News

Powerful films from 5 young people: What health inequality looks like in the US

This was definitely worth watching and should be shown to youth today. Many youth live in nice, safe communities and neighborhoods while others do not.
Such powerful films as these should be shown to politicians, leaders and those in power to force them to see that youth wants change for themselves and for future generations…..

TED Blog

By Michael Painter. 

For some of us, it’s easy to choose to be healthy. We can’t control whether disease or accidents strike, but we can decide where we live and what we eat, as well as if, when and how much we’ll exercise. Some of us live in a culture of health — a time and place where, for the most part, we have the real hope and opportunity to live a healthy life.

But for many more of us, it isn’t — we don’t have that choice. We live in unsafe neighborhoods. We don’t have strong families to help us through life’s challenges. We can’t readily get nutritious food. We don’t have easy ways to exercise. It’s difficult — or even impossible — to keep our children safe.

The Robert Wood Johnson Foundation was at TED2015 in Vancouver last week, where the theme was Truth & Dare. And we took…

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News

Mom’s Last Days – Tweeting Mom’s Goodbye – NYTimes.com

“During that week, my world shrank to the confines of my mother’s hospital room. But that world was not confining. As my mother’s life wound down, she felt an urgency to pass on memories and insights with the honed perspective of someone who had seen a lot of life, and had now begun to see through whatever door opens to whatever is next. My mother showed us how to bow out of this life, which is something all of us would be blessed to live to do.

I suppose I could have kept all this to myself. But there’s a reason I went into broadcasting, not espionage. I am grateful when I can pass on something to others. Tweeting let me do that as we lived through it.”
Sharing the experience whether with one person, a few or many is helpful. Death and the grief that goes along with it are not easy…..
“Life-changing experiences can move us to pass along what we believe we’ve learned. We want to shout about a birth into the heavens. We want to place the face of someone we’ve lost in the stars. We want people to know.”

Loss, Grief, Bereavement and Life Transitions Resource Library

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News

Shared via Sacred Dying – Meet the women who believe the final moments of our lives are the most important (From Daily Echo)

When we see it this way-that in order to give life, to give birth….eventually death will happen; it normalizes it!
To be pregnant is wonderful, to feel the baby kick and move around inside you and then the moment comes where he or she enters the world!
Babies bring so much joy to so many and require a lot of care and nurturing…
But, when you think about it, when a person is dying-although it is sad, terrifying for some….difficult. The dying person still requires care and nurturing.

“In ancient days, the midwife of birth also served as a midwife of death. Today, there are a handful of American women trained to offer comfort in both dying and birthing. Though few in number, I draw strength from my sister doulas of birth and death. So much of my doula training deeply reflects the skills needed to support the dying.”

Loss, Grief, Bereavement and Life Transitions Resource Library

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Healthcare

The Intimacy Gap

I used to think that there was a communication gulf between doctors and patients. Somewhere in the hub-bub of of the harried office visit some secret sauce was missing. A divide that was so fundamental that both parties often left the room feeling disjointed and uneasy. Patients wondered if doctors truly heard them. Physicians wondered if any one was listening to what they were saying. The tension ebbed and flowed, but never disappeared. This has been the state of health care over the last decade. This has been the environment in which I have built my clinical career.

I now believe that the term “communication” is imperfect and lacks the specificity that I am looking for. I think what we truly have is an intimacy gap. What separates doctors and patients is a disjointed and unnatural version of intimacy that in no way mirrors the important bonds that we form in real life non-medical relationships.

Let me explain.

A patient walks into the exam room and unloads the most intimate, embarrassing, and frightening secrets to their doctor. Unlike close friends or loved ones, the physician has in no way earned this privilege. They had not gained this right through hours of conversation, years of support, or acts of selflessness. There is no shared struggle or trust. It is given too freely.

The doctor listens patiently and kindheartedly. But the interaction can only be so rewarding. There is no mutual disclosure of secrets. No bidirectional sharing of intimacy. The physician remains stone faced, objectively detached. This is what we learned in training.

The practitioner, conversely, is bombarded day in and day out with urgent and emergent situations. There often is no normal period to engage and form stronger bonds. They are shuttled from exam room to exam room trying to put out fires without any of the nicety of experiencing their patients during non turbulent times.

When disaster hits, physicians become immersed in someone else’s pain and tragedy. But when they die, or get better, or move away, we are plucked out of their lives and rarely are present for any sense of closure. By then we have moved on to the next case, the next emergency.

Disjointed, unnatural intimacy.

I don’t know how to solve this problem.

For my part, I have decided the only solution is to strive for mutual disclosure. Maybe we, as physicians, can tell our stories.

We can tell our stories to those we care for,

so that they may also care for us.

By Dr. Jordan Grumet, Internal Medicine

*Re-posted with permission

Original can be found at: http://jordan-inmyhumbleopinion.blogspot.ca/2015/03/the-intimacy-gap.html

ICU

Accompanying the Family

Hola a tod@s, my dear friends.


