9 Tips Before THEY Amputate Your Legs Below the Knee!
By Dan Wimer, RN, MPLC
I am a RN with 22 years of IV knowledge and I have been in the hospital 3 times in the past year. Two of the times I was on the receiving end of poor nursing care. The first stay, in May of 2009, the nurses managed to infect me with Staphylococcus aureus. The nurses at the hospital did not follow established protocols for the maintenance of an IV site. As the result of their neglecting basic IV protocols I spent 11 days in the hospital, twice; plus 3 weeks of home IV therapy, twice.
If poor care can happen to a RN it can happen to you. My wife and I are both RN’s, she in the area of surgical nursing and I in home health, IV’s, and Psychiatric nursing. We had problems, and we are supposed to be in the know; just imagine the lay person who does not know? I have put together a few tips for you to help survive poor care.
1. Take care of your Spiritual needs first!
Studies have shown that people that have a strong Spiritual background do better in stressful situations, like hospital stays, than the people that do not have strong Spiritual ties.
If you do not have a minister, talk with the Chaplin at your facility.
Now is a good time to take out and dust off your Bible.
Be prayed up, that’s a good thing to do in any case.
2. Good Records Keeping IS A Must!
Keep a list of your medicines in your wallet or your purse. Over the years, as a RN, I found people often forget what medicines they are on. Stress helps to you to be confused and forgetful. Often those who are with you are no help, even though they want help, because they do not know where that valuable information is or know how to get it.
Your Doctors, Primary or Specialists and ER need updated records/medicines lists in order to fully understand what is going on with you and how this new problem is different from before.
When I had my third stroke my wife had my medicine list. I keep it in my wallet. By the time EMT arrived I could not talk coherently; she had all the vital information they needed. 20 years of being a RN did not help; my wife had to deal with the EMT’s. Thank God for wives. (The last was for my wife, Christmas is only a few weeks away.)
3. 9-1-1 Call Now rather later!
The time to call is now, the “Golden Hour” starts when the first symptoms show up, not when EMS is called. 50% of first time heart attacks are fatal despite there being no prior problem or bad history about the patient.
Being a diabetic you have 5-7 times chance of having a cardiac incident.
When I worked as a Telephone Triage Nurse for a large insurance company, I was astonished by the lack of knowledge by my clients about the signs of a heart attack.
The most frequently occurring sign is heartburn that is NOT relived by antacids.
The most common symptom or feeling is that feeling of general discomfort or pressure on the chest, not pain. Usually, you get the response from the patient is that they are “just uncomfortable and if they burp they will feel better.”
Chest pain or pressure is the second most common sign of a cardiac event, and arm, jaw or leg numbness is the third. Often one has multiple symptoms.
Pain is not a good indicator of how bad the heart attack is. Many people report that they had little or no pain with their attack.
When in doubt call 911 and have the person chew 1 aspirin. Chewing ensures quick absorption of the medication.
Time is not on your side!
4. Now, for our sponsor, Mr. Stroke.
Like a cardiac incident, time is essential and I would give the victim an aspirin (ASA). There are two positions about giving ASA. I side on using ASA. The reason is that if it is a TIA (more about TIA later) the ASA helps thin the blood and reducing effects of the blood clot in the vein. If the stroke is a hemorrhagic stroke there is a better than 50% chance it is fixable.
There are 3 types stroke: Silent, Hemorrhagic, and Transient Ischemic Attack (TIA). Silent strokes are usually only detectable by brain test unless they are observed; but for our purpose there are 2 types; Hemorrhagic and TIA’s.
Hemorrhagic strokes are usually fatal with only a 20-30% survival rate, the blood vessels the brain burst causing rapid bleeding in the skull. The pressure built up by the bleeding vessels squeezes the brain which leads to death.
My mother died from this type stroke. She appeared to get better but the doctors were not able to balance the need for reducing the high pressure and stopping the bleeding. The area of the injury was inoperable. She died after three days.
TIA’s on the other hand the survival rate is 70-80%. My three strokes were TIAs. Of course the next stroke could be my last. Repeat TIAs increase the chance of getting dementia.
Again, diabetes increases the chances of having a stroke.
5. ER and/or the hospital-what a choice.
Take out your list now.
Well, after a long wait in ER you are now in your room in the hospital. Now the interrogation by the nurse begins. Remember, that you have brought your list with you.
It is scary that most married couples do not know what their spouses take for medicine. “He takes a blue pill for his high blood pressure. Or is it white?” Another killer is that men, more often than not, do not tell anyone that they have stopped taking a medicine. “I feel good so I don’t need it,” he says as he dies from his heart attack.
More women die from being cheap. They cut in half a pill to save money. However, they live longer than men, go figure.
6. Ask and Ask Again “What IS IT That YOU ARE Giving ME?”
Try to stick to a schedule that you use at home. The hospital is run for the convenience of the staff, not for you.
Timing of certain meds, such as Insulin, is very, very important. This is very important to diabetics since our bodies need food at regular times. In my case I take my insulin at supper time every 24 hours. Timing with my food is essential. The hospital staff thought at it was all right to give me my insulin at 9 PM, or when the pharmacy finally got the medication to the floor. I demanded that my insulin was to be given with my meals like I normally took it. The doctor agreed to write new orders.
In my case I take my blood pressure (BP) and my antidepressant meds at night. The reason that I take these meds like this is that they have a side effect of making one sleepy, drowsy, or tired so I use the side effect to help me to sleep at night.
The last time that I was in the hospital the pharmacy insisted that I take my BP meds in the morning; the B/P meds tends to make me very sleepy.
I was proactive and you need to be proactive also.
7. Ask: “What is that medicine and what is its purpose?”
Staffs are often tired and make mistakes. They should tell you what is the thingy (tech nurse talk) that your taking or the procedure your about to have. Question everything.
Do you see some trend in my line of questions?
8. You are allowed to sleep at night!
Unless you have a raging fever, a fever over 101.6F that is not resolved by meds, you need to sleep. The “little dirty secret” of medicine is that over 50% of healing is by the body’s own immune system. The heating up the body to over 101.0F burns up viruses and bacteria in our bodies. This is the major way we get healed.
By taking meds, such as ASA and Tylenol to keep fevers below 101.6F we wipe out better than 50% of our bodies’ own ability to get rid of infection. Sleeping also gives the body a chance to heal itself. We as a nation have forgotten the healing power of “good sleep.”
Unfortunately, hospitals are run as well oiled machine and we as patients are a necessary evil.
There is little reason to wake up a person after 10PM.
Each time I go into a hospital as a patient I have my Primary Admitting Doctor write orders that state that I should not be awakened for vital signs or routine labs between 10PM and 6AM.
Our bodies require at least 6 hours of sleep. More recent studies make a big case for 8 hours of sleep.
9. Question Everything!
All doctors and healthcare workers make mistakes from time to time. They/we do not make a habit of making mistakes but they do happen.
The most common mistake is medication error; either the doctor prescribes the wrong med or the wrong dose of a medicine. The second problem is the nurse gives the wrong medication and/or dose.
The problem is that the nursing staff is overworked and/or short staffed. Doctors, especially Family Practice (FP) practitioners, are overworked. Many FPs cannot do hospital rounds anymore because their workload is too great.
What is happening is that we find our healthcare workers are tired, frazzled, and pooped out.
The remedy is that you or your healthcare advocate must be always alert to the patient’s condition.
Bonus Round- Question Everything and Everyone!
If you have questions ask!
If the answers do not make sense to you have them rephrase the explanation.
It is your life not theirs that hangs out in the breeze.
Finally, I hope that if you, or someone you know, need to go into a hospital, you have a good result from that stay.
God bless you and yours.
Merry Hanukah, Happy Christmas, and a Joyful New Year!
