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Brenda F. Johnson

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Like 17

  1. Like
    Brenda F. Johnson reacted to SafetyNurse1968, ADN, BSN, MSN, PhD in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    Thanks everyone, I'm going to insist on a colonoscopy next time. I appreciate you taking the time to CARE! much nurse love.
  2. Like
    Brenda F. Johnson reacted to beckyboo1 in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    No no no!  It is not even in the same category.  Insist on a colonoscopy...and not a Cologuard either!  I wonder how out of touch your physician is about other medical conditions.  I can't even count how many times in my 2 years assisting with colonoscopies that I've seen colon cancer in ppl age 70+ who just never could see the need for one.  People are so afraid of the prep and my thought on that is always, do you think chemo-radiation-surgery-colostomy wouldn't be scary? 
  3. Like
    Brenda F. Johnson reacted to Cuttykupcake in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    I’m nowhere near the age where it is “recommended” but I’ve had several now thanks to having ulcerative colitis. The prep is the worst part and always makes me vomit no matter what method I use. Wish there was an easier way to do it.
     
    Now, my mom IS at the recommended age but refuses to have it done even though I’ve told her how important it is...
  4. Like
    Brenda F. Johnson reacted to Bandaide in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    I've had 4 or 5 colonoscopies without sedation. I have an IV, and sometimes get a  little fentanyl as the scope goes round the bend - usually for the doctor's comfort. The doctor had never done one that way before, but now he has a bunch of patients who elect to do it without sedation.
  5. Like
    Brenda F. Johnson reacted to Workitinurfava in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    I had one a few years ago, all was well. I waa so scared but nothing bad happened. I thought it would be a pain in the asz procedure but it wasn't.🤣
  6. Like
    Brenda F. Johnson got a reaction from OldDude in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    The hemocult card is in no way good enough.  It may not detect blood in that particular sample.  You need a colonoscopy, there is no substitute for a visual inspection.  Once you get past the prep for the test, the rest is a piece of cake (so to speak).  The standard of practice is a colonoscopy at 50, find a good Gastroenterologist and get it done.  🙂
     
  7. Like
    Brenda F. Johnson got a reaction from traumaRUs, MSN, APRN in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    I’ve been a GI nurse for about 25 of my 27 years of nursing and I have seen a multitude of changes take place.  The proficiency of a colonoscopy has improved as scopes have become more flexible with high definition cameras that lead to an increased adenoma detection rate. Now that screening colonoscopy is paid for by insurance, more people are getting one and lives are being saved.  But there still remains a societal imputation around the test that hopefully over time will disappear with education and awareness.
    March 24 - 28 is GI nurses week this year, so if you know a GI nurse, please celebrate with them.  SGNA is the national organization for GI nurses that sets the guidelines for standards of practice and provides many services with the most important being education about gastroenterology.  
    There are many opportunities in your community to serve as a volunteer or participant at a colon cancer awareness event.  Here in Chattanooga, we have the Rump Run on March 9th. It is a run or walk event with a bouncy house and face painting for the kids, and a large colon to walk through that exhibits different types of colon polyps and cancers.  Colon cancer survivors are the highlighted guests of the day as they share their stories to help spread awareness. It is a fun way to spend a Saturday morning.
    The reason a colon screening is so important is that very often there are no symptoms when a person has colon cancer.  There may not be any visible bleeding or pain and therefore some cases of colon cancer are not detected until there is an occluding tumor or metastasis.  Educate your circle of friends and family to talk to their doctor about when they should get a colonoscopy. The first time screening is at age 50 except for African Americans who should get one at 45, and of course those with a family history.
    Some of you may have read or heard that colon cancer is on the increase in younger people. The highest increase has been seen in the age group of 20s. Although the exact cause is not known, genetics and environmental factors are thought to play a role. These younger patients are more likely to die from the diagnosis than older patients (Priedt, 2018).
    Some signs and symptoms that we can tell our patients to watch for is blood in the stool, diarrhea and constipation, abdominal cramps, and the feeling that aren’t empty after a bowel movement.  If one of your patients, friends or family has unexplained weight loss, fatigue, and jaundice, make sure they make an appointment to see their doctor right away. These are signs of advanced colon cancer and they need to be addressed.
    Most of us have known someone affected by colon cancer, and the fright that diagnosis can bring. We lift up those going through the trenches of surgery, chemo and radiation in our prayers.  Also, we celebrate the survivors, those who have been in the pit and are now on the other side. Many survivors give back by telling their story and educating their community. March is the month to highlight these wonderful people and one by one, save a life.
