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Brenda F. Johnson

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  1. In our country, and specifically in healthcare, we are leadership deprived. It is difficult to lure good leaders into management positions due to the increased stress that they will have to deal with. Adding to that, younger nurses don’t want it either. There are other fields of nursing that they can invest education and experience in that will yield them more money. Some nurse managers are promoted out of convenience or because they are great nurses. However, Good clinicians don’t always make effective managers because they may not have any leadership skills. Over 70% of nurse staff turnover is because of bad managers (Roussal, 2016). When a nurse leaves a position, it can cost around $75,000 to replace that person (Roussal, 2016). This includes the recruitment of the new staff person, replacement, and possibly temporary staff until the position is filled. Included in that number is the overtime paid to the present staff and the orientation of the new person. When there is a high turnover, the core staff become burned out and unhappy leading to the potential of additional turnover. Personally, I have had some fantastic nurse managers, and some not so fantastic. But my recent experience tops the not so fantastic scale by epic proportions. I kept waiting for the lies to catch up to this person, or the emotional bullying to escalate until someone finally reported the problem. For years, I had begged for help from the manager’s superior, but to no avail. Nothing happened. I felt trapped, frustrated, and angry. Was there no one who cared that the whole department was stressed and unhappy? A part of my frustration was that my co-workers would not stand up for themselves and report the manager. A culture of co-dependency and toxic circumstances had festered for so many years, that I guess they accepted it as status quo. Recently, my manager did something that was so egregious that this person is now forced to step down from their position. What I have realized from this experience is that some of my co-workers who would not have reported this incident. The manager would have gotten by with it, and gone on to commit other intentional errors. Now that there is some exposure to the bad management, my co-workers are more willing to speak up. The people who were brave enough to speak up in the first place did so with much consideration and purpose. There are incidents that are reportable, that must be reported by those with knowledge of what happened. Of course, there are incidents that aren’t harmful but still need to be reported. This allows for a review of the system and root cause analysis that improves how we do things and prevent future incidents. There are a few leadership qualities that lead to failure; lack of vision is one of them. Leaders must be able to articulate their vision so that the staff can relate and understand. This will help staff know that they are a vital part of fulfilling that vision. If a leader has no connection to the larger picture, the staff feel disconnected and unimportant. When a manager has no empathy, the staff don’t feel cared for. Part of having empathy is being able to listen and hear them when they have concerns. No motivation can kill a department’s ability to thrive. Having an environment that helps to create energy and purpose will allow the staff to enjoy their workplace. Also, when a leader has no eye on the future, the staff feel stifled and are unable to learn and grow. Good leaders create trust between themselves and the staff. If the staff has trust, then they will feel comfortable bringing to you issues that they have. They will also know that the manager has their back in difficult situations. A nurturing environment will grow empowerment amongst the staff. A good leader accepts responsibility for things that are their responsibility. They don’t deflect blame onto the staff, or elsewhere but instead are mature enough to self evaluate and use situations to improve their leadership skills. Being an advocate and liaison between the staff and upper management, other departments, and ancillary is an important part of being a good manager. Being open and approachable will go a long way in human relationships. Having a good emotional IQ helps as well. Communication is extremely vital in maintaining any relationship, and especially important with management. Being able to effectively communicate and have crucial conversations will make all the difference in how staff respond to changes. Not every good leader can be excellent in all aspects, but they can continue to try and learn. As for those bad leaders. . . I have no idea! Tell us about your good leader, or bad one. Give us the reasons they are either good or bad. Reference Roussal, L., Harris, J., Thomas, T. (2016). Management and Leadership for Nurse Administrators, 7th Edition. (Western Governors University). Retrieved from: https://wgu.vitalsource..com/#/books/undefined/
