Health Promotion,and Prevent Diseases.

Thank you very much.

Nurses You Move Me

Health Promotion: Is the believe or assumption that people will maintain their health by participating in certain type of life style changes that will prevent stroke,heart disease ,lung cancer,chronic pain,diabetes.And there are services that will help people to maintain healthy life no matter their social economic or their geographical location in the world.

Below are Health Promotion Behaviors.(Voluntary behavior)

No smoking (If you can do not smoke)

Good Nutrition: Eat moderately.

Maintain idea body weight.

If you are pregnant attend prenatal classes and follow doctor’s

orders.

Sleep atleast seven hours a night.

Eat your breakfast (Most important meal of the day)

Do not live a sedentary life style.

Moderate Exercise. Little exercise a day will not kill you rather it will make you stronger.

Education :Get information about your health .

Communicate and learn from others and healthcare providers about

health promotion and…

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Health Promotion,and Prevent Diseases.

Health Promotion: Is the believe or assumption that people will maintain their health by participating in certain type of life style changes that will prevent stroke,heart disease ,lung cancer,chronic pain,diabetes.And there are services that will help people  to maintain healthy life no matter their social economic or their geographical location in the world.

Below are Health Promotion Behaviors.(Voluntary behavior)

No smoking (If you can do not smoke)

Good Nutrition: Eat moderately.

Maintain idea body weight.

If you are pregnant attend prenatal classes and follow doctor’s

orders.

Sleep atleast seven hours a night.

Eat your breakfast (Most important meal of the day)

Do not live a sedentary life style.

Moderate Exercise. Little exercise a day will not kill you rather it will make you stronger.

Education :Get information about your health .

Communicate and learn from others and healthcare providers about

health promotion and disease prevention.

Drink moderate alcohol or wine

.Be happy because good mental health is good for the overall health.

Disease Prevention

This is to reduce the development of chronic diseases.Disease prevention is the action taken by individuals to avoid the display of disease.These actions

are taken to improve health by changes of social and economic determinant on health.By provision of information on people behavior,consultations and resources made available will help the prevention of chronic diseases.That is the prevention of acute,chronic and castastropic conditions.We must do the right thing to maintain our health.

For Examples.

Immunizations

Proper diet.

Adequate Exercise.

Doctor visit for early detection of

high blood pressure,

High blood Glucose.

Fever of Unknown origin.

Cancer.

What is the Role of Nurses in Health Promotion.

The Nurse should encourage patients to make informed decision.

Education: The Nurse should educate the patients on how to promote their health and prevent diseases.Inform patients of two groups of illness.Acute and Chronic illness.Acute illness is a rapid onset of self limiting but patient can receive specific treatment and return to their original state.Whereas Chronic illness is referred to as permanent disease.That is the deviation from normal to sickness state.It is an irreversible illness for example Cancer,heart disease,diabetes,and Chronic pain.

Florence Nightingale 1859 “Nursing ought to signify the proper use of fresh air,light,warmth,cleanliness,quiet,and the proper selection and administration of Diet ,all at the least expense of vital power to the patient.

And what nursing has to do  is put patient in the best condition for Nature to act upon him.”.

Nurses should educate patients to:

Take their Medications

Follow up appointment as scheduled.

Eat Right

Avoid Stress.

No Smoking.

Happy doctor with drug and patient on bed at clinic
Happy doctor with drug and patient on bed at clinic

 

I Finally Scheduled My Annual Physical.

What do I ask my doctor?

Assessment:Let the doctor do your physical assessment from your head to your toes.

Eyes sight examine

Check your vision(Known as eye Exam)

Check your hearing.

Check your mouth.

Vital Signs :The Nurse will check your blood Pressure.If you have

heart problems Cardiologist consult will be ordered.If you have kidney disease Urologist consult will be ordered.

Blood draw,pap smear .Referral for mammogram given if you are of age

or family history of cancer.

Happy doctor with drug and patient on bed at clinic

Weight loss: Inform the doctor of unintentional weight loss. Unintentional weight loss could be very serious and sometimes deadly.Speak up.

Possible chest Xray based on why you are there.

Medical, Social history and Surgical history should be provided to the Doctor and Nurses.Heath history and family history should be provided to

your Doctor so that they can take good care of you.

Vaccine : When was the last time that you have your flu and pneumonia vaccine?
Homelessness: Where do you live? Your living condition must be provided too.

If your condition is serious you might be referred for admission into the hospital for observation and treatment.

Be your own Advocate.

Provide Emotional Support,Be There.

A Retired 70years Biology Teacher recently came to the hospital

due to fluid in her lungs and abdomen. Parenthesis was done to remove the fluid. The fluid was drained ,pain was controlled and diabetes was properly managed. But the sad news was that the Doctor told her that she has only three months to live. Because the cancer has spread all over her organs.She understood the pathophysiology of the disease process. Her only daughter does not seem to understand ,so she intentionally brought her to the doctor .