    I am proud to be a GI nurse and I learn something all the time.  I have come to respect the GI system and how important it is to our bodies.  Research is continually realizing all that the GI system does for us and how we treat it is so important.  What we eat and drink really does matter. Celebrate Colon Cancer awareness month in your unit or office this year and make it an annual event.  Participate or volunteer in a local event, it is rewarding and not to mention a lot of fun!
    Are you a colon cancer survivor?  If so, please share your story with us.
    Reference
    Preidt, R. Colon Cancer Hits Younger Adults Especially Hard, 1 Oct, 2108. Healthday Reporter. Retrieved from https://www.webmd.com/colorectal-cancer/news/20131001/colon-cancer-hits-younger-adults-especially-hard-study-finds#1
  8. Like
    Brenda F. Johnson got a reaction from OldDude in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    The hemocult card is in no way good enough.  It may not detect blood in that particular sample.  You need a colonoscopy, there is no substitute for a visual inspection.  Once you get past the prep for the test, the rest is a piece of cake (so to speak).  The standard of practice is a colonoscopy at 50, find a good Gastroenterologist and get it done.  🙂
     
  9. Like
    Brenda F. Johnson reacted to SafetyNurse1968, ADN, BSN, MSN, PhD in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    I was approaching my 50th birthday with trepidation - knowing part of that birthday involves a colonoscopy. Much to my surprise, they handed me a card to "poop on" instead (sorry for my scatological humor, can't help it.) I was assured the card is as good a screen as the colonoscopy. Curious as to what others think and what other folks have experienced?
  10. Like
    Brenda F. Johnson reacted to OldDude in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    My limited knowledge of this field obviously will prejudice my statement but the hemoccult cards will be positive for blood in the stool...which means there is a source for the blood requiring further testing. The full blown visual tour of the colon would identify the source of such a positive hemoccult and thus go a long way toward the diagnosis of the issue.
    Secondly, benign polyps can be removed during a colonoscopy that could prevent future cancer development. During my first routine colonoscopy the doctor removed a few polyps; all benign. Ten years (plus a few) later I had my 2nd colonoscopy and there were no polyps...squeaky clean colon.
    So...I think the hemoccult cards are good for a snapshot of colon health but I'd rely more on the colonoscopy regarding prevention issues.
    Excellent article Brenda, thank you!
  11. Like
    Brenda F. Johnson got a reaction from traumaRUs, MSN, APRN in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    I’ve been a GI nurse for about 25 of my 27 years of nursing and I have seen a multitude of changes take place.  The proficiency of a colonoscopy has improved as scopes have become more flexible with high definition cameras that lead to an increased adenoma detection rate. Now that screening colonoscopy is paid for by insurance, more people are getting one and lives are being saved.  But there still remains a societal imputation around the test that hopefully over time will disappear with education and awareness.
    March 24 - 28 is GI nurses week this year, so if you know a GI nurse, please celebrate with them.  SGNA is the national organization for GI nurses that sets the guidelines for standards of practice and provides many services with the most important being education about gastroenterology.  
    There are many opportunities in your community to serve as a volunteer or participant at a colon cancer awareness event.  Here in Chattanooga, we have the Rump Run on March 9th. It is a run or walk event with a bouncy house and face painting for the kids, and a large colon to walk through that exhibits different types of colon polyps and cancers.  Colon cancer survivors are the highlighted guests of the day as they share their stories to help spread awareness. It is a fun way to spend a Saturday morning.
    The reason a colon screening is so important is that very often there are no symptoms when a person has colon cancer.  There may not be any visible bleeding or pain and therefore some cases of colon cancer are not detected until there is an occluding tumor or metastasis.  Educate your circle of friends and family to talk to their doctor about when they should get a colonoscopy. The first time screening is at age 50 except for African Americans who should get one at 45, and of course those with a family history.
    Some of you may have read or heard that colon cancer is on the increase in younger people. The highest increase has been seen in the age group of 20s. Although the exact cause is not known, genetics and environmental factors are thought to play a role. These younger patients are more likely to die from the diagnosis than older patients (Priedt, 2018).
