Nurses week: celebrating GeriPal nurse scientists

Diagram by Florence Nightingale showing that deaths in the British Army during the Crimean war due to preventable infectious diseases (blue wedges) far outnumbered deaths due to wounds (red) or other causes (black).

by: Alex Smith @AlexSmithMD

It's nurses week! Please take a moment to thank the nurses in your life for the extraordinary work that they do.

For GeriPal, let's take a few moments to focus this year on thanking the many amazing nurse scientists in geriatrics and palliative care.

This is a list of a few of the many nurse scientists who have pushed hard on the boundaries of what is known in geriatrics and palliative care. I've just listed a first few to get the ball rolling.

Mary Naylor - Developed the Transitional Care Model, research focuses on helping older adults with chronic conditions receive high quality care and avoid unnecessary hospitalizations.
June Lunney - Described and provided empirical evidence for functional trajectories toward the end of life. People with cancer have a clear downward functional trajectory, whereas people with dementia slowly dwindle.
Meg Wallhagen - Put hearing loss on the map as a major but often overlooked issue in the elderly, not to mention the elderly in palliative care.
Marie Bakitas - Pioneer in palliative care in rural settings. Developed project ENABLE, a telephone based support intervention for people with advanced cancer.
Betty Ferrell - THE big name researcher in the field of pain and quality of life for patients with cancer.
Chris Miaskowski - Remarkable work in symptoms, symptom clusters, and translational research.
Mary Ersek - National leader in palliative care in the nursing home and palliative care for Veterans.
Judy Paice - Leading pain researcher nationally and internationally.

This list is by no means exhaustive! Not even close. But with your help it could be - please add to this list in the comments and via twitter.

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Practical Advice for the End of Life: A Podcast with BJ Miller

This week we talk with BJ Miller, hospice and palliative care physician, public speaker, and now author with Shoshana Berger of the book "A Beginner's Guide to the End."

As we note on the podcast, BJ is about as close as we get to a celebrity in Hospice and Palliative Care. His TED Talk "What Really Matters at the End of Life" has been viewed more than 9 million times. As we discuss on the Podcast, this has changed BJ's life, and he spends most of his working time engaged in public speaking, being the public "face" of the hospice and palliative care movement.

The book he and Berger wrote is filled to the brim with practical advice. I mean, nuts and bolts practical advice. Things like:
How to clean out not only your emotional house but your physical house (turns out there are services for that!)Posting about your illness on social media (should you post to Facebook)What is the difference between a funeral home and mortuaryCan I afford to die? …

Improving Advance Care Planning for Latinos with Cancer: A Podcast with Fischer and Fink

In this week's GeriPal podcast we talk with Stacy Fischer, MD and Regina Fink, RN, PhD, both from the University of Colorado, about a lay health navigator intervention to improve advance care planning with Latinos with advanced cancer. The issue of lay health navigators raises several issues that we discuss, including:
What is a lay health navigator?What do they do? How are they trained?What do lay health navigators offer that specialized palliative care doesn't? Are they replacing us?What makes the health navigator intervention particularly appropriate for Latinos and rural individuals? For advance care planning? Eric and I had fun singing in French (yes French, not Spanish, listen to the podcast to learn why).
Enjoy! -@AlexSmithMD

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Transcript

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: And Alex, I'm really excited about toda…

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers. Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …

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