St. John's Riverside Hospital’s Post

We physicians, nursing folks need to try to stay two steps ahead of Pinocchio! The concept of Pinocchio and misinformation in medicine can be connected in various ways. In a broader sense, the story of Pinocchio, with its theme of falsehood and consequences, parallels the dissemination of false or misleading information in the field of medicine. Misinformation in medicine can have serious consequences, impacting decisions related to health, treatments, and well-being. Similar to Pinocchio's nose growing when he lied, misinformation can spread and magnify, leading to potential harm or misunderstanding. There are several ways misinformation in medicine can manifest: False Claims: Misleading or false claims about certain treatments, supplements, or remedies can gain traction, leading individuals to believe in their efficacy despite a lack of scientific evidence. Misinterpreted Studies: Sometimes, studies or research findings might be misinterpreted or taken out of context, leading to incorrect conclusions about the effectiveness or risks of certain medical interventions. Social Media and Misinformation: Platforms like social media can easily amplify misinformation in medicine. Rumors, unverified claims, and anecdotes spread quickly, often without proper scrutiny or fact-checking. Conflicting Information: With the vast amount of health information available online, there can be conflicting advice, causing confusion and uncertainty among people seeking reliable guidance. Addressing misinformation in medicine involves critical thinking, promoting health literacy, and relying on reputable sources of information such as peer-reviewed studies, expert opinions, and trusted medical institutions. Similar to Pinocchio learning and growing throughout his journey, combating medical misinformation involves education, skepticism toward unverified claims, and promoting a culture of evidence-based medicine to make informed decisions about health and wellness.

These same healthcare systems are often set up to deploy a con we can call the sham wellness program. This is where the CEO has posted a Chief Wellness Officer between the Ivory Tower and the workers ... and is using the CWO as a human shield from the pain and struggle of their employees. => The CWO loves the rank and the seniority but finds it mysteriously impossible to make a real difference no matter how hard they try. Any time they get close, the CFO can't see a justification for the effort, "we don't have the money". => The CEO is so happy to have passed the buck and checked the box and kept the board smiling. It does not have to be this way. Senior leader active support is key. If your organization cares from the very tippy top, workforce wellness is not rocket science. And if your CEO is a POSER and your wellness program is being undermined at every turn, I encourage you to walk away. Do not empower posers. What does a real physician wellness strategy look like? https://lnkd.in/gB7qCVHY

Family medicine providers, also known as family physicians or general practitioners, are healthcare professionals who specialize in providing comprehensive medical care to patients of all ages, from infants to seniors. Here are some key details about family medicine providers: Scope of Practice: Family medicine providers offer a wide range of medical services, including preventive care, diagnosis and treatment of acute and chronic illnesses, management of chronic conditions, and coordination of care for complex medical issues. They emphasize a holistic approach to healthcare, considering the physical, emotional, and social factors that influence a patient's well-being.Patient-Centered Care: Family medicine providers prioritize building strong doctor-patient relationships based on trust, empathy, and open communication. They take the time to listen to patients' concerns, understand their unique health needs, and involve them in decision-making regarding their care. Preventive Medicine: One of the core principles of family medicine is preventive care. Providers focus on promoting healthy lifestyle habits, conducting routine screenings and immunizations, and identifying risk factors for disease early on. By emphasizing preventive measures, they strive to reduce the incidence of illness and improve overall health outcomes. Continuity of Care: Family medicine providers serve as primary care physicians, meaning they are often the first point of contact for patients seeking medical care. They provide continuity of care by managing patients' health over time, addressing both acute concerns and chronic conditions, and coordinating with specialists when necessary. Community Advocates: Family medicine providers play an essential role in promoting public health within their communities. They may participate in health education initiatives, advocate for policies that improve access to healthcare services, and collaborate with local organizations to address community health needs. Lifelong Learning: Family medicine is a dynamic field that requires ongoing education and training to stay current with medical advancements and best practices. Providers engage in continuing medical education activities, attend conferences, and pursue board certifications to enhance their knowledge and skills. Cultural Competence: Family medicine providers recognize the importance of cultural competence in delivering effective healthcare. They strive to understand and respect the diverse backgrounds, beliefs, and values of their patients, ensuring that care is delivered in a culturally sensitive manner. Overall, family medicine providers are dedicated professionals committed to promoting the health and well-being of individuals and families across the lifespan. Their comprehensive approach to care, patient-centered philosophy, and commitment to lifelong learning make them invaluable members of the healthcare team.