    Some signs and symptoms that we can tell our patients to watch for is blood in the stool, diarrhea and constipation, abdominal cramps, and the feeling that aren’t empty after a bowel movement.  If one of your patients, friends or family has unexplained weight loss, fatigue, and jaundice, make sure they make an appointment to see their doctor right away. These are signs of advanced colon cancer and they need to be addressed.
    Most of us have known someone affected by colon cancer, and the fright that diagnosis can bring. We lift up those going through the trenches of surgery, chemo and radiation in our prayers.  Also, we celebrate the survivors, those who have been in the pit and are now on the other side. Many survivors give back by telling their story and educating their community. March is the month to highlight these wonderful people and one by one, save a life.
    I am proud to be a GI nurse and I learn something all the time.  I have come to respect the GI system and how important it is to our bodies.  Research is continually realizing all that the GI system does for us and how we treat it is so important.  What we eat and drink really does matter. Celebrate Colon Cancer awareness month in your unit or office this year and make it an annual event.  Participate or volunteer in a local event, it is rewarding and not to mention a lot of fun!
    Are you a colon cancer survivor?  If so, please share your story with us.
    Reference
    Preidt, R. Colon Cancer Hits Younger Adults Especially Hard, 1 Oct, 2108. Healthday Reporter. Retrieved from https://www.webmd.com/colorectal-cancer/news/20131001/colon-cancer-hits-younger-adults-especially-hard-study-finds#1
  12. Like
    Brenda F. Johnson got a reaction from traumaRUs, MSN, APRN in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    I’ve been a GI nurse for about 25 of my 27 years of nursing and I have seen a multitude of changes take place.  The proficiency of a colonoscopy has improved as scopes have become more flexible with high definition cameras that lead to an increased adenoma detection rate. Now that screening colonoscopy is paid for by insurance, more people are getting one and lives are being saved.  But there still remains a societal imputation around the test that hopefully over time will disappear with education and awareness.
    March 24 - 28 is GI nurses week this year, so if you know a GI nurse, please celebrate with them.  SGNA is the national organization for GI nurses that sets the guidelines for standards of practice and provides many services with the most important being education about gastroenterology.  
    There are many opportunities in your community to serve as a volunteer or participant at a colon cancer awareness event.  Here in Chattanooga, we have the Rump Run on March 9th. It is a run or walk event with a bouncy house and face painting for the kids, and a large colon to walk through that exhibits different types of colon polyps and cancers.  Colon cancer survivors are the highlighted guests of the day as they share their stories to help spread awareness. It is a fun way to spend a Saturday morning.
    The reason a colon screening is so important is that very often there are no symptoms when a person has colon cancer.  There may not be any visible bleeding or pain and therefore some cases of colon cancer are not detected until there is an occluding tumor or metastasis.  Educate your circle of friends and family to talk to their doctor about when they should get a colonoscopy. The first time screening is at age 50 except for African Americans who should get one at 45, and of course those with a family history.
    Some of you may have read or heard that colon cancer is on the increase in younger people. The highest increase has been seen in the age group of 20s. Although the exact cause is not known, genetics and environmental factors are thought to play a role. These younger patients are more likely to die from the diagnosis than older patients (Priedt, 2018).
    Some signs and symptoms that we can tell our patients to watch for is blood in the stool, diarrhea and constipation, abdominal cramps, and the feeling that aren’t empty after a bowel movement.  If one of your patients, friends or family has unexplained weight loss, fatigue, and jaundice, make sure they make an appointment to see their doctor right away. These are signs of advanced colon cancer and they need to be addressed.
    Most of us have known someone affected by colon cancer, and the fright that diagnosis can bring. We lift up those going through the trenches of surgery, chemo and radiation in our prayers.  Also, we celebrate the survivors, those who have been in the pit and are now on the other side. Many survivors give back by telling their story and educating their community. March is the month to highlight these wonderful people and one by one, save a life.
    I am proud to be a GI nurse and I learn something all the time.  I have come to respect the GI system and how important it is to our bodies.  Research is continually realizing all that the GI system does for us and how we treat it is so important.  What we eat and drink really does matter. Celebrate Colon Cancer awareness month in your unit or office this year and make it an annual event.  Participate or volunteer in a local event, it is rewarding and not to mention a lot of fun!
    Are you a colon cancer survivor?  If so, please share your story with us.
