Monday, January 3, 2011

California Nurse Entrepreneurs, Nurse-Owned Businesses

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Donna M. Post, RN, BSN, MBA / HCM, CLNC, LNCP-C , Mid-Valley Legal Nurse Consulting, Inc., California Nurse Entrepreneurs, Legal Nurse Consultants:"Mid-Valley Legal Nurse Consulting has over 24 years of experience clinically and administratively, in cardiac, adult and pediatric critical care, and dialysis. Our experience extends to both the inpatient and outpatient settings. MVLNC provides effective identification of practice standards, regulatory standards, adherence and/or deviations to these standards. Our background provides our clients the added benefit of understanding healthcare infrastructure, budgets, and healthcare labor issues. This extensive experience allows for identification of medical and nursing issues in any case that involves health, illness and injury. The clients we serve are attorneys, insurance companies, healthcare facilities and others. At Mid-Valley Legal Nurse Consulting, our goal is to provide our clients with cost-effective, efficient, review and analysis – providing you with winning services while critically defending your bottom-line.
2491 Alluvial #7
Clovis, Ca 93611
Phone: 559-294-7580 or 877-532-5676
Email: midvalleylegalnurseconsulting@gmail.com
http://www.mvlnc.com
http://www.nursingentrepreneurs.com/post/

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Romaine A Settle, RN, RoMedLLC, Makers of Comfeeze, California Nurse-Owned Businesses, Nursing Entrepreneurs, Nurse Inventors:"Manufacture and distribute "Comfeeze". "Comfeeze" is made of a soft fleece material with Velcro strips to secure it around the oxygen cannula, preventing sores at the site of the ears and providing comfort for those who are required to use supplemental oxygen."
Romaine A Settle, RN
RoMedLLC
Street Address: 4224 Massachusetts St.
City: Long Beach State: California Zip Code: 90814
E-mail Address: RoMedLLC@aol.com
http://www.nursingentrepreneurs.com/settle/

Categories: California Nurse Entrepreneurs, Nurse-Owned Businesses, http://www.nursingentrepreneurs.com/california/
California Nurses, California Nursing, http://www.nursefriendly.com/california/
Medical Surgical Nurses, http://www.nursefriendly.com/med.surg/
Nurse Inventors, Mothers of Invention, http://www.nursingentrepreneurs.com/inventors/

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Parks Medical-Legal Consulting:"Parks Medical-Legal Consulting is an Independent Medical-Legal Consulting firm owned and operated by Mr. Paul Parks. A strong Patient advocate, Mr. Parks educates in all areas of medicine taking complex information and breaking it down in an easy to digest way that both jurors and clients can easily understand. Mr. Parks has had extensive training and clinical experience working in some of the most prestigious teaching institutions in southern California including: UC Irvine, Loma Linda University Medical Center, Balboa Naval Hospital, UC San Diego, and numerous free standing surgical centers practicing special procedures in such areas as: pain management, urology, plastic surgery, gastroenterology, same day surgery both as an OR circulator and sedation nurse. Administration of sedative hypnotic agents for sleep induction both in the hospital setting and as an independent practitioner. He is fluent and up to date on all of the latest standards of care and guidelines in all areas of nursing and medicine and is an excellent source for a thorough understanding of medical care in a truly objective manner."
38510 orangecrest rd.
Palm Desert, CA 92211
Phone: (760) 772-8032
Fax: (760) 772-8032
Email: paulparksLNC@dc.rr.com
http://www.parksmedicallegal.com/

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Please select from the following:

Cynthia Antone, RN, BSN, CCHP, SNC, California, Legal Nurse Consultant Expert Witness, Correctional Health Care, Intensive Care Unit (ICU), Psych, Substance Abuse
http://www.nursingexperts.com/antone/

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Cari Caruso, RN SANE-A, Forensic Nurse Professionals, Inc., California Nurse Entrepreneurs:"Forensic Services: Forensic Sexual Assault, Evidentiary Exams for Victims and Suspects, Domestic/Interpersonal Violence evaluations and Photography, Consulting for Defense and Prosecuting Attorneys, Expert Testimony, Education."
Specialty Areas:

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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California Legal Nurse Consultants on: The Nursefriendly

New!

