Education, End-of-Life, Humanity, Social Work/Helping Profession/Mental Health

When the greatest of tragedies strikes, how do you keep going?

That is a very difficult question; Do you know the answer? I do not…because the answer will be different for each person.

What is a tragedy? Job loss, homelessness, fire, car accident, tropical storm, ice storm, a pet dying, a family member dying, abuse-whether physical, mental, emotional, sexual or financial…the list goes on and on.

For this particular article, it is about death, and unexpected death of a spouse.

Imagine all of a sudden you are a widower with 2 children. Are you prepared financially? Mentally? Emotionally? Is all the paperwork in order?

Do you have any family to help you? Do you have friends to help you?

Think of all of this as food for thought and the type of questions that need to occur BEFORE death happens; not after…


Source: How to recover from tragedy

via How to recover from tragedy — Loss, Grief, Bereavement and Life Transitions Resource Library

Aging/Gerontology, End-of-Life, Grief/Grieving/Bereavement, Healthcare, Humanity, ICU, News, Social Work/Helping Profession/Mental Health

“Journey’s End: Death, Dying, and the End of Life”: Is out Soon!

A book that has been in the makings for almost 2.5 years……..a well thought out book that focuses on death, dying, and end of life issues with over 50 contributors mostly from Canada and the U.S.A. and a few from other countries around the world!

The book has many chapters that focus on death of spouses, parents, friends, children, friends, colleagues, clients, pets, multiple deaths, suicide, and includes resource information, training information, checklists, quotes, information on Assisted Dying around the world, Grief & Bereavement support is included, End of Life communication, planning and preparing information and more!

This is a go to book for everyone! 500 pages of information that students, professionals, lay people, and caregivers can read and use.

It has been a long journey to get to this point, but well worth it! Thank you, Julie, for your understanding when things were going on in my life-we made a great team!

The book will be printed within the next 2-3 weeks and we look forward to sharing it with you!

Julie and I are already planning book 2, so if you are interested in participating/contributing, the book will focus on death, dying, and end of life, but from cultural, ethnic, and religious perspectives.

Burial and mourning rituals with a twist as each culture, religion, and ethnicity have different and unique traditions and customs along with grief, bereavement, and end of life discussions and planning. Contact me-


Vikki and Julie

NorthernMSW & CreateWrite Enterprises


Burned Out

Walter was far older than his chronological age. A mere thirteen years, he kept company with a much older crew. Doctors, nurses, and CNA’s were his constant companions. The other kids on his floor were either too sick to interact, or came and left within a matter of days. But not Walter. His heart was too weak to allow his departure, but too strong to be first in line for a transplant.

So he passed his spare time with the staff. He often duped me and the other medical students out of our pocket change with some confidence game or another. He was like a younger sibling, or maybe the hospital mascot. Everybody knew him, and everybody loved him. Unlike friends and neighbors, however, we knew the most intimate details of his medical history.  We examined his body and ordered blood tests. We were in charge of his well being.

Walter was the patient I spent the most time with during my medical school career. He was a constant presence throughout my three months of pediatrics. The last day of my rotation, the nursing staff got the unexpected call. Walter was prepped and taken to the operating room. A child had died tragically, and Walter was given a second chance at life. Around midnight my team snuck into the ICU and peeled back the curtain.

Walter was alive and well. A breathing tube snaked from his mouth and chest tubes hung from his bedside. The grayish pallor of his face had been replaced by a pink glow. I took one last look back and left the ICU. And left my pediatrics rotation.

And stepped out of Walter’s life forever.

Years later, I am struck by how many times I have repeated this cycle in my medical career. Patients come and go. Doctor is inserted at most intense moment. The patient dies, or leaves the hospital, or exits the nursing home, or moves away.  We live a life of transience.

I used to think of this as intimacy. As I get older, I question this belief more and more. For true intimacy, confidence is earned, not given forthright. It is the product of shared struggle and trust. And when someone you are intimate with dies or leaves your life, there is a period of mourning, a time for closure.

