Patient And Family Education: Fill & Download for Free

I'm going to write about what I've seen in my hospital. The top 5 things nurses know and doctors don't have a clue.1.- How to dilute antibiotics and how fast you're going to IV drip them.2.- Drug concentrations; like Ceftriaxone IV is 1g/10ml and 500mg/5ml but IM is 1g/5ml and 500mg/3ml.3.- How to save an IV line when the pump shows “pressure”, so that you don't need to get a new venous acces.4.- Perfect and tidy “Rosiere”, security sheets, soft restraints5.- Patient and family home cares, lactation education, fall and burns prevention programme and much moreThank God for giving us nurses, cause without them we (doctors) will be lost.

Boost and Ensure are easy solutions for cancer patients and family members who struggle with cancer cachexia; the process by which advanced cancer patients develop anorexia, early satiety, weight loss, muscle loss and weakness.There is only one solution for this problem and that is effective cancer treatment. Absent that, nothing from the nutritional standpoint will work to improve strength.A number of decades ago, we used to put feeding tubes in patients or give high calorie IV feedings through a central line called TPN. We could give more than 2,000 plus calories a day. In the absence of effective cancer treatment, all those calories just went to cancer growth because that was the tissue most metabolically active. Meanwhile patients continued to lose muscle mass and got weaker.So Ensure and Boost are recommended because it frees family members and loved ones from wracking their brains and wasting countless precious hours a day trying to cook up that very special something that our struggling patient would eat. I’ve literally had families spend half the day in the kitchen only to have their very hard worked meal or soup turned away after a handful of bites resulting in everyone being in tears.I try to educate both my patients and family members that what is happening in terms of weight loss and weakness is not due to lack of effort on any of their parts. The problem will not be overcome by finding the right solution to eating in the absence of effective cancer treatment.In fact, the very large majority of cancer patients and family members intuitively know that the treatment is working well ahead of their scan appointment because one of the first things to improve is appetite, calorie intake and improved energy.So Ensure and Boost are recommended because they are no trouble. If the can isn’t finished it can be refrigerated and kept for later. I sometimes advise family members to put a can in a blender with ice and have the patient ingest it spoonful by spoonful. The most important thing is hydration and only secondarily calories. Nothing will worsen weakness like dehydration.Ensure and Boost reduces a lot of guilt from patients and family members and reduces a major area of emotional stress.As an aside, I personally like the taste of Boost better and often drink a can when I don’t have time for lunch.

During my residency and oncology fellowship, I observed many different professors give bad news. Some of them did it better than others.Consider asking permission as a first step. That allows the presentation to be less blunt, something that doctors are frequently criticized for.“You had an HIV test last week. Would you like to go over the results?”Of course the answer will be yes but consider it a small courtesy to ask first.I was taught by my Division Chief at Stanford, Saul Rosenberg, to be open, frank, and to speak plain language. That's worked for me and that is how I taught my residents and fellows.“I'm sorry to tell you that your test was abnormal and you are infected with HIV”. I don't use terms like positive and negative as they tend to be misinterpreted by many patients.And then I wait for a reaction. Many studies indicate that after giving bad news, whatever a doctor says after that goes unheard. Give the patients a moment to collect themselves.Then begin the education on the next steps taken, how effective the treatments are with modern antivirals, notification of partners, precautions to reduce risk to others, and a very favorable prognosis.This moment of receiving bad news is something that patients and family members never forget. Make sure that you have time, that you will not have interruption, place yourself close in front of the patient, look at their face when giving bad news, and at some point in time put your hand on their knee or shoulder.That touch will indicate to family members that contact is good for the patient and is also okay for them.