  2. On the NSFC website, they list goals for November to raise awareness for Stomach cancer. Education is always top in the list because it encourages us to tell people about the risks factors, detection, and prevention. As with any type of cancer, funding is needed to continue research and improve treatments. They have educational events and a worldwide annual walk to help improve early detection rates and save lives. While we are focusing on our Thanksgiving menu, lets look at what can cause stomach cancer. While the exact cause is unknown, there are identified foods that correlate to stomach cancer such as foods that are prepared by salting, pickled, or smoked. There is a lot of information on the Moffitt website regarding stomach cancer. Some things that can be a precursor for stomach cancer are atrophic gastritis and intestinal metaplasia. Either of these conditions would be diagnosed with an EGD, and these procedures are not approved for screening. Therefore, at this point, symptoms must be present in order to get an EGD. Some symptoms to look for according to Moffitt are: pain in the stomach area, swallowing difficulties, heartburn, jaundice, decreased appetite, and feeling full with little food. Some advances symptoms may include: fatigue, vomiting up blood, blood in stool, and weight loss. Moffitt's cancer center phone number is 1-888-663-3488 If you have patients, friends or family with any of the above symptoms, encourage them to see their primary physician or Gastrointestinal doctor. Nurses are often in the teaching role, and there are risk factors that patients can be aware of. Some of the risk factors we can be on the lookout for are: pickled and smoked foods (as mentioned before), previous surgery, obesity, smoking, excess alcohol, exposure to fumes and dust, and a history of stomach polyps, or long term stomach inflammation. There are hereditary genetic disorders that need to be surveyed such as non-polyposis colorectal cancer, hereditary diffuse gastric cancer, and familial polyposis. We have heard of H pylori and its effect on the stomach, but it is also one of the largest risk factors for gastric cancer. Because of H pylori propensity to cause ulcers and inflammation, it increases a person's chance of stomach cancer by six according to Moffitt. For those with a history of H pylori, the above genetic factors, or previous gastrectomies, there are tests that can be done to screen for stomach cancer. The EGD is the most effective because the doctor is able to take a biopsy of the stomach lining, a serum pepsinogen measurement, and a barium-meal gastric photofluorography. Depending on the type of stomach cancer a patient has and the stage will dictate the type of treatment. Whether it is Lymphoma, carcinoid, squamous cell, small cell, GIST, or Leiomyosarcoma, the oncologist will know best how to treat the cancer. A patient can undergo chemo, radiation, surgery, and molecularly targeted therapy for their cancer. There are several types of surgeries as well. The surgeries performed for stomach cancer can be as minimally invasive as a an endoscopic mucosal resection, to a partial gastrectomy, or a total gastrectomy. If you have taken care of patients or have family members who have undergone a total or partial gastrectomy, you have seen the difficulty they have just being able to eat. This subject is personal to me not only because I am a GI nurse, but because my precious Uncle had gastric/esophageal cancer. He is no longer with us, and the cancer isn't the only problem that he suffered with, but it changed his life. He had a partial gastrectomy and part of his esophagus removed. The recovery was horrible, but the part that bothered me the most was his inability to eat. He was never able to eat normally after his surgery and lost a tremendous amount of weight. To be able to sit with him and enjoy a meal, only to see him stop after a couple of bites and even be in pain was difficult to see. He had a long history of smoking and drinking which probably played a part in his cancer. Love and miss you Uncle Ed. Share your stories about gastric cancer and keep educating!