What physicians experience today is feigned intimacy. We swoop into people’s lives during their most intense moments and leave abruptly.

It’s no wonder most of us walk the hospital floors with gaping holes in our sides that only we are unable to see.


Gasping for air amongst the charred remains.

Burned out.

By Dr. Jordan Grumet, Internal Medicine

*Re-posted with permission. Original can be found at:

Healthcare, ICU

Day 2 #UCIamable (friendly ICU): Yoga in ICU of Hospital 12 de Octubre

Hola a tod@s, my dear friends.

Day 2 #UCIamable (friendly ICU) Campaining, and Maria Soledad Martínez Ávila shares with us a very interesting research project. Stay alert:

Yoga is an ancient practice that appears in the Indus Valley in the 17th Century BC.

There are different types of yoga, the most widespread and known in the West is Hatha Yoga. It is a system of physical postures called asanas, whose purpose is to prepare the body for meditation. This type of yoga emphasizes physical, mental serenity, and relaxation, through proper breathing, control of our body and the meditation.

Yoga and meditation favor a transformation or personal change that leads to a better quality of life.

This improvement is reflected:

* At the physiological level, it induces a response of the parasympathetic nervous system.

* At the cognitive level, it produces changes in the valuation of stressful situations (primary value) and the capacity to deal with it and the associated potential consequences (secondary assessment). An attitude of objectivity and fairness takes place before the events of life, favouring an attitude of detachment and distance to this events and their results, allowing relative problems and facilitate coping of them. In addition, the practice of yoga develops attention and consciousness about our acts, thoughts and emotions, which allows to detect the physical and mental state of tension to confront it with the available resources.

* At the behavioral level, it can contribute to access to internal resources for coping. People learn to control impulses, to relax, to ask for help, to seek information and to develop healthier habits and behaviors.

* On the emotional level, improves mood, increases optimism, acceptance and favour emotional regulation.

I am María Soledad Martínez Ávila, ICU nurse of the Hospital 12 de Octubre in Madrid. With all these benefits associated, I thought that it would be a good idea to bring yoga and meditation to the hospital, and that my mates could enjoy and feel this awakening of consciousness, which would turn around in our patients, families and work environment.

I’ve been practicing yoga for more than three years, and last year I began my training as a teacher of therapy yoga.

I am developing a research project in my hospital ICUs. We want to study what effects yoga and meditation have on stress in doctors, nurses and auxiliary nurses. Among other parameters, we intend to carry out two determinations of cortisol in blood, at the beginning of the study and at the end of this.

And although the truth is that the project has been well received, I need funding to make the analytical determinations. I am looking for ideas, sponsors or help to carry out the project, so do not hesitate to contact me ( Thank you for your collaboration!

“The richness of the human being is a human being, one who lives in peace with oneself and in harmony with the world. The principle of yoga is driving the mind.”

Swami Niranjanananda
*Re-posted with permission from IC-HU Project
Original can be found at:

Health care at the end of life: Trending Topic

Articles of opinion, research studies or reports of Scientific Societies in relation to care for the patients at the end of life have been numerous in recent months.

It is an issue which is of concern to citizens and health professionals. Health institutions and services have not succeeded in producing processes that, based on scientific knowledge and respecting the preferences of patients, improve coordination of treatments, care and spiritual care requiring patients and their families.

Thus, the journal New England Jornal of Medicine in its issue of February 12, 2015 published several articles.

In End-of-Life Advance Directives we are invited to reflect and send feedback on a practical case in which arises what specialist could arrange the best way of decision-making with the patient and care planning. How, when and where. At first glance we could suggest a coordinated care, but it is interesting to read the arguments of each professional.

Another interesting item is the revision of laws and American programs related to end of life care in the last 40 years. Both in this text (Forty Years of Work in End-of-Life Care – From Patient´s Rights to Systemic Reform) as in other of the same number (Should we practice what we profess? Care near the End-of-Life) it is cited the report Dying in America del Institute of Medicine (IOM), whose basic recommendations are:

1. Providing comprehensive and coordinated palliative care.

2. Improving communication with the patient and care planning.

3. Training on aspects related to the end of life.

4. Institutional programmes focusing on the patient care.

5. Information for citizens to achieve their involvement.

Reading these articles should invite us to reflect in a first step and then act.