From Asociación Humanizar of Hospital San Juan de Alicante, we have been informed about the following workshop on 25 March:

One of the projects of this volunteer is the accompaniment and listening to/with the relatives of the patients admitted to the ICU: welcome them and accompanied by giving them some instructions and helping them to wear coveralls when a patient requires contact or respiratory isolation.

They wait with the families during the visit and are responsible for give comfort and even embrace people who need it.

For more information about this workshop, click here (only available in Spanish).

Excellent initiative that goes in harmony with the concept redesign your waiting room pointed by Isidro Manrique (@uciero) which is already been presented in our talks

What about you? How would you improve this space and handling it in a more useful area?

Share it with us, we want to hear you!

By Dr. Gabi Heras, ICU Physician
*Re-posted with permission
Original can be found at: http://www.humanizingintensivecare.com/2015/03/accompanying-family.html
Healthcare, Humanity

The Human Factor at Emergency Department

Hola a tod@s, my dear friends.

Something is changing in the hospital, specially at Emergency Department of the Hospital Universitario San Juan de Alicante. Montserrat Soler, auxiliary nurse, has edited “The Human Factor at Emergency Department,” a guide to humanize care of patients and families in this area of the hospital.

In her own words, “Humanize care requires interaction between the knowledge of Science and Human values to establish a quality assistance.”


“Since many years I have been working in the care of patients in the Emergency Room and I have learned many things, but the most important is the great role that we have to do in a human level in critical situations where already nothing technical can be done,” explains Montserrat Soler. A quote from Doctor Marañón, “Only with dignity we can be physicians (nurses, assistants or healthcare providers) with the idea stuck in the heart that we work with imperfect tools and media of uncertain utility, but with the awareness that where Knowledge can not reach, always gets Love.”

The guide presents strategies to promote the humanization of the intervention of nursing in each one of the different steps comprising the process of care in the Emergency Department.

Also, the guide talks about the importance of the first contact with the patient (greeting with kindness, asking the name, listening carefully the reason for consultation, demonstrating interest in helping it, explaining the procedure to be followed, and the likely waiting time for medical care); on respect and privacy during the stay in the service; what is the relevant information to patient and family and emphasizes the use of a language adapted to the receiver.

It also discusses some environmental factors, that can help to rest and tranquility: change of sheets, the position, temperature, or the facilitation of the night’s rest.


The Guide also covers the information and explanations to discharge, or the handling of acute resuscitation situations.

For the moment, the publication is available for members of the Emergency Department and also will be available to the rest of the staff of the Department. The IC-HU Project will contact with Montserrat to try to broadcast from this platform, because we consider this is an excellent project of general interest.

Congratulations and thank you!

By Dr. Gabi Heras, ICU Physician
*Re-posted with permission
Original can be found at: http://www.humanizingintensivecare.com/2015/03/the-human-factor-at-emergency-department.html
Healthcare

My First Lesson in Humility

I remember being more confident that most of my peers. The look of dread on my fellow interns face pre-call, and the fatigue post-call always seemed unnatural to me. Maybe it was on account of my life-long pursuit of medicine. I felt nothing but elation at the newly branded “M” and “D” that came after my name on the hospital badge. I was no longer a volunteer, no longer a student. I was a doctor. And part of that persona was walking into the unknown with a certain amount of confidence. This was exactly where I was meant to be.

A few months into internship, I admitted an obese lady with a skin infection on her thigh. I started the appropriate antibiotics and waited. My resident noting the appearance of the skin asked me to order an X-ray. I placed the order but secretly was befuddled. Why order an X-ray? What on earth was that going to show?

I was on call and busied myself with the drudgery of being the low man on the totem pole. I admitted  5 new patients. I drew blood. I did paperwork. I spent hours in front of the computer screen looking up labs and filling out charts. I forgot one thing though.

Maybe it was because I didn’t understand my resident’s clinical reasoning. Maybe somewhere in the recesses of my mind I had written the order off as something superfluous or unnecessary. To this day, I can’t explain why I failed to follow up on the X-ray of the thigh and retrieve the results. Some things may remain unexplained.

The next morning my resident and I breathlessly ran to the patient’s room at her nurses prompting. Her blood pressure was dangerously low and her temperature was sky high. My resident looked at me in a panic and inquired about the X-ray. After we stabilized the patient, we ran down the stairs to radiology and glanced at the films. Our worst fears were confirmed upon staring up at the light box: subcutaneous gas.

The patient had necrotizing fasciitis (a severe form of skin infection) and needed immediate surgery to remove as much of the infected tissue as possible. She would likely lose her limb and possibly more.

Years later, I can’t help but wonder how much better she would have done if I had seen the film the night before, and surgery had been called immediately. The patient survived either way, but by a hair.

And I learned an important lesson that night in humility. A lesson I would be taught over and over again as I journeyed through medical education and beyond.

Disease is tougher, more resilient, and far more cunning than the minds of the medical experts who struggle to tame it.

It is only to be rivaled by the human spirit of our brave patients, who battle day in and day out to survive.

By Dr. Jordan Grumet, Internal Medicine

*Re-posted with permission

Original can be found at: http://jordan-inmyhumbleopinion.blogspot.ca/2015/03/my-first-lesson-in-humility.html