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Dr Georgianna Donadio

Dr Georgianna Donadio PhD

Content by Dr Georgianna Donadio

  1. Dr Georgianna Donadio

    How Gossip Hurts All of Us

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

    How Gossip Hurts All of Us

    Thank you DCubed and subee for sharing your insights! Yes, imagine how lovely life would be if all of us agreed to not talk about one another, unless we had something positive to say! Many thanks and kind regards, Georgianna
  3. Dr Georgianna Donadio

    Personal and Professional Benefits of Self Care

    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?
  4. Dr Georgianna Donadio

    Personal and Professional Benefits of Self Care

    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
  5. Dr Georgianna Donadio

    Personal and Professional Benefits of Self Care

    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
  6. Dr Georgianna Donadio

    Rudeness versus Caring

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

    Dog Therapy As Good Medicine For Seniors

    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
  8. Dr Georgianna Donadio

    Dog Therapy As Good Medicine For Seniors

    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
  9. Dr Georgianna Donadio

    Dog Therapy As Good Medicine For Seniors

    Hello homeopathylover, Thanks for your comment and happy to hear your mother is doing well with your dog. They are amazing "angels among us" and its wonderful to see how they are now getting recognized for their healing qualities! Kind regards, Georgianna
  10. Dr Georgianna Donadio

    What do patients REALLY want from their health care professionals?

    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
  11. 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
  12. Dr Georgianna Donadio

    What do patients REALLY want from their health care professionals?

    And, YES Dallas SMILING is the communication MOST welcome from anyone, most especially in our healthcare providers! Warm regards, Georgianna
  13. Dr Georgianna Donadio

    What do patients REALLY want from their health care professionals?

    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
  14. Dr Georgianna Donadio

    Your Third Act

    Yes, dad was a great role model in many ways. He taught us to stay humble, work hard and be grateful. A pretty good formula for happiness. Kind regards, Georgianna
  15. Dr Georgianna Donadio

    Your Third Act

    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.
  16. Dr Georgianna Donadio

    Nutrition Counseling in Nursing Practice

    More and more nurses are leaving bedside care or physician-led practices to pursue their desire to practice less symptom driven medical care and have more disease prevention and health maintenance interaction with their patients. It is projected that by 2030 seventy percent (70%) of nurses will be working outside of a hospital or medical facilities, in various venues and specialties with chronic disease prevention, health and wellness, and anti-aging being the more populated areas these nurses will be working in. In addition, a significant number will be conducting individual private practices or working with nurse practitioners. The previous article in this series discusses at length the practical and legal guidelines surrounding nursing private practice outside of an APRN specialty. These are important things to be aware of if you are one of the less than half of all RNs in the U.S. who work outside of an acute care or hospital setting. Currently, there are so many nurses moving out of acute patient care that this past decade is being referred to as “the decade of the nurse entrepreneur”. As the breadth of diversity in jobs for nurses is a relatively new occurrence, many nurses are not as familiar with the laws governing nurses in private settings and what the parameters are for specific areas of specialty. This can lead to both legal and financial problems for nurses who inadvertently violate laws pertaining to the practice and regulation of particular modalities or methods. One significant example is the practice of nutrition counseling in a private nursing practice. While a nurse can offer nutrition education or guidance in a medical practice, once he/she goes outside of a professional position that is supervised by a medical physician, things change according to state laws and licensing. These state laws are continually changing in that more and more states are restricting individuals, including licensed nurses, from practicing nutrition counseling. Currently, all states have regulations in place regarding nutrition counseling. And, not being aware of the law does not exempt anyone from being prosecuted for its violation. “Ignorantia juris non excusat or ignorantia legis neminem excusat” is a legal principle holding that a person who is unaware of a law may not escape liability for violating that law merely because one was unaware of its content. There are at present four different classifications of permissions utilized by all 50 states for nutrition counseling: 16 states adhere to the following classification: “It is illegal to perform individualized nutrition counseling unless licensed or exempt. Effectively only RDs are eligible for licensure.” The law in 5 states is: “It is illegal to perform individualized nutrition counseling unless licensed or exempt. There is a non-RD pathway for licensure. Check for exemptions.” In 16 more states, “It is legal for all to perform individualized nutrition counseling. Effectively, only RDs are eligible for state recognition.” In 13 additional states, the law states, “It is legal for all to perform individualized nutrition counseling; there may be restrictions on medical nutrition therapy.” Apart from the state laws and regulations, there is a caveat here that needs to be paid close attention to. Outside of a license to practice nutrition, which allows for professional liability insurance to protect you from any legal form of claim or lawsuit, if you are not credentialed and choose to practice nutrition without defendable training and professional liability insurance, you may be placing your license and yourself in a vulnerable position, in the event a claim is taken against you. Some might dismiss the idea of a nutritional lawsuit and the lack of any real danger to your livelihood or finances. I will share a real-life story with you that occurred in the state I live in, which allows for “all to perform nutrition counseling”. This happened to a caring and enthusiastic nurse who had a passion for all things nutrition. She opened her own nutrition counseling practice and was well thought of. She had a friend of a friend’s husband consult with her regarding his desire to get off his hypertensive medication, which was interfering with his physical marital relations. This nurse called herself a health coach and as such was coaching the man on how to reduce his blood pressure. She explained to him that the reason he had to take the medication was because he needed to lose 40 pounds, start eating less processed foods, try meditation or yoga to decrease work stress and get more sleep. She well-meaningly told him that if he did all of those things he wouldn’t have hypertension and that translated to he wouldn’t need to take the medication. The client did follow her recommendations for losing weight through better eating. After 3 months, he reported he felt better and that he would follow up with the health coach as needed. Nine months after she last heard from him he had a stroke. He has stopped taking his medications and his wife, on behalf of her husband, took a lawsuit against the health coach. The court favored the client’s claim and the nurse had disciplinary action taken against her license and wound up losing her home to pay damages. It would appear from the exchange between her and the client that she did nothing wrong and was not responsible for this man’s stroke. The court did not see it that way. If someone takes an action against a practitioner who is not licensed in their practice area or does not have liability insurance in the specialty, they can be charged with practicing medicine without a license. We know about this case because the organization I work for was asked to appear as an expert witness, which they declined to do. The unfortunate thing is these types of claims are not as isolated as one might think. In a recent discussion with the Executive Director of AHNA, she expressed her concern for the rising number of nurses who are getting into legal and financial trouble because of a lack of knowledge of the law in their state regarding their license scope of practice and the guidelines surrounding any specialty modality they may be offering to clients. We are working cooperatively with nurse organizations to provide free seminars on this important subject of professional and legal guidelines and regulations. If you would like more information about the free seminars, endorsed by AHNA, you can e-mail conor@niwh.org for information.
  17. Dr Georgianna Donadio