  3. In the past few years, there have been great strides in improved medication and insulin for the treatment of diabetes. November is the month that diabetes is highlighted to bring awareness to the chronic disease that affects so many Americans. Sometimes, the actions that need to take place are in the political arena. On the American Diabetes Association website, they ask people in states with issues to support legislation that will help people with diabetes. One plea comes from California where low-income families cannot get their monitors covered; Medicaid does not cover this item in California. There are victories noted regarding diabetes research such as Congress renewing federal funding. There are opportunities to get involved at all levels: local, state, and federal, which is what the ADA is hoping for by increasing awareness. American Diabetes Association - Take Action As nurses, we see patients who have been ravaged by diabetes. Those who have lost limbs, eyesight, and have serious heart and kidney issues and suffer on a daily basis. We see the struggle that these patients deal with in trying to control their daily sugar levels. Young children and their parents who deal with insulin control have a whole other set of worries. Keeping young children compliant can be difficult and can result in anger or depression in the child. Diabetes is one of the leading diseases in America, and the fight for these patients never stops. The ADA website talks about some myths associated with diabetes. The first myth is the common belief that overweight people will get diabetes. Being overweight is certainly a risk factor, but there are other factors involved. Genetics play a role in who will most likely get diabetes. Those with a strong family history are at risk for developing diabetes and should get tested regularly as well as practice healthy behaviors that will decrease their risk. Ethnicity also will determine who will get diabetes. Those who are African American, American Indians, American Mexicans, and Asians are at a higher risk. And let's not forget age, as we get older, our risk gets higher. Can eating too much sugar cause you to develop diabetes? Actually, no. Eating a lot of sugar can make you gain weight, which puts you at higher risk, but genetics and the other factors listed previously predispose one to diabetes. Another misconception is that when the doctor puts a patient on insulin, that means that the patient is not doing a good job at controlling their disease. Over time, a person's body produces less insulin and that requires them to be put on insulin. The insulin will help them keep their sugars at a good level and therefore decrease complications, making insulin a good option for these patients. There is an advocacy group called "Beyond Type 1" that is supported by people who have diabetes, (some are famous) to help educate and support those with type 1 diabetes. They offer suggestions for this month to spread awareness. Their goal is to educate people about diabetes and eradicate ignorance and misconceptions. They encourage the use of social media and taking diabetes awareness into the classroom to help support children with diabetes, giving them encouragement and positiveness in their day. Some of us have encountered the patient who is okay with having a 300 fasting blood sugar. As nurses, we must keep educating these patients and their families. Being truthful in the reality of their situation is showing that we care about them and their future. For others, the cost of insulin or supplies can be a barrier to compliance. That is where our involvement in our local government can help these patients. We as nurses are the largest body of educators, and we have the power to change our communities. Encourage your patients to exercise, eat healthy, and check their sugars often. They are empowered, as are we, when they take control of their own bodies. There are many nurses out there with diabetes, and we are the ones who really can put reality into practice for our patients. Each time we teach, we are putting another brick in the foundation of their knowledge and understanding of their disease. Celebrate Diabetes Awareness this month and share your stories with your community here in allnurses!
  4. Brenda F. Johnson