    Reference
    Preidt, R. Colon Cancer Hits Younger Adults Especially Hard, 1 Oct, 2108. Healthday Reporter. Retrieved from https://www.webmd.com/colorectal-cancer/news/20131001/colon-cancer-hits-younger-adults-especially-hard-study-finds#1
  13. Like
    Brenda F. Johnson got a reaction from traumaRUs, MSN, APRN in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    I’ve been a GI nurse for about 25 of my 27 years of nursing and I have seen a multitude of changes take place.  The proficiency of a colonoscopy has improved as scopes have become more flexible with high definition cameras that lead to an increased adenoma detection rate. Now that screening colonoscopy is paid for by insurance, more people are getting one and lives are being saved.  But there still remains a societal imputation around the test that hopefully over time will disappear with education and awareness.
    March 24 - 28 is GI nurses week this year, so if you know a GI nurse, please celebrate with them.  SGNA is the national organization for GI nurses that sets the guidelines for standards of practice and provides many services with the most important being education about gastroenterology.  
    There are many opportunities in your community to serve as a volunteer or participant at a colon cancer awareness event.  Here in Chattanooga, we have the Rump Run on March 9th. It is a run or walk event with a bouncy house and face painting for the kids, and a large colon to walk through that exhibits different types of colon polyps and cancers.  Colon cancer survivors are the highlighted guests of the day as they share their stories to help spread awareness. It is a fun way to spend a Saturday morning.
    The reason a colon screening is so important is that very often there are no symptoms when a person has colon cancer.  There may not be any visible bleeding or pain and therefore some cases of colon cancer are not detected until there is an occluding tumor or metastasis.  Educate your circle of friends and family to talk to their doctor about when they should get a colonoscopy. The first time screening is at age 50 except for African Americans who should get one at 45, and of course those with a family history.
    Some of you may have read or heard that colon cancer is on the increase in younger people. The highest increase has been seen in the age group of 20s. Although the exact cause is not known, genetics and environmental factors are thought to play a role. These younger patients are more likely to die from the diagnosis than older patients (Priedt, 2018).
    Some signs and symptoms that we can tell our patients to watch for is blood in the stool, diarrhea and constipation, abdominal cramps, and the feeling that aren’t empty after a bowel movement.  If one of your patients, friends or family has unexplained weight loss, fatigue, and jaundice, make sure they make an appointment to see their doctor right away. These are signs of advanced colon cancer and they need to be addressed.
    Most of us have known someone affected by colon cancer, and the fright that diagnosis can bring. We lift up those going through the trenches of surgery, chemo and radiation in our prayers.  Also, we celebrate the survivors, those who have been in the pit and are now on the other side. Many survivors give back by telling their story and educating their community. March is the month to highlight these wonderful people and one by one, save a life.
    I am proud to be a GI nurse and I learn something all the time.  I have come to respect the GI system and how important it is to our bodies.  Research is continually realizing all that the GI system does for us and how we treat it is so important.  What we eat and drink really does matter. Celebrate Colon Cancer awareness month in your unit or office this year and make it an annual event.  Participate or volunteer in a local event, it is rewarding and not to mention a lot of fun!
    Are you a colon cancer survivor?  If so, please share your story with us.
    Reference
    Preidt, R. Colon Cancer Hits Younger Adults Especially Hard, 1 Oct, 2108. Healthday Reporter. Retrieved from https://www.webmd.com/colorectal-cancer/news/20131001/colon-cancer-hits-younger-adults-especially-hard-study-finds#1
  14. Like
    Brenda F. Johnson got a reaction from traumaRUs, MSN, APRN in Have you had your Colonoscopy? March is Colon Cancer Awareness Month   
    I’ve been a GI nurse for about 25 of my 27 years of nursing and I have seen a multitude of changes take place.  The proficiency of a colonoscopy has improved as scopes have become more flexible with high definition cameras that lead to an increased adenoma detection rate. Now that screening colonoscopy is paid for by insurance, more people are getting one and lives are being saved.  But there still remains a societal imputation around the test that hopefully over time will disappear with education and awareness.
    March 24 - 28 is GI nurses week this year, so if you know a GI nurse, please celebrate with them.  SGNA is the national organization for GI nurses that sets the guidelines for standards of practice and provides many services with the most important being education about gastroenterology.  
    There are many opportunities in your community to serve as a volunteer or participant at a colon cancer awareness event.  Here in Chattanooga, we have the Rump Run on March 9th. It is a run or walk event with a bouncy house and face painting for the kids, and a large colon to walk through that exhibits different types of colon polyps and cancers.  Colon cancer survivors are the highlighted guests of the day as they share their stories to help spread awareness. It is a fun way to spend a Saturday morning.