    Nutrition Counseling in Nursing Practice

    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. Dr Georgianna Donadio

    Nutrition Counseling in Nursing Practice

    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. Dr Georgianna Donadio

    What Does 5G Technology Mean to Healthcare?

    It's unfortunate that every advance has its drawbacks. Better communication is good, radiation health issues is not. Quite a quandary for all of us!!! Kind regards, Georgianna
  20. Dr Georgianna Donadio

    What Does 5G Technology Mean to Healthcare?

    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.
  21. Dr Georgianna Donadio

    Anyone done NIWH Whole Health Educator program?

    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
  22. Dr Georgianna Donadio

    Anyone done NIWH Whole Health Educator program?

    Hello cbrubaker, If you would like more information about our program (a comprehensive e-mail which includes comments from our nurse graduates and their websites with their permission) please feel free to send us an information request and we will be happy to send it out to you. Also feel free to contact us directly at either 888-354-HEAL (4325) or 508-785-2592. Kind regards, Georgianna www.niwh.org
  23. Dr Georgianna Donadio

    Acute Care Nursing or Wellness and Disease Prevention Nursing?

    Hello Golden, RN, MSN - Thank you for your post. Today there are many different specialty trainings that allow nurses to work in wellness or areas of health care that are not acute care. For instance, Doula, homeopathics (yes, you can get an NPI number for both of these specialties), various rehabilitation specialties, patient advocate, patient navigator or patient health education to name a few. The current direction of health care is prevention because finally the money managers (Value-care) have seen that preventing disease is much less expense than treating it. 90% of all healthcare costs originate out of chronic disease, so it makes sense that what is desirable is to create a medical environment where alternative and preventative care is utilized. If you are interested in this topic and would like more information here is a free seminar coming up April 11th at 8:00 EST on the subject. You can find out more at: http://bit.ly/CallInSeminarNIWH Thanks for your comment, Kind regards, Georgianna
  24. In a relatively short time – over the past 15 to 20 years – options for nursing professionals have expanded significantly with the increased focus on disease prevention, wellness, aging issues and improved longevity. This increase has been driven by the consumer as well as the various medical institutions and industry interests looking to lower health care costs and increase consumer satisfaction. With escalating levels of chronic disease, and the associated staggering health care costs it became imperative that national medical oversight organizations begin to address some of the underlying factors that have contributed to these rising problems. Because of the high price tag on our health care, we Americans like to assume that we have the best healthcare money can buy. However, a 2016 report compared the healthcare system in the U.S. to 16 other countries health care offerings. The study showed the U.S. 12th out of the 16 countries, with China ranking as the #1 system in the world. The Centers for Disease Control statistics show that 90% of national health care dollars are spent on the care and treatment of chronic disease and mental health. This has become an important flashpoint to address and reduce healthcare costs in the U.S. while decreasing chronic health conditions. Much of medical acute care is also directed at the urgent care treatment of chronic presentations, with the obvious exception of trauma. Not only is consumer dissatisfaction driving initiatives to find successful alternatives, in addition, dissatisfaction among health care workers and professionals a concern as well. This particular issue, which has a significant impact on the nursing profession, has manifested in several ways. First being that currently there is a large population of nurses who are interested in moving away from symptomatic medicine towards prevention and “wellness” environments. This move away from acute care, symptomatic treatment of illness towards disease prevention, have crafted two “camps”, if you will, of nursing professionals pursuing two different objectives within nursing practice. The current focus towards prevention and patient autonomy is also impacting the practice of acute care medicine. This point is well made in the January, 2017 Orthopedic Nursing journal regarding healthcare transformation and the changing role of nursing: “The Future of Nursing: Leading Change, Advancing Health asserts that nursing has a critical