    October 15, 2018 is Global Handwashing Day

    For us in the medical field, handwashing is second nature. We wash our hands before assessing a patient, and then again after. We understand how vital it is not to pass germs from patient to patient or surface to surface. Most Americans also share our understanding about the importance of handwashing. However, there is a large part of the population that does not share our understanding. The Global Handwashing Partnership has put out some information and goals for worldwide education regarding handwashing. The global advocacy group has created some simple reminders for families across the world to help them remember when is the most important times to wash their hands with soap. Their logo for this year is, "Clean hands - A recipe for health". Their goal is to link food preparation and eating with washing hands with soap. Preventing the spread of disease and improving how people prepare food will prevent the spread of disease and improve their children's health, even save their lives. In low income homes, food preparation has shown to be one of the largest problem with almost 70 percent of diarrhea resulting from inadequate food preparation. This is especially the case in children under the age of five. However, pregnant women, those who have compromised immune systems and even the unborn are also at risk.The Global Handwashing Partnership has defined critical times to wash hands in their initiative in relation to food: Before cooking/preparing food Before eating and feeding someone /includes breastfeeding Those who fall into a caregiver role are to be the responsible example. By washing our hands at the most critical times, we will create habits for ourselves and those around us. By washing hands and our food better, diarrhea will be decreased especially in the very young. Diarrhea as we know can not only cause malabsorption, but death. When children do not get proper nutrition, in their first few years of life, they can have issues with growing. Their brain growth could be stunted and their immune system compromised, which they cannot make up for, the damage is permanent. If these children can be taught to wash their hands with soap and water, then their diarrhea can be greatly decreased and then as a result their risk for underdevelopment will be too. Chronic environmental enteric dysfunction is caused by fecal contaminated food. The body can't absorb nutrients because it is too busy fighting off disease. Plus, these kids don't eat when they feel so sick which makes them more susceptible to future disease and recurrent diarrhea. Here's more information on this organization and what resources they offer. They have tools and materials that you can use. Taken from their website, here are some ways that you can make a difference today. *wash your hands with soap at critical times -before eating, cooking, or feeding others *model good handwashing behavior *make handwashing part of family meals *establish places to wash your hands in the house, community, school, and health facility *promote effective handwashing behavior change in research, programs, and advocacy When you are busy at work and are tempted to skip washing your hands, remember how important it is and take the time to do it for you and your patient's. We often forget how many surfaces we come in contact with and who made contact with that surface before you. Just because we can't see them, bacteria and viruses can live on surfaces for a very long time. If you are part of an advocacy group that educates on handwashing, tell us what you do and what a difference it has made in your world.
  5. Brenda F. Johnson

