flavor and textures  of the foods you are eating.

Fresh fruits and vegetables abound. Get out there, visit a local market or stand, prepare some fresh foods and enjoy the moments of pleasure they provide!