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Dr Georgianna Donadio

Dr Georgianna Donadio PhD

Posts by Dr Georgianna Donadio

  1. Hi Jednurse,
    Yes, it certainly could mean that! And, it might be that people who can express kindness find themselves in better psychological health than those of us we are angry, resentful or bitter as a result of our
    disappointments and life experience. It's like the chicken and egg discussion. 

    What we do know is that doing acts of kindness, or showing kindness to others in any form, is healing for ourselves and for others. It could be that getting to a place in our emotional life where we choose to
    express kindness, in spite of what we experience, is the "special sauce"
    that makes it work.

    Thanks for sharing!
    Kind regards,
    Georgianna

  2. Kindness vs. Incivility

    With the holidays approaching and another year coming to a close, this time spent with friends and family can serve as an opportunity to reflect on the power of kindness, which is badly needed in our contentious world today. Whether through the mediums of social media or television news as well as in our workplaces, homes, and relationships, we have all experienced the rising tide of incivility which seems to be sweeping over our nation. 

    According to the most current survey numbers, gathered by Weber and Shandwick and Powell Tate in their report titled Civility in America, 84% of Americans polled reported personally experiencing incivility. 69% of those polled cited the Internet and social media as the prime conduits of rudeness, with 25% reporting having been the victim of cyberbullying, compared to 9% in 2011. Additional alarming numbers include the 59% of respondents who said they had disengaged from politics due to rising incivility; the 56% who've experienced road rage; 34% on the receiving end of rudeness in the workplace, and 25% of parents who've had their children transfer schools due to cultures of incivility and bullying.

    When asked to define civility, the poll participants answered in part:

    "Being civil - thoughtful, kind, sympathetic, able to get along with others, understanding in thought and word."

    "Observing the rules of social etiquette, even when one disagrees."

    "Respect and honor people as you would like to be treated"

    The Golden Rule

    This last response, of course, is the essence of the Golden Rule, which sits at the heart of all the world's major religious and ethical systems. It's central tenant of reciprocity, familiar to so many of us that we take it for granted,  is as with all wisdom simple in hearing, difficult in application, as these poll numbers demonstrate. Even our own profession of nursing, routinely voted as one of the most trusted of vocations, isn't immune to the virus of incivility, as was addressed in a previous post. 

    How to Alleviate Rudeness

    What steps can we take to begin alleviating this rudeness epidemic, which is detrimental to individual and collective physical, psychological, and emotional health? In a September 2019 article from The Houston Chronicle, Drs. Michael Roizen and Mehmet Oz point out that "Accumulating research from around the globe shows how powerfully beneficial kindness, both extended to others and received from others, is to your physical and emotional well-being." In fact, they contend, "[Kindness] may be the missing component in your quest for better health."

    The Power of Kindness

    Among the work they cite is a book titled The Rabbit Effect by Dr. Kelli Harding, former emergency room psychiatrist at New York Presbyterian Hospital. It "explores the power of kindness and its importance in achieving health, both individually and as a nation." The book gets its title from the remarkable discovery that rabbits on a high-fat diet, when treated with kindness (cuddled and talked to tenderly) were found to have 60% fewer artery-blocking deposits than rabbits fed the same diet but given similar treatment. 

    Additionally, Dr. Harding's book highlights a Carnegie Mellon study where 400 volunteers were exposed to a cold virus, with those volunteers who received a daily hug being 32% less likely to come down with the cold. Drs. Roizen and Oz also mention the well-known Harvard Study of Adult Development, which found that relationship satisfaction (built on empathy and compassion) among the all-male study group was more determinate of overall health than factors such as cholesterol levels. There are also the results of a University of California study which showed that participants aged 65 and older who volunteered for two or more organizations "had a 44 percent lower likelihood of dying over the time of the study. That means that the kindness of volunteering is nearly as beneficial to your health as quitting smoking!"

    They write further:

    Quote

    "Generosity, empathy, selflessness, friendship, love and volunteering to help others: All these qualities promote robust good health by reducing stress, increasing happiness (all those good hormones, like oxytocin, that surge around your body) and easing inflammation."

    Peace on Earth and Goodwill to All

    When practiced in conjunction with a balanced, whole food diet, regular exercise, and restful sleep, regular acts of kindness can help promote a cultural shift toward "peace on earth and goodwill to all." 

