Wednesday, November 14, 2012

Who's In Charge of Teaching Me?

How we learn & who gets to teach....! Here's my Aunt Anna teaching us how to carve a roast., we are in the middle of a snow storm. I'm looking out the window & thinking cold thoughts, happy that the election was yesterday & not today. My eBooks, etc. are linked in the left column. New books will be available soon....the thoughtWARE Series is on my desk. I think you will like these. They will also come with "apps" you can carry your thoughtWARE in your pocket! I'm also busy catching up on writing deadlines, etc....most of which I set for myself as I am an independent writer & publisher. But...we all need "self-discipline, systems & rules." If not, we go nowhere. And so... I'm still in involved with the National Health Blog Post Month, known as NHBPM. Sounds right to me. Here's the challenge for today.... CHALLENGE - REDESIGN A DOTOR'S OFFICE OH....OK. When I read this subject I thought, "Oh, I don't have much interest in this, but then after thinking about it, I realized that I had quite a bit of interest. Here's why... When I left my work in the hospital & my department of staff development, I opened my own private practice. At the same time I began my first website...this was several decades ago. I had very specific ideas. My son was in charge of building the website as I had no idea about computers, etc. I remember the first time I went online...very scary. I told him that I wanted to build an "educational center online." His response..." don't know anything." Well, maybe I don't, but then again, maybe I do. I certainly know what patients need. In short, he followed what I told him & the rest is history. When I left the hospital things were changing dramatically. Patients no longer spent weeks getting better. They were simply "in & out." Many hospitalizations were done as out-patient procedures, leaving little or no time for nurses to do their job, which to my mind was & still is "healing, health & prevention teaching." One barely had time to speak to the patient. Everything was about admission papers & then discharge. At the very most, we gave patients a discharge plan which was less than basic. Nothing was designed specifically "for the particular patient." When I opened my private practice I took great pride in a very detailed admission interview. My appointments were one hour, but the admission appointment was 1.5 & sometimes 2 hours. I always left the time open...just in case. Some interviews took longer than others depending on the complexity of the problems. Yes, some were simply for smoking cessation, but let me share this. There is no such thing as "simply" in any medical issue. If I was going to help a patient stop smoking, then I had to go "underneath" the addiction to the root causes & this needed to be exposed in the opening interview. The same with eating issues & weight loss. The body was storing fat for some particular reason & so my job was to uncover those particulars. If the patient came for poor concentration or pain management or lack of confidence....I needed to go underneath the presenting symptoms & locate the probable cause or causes. So...back to the design of a doctor's office...for this is the challenge. Each doctor needs a properly trained "intake nurse." She or he doesn't take the place of the papers one fills in when seeing the doctor for the first time. It is the job of the intake nurse to do the "all important" interview. This includes personal & family medical history, nutritional history, addictions history, behaviors & habits, stress-indicators & how the patient currently manages his or her life issues. This includes relationships with significant others, children, extended family, work, social issues, etc. The job of the nurse is to do a thorough examination of the patient ( clothes on ). It's a talking interview...the most important kind. The nurse will uncover diet history, eating habits, strengths, weaknesses & anything else the patient gives forth....& the patient will do this in the proper environment. Then, the nurses job is to organize this information for the doctor & make out a provisional nursing care plan for that patient. This will include needed education, community resources & anything else that will assist in managing the patient's total care. Then, the doctor does the medical issues. The idea that a patient goes to the doctor "only with medical issues" is extremely outdated. For example, a doctor is not going to manage a patient's cholesterol level just with medication. The doctor will not manage IBS just with a colonoscopy & medication. If patients are to get well & if we are going to cut back on the expense of patient care, then we need nurses who are trained to do this work or assessment.....& the idea that nurses' aren't available for this is ridiculous. This is what all nurses did or do when patients are admitted to the hospital....or at least they did when time allowed for proper care. I would also like to see nurses provide patients with the information or tools that they need to learn to take care of themselves & family. This would include written information, CD's, webinars & classes made available in the doctor's office. I have talked to MD's about this with always the same money, no insurance coverage, no time, etc. I never accept the NO ANSWER. I believe there is an answer & to state this more strongly, THERE MUST BE AN ANSWER. Doctors purchase new furniture, computer systems, TV's, etc. for their offices. So, this is my addition to what is truly needed. I don't just "think" this, I know it from my own experience. If I could do it in my humble office & online on my "educational websites", then I can't take NO for an answer when my salary was not anywhere near those of the MD's I've met along the way. For those who are new to my writing, I'm in the middle of this monthly blog experiment. I invite you to my Team...Sugar & Food Addiction. We are all about getting to the bottom of eating issues & changing outcomes permanently. Please join us.

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