Donna M. Post, RN, BSN, MBA / HCM, CLNC, LNCP-C , Mid-Valley Legal Nurse Consulting, Inc., California Nurse Entrepreneurs, Legal Nurse Consultants:"Mid-Valley Legal Nurse Consulting has over 24 years of experience clinically and administratively, in cardiac, adult and pediatric critical care, and dialysis. Our experience extends to both the inpatient and outpatient settings. MVLNC provides effective identification of practice standards, regulatory standards, adherence and/or deviations to these standards. Our background provides our clients the added benefit of understanding healthcare infrastructure, budgets, and healthcare labor issues. This extensive experience allows for identification of medical and nursing issues in any case that involves health, illness and injury. The clients we serve are attorneys, insurance companies, healthcare facilities and others. At Mid-Valley Legal Nurse Consulting, our goal is to provide our clients with cost-effective, efficient, review and analysis – providing you with winning services while critically defending your bottom-line.
2491 Alluvial #7
Clovis, Ca 93611
Phone: 559-294-7580 or 877-532-5676
Email: midvalleylegalnurseconsulting@gmail.com
http://www.mvlnc.com
http://www.nursingentrepreneurs.com/post/

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Please select from the following:

Cynthia Antone, RN, BSN, CCHP, SNC, California, Legal Nurse Consultant Expert Witness, Correctional Health Care, Intensive Care Unit (ICU), Psych, Substance Abuse
http://www.nursingexperts.com/antone/

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Cari Caruso, RN SANE-A, Forensic Nurse Professionals, Inc., California Nurse Entrepreneurs:"Forensic Services: Forensic Sexual Assault, Evidentiary Exams for Victims and Suspects, Domestic/Interpersonal Violence evaluations and Photography, Consulting for Defense and Prosecuting Attorneys, Expert Testimony, Education."
Specialty Areas:

    Emergency Department, http://www.nursefriendly.com/emergency/
    Evidentiary Exams, http://www.nursingexperts.com/ee
    Expert Witness Testimony, http://www.nursingexperts.com
    Forensic Sexual Assault, http://www.nursingexperts.com/sane/
    Forensic Nursing, http://www.nursingexperts.com/forensics/
    Nurse Consultants, http://www.nursingentrepreneurs.com/consult/
    Nurse Educator, http://www.nursefriendly.com/educators
    Pediatrics, http://www.nursefriendly.com/pediatric/
    Sexual Assault Nurse Examiners, http://www.nursingexperts.com/sane/
    http://www.nursingexperts.com/fnpi/

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    Nancy Emma, RN, LNC, MLC Legal Nurse Consulting Services:"Screening of cases for merit, pagination & organization of medical records, Expert witness, Obtain expert witnesses for lawyers, identification of adherences to and departures from Standards of Care. Medical Malpractice, Personal Injury, Workman's Compensation both Defense and Plaintiff issues."
    Specialty Areas: California Nurse Entrepreneurs, Consulting, Expert Witness, Emergency Department Nursing, Expert Witness (And Locating of Same), Medical Malpractice, Personal Injury, Workman's Compensation
    http://www.nursingexperts.com/emma/

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    Debra L. Fore, RN, MSN, Vista HealthCare Consulting:"Legal Nurse Consultant, primarily Medical Malpractice and Personal Injury, Social Security Claimants' Representative."
    Specialty areas: Adult Critical Care, Disability, Legal Nurse Consultant, Medical Malpractice, Oncology, Personal Injury, Renal Dialysis, Social Security Claims Telemetry-Step Down
    http://www.nursingexperts.com/fore/

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    Mary Rosabell Higgins, BSN, Registered Nurse, M. R. Higgins & Associates Legal Nurse Consultants:"M. R. Higgins & Associates-Legal Nurse Consultants, a professional service company specializing in litigation review. Established in 1997, the company is headquartered in San Francisco, California. Services include: comprehensive medical research; investigation of medical records to determine accuracy and or tampering; translation of medical terminology and deposition reports; and, interpretation of health science literature and documents. Consultation also comprises developing chronological summary reports from medical records. Reports often include analytical commentary.