  3. Hello Meagan,

    Thank you for this touching article. It is the humanity of nursing that makes it special, isn't it?

    It was 1963 when I entered nursing and, while the profession has gone through many changes since then, what hasn't changed at the core is that we have the opportunity to learn what true caring is. The reason nurses are the most trusted and loved health care professionals is because of who we become as we serve and learn from our patients.

    All the best to you in the years ahead.
    Kind regards,
    Georgianna

  4. Research conducted in the field of positive psychology provides empirical support for the intuitive wisdom of the many spiritual traditions regarding the practice of gratitude. Dr. Martin Seligman, (1) considered the founder of the school of positive psychology, conducted a study in which the effects of positive interventions were measured on 411 participants, along with a control measure of writing about their earliest memories:

    "When their week's assignment was to write and personally deliver a letter of gratitude to someone who had never been properly thanked for his or her kindness, participants immediately exhibited a huge increase in happiness scores. This impact was greater than that from any other intervention, with benefits lasting for a month."

    We hear much in today's self-care cultural about the need to develop an "attitude of gratitude." And, especially around this time of year, many of us are encouraged to reflect on the people and things which we are most grateful for in our lives. But, as with many practices such as "mindfulness" and "holistic health", to name a few, unless it becomes a part of our beliefs and worldview we easily lose sight of the inherent power it can have in our lives. To be able to truly embrace, appreciate and believe in the manifold benefits of gratitude, we must start by exploring its etymological roots.

    According to the article linked below from Harvard Medical School (1), titled "In Praise of Gratitude", the word is derived from the Latin gratia, denoting grace, graciousness, or gratefulness. Gratitude, in short, is "a thankful appreciation for what an individual receives, whether tangible or intangible." This can include anything from our state of health and our finances to our relationship with our families, as well as our connection to the wider world and universe. 

    It is no surprise, then, that gratitude is a central tenant of many of the world's religions, encouraging people to express thanksgiving for the blessings and good fortune they have received. Even seemingly negative experiences can serve as sources of gratitude, if they have helped spurred us to greater growth, awareness, and understanding. As St. Paul writes in 1 Thessalonians: "In all things, give thanks." (5:18)

    In another study, conducted by Drs. Robert A. Emmons and Michael E. McCullough (1), participants were tasked with writing a few sentences per week focusing on specific topics:

    "One group wrote about things they were grateful for that had occurred during the week. A second group wrote about daily irritations or things that had displeased them, and the third wrote about events that had affected them, with no emphasis on them being positive or negative. After 10 weeks, those who wrote about gratitude were more optimistic and felt better about their lives. Surprisingly, they also exercised more and had fewer visits to physicians than those who focused on sources of aggravation." Gratitude helps organize our time and lives.

    Gratitude can also pay dividends in the workplace. Supervisors who make it a point to express thanks for their employee's efforts can see an increase in worker productivity. Wharton School researchers found that university employees soliciting alumni donations who received encouraging words of gratitude from their director, "made 50% more fund-raising calls than those who did not." (2)

    While studies such as these cannot conclusively demonstrate a cause and effect relationship, they do show an encouraging correlation between adopting practices of gratitude and an increased sense of well-being.

    What are some ways gratitude can be practiced and cultivated?

    Show your gratitude to co-workers

    Sometimes just a simple compliment, or giving recognition for their caring work and how that impacts your day is a great way to not only enhance your colleagues sense of value, but also uplift the work place. It gives you an opportunity to reward an individual who is caring and helping others.

    Write a thank you note

    "You can make yourself happier and nurture your relationship with another person by writing a thank-you letter expressing your enjoyment and appreciation of that person's impact on your life. Send it, or better yet, deliver and read it in person if possible. Make a habit of sending at least one gratitude letter a month. Once in a while, write one to yourself."

    Count blessings

    "Pick a time every week to sit down and write about your blessings - reflecting on what went right or what you are grateful for. Sometimes it helps to pick a number - such as three to five things - that you will identify each week. As you write, be specific and think about the sensations you felt when something good happened to you."

    Prayer

    "People who are religious can use prayer to cultivate gratitude."