Dan
Friday, December 18, 2009
Wednesday, July 8, 2009
God is Medicine
God and Medicine-1
OVERVIEW
Recently, the FDA (Federal Drug Administration) had the makers of acetaminophen (Tylenol) place a strong warning (called a black box warning) about the dangers of overdosing on acetaminophen. Doctors have known that if you give a 170 pound man approximately 5000 mg, or 10 tabs of 500mg. of acetaminophen over 24 hours you run the risk of permanently ruining his liver and without a liver transplant you will die. We are victims of advertising Tylenol is not the only company, the pharmacy companies that tells only part of the story. What Tylenol says is reads…”doctors recommended” they do not say is that doctors use acetaminophen (Tylenol) because it causes less gastric upset than non-steroidal anti-inflammatory drugs (NSAID’S) such as, aspirin (ASA), ibuprofen (Advil, Motrin ), naproxen (Al eve).
All drugs have side effects, ALL treatments have side effects some have more and of course, some have less. This is true in Psychological treatments whether you use psychotherapy, drugs or a combination of both.
When I got my degree in psychology (1971) it was the “dark ages” we known so much more now. The last 10 years we as a people have learned more about psychology than all of the pre-vious times. We know that the level of dopamine, serotonin, norepinephrine, and epinephrine in the brain affects our emotions and our actions. The lack of, or too much, of a neurotransmitter often are the root of our psychological problem. The problem is this, what came first the mental symptoms (The Chicken) or the physical symptoms (The Egg)? The truth is that in many cases it is a mixture of both. Years ago psychology took a turn towards the medical model. When that happened psychologist and psychiatrist strolled hand in hand thru the tulips. The medical model was the only game in town. The medical model looks at the world with perspec-tive of being sick and the reasons for being sick. This model sees you’re as needing a cure, because you have a disease.
The roots of positive psychology go back into the ‘dark ages’ of the 1950’s. B. F. Skinner’s ‘rats nest’ behaviorist ideas ruled in psychology. His operant condition theory seems to rule at time. However, humanistic psychologists such as Abraham Maslow, Carl Rogers, Erich Fromm, shaped a more natural path to well being. Psychiatrists, for the most part, were looking at the medicine/sickness/disease model as their source of inspiration. Psychologists were looking at the person as someone who needed help to cope in the clients’ life. The difference being psychiatrist tended to look for the ‘magic pill’, which they eventfully found after many, many years of research. The psychologists were searching for the ‘magic therapy.’ Today, psychologist and psychiatrist generally agree that a combination of medicine and psychotherapy works well for most clients.
We come back to the Egg and Chicken, again. The question is if our thoughts/emotions are in control or genetics in control of our behaviors. The answer is an unequivocal, sometimes both. We know from recent research that severe mental disorders, i.e. schizophrenia, Bi-Polar (Manic-Depressive), psychotic episodes, Major Depression there is a genetic component in the ma-keup of the client. They lack or have too much of one or more of the neurotransmitters; they need medicine and psychotherapy. The vast majority of the people who need psychology help-can are helped by a form of talk therapy. Most patients can be helped by combinations of med-icine and psychotherapy. In the last 5-10 years Positive Psychology has come into its own as a viable tool in unlocking people’s potential and seeing themselves as their own best friend.
Happiness is Just around the Corner
The long promised salvation as come and it is the Positive Psychology and Resilience theories. Positive psychology and resiliency move in the realm of the here and now, not worrying about what the mother or your teacher did to you when you were 12!
Psychology has now has discovered resilience (about 20 years ago) due the pioneer work of Dr's. Martin Seligman, E.E. Werner, Al Siebert and others. Their work started as a look at people who were supposed have poor coping skills because their low socioeconomic status. They found that about 1/3 of the subjects were able to thrive in poor circumstances. This led to wondering why they were different, and eventually researchers were able to quantify the coping skills of this group. They were resilient in their everyday lives Researchers found that the coping skills of the resilient could be learned. The study of resilience helped to found to a school of psychology called “Positive Psychology.”
About 3,000 years ago the Bible stated that; “A cheerful heart is good medicine, but a crushed spirit dries up the bones.”Proverbs 17: 22 (NIV) Another version reads; “A happy heart is good medicine, but low spirits sap one’s strength.”(CJB) Happiness has found a home. In the context of Resilience/Positive Psychology happiness means the good life. The root word is from ancient Greek. “…eudaemonia or eudaimonia, the good life, which is what Thomas Jefferson and Aristotle meant by the pursuit of happiness. They did not mean smiling a lot of giggling. Aristotle is talking about the pleasures of contemplation and the pleasure of good conversation. Aristotle is not talking feeling, about thrills, about orgasms. Aristotle is talking about what Mike Csikszentmihali works on, and that is, when one has a good conversation, when contemplates well. When one is in eudaemonia, time stops. You feel completely at home. Self-consciousness is blocked; you are one with music.” (Edge Foundation, Inc., 2004)
Happiness, then, is more than having good time or laughing out loud. The phrase, “simple pleasures” has a meaning to us. We, as a race, have strong feelings about sun sets and sun rises. They raise positive emotions in us. We can appreciate the beauty of nature. Happiness is knowing that what we do is fulfilling it does not depend on material wealth or other’s actions.
Resilience
END OF PART ONE
OVERVIEW
Recently, the FDA (Federal Drug Administration) had the makers of acetaminophen (Tylenol) place a strong warning (called a black box warning) about the dangers of overdosing on acetaminophen. Doctors have known that if you give a 170 pound man approximately 5000 mg, or 10 tabs of 500mg. of acetaminophen over 24 hours you run the risk of permanently ruining his liver and without a liver transplant you will die. We are victims of advertising Tylenol is not the only company, the pharmacy companies that tells only part of the story. What Tylenol says is reads…”doctors recommended” they do not say is that doctors use acetaminophen (Tylenol) because it causes less gastric upset than non-steroidal anti-inflammatory drugs (NSAID’S) such as, aspirin (ASA), ibuprofen (Advil, Motrin ), naproxen (Al eve).
All drugs have side effects, ALL treatments have side effects some have more and of course, some have less. This is true in Psychological treatments whether you use psychotherapy, drugs or a combination of both.
When I got my degree in psychology (1971) it was the “dark ages” we known so much more now. The last 10 years we as a people have learned more about psychology than all of the pre-vious times. We know that the level of dopamine, serotonin, norepinephrine, and epinephrine in the brain affects our emotions and our actions. The lack of, or too much, of a neurotransmitter often are the root of our psychological problem. The problem is this, what came first the mental symptoms (The Chicken) or the physical symptoms (The Egg)? The truth is that in many cases it is a mixture of both. Years ago psychology took a turn towards the medical model. When that happened psychologist and psychiatrist strolled hand in hand thru the tulips. The medical model was the only game in town. The medical model looks at the world with perspec-tive of being sick and the reasons for being sick. This model sees you’re as needing a cure, because you have a disease.
The roots of positive psychology go back into the ‘dark ages’ of the 1950’s. B. F. Skinner’s ‘rats nest’ behaviorist ideas ruled in psychology. His operant condition theory seems to rule at time. However, humanistic psychologists such as Abraham Maslow, Carl Rogers, Erich Fromm, shaped a more natural path to well being. Psychiatrists, for the most part, were looking at the medicine/sickness/disease model as their source of inspiration. Psychologists were looking at the person as someone who needed help to cope in the clients’ life. The difference being psychiatrist tended to look for the ‘magic pill’, which they eventfully found after many, many years of research. The psychologists were searching for the ‘magic therapy.’ Today, psychologist and psychiatrist generally agree that a combination of medicine and psychotherapy works well for most clients.
We come back to the Egg and Chicken, again. The question is if our thoughts/emotions are in control or genetics in control of our behaviors. The answer is an unequivocal, sometimes both. We know from recent research that severe mental disorders, i.e. schizophrenia, Bi-Polar (Manic-Depressive), psychotic episodes, Major Depression there is a genetic component in the ma-keup of the client. They lack or have too much of one or more of the neurotransmitters; they need medicine and psychotherapy. The vast majority of the people who need psychology help-can are helped by a form of talk therapy. Most patients can be helped by combinations of med-icine and psychotherapy. In the last 5-10 years Positive Psychology has come into its own as a viable tool in unlocking people’s potential and seeing themselves as their own best friend.