    http://www.nursingexperts.com/higgins/

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    Tricia West, RN, BSN, MBA/HCM, LNC, P.J. West & Associates, California Legal Nurse Consultants:"PJWA has been doing medical legal consulting since 1980 in the areas of personal injury, medical malpractice, worker's compensation, product liability, Medicare Fraud, Insurance billing Fraud and Risk Management for both the defense and plaintiff. Our goal is to provide you with ethical, timely and exceptional support services. We can make your job easier by assisting with the evaluation of cases for merit, conduct extensive medical legal research, review medical records and provide expert testimony in all specialty areas of nursing."
    29715 Windsong Lane
    Agoura Hills, CA 91301-4019
    (818) 707-0051
    E-mail Address: Twest@PJWA.com
    http://www.legalnursingconsultant.org/west

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    Barnes Medical Legal Services:"Our comprehensive medical legal assistance programs, specifically designed for attorneys, hospitals, and insurance companies, have been proven to be an efficient and cost-effective adjunct to litigation efforts. Our staff of Medical Legal Nurse Consultants handles all types of cases with a personal yet professional touch. Barnes Medical Legal Services guarantees expedient results, a reduction in discovery and evaluation expense, and an increase in overall case management productivity."
    Barnes Medical-Legal Services
    Dale Barnes, MSN, RN
    Certified Legal Nurse Consultant
    Business 858-454-4888 FAX 858-454-4827
    Email: dale@dalebarnesrn.com
    http://www.dalebarnesrn.com/

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    Denise B. Sannicandro, RN, BSN, PHN, LNC, DBS & Associates:"It is the Mission of DBS & Associates Legal Nurse Consulting to bridge the gap between the medical and legal communities by offering quality and professional consulting services."
    Denise B. Sannicandro, RN, BSN, PHN, LNC.
    DBS & Associates Legal Nurse Consulting
    California, USA
    Phone: (619) 644-0344 OR (619) 518-6476
    Fax: (619) 644-0544
    e-Mail: DBSLNC@cox.net
    http://www.dbslnc.com/

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    Fyler Associates: Fyler Associates is a multi-specialty legal nurse consulting agency with over 200 nursing experts. Whereas other companies sub work to three or four nurses, Fyler Associates is a one of a kind agency that focuses on just about every conceivable specialty and sub-specialty in the legal nurse field. We only bring on Registered Nurses with a minimum of ten years as an RN, and they must be presently active in their clinical specialty.
    2138 East Westmoreland Drive/Brea, California/92821/ 1-800-995-4279/Fax: 714-990-4629/Email: brea2@aol.com

    http://www.fyler.com/

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    Legal Edge Medical Services:"Since 1984, LEGAL EDGE MEDICAL SERVICES, through our LEGAL NURSE CONSULTANTS have been providing reviews of medical records, including organization of documents, in depth detailed summaries and chronology of events, as well as a wide variety of litigation support services, including expert testimony at depositions and trial. Our knowledgeable, accurate, dependable, and cost effective reviews of Medical Malpractice, General & Product Liability and Personal Injury cases proudly include several Fortune 500 corporate accounts as clients."
    7929 W. 81st ST. Playa Del Rey, CA 90293
    Legal Edge Medical Services
    310) 306-0046 (760) 777-8959 FAX (760) 777-8947 info@NurseConsultants.com
    http://www.nurseconsultants.com

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    LINC Software Services:"LINC Software Services, a national Case Management and Medical/Legal Consulting service and Software Company, has been in existence since 1987 and is well known within the healthcare industry for its innovative concepts and advanced strategies to improve the efficiency of the Case Management process. In 1997, LINC merged with, and is now a wholly owned subsidiary of Velocity.com, Inc, a San Francisco based healthcare informatics company focused on providing viable "solutions" for managed care. In addition to LINC's Case Manager Assistant® software and services, the Velocity.com solutions also include: PSIMED, a provider of software and services for billing and practice management."
    LINC
    41 East Foothill Blvd Suite 102 Arcadia, CA. 91006
    (626) 462-9675 extension 17, Fax: (626) 462-9676
    Email: info@linccma.com
    http://linccma.com/

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    Elana Marceron, RN, LNC, Professional LegalMed Consulting:"Ms. Marceron, owner of Professional LegalMed Consulting, was raised with a strong interest and respect for the law. She was inspired to become a Legal Nurse Consultant in 1998 by two very successful attorneys in her life. Her career path as a registered nurse has included a wide range of nursing experience over the last two decades including Case Manager for a managed care group, gerontology, medical/surgical nursing, obstetrics, oncology, orthopedics, pediatrics and pulmonology. Ms. Marceron has worked both as an in-house and independent legal nurse consultant, specializing in product liability, toxic tort, personal injury, medical malpractice and worker's compensation cases. She continually updates her medical and nursing knowledge by maintaining a working connection to the acute care medical setting."
    Professional LegalMed Consulting
    776 La Mirada Ave.
    Encinitas CA 92024
    Phone: 888-429-4378
    Fax: 760-944-0102
    Email: Elana@Prolegalmed
    http://www.prolegalmed.com/