People should be alarmed when the most consistent and sound strategic planning today is among physicians exiting clinical medicine. The article I posted yesterday from Becker's Healthcare alluded to hospitals catching up on the "redesign to provide more care and services with fewer staff members and tighter margins than ever before." Those interviewed alluded to the current staffing shortages being challenging for the next ten years or more. Much like nurses, and other clinicians, physicians are tired of the 'do more with less' mantra and being a nameless cog in the wheel of corporate medicine - the wheel with flat tires and the smell of burning rubber. Nameless until you speak up in advocacy for your patients, care team, and yourself; suddenly, the "leadership" remembers your name as they write you up or send you off for a mandatory psychiatric evaluation. Make no mistake; you are talked about in the most vicious ways behind those big doors in the C-suite in poorly run hospitals. Medical careers are ruined, and some do not make it; they die by their own hand. Despite popular belief, most physicians have 24/7 accountability for their patients, and their compensation represents about 20% of the healthcare revenue pie. In the stories shared with me from physicians and nurses abused and silenced by toxic leadership, more than 90% of those "leaders" are physicians and nurses - CEOs, CMOs, CNOs, COOs, and DONs. Abuse is rampant in healthcare organizations, and it is across the board. Those who speak up in cultures that are not psychologically safe are silenced. Accountability for abuse starts with the CEO and Board, but most are too afraid to report, thus the culture of complicity and sycophants. Restoring dignity, respect, and joy in medicine will come as more physicians consider the strength of independent practice that embraces autonomy in the relationship between themselves and their patients. We need to better prepare undergraduates for the realities of medicine today as they consider medical school; I speak to too many today who regret their career decision. We need to better educate medical students and residents about their career options despite the pull toward the employed physician model. We need better medical role models and mentors, including those secure in independent practice. Healthcare with a heart requires a reality check; self-awareness at every level is often missing, making more noise, and the 'blame game' is not helping. The gap between administration and the workforce is widening, and we need to collaborate to improve knowledge and engagement. Patients will continue to lose this battle as access to care diminishes. 💔 #moralinjury #exitstrategy #ceo #hospitals #dpc #dc #dte #compassion #rolemodels #mentoring #selfawareness #988lifeline #empathy #healthcareonlinkedin #accountability #patientsafety #advocacymatters