Happiness is Just around the Corner
The long promised salvation as come and it is the Positive Psychology and Resilience theories. Positive psychology and resiliency move in the realm of the here and now, not worrying about what the mother or your teacher did to you when you were 12!
Psychology has now has discovered resilience (about 20 years ago) due the pioneer work of Dr's. Martin Seligman, E.E. Werner, Al Siebert and others. Their work started as a look at people who were supposed have poor coping skills because their low socioeconomic status. They found that about 1/3 of the subjects were able to thrive in poor circumstances. This led to wondering why they were different, and eventually researchers were able to quantify the coping skills of this group. They were resilient in their everyday lives Researchers found that the coping skills of the resilient could be learned. The study of resilience helped to found to a school of psychology called “Positive Psychology.”
About 3,000 years ago the Bible stated that; “A cheerful heart is good medicine, but a crushed spirit dries up the bones.”Proverbs 17: 22 (NIV) Another version reads; “A happy heart is good medicine, but low spirits sap one’s strength.”(CJB) Happiness has found a home. In the context of Resilience/Positive Psychology happiness means the good life. The root word is from ancient Greek. “…eudaemonia or eudaimonia, the good life, which is what Thomas Jefferson and Aristotle meant by the pursuit of happiness. They did not mean smiling a lot of giggling. Aristotle is talking about the pleasures of contemplation and the pleasure of good conversation. Aristotle is not talking feeling, about thrills, about orgasms. Aristotle is talking about what Mike Csikszentmihali works on, and that is, when one has a good conversation, when contemplates well. When one is in eudaemonia, time stops. You feel completely at home. Self-consciousness is blocked; you are one with music.” (Edge Foundation, Inc., 2004)
Happiness, then, is more than having good time or laughing out loud. The phrase, “simple pleasures” has a meaning to us. We, as a race, have strong feelings about sun sets and sun rises. They raise positive emotions in us. We can appreciate the beauty of nature. Happiness is knowing that what we do is fulfilling it does not depend on material wealth or other’s actions.
Resilience
END OF PART ONE
Friday, May 22, 2009
Cargiver Stress and Depression
Caregiver Stress and Depression
By Daniel Wimer, RN, PLC
Overview
Depression is normal in life changing moments. Whether trauma is physical or emotional it is normal to have temporary depression during and following trauma in our life. The problem can be grief, losing one’s job, finding out your loved one has Alzheimer’s, a heart attack, cancer, or a stroke, the list is endless yet has a huge impact on the affected. Depression affects both the caregiver and the receiver of care.
The National Institute of Mental Health (NIMH) estimated that 14-17 million people, in the USA, have a form of depression. Mostly the depression is short lived less than 3 months and lifts by itself. The American Psychiatric Association (APA) uses a manual called the “Diagnostic and Statistical Manual of Mental Disorders, 4th, Edition, Text Revision,” or simply DSM-IV-TR. In truth the manual is written by the American Psychology Association (APA) for the APA under contract. DSM-IV is the source for making diagnoses about mental problems.
The most common types of depression disorder include major depression disorder. Dysthymia is less severe but with chronic symptoms that do not completely disable, but preventing one feeling well or good about them. Bipolar disorder has cycling mood swings from depression to mania. Psychotic depression is coupled with psychosis. Postpartum depression goes with childbirth which strikes 10-15% of new mothers in about one month after childbirth.
Depression is a Real Problem
While statistics show that women have more depression, I think that the stats are skewed because men try to hide their depression. They think that it is not manly to show depression they think that it is a sign of weakness to have psyche problems.
What are the signs of depression? According to the DSM-IV, depression is diagnosed when five or more of the following symptoms of depression are present for most of the day for least two weeks. The following are the usual symptoms:
Continual sad, anxious, or empty mood
Feelings of hopelessness, pessimism
Feelings of guilt, worthlessness, helplessness
Loss of interest or pleasure in activities that were once enjoyed
Decreased energy, fatigue, being slowed down
Difficulty concentrating, remembering, making decisions
Insomnia, early-morning awakening, or oversleeping
Appetite and/or weight loss, or overeating and weight gain
Thoughts of death or suicide; suicide attempts
Restlessness, irritability
Persistent physical symptoms that do not respond to treatment
Mania (severe highs-abnormal or excessive excitement)
Mania including unusual irritability, grandiose notions, racing thoughts, etc.
Survivors and their caregivers often suffer depression but not at the same time. The caregiver usually lags behind the survivor. They often suffer, especially survivors, a long term form of depression called, Dysthymia. In an article appearing in Stroke Connection Magazine-Sep/Oct 2003 titled “Depression trumps Recovery.”, Dr. Mark Huang of the Rehabilitation Institute of Chicago writes:
“Some survivors who are depressed may not find the motivation to work in rehabilitation. They feel discouraged and hopeless. Hey may feel fatigue, sleep poorly, and they don’t eat well… Their thinking skills are also affected by depression. They have a hard time concentrating in rehabilitation. Their attention to detail is affected was well. Treating depression can improve thinking skills. The rehab team needs to be on the lookout for depression. They need to notice the survivor’s mood and participation level.”
Dr. Robert Robinson in the same article writes:
“Several studies demonstrate that most (emphasis mine) patients who suffer depression after a stroke do not receive treatment for it. Many doctors, as well as family members, tend to explain away depression as an understandable response to the loss and impairment stroke produces.
Depression can be effectively treated whether it is the result of biochemical change in the brain or it is psychological reaction to the stroke. He stresses, ‘It is so important for family members and caregivers to make sure that survivors do not explain away their depression and deny they need treatment because is ‘understandable.’”
Treating depression not only improves the survivor’s mood, it improves their physical recovery and their cognitive or intellectual recovery as well.
The sad fact is that most MD’s rely on information from drug representatives on the prescribing of antidepressants. The results are ‘Me-To-Drugs’ that are sold to doctors as the new cure. ‘Me-To-Drugs’ are basically the same but with minor changes in the chemistry so that the drugs can be patented. The MD-Family Practice or Internist does not have the time to study all of the new drugs and they rely on the drug reps’ to inform them what is what. The drug reps do not lie but they do not tell the whole story either. The results are that most depression symptoms are misdiagnosed or they are given the wrong medicine or the wrong dosage. Even worse often they do not stay on the medicine long enough to do any good. Then the caregivers pressure the MD’s to try a new medicine, and thus the cycle start over.
Help is on the Way
The caregiver and the survivor need to understand the depression is normal following life changing events. It is better to ask for help that you do not need rather than ‘toughing it out.’
The survivor needs to be honest in his or hers thoughts and feelings
The time to seek a Psychiatrist is at the start of the event, if his thinks one does not need his services, to much the better.
Psychiatrist’s goal is to eventually not need him
Caregivers should try to recognize the signs of depression not only in the survivor but in themselves.
Dysthymia can slowly slip upon you
Ask for ask for help from friends and family
Medicare and most insurances provide respite care for the caregiver, use it
You are not alone blog for support groups
Afterword
1. You should be able to recognize the signs of Depression
2. You should be able to recognize the signs of Dysthymia
3. Have a understanding of how that Depression affects the course of treatment
4. Seek professional help sooner rather than later
5. “Depression Trumps Recovery
Reprint Permission-If this article was helpful you are invited to share it with you own list at work or church, forward it to friends and family, or post it on your blog. Just leave intact and do not alter this in way. Please include the following paragraph in your reprint.
“Reprinted with permission from D.E .Wimer, RN and Associates, Inc (copyright @ 2009 by D.E. Wimer, RN and Associates, Inc, in Florida 813-997-6564)”
About the Author-Daniel “Dan “Wimer is dedicated to helping you achieve the maximum results in your personal and professional life. He is a Registered Nurse with over 20 years of experience in Psychiatric Nursing, and Professional Life Coach, with a BA in Psychology. Dan is a Communicator and a member of the National Speaker Associates of Central Florida. Dan is a “3 Time Stroke Survivor” who specializing in motivational survival skills for business and the individuals. His blog is Daniel Wimer- Professional Life Coach.