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    Medical Consultants at Source4, Inc:"• Consist of highly trained LNC's, indicating an advanced knowledge base in the medical-legal field • Are RN's with varying backgrounds and a wide range of specialty areas • Utilize cutting edge technology for case development and report writing • Maintain the highest Standards of Care as defined by NALNC."
    Source4, Incorporated
    5870 Mission Center Road, Suite B San Diego, CA 92123
    (800) 878-1728 or (858)492-9400
    legal@source4info.com
    http://www.source4info.com/

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    Medical Legal Resources, Karen L. Wetther:"Medical Legal Resources has been a leader in the field of legal nurse consulting and an educator of legal nurse consultants (LNCs) since its inception in 1987. It is a privately owned service business which provides consulting services to plaintiff and defense attorneys and insurance companies regarding the medical aspects of their cases and training workshops and educational materials on legal nurse consulting to nurses who choose to pursue this nursing specialty and to practicing LNCs who wish to continue to expand their knowledge base on issues relating to law and medicine and how they interrelate. Its primary goal has always been to serve as a cost-effective and time-efficient source of help and support to the legal and health care communities."
    7040 Avenida Encinas Suite 104 PMB #260
    Carlsbad, CA 92009-4652
    Phone: 619-584-6489 FAX: 619-725-0919
    E-Mail: info@medicallegalresources.com
    http://www.medicallegalresources.com/

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    P.J.West and Associates, Inc.:"PJWA has been doing medical legal consulting since 1980 in the areas of personal injury, medical malpractice, worker's compensation, product liability, Medicare Fraud, Insurance billing Fraud and Risk Management for both the defense and plaintiff. Our goal is to provide you with ethical, timely and exceptional support services. We can make your job easier by assisting with the evaluation of cases for merit, conduct extensive medical legal research, review medical records and provide expert testimony in all specialty areas of nursing."
    Tricia West, RN, BSN, MBA/HCM, LNC
    P.J.West and Associates, Inc.
    Legal Nurse Consulting
    Agoura Hills, California
    818 707-0051
    818 706-0041 fax
    service@pjwa.com
    http://www.pjwa.com

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    Parks Medical-Legal Consulting:"Parks Medical-Legal Consulting is an Independent Medical-Legal Consulting firm owned and operated by Mr. Paul Parks. A strong Patient advocate, Mr. Parks educates in all areas of medicine taking complex information and breaking it down in an easy to digest way that both jurors and clients can easily understand. Mr. Parks has had extensive training and clinical experience working in some of the most prestigious teaching institutions in southern California including: UC Irvine, Loma Linda University Medical Center, Balboa Naval Hospital, UC San Diego, and numerous free standing surgical centers practicing special procedures in such areas as: pain management, urology, plastic surgery, gastroenterology, same day surgery both as an OR circulator and sedation nurse. Administration of sedative hypnotic agents for sleep induction both in the hospital setting and as an independent practitioner. He is fluent and up to date on all of the latest standards of care and guidelines in all areas of nursing and medicine and is an excellent source for a thorough understanding of medical care in a truly objective manner."
    38510 orangecrest rd.
    Palm Desert, CA 92211
    Phone: (760) 772-8032
    Fax: (760) 772-8032
    Email: paulparksLNC@dc.rr.com
    http://www.parksmedicallegal.com/

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    Source4, Inc., Medical Consultants at:"• Consist of highly trained LNC's, indicating an advanced knowledge base in the medical-legal field • Are RN's with varying backgrounds and a wide range of specialty areas • Utilize cutting edge technology for case development and report writing • Maintain the highest Standards of Care as defined by NALNC."
    Source4, Incorporated
    5870 Mission Center Road, Suite B San Diego, CA 92123
    (800) 878-1728 or (858)492-9400
    legal@source4info.com
    http://www.source4info.com/

