Wearing masks helps slow the spread of COVID-19

Wearing masks helps slow the spread of COVID-19, along with distancing ourselves at least 6 feet from others (which is about 2-arms' length), hand washing and avoiding crowds.

A person that wears a mask when out in public, and wears it correctly (covering BOTH their nose and mouth) protects others from their respiratory droplets - this is how wearing masks helps to slow the spread of COVID-19. 

A person can infect others, even if they don't have symptoms (asymptomatic).

Facial masks by Carole Jakucs, June 12, 2020. Image subject to copyright.

• When you wear a mask - you protect others. 
• When others wear a mask - they protect you.

There is no cure and no vaccine yet for COVID-19 (also known as SARS-CoV-2 and coronavirus disease).

So, it’s important not to let our guard down, work together to protect each other, and continue with safe behaviors to protect ourselves, our families, friends and communities. 

Carole's Italian kale, white bean and vegetable soup

After several creative sessions in the kitchen, I came up with this recipe for a healthy, delicious, nutrient dense soup. Kale is loaded with vitamins K, C and A. 

The other vegetables in this recipe are bursting with vitamins and nutrients too.

Among their many important functions, vitamin K is essential for bone health, vitamin C supports our immune system, and vitamin A is necessary for eye health.

Even though our bodies process beans as carbohydrates, cannellini beans have a fair amount of protein and fiber. And if you decide to use bone broth, it will add more protein. 

Carole Jakucs Italian Kale, white bean and vegetable soup - 2020 - image subject to copyright.

Carole's Italian Kale, White Bean and Vegetable Soup

Ingredients:

• 4 tablespoons olive oil
• 1 (16-oz) bag of peeled, baby carrots, sliced or chopped (about 2 cups)
• 3 – 4 large celery stalks, rinsed and chopped (about 2 cups)
• 1 medium sweet or yellow onion, chopped (about 2 cups chopped)
• 1 bunch of kale rinsed, remove large stems and finely chop the remaining leaves (about 6 loosely packed cups of kale leaves)
• 1 (32-ounce) container chicken bone broth, chicken broth or vegetable broth
• 2 (15.5-ounce) cans cannellini beans (drained), you can substitute great northern beans if you don’t have cannellini beans
• 1 (28-ounce) can diced tomatoes (with juice)
• If you like potato in your soup, you can add one medium potato, skinned and finely chopped (this is optional)
• 1 tablespoon freshly minced garlic
• 2 – 3 tablespoons Italian seasoning, to taste
• Salt and pepper, to taste

Instructions:

• Heat olive oil for one minute over low heat in a 5 or 6-quart pot. Add onions, celery, carrots and cook for 4 minutes, stirring frequently.
• Add kale and cook for an additional 4 minutes, stirring frequently.
• Add broth, cannellini beans, diced tomatoes, potato (if you decide to use), garlic, Italian seasoning, salt and pepper. Bring to a gentle boil. Reduce heat and cover keeping a gentle simmer. Cook with lid for 25 – 35 minutes, or until carrots are tender. 

Carole Jakucs Italian kale, white bean, and vegetable-soup - 2020 - image subject to copyright.

Try this soup and enjoy. Wishing you good health!

10 tips to have fun and stay fit during the stay-at-home order for COVID-19

It’s important to keep busy and remain positive during the stay-at-home order due to COVID-19. Some fun ways I found to stay busy and fit are:

 

Photo credit of coronavirus image: CDC/ Alissa Eckert, MS; Dan Higgins, MAMS

1. Work from home if your job allows.
2. Catch up on reading books you’ve not had time to read.
3. If you begin to feel stressed or fearful, consider prayer, meditation or relaxation breathing. These can help calm your mind.
4. Reach out electronically to family and friends you miss.
5. Discover some great new music and new composers to listen to.
6. Stay physically active with fun dance and exercise videos via stream or DVD.  The choices are endless; jazz, tap, ballet, hip-hop, Bollywood, Tai Chi and Yoga.
7. And don’t forget stretching and resistance training. Both are an important part of a complete fitness program in addition to cardio.
8. Since going out to eat is on hold right now, consider trying some new, healthy recipes to dazzle your taste buds and alleviate boredom.
9. Consider decluttering closets and cabinets while you’re stuck at home. Prepare bags of unwanted clothes and other items for donation to your favorite charities. Helping others can help us too.
10. And last; resist the temptation to overindulge in junk foods, alcohol or other drugs. You’ll feel better for it both physically and mentally if you maintain a healthy diet, weight and lifestyle. 