By Daniel Wimer, RN, PLC
Overview
Depression is normal in life changing moments. Whether trauma is physical or emotional it is normal to have temporary depression during and following trauma in our life. The problem can be grief, losing one’s job, finding out your loved one has Alzheimer’s, a heart attack, cancer, or a stroke, the list is endless yet has a huge impact on the affected. Depression affects both the caregiver and the receiver of care.
The National Institute of Mental Health (NIMH) estimated that 14-17 million people, in the USA, have a form of depression. Mostly the depression is short lived less than 3 months and lifts by itself. The American Psychiatric Association (APA) uses a manual called the “Diagnostic and Statistical Manual of Mental Disorders, 4th, Edition, Text Revision,” or simply DSM-IV-TR. In truth the manual is written by the American Psychology Association (APA) for the APA under contract. DSM-IV is the source for making diagnoses about mental problems.
The most common types of depression disorder include major depression disorder. Dysthymia is less severe but with chronic symptoms that do not completely disable, but preventing one feeling well or good about them. Bipolar disorder has cycling mood swings from depression to mania. Psychotic depression is coupled with psychosis. Postpartum depression goes with childbirth which strikes 10-15% of new mothers in about one month after childbirth.
Depression is a Real Problem
While statistics show that women have more depression, I think that the stats are skewed because men try to hide their depression. They think that it is not manly to show depression they think that it is a sign of weakness to have psyche problems.
What are the signs of depression? According to the DSM-IV, depression is diagnosed when five or more of the following symptoms of depression are present for most of the day for least two weeks. The following are the usual symptoms:
Continual sad, anxious, or empty mood
Feelings of hopelessness, pessimism
Feelings of guilt, worthlessness, helplessness
Loss of interest or pleasure in activities that were once enjoyed
Decreased energy, fatigue, being slowed down
Difficulty concentrating, remembering, making decisions
Insomnia, early-morning awakening, or oversleeping
Appetite and/or weight loss, or overeating and weight gain
Thoughts of death or suicide; suicide attempts
Restlessness, irritability
Persistent physical symptoms that do not respond to treatment
Mania (severe highs-abnormal or excessive excitement)
Mania including unusual irritability, grandiose notions, racing thoughts, etc.
Survivors and their caregivers often suffer depression but not at the same time. The caregiver usually lags behind the survivor. They often suffer, especially survivors, a long term form of depression called, Dysthymia. In an article appearing in Stroke Connection Magazine-Sep/Oct 2003 titled “Depression trumps Recovery.”, Dr. Mark Huang of the Rehabilitation Institute of Chicago writes:
“Some survivors who are depressed may not find the motivation to work in rehabilitation. They feel discouraged and hopeless. Hey may feel fatigue, sleep poorly, and they don’t eat well… Their thinking skills are also affected by depression. They have a hard time concentrating in rehabilitation. Their attention to detail is affected was well. Treating depression can improve thinking skills. The rehab team needs to be on the lookout for depression. They need to notice the survivor’s mood and participation level.”
Dr. Robert Robinson in the same article writes:
“Several studies demonstrate that most (emphasis mine) patients who suffer depression after a stroke do not receive treatment for it. Many doctors, as well as family members, tend to explain away depression as an understandable response to the loss and impairment stroke produces.
Depression can be effectively treated whether it is the result of biochemical change in the brain or it is psychological reaction to the stroke. He stresses, ‘It is so important for family members and caregivers to make sure that survivors do not explain away their depression and deny they need treatment because is ‘understandable.’”
Treating depression not only improves the survivor’s mood, it improves their physical recovery and their cognitive or intellectual recovery as well.
The sad fact is that most MD’s rely on information from drug representatives on the prescribing of antidepressants. The results are ‘Me-To-Drugs’ that are sold to doctors as the new cure. ‘Me-To-Drugs’ are basically the same but with minor changes in the chemistry so that the drugs can be patented. The MD-Family Practice or Internist does not have the time to study all of the new drugs and they rely on the drug reps’ to inform them what is what. The drug reps do not lie but they do not tell the whole story either. The results are that most depression symptoms are misdiagnosed or they are given the wrong medicine or the wrong dosage. Even worse often they do not stay on the medicine long enough to do any good. Then the caregivers pressure the MD’s to try a new medicine, and thus the cycle start over.
Help is on the Way
The caregiver and the survivor need to understand the depression is normal following life changing events. It is better to ask for help that you do not need rather than ‘toughing it out.’
The survivor needs to be honest in his or hers thoughts and feelings
The time to seek a Psychiatrist is at the start of the event, if his thinks one does not need his services, to much the better.
Psychiatrist’s goal is to eventually not need him
Caregivers should try to recognize the signs of depression not only in the survivor but in themselves.
Dysthymia can slowly slip upon you
Ask for ask for help from friends and family
Medicare and most insurances provide respite care for the caregiver, use it
You are not alone blog for support groups
Afterword
1. You should be able to recognize the signs of Depression
2. You should be able to recognize the signs of Dysthymia
3. Have a understanding of how that Depression affects the course of treatment
4. Seek professional help sooner rather than later
5. “Depression Trumps Recovery
Reprint Permission-If this article was helpful you are invited to share it with you own list at work or church, forward it to friends and family, or post it on your blog. Just leave intact and do not alter this in way. Please include the following paragraph in your reprint.
“Reprinted with permission from D.E .Wimer, RN and Associates, Inc (copyright @ 2009 by D.E. Wimer, RN and Associates, Inc, in Florida 813-997-6564)”
About the Author-Daniel “Dan “Wimer is dedicated to helping you achieve the maximum results in your personal and professional life. He is a Registered Nurse with over 20 years of experience in Psychiatric Nursing, and Professional Life Coach, with a BA in Psychology. Dan is a Communicator and a member of the National Speaker Associates of Central Florida. Dan is a “3 Time Stroke Survivor” who specializing in motivational survival skills for business and the individuals. His blog is Daniel Wimer- Professional Life Coach.
Wednesday, March 25, 2009
Caregiver Stress
Caregiver Stress is a Real Problem!
By Daniel E. Wimer, RN - Professional Life Coach
“Tension is who you think you should be. Relaxation is who you are.” Chinese Proverb
We live longer and we have spread out across the world. In America, the nuclear family is not the norm now. There was a time that you lived in your local community, grew up, raised your family, and died there within 25 miles of your birthplace. When the age of 40 was considered old, and the century was the first half of 20th, before 1940, you took care of your own through the extended family that lived with, or near, you to help with the burdens of giving care to those in need. The Amish still live this way, but for the most part, we have moved away from our friends and family. More importantly, we lose our natural support group, our family. When we have no stress relievers, it causes a conditioned known as “burn out.” You have to lighten up the load to prevent major burnout. Many times it’s easy to overlook just how tired, frustrated or angry someone is when they are buried in the dozens of day to day tasks required of primary caregivers. Stress is an occupational given in caring for another. This report is to designed to help you spot the danger signs when you have done too much for too long and do not have enough energy to help anyone, including yourself.
To be a Caregiver is to provide financial, relational, physical, spiritual, or emotional support to someone who is unable to live independently like:
Ø newborns or small children
Ø those recovering from an injury or illness
Ø aging loved ones
Ø anyone facing a terminal illness
Ø those who are disabled in some way (physically, mentally, emotionally)
This just about covers parents and people from all walks of life and all ages. We want to you to understand the dangers of being a ‘good Samaritan’ and find out how to avoid the often overwhelming stress that can come as a being compassionate parent, adult child, or primary caregiver.
Caretakers provide a level of compassionate service in need, often for a fee or salary of some kind. Nurses, teachers, doctors, counselors, or pastors and rabbis, yet at the end of their day, it is their job and they get paid to do it. It’s important work, often tiring, but not overwhelming enough to create compassion fatigue because there are defined duties, reasonable expectations , as well a defined hours of service.
