A Patient's Guide on Keeping your Voice

A few weeks ago I had the pleasure of taking care of a very spry 89 year old man who suffered from a stroke. For those of you who do not know what a stroke entails, let me explain. There are two different kinds of stroke; Ischemic and hemorrhagic. Ischemic is where you have a blockage in an artery preventing blood flow to parts of your brain and hemorrhagic is when one of those arteries breaks and bleeds into your brain. Both of these can be potentially life threatening. This young man suffered from an ischemic stroke and was fortunate enough that his wife recognized the symptoms and called 911 immediately. We were able to remove the blockage in his artery and he eventually gained full function again (this is not always the case, believe me). Prior to this man's recovery he suffered from what we call expressive aphasia; this means that he is able to understand what you are saying and also form his own thoughts, however when he tries to speak, the words come out garbled. This man has lost his voice, literally. He has just found himself in a very vulnerable situation and unable to communicate his wants or needs. Now there are multiple ways, especially in the ICU that you can lose your voice. You can be intubated on a ventilator (breathing machine), you can be sedated with drugs, if you are elderly sometimes your family members will automatically assume you cannot make your own decisions even if you are of sound and mind and speak for you, you can be an alcoholic or drug addict going through withdrawal and be totally out of your mind, or you can have a doctor or nurse who just doesn't listen to you. So what can you as a patient do to keep your voice while in the hospital?

1. Prepare a living will or five wishes form before you get to the hospital. If you do not want to be put on life support and have feeding tubes, and other tubes (we have a tube for everything nowadays) put into your body and be left in a vegetative or bed bound state for the rest of you days then please write this down. It is not fair to your loved ones to leave them with this decision. I know that some people will state that they do not want to live this way and they do have this discussion with their spouse but that is not good enough, it must be written down. Here is a link to download the five wishes form http://www.agingwithdignity.org. This is the easiest way to let your medical providers and family members know your wishes. You can also ask for a living will form from your local hospital or download it off the Internet as well. 
2. Designate someone to advocate for you if you are unable to speak for yourself. You can do this by obtaining a medical durable power of attorney. These forms are state specific and can be downloaded from the Internet. To make it legal just have it witnessed and notarized. Try to choose someone who is not intimidated by medical professionals, who can ask challenging questions and who can put aside their own feelings in order to ensure your wishes are carried out. 
3. If you find that your doctor or nurse is not listening to you, ask to speak to the charge nurse or patient advocate in the hospital. Tell them your concerns, calmly, and maybe they can help address them. If this doesn't work you can always resort to firing your nurse or doctor. You have what we call patient rights and that's one of them. 
4. For some reason when elderly patients come into the hospital, people, including family members, tend to treat them like children. Do not let this happen to you and try not to do this to your family member. If you or your loved one are capable of making decisions then it would be best if they were involved in the decision making process. I have seen many occasions when patient's family members push a medical intervention on them just to show that they are not "giving up." 

It is always best to have these discussions before entering the hospital system. Being a patient can be one of the scariest and most challenging events in a person's life. Making decisions under this amount of stress can just make situations more difficult. I know thinking about and addressing end of life decisions may seem like a far fetched way to spend your free time but the truth of the matter, is that death is inevitable and cannot be predicted. People's poor dietary and lifestyle habits are causing them to be more sick and at higher risk for disease and death at a younger age. Take the time this week or month to talk with your loved ones about end of life decisions. While your at it, may talk to them about their current life decisions as well:)

Grassroots Prevention: How to stay out of the hospital and protect yourself when you get there: How to Find Your Voice and Influence Change I had ...

Grassroots Prevention: How to stay out of the hospital and protect yourself when you get there: How to Find Your Voice and Influence Change I had ...: How to Find Your Voice and Influence Change  I had a comment on my previous post about how difficult it is in the world of healthcare to...

How to Find Your Voice and Influence Change

 I had a comment on my previous post about how difficult it is in the world of healthcare to have your voice heard and I have to say that I do agree with this statement, for the most part. There have been numerous times in my career that I have questioned current practices, suggested new ways of going about things and have been ignored. These failed attempts to influence change on a larger level have left me feeling hopeless and resentful; which is perfect for a travel nurse! I no longer have to get involved with the BS hospital politics. If they want to waste taxpayer dollars on flushing NG tubes with sterile water and placing everyone and their mother on the sepsis protocol then so be it. I am here to take care of my patient and that's it! Through this separation between myself and administration I have learned that the best way to have your voice heard is to speak with people who actually want to listen to you. This means avoiding those people who attempt to assault you with holy water because it's your fault their son is an alcoholic; this person is not a good candidate for influencing change. There are many people in this world who care about themselves enough to open their ears and listen to what we have to say. You may not find these people at work. This person might be your spouse, your child, your neighbor, a friend, or even a complete stranger. I have learned through my studies in nutrition that the most powerful way to influence change starts with the individual. Healthcare professionals as well as other professionals have a wealth of knowledge that can benefit the population as a whole. We have the ability to teach people about their bodies, how to take better care of themselves, the warning signs of heart attack and stroke and even save their lives. This information should no be kept to ourselves. It is time to stop trying to change the system and instead change ourselves and our community.

Opportunities for Change

• Feed your children healthy food and show them how to play
• Teach your children about the dangers of smoking, drinking alcohol and drugs
• Take the time to educate your patients and their families
• Volunteer 
• Teach a class to your neighbors on the signs of stroke and heart attack
• Set up a health fair at your church
• Educate yourself on proper nutrition and exercise, then spread the word

Today is the first post of my official Blog. To let you know I actually had to Google what a blog was before I even started so that lets you know the extent of my knowledge. I had recently been following the Zen Habits blog (which I didn't even know was a blog) and took the author, Leo Babauta's advice on the benefits of writing daily. I had also recently listened to a webinar from the Institute of Integrative Nutrition, where I am currently becoming certified in holistic nutrition, on the practice of "morning pages." The practice of "morning pages" involves writing every day as soon as you wake up in the morning. This daily practice is suppose to unleash your inner creativity and also serve as an outlet for stress. I found this to be very beneficial, but as most of you who know me personally, I like to share my opinions with the world, even if the world isn't exactly ready to hear about them. So here I am. Now according to a few websites on blogging, apparently you are supposed to write about something you are passionate about and that might interest others. I know I am passionate about health and wellness but telling people what to eat every day gets a little boring. So I asked myself what do I constantly complain about and guess what came to mind? The healthcare system. Yes my friends, and most likely co-workers, we all do it. Rather than going into the med room to complain about our crazy patients, their families, administration, physicians, other nurses and if Phil is involved the government, I have decided to bring my issues to the table to hopefully effectively start conversations and slowly change the way we practice healthcare. This is why the title of my blog is "Grassroots Prevention." We cannot sit around and wait for the government to change the system. The new healthcare reform act just passed which actually has nothing to do about people's health, only their health insurance. The government has no flippin idea what goes down in the real world. The people in the trenches, because that is what it is beginning to feel like, have to start changing the system. We the people have to start taking responsibility for our own health by eating better, exercising, educating ourselves about our diagnoses and medications, taking control of our own health, and preparing for end of life issues. These are just a few ways to improve the state of our healthcare system and it starts with the individual. I hope to spark conversation across the board. This will hopefully be an open forum for healthcare providers and patients, so remember to make sure your comments actually have a purpose and are respectful. Wish me luck. This is about to get interesting!!!