    Celebrate Our LPN/LVNs October 7-13, 2018

    My husband is an LPN and had no idea that there was an LPN week.
  6. Brenda F. Johnson

    Mental Illness Awareness Week October 7-13, 2018

    Thank you for working in mental health, it is a difficult area. I understand what you are saying because I see it in my own family. We can hope that with more awareness, the younger generation will get treatment earlier and be more open to it.
  7. Brenda F. Johnson

    Mental Illness Awareness Week October 7-13, 2018

    I know, it is so frustrating. But often this is the case.
  8. Brenda F. Johnson

    Mental Illness Awareness Week October 7-13, 2018

    Whether it is a family member, friend, or you, mental illness can be devastating, especially when it goes untreated. When a person with mental illness reaches out to someone they feel safe with and then receive negative feedback, they can be devastated. People who don't understand, will often say something that hurts the person reaching out. As a result, that person may not tell another person, ever. People who are suffering with a disease need help, support and treatment. Mental illness is no different than any other disease but it is one that often gets hidden until something tragic happens. Sometimes all a person needs is for someone to listen. Caring enough to actively listen can mean a lot. We know as healthcare workers how much listening can change a situation. The National Alliance on Mental Illness is an organization here to help change America's perception of mental illness. They advance their cause through education, support, and patient advocacy. Their website tells us that eating disorders are the most harmful. Eating disorders can start young, so being able to detect a child with one could save their lives. The National Institute for Mental Health reported a study from 2015 that tells us that one in five people (43.8 million) adults have a mental illness. America's young people age 13-18 have a high number of those affected as well. In fact 21.4% will deal with some form of mental illness in their life. These numbers are high, and that isn't including those who do not discuss their problems with their doctors and go undiagnosed. Whenever we have a problem, no matter what it is, having someone who understands, helps us to feel better about the situation. We share our stories because we know that the other person relates on a gut level. As a person with a mental illness, finding a support group, or someone they can talk to, can make a huge difference in their treatment. Knowing that they are not alone can be the difference between life and death. Having family members who have mental illnesses, I see how ignoring the issue can make it so much worse. These people often mask their feelings with alcohol or drugs, leading to other physical illness. Many people refuse treatment while others take medication and once they feel better, they stop taking it. This cycle can be dangerous for the patient. Talking to our loved ones can be tricky. Staying nonjudgemental and open to what they say is essential. Having real conversations helps everyone involved. *The helpline for the National Eating Disorders Association is 800-931-2237 *Text NEDA to 741741 to get connected to a volunteer National Suicide Prevention Lifeline 800-273-TALK (8255) The more we share information and talk about mental illness, the more the stigma will dissolve. We can be part of the movement to educate ourselves and others about mental illness. As nurses, we can talk to our patients openly and honestly helping them to get the correct treatment. Involving their families will also decrease the stigma that surrounds mental illness. Allowing both the patient and the family to ask questions of us and the doctors will help one by one getting past learned prejudices about mental illness. We as nurses can also be the voice of reason among our peers. A person who is mentally ill can cause their caretaker to fear them due to not knowing how to properly approach their care. When we coach our co-workers and lead by example we will improve the patient's experience along with educating each other. Understanding the dynamics of their illness will help us in treating them. Speak to the patient about their illness as you would their other physical issues. They will appreciate the openness and honesty. I know there are a lot of nurses out there that work in the field of mental illness. Share with us your experience to help us educate each other and the patient.
  9. Brenda F. Johnson