Six tips for protecting yourself from COVID-19 (Coronavirus Disease 2019)

Here is a brief overview of some of the advice given from the Centers for Disease Control and Prevention (CDC) and infection control experts, regarding how you can help prevent the spread of COVID-19 (also known as the coronavirus, novel coronavirus, and coronavirus disease 2019) to reduce your risk of infecting others or becoming infected yourself.

Image by Carole Jakucs, 2020. Subject to copyright. 

Hand washing

Wash your hands frequently with soap and clean, running water for at least 20 seconds. Singing the song, "Happy Birthday" twice, which is about 20 seconds.

Make sure you rub all surfaces of both your hands under clear, running water and don't forget to include your fingertips, thumbs, tops of hands, palms and between your fingers.

If you're not near a sink with soap and running water, the next best way to clean your hands is by using hand sanitizer with at least 60% alcohol to clean your hands, until you can get to a sink and wash your hands with soap and water.

Make sure you wash your hands before and after eating, using the bathroom, touching your eyes, nose and mouth or the rare venturing out of the house for necessities such as groceries.

Cover your coughs and sneezes

Always cover your mouth and nose with a tissue when you cough and sneeze (a sleeve will do if you don't have a tissue and is better than nothing) then throw the tissue in the trash and wash your hands.

Don't touch your eyes, nose or mouth with unwashed (unclean) hands

If you don't heed this advice and your hands have infectious germs on them, you can make yourself sick (inoculate yourself) with COVID-19, other viruses and bacteria.

Stay home when advised to do so 

Heed the rules, guidelines and recommendations by your local, state and federal leaders and public health departments regarding sheltering in place. The current CDC Guidelines of 15 days to Slow the Spread is for the entire U.S. Some states that have greater numbers of COVID-19 infections such as New York, California and Washington, may have additional guidelines dictated by their local conditions on the ground.

If you're sick and have seen a physician and/or have had a known exposure, the current recommendation is to isolate yourself at home for at least 14 days (known as self-quarantine or self-isolation). Always follow the advise given to you by your physician. 

Practice social distancing 

When you do need to venture out of the house for groceries for example, ensure you maintain at least 6 feet of space between yourself and others. 

Disinfect suspected or confirmed contaminated and high-use surfaces

Make sure you frequently clean (using disinfectant solution or wipes) any and all surfaces that may be contaminated such as: Shopping cart handles, payment key pad surfaces at grocery or pharmacy check-outs, counter tops, door knobs, light switches, keyboards, cell phones, the steering wheel of your car, etc.just to name a few.

*This blog is not a comprehensive list of all you can do to protect yourself and others from getting COVID-19. Please visit the CDC and the National Institutes of Health for more information.

November is Diabetes Awareness Month - do you have diabetes?

November is National Diabetes Awareness Month. As of the latest stats from 2015, the number of people living with diabetes in the U.S. was just over 30 million. Out of those, close to 29 million had type 2 diabetes.

These numbers are staggering. Another shocker? It was estimated that just over 80 million people in the U.S. had prediabetes (also as of 2015) and many of  them were unaware they had the condition.

If you want to increase your chances of enjoying improved health and a longer lifespan, and be there for yourself and your loved ones (to enjoy scenes like this one below) it's important to know if you have prediabetes or diabetes.

Why? So you can take the necessary steps under the guidance of your healthcare provider and diabetes educator, to better manage your condition so you blood sugar stays under control (in your target range). This is key to help reduce your risk of developing the complications that can come from diabetes due to out of control (high) blood glucose.

Photo by: Carole Jakucs, October, 2019. Image subject to copyright. 

If you're not sure if you've been tested for diabetes, ask your healthcare provider (MD, NP or PA) to check you for it. This typically involves testing your blood for a fasting blood sugar, and an A1C (hemoglobin A1C). Additional tests may be indicated depending on other medical conditions you have, any current signs or symptoms you may be experiencing, and your medical history.

If you don't know if you've been tested, take the first step and find out. Good luck and good health!

Cranberry Sauce with a Crunch - an easy, healthy and tasty recipe for the holidays or anytime

It’s National Eat A Cranberry Day! With the holidays here be sure to add cranberries (which are high in vitamin C and anti-aging antioxidants) to your holiday meals and regular meals too. Here’s my recipe – it’s lower in sugar and high in omega 3s and antioxidants on top of it being delicious. 