  5. Hello TitaniumPlates,

    Thanks for your wonderful response -very well said. Ignoring or walking away is hard but extremely effective. My grandmother used to say the best way to give someone the message that you don't value their behavior is to ignore them
    and when it comes to gossip, it is certainly true!
    Thank you for sharing your insights and experience ~
    Kind regards,

    Georgianna

  6. Despite its evolutionary origins as a method of establishing social networks, gossip is among the negative behaviors we frown upon as a culture. Defined by Webster's as a "rumor or report of an intimate nature", gossip oftentimes starts innocently enough as idle chitchat about friends, family members, and coworkers. While it can be positive in nature (such as discussing a potential promotion for example), gossip can quickly veer into negative territory, spreading unfounded rumors and speculation which can seriously damage a person's reputation.

    This is especially the case in our age of social media, where a negative comment or picture, which may or may not be true, can go viral in the blink of an eye.  It can also escalate to full-on bullying, social ostracizing, or physical violence, leading to a number of physical and mental health issues, including depression, anxiety, exhaustion, and in extreme circumstances suicide.

    It is this potential for spreading individual and collective toxicity that has led to the historical aversion to gossip, codified in many world religions and ethical systems:

    • "A gossip betrays a confidence, but a trustworthy person keeps a secret." Proverbs 11:13
    • "What is told in the ear of a man is often heard 100 miles away." Chinese proverb
    • "If you can't say anything nice, then don't say anything at all." Aesop    

    This is also true in our professional lives. In a field such as nursing, which has consistently earned public trust, it is all the more important to be aware of the corrosive effect that gossip can have on our interactions with patients and colleagues. In an article1  for NurseChoice.com, Melissa Wirkus Hagstrom outlines three dangers of nurse station gossip.

    What are the Dangers of Nurse Station Gossip?

    1 - It Damages Relationships

    Hagstrom quotes Connie Barden, chief clinical officer of the American Association of Critical Care Nurses:

    "It's important to create an environment that fosters effective and skillful communication and collaboration as outlined in the AACN Standards for Establishing and Sustaining Healthy Work Environments…There are few places where the stakes are as high as in a hospital. Demeaning, belittling, and disrespectful gossip damages relationships, contributes to errors, and adversely impacts nurses, coworkers, and patients."

    2 - Leads to a Lack of Trust and Respect

    "When there is negative gossip, it's difficult for trust and respect to flourish. Both the person doing the gossiping and the person listening to the conversation can be perceived as untrustworthy for talking about someone who is not present…As in other aspects of life, it's best to focus on taking the 'high road' with our conversations."

    3 - Possible HIPAA Violations

    An article2 in Becker'sHealth IT and CIO Review lists some of the more common reasons for Health Insurance Portability and Accountability Act (HIPAA) violation citations, with Employees Disclosing Patient Information at the top of the list. "In their 2016 list of the most common HIPAA violations, they explain that employees' gossiping about patients to friends or co-workers is a violation that can lead to significant fines."
    Such negative effects have been empirically demonstrated.

    A multi-nation study3 published in the September 2014 journal Research Burnout found a positive relation between burnout and negative gossip in a hospital setting, as well as a positive relation between negative gossip and suboptimal care. However, as Anthony Montgomery, a co-author of the study, reports, "Nurses often use gossip to express some of the deepest emotions about patients and fellow workers and gossip has been considered as a form of emotional support and a way to relieve stress."

    While we should never seek to repress or stifle the need to voice frustrations in our relationships, taking a more positive slant in our conversations can go a long way to avoid poisoning the well either at home or at work.


    REFERENCES

    1. 3 Dangers of Nurses Station Gossip - and How to Avoid It
    2. 10 Common HIPAA Violations and Preventative Measures to Keep Your Practice in Compliance
    3. Talking Behind Their Backs: Negative Gossip and Burnout in Hospitals

     

  7. Hello Snatchedwig -

    One of the biggest challenges many nurses face is taking the time to take care of ourselves. Even if we start with one small thing, like taking a multiple vitamin, or 5 minutes of stretching, we can start to develop the habit of making time for more self care.