Caregivers do the same work, but often with greater intensity. They often give and give expecting nothing in return; that is often why they run out of energy and experience burnout. Caregivers do the same work as the caretakers but they work for love and/or compassion for the person in need. It can get very stressful, very fast because you cannot do everything all the time without it leading to caregiver stress. My friend, Dwight Bain, with his friend, June Hunt, has some hints for knowing that you are experiencing caregiver stress, which blocks healthy relationships.
The Caregiver Stress Checklist
In asking yourself these questions, honestly assess your feelings to determine if it could be time to seek professional help to overcome caregiver stress.
v Am I easily agitated with those I love?
v Am I becoming more critical of others?
v Am I having difficulty laughing or having fun?
v Am I turning down most invitations to be with others?
v Am I feeling depressed about my situation?
v Am I feeling hurt when my efforts are unnoticed?
v Am I resentful when other family members are not helping?
v Am I feeling trapped by all the responsibilities?
v Am I being manipulated?
v Am I missing sleep and regular exercise?
v Am I too busy for quiet time with God?
v Am I feeling guilty when I take time for myself?
Warning Signs of Caregiver Stress:
Physically - exhausted and worn out
Emotionally - resentful, stressed, and bitter
Financially - overwhelmed or depleted
Is it right to care for those in need or have compassion for those who are hurting? The answer is a resounding YES! Of course it is. Caring can help you to feel better about yourself, and rightly so. Caring is important – but there are some hidden dangers if you care too much.
“Love your neighbor as yourself.”
There is no better example of being a compassionate caregiver than the timeless story taught by Jesus about the Good Samaritan. Jesus showed that the person who really showed love for his neighbor was not the most religious, or the best educated, nor even from the same culture; rather the one who showed the greatest compassion was the only one who fulfilled the great commandment to ‘Love your neighbor as yourself.’
The point here is that the Good Samaritan is a caretaker rather a caregiver. He assembled a team of helpers. When we are a part of a team, we have more resources at hand, emotional, spiritual, time, and help. You can rest and get a break from care giving so that you have more energy to help others. If you are exhausted, you are no good to others.
Self Care comes First
Dwight Bain wrote about his experiences at Ground Zero with Chaplin Max Helton after 9/11/01 in New York City. Dwight says that he learned from him a great process in dealing with overwhelming situations:
“First, focus on ‘self-care’ then ‘buddy-care’ and finally ‘other care’. This way you can protect your own energy, help others facing the same caregiving challenges, and then together be much stronger and more focused on how to better serve others. It can be done, but it can’t be done alone. God designed us to work together in partnership with others….basically anyone could be in a situation of being a caregiver, but remember the principle do not go it alone. Let others help you.” (Emphasis mine)
Asking for help isn’t a sign of weakness-it’s a sign of being human
We as humans, tend to go it alone and hate asking for help as if it is shameful to do so. We should be fully armored against all problems. The fact is we need help and that is what friends and family do. Caregiver stress comes on gradually, it creeps up on you and sooner rather than later it eats your energy and you hope. You are not alone. There is help in your community, such as National Family Caregivers Association, your church, and neighbors.
How to prevent being so full of “care” that you can’t care for yourself
According to Dwight there are seven things you can do to help you to care for yourself:
1. Be aware of the common stress signals that come with being a caregiver
__irritability or moodiness
__feeling of resentment
__loss of sleep or feeling frequently exhausted
__increased susceptibility to colds and flu
__feeling guilty about taking time for yourself
2. Be aware of the pressure of caregiving and that it builds over time
3. Be aware that as caregiving goes up, additional coping skills should go up too
4. Be aware of your own needs and don’t be afraid to ask for help
5. Be aware of the resources around you, and be willing to take a respite
6. Be aware that sometimes you need to just sit on the floor and laugh or cry
7. Be aware that caregiving is hard work and often times you may want to quit, yet it is still one of the most loving acts of Servant Leadership
Now go and do good!
Afterword
I want to thank Dwight Bain for his support and help with this article, which contains many of his thoughts. His is the founder of www.LifeWorksGroup.org.
Reprint Permission-If this article was helpful you are invited to share it with your own list at work or church, forward it to friends and family, or post it on your own or blog. Just leave intact and do not alter this in any way. Please include the following paragraph in your reprint.
“Reprinted with permission from D.E.Wimer, RN and Associates, inc. (copyright@ 2009 by D.E.Wimer, RN and Associates, inc. in Florida 813-997-6564)”
About the Author-Daniel “Dan” Wimer is dedicated to helping you achieve the maximum results in your personal and professional life. He is a Registered Nurse with over 20 years of experience in Psychiatric Nursing, and Professional Life Coach, with a BA in Psychology. Dan is a Communicator and a member of the National Speaker Association of Central Florida. Dan is a “3 Time Stroke Survivor” who specializing in motivational survival skills for business and individuals. His blog is Daniel Wimer -Professional Life Coach.
By Daniel E. Wimer, RN - Professional Life Coach
“Tension is who you think you should be. Relaxation is who you are.” Chinese Proverb
We live longer and we have spread out across the world. In America, the nuclear family is not the norm now. There was a time that you lived in your local community, grew up, raised your family, and died there within 25 miles of your birthplace. When the age of 40 was considered old, and the century was the first half of 20th, before 1940, you took care of your own through the extended family that lived with, or near, you to help with the burdens of giving care to those in need. The Amish still live this way, but for the most part, we have moved away from our friends and family. More importantly, we lose our natural support group, our family. When we have no stress relievers, it causes a conditioned known as “burn out.” You have to lighten up the load to prevent major burnout. Many times it’s easy to overlook just how tired, frustrated or angry someone is when they are buried in the dozens of day to day tasks required of primary caregivers. Stress is an occupational given in caring for another. This report is to designed to help you spot the danger signs when you have done too much for too long and do not have enough energy to help anyone, including yourself.
To be a Caregiver is to provide financial, relational, physical, spiritual, or emotional support to someone who is unable to live independently like:
Ø newborns or small children
Ø those recovering from an injury or illness
Ø aging loved ones
Ø anyone facing a terminal illness
Ø those who are disabled in some way (physically, mentally, emotionally)
This just about covers parents and people from all walks of life and all ages. We want to you to understand the dangers of being a ‘good Samaritan’ and find out how to avoid the often overwhelming stress that can come as a being compassionate parent, adult child, or primary caregiver.
Caretakers provide a level of compassionate service in need, often for a fee or salary of some kind. Nurses, teachers, doctors, counselors, or pastors and rabbis, yet at the end of their day, it is their job and they get paid to do it. It’s important work, often tiring, but not overwhelming enough to create compassion fatigue because there are defined duties, reasonable expectations , as well a defined hours of service.
Caregivers do the same work, but often with greater intensity. They often give and give expecting nothing in return; that is often why they run out of energy and experience burnout. Caregivers do the same work as the caretakers but they work for love and/or compassion for the person in need. It can get very stressful, very fast because you cannot do everything all the time without it leading to caregiver stress. My friend, Dwight Bain, with his friend, June Hunt, has some hints for knowing that you are experiencing caregiver stress, which blocks healthy relationships.
The Caregiver Stress Checklist
In asking yourself these questions, honestly assess your feelings to determine if it could be time to seek professional help to overcome caregiver stress.
v Am I easily agitated with those I love?
v Am I becoming more critical of others?
v Am I having difficulty laughing or having fun?
v Am I turning down most invitations to be with others?
v Am I feeling depressed about my situation?
v Am I feeling hurt when my efforts are unnoticed?
v Am I resentful when other family members are not helping?
v Am I feeling trapped by all the responsibilities?
v Am I being manipulated?
v Am I missing sleep and regular exercise?
v Am I too busy for quiet time with God?
v Am I feeling guilty when I take time for myself?
Warning Signs of Caregiver Stress:
Physically - exhausted and worn out
Emotionally - resentful, stressed, and bitter
Financially - overwhelmed or depleted
Is it right to care for those in need or have compassion for those who are hurting? The answer is a resounding YES! Of course it is. Caring can help you to feel better about yourself, and rightly so. Caring is important – but there are some hidden dangers if you care too much.
