Atul Gawande and Palliative Care

k13613741      As I have been reading Atul Gawande’s  new book Being Mortal, I am fascinated by the fact that it has taken this surgeon so long to discover the realities of the human condition, the fact that aging and death really isn’t optional and that there should be a better way. (Reading Gawande, I am reminded of esteemed physician Arnold Relman’s semi-deathbed realization that nurses are actually important to patient care and that physicians rarely talk to their patients, see my blogpost on this). Even though his discussion of the palliative care/hospice option may prove to help Americans understand that there is an alternative to the torturous American way of death, there is a serious problem with a model of medical philosophizing.   These reflection rely far too much on personal experience and not enough on the ability of physicians to reflect on the scientific facts (that so many of the treatments MDs recommend are, in fact, futile) or on a close observation of their patient’s experience (which would clearly highlight the torturous nature of so many modern medical treatments).

Listen to our first HIIPcast

We would like to welcome you to the first of what we hope will be many HIIPcasts. Our team is committed to using podcasts to get the word out about exciting innovations and concepts that will allow people to embrace, practice, and promote healthcare safety and quality. Think of this as a kind of patient safety radio whose goal is to play it forward. Our first podcast is a conversation between HIIP founding team members Suzanne Gordon and John Chuo. Please check out our website to learn more about both of us.

In the coming months we will record conversations that explore critical healthcare issues and inform you about new books, articles, and other forms of media which advance quality care and safety. The goal here is to highlight initiatives, people or projects that can transform the way we think about, deliver, and receive healthcare services. We invite you to click, listen, and pass it on and to send us any suggestions you might have for interesting subjects, people, or projects.

Another Story on Nurses’ Injuries by NPR’s Daniel Zwerdling

imagesOnce again, the issue of nurses’ injuries is the focus on Daniel Zwerdling’s second installment of a series on the injuries of nurses and other hospital staff.  This story focuses on the myth of proper lifting techniques.  For years, those looking into the proper body mechanics during lifting have documented that there is no safe way to lift a heavy patient safely without proper equipment.  Studies show that you can’t lift a trim adult safety.  Nurses and nursing assistants today are asked to deal with a population that is 70% overweight — many weighing 300 pounds or more.  Yet nursing schools, perhaps in an inadvertent but nonetheless dangerous alignment with hospitals, teach nurses that you can lift patients with “proper body mechanics” or  “proper alignment.”  William Marras at The Spine Research Institute at the University of Ohio has challenged this myth in years of research.  People have to listen to this series.  Particularly those who teach nurses and employ them.  It is not only financially nuts to turn nurses into patients as they take care of patients.  It’s also morally unacceptable.  Nursing schools have got to get on the … Continue reading

Injured Nurses Story on NPR

imagesEveryone should check out the new series on NPR by Daniel Zwerdling on Injured nurses.  It’s running all month.  I have the honor of helping Danny on this series.  He spent months and months delving into this very serious problem and has produced a great series.  His first section focuses on Kaiser and its failure to act to protect nurses.  Lift equipment should be a non-negotiable in every hospital.  Patients are getting heavier and heavier and nurses are now being asked to lift patients who weight hundreds of pounds.  Remember it’s not safe to lift even fifty pounds without help.  I was once in a hospital that put out a call asking nurses to lift an 800 pound man.  We never see people that obese walking down the street, but they are patients in our nation’s hospitals.

As Zwerdling points out:

“According to surveys by the Department of Labor’s Bureau of Labor Statistics (BLS), there are more than 35,000 back and other injuries among nursing employees every year, severe enough that they have to miss work. Nursing assistants and orderlies each suffer roughly three times the rate of back and other … Continue reading

The Thickened Liquid Challenge

I just posted this on the wonderful GeriPal Blog.

GeriPal - Geriatrics and Palliative Care BlogWednesday, February 4, 2015

The Meaning of the Challenge: It’s about More Than Thickened Liquids

by: Suzanne Gordon

The other day, with much trepidation, I took the Thickened Liquid Challenge. As a well known wimp, I only did the one shot version. And believe me that was enough. I could barely get it down. I can’t imagine what it would have been like to attempt to drink glass after glass hour after hour. In fact, I did the challenge in Eric Widera’s office and when he made me my first dose it was so thick that it wouldn’t even pour into my mouth. Thusly showing that there is more to a challenge than meets at least these two pair of eyes and two pretty sharp brains. Imagine an elderly person or their caregiver trying to mix up this potion on their own and trying to get it to be just the right consistency. And then imagine drinking it.

I took this challenge not as a provider … Continue reading