    Thanks for sharing!
    Kind regards,
    Georgianna

  8. Edited by Dr Georgianna Donadio
    spelling error

    Hello tinyRN72,
    Thank you for sharing your experience with self-care. Its quite remarkable how often we "don't know what we are missing" until
    we take the leap to try something different.
     

    Good for you - and yes taking care of yourself allows us to take better care of others!

    Thanks for posting,
    Georgianna

  9. As trusted health professionals it is our responsibility, and our calling as nurses, to provide compassionate, competent care, as well as to educate our patients and clients on an important topic in today’s health and wellness landscape, which is the growing need for and a demystified presentation of what is referred to as “self-care.”

    Self-Care: The Foundation for Healthy Living

    Self-care has been misinterpreted by some as potentially unrealistic because it is believed that lay people do not have the knowledge required to make the best decisions for their health. However, research studies are revealing that “self-care” is the foundation for leading a happy, healthy, and purposeful life, not only for ourselves but for our families and communities and does not have to be complicated, hard to understand or require special knowledge to integrate into our lifestyle.

    While there remains an emphasis in our culture on putting the needs of others before ourselves – whether it be at home, work, worship, etc. – this practiced selflessness at the expense of our well being can lead to chronic illnesses, depression, and a host of other maladies. We especially see this in what has been referred to as the “sandwich” generation which finds adults caring for their children, as well as their aging parents. Without self-care, these caregivers burn out or become ill within a relatively short space of time.

    A common message during air travel is “in the event of an emergency, put on your oxygen mask first before trying to assist anyone else.” The same is true with serving others as a nurse, as a family member or community member. If we cannot take care of ourselves in a way that supports our own well-being, we are less effective in assisting or caring for others.

    In the patient health education program I work at, we teach that a person’s whole health is contingent upon multiple factors in their lives – such as the physical, emotional, environmental, nutritional, and spirituality/world-view. If there is an imbalance in any or even some of these areas due to neglect or stress, it can lead to a whole array of health concerns, affecting not only us but our immediate family and social networks.

    Taking the time for proper self-care is all the more important given the competitive, stress inducing nature of our culture today. An article published this past April in The New York Times reported that, according to an annual Gallop poll of more than 150,000 global participants, those Americans polled “reported feeling stress, anger, and worry at the highest levels in a decade”. (1)

    When asked how much stress they’d experienced the day before being polled, 55% of Americans felt “a lot” of stress, versus 35% of the world population. When it came to worrying, 45% of Americans said they worried “a lot”, versus 39% of the rest of the world. 22% of Americans also felt “a lot” of anger, in line with the global average.

    Furthermore, American participants cited a rise in the number of negative experiences they had. While there are a wide range of factors that can account for this rise in stress and worry, it is well documented from years of study and research the toll which chronic stress, worry, and anger can take on physical and mental health, individually and collectively.

    Though the polling data cited in the article is alarming, we thankfully live in a time of unparalleled access to information to educate ourselves with regarding the myriad benefits of self-care. Knowledge is power as we know and with everything that medical research has revealed it is perhaps easier than ever to make informed, evidence based decisions for our health and well-being. In a blog post for Psychology Today, Tchiki Davis and Brad Krause identify 12 easy to implement steps for creating a sustainable self-care plan. (2) Among them are:

    What are Some of the Steps for Sustainable Self-Care?

    Get enough sleep

    As Davis and Krause write, “Sleep can have a huge effect on how you feel both emotionally and physically. Not getting enough can even cause major health issues. But stress and other distractions can wreak havoc on our sleep.”

    Exercise regularly

    “Daily exercise can help you both physically and mentally, boosting your mood and reducing stress and anxiety, not to mention helping you shed extra weight.”

    Proper nutrition

    “The food we eat has the potential to either keep us healthy or contribute to weight gain or diseases such as diabetes, but it can also keep our minds working and alert.”

    Learn that it’s ok to say “no”

    “It may take a little practice, but once you learn how to politely say no, you'll start to feel more empowered, and you'll have more time for your self-care.”

    Spend time in Nature

    “Spending time outside can help you reduce stress, lower your blood pressure, and be more mindful. Studies have even shown that getting outside can help reduce fatigue, making it a great way to overcome symptoms of depression or burnout.”