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    V/G Associates:"Two enterprising legal nurse consultants started V/G Associates in 1993. They have developed an exemplary reputation with the legal and insurance communities, serving clients nationwide. Claudette Varanko, RN, BS. Claudette is a founding member of the American Association of Legal Nurse Consultants. She has more than 30 years experience in nursing and 10 years of medical-legal experience, 3 of which were with a highly reputable defense firm. Agnes Grogan, RN, BS. Agnes is also a founding member of the American Association of Legal Nurse Consultants with 30 years of nursing experience and 10 years of medical-legal experience. She has written articles and authored a chapter on medical bill review in the American Association of Legal Nurse Consultant's core curriculum text."
    V/G Associates
    16478 Beach Blvd. # 423 Westminster, CA 92683
    V/G Associates 1-800-388-4100, vgassoc@gte.net
    http://www.vgassociates.com/

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    Legal Consulting by Nurses, By Joy Collins, RN, BSBA, CLNC, LNCC, Wild Iris Medical Education, Inc.:"Nurses have been assisting attorneys with their medically related cases for far longer than is generally realized. It is only lately that the sub-specialty of legal nurse consulting has become a recognized field of nursing that the media has thrust into the mainstream. As far back as the 1980s (and probably earlier), nurses and other medical professionals were assisting the legal world to arrive at a fair settlement by moving through the quagmire of medical records and jargon that we nurses take for granted."
    Wild Iris Medical Education
    PO Box 257 Comptche, CA 95427
    (707) 937-0518 ph (707) 937-2546 fax nurses@nursingceu.com
    http://www.nursingceu.com/courses/244/index_nceu.html

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    Whitehouse & Associates Medical-Legal Nurse Consulting:"We are your first line resource dedicated to the successful outcome of your case. Meeting our client's needs in an efficient, timely manner is our highest priority. Save time and money. Utilize the services of CLNCs with over 20 years of experience in the health care system. We are experts at navigating the medical record. We are a cost effective alternative to using physicians to screen your medically related cases. We can help you identify who it is that you should include on your list of experts."
    Whitehouse & Associates
    Medical-Legal Nurse Consulting
    37 High Bluff
    Laguna Niguel, California 92677
    tel. 949-481-1213
    fax 949-481-1214
    Rnclnc4u@aol.com
    http://legalnurse4u.net

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    Please choose from the following:

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Any questions, please drop me a line.

******************************************************
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******************************************************

Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4nursing.com
http://www.legalnursingconsultant.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingcasestudy.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com

Sunday, January 2, 2011

Drug recalls surge to more than 1,700 in 2009 - Aug. 16, 2010

Recalls of prescription and over the counter drugs are surging, raising questions about the quality of drug manufacturing in the United States.

The Food and Drug Administration reported more than 1,742 recalls last year, skyrocketing from 426 in 2008, according to the Gold Sheet, a trade publication on drug quality that analyzes FDA data.

One company, drug repackager Advantage Dose, accounted for more than 1,000 of those recalls. Even excluding Advantage Dose, which has shut down, recalls jumped 50% last year.

"We've seen a trend where the last four years are among the top five for the most number of drug recalls since we began tallying recalls in 1988," said Bowman Cox, managing editor of the Gold Sheet. "That's a meaningful development."

The fast pace of drug recalls seems to be continuing in 2010. Drug recalls totaled 296 from January through June of this year, said Cox. "If we continue at this same rate, we could get 600 or more recalls by the end of the year," he said. "That's still a very high rate of recalls."

Follow the link above to read the full article:

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******************************************************

Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4nursing.com
http://www.legalnursingconsultant.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingcasestudy.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com

Saturday, January 1, 2011

Mortgage rates surge in recent weeks, nearing 5% - Dec. 30, 2010, CNN Money

The era of near 4% mortgage rates has ended after a quick rate rise since early November. But some industry experts think that may be a good thing for the flagging housing market.

The average 30-year fixed mortgage rate has risen to 4.86% from 4.17%, according to Freddie Mac's weekly mortgage market survey. In the Bankrate.com weekly survey, the rate has risen to 5.02% -- crossing the 5% mark for the second time in three weeks -- after being as low as 4.42% as recently as early November.

Rates haven't been this high since May and forecasters now predict them to remain between 5% and 6% for all of 2011.

"You can kiss those record lows goodbye," said Greg McBride, chief economist for Bankrate.com.

