As part of the admission process for a hospice patient, the admission team will ask the patient about their spiritual orientation and/or religion. Because there is so much information and education to convey at the admission, the discussion of a patient’s spiritually may only be minimally discussed. It is important for the hospice team to be aware of a patient’s spiritual orientation because it can affect their choices regarding treatment ...

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Ebola in Texas: A fascinating story of system errors Ebola is in the United States!  Everybody (please don't) panic!  Quarantine all Texans!  Though that might be a good idea anyway (just kidding).  More on Ebola in general in another post if I have time. First off though, we've found out more information about the sequence of events leading to the hospitalization of the patient, Thomas Duncan.  Apparently, he came ...

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Top stories in health and medicine, October 15, 2014From MedPage Today:

  1. Ebola: Are Community Hospitals Up to the Task? With the announcement that a nurse in Dallas contracted Ebola while caring for an infected patient in a community hospital, calls are increasing to treat the disease only in centers specializing in treatment of highly contagious and highly virulent diseases.
  2. Unneeded ...

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See Ebola through the eyes of the virus As you no doubt know, Ebola has been brought to the U.S. Predictably, this has resulted in a media feeding frenzy, rumination, recrimination, and the familiar blend of hyberbole and hysteria that tends to populate those infamous 15 minutes during which any given crisis holds our attention. No, we are not suddenly at risk. As the media coverage spells out, the ...

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An ER missed Ebola.  Heres how it could happen to you. How did the emergency department staff of a Texas hospital see, and discharge, a patient infected with Ebola? Despite the fact that blame spreads through hospitals faster than hemorrhagic fever viruses, I’m not interested in pinning down a single person, or a single thing, which may have allowed that to happen. I am very interested, however, in offering a few insights ...

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Earlier this year, our hospital staff was weighing a new 24/7 family presence policy to allow immediate family members to stay with  patients 24 hours a day. We knew this was a step in the direction of delivering patient- and family-centered care. We presented the proposal at a meeting of our patient and family advisory council.  One of the members of the council told a story that drove home the importance ...

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During most of my career as a psychiatrist, I haven't often dealt directly with death. For the past five years, though, I have had the privilege of spending two days a week treating service men and women returning from deployments in Afghanistan and Iraq. Listening to their stories and talking with them about their war experiences, I've spent much more time thinking about death and dying. Despite this, I was shocked ...

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In August, I posted this: "A paper of mine was published. Did anyone read it?" A recent comment on it raised an interesting point. Dr. Christian Sinclair at Pallimed said the site had received almost 2 million views since 2005. He then made the following calculation: Two million views with an average of 1:30 minutes on a page = 3 million minutes = 50,000 hours = 2,083 days = 5.7 years ...

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Physicians, whether practicing medicine or not, should not be involved in clinical research. They should never be consulted on development of new drugs and medical devices. Doctors should not invent new treatments, and should never supervise clinical trials. They should not travel to or speak at conferences either, and they should banish all entrepreneurial notions out of their heads. If they insist on engaging in these activities, they should do ...

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Thousands of people have travelled from West Africa to the U.S. in the last 6 months.  While the CDC and others throughout the Obama administration continue to reassure everyone that the U.S. is 100 percent prepared for an outbreak,  potential cases and exposures continue to surface all across the country. In Dallas, the first confirmed case of Ebola has passed away.  Even more concerning is the fact that the patient initially ...

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Top stories in health and medicine, October 14, 2014From MedPage Today:

  1. ID System Reduces NICU Errors. Mistakes made when entering clinical orders in one hospital's electronic medical records system were reduced after implementation of a unique naming system to reduce confusion and miscommunication in the neonatal intensive care unit (NICU).
  2. Clinicians Explore EV-D68, Paralysis Link. The mysterious cases of acute ...

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Having a healthy life is more than getting an annual physical examination. It is about having healthy habits. Some of these healthy habits make common sense. Others seen unnatural, but yet are vitally important. A healthy life is more than feeling well. It is about living life to the fullest and ensuring you are doing your part to improve both your quality of life and longevity. Which ones are you missing? How do ...

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What the Dallas Cowboys cheerleaders can teach us about hiring doctors I’ll admit it. I like reality TV. In fact, one of my favorite reality TV shows is Dallas Cowboys Cheerleaders: Making the Team. It shows what it takes to become a Dallas Cowboys cheerleader (DCC). Why am I talking about cheerleading in a health care blog? Because the Dallas Cowboys cheerleaders put more effort into hiring cheerleaders than most health care ...

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Ebola in the ER: What you should and shouldnt worry about As an ER doctor, right now I'm thinking a lot about Ebola -- it's in the news, in my inbox, and in questions from my patients.  Whether it's an outbreak, a flu epidemic, or a bombing -- we in the ER see them first, and so I'm always thinking about how we'll be ready. So, what concerns me, and what doesn’t? Ebola patients in the ...

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All health care professionals must be skilled at effectively communicating with patients who have dementia.  Some professionals may erroneously assume that only those employed in long-term care, assisted living facility and other similar places need these skills.  However, patients with dementia visit medical practices, acute care hospitals and other health care centers.  This article will provide a framework to effectively interact with patients who have dementia. Go along to get along This ...

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Giving prescription refills is not quite as fun as it used to be. Years ago, we doctors would whip out our prescription pads -- often sooner than we should have -- and we’d scribble some coded language that pharmacists were trained to decipher. I’m surprised there were not more errors owing to doctors’ horrendous penmanship. On occasion, the Food and Drug Administration (FDA) would require a pharmaceutical company to change ...

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The Internet was recently atwitter (see what I did there) about the major health care story of Ebola in the United States. However, there was also a interesting rumor announced at the end of last week, to which people should really be paying attention. As reported by Reuters, Facebook is taking aim at health care, your health care: "The company is exploring creating online 'support communities' that would connect Facebook users ...

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Top stories in health and medicine, October 13, 2014From MedPage Today:

  1. Cashing in on Ebola. What was your reaction when you first realized that Ebola was killing thousands of people in Africa and would probably come ashore in America at some point? Sympathy? Worry? Scientific curiosity? An urge to hop the first plane to Monrovia?
  2. Ebola: Body Fluids Carry the ...

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Why do doctors still use pagers? I was on call last night. Don't get me wrong, this is not as bad as it sounds. With over 20 partners sharing evening call, and residents getting the calls first, we do not have it bad at all. And certainly nothing like my obstetrician friends, who seem to go in every time they are on call for labor and delivery and then ...

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Please don’t call call me a “prescriber.” Yes, I know it’s easier to say “prescriber” than “psychiatric nurse practitioner or psychiatrist.” The word “prescriber,” however, puts severe limits on what I can do and how I can help. You may believe that, because I have a license to prescribe medications, that’s all I choose to do. In fact, you may believe that’s all I know how to do. Psychiatrists can do a lot more than that. As ...

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