    These are just a few of the ways we can cultivate a consistent and centering practice of self-care for optimal health and well-being. Prevention is a major focus in medical health care today and there is no better way to prevent disease than to develop these simple, easy to implement steps to better health and longevity.

    What are some steps to healthy living that you have implemented?

  10. Alongside obesity, chronic disease, and addiction, many Americans believe we are in the midst of an equally serious epidemic of rudeness and a lack of kindness towards others. Webster's defines the adjective rude as "discourteous", and being "offensive in manner or action". According to several leading polls (1) conducted over the last decade and a half, approximately 75% of Americans believed that our country is getting progressively ruder, with many citing our high tech, high stress culture as the breeding ground for bad manners.

    The same holds true in the workplace. As per the most recently published research, (2) conducted by Dr. Christine Porath of Georgetown University School of Business, thousands of workers were asked how they felt treated on the job. A startling 98% said they'd been on the receiving end of uncivil behavior, with 56% reporting it occurred at least once a week. This kind of systemic rudeness can be detrimental in many ways, causing coworkers to become disengaged from one another and their work, leading to a decline in productivity as well as physical and mental stress. "Incivility is a virus," Dr. Porath says. "You touch it and unfortunately we often don't realize we pass it on to others."

    As members of the most publicly trusted career field, it is imperative that we as nurses are mindful of the negative effects that rudeness can have on our patient's health outcomes as well as our job performance and workplace relationships. Indeed, in a study (3) conducted by the American Academy of Pediatrics simulating a high stakes pediatric procedure, the NICU teams which were subjected to rude comments from observers scored 52% lower in correctly diagnosing the condition and 43% lower in administering treatment than the control group.

    Studies aside, our own experiences in the workplace or out in public can confirm that we as a collective culture seem far too distracted, time pressured and stressed to often realize how we are reacting and communicating with others. Our cell phone addiction, which has many of us oblivious to what is going on around us much of the time, is a huge contributor to how our current day to day communication has changed, arguably not for the better, in the span of a few decades.

    Add in the anonymity of social media, with its invitation to "get away" with behaving in in a manner we would never think of doing in person, and we have a formula that easily leads to the current lack of civility and kindness in contemporary society.

    There is however, at least one ray of light that shines through this growing rudeness.

    In a 2019 study, highlighted below, almost 63.9% of those surveyed scored the nursing care provided during their hospitalization. The study went on to cite that the overwhelming feedback from the 635 patients surveyed was that nurses tend to be more caring, polite, considerate, compassionate and empathetic than other care providers.

    Nurses have, for a long time, been looked upon as standard bearers for compassionate and comforting support and patient engagement within healthcare. When I was trained back in the 1960's the Florence Nightingale persona was the model for all of us nubile nurses to aspire to. Even today in our highly technical medical environment our nurses are who we expect to receive comfort, along with medical competency, from.

    At the continuing education program I work at our saying is "nurses are the hands and hearts of health care." The one notable comment found in the above study is that nurses need to become more skilled and interested in understanding how to provide information to their patients. When a patient received information explaining the how and why of their condition their anxiety is greatly decreased. Their sense of having some control over the problem is also greatly increased.

    Politeness, courtesy and respect for others is something we all appreciate. As nurses these are qualities our patients look to us for. Being mindful of how we treat and relate to our patients can go a long way in making their experience "a kinder and gentler" experience of their health care.

    This survey (4) appears online at: Wiley Online Library: Patient satisfaction with the quality of nursing care

    Aim

    To evaluate patients' satisfaction with the quality of nursing care and examine associated factors.

    Design

    A cross-sectional, descriptive survey study.

    Methods

    The sample was composed of 635 patients discharged from a private hospital. Data were collected using "Patient Satisfaction with Nursing Care Quality Questionnaire" with a total of 19 items, and a questionnaire designed to record socio-demographic characteristics and medical histories between January 1 and May 31, 2015.

    Results

    Patients were more satisfied with the "Concern and Caring by Nurses" and less satisfied with the "Information You Were Given." Patients (63.9%) described nursing care offered during hospitalization as excellent. Patients who were 18-35 years old, married, college or university graduates, treated at the surgery and obstetrics-gynecology units, and patients who stated their health as excellent and hospitalized once or at least five times were more satisfied with the nursing care. According to this study, the nurses needed to show greater amount of interest to the information-giving process.