“Love your neighbor as yourself.”
There is no better example of being a compassionate caregiver than the timeless story taught by Jesus about the Good Samaritan. Jesus showed that the person who really showed love for his neighbor was not the most religious, or the best educated, nor even from the same culture; rather the one who showed the greatest compassion was the only one who fulfilled the great commandment to ‘Love your neighbor as yourself.’
The point here is that the Good Samaritan is a caretaker rather a caregiver. He assembled a team of helpers. When we are a part of a team, we have more resources at hand, emotional, spiritual, time, and help. You can rest and get a break from care giving so that you have more energy to help others. If you are exhausted, you are no good to others.
Self Care comes First
Dwight Bain wrote about his experiences at Ground Zero with Chaplin Max Helton after 9/11/01 in New York City. Dwight says that he learned from him a great process in dealing with overwhelming situations:
“First, focus on ‘self-care’ then ‘buddy-care’ and finally ‘other care’. This way you can protect your own energy, help others facing the same caregiving challenges, and then together be much stronger and more focused on how to better serve others. It can be done, but it can’t be done alone. God designed us to work together in partnership with others….basically anyone could be in a situation of being a caregiver, but remember the principle do not go it alone. Let others help you.” (Emphasis mine)
Asking for help isn’t a sign of weakness-it’s a sign of being human
We as humans, tend to go it alone and hate asking for help as if it is shameful to do so. We should be fully armored against all problems. The fact is we need help and that is what friends and family do. Caregiver stress comes on gradually, it creeps up on you and sooner rather than later it eats your energy and you hope. You are not alone. There is help in your community, such as National Family Caregivers Association, your church, and neighbors.
How to prevent being so full of “care” that you can’t care for yourself
According to Dwight there are seven things you can do to help you to care for yourself:
1. Be aware of the common stress signals that come with being a caregiver
__irritability or moodiness
__feeling of resentment
__loss of sleep or feeling frequently exhausted
__increased susceptibility to colds and flu
__feeling guilty about taking time for yourself
2. Be aware of the pressure of caregiving and that it builds over time
3. Be aware that as caregiving goes up, additional coping skills should go up too
4. Be aware of your own needs and don’t be afraid to ask for help
5. Be aware of the resources around you, and be willing to take a respite
6. Be aware that sometimes you need to just sit on the floor and laugh or cry
7. Be aware that caregiving is hard work and often times you may want to quit, yet it is still one of the most loving acts of Servant Leadership
Now go and do good!
Afterword
I want to thank Dwight Bain for his support and help with this article, which contains many of his thoughts. His is the founder of www.LifeWorksGroup.org.
Reprint Permission-If this article was helpful you are invited to share it with your own list at work or church, forward it to friends and family, or post it on your own or blog. Just leave intact and do not alter this in any way. Please include the following paragraph in your reprint.
“Reprinted with permission from D.E.Wimer, RN and Associates, inc. (copyright@ 2009 by D.E.Wimer, RN and Associates, inc. in Florida 813-997-6564)”
About the Author-Daniel “Dan” Wimer is dedicated to helping you achieve the maximum results in your personal and professional life. He is a Registered Nurse with over 20 years of experience in Psychiatric Nursing, and Professional Life Coach, with a BA in Psychology. Dan is a Communicator and a member of the National Speaker Association of Central Florida. Dan is a “3 Time Stroke Survivor” who specializing in motivational survival skills for business and individuals. His blog is Daniel Wimer -Professional Life Coach.
Sunday, February 8, 2009
When Does Integrity Die?
When Does Integrity Die?
By Daniel E. Wimer, RN - Professional Life Coach
Eli Lilly & Co. will pay a combined $1.42 billion, that’s “B” as in billion (1000 million) in fines and settlements for their actions in marketing Zyprexa off label for dementia. “Off Label” is term the FDA uses when a medicine is used for some other reason than stated in the literature of the product. The CEO of Eli Lilly, John C. Lechleiter, Ph.D. is not the Chief Ethical Officer of his company, he should be, but he is not. Bernard Madoff is a self-confessed crook, of a $50 billion Ponzi scheme, lacks integrity. Arthur Nadel disappeared leaving his investors holding worthless paper investments of $350 million. He was not the Chief Ethical Officer at Scoop Management, his company. Congressman Barnny Frank is allegedly pressured FANNIE MAE, FEDDY MAC, other banking, and mortage companies to make home loans to unqualified borrowers for political reasons. He is not a Chief Ethical Officer for the House of Representative’s Banking Committee, which he heads. One could go on seemingly forever in a in a never-ending list of public figures that have betrayed their trust.
When does our integrity die?
James E. Lukuaszerewski in a speech; “Avoiding Integrity” found in VITAL SPEECES of the day, (May 2007) 197-200. He states, rightly so, “… integrity as the inherent tendency in individuals and organizations to the right thing at every opportunity when with choice, options, or dilemmas.” He goes on, “Integrity is the oxygen that drives the ethics process. So long as people have to behave differently at work that they do at home . . . I call them ‘Insidious Unethical Behaviors’ can present and operating within an organization.” He calls the CEO the Chief Integrity Officer. I use Chief Ethical Officer but the meanings are the same.
Dr. Ronald W. Clement, of Pittsburgh State U. states;”...unethical behavior starts from top down.” The results of unethical decisions are, ultimately, the executives’ responsibility. Everyone has ethics good, bad, or indifferent, but how we apply our ethics to life makes us the people we are! In the 1987, film Wall Street by director Oliver Stone the character Gordon Gekko, portrayed by Michael Douglas, spoke the now famous line “Greed, for lack of a word, is good.” (Wikipedia 2009). Twenty years have not kind to Wall Street yet greed still lives in comfort for a few. What would Gekko say to the today’s Wall Streeter? “Do not get caught!” maybe.
Integrity cannot be sold or bought, the moment give in to sin you lose your right to be called an honest man.
“Better is a little income with righteousness than great wealth with injustice.” Proverbs 16:8.
“Reprinted with permission from D.E.Wimer, RN and Associates, inc. (copyright@ 2009 by D.E.Wimer, RN and Associates, inc. in Florida 813-997-6564)”About the Author-Daniel “Dan” Wimer is dedicated to helping you achieve the maximum results in your personal and professional life. He is a Registered Nurse with over 20 years of experience in Psychiatric Nursing, and Professional Life Coach, with a BA in Psychology. Dan is a Communicator and a member of the National Speaker Association of Central Florida. Dan is a “3 Time Stroke Survivor” who specializing in motivational survival skills for business and individuals. His blog is Daniel Wimer -Professional Life Coach.
By Daniel E. Wimer, RN - Professional Life Coach
Eli Lilly & Co. will pay a combined $1.42 billion, that’s “B” as in billion (1000 million) in fines and settlements for their actions in marketing Zyprexa off label for dementia. “Off Label” is term the FDA uses when a medicine is used for some other reason than stated in the literature of the product. The CEO of Eli Lilly, John C. Lechleiter, Ph.D. is not the Chief Ethical Officer of his company, he should be, but he is not. Bernard Madoff is a self-confessed crook, of a $50 billion Ponzi scheme, lacks integrity. Arthur Nadel disappeared leaving his investors holding worthless paper investments of $350 million. He was not the Chief Ethical Officer at Scoop Management, his company. Congressman Barnny Frank is allegedly pressured FANNIE MAE, FEDDY MAC, other banking, and mortage companies to make home loans to unqualified borrowers for political reasons. He is not a Chief Ethical Officer for the House of Representative’s Banking Committee, which he heads. One could go on seemingly forever in a in a never-ending list of public figures that have betrayed their trust.
When does our integrity die?