𝗪𝗵𝗲𝗻 𝘁𝗵𝗶𝗻𝗴𝘀 𝗴𝗲𝘁 𝗰𝗵𝗮𝗹𝗹𝗲𝗻𝗴𝗶𝗻𝗴 𝗮𝗴𝗮𝗶𝗻 🥴    A medical center in Berlin, specializing in vascular medicine. The team is well-coordinated: studies are a daily routine here. Both interventional and observational studies are conducted at the national and international levels. The chief physician has been working with a permanently employed Study Nurse for several years. Conditions that seem perfect, as the Camovis team reflects on the deployment…    The medical center had played its trump card. The card with the broad yellow border and the radiant Joker in Camovis colors was designed by the company to capture the attention of sites that otherwise work with their own nurses. Almost like a personal backup before the success of a study starts to waver: when personnel resources become scarce, a Flying Study Nurse from Camovis steps in – precisely where the situation is tight at that moment.    Just like the situation in Berlin. The Camovis team was to support the study 18 hours a week to fill the emerging gap. The employed nurse was on parental leave, but her replacement had decided to pursue different professional paths after four months. A new replacement had not been found yet – and when the phone rang at Camovis in Charlottenburg, it was less than a week until the position would be vacant.    30 patients, a chaotic data situation, and a doctor with limited time awaited the Flying Study Nurse on Day One of the project. The interventional study focused on a medication designed to alleviate circulatory disorders in the extremities when used in addition to aspirin treatment. One patient group received the medication while the other received a placebo. Collaborative work was required, with precise documentation of how the subjects' health status behaved after administration.    After three days of orientation, the complete study back office was the responsibility of the Camovis employee. Additionally, there was the monumental task of data cleaning: the frequent turnover in the Study Nurse position had resulted in a far from consistent data situation. From 18 weekly hours, it escalated to 45 hours – over a period of nearly 6 months until the handover could ultimately be made to the medical center's new Study Nurse.    Satisfied faces rewarded the efforts of the Flying Study Nurse. On the patients' and the site's side. Not only had the Joker done exactly what it had promised: the study continued successfully. Financially, Camovis had also extended its generosity. The increased extent of the Flying Study Nurse's engagement led to a new offer, allowing him to benefit from a more favorable hourly rate.    𝗬𝗼𝘂 𝘄𝗮𝗻𝘁 𝘁𝗼 𝗰𝗼𝗹𝗹𝗮𝗯𝗼𝗿𝗮𝘁𝗲 𝘄𝗶𝘁𝗵 𝘂𝘀? 𝗪𝗿𝗶𝘁𝗲 𝘂𝘀 𝗮𝗻 𝗲𝗺𝗮𝗶𝗹 𝗮𝘁 𝗶𝗻𝗳𝗼@𝗰𝗮𝗺𝗼𝘃𝗶𝘀.𝗱𝗲     #Challenges #clinicalstudies #studynurse #medical #cooperation 

Check out our latest blog post on POCUS supervision. Learn about trends in POCUS education among med students, NPs, and PAs. What should one consider when implementing POCUS program for residents and APPs in terms of credentialing process and supervision? #pocus #ultrasound #advancedpractice #residencyprogram #medicaleducation #credentialing #implementation #compliance

I am thrilled to share Hello Sono's latest blog post on supervision of #pocus. If you are curious what are the best practices for supervision of midlevel providers and residents, please take a deep dive by reading the linked post. What are the current trends in POCUS training for medical students, NPs, and PAs? What are some implementation success stories in residency programs? What should one watch out for when supervising residents doing "educational" scans? What's the deal with the scope of practice and supervision? But here is the bottom line for those of you in a hurry! POCUS can be safely performed by a broad group of clinicians. The integration of POCUS education is growing in PA, nursing, and medical schools. Similarly, POCUS programs are now being effectively implemented in IM and FM residency programs. Given considerable variability in POCUS knowledge, it’s imperative for institutions to have vigorous credentialing and quality assurance processes. In addition, make sure to check your state requirements for supervision of APPs. Stay compliant. Ensure performance of high quality scans. Do the right thing! 🤩 If you find this post useful, please share! DM me or email info@hellosono.com for support with POCUS implementation and provider credentialing. #pocus #ultrasound #medicaleducation #advancedpractice #midlevel #residencyprogram #implementation #internalmedicine #familymedicine #nursepractitioner #emergencymedicine #compliance https://lnkd.in/gSaKwBYQ