Ingredients: 

One package of cranberries 

one cup of water

1/3 cup of sugar

1/3 cup of chopped walnuts

1/3 cup of chopped celery 

Photo by Courtney Trefzger, 2018. Image subject to copyright. Cranberry sauce with holiday food.

Directions:

1. Rinse and drain cranberries

2. Combine cranberries, water and sugar 

3. Place in a 3-quart pan and cook for 5 minutes on a medium heat, stirring occasionally during this time while the cranberries pop

4. Remove cranberry mixture from heat, place in a serving dish

5. Add chopped walnuts and celery.  Mix well. 

6. Cover then chill for at least 4 hours

7. Enjoy! 

How to Avoid Some of the Common Errors that Occur in Outpatient Care

If you read my last post, you’ll know I talked about some of the common mistakes made in outpatient settings, to include doctor’s offices and any type of clinic; errors that can truly make you sick or cause an injury. While most healthcare providers strive to provide excellent care to everyone they see; unfortunately some do not. 

What can you do to prevent medical errors from happening to you? While no one can control everything, and some things can be out of our control, there are some steps you can take to reduce your risk of being on the receiving-end of a medical mistake.

There are also red flags you can keep your eyes open for – telltale signs of a dysfunctional provider, staff and medical team, a poorly run practice, and staff members who don’t care about you or the care they provide.

As in my last post: The situations below are all ones that I have either experienced personally as a patient, or have witnessed when I've accompanied a family member or friend to an appointment...I wish these were not real events and situations, but sadly, they are.

So...buyer and patient beware, and read on...

Photo credit:

Public Domain Photo by the CDC/Debora Cartagena

First the red flags and steps to take when you see them:

Here are some signs that should cause you to reconsider if you want to continue receiving services at any type of doctor’s office, clinic, and medical practice of any kind.

Rushing

What is rushing? A doctor or other provider who runs towards the door and is half way out the door before you’ve had a chance to ask even one question about your new diagnosis, a medication, or his or her synopsis/opinion of your condition.

Providers who rush can and DO make mistakes such as making the wrong diagnosis, giving the wrong drug or dose, or not recommending the appropriate tests, or follow-up visits for the real problem, or for a condition that is in evolution but was missed – and one that needs close monitoring.

Rushed providers may not (and sometimes do not) take the time to tell patients the risks and benefits of a recommended surgery, procedure, or medication. 

High volume practices of any type that stuff patients in by horrific, continuous overbooking practices, should give you cause to pause, step back, and think about the quality of care your provider is delivering to you.

If you see a provider that's always rushed, and you feel comfortable broaching the subject with him or her, discuss the fact that this makes you very concerned and uncomfortable about the quality of care you're receiving. If you're not comfy bringing the topic up and not happy with your care...it may be time to move on. Find another provider. Most likely things will not change, but it may be worth a try if you feel the need to do so.

Stressed Out Staff

If most of the staff seems high strung, rushed, and don’t appear to have the ability to connect with you, your family or other patients, these can be signs of poor working conditions, chronic short staffing, managers that make poor choices and hire the wrong staff, and poor management of the practice and clinic overall. 

Multiple studies have shown that tense, stressed medical staff make more mistakes.

If you witness staff tension, ask to speak with the supervisor or manager. Discuss your concerns with them. If you feel your concerns are not being heard, consider changing providers.

Rudeness

Rudeness can manifest in many ways such as; terse responses from staff to your questions, outright rude behavior directed towards you or a loved one, a condescending attitude directed at you from any staff member, staff that are openly fighting between themselves, and witnessed bullying of one staff member towards another.

Any type of rude behavior can translate into the practice and providers not valuing your business, your health, and your welfare. Who wants to be treated rudely at any time, let alone when you’re sick, injured and worried about your health. Providing the best care to you and the other patients should be the focus of all staff members' attention – and nothing else.

Rude treatment by staff is also a topic you'll want to bring up with the physician/provider in charge, or the nurse or practice manager. 

What additional steps can you take to assure you’re receiving accurate care?

Medications

If you're placed in an exam room and find any type of medication left unattended such as, a filled syringe or cup of oral medications, that spells trouble. This is sloppy, dangerous and negligent. If in fact, this happens to be a medication intended for you, you can refuse it and ask to see your medication being drawn up, or oral medication pulled from its package. 