    Celebrate Our LPN/LVNs October 7-13, 2018

    Licensed Practical Nurses across the country are commemorated during the month of October. If you work with an LPN, make sure to recognize them with a banner, food and gifts during the week of October 7 to 13th. Let them know how much we appreciate them and all the hard work that they do. LPNs supervise unlicensed assistant personnel, provide direct patient care, and education. Working under the supervision of a doctor or RN, LPNs can also insert catheters and IVs. Over the years, LPNs have been able to work in a variety of settings. They work in doctors offices, hospitals, nursing homes, and long-term care facilities (National LPN/LVN, 2015). We celebrate their dedication and hard work over the weekends, holidays and nights. Americans are living longer which increases the need for long-term care. The U.S. Department of Labor Bureau of Labor Statistics tell us that the need for LPNs will expand by 25% during the years of 2012 and 2022 (National LPN/LVN, 2015). The evolution of the LPN is an interesting story and often unacknowledged. Originally, the nurses would work in family homes taking care of sick people and also doing housework and watching children. That was in the 1800s, and in 1897, in New York City, a school named Ballard School began giving classes to these healthcare workers (History of LPN, 2014). Disease was widespread in the city, so the practical nurses went into the slums to educate and treat the people hands on. This is the essence of community health care. They realized that better sanitation was the key to improving New York's life from the inside out according to the article, History of LPN Field (2014). Eventually, in 1914, Mississippi was the only state that passed laws regarding LPNs. Then in 1917, the National League of Nursing Education started the process of establishing standards for the practical nurse. When World War I rocked the United States, nurses were needed, however, after the war, many didn't return to the field due to the trauma that they had endured during the war. This added to the nursing shortage throughout the United States (History of LPN, 2014). History of LPN Field (2014) tells us that during the period of 1920 to 1940, most LPNs were found in the public health field. But then World War II came and once again the number of LPNs grew tremendously. At this point, they worked mostly in the hospital. By 1952, the nursing field was 60% LPNs, and licensure became required. During the 1980s, the different levels of the nurse role went through professional scrutiny and as a result, many LPN roles transitioned from the hospital back into the community. Presently, LPNs practice in all roles across the healthcare spectrum (History of LPN, 2014). LPNs have had a varied past of experience and service. This week is your opportunity to be acknowledged for all of the hard work that you do. My husband is an LPN and has been one for many years, so I realize what you go through. Long-term caretakers have a special heart that endures long shifts with aching backs. The care you give makes the patient's life better, and we thank you for that. Healthcare wouldn't be the same without you! Are you an LPN? Tell us about your journey, where you work and what you value. Also, celebrate each other as we recognize you! References: History of LPN Field. (2014). LPNJobsHelp.comNational LPN/LVN Recognition week/ Dorsey Schools. (2015). Dorsey Campuses (Michigan Events).
  10. NPAC Conference 2018 - Barkley & Associates Earn up to 48 contact hours at the National Conference for Nurse Practitioners in Acute Care (NPAC) 2018. If you are a Nurse Practitioner who rounds in a hospital, works in the emergency room, or see acutely ill patients, then this is the conference for you. Join colleagues from all over the country in celebrating this year's theme, "Expanding Our Horizons." Learn while you network with experts in your field, you never know what opportunities you will happen upon. Bring back to your work and place of practice new evidence-based knowledge that you can incorporate into patient care. But don't forget to take advantage of some fun activities Las Vegas has to offer. When and Where The conference will be at the Westgate Las Vegas Resort and Casino on November 7-11, 2018. Westgate Las Vegas Resort & Casino 3000 Paradise Rd. Las Vegas, NV 89109 $109 per night plus $25 resort fee and tax For online reservations CLICK HERE For phone reservations to the Westgate, call 1-800-732-7117 and use passcode SBA8R. Sessions There are over 30 opportunities for pre-conference advanced procedure workshops sessions with the opportunity of receiving 3 CEUs. From "Difficult Airway Management" to "Managing Extremity Issues", you can choose the time that is best for your schedule. Also available during the preconference are special courses: ENLS Course, Emergency Neurological Life Support" 12 Lead ECG Workshop" Advanced Imaging and Radiology Workshop: CTs, MRIs, PET, and More. A Post Conference is available - "Procedural Workshop: Advanced Suturing". The full brochure is available at the following link: Brochure: http://www.npcourses.com/NPAC/Las.Vegas.2018/Brochures/AB.8.30.18.pdf Provider approved by the California Board of Registered Nursing, Provider Number CEP 15436. All NP state regulatory agencies (i.e., State Boards of Nursing) and all national certifying bodies (e.g., ANCC, AANP, AACN, PNCB, and NCC) recognize and accept AANP CE credit for recertification! Conference Faculty The Keynote speaker is Ruth Kleinpell Phd, ACNP-BC, FAANP, FCCM, FAAN and she will talk about the Advancing NP Practice: Setting the Future Agenda. Special Events Join your peers and see all the exhibits at the Welcome Reception on Thursday, November 8, 2018 from 5:30 to 7:30. Make sure to take the time to participate in the Poster Sessions. There will be a peer-reviewed session on both Friday and Saturday Registration Information Early Bird is n longer available at this time. The conference registration is $689 until 10/23/18 and then it will be $719. Nursing students receive a lower price at $449 but you must provide ID. Conference cancellations must be done by mail to Barkley & Associates. After September 25th there will be no refunds. Prices are subject to change without notice. Preconference Prices With the main conference, the pre-conferences cost $89, without it is $139. The special workshops are $129 to $199 with the conference and $179 to $249. There are daily and combination fees available on the website. Hurry and Register for the NPAC Conference! Come and learn with hundreds of other nurse practitioners, take part in the hands-on workshops and sit in on the sessions to hear from the best in the field. You will find a rich and diverse program that offers a max of 48.75 CEUs, 14.25 in pharmacology and 1.25 in advanced procedures. Full conference registration is available all day on Thursday. Let it all soak in while you learn, network, and recharge in Las Vegas. Bring a best friend or family member to enjoy the city and all it has to offer!
  11. Brenda F. Johnson