    Resources/References

    1. American Academy of Pediatrics: The Impact of Rudeness on Medical Team Performance: A Randomized Trial
    2. Psychology Today: Why Are Our Workplaces Getting Ruder?
    3. NBCNews.com: Are Modern Americans a Rude, Boorish Lot?
    4. Wiley Online Library: Patient satisfaction with the quality of nursing care
  11. Hello jeastridge,

    More and more therapy dogs and emotional support animals are being used in many hospitals. They are effective with young and old alike and are a "trend" that is being considered around the country. They provide comfort, emotional support and companionship. With loneliness as the number one concern for health, wellness and recovery, animals can provide a natural, inexpensive solution.

    Here is a link to an article you may find interesting about the subject. I found it
    uplifting and hopeful for bringing the experience of whole person care into the hospital and medical settings.

    https://www.petmd.com/news/view/pet-visits-hospitals-what-are-risks-36206

    Thank you for sharing your comment,

    Kind regards,

    Georgianna
     

     

  12. One of the most popular and rapidly growing alternative modalities to help seniors retain their health and prevent the development or progression of both physical and mental conditions, is Animal Therapy. Dogs are the leaders in providing the succor and outcomes that are well documented on senior interaction with our animal friends.

    A study out of the University of Pittsburgh, published in the Journal of Pain Medicine, demonstrated that the presence of a dog in an older individual’s life can help to significantly reduce physical pain as well as emotional distress.

    There is little debate that physical exercise and healthy nutrition is essential to maintaining health and well-being at any age, especially the senior years. However, the addition of dog therapy can also be a tremendous addition to any senior’s self-care and disease prevention plan.

    Dog Walking Takes Us Steps toward Better Health

    As an educator in The 5 Aspects of Whole Health™, developed by the National Institute of Whole Health, I enjoy using these 5 aspects to identify the benefits of various approaches to health and wellness.

    1 - The Physical Benefits

    On the physical side, having a dog provides a mandatory reason and motivator for a senior to get outside and walk. There is also the physical movements of feeding and providing water every day for your pet. These activities all contribute to lower blood pressure and fewer occurrences of chronic health conditions, like obesity and diabetes.

    In fact, a University of Missouri study showed that walking a dog regularly can lead to a lower body mass index. This can positively contribute to overall health and help prevent conditions such as heart disease and diabetes. Seniors in the study who walked their dog also reported fewer doctor visits.

    2 - Emotional Benefits

    The emotional component of pet ownership, especially for single seniors, either at home or in an assisted living facility, is critical. Having a dog is a major winner in the battle against loneliness as well as the loss of purpose many seniors feel after retirement or after a major illness. Taking care of a pet can provide a focused purpose and important reason for getting up, dressed and moving each and every day.

    3 - Environmental – Social

    Dogs have long been a known attraction for singles to meet one another and in the same way dogs provide seniors with the social benefits of how to meet others through dog walking or pet play dates. Seniors can make friends or enhance their social activities by having a pet, especially dogs as they are walked daily, without feeling awkward or shy as so much of that activity is about their beloved pet and meeting others who share their enthusiasm for “pet parenthood”.

    4 - Chemically and Nutritional

    As we age our cognitive health and depth of memory can be effected. Much research is showing that having a pet in our later years can greatly reduce stress and the nutrition deficiencies stress can cause. Pet ownership can also strengthen brain function and extend our memory. According to Dr. Penny B. Donnenfeld. “I’ve seen those with memory loss interact with an animal and regain access to memories from long ago,” the psychologist explains. “Having a pet helps the senior focus on something other than their physical problems and negative preoccupations about loss or aging.”

    5 - Spiritual

    Experiencing a shared life and purpose with our animals, dog ownership connects us to the inter-dependence of our humanity and promotes a sense of belonging and being loved that enhances our relationship with ourselves and others.

    Recognizing the Connection

    The established correlation between pet ownership and better health now has assisted-living communities allowing and even encouraging pet ownership.

    For seniors who do not want to take on the responsibility of owing a pet or are not in a living situation that allows for pet ownership, many senior facilities have created programs which have various rescue organizations that brings dogs into facilities during week days for residence to enjoy “pet therapy” and companionship.