If you’re given medication samples, you’ll want to check the expiration dates, name of the drug and the dose, to make sure you’re being given the same drug you were told about during your exam and visit.

If you’re picking up any type of prescription from a pharmacy, verify the name of the drug, the dose, and the dosing instructions. Also, check the label to make sure that the pills inside of the bottle, match the description of the drug listed on the label. Example: The label says a round blue tablet with the letters AB on it, and inside your bottle you have an oblong white tablet with different letters or numbers.

If there is any mismatch or if you have any concern there is a problem – don’t take the medication and immediately reach out to your pharmacist and, or prescribing provider to alert them to the problem and get the correct medication.

Labs and Diagnostic Tests

Follow up calls on lab or other tests that you need to take, or need the results of: If you’ve been told you need lab or diagnostic test, and no one has contacted you to schedule the test, or you were not given an order for it, call your doctor’s office to follow up.

If you had tests already and you never received the results, call your doctor’s office and tell them you need your test results so you can be scheduled for a follow-up visit to get your results. 

Tests results can many times result in a new medication being prescribed, a medication that can now be deprescribed (discontinued), a switch to a different drug, or the dose of the same medication lowered or raised. These are some examples of why it’s so important to receive your results. 

Also you may have a new medical diagnosis that you need to know about as a result of the tests you had done. On the flipside, you may no longer have a condition that you thought you had, or were told you once had, due to the findings of your latest test results. 

Last, follow your gut and your heart!! 

If you feel you’ve seen a doctor or other provider who sped through your exam and visit at lightning speed or had their hands on the door knob while speaking with you, have been the recipient of rude behavior, have been given the wrong diagnosis, was prescribed the wrong medication, experienced billing errors, or have any other concerns about the care you're receiving, you may want to seriously consider seeing another provider. 

Maintaining a proactive role in your health and care, and educating yourself from reputable sources for medical information regarding your conditions and medications, can help you stay on a path to better health and safe care. 

Poorly Managed Medical Offices and their Staff Can Make You Sick: Common Errors in Outpatient Care

When most people think of medical mistakes, their minds immediately jump to dramatic life-threatening errors that can occur from emergency care by first responders out in the field, in emergency rooms, or on hospital floors. While errors can and do occur in any patient care environment, staff errors that happen in private medical offices and clinics can occur on a frequent basis, and sometimes continue for a long time with no supervision, correction or resolution by the physician in charge. And if there is not a nurse manager to oversee patient care and operations, many times the doctor in charge is not even aware that problems exist.

Sometimes mistakes are made by unlicensed personnel, while other times it's the doctor or another licensed provider. While to error is human as the famous quote goes, it's how errors are handled and resolved that makes the difference when caring for patients. If no attempt is made to correct errors that affected you or other patients - it's a red flag warning that you may want to consider changing healthcare providers.

While many outpatient providers consist of hard-working, dedicated staff that truly care about providing professional, timely, safe patient care and friendly services, sadly…some do not. 

Errors in outpatient care can and do severely impact patients’ lives in profound and negative ways, just as mistakes at a hospital or at the scene of a car accident can. From billing errors, to office procedural errors, to errors with hands-on patient care, all can make life miserable for you and other patients. If you were not in an ill state already, dealing with the fallout of others' mistakes, can truly make you sick. Just like the delicate flowers in the photo below, care must be taken to prevent harm to all patients, and especially those who are experiencing acute medical problems, are in delicate conditions, and difficult situations.

Delicate spring flowers by Carole Jakucs. May, 2017. Image subject to copyright.

Many times, the perpetrators of outpatient/ambulatory care errors continue their negligence and, or, sloppy care without appropriate intervention from management or the physician, due to a lack of having licensed staff (RNs or LVNs) to provide care and serve as a staff resource to supervise unlicensed staff, a lack of time for the physician to maintain proper oversight of unlicensed staff, or simply due to a laissez faire attitude on the part of the doctor(s), practice manager, and, or, clinic management.

Below are some common errors and unethical practices that occur in private medical offices, clinics, urgent care centers, dental offices, and surgery centers.

I've personally witnessed the errors below either as a patient, while accompanying loved ones and friends to appointments, or in my professional capacity as a registered nurse while working to help patients who were on the receiving end of irresponsible care.

