Thursday, May 14, 2015

The oldest working nurse in US gets a surprise birthday party

Many nurses can't wait until they get to retirement age. Some even leave before that magical age, usually either 60 or 65 years old. But every so often, we hear about a nurse who really doesn't want to leave the profession. He or she enjoys it and likes going to work, making a difference in the lives of their patients and their families.

What is the oldest age you've ever heard of when it comes to a nurse who is still actively working? Seventy? Eighty? How about 90?

On May 8, 2015, Florence "SeeSee" Rigney celebrated her 90th birthday - while she was at work. She is the oldest working nurse in the U.S. today. Rigney works two days per week at Tacoma General Hospital in Washington, where she sets up the operating room. She only gave up direct patient care two years ago, when she was 88.

Watch this video to see the surprise birthday bash Rigney's coworkers threw for her.




Nurses? How old do you plan to be when you retire?

Wednesday, May 6, 2015

My interview on RadioMD.com

I'm working to promote my book in as many ways as I can (did you buy it yet? :-) ) so I agreed to be on HealthyTalk over at RadioMD. I was invited for two 10-minute sessions, which were done live yesterday.

If you'd like to hear them, the links to the recordings are here:


How to take your prescription drugs safely


and


Questions to ask your pharmacist



I think they went rather well.

If you have any questions about the book or the topic, feel free to leave them here and I'll do my best to answer them.

You can also visit JustTheRightDose.com, where there is more information about the book.

Thursday, February 26, 2015

A Quicker, Possibly Better Measurement of Frailty Before Surgery

Young or old, one of the biggest concerns about having surgery is how well you are going to do after. Surgery is meant to cure a problem or to improve quality of life, but the outcome isn't always what we may hope for. While some people breeze through post-operative recovery, others struggle and have set backs. In some cases, the surgery and its effects start a downward spiral that is hard to stop.

Seniors are frequently considered to be at risk for surgical complications. Many have other medical problems, may be taking prescription medications, and may not have a support system at home to help them when they recover. However, it's not just seniors who can be at risk for post-surgery difficulties - young adults can be just as well.

Frailty tests are meant to help physicians understand which patients are at highest risk for complications after surgery. The most common test is the Fried Frailty Criteria.  "Frail means they don't have the physiologic reserve to bounce back after the operation, so they start down a path that they may not easy recover from," coauthor Kenneth Ogan, MD, said in a press release.

This assessment looks at five distinct features: shrinking (has the patient had any unexplained or unintentional weight loss of 10 or more pounds over the past year), grip strength, exhaustion (how tired is the patient?), activity level, and walking speed (how quickly can the patient walk 15 feet?). The assessment can take about 10 minutes to complete.

A study just published in the Journal of the American College of Surgeons looked patients who had major abdominal surgery and the researchers examined if there was a better way to assess the patients that was also less time consuming.

Of the 351 patients in the study, 36.7% of them had experienced a post-operative complication within 30 days of the surgery. Almost 25% were minor complications, but just over 14% were major, such as wound infections, pneumonia, and stroke. Some died.

The researchers went back and to see what the prediction would be if the testers had used just two of the five frailty factors, grip strength and weight loss. They found that the prediction results of post-surgery outcomes were the same using the two assessments as with the full five-point assessment.

The researchers then added two other factors (the patients' physical status for anesthesia and hemoglobin levels in the blood), and the ability to predict complications was better than with just the frailty test.

The advantage to this finding is that the preoperative testing for just two frailty factors, plus the physical status and blood tests cuts down the testing time to less than a minute, the researchers said. In addition, if there are issues like poor grip strength and weight loss, it might be possible to address these problems before surgery, perhaps reducing the risk of complications after.

Thursday, February 5, 2015

Medicine errors at home: all too common, especially for children

It's a common event in many households - a child has an ear infection and has to take antibiotics. A family member has an injury and needs to take analgesics, pain relievers. In other families, someone has a chronic illness that requires regular prescription drugs. Medicines are a part of modern life. They keep us alive and they make life more liveable for millions of people.

According to an article in Family Practice Management, in any given week, four out of five Americans take either a prescription drug, an over-the-counter (OTC) medicine, or a dietary or herbal supplement. That's a lot of people. The article goes on to say that nearly 1/3 of American adults take five or more drugs. But if you think about it, that's not too surprising. Let's say our friend Mr. Johnson has type 2 diabetes, arthritis, and hypertension. He may take one or two prescription meds for each condition - and then on top of it, he may have other medicines to take occasionally if he had an infection or some other short-term health problem. That's easily five or more medicines at one time.

Any time you take a prescription drug, there's room for error - if you take more than one, the chances of making mistakes multiply.

If you're a parent, giving medicine to a child, you know how easy it is to make a mistake. The journal Pediatrics, published a study last year that found that outside of the hospital environment, every eight minutes in the U.S., a child under the age of six years old is subjected to a drug error. One every eight minutes. The study looked at a period of 10 years. Almost 700,000 children had medication errors - 25 of the children died. Almost 2,000 were admitted to critical care units.

The most common drug error at home is dosage - the amount of the drug given or taken, according to that last study. Dosing mistakes like giving too much of a medicine or not enough. If you're giving or taking a liquid medicine, dosing errors usually come from incorrect measuring. Someone may use a tablespoon instead of a teaspoon or the other way around. Kitchen spoons aren't specific enough for medicines either, so the dose isn't precise. If parents or other caregivers are giving medicines to children, one caregiver may give a dose not realizing another already gave it.

Other common errors involve:

  • Chewing or breaking a pill or capsule that shouldn't be chewed or broken. This is a common mistake. Many pills shouldn't be broken because they have a special coating on them to prevent the medicine from being absorbed in the body too early in the digestive process.

  • Taking at the wrong time. Some pills must be taken with food, others on an empty stomach. Taking them incorrectly will affect how they are absorbed and how effective they are. And taking some pills on an empty stomach can cause serious irritation, leading to other problems.

  • Missing doses. Forgetting to take medicine is a common problem and just about everyone who has ever taken a prescription drug has forgotten a dose from time to time. 

  • Misunderstanding directions. Taking medicines can be stressful. You're not feeling well when you've gone to the doctor or nurse practitioner. You may feel rushed or you may not think to review the prescription - this can lead to misunderstanding the instructions. Unfortunately, this is more common than people realize.


Prescription and over-the-counter drugs are serious products and while we may take them every day, it's really important not to ever take them for granted. Mistakes happen and they happen every day. So know your prescription and how it should be taken. If you have any questions about any drugs you take, ask your pharmacist. Your pharmacist is your best resource when it comes to medications - it's his or her specialty.