    The reason a colon screening is so important is that very often there are no symptoms when a person has colon cancer.  There may not be any visible bleeding or pain and therefore some cases of colon cancer are not detected until there is an occluding tumor or metastasis.  Educate your circle of friends and family to talk to their doctor about when they should get a colonoscopy. The first time screening is at age 50 except for African Americans who should get one at 45, and of course those with a family history.
    Some of you may have read or heard that colon cancer is on the increase in younger people. The highest increase has been seen in the age group of 20s. Although the exact cause is not known, genetics and environmental factors are thought to play a role. These younger patients are more likely to die from the diagnosis than older patients (Priedt, 2018).
    Some signs and symptoms that we can tell our patients to watch for is blood in the stool, diarrhea and constipation, abdominal cramps, and the feeling that aren’t empty after a bowel movement.  If one of your patients, friends or family has unexplained weight loss, fatigue, and jaundice, make sure they make an appointment to see their doctor right away. These are signs of advanced colon cancer and they need to be addressed.
    Most of us have known someone affected by colon cancer, and the fright that diagnosis can bring. We lift up those going through the trenches of surgery, chemo and radiation in our prayers.  Also, we celebrate the survivors, those who have been in the pit and are now on the other side. Many survivors give back by telling their story and educating their community. March is the month to highlight these wonderful people and one by one, save a life.
    I am proud to be a GI nurse and I learn something all the time.  I have come to respect the GI system and how important it is to our bodies.  Research is continually realizing all that the GI system does for us and how we treat it is so important.  What we eat and drink really does matter. Celebrate Colon Cancer awareness month in your unit or office this year and make it an annual event.  Participate or volunteer in a local event, it is rewarding and not to mention a lot of fun!
    Are you a colon cancer survivor?  If so, please share your story with us.
    Reference
    Preidt, R. Colon Cancer Hits Younger Adults Especially Hard, 1 Oct, 2108. Healthday Reporter. Retrieved from https://www.webmd.com/colorectal-cancer/news/20131001/colon-cancer-hits-younger-adults-especially-hard-study-finds#1
  15. Like
    Brenda F. Johnson got a reaction from traumaRUs, MSN, APRN in Congratulations! You're a New Nurse Leader…Now What?   
    Thank you for this article, I can relate to the information because I am in a new role of leadership after many years. The biggest change for me is the information that I learn, I also want to share, but cannot.  Before, I didn't really have to have a filter, now I have to check myself before sharing certain things.  Doing the little things for my unit and staff goes a long way for unity and satisfaction. 
  16. Like
    Brenda F. Johnson reacted to Emergent in Nurse Charged With Homicide   
    Yes, of course I meant "charges". Dang it all, posting on my phone after a glass of wine. 
     
  17. Like
    Brenda F. Johnson reacted to Emergent in Nurse Charged With Homicide   
    I have a feeling that someone with clout, associated with the hospital,  is behind this. Someone who perhaps plays golf with the chief prosecutor?
    How convenient,  to divert attention away from the hospital's deficiencies by vilifying this unfortunate woman.  
  18. Like
    Brenda F. Johnson reacted to Maureen Bonatch MSN in Congratulations! You're a New Nurse Leader…Now What?   
    Maybe you’ve been preparing for years for a leadership position through education and promotions, or perhaps the opportunity was thrust upon you. Regardless of the path you took to get here, you’re now in a nursing leadership position. Even if this position is within the organization you’ve worked within for years, your priorities have changed. In addition to being responsible to your patients, you’re now responsible for your employees, as well.
    Even if you know all the employees, and have worked beside them, they’ll have different expectations of you in your new role. Most leadership positions have tasks that require the skills of either a manager, a leader, or both. Only you can determine how to balance the key aspects of both roles and carve a successful path as a nurse leader.
    Manager versus Leader
    It’s not necessary to be assigned a leadership position to be a leader, and all nurse leaders aren’t successful in leading their employees. You can lead from wherever you are in the organization if you know how to project qualities and characteristics that inspire and influence others.
    Organizations need both managers and leaders. Both roles have different priorities, and sometimes you might need to combine the skills of each. You might be required to manage budgets, inventory, staffing, and quality improvement efforts, while a leader’s duties extend beyond required tasks. Leaders must consider their employees emotions, and recognize and respect them as individuals. To gain their trust and respect, leaders must ensure their employees feel appreciated, and that they believe their efforts make a difference in the organization.