She told the doctor that she does not want to be in pain so she demanded for strong pain medications to ease her dead.So that she will not suffer too much. Her husband later walked in.Her husband was space out ,for him it was like a nightmare that has refused to end.But as for the the daughter she was in complete denial.

Daughter: No,no I am not ready for my mother to transition to the other side..I am still single ,I have not got my life together.And I need to get my life together before you do any of these things that she is demanding.

Doctor: Replied to the patient daughter if we do not give her the medication

to relief her pain ,she will suffer.

Daughter: I am not ready doctor I am not ready.

Doctor: You need to Provide Emotional Support and be there for your dying mother.You can still put your life together later.But your mother as my patient has the Right to have Respectful and Compassionate care.Also the Right for complete information about her treatment the way that she will understand and benefit.She has the Right of her Privacy of who should and should not be involved with her care. And the Right to know the nurses,doctors,physical Therapist,case managers,and Social workers involve in her care.

Daughter: Oh, I did not know that.

Doctor : Replied which one of these list that you did not know?

,Daughter : The Right to her privacy of who are invited and who are not invited.


What Do You Want When You Are In Hospital.

Clean Environment.Cleanliness is next to Godliness.You want the environment to be clean because first impression matters.No ugly smells,no roaches or bedbugs.

Hand Sanitizers and Hand Washing Stations in place.No signs of Hospital acquired infection.Doctors and Nurses must wash their hands before and after touching you.

Your Rights as a Patient. Know your rights as a patient.All of your rights must be explained to you.Demand for your rights.But do not forget that respect is reciprocal.Give me some respect.You have the right to accept and refuse treatment as long as you are not altered.
Lab Values : Normal lab values are important for your health.For example Potassium is one of the electrolytes of the body.Normal potassium level is 3.5-5.5millimole.An abnormal low potassium which is also known as Hypokalemia can lead to arrhythmia,and muscle cramps. Hyperkalemia is known as high potassium level and it can destroy your kidney. And low sodium can cause confusion or seizure activities of he body.(Normal sodium level is 135-145mEq/L) Diarrhea ,vomiting and certain medications can make you loose potassium.

Your blood level is also very important .We have red blood cells known as Hemoglobin and Hematocrit.Normal Hemoglobin is14-18g/dl.Normal(male)12-16g/dl (Female)

Hematocrit is the blood test that measures your total portion of red blood cells in your blood.Hematocrit  normal level  42-52High

White blood cell is sign of infection.Normal (WBC) White blood cell count is 4.5-11

 

Informed Consent: You need to be informed of any procedures that needed to be done by the doctor.The consent will explain your risk and benefits.The benefits and risk of the surgery will be clearly demonstrated.And you will sign if you agreed to the plans.If you are to receive blood transfusion ,you will need to need to sign.Do not be shy to ask questions.And do not pretend that you do not need what you need.

For example a 32 years woman was pregnant she has a sickle cell disease her hemoglobin dropped  down to 5.3.

She was told that she needed blood transfusion.But because she had previously lied to her husband that she does not have sickle cell disease.

She refused blood transfusion,only to die one week later at home.It was very painful and a sad case.”Knowledge deficit related to disease process”.

Pain Medications: You should be medicated for pain as ordered and as needed .If the particular medication that you are taking is not working ,let your Nurse know.

Language : There is need to have access for language interpreter.This allows the Nurses and Doctors to communicate with you and gather accurate information about your health.

Generalized edema or edema in the upper extremity.Notify your nurse immediately.Why are you swollen?Find out why.

,Output: Urine color,appearance,  consistence ,and frequency of urination.Are you have difficulty to urinate?Foley catheter? To avoid infection you should not have Foley catheter  for more than 48hours to 72hours maximum, unless you have retention,stage 111- 1V pelvic wounds , Neurogenic bladder and other related factors.Bowel sound: Are you having a good bowel movement.If do you not let your Nurse know.

Room  Mate : You are all by yourself in a room, nice.But sometimes you are not.It is the responsibility of the Charge Nurse to pair you with the right room mate.I do not want a patient that snores too loud or watch Television all night,or talk all night or has constant smelling loose stool all day and night either.

Check on Me: You want your Nurses to check on you regularly.Proactive Nurses will anticipate your needs and do it.

Discharge Dates:You want to know  your discharge date upon admission to the hospital.This allows you and your family to make plans and stick to it.Because you have life after hospitalization.

 

Noncompliant Patient.

Compliance means to be cooperative, willing to follow Treatment Regimen.

Noncompliance means not cooperative, unwilling to follow Treatment Regimen.