    Dogs have long been considered “man’s (humans) best friend” – maybe this is even truer in our advanced years. Having the love and companionship of a four-legged best friend is proving to be not only enjoyable, but also good medicine.

    Resources

    ScienceDaily: Senior adults can see health benefits from dog ownership

    National Center for Biotechnology Information: Animal-assisted therapy at an outpatient pain management clinic

    Centers for Disease Control and Prevention: Older Adults

  13. Hello Kaisu,
    Thank you for confirming these four questions! Don't we all want to be treated in this way? The fun thing is to take these four questions and adapt them to any relationship or dialog we are having with another person. Many times when our friends or family are seeking our support these are the same four questions, with a different tweak to them that they are asking.

    For example - if a friend calls and is asking about a situation with their partner the questions might be:

    > Are you listening?
    > Can you suggest why he/she/they may have reacted as they did?
    > Do you want to know what I intuitively think the issue is and do you think I might be onto something with that insight?
    > Can you give me some insight into how I might approach the situation until we can sort it all out together?

    We all really want to be affirmed in our process of self-discernment.
    instead of being told what to do. This seems to be a great solution for many situations!

    Thanks so much for sharing your experience,
    Georgianna

  14. Hello DallasRN,

    BRAVO to you and many thanks for sharing your personal story. So uplifting to hear that you asserted your right and prerogative NOT to accept such behavior from a "healthcare provider" when he displayed none of the essentials to caring for another human being!

    For over 40 years I have been working to help create and promote patient advocacy and whole health information to empower all of us to be better able to control our health outcomes - so it is very rewarding to hear your story as well as the many voices who are now being heard throughout the healthcare system asserting our right to the respect, compassion and dignity that we all deserve as human beings, let alone recipients of health "care".

    Please keep sharing your story as it will inspire others to take back their rights and express their own powerful voice, leading to better, safer health care!

    With admiration and many thanks for sharing,

    Georgianna

  15. According to research studies conducted at the University of Washington Medical School, there are four primary questions that all clients or patients want answered by the person they see for their health care or for health related consultations. There are variations on these questions in different circumstances and practices, however, they are all derived from the most basic need we as human beings have in our relationships and particularly with our health care professionals. The four questions are as follows:

    “Are you listening to me?”  

    This is a critical question every client or patient wants answered in their partnership with whatever type of health care professional they are working with. Mindful, respectful listening, which commits your total presence and attention to another individual, is the most powerful gift we as health professionals can give to our clients. This form of human intimacy, valuing another so that our self-awareness falls away and we become egoless in their presence, is a healing and transformational experience for both client and professional.

    “Can you explain to me how and why this is happening to me (my body or mind)?”

    The great value of incorporating into your practice or work evidence-based, integrative and demystified health information is that it answers this question. For instance, you can explain to a client that processed carbohydrates are five carbon molecules which elicit insulin secretion to break down the five carbon structure.

    They are chemically unlike fruits, sweet vegetables or sprouted grains that are six carbon molecules. These six carbon structures do not require the elicitation of insulin for them to be utilized in the Krebs energy cycle. (Calvin cycle – photosynthesis). This knowledge transforms an individual’s understanding from a theory about nutrition to an organic chemistry reality which explains why and how processed foods affect their body. More importantly, this information gives your client powerful tools and knowledge to make sustainable lifestyle changes.

    “Do you care about what I know about my own body and health concerns?”

    What they are really asking is – “Do you care about, and will you respect, what I know about the problem I live with 24/7?” As a nurse or any other health care, advocacy or counseling professional, we must always listen to and respect the person sitting before us as the foremost expert on their health condition. They may not be able to articulate the “how” and “why” of their conditions, but when provided some facilitation to fully remember all that they know, they may be better able to make appropriate changes to craft a long and healthy life.

    “Can you explain to me how I can control my symptoms?”

    Controlling a condition or its symptoms is often more important to an individual than “curing” the problem. This is especially true with older adults who are more concerned with avoiding the disability or pain of a chronic condition.

    This is why the field of patient health education, through providing a clear understanding of how all aspects of an individual’s life may influence any given health condition, is an important addition to any health professional’s skill set. Assisting an individual to understand what they can do to take control over their symptoms and discomfort, and to create a greater sense of ease and control over their condition and/or symptoms, is of the utmost importance.