    Qualities of a Good Leader
    Often nurses are promoted into leadership positions because they’re good clinicians, critical thinkers, or since they have the most experience. But perseverance doesn’t procure leadership skills, although that doesn’t mean you can’t work to acquire or enhance these skills.
    Consider what qualities you’ve sought, or admire, in a leader, and how you might work to develop, or model, those behaviors. A few desired qualities in a leader might include:
    Presenting as a role model in a professional, and ethical manner Being fair and consistent Taking responsibility, and being accountable for their own performance Keeping the bigger picture within view Displaying passion, vision, and focus A commitment to the organization, and their employees An empathetic and caring nature Excellent communication skills Seek a nurse mentor who will provide you with honest feedback to help you determine where you fall within this spectrum, and what skills you should strive to improve. Listen to their feedback with the understanding that acquiring a nurse leadership position is only the beginning, to succeed it’s important to continue with professional development and keep abreast on potential organizational challenges.
    Initial Efforts Reap Rewards
    Without the heart and soul of a leader, you can be in a leadership role but not be successful in leading. Inspired and motivated followers who support their leader are essential to accomplishing organizational goals. Whether you’re new to the organization or adjusting to a role in which you’re now supervising your coworkers and friends, taking the time to listen, rather than making assumptions on what you believe needs done, can assist in achieving success.
    Initially, most new leaders can benefit from spending more time listening, than delegating tasks and acting. Take advantage of the knowledge and expertise at your fingertips, and share your expectations, as well as clarify what your employees expect from you in this new role. A leader is one person, it requires communicating and collaborating with your team, and addressing individual concerns, to earn the respect and support essential to achieving success.
    Find Your Peers
    It can be lonely at the top when you realize that although you can still be friendly, and even friends with your employees, you have a new level of responsibility and often have access to confidential information that you can’t share. It’s helpful to develop a social network, and professional relationships, with other nurse leaders to reduce feelings of isolation.
    Broadening your network can allow you to establish mutually beneficial relationships in which you can share best practices, knowledge, and validate that you may face the same challenges. If you’re concerned about asking for advice, or sharing experiences, with local competitors, there may be opportunities to establish trustworthy relationships online where you’re not in direct competition. These can be acquired through professional networks, or on social networks such as LinkedIn.
    New Challenges and Rewards
    A new nurse leader can be presented with many challenges. But there are also opportunities to reap rewards and gain professional satisfaction from having the chance to make a difference in your organization, and for your employees.
  19. Like
    Brenda F. Johnson got a reaction from sirI, MSN, APRN, NP in Over 70% of Nurse Staff Turnover is Due to Bad Leadership   
    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/
  20. Like
    Brenda F. Johnson got a reaction from sirI, MSN, APRN, NP in Over 70% of Nurse Staff Turnover is Due to Bad Leadership   
    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/
  21. Like
    Brenda F. Johnson got a reaction from sirI, MSN, APRN, NP in Over 70% of Nurse Staff Turnover is Due to Bad Leadership   
    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/
  22. Like
    Brenda F. Johnson got a reaction from sirI, MSN, APRN, NP in Over 70% of Nurse Staff Turnover is Due to Bad Leadership   
    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/
  23. Like
    Brenda F. Johnson got a reaction from sirI, MSN, APRN, NP in Over 70% of Nurse Staff Turnover is Due to Bad Leadership   
    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/
  24. Like
    Brenda F. Johnson got a reaction from traumaRUs, MSN, APRN in Word Love; My Writing Journey   
    After my high school graduation in 1983, I got married to my high school sweetheart and we moved from Florida to Clarksville, TN. He was in the Army and that is where we were stationed and where we began our lives together. Being away from family and on our own, we learned to rely on ourselves and make our own decisions. It was liberating for me. However, there were times I found myself sitting on the green shag carpet of our small trailer, crying with frustration, but together we pressed on. Those years taught me who I was and how strong I could be.
    I worked at a local sub shop (that is still there) called Foxx's Sub Shop. I loved working there and found some great friends. After about a year, I looked into college. I knew I wanted to go, it was important to me. I enrolled at Austin Peay State University where I was going to study journalism. I loved being on campus, attending class and studying in the library. In those days we were allowed to smoke in the classrooms and the library. There were small copper colored ashtrays on every desk. I remember the teachers smoking while lecturing and the smell of stale cigarette smoke.