Throughout my academic career I have noticed that EMS has established a research framework and process that is second to none. When it comes to clinical outcomes, scope of practice and the application of medicine, EMS is on the cutting edge. Yet, once the subjects/topics move from the back of the bus to the real world, that research juggernaut almost disappears. Despite EMS retention levels never being high, there is very little academic research to figure out the issue. Kurth et al. (2023) said it best, “No comprehensive national dataset captures EMS leaving using consistent and replicable estimates that can be compared over time.” For an industry that is close to celebrating 50 years of service, the fact that no comprehensive study in EMS retention has been done should raise a few eyebrows. With 24 years within this profession, I have witnessed many fantastic advances within the scope of our practice. This drive to serve the public better, more efficiently and provide the highest level of patient care is what drove our industry’s research and development machine. Yet, when it comes to how our industry is led, we have progressed very little in almost half a century. Why has our industry not delved wholly into this ongoing issue? Now, I must clarify, I said led, not managed. We have many articles to help the EMS chief better manage their people, yet there has not been an academic paper on leadership and EMS for many years. Therefore, I must ask why? What are we afraid of hearing and/or seeing? To give full discloser, I am working on my Doctorate in Leadership with EMS being my sole focus. During this time, this enormous gap in research has become even more evident. I have had to go to Nursing. Physicians, Pharmacists and Physicians Assistant school and literature to find subjects that relate to EMS and Leadership. We have an amazing body of work in regard to our patient care, response methodologies, unit readiness and…finally, PTSD and the job. Yet, this robust research mechanism seems to stop once the bus is parked back at base. Until next time everyone Michael   Kurth, J. D., Powell, J. R., Gage, C. B., Fauvel, A. D., Crowe, R. P., Cash, R. E., & Panchal, A. R. (2023). Evaluating changes in the emergency medical services workforce: A preliminary multistate study. Journal of the American College of Emergency Physicians Open, 4(3), e12975-n/a.

🥼The education paths for an MD (Doctor of Medicine) and a DNP (Doctorate of Nursing Practice) differ significantly. 🥼MD or Physician: 1. Completion of a four year bachelor’s degree (usually in a science-related field). 2. Attend a four year medical school, which focuses on foundational medical sciences and clinical skills. 3. Followed by a four year residency training in a specific medical specialty. Most of our MDs completed this training in Anesthesiology. 4. A one year specialty training in the field of interventional pain management. 5. This averages a rigorous 13 year educational path that results in a Medical Doctor Degree once oral and written boards have been passed. 6. For anesthesiologists specializing in Pain Medicine, the American Board of Anesthesia is responsible for the examination. 7. All NEXus Pain Physicians are Board- Certified. 🥼DNP or Advanced Practice Nurse : 1. Completion of a four year bachelor’s degree in nursing and a passing the NCLEX exam, regulated by The National Council of State Boards of Nursing (NCSBN), post graduation. 2. Earn a four year Master of Science in Nursing (MSN), which may involve specialization (e.g., family nurse practitioner, nurse anesthetist, pediatric nurse practitioner). 3. Pursue a one to two year DNP degree, which is a terminal degree in nursing practice, involving advanced coursework in leadership, research, and clinical practice. 4. This DNP path results in the most advanced nursing degree once the program has been completed. 🥼While both paths lead to doctoral-level qualifications, they emphasize different aspects of healthcare and have distinct educational differences, training and structures. 🥼DNPs are required to work under the supervision of an MD in most medical practices. Exceptions are made in rural and underserved communities. 🥼Nurse practitioners (NPs and DNPs) have limited authority to prescribe Schedule II controlled substances in the state of Georgia, which include many opioids. An MD will have to sign or send these specific medications when patients are seen by NPs and DNPs. #medicaldoctor #nursepractitioner #healthcare #graduatedegrees #nclex #DNP #ncsbn #whatsthedifference

Another reason I left the ER after being there for 14 years. Licensed Inpatient beds/rooms sit EMPTY while ER hallways are LINED with inpatients waiting for a bed/room amongst the continuous ER patients rolling in. The inpatient rooms are empty because they can’t get enough nurses to safely staff to full census. A 50 bed PCU unit sits at a census of 25-35 daily because that’s all the staff they have… So next time you or a family member is waiting for a “room”, you are likely waiting for nursing staff that the organization has failed to hire or retain…. What does reimbursement look like if an #Inpatient never leaves the ER? If it is the same whether they get an actual room or not, maybe that’s part of the problem? #Nurse #Healthcare #ER #Inpatient #Staffing #SafePatientCare