contribution in healthcare reform and the demands for a safe, quality, patient-centered, accessible, and affordable healthcare system (IOM, 2010). To deliver these outcomes, nurses, from the chief nursing officer to the staff nurse, must understand how nursing practice must be dramatically different to deliver the expected level of quality care and proactively and passionately become involved in the change. These changes will require a new or enhanced skill set on wellness and population care, with a renewed focus on patient-centered care, care coordination, data analytics, and quality improvement.” Many nurses today do feel passionate about patient-centered care, which invites the patient into the center of their own health and wellness, refocusing control from the doctor or provider to the patient, who then has greater autonomy and decision making over the quality of their health care but also the quality of their life. At the same time, many nurses are looking to provide more whole-patient focused care, there is data showing an increase in turnover and job dissatisfaction in traditional medical care facilities. There may be a strong correlation between these two trends. According to a 2012 report from the Robert Wood Johnson Foundation, 57.3% of nurses are currently working in hospitals. There is, however, a significant problem with nurse retention. From the 2018 National Healthcare Retention and RN Staffing and Report: “Hospital turnover is on the rise and executives need to be concerned since this is a leading indicator of future financial pressure, and patient & employee satisfaction. 2017 recorded the highest hospital turnover since launching this study almost a decade ago. For-Profit hospitals with under 350 beds and located in the North-Central and West experienced turnover below the national average and tend to have a greater retention level. Conversely, the profile of a hospital with the highest turnover is a facility with 350-500 beds and located in the South-Central region. The 2016-17 percent change in regional turnover ranges from -0.6% to +1.9%. The North-East experienced the greatest decrease in turnover from the prior year, while the South-East experienced the greatest increase.” The U.S. culture is also trending towards a more self-care, self-directed lifestyle with many Americans, of all ages, turning to alternative health care as an option for staying healthier longer and avoiding many of the health care crises that can arise from sedentary and unhealthy lifestyle habits. A mere 25 years ago, organic foods, vitamin supplementation, daily workouts, meditation, yoga, having enough sleep and stress reduction were considered to be too “unproven” and “nutty crunchy” for mainstream medicine. Today, vanguards like Harvard Medical School and its Ivy League peers, all offer online health information subscriptions and health education libraries to help make available to the general population, information they can use to create healthier, longer lives, including previous “alternatives”. There are currently more options, than ever before for nurses to work with patients and tap into their passion to serve others. The integrative health field, wellness as a lifestyle, anti-aging, disease prevention, patient empowerment through advocacy, patient health education and lifestyle support, healthcare coaching, patient navigators and more options are available for today’s nurses. It’s a wonderful time for nurses! References: 2018 National Healthcare Retention and RN Staffing Report Centers for Disease Control Healthcare Transformation and Changing Roles for Nurses Nursing Where the Jobs Are Quality of Healthcare in the US and World
  25. Dr Georgianna Donadio

    Acute Care Nursing or Wellness and Disease Prevention Nursing?

    Hello DallasRN Yes, several years ago hiring health coaches was quite common and popular. The reason things did not work out was health coaching is not billable or reimbursable service. It is viewed as a communication model, which all health providers should train in, but its not seen as a medical service. Not even if done by a physician. Value-Care (which determines how providers are paid for medical services) has its emphasis on patient health education using a whole person, whole health model. The VA has embraced the whole health model and the focus is now more on whole person health education and advocacy to empower individuals with self-directed prevention. Many nurses are leaving acute care for whole health and wellness work and as a result the field is growing and nurses are being sought after as patient educators and advocates. If you want more information, there is a free call-in seminar on April 11th at 8:00 EST. Thanks for your post! Kind regards, Georgianna
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