    My husband and I wanted a family, so before I finished my first year at college, I found myself pregnant. I was so delighted! I did not have many people in my life available to help me with decisions, so I withdrew from school with the thought that I couldn't do both.
    It wasn't until my second child was about a year old that I began to think about college again. We were back at home, John was done with the Army and we were both working at a boat manufacturing plant. He worked days, I worked evenings. I was exhausted but enjoying being a mother. The kids were my top priority and I had to work to help keep them fed and clothed. Then one day the plant eliminated the evening shift and I found day care getting my entire paycheck. That was the day I went to the local community college.
    Nursing had always seemed interesting to me, and the program seemed easy enough so I began taking my prerequisites. I left the boat business and got a paper route. Those were the toughest three years of my life (until the kids became teenagers). My day began at 2 am to get the papers. I learned to roll them as I drove to save time, and once I delivered them I ran home to get ready for school and get the kids ready for daycare.
    My house was hardly ever clean or my laundry done during those years. But I realized that something had to give. The kids were toddlers and demanded my attention, often making it difficult to study. Naps on Sundays were a must, and we all crashed into bed after church.
    Graduating from nursing school was one of my proudest days, followed by getting that long awaited letter in the mail saying I could finally use RN at the end of my signature. I worked nights on a med surg floor for the first two years. I had the time of my life. I met some of the most fantastic women I have ever met - they were great nurses too.
    My nursing supervisor was very supportive and when I decided to go for my bachelors, she backed me 100%. So there I was, back in school. The hospital that I worked at was offering a satellite program for RN to BSN, and I couldn't pass it up. It was a personal goal of mine. I was on day shift now, and my classes were in the evening. There were a lot of papers to write and while everyone else complained, I actually enjoyed writing them.
    Skipping forward in time, I now work in a GI/OPS department and have found my niche. I work in a great department with co-workers that became my family. I have another beautiful daughter who is about ten. I got the itch to go back to school, and my youngest was old enough that I felt she could handle me being gone occasionally for school. Once I made the decision to go back to school, I couldn't land on a major. For an entire year, I thought about it and prayed about it. I weighed my options with becoming a nurse practitioner, education, or management. Neither made my heart beat faster.
    Driving to work one day, the idea hit me with such intensity I felt dizzy. What took it so long I have no idea. But there it was! Writing! My first love had circled back around and now I could use my nursing knowledge along with my life experience to do the one thing that I longed to do so badly. After taking one class at a large university, I found Eckerd College who offered a bachelor's in creative writing. So began my trek twice a week to learn how to write correctly and professionally so I could be taken seriously.
    At Eckerd College, I was blessed with so many great and passionate professors who realized how much I wanted to do well and invested in me the time and expertise to mold me into a better writer. During that time I realized how much I loved poetry. I went into my poetry class with trepidation but soon found it was my passion.
    When the time came for me to sit and defend my thesis in creative nonfiction felt surreal. I had worked hard to be sitting there, and now my dream was about to be fulfilled. Walking out of there on that sunny, breezy day, my heart rejoiced.
    My family and I had the chance to move from Florida to Tennessee about two and a half years ago. We had been wanting to move for a very long time, so this was a dream come true. Soon after, I saw that allnurses.com was looking for writers and I immediately applied. I could barely contain my excitement while having my over the phone interview, and soon I was writing articles.
    I have some personal projects that I am working on, but life often slows that process down. I also do contributory work for SGNA, helping to update, edit and contribute to the Study Book for Certification, and now I am working on the review manual. I have days when I wish that I could spend my days writing. I crave to write, as I craved as a child to learn to read those words on the page. I have many great stories to tell, some of them true. One day I will see my dream come to fruition and publish a book (being honest, I want to write many books!). In the meantime, I relish writing nursing articles and I hope you enjoy reading them. Lately, I have thought about getting my master's in creative writing . . .
  25. Like
    Brenda F. Johnson got a reaction from traumaRUs, MSN, APRN in Hormones Linked to Fecal Incontinence in Postmenopausal Women   
    Anatomy
    In adults, the rectum is about 15cm in length with the distal end called the anal canal being an inch wide. The colonic nerve supply controls contractions, mucus secretion, and the rectal sphincter.
    The involuntary striated muscles and levator ani muscles surround the rectum and keep defecation voluntary. Fecal incontinence is caused when the anal sphincter becomes incompetent to voluntarily hold stool.