    Injection Gone Wrong: Part 1

    Your story is much like the woman's I wrote about. She is still on workman's comp though. She actually just came back to work after another surgery. It's a shame that this is common. It shouldn't be.
  12. Brenda F. Johnson

    One Stop Shopping: The Trend of Retail Healthcare

    Thank you for your insight. I think what worries me most is what you talked about in 1 and 2, lack of follow up and missing an important diagnosis because they are not looking at the whole patient like the primary caregivers.
  13. Brenda F. Johnson

    One Stop Shopping: The Trend of Retail Healthcare

    Americans thrive on being able to access things quickly. Drive-thrus give us our coffee, hamburger, or prescription through our car window. We are busy people, and this allows us to multitask without dragging the kids or dog out of the car. We can't see a doctor or nurse practitioner through our car window, but we can stop at our convenience at a clinic on the corner or in the grocery store for our UTI. That is retail healthcare. As Jeannette Y. Wick RPh, MBA tells us in the article, "Retail Health Care: Where It's Been, Where It's Going", there has been a shift in the recent years away from the emergency room for those non-emergency healthcare problems such as bronchitis or that rash on your belly. The cost is less for the patient, and valuable resources are not held up when an urgent care clinic is visited instead of a hospital emergency room that is trying to help a person in a real crisis. Retail healthcare is attractive to the consumer, but for the investor, it is even more so. "What's Behind the Surge in Retail Healthcare Deals?" written by Nirad Jain, Jeremy Martin and Kara Murphy explain that, "From 2012 to 2017, the number of deals involving retail health companies-those that operate freestanding health-related outlets like dental clinics or urgent care facilities-has soared, increasing at a compound annual rate of 34%" That is a large number, and for investors it means a good return. The owners examine it from the patient's side as well as a business side to find the best solution for both parties, their competition is the patient's (consumer's) reward. The investing companies are dependent on the consumer and the consumer has a choice whether to use them or not. This makes the company look at patient proximity, specialization of care, cost, and last but not least customer satisfaction. Patients are becoming self-advocates. One out of three patients look online for a diagnosis and 41% say that a medical professional confirm their diagnosis according to the article by Gary Druckermiller, "What Can the healthcare Industry Borrow From Retail Marketing?". We've already seen the upside to this form of healthcare: a variety of health care services, close proximity to patients, less cost to the patient, less wait times, profit for the owners, and standardized protocols. There are some issues that have to be taken into consideration regarding retail healthcare. No company can provide everything to everyone, so they have to cater to the "most valuable" according to Jain. Knowing the patient's needs coupled with the business side of knowing the regional market is a must for their success. Another issue for the corner clinics is keeping doctors and nurse practitioners. Recruitment for this type of job is not easy and not having the proper number of clinicians can back up the patient load and eventually, the consumer will go somewhere else. There is a fine balancing act by the investing companies that goes into these clinics. Reimbursement looms as an ever-changing factor for these clinics, making the owners concerned. As reimbursement changes, especially if it increases, will roll down to the customer and possibly increase the rates. Continuity of care for the patient is very important. Guiding a patient over time and making sure they receive the proper care can get lost if the primary physician is not informed. For example, it a patient visits a clinic for a UTI, the primary doctor doesn't necessarily get notified. One time is fine, but if the patient is having frequent UTIs and goes to more than one clinic, a diagnosis could get missed. The patient could potentially have other issues going on that require more intense studies. A breakdown in the patient to primary relationship will happen if the patient solely relies on the clinics therefore, the continuity of care will be fractured. In a study cited by Jeannette Y. Wick in her article, "Retail Healthcare: Where It's Been, Where It's Going," she tells us that between 2008 and 2015, 21 million uninsured people made 52 million visits to urgent care clinics. The use of urgent care has increased greatly and will continue to do so. In fact, they have increased by 93% With the multiple advantages of retail healthcare, there can be a downside. With all the conveniences, patients may go long periods of time not seeing the primary and miss doing essential exams, or fall through the cracks on a diagnosis. Have you seen it effect your patients? References Druckenmiller,Gary. "What Can the Healthcare Industry Borrow From the Retail Marketing?" Evariant. 14 January, 2016. 29 August, 2018. Web. Jain, Nirad., Martin, Jeremy., and Murphy, Kara. "What's Behind the Surge in Retail Healthcare Deals? Bain & Company. 9 May, 2018. 28 August, 2018. Web. Wade, Evan. "Investigating the Rise of Retail Clinics." HealthCare News. 11 April, 2018. 28 August, 2018. Web. Wick, Jeannette Y RPh, MBA. "Retail Health Care: Where It's Been, Where It's Going". Contemporary Clinic Pharmacy Times. N.d. 29 August, 2018. Web.
  14. Brenda F. Johnson

    Has Medication Advertising Affected Drug Intake?

    Haha, I will have to pay attention to that!
  15. Brenda F. Johnson

    Has Medication Advertising Affected Drug Intake?