James E. Lukuaszerewski in a speech; “Avoiding Integrity” found in VITAL SPEECES of the day, (May 2007) 197-200. He states, rightly so, “… integrity as the inherent tendency in individuals and organizations to the right thing at every opportunity when with choice, options, or dilemmas.” He goes on, “Integrity is the oxygen that drives the ethics process. So long as people have to behave differently at work that they do at home . . . I call them ‘Insidious Unethical Behaviors’ can present and operating within an organization.” He calls the CEO the Chief Integrity Officer. I use Chief Ethical Officer but the meanings are the same.
Dr. Ronald W. Clement, of Pittsburgh State U. states;”...unethical behavior starts from top down.” The results of unethical decisions are, ultimately, the executives’ responsibility. Everyone has ethics good, bad, or indifferent, but how we apply our ethics to life makes us the people we are! In the 1987, film Wall Street by director Oliver Stone the character Gordon Gekko, portrayed by Michael Douglas, spoke the now famous line “Greed, for lack of a word, is good.” (Wikipedia 2009). Twenty years have not kind to Wall Street yet greed still lives in comfort for a few. What would Gekko say to the today’s Wall Streeter? “Do not get caught!” maybe.
Integrity cannot be sold or bought, the moment give in to sin you lose your right to be called an honest man.
“Better is a little income with righteousness than great wealth with injustice.” Proverbs 16:8.
“Reprinted with permission from D.E.Wimer, RN and Associates, inc. (copyright@ 2009 by D.E.Wimer, RN and Associates, inc. in Florida 813-997-6564)”About the Author-Daniel “Dan” Wimer is dedicated to helping you achieve the maximum results in your personal and professional life. He is a Registered Nurse with over 20 years of experience in Psychiatric Nursing, and Professional Life Coach, with a BA in Psychology. Dan is a Communicator and a member of the National Speaker Association of Central Florida. Dan is a “3 Time Stroke Survivor” who specializing in motivational survival skills for business and individuals. His blog is Daniel Wimer -Professional Life Coach.
Friday, January 9, 2009
A Old Fart's View about His Strokes!
Three Problems I had as a Stroke Victim as a Nurse.
Are we looking at the stroke patient as human?
Daniel E. Wimer, RN, BA, & Life Coach
Persistence meris a virtue that tries men souls!
Overview:
The Healthcare business is a business but we as nurses somtimes forget the patients's needs.
Participants will be able define the type of strokes and recognize the symptoms of Silent, Ischemic, and Hemorrhagic strokes.
Participants will be able to distinguish between Aphasia and Apraxia.
Participants will be able understand the inability to communicate strikes fear in the stroke victims heart.
The American Stroke Association (ASA) data show that approximately 700,000 people in the US have stokes every year; 500,000 are first attacks and 200,000 are recurrent attacks. These stats are personal since I have had three strokes, the last one in September of 2006.
Silent strokes. My first stroke was a silent type, similar to a silent heart attack. The doctors found evidence of a first stroke on a CAT scan after following my second stroke. For obvious reasons silent strokes are only detected after they have happen.
Ischemic Strokes. Within three days of my second and third stroke, 80% of my symptoms went away. Not all strokes are ischemic, about 80% are, and not all of them resolve as quickly as mine did. The source of the stroke is often a blood clot traveling to the brain from elsewhere in the body. This type of stroke the blood flow is block or greatly reduced, in the brain, or the vessel goes into spasms.
Hemorrhagic Strokes are less common but more deadly than an ischemic stroke according to the ASA. When a blood vessel bursts in the brain, the effect is usually catastrophic, resulting in a quick death.
1. We are not doing “good’.
The lost of communication was frustrating when I had my strokes. Strokes leave your mind intact but your body does not want to work. MOST males do not like the impersonal “WE.” “How are we doing tonight?”I am doing lousy and I hate the world how about you, says he?” “Besides which, I cannot talk, you idiot” or thoughts to that effect. The use of the impersonal “WE” is so pervasive in the helping professions. I fear that the PC Police will force us to continue use “we”. The use of “we” is offensive because you are not asking how I feel. It has become a barrier to commutation. You are talking at me, about me, but you really do not care about my answer.
Two of the most common problems of stroke victims are Aphasia and Apraxia.
Aphasia is the partial or total loss of the ability to articulate ideas or compare spoken or written language, resulting from injury or disease.
Apraxia is the inability to perform learned movements on comma, it is understood and there is willingness to perform the movement. Both the desire and the capacity to move are present but the person simply cannot execute the act. The client fells trapped.
The hospital where I was taken after my third stroke had a stroke unit but I had recovered very quickly so they placed me on a Cardiac floor for heart monitoring. The nurses kept asking me about my chest pain level. They had apparently never read my chart and did not know that I was there as stroke patient. I had a commutation problem mine was aphasia what was thier exuse? Two days later I was able to let them know my diagnosis since I had somewhat regained my ability to talk.
Lesson 1: Stroke patients normally hear everything but cannot act on their needs. Plain writing pads works best or “Yes or No” type questions are best. Pay attention to the patient chart. A real problem for the stroke patient is that they feel helpless; they fear that no one will know when they need help. Checking on them hourly is very important to them and eases their fear.
2. Do not choke your patient before it is His Time to Go!
We all have had patients that we would kill if the opportunity came up. We are in the helping profession after all. I have had three major strokes and multiple focal seizures. My last stoke was in September of 2006 but I want to deal with my second stroke in AUG 2005. I had this stroke in my bathroom. I could stand but not walk. My wife put me in a chair with wheels and we waited for EMS. EMS had to carry me down the hall, down three steps to place me on the gurney. I weighed, at that time, around 300 lbs. Meanwhile, I was steadily going downhill, I could not talk or move myself. In the process of getting out the chair my head fell to my chest. I had lost all control of my neck muscles. The EMTs stopped to access their situation but not my status.
Meanwhile, I was running out of air, and I could not tell them, or anyone else for that matter. The need for air is bothersome, to say the least. The hour (an hour to me at least) that it took to carry me down the stairs was filled with increasing terror on my part. I started to have tunnel vision, a sign of hypoxia. By now, I really wanted air, Really, REALLY, WANTED LOTS OF AIR. Finally, the EMTs placed me on the gurney. They lowered my head and my head flopped up to back to normal position. Suddenly, I felt better; I had no more tunnel vision and I felt the air going into my lungs.
Lesson 2: A soft Cervical Collar will stabilize the neck in case the stroke victim loses their neck muscle control. The collar is a quick, efficient, and cheap way to help the victim regain his cool.
3. Men are not like women!
Lately, a local clinic, nearby, instigated a new policy that staff will not use terms like “Honey,” or the horrible appellation “Sugar.” I can guarantee that a female VP wrote the memo. Not surprising 95% of nurses are women; therefore; they view actions as needing action plans, in which most men see as no problem. They do not treat men as men. I, as a patient, with or without a stroke, felt more at ease with the friendly “Honey.” Women, however, especially those in power, take offense over the perceived slight and are more rigid in their relationships. Men are not like women. (Nurses should read. “Men are from Mars and Women are from Venus.” by John Gray, Ph.D.).I, as a man, want to know the facts, when he can get out and go back work. I could less about you calling me Mr. Wimer. I do like a homey atmosphere; friendly is the key. Men need a different approach
By the way, when you leave my room do not say to me,” Have a good one!” Do you mean, “Have a good day, a good stroke, or a good BM?” I have been a RN for over 20 years and still this saying grates on my ears.
Lesson 3: In the search for PC equality, the mangers, they have taken the patient’s individuality and destroyed it, even shredded it. They have turned to being mangers not Leaders. ROne of the surest ways is to retain their name; my name is Dan not Mr. Wimer. By necessity, a hospital is not home but the stroke patient needs to feel at home as much as possible. Friendly staff with a few ‘Honeys’ thrown in helps their stay be ‘user friendly’.
After View: What have you learned?
The air we breathe is better when one is not choking. Using a soft cervical collar is a handy device to stabilize a patient. When you are transferring a person, double-check his airway for air going in and out.
Stroke patients’ communication problem is called Aphasia. The pervasive “WE” is impersonal. Pay attention to the patient chart, read at least the diagnoses. Stroke patients feel very alone, helpless and afraid. Check on them more frequently.