The questions that arises is why will someone refuse treatment regimen?Why will someone refuse to cooperate with their plan of care.Why will you reject something that will make you better. Something that will keep you healthy and possibly prolong your life?

Here are Some Reasons:

“No English”.Some people will pretend that they do not understand English to see what the healthcare professional might be saying about them.Which did not make sense but for them it made a lot of sense.We should use the language line to make sure that they understand.

Denial of the problem: Refusal to accept diagnosis but did nothing about it .Some are too proud of themselves that they will not confess that they don’t have the resources. Therefore they rather hope against hope until it is to late.Then BIBA to the Emergency Room.

Importance of Previous Experience:One good experience deserve another. Bad experience is always discouraging.

Lack of Adequate Support System: It is very important to reject “NO”for any unreliable answer. According to WHO about 125,000 people die within a year due to noncompliance.

Other Factors include negative attitude, lack of motivation, cultural and Beliefs System,Educational level, Gender and Marital Status.

Cost of Treatment : Most people cannot afford to pay for treatment, but has no solutions.

Age.This is one of the factors that can affect compliance,because patient is demented and does not comprehend the needs to cooperate. So families or other social support should be involved.

Language barrier.Patient does not understand.It is very difficult for both the patient and healthcare workers when patient does not understand.Language line can help or qualify interpreter.

Belief System.In Africa in those days there was the beliefs that Cancer, Diabetes, hypertension and Aids are “White man’s” disease.This is due to ignorance and lack of understanding.

People were living longer then due to lack of Stress,their means of livelihood was Agriculture, there was no Processed Food,live was simple.Everybody was their brother’s Keeper, caring for each other .

Then came the era of processed Food,Greed,Stress,Dishonesty.The Culture,Norms and Value System of the Ancestors were Relegated to the Background.

So you get what you paid.You want to emulate the Western World.You must have a system that are in place to move the Country forward with modernization. But unfortunately for people in Africa they have No Adequate Healthcare System to take care of their “New attitude”And the current Death Rate is alarming.They have no solutions, the Government are Corrupt through and through.The rich seek Treatment overseas and the Masses die of diseases, hunger,and starvation.

We did a health Fair over in Africa twelve years ago, in which one of the client blood pressure was over 200 Systolic and diastytolic of over 120.She said that she had no money for doctor’s visit,we paid for doctor visit and medications .But she ignored all warnings.Did not take her medications.According to her “high blood pressure did not kill my parents and will not kill me”. She died three weeks later.Some people will just believe what they want to believe which might be detrimental to their live.Did she know what killed her parents since there was no autopsy?

No she did not.

I have hoped against hope that one day,reality will set in and they will realize the truth and that day may be “Now”.

There are people in various parts of the world that don’t understand the disease process and don’t want or believe in it or care.And there are other people who understand and do the right thing.Health Promotion and Disease Prevention.So life expectancy in third world countries are low due poverty,access to health clinics,knowledge deficits, finance, substance abuse,age,belief systems and so many other factors.

Finance.someone people have no means of transportation to the clinics or money to buy the needed medications.

Nutrition.So many patients do not follow the right diet.For example the dialysis patients should avoid the three Ps which are potassium, phosphorus and protein.But they do not because so many of them cannot afford it.

Substance Abuse.Most often patients that abuse drug and alcohol don’t follow doctors orders, so they end up in Emergency Rooms.According to World Health Organizations most of the hospitals and Nursing homes admissions are due to noncompliance.

Nonchalant attitude.Some patients don’t care and they don’t see it as their problem.Rather it is the doctors and hospital problem.”Is their problem not my problem”

Frequent Flyers.The frequent flyers do not pay attention to their health,so they come to the hospital frequently only to go out and continue to do the same thing again,and again.

Homelessness.When you are homeless it becomes difficult if not impossible to take control of your health or your life.

Poverty. Poverty can be a disease.Seek help from all the right places.Do not give up.There is government hospitals, Meals on the Wheels,Public Transportation systems,Homeless Shelter, and various places that you can go to get help.

SOLUTION.

Nurses to Educate Patients.Educating the patients about their disease process ,and how to manage their health is very important. For example a diabetic patient need to have accucheck machine, and all the needed supplies to check their blood sugar.

Patients Education .Educate patients on the importance of compliance.Explain to patients and families the disease process and the need to comply.Because noncompliance can lead to so many problems.

Education,education with case scenarios for those who believe that it cannot happen to them because it can happen to anyone.Educate on Prevention and Health Promotion and also explain the pathophysiology of the body.

Happy doctor with drug and patient on bed at clinic

Involvement patients in their Plan of Care.

Patients should be involved in their plan of care.Encourage them to follow up with their doctors orders.Take medication as prescribed.

Family Involvement.Involve patients families. Educate them on how to take care of their love ones.