Keith Gumbinger of HSH Associates, a provider of mortgage information said that the market reached a new plateau.

"I don't think we're going back to a 50-year low anytime soon without an economic collapse," he said. "Rates will probably never revisit those levels."

Read the complete article on money.cnn.com

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******************************************************

Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4nursing.com
http://www.legalnursingconsultant.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingcasestudy.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com

Discussing cancer treatment with the terminal patient, KevinMD.com

“Are you giving up on me?” My patient looks at me severely. “There must be other treatment options! Aren’t there some experimental drugs out there? I have beaten this cancer twice before. Are you saying that I can’t beat it again?”

No one can ever know with absolute certainty whether my patient’s newly recurrent cancer might miraculously disappear with one more treatment. His recurrence, however, has developed very quickly and is growing very rapidly. New cancer nodules are developing weekly. I have never seen a patient with a cancer this aggressive have a meaningful, sustained response to further treatment. The research literature confirms my impression.

It is always difficult to know what to recommend. Although “no further treatment” is always an alternative, I routinely run through all of the options, reviewing whatever is available, and hoping that we land on the combination that offers that improbable, one-in-a-thousand cure. However unlikely, we sometimes set up appointments and hope for the best.

Today, though, my sense is that it is time to focus on new goals.

The decision not to pursue more studies and more treatment can be very, very difficult. Surgeon and journalist Atul Gawande in an essay in The New Yorker entitled “Letting Go,” writes about how difficult it can be for physicians and patients to halt cancer treatment as the end of life draws near. The dilemma, he concludes, “arises from a still unresolved argument about what the function of medicine really is — what, in other words, we should and should not be paying for doctors to do.” In Gawande’s view, the profession should equip and supply doctors and nurses “who are willing to have the hard discussions and say what they have seen …”

Article continues at KevinMD.com
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******************************************************

Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4nursing.com
http://www.legalnursingconsultant.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingcasestudy.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com

Hospital meals make it difficult to control blood sugars, KevinMD.com

My mom doesn’t take any diabetes medicine.  She keeps her blood sugars normal through a combination of common sense and careful carbohydrate consumption.

A few months ago, she had to be hospitalized for what she calls a “minor procedure.”  The procedure went fine, but not the food.  The first meal they brought her consisted of breaded fish (frozen), mashed potatoes (instant), corn (canned), a dinner roll (frozen), and tea (2 sugar packets on tray).  “If I ate that, my blood sugars would have gone through the roof!” she told me.  She drank the tea, and called my dad, who arrived shortly with chopped salad, roasted peppers, and meat loaf.  This week’s post is about hospital food, if you can call it that.  You are not going to believe what it’s like to order meals for hospitalized patients.

Let’s imagine, for example, a diabetic guy in the intensive care unit.  His blood sugars have been completely out of control, up and down, up and down.  He is recovering slowly from a very serious pneumonia, and is only now beginning to eat again.  The nurse asks if I’d like to order an 1800 kcal ADA diet, which I do not.

An “1800 kcal ADA” diet means 1800 calories total each day, in accordance with the recommendations of the American Diabetic Association.  Their recommended diet is loaded (and I am not exaggerating here) with processed carbohydrate items guaranteed to make it nearly impossible to control one’s blood sugar.  No thanks.

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Friday, December 31, 2010

Primary care needs more than 15 minutes for patients, KevinMD.com

Psychotherapy appointments have traditionally lasted 50 minutes with 10 minutes for paperwork. This has lead to the expression, “the 50-minute hour”.

More recently there has been talk of incorporating psychotherapy techniques in brief visits in primary care. The provoking title “The Fifteen Minute Hour” is from a book about addressing the emotional aspects of disease in primary care during brief appointments. The title and the concept seem relevant to much of what we do in my specialty.

In primary care we seldom spend more than 15 minutes at a time with an established patient. Yet we are required to cover infinitely more details and consider more outside authorities in every visit today than when I first started practicing medicine. Between health insurance and office administration, there are now many more mouths to feed from the office charges than there were then. Sometimes it feels like we are not alone in the exam room even for the short time we do have.

Except for doctors in concierge medicine or micropactices, most of us cannot change the amount of time we have with each patient. Even if we hope to change the system, the patients we see today deserve the best we can give them in today’s 15-minute visits.

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