    Before the FDA gained control of how networks can air medication commercials, several doctors did some research and wrote if their findings in, "Television Advertising and Drug Use", by Barry Peterson, Ph.D., et al. They take the stance that advertisements of over the counter drugs contributes to public misconceptions and encourage drug use. "In promoting OTC drugs for the relief of everyday symptoms such as pain, nervousness, or lethargy, drug companies may deceive the public into thinking that drugs are an easy way out of everyday discomfort". That was 42 years ago, but the same concern is echoed by doctors in 2001. In the article, "Ban TV ads For Prescription Drugs?" it tells us that the American Medical Association would advocate for banning prescription drugs ads from television, newspapers, and magazines. They feel that the misinformation is causing problems with the patient population. They also say that these ads undermine their credibility. Doctors find themselves in a quandary when patients demand a medication they saw advertised, but the doctor feels another medication would better fit the patient's problem. Dr. Angelo Agro, an ear, nose, and throat doctor says this about medication ads, "Ads by their nature are biased and compressed and are driven more by drug companies' financial concern than by concern for the patients' best interest". Although there were doctors meeting to lobby against the drug companies advertising, there were also doctors who felt that a ban would violate free speech. The latter group of doctors that felt the ban was unnecessary and made it known to the committee that they saw medication advertisements as a positive because they may encourage patients to see their doctor, even those who wouldn't normally seek medical treatment. They also felt that these ads help to take the stigma out of certain conditions such as depression. Present day research is related in the article written in 2018, "Coverage By The Media Of The Benefits And Risks Of Medications", by Roy Moynihan B.A. et. al. They discuss how news stories need to cover adverse effects as well as benefits, and often research is focused on the results to favor the company. They found that out of the 207 newspapers and television stories they looked at exhibited shortcomings in their reporting. Moynihan reported that only 15 percent of the media outlets presented relative and absolute benefits; 83 percent gave information in relative terms only which can be misleading. Declaring only absolute or relative benefits does not tell the full story. 53 percent did not talk about potential harms, and 70 percent did not mention cost. Cost can be a deciding factor for many patients in whether they will choose a particular medication. Disclosure was an issue also. Scientific literature underreports the ties between research results and industry. They conclude that the news media should "focus" more. They suggest an educational program for journalists that would help them to focus on the reporting and interpretation of clinical findings. The FDA states on their website under the title "Background on Drug Advertising", the following: The FDA oversees the approval and marketing of prescription drugs through the law, "Federal Food, Drug, and Cosmetic Act". We have a lot of regulation in regards to getting medications on the market compared to other countries. The mid-80s saw more involvement of the media in direct to consumer advertising instead of only to doctors and pharmacists. You have probably noticed that there are some commercials that are really vague, and others that go into great detail. There are several classifications of drug ads: Product Claim Advertisements - These are the only ads that state the benefits and risks of a drug Reminder Advertisements - These ads give the name of the drug, but not the drug's uses. Help-Seeking Advertisements - These describe a disease or condition but do not suggest a specific drug. Ex. are ads for allergies, asthma, or erectile dysfunction. I have noticed an increase in advertisements for medications, especially on television and in magazines. Ever since the FDA approved advertising for medications years ago, the number per commercial break has skyrocketed. According to the article, "Think You're Seeing More Drug Ads on TV? You Are, and Here's Why" by Joanne Kaufman, 771,368 medication ads were shown in 2016. She states that it is "an increase of almost 65 percent over 2012". Not only has the number increased for medical advertising, but the class of drugs as well. Years ago, we saw ads for allergy medication or reflux, but now we see chemo drugs, cardiology drugs, and insulin. The marketing is towards those who are older (and still watching TV), rather than the younger generations. The professional opinions are varied in regards to advertising of drugs, some have reasons they are for them, and those opposed have their thoughts. Research shows that the average consumer can be misled by these advertisements. This misinformation can cause issues between the caregiver and the patient. The doctor may have several reasons why a particular medication may not be right for their patient but the patient feels that it is the best choice for them. Cost is another factor, especially with new medications. Insurance may not pay for a new drug, and the patient is left with a large bill or having to go back and ask the doctor for another alternative. Some patients are more pill driven than life-changing driven in regards to treatment and end up on a long list of medications. Should drug companies be allowed to advertise at all? Should the government be involved? It's difficult to turn back federal regulation, and advertising is money driven. What would you like to see happen regarding the advertising of medications? References "Background on Drug Advertising". www.fda.gov/Drugs/ResourcesForYou/Consumers/PrescriptionDrugAdvertising. 20 July, 2018. Web. "Ban TV Ads For Prescription Drugs?". CBS News. 18 June, 2001. 20 July, 2018. Web. "Basics of Drug Ads". www.fda.gov/Drugs/ResourcesForYou/Consumers/PrescriptionDrugAdvertising. 20 July, 2018. Web. Bell, Robert A. Phd, Kravitz, Richard L. MD MSPH, Wilkes, Michael S. MD PHD. "Direct to Consumer Prescription Drug Advertising and the Public". 14(11)651-657. Journal of General Internal Medicine. 14 Nov, 1999. 20 July, 2018. Web. Kaufman, Joanne. "Think You Seeing More Drug Ads on TV? You Are, and Here's Why." The New York Times. 24 Dec. 2017. 20 July, 2018. Web. Moynihan, Ray B.A. et al. "Coverage By The News Media Of The Benefits And Risks Of Medication". The New England Journal Of Medicine. Vol. 342 Nu. 22, 11 July, 2018. 20 July, 2018. Web.
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