Breaches of Patient Confidentiality by all Staff:

• Paper charts or test/lab results being left on counters and desktops for all to see.

• Electronic medical records: Patient charts not being exited and the staff member not logging off and out of the system when they leave their desk or the patient’s exam room; patient charts left up on the screen for anyone to see.

Billing Errors:

• Negligent billing staff that submits overcharges to patients’ insurance companies for services not received, or sending duplicate bills (charges for the same date of service twice or more).

• Negligent billing staff that tells patients’ insurance companies they have another insurance provider (in addition to them) when in fact, they do not. This causes an alert in the insurance company’s data base system to place this person’s medical insurance on hold, as the company then seeks out information on who the other company is – when in fact, the patient has no other insurance. This causes a delay in all subsequent bills being paid, requires patients to make multiple phone calls to straighten out the problem with their insurance company, and alert the doctor’s billing staff to their mistake.

Calling Wrong Numbers or Not Calling at All:

• Negligent office staff that call the wrong number, leave a phone message on the wrong voicemail of with someone other than the patient, or worse yet, saying and charting that they spoke to a patient when they did not - engaging in outright lies.These phone calls can pertain important issues such as, but not limited to, confirming patients’ future appointments, advising patients they need a follow up visit with the physician, or a new diagnostic test is needed (MRI, lab test, etc.)

Unlicensed staff practicing beyond the scope of their training and the law, such as when:

• When unlicensed staff are trained to conduct invasive procedures on patients that are beyond the scope of their practice, or dispense medications that are not properly labeled according the state medical board’s requirements.

• Unlicensed staff such as medical office workers and medical assistants providing telephone triage or in-person triage, dispensing medical or nursing advice without the license, education, or training to do so. This is not legal and just plain wrong.

Poor Practices:

• Medical offices and clinics that have no process in place for double checks to be done for staff for fellow staffers, prior to injectable medications being given to patients.

• Medications left unattended in exam rooms.

• Inaccurate blood pressure readings - and usually they're false highs. This can lead to a mistaken diagnosis of high blood pressure (hypertension/HTN) and prescriptions you don't need, all due to the fact that the person tasked with taking your blood pressure is doing it WRONG.

Problems with Prescribed Medications: 

• Concerns about adverse drug reactions (side effects) from a medication you've been prescribed are ignored by the prescriber (MD, PA, NP).

• The prescribing of medications that cause known side effects such as liver damage, kidney damage, muscle damage, B-12 deficiency, and magnesium deficiency, to name a few; and no follow up lab work is done to monitor the patient for the development of these complications. Some common drug culprits are proton pump inhibitors, statins, oral antidiabetics, and blood pressure medications. 

• The prescribing of medications YOU DON'T NEED or, the prescribing of too high a dose, or for too long of a time period. 

Other Lapses in Care:

• Staff that call in (or fax) the wrong prescription drug to a pharmacy for a patient, and, or the wrong dose. 

• When physicians refer to their assistants as “nurses” when they are not licensed nurses such as an RN or LVN. Thus, patients think they are speaking to a licensed nurse such as, an RN or LVN, and if they are not, it's misleading. *In some states, is illegal to refer to someone as a “nurse” when they are not.

• Medical offices and urgent care centers that don't have licensed RNs or LVNs on staff. While it may not be financially feasible for every medical practice and clinic to have licensed staff present, this can be problematic, as unless the physician(s) in that practice has a tremendous amount of time to supervise their staff, (which most do not), staff errors and bad practices can go on forever, unchecked by anyone. *Even licensed staff members need a resource person, peer consultation, peer-review, and a supervisor to help maintain standards and high-quality patient care.

• Clinics, offices, or ambulatory surgery centers that could benefit from an outside resource reviewing the quality of the patient care they provide, policies, and procedures, but have not spent the time or resources to do so. One example of a commitment to quality is when organizations seek accreditation from a third-party such as a nationally recognized accreditation organization.

• When concerns about the care you received, a problem you've encountered with a staff member or, a mistake you've been dealt due to an office procedure are ignored; your request to speak with the manager goes nowhere, no one calls you back, no one take responsibility for the error, no one apologizes for the incident, and, or you are not given a chance to speak a supervisor (or there is no designated supervisor) who has the power to resolve the situation for you and ensure that it won't happen again.

Coming soon: How patients can avoid some of the common errors that occur in outpatient care, and inaccurate blood pressure readings.