Clinical Bioethics could be interesting and entertaining. This is one of the aspects to improve: Bioethics as pure entertainment, when in essence should be action.

To act essentially we need to read, listen, reflect, discuss, propose, and finally implement programs and processes that improve health care with the ill person as the objective.

Dr. Iñaki Saralegui (@InakiSaralegui)
Intensive Care Unit. 
Hospital Universitario de Alava.
Chairman of the Medical Ethics Committee
Bioethics Working Group – SEMICYUC

*Re-posted with permission from Dr. Gabi Heras. Original can be found at:

Getting Started With a Health Blog  

Hola a tod@s, my dear friends.

We would like to share today the article published on February 3 in the blog that will come out in paper in the next issue of ICU Management, the journal whose Editor in Chief is nothing more and nothing less than the Professor Jean-Louis Vincent, head of the ICU of the Erasme Hospital in Brussels.

From the Journal, they got in touch with us to write an article to encourage other health and intensive care professionals to create a blog. Without hesitation, I contacted Salvador Casado (La consulta del Dr. Casado) and José María Cepeda (Salud Conectada), whom I consider a reference in Spain to invite them to write the article  together.

The continuum of care is part of the biographical process of our patients, and it seemed logical that a general practitioner, an A & E Staff nurse and an Intensivist, all bloggers, share this opportunity and write about the topic that we had commissioned.

And this is the result. I present the article Getting Started With a Health Blog, which we hope will be useful and encourage you to be a part of the blogger world.

Many thanks to Salvador and Chema, it was a pleasure to work with excellent professionals who in addition, they are better people and looking to change what we have in the present in order to have a more favourable future.

By Dr. Gabi Heras, ICU Physician
*Re-posted with permission. Original can be found at:
Healthcare, News

The Benefits to Attending Conferences

I was fortunate enough to be ‘in the right place at the right time’ as the expression goes. Thanks to my moderating a group on LinkedIn in an area that interests me both professionally and personally, I just attended The National Forum on Patient Experience in Toronto, Ontario, Canada.

The forum began on a high note when I was able to meet the other moderator, Lewis Hooper and the group manager, Paul Gallant of the LinkedIn group Canada Health and Healthcare Consultants in person the night before the conference began. One is from the Toronto area and the other from Vancouver. As I am from Montreal, 3 major hubs in Canada were covered geographically!

Besides the importance of professionals updating their ‘toolbox’ by taking workshops, courses, classes, certification programs or designations, it is equally important to attend conferences when one is able to.

Health and healthcare affects each and every one of us and for some, the effect is both personal and professional. I work with older adults and so my interest in healthcare. As I am a dual citizen of the United States and Canada I have seen, been part of and realize the need for change and restructuring in order for healthcare to continue to be sustainable.

I have been a patient in both the U.S. system and the Canadian healthcare system. I much prefer the Canadian healthcare system and truly believe a major overhaul is needed. With the ‘greying’ of the population due to the number of baby boomers entering the 65+demographic daily, the system is not sustainable as is.

Baby boomers want and will demand more and the system will have to respond. Baby boomers are typically highly educated, do research, know what they do and do not want in the future and the current system of senior residences, Long Term Care/nursing homes are not what they want! The ‘aging in place’ phenomenon has begun. ‘Senior’ communities with services are wanted along with the renovation of ones current home. Some are choosing to downsize into a smaller living environment on one level should mobility become an issue in the future and others are continuing to work part-time while enjoying semi-retirement. These active and engaging ‘seniors’ or older adults are up-to-date on the current trends, are social, technologically savvy, educated, involved in the community as in active volunteers and believe and have lived advocacy. Think Civil Rights, Women’s Lib, protesting the Vietnam War, Gay and Lesbian Rights, humanitarian initiatives and modern-day wars.

By Victoria Brewster, MSW