Again, I say Men are not like Women. The fear of lawsuits has made hospitals less friendly. We can put back humanness in our dealing with others.
Bonus Tip: Humor is a very, very helpful for the stroke patient, for that matter anyone is helped by humor. On the second day of my third stroke, I showed my neurologist a new skill that I had learned which I was able to pick my nose with my left hand and we laughed. My wife was appalled by the comment but my doctor understood my point. You have a choice in life and I choose to face my problem with humor. Laughing about yourself makes you less depressed and willing to take on the hard task of rehabilitation.
NOTE: you can freely redistribute this helpful resource, electronically or in print, provided you leave the authors contact information intact in the box below.
About the Author: Daniel Wimer is a Life Coach, RN, public speaker. He is the Chief Ethical Officer of D.E.WIMER, RN and Associates, Inc, and partners with individuals, corporations and organizations to help them change strategically change to experience success. To access more complimentary coaching resources contact us at www.DanielWimerLifeCoach.com
Are we looking at the stroke patient as human?
Daniel E. Wimer, RN, BA, & Life Coach
Persistence meris a virtue that tries men souls!
Overview:
The Healthcare business is a business but we as nurses somtimes forget the patients's needs.
Participants will be able define the type of strokes and recognize the symptoms of Silent, Ischemic, and Hemorrhagic strokes.
Participants will be able to distinguish between Aphasia and Apraxia.
Participants will be able understand the inability to communicate strikes fear in the stroke victims heart.
The American Stroke Association (ASA) data show that approximately 700,000 people in the US have stokes every year; 500,000 are first attacks and 200,000 are recurrent attacks. These stats are personal since I have had three strokes, the last one in September of 2006.
Silent strokes. My first stroke was a silent type, similar to a silent heart attack. The doctors found evidence of a first stroke on a CAT scan after following my second stroke. For obvious reasons silent strokes are only detected after they have happen.
Ischemic Strokes. Within three days of my second and third stroke, 80% of my symptoms went away. Not all strokes are ischemic, about 80% are, and not all of them resolve as quickly as mine did. The source of the stroke is often a blood clot traveling to the brain from elsewhere in the body. This type of stroke the blood flow is block or greatly reduced, in the brain, or the vessel goes into spasms.
Hemorrhagic Strokes are less common but more deadly than an ischemic stroke according to the ASA. When a blood vessel bursts in the brain, the effect is usually catastrophic, resulting in a quick death.
1. We are not doing “good’.
The lost of communication was frustrating when I had my strokes. Strokes leave your mind intact but your body does not want to work. MOST males do not like the impersonal “WE.” “How are we doing tonight?”I am doing lousy and I hate the world how about you, says he?” “Besides which, I cannot talk, you idiot” or thoughts to that effect. The use of the impersonal “WE” is so pervasive in the helping professions. I fear that the PC Police will force us to continue use “we”. The use of “we” is offensive because you are not asking how I feel. It has become a barrier to commutation. You are talking at me, about me, but you really do not care about my answer.
Two of the most common problems of stroke victims are Aphasia and Apraxia.
Aphasia is the partial or total loss of the ability to articulate ideas or compare spoken or written language, resulting from injury or disease.
Apraxia is the inability to perform learned movements on comma, it is understood and there is willingness to perform the movement. Both the desire and the capacity to move are present but the person simply cannot execute the act. The client fells trapped.
The hospital where I was taken after my third stroke had a stroke unit but I had recovered very quickly so they placed me on a Cardiac floor for heart monitoring. The nurses kept asking me about my chest pain level. They had apparently never read my chart and did not know that I was there as stroke patient. I had a commutation problem mine was aphasia what was thier exuse? Two days later I was able to let them know my diagnosis since I had somewhat regained my ability to talk.
Lesson 1: Stroke patients normally hear everything but cannot act on their needs. Plain writing pads works best or “Yes or No” type questions are best. Pay attention to the patient chart. A real problem for the stroke patient is that they feel helpless; they fear that no one will know when they need help. Checking on them hourly is very important to them and eases their fear.
2. Do not choke your patient before it is His Time to Go!
We all have had patients that we would kill if the opportunity came up. We are in the helping profession after all. I have had three major strokes and multiple focal seizures. My last stoke was in September of 2006 but I want to deal with my second stroke in AUG 2005. I had this stroke in my bathroom. I could stand but not walk. My wife put me in a chair with wheels and we waited for EMS. EMS had to carry me down the hall, down three steps to place me on the gurney. I weighed, at that time, around 300 lbs. Meanwhile, I was steadily going downhill, I could not talk or move myself. In the process of getting out the chair my head fell to my chest. I had lost all control of my neck muscles. The EMTs stopped to access their situation but not my status.
Meanwhile, I was running out of air, and I could not tell them, or anyone else for that matter. The need for air is bothersome, to say the least. The hour (an hour to me at least) that it took to carry me down the stairs was filled with increasing terror on my part. I started to have tunnel vision, a sign of hypoxia. By now, I really wanted air, Really, REALLY, WANTED LOTS OF AIR. Finally, the EMTs placed me on the gurney. They lowered my head and my head flopped up to back to normal position. Suddenly, I felt better; I had no more tunnel vision and I felt the air going into my lungs.
Lesson 2: A soft Cervical Collar will stabilize the neck in case the stroke victim loses their neck muscle control. The collar is a quick, efficient, and cheap way to help the victim regain his cool.
3. Men are not like women!
Lately, a local clinic, nearby, instigated a new policy that staff will not use terms like “Honey,” or the horrible appellation “Sugar.” I can guarantee that a female VP wrote the memo. Not surprising 95% of nurses are women; therefore; they view actions as needing action plans, in which most men see as no problem. They do not treat men as men. I, as a patient, with or without a stroke, felt more at ease with the friendly “Honey.” Women, however, especially those in power, take offense over the perceived slight and are more rigid in their relationships. Men are not like women. (Nurses should read. “Men are from Mars and Women are from Venus.” by John Gray, Ph.D.).I, as a man, want to know the facts, when he can get out and go back work. I could less about you calling me Mr. Wimer. I do like a homey atmosphere; friendly is the key. Men need a different approach
By the way, when you leave my room do not say to me,” Have a good one!” Do you mean, “Have a good day, a good stroke, or a good BM?” I have been a RN for over 20 years and still this saying grates on my ears.
Lesson 3: In the search for PC equality, the mangers, they have taken the patient’s individuality and destroyed it, even shredded it. They have turned to being mangers not Leaders. ROne of the surest ways is to retain their name; my name is Dan not Mr. Wimer. By necessity, a hospital is not home but the stroke patient needs to feel at home as much as possible. Friendly staff with a few ‘Honeys’ thrown in helps their stay be ‘user friendly’.
After View: What have you learned?
The air we breathe is better when one is not choking. Using a soft cervical collar is a handy device to stabilize a patient. When you are transferring a person, double-check his airway for air going in and out.
Stroke patients’ communication problem is called Aphasia. The pervasive “WE” is impersonal. Pay attention to the patient chart, read at least the diagnoses. Stroke patients feel very alone, helpless and afraid. Check on them more frequently.
Again, I say Men are not like Women. The fear of lawsuits has made hospitals less friendly. We can put back humanness in our dealing with others.
Bonus Tip: Humor is a very, very helpful for the stroke patient, for that matter anyone is helped by humor. On the second day of my third stroke, I showed my neurologist a new skill that I had learned which I was able to pick my nose with my left hand and we laughed. My wife was appalled by the comment but my doctor understood my point. You have a choice in life and I choose to face my problem with humor. Laughing about yourself makes you less depressed and willing to take on the hard task of rehabilitation.
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About the Author: Daniel Wimer is a Life Coach, RN, public speaker. He is the Chief Ethical Officer of D.E.WIMER, RN and Associates, Inc, and partners with individuals, corporations and organizations to help them change strategically change to experience success. To access more complimentary coaching resources contact us at www.DanielWimerLifeCoach.com
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