    Common Causes
    When the ring of smooth muscles and nerves at the end of the rectum are damaged it makes it difficult to hold stool. Below is a list of causes:
    Multiple Sclerosis
    Diabetes
    Childbirth (especially if forceps are used or patient gets an episiotomy)
    Stroke
    Spinal cord injuries
    Scarring from IBS
    Radiation therapy
    Fecal incontinence has such a stigma attached to it that many people suffer from depression, work attendance issues, and social isolation.
    Women Over 40 Are More At Risk
    According to the article, "Fecal Incontinence in Females Older Than Aged 40 Years: Who is at Risk?" by Madhulika G. Varma M.D. et. al., out of the 2,106 racially diverse group of women, almost one quarter reported fecal incontinence, making it as common as any chronic illness. The average age of women in the study was 55 plus or minus.
    Some risk factors for fecal incontinence are; obesity, IBS, urinary incontinence, COPD, and a history of having a colectomy. There is new research to add another risk factor to the list - hormones.
    Role of Menopausal Hormones
    56,000 postmenopausal women were part of a study published in February by Kyle Staller, MD. part of the American Gastroenterological Association titled, "Menopausal Hormone Therapy is Associated With Increased Risk of Fecal Incontinence in Women After Menopause". The research began in 2008 with women who reported no history of fecal incontinence.
    Current users of hormones - 32% had fecal incontinence
    Former users of hormones - 26% had fecal incontinence
    Dr. Staller is quoted as saying, "It's enough that it could significantly worsen the problem among women who already have mild leakage due to factors such as diabetes, prior multiple vaginal births with anal sphincter trauma, or neurological conditions such as multiple sclerosis or Parkinson's". The ratio is relatively small between current hormone users and those who are former users, but with these other factors added in, fecal incontinence can be exacerbated.
    If these women are already on the cusp of suffering from fecal incontinence, then hormone therapy may just be that one factor to push them to be a candidate. However, Stellar states that if a woman is healthy other than menopausal symptoms, "hormone therapy may outweigh the risks".
    Research also reinforces the recommendation that hormones be used for the shortest duration possible. The study shows that the longer you are on hormones, the more prevalence of fecal incontinence, and the longer one is off hormones the risk decreases.
    Mirium E. Tucker's article, "Menopausal Hormone Therapy Tied to Fecal Incontinence", talks about the mechanism of hormones and anorectal estrogen receptors. She compares it to the link between hormones and urinary incontinence.
    "The idea is that the tissues are all potentially estrogen-sensitive. Certainly in the case of urinary incontinence we know the tissues around the urethra and vagina are estrogen-sensitive, which is why many complaints about vaginal dryness come up when estrogen is depleted naturally".
    Tucker's article suggest there may be estrogen receptors in the anus and rectum, but at this time not enough is known to give a clear explanation. There is another theory that estrogen might affect the breakdown of connective tissue. Connective tissue holds everything in place, therefore if it can't do it's job than incontinence could be a result.
    Starting the Conversation
    The takeaway from this information is that women need to know that as they enter into postmenopause, that there are many changes that will happen to their body, and incontinence can be one of those things. If they know it could happen, and become comfortable with discussing it, then treatments and options can then be brought into the conversation.
    Conclusion
    As we have learned, there is a small chance that fecal incontinence can occur in relation to taking hormones during the postmenopausal period. Fecal incontinence is a difficult thing to talk about, so many women avoid the subject. Being aware of what can happen as our bodies age is important for us nurses, not just for ourselves but our patients as well. Do you suffer from fecal incontinence due to hormones or do you treat patients that do? Tell us your story and what treatments or alternatives were incorporated for treatment.
    References
    Staller, Kyle M.D. et. al."Menopausal Hormone Therapy is Associated With Increased Risk of Fecal Incontinence in Women After Menopause". 13 Feb, 2017. American Gastroenterological Association. 24 Feb. 2017. Web.
    Tucker, Miriam. "Menopausal Hormone Therapy Tied to Fecal Incontinence". 24 Feb. 2107. Medscape. 24 Feb. 2017. Web.
    Varma, Madhulika G. M.D., "Fecal Incontinence in Females Older Than Aged 40 Years: Who is at Risk?". June 2006. HHS Public Access Author manuscript, Peer Reviewed and accepted for publication. 24 Feb. 2017. Web.
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