    In a recent study, conducted by Michigan State University, College of Human Medicine (see attached study), the utilization of a communication and patient education model, Behavioral Engagement with Pure Presence, led to 28.5 - 33% increase in both patient and physician satisfaction.

    As demonstrated in number two and four of the above questions, patients are looking for information as well as active, respectful listening in order to discern the choices they may or may not elect to make for their own self-care. Not providing appropriate presence, mindful listening and, demystified evidence-based health information withholds the tools our clients, as well as ourselves, need to truly take control of our health destiny, is a disservice to those we serve.

    Value-care, the measure of reimbursement for medical services, now recognizes that disease prevention and effective patient health education are both critical in reducing the epidemic  of chronic disease in our culture.

    IJMB_Vol_9_1_Clipper (1).pdf

  16. Hello RobbiRN -
    Thanks for a great article! I read recently that we are not considered "getting old" until we pass 72 years and then we can be a "young older person" or an "old older person" depending upon how we choose to live, as you very eloquently wrote about.

    Attitude, especially gratitude, appears to be critical in this whole process. My father died at 101 and the first thing he did when he woke everyday was thank his creator for all his blessings and another day of life. 

  17. Hello HCT,
    Fortunately, the man did not die but was impaired, which is bad enough. I agree with and understand everything you are saying. Today, boundaries are blurred, especially with nutrition. Many lay people, as well professionals, cross the line with "recommendations" and prescriptions and as you can see there is "no one size fits all" approach to anything in medical or healthcare, let alone something as individual as nutrition.

    Our organization does its best to educate nurses about appropriate boundaries and the legalities surrounding
    many issues that can come up in private practice. There needs to be a balance between our passion for self-directed care and rejection of established standards and regulations for various medical specialty practices.

    Thanks again for your comment. 
    Kind regards,
    Georgianna

  18. Hello HCT and thank you for your comment.
    ou are COMPLETELY spot on regarding nutrition counseling.

    As a nurse educator, the intent of the article was to caution nurses that the practice of nutrition is a separate credentialed scope of practice. 

    While some states allow an individual to do nutrition counseling without a license as an RD or licensed nutritionists (usually masters degree level)
    that does not imply that an individual can "practice" nutrition which involves professional, legal and ethical considerations.

    The allowance of nutrition counseling is often available for weight loss in a variety of settings, which given our runaway obesity rates, can be helpful for those struggling with to get their weight under control. Almost all weight loss programs now have individuals who can answer questions about the diet plan and losing weight being offered.

    Unfortunately, there are many nurses who take courses in various kinds of nutrition and are conducting private practices where they function in the capacity of nutritionists. 
    This has become commonplace today and many nurses find themselves with legal or professional issues as a result.

    EDUCATING a patient about nutrition is very different than practicing nutrition. Providing holistic, evidence-based health information that allows the patient to understand why they may chose to make lifestyle changes is not the same as directing the patient on nutrition issues and also avoids the pitfalls you so appropriately pointed out.

    Many thanks for taking the time to comment.
    Kind regards
    Georgianna 

     

  19. Unfortunately, with these technological benefits come with significant health risks due to exposure of radiation associated with 5 G utilization. This is just one of many articles addressing this concern:

    https://eluxemagazine.com/magazine/dangers-of-5g/

    Plans to have a tower on every block would mean massive amounts of radiation in the environment. Aside from better communication, the need to look at the bigger picture is very important, especially for our children.
     

  20. Hello JRaphasRN,

    Thanks for posting your comments. Not everyone shares the same experience going through a program and clearly yours was very different from the majority of our graduates.

    There are many programs available for health professionals and nurses. NIWH is unique in many ways and offers an experience 
    different from other programs. It is also currently the only nationally accredited program for patient educators, health advocates and
    whole health coaches. We have been accredited since 2015 and currently our courses are reviewed by ANCC and ICF each year for content and relevance. The courses are annually updated with evidence-based research materials and abstracts.

    I am sorry you did not enjoy a better experience of the program but appreciate your comments as we find all feedback helpful.
    Best wishes with your work in nursing,

    Kind regards,
    Georgianna Donadio

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