Financial support: Refer their to the proper department to help with payment.

Social Work and Case Manager should be involved to follow up with patients and make arrangement to help with supplies of important medications for one to three months supplies.Until patients can find their grounds.

Mathematics Test( in relation to Flight and Fight).

The teacher wanted to give the students surprise Math Test . He distributed the test on their desk before the students came in.

As they walked in,he announced put away your backpacks bring out your pencils and have your seats.And he distributed the calculators.

They all sat down quietly.One of the students looked at the mathematics and said,”Math,algebra or whatever they call you .My teacher has never taught us this.Immediately

Pupils became dilated due to fear.

Flushed Skin

He started to tremble.

Heart Rate went up.

His breathing became fast.

His body is ready to respond.

The body ready to respond is been triggered by the release of hormones known as Nor epinephrine and epinephrine, released by

the nervous system and adrenal medulla.

Then the body now prepares to run or stay.And that is; do I take this algebra test
or do go home sick?.

Then here comes the teacher, Paul you are good at this.Remember last time you were helping other students.

Paul then relax did not run but stayed and took the algebra test.

DIFFICULT PATIENT.

The Doctor and His Patient.

Doctor M.X walked into patient room ,introduced himself to the patient as his doctor.

He told the patient that he want to assess him and change his wound dressing.The patient replied no you are not.

Fuck out, get out of this room right now.

The doctor tried to explain again what he wanted to do .The patient said ,”get your ugly face out of my room now.Go, I said leave.

Doctor :” You do not want me to check you and see how you are doing?

Patient : No I said fuck out,get out of my room.This is my domain.And if you insist I will file assault charges against you.

Doctor : Okay thank you very much.

Patient : Yes fuck out ,go and eat shit and die,ugly bitch.

Doctor : Walked away quietly and documented his experience.


PATIENT EDUCATION.

Nurse and Patient Husband.

Foley catheter was inserted in a fifty years old female due to urinary retention based on the Emergency Room doctor’s order.Patient was having difficulty to urinate,all effort for her to urinate before placing the Foley catheter in her was impossible. Bladder scan was done and it showed that she had over one thousand, three hundred urine in her bladder.

Upon insertion of the Foley catheter, one thousand of amber colored urine was drained out.Patient said that she felt better.Then came patient husband,

he pushed the call light and the nurse walked into the room.”My wife does not need that thing inside her private part.I felt insulted and violated that you put that thing inside my wife without consulting me.”(Husband)

Nurse : Sir I understand that you do not want the Foley catheter.

But why do you feel insulted?

Husband : Kept quiet for few minutes and replied because she does not need the tube inside of her.

Nurse : You feel that her private part is your territory.

Husband : Exactly,nobody has the right to put that thing in my wife. Not even President Bush can tell me what to do with my wife.

Nurse : Mr C.S you wife is not able to urinate.

Husband : I do not like it when you guys act like you know everything.My wife can make urine.And she has been making urine for a long ,long time.

How can you say that because I brought her to the hospital. And because I wanted the doctor to change her blood pressure medication and pain medications. Now she cannot produce urine. Who the hell are you? Are you God?

Nurse : We are not God ,the doctor ordered some test on her to see what is going on with her.And she will be admitted to the Med/Surgical floor to monitor her ,give her some fluid, antibiotics and run more test.We will make her comfortable.

Husband : Okay I still need that thing out right away.Now.

Nurse : Okay sir, I will let the doctor know. Can I get you something to drink?

Husband : No I will be leaving soon. We live two hours away from the hospital.Thanks Nurse you know what you are doing.Nurses are great people.I will call you when I get home.What is your name?

Nurse : My name is Jenny.



PATIENT EDUCATION

Nurse and Patient Daughter:

Patient daughter called the Nurse to the room because her mother wanted to urinate(void)The doctor has ordered to ambulate patient three times a day(TID) So when the patient called that she wanted to urinate.The Nurse was happy because it is a great opportunity to start the ambulation.

So when the nurse came in ,she said that she will take the patient to the restroom.But Patient Daughter said,” I prefer her to use the bedpan instead of walking her to the restroom.

The Nurse explained that the Doctor wanted the patient to walk three times a day.The daughter was furious “,You nurses are so lazy and do not want to do a shit.I do not care what the doctor said.The nurse went further to explain that walking your mother is actually good for her,it will increase circulation,and make her recovery faster.Also will help to prevent DVT (Deep Vein Thrombosis)

The Nurse decided to do patient/family education .

Patient Daughter: I am not interested in any of that ,call the doctor.

Nurse : Called the doctor and over the phone the Doctor explained the need for patient to ambulation three times a day.

Patient : Apologized to the Nurse.

Patient Daughter : Whispered to the patient,” I do not like her”.