Comm Studies 431/531:
Health Communications
Nicole English
Presentation Outline
- The Story
- About My Mom
- Photos
- Before
- After
- Dancing photos, Leotard
photos, SHAPE Magazine photos, Orlando photos
- Description
- Professional dancer,
teacher, aqua-aerobics instructor, MA in Guidance and Counseling,
Activities Director in various Health Facilities
- Fitness: 5', 100lbs,
pulse: 60, BP: 90/60, Low Cholesterol, semi-vegetarian, active.
- Sonogram in Sept.
2000 indicated she had the "heart of a 40-yr old".
- Co-taught a dance
seminar in Orlando, Fla. Feb. 24-25, 6 hours per day.
- Episodes
- Arrhythmia, 2pm 03/10/98W
- Heart Attack, 6am 03/12/01M
- Return to Emergency, 1am
03/22/01R
- Congestive Heart Failure,
3am 04/18/01W
- Episode Narratives
- Arrhythmia, 2pm 03/10/98W
- Description
- Stress-induced
heart irregularity.
- Problems in Communications
- Dismissing her
as "old" or permanently disabled.
- She broke the
mold by healing up on her own. She did not fit their stereotypes.
She had to take responsibility for her own illness, healing,
and treatment.
- After recovering,
she cut back on her alternative therapy when I lost my full-time
position in Oct., 2000. We think this contributed to the situation
leading to the next episode.
- Heart Attack, 6am 03/12/01M
- Description
- Problems in Communications
- It took me over
a week to get the diagnosis terminology.
- "What do
you expect? You're old." This statement caused my mother
to completely disregard the rest of the conversation with
the doctor.
- Return to Emergency, 1am
03/22/01R
- Description
- Severe anxiety,
chest pains, trouble with breathing.
- Problems in Communications
- They thought she
was a psychiatric case due to the anxiety.
- She could not
sleep due to the breathlessness and anxiety. Fatigue was overwhelming.
- We now know that
it was partly due to CHF symptoms.
- Congestive Heart Failure,
3am 04/18/01W
- Description
- She had 12 lbs
of water weight and her legs were so swollen that they looked
malformed. Little or nothing was done until she was taken
to Emergency Room with CHF.
- Problems in Communications
- Repeated complaints
and inquiries about her shortness of breath, fatigue, and
swelling all went unheeded, and yet they are classic symptoms
of CHF.
- "I am not
giving you anything to make you sick." in response to
my mother's request to break up the dosages over the day.
- General Health Communication
Problems Involved
- Each nurse, doctor, or
staff person told us something different.
- Hospital and medical staff
did not speak our "language" (We were Biopsychosocial, and they were
not).
- Not everything got written
down in her file, some orders were verbal and did not get distributed
to all of the staff.
- The constant change of
staff at hospital. Instructions often had to be reissued/redistributed
at the beginning of each shift, or change of staff for the week. Constant
"breaking-in" of new staff.
- Doctors and Nurses keep
two different sets of notes on file, (non-integrated, mutually exclusive,
all hand-written).
- Doctors at St. Luke's
were of a traditional biomedical model and were not very forthcoming
concerning information.
- Medical staff would talk
to my mom and not to me. She was on drugs and I could not get any
information from anyone.
- Helpful Resources
- Most Helpful
- Psychiatric Nurse:
Jim Current, St. Luke's
- Books, Articles,
Same Language
- Web Sites
- John Hopkins
- American Heart
Association Link
- HeartCenter Online
for Cardiologists and Their Patients Link
- Occupational Therapist
at Mid-America
- Noticed her swelling,
but did not have much clout to get the problem corrected.
- Video at St. Luke's
on Heart Attacks, (2 short, locally produced videos)
- Books and Articles
- Heart to
Heart Book Link
- Reviews From
Library Journal: Severe cardiovascular disease can be
emotionally crippling. Budnick, a psychotherapist specializing
in patients with heart disease and their families, addresses
this highly original study to those who must grapple with
the uncertainties and fears created by a life-threatening
disorder. In simple, readily comprehensible language,
he provides reassurance and offers coping mechanisms for
adjusting to the many changes necessitated by the illness.
Drawing on both personal (having witnessed his father
and sister succumb to heart disease) as well as professional
experience, Budnick offers succinct advice regarding the
changing roles of each family member. His very practical
book is recommended for public libraries as well as medical
libraries that permit patient access.-- Carol R. Glatt,
VA Medical Ctr. Lib., Philadelphia
- Friends Judy, Barb,
Suzanne, and my counselor, Vicki
- Judy's mother
had a similar experience, so she gave very helpful, practical
advice.
- Medium Helpful
- "Cardiac Families",
a Regular Lecture at St. Luke's, 1pm Thursdays (helpful intent,
but not very convenient)
- Standard Issue Instructional
Materials (brochures, notebook, etc.) from St. Luke's (daunting,
gray text, uninspired, thick language, but lots of information,
some relevant, some not)
- Case Managers (only
concerned for duration; no continuity; unavailable)
- Some Nurses (supportive,
very nice, very bright, but not much clout, not always informed
or willing to share information, big differences in attitudes/abilities
between nurses, i.e. BSN/MSN, LPN, ASN, etc.)
- Least Helpful
- Doctors
- Most Nurses and staff
(circumscribed duties, busy, not available, judgmental, different
attitudes about what was "correct" to do)
- Suggestions for Improved Health
Communication
- A single case manager,
or a connection between case managers at different locations. Networked
institutions?
- Integrated medical notes
for each patient, digitized (not just hand-written)
- Compensation for patient
education by insurance, Medicare, Medicaid.
- A Web site at each location,
or better, interconnected Web sites for the locations involved.
- Printable materials,
photos, search engine, resources, book lists, etc.
- Related brochures,
charts, instructional materials
- Online assessments
(Example: My Project)
- Streamed video
- Threaded discussions,
bulletin boards, chat rooms, emailing lists, online counseling,
self-help groups, support groups (online and face-to-face). (Example:
My NSF
Proposal)
- Distance education
for both patients and medical staff
- Web site planning
has a way of organizing the system process that reaches beyond
the Web site itself.
- Public computing areas,
Church, Community, and HS programs,
- Better use of Symbols,
Images, Film
- Both within organization
and with patients
- Films with encouraging
themes?
- Mainstream media dealing
with these issues.
- Structural, Human
Resources, Political Frame approaches to organizations
- Symbolic Frame
Notes
- Power Point
Presentation Link
- Web Page Presentation
Link
- The Symbolic Frame
in Organizations
- Outside Supporting References
Links
- BH, Master of Social Work
(MSW) degree, worked in mental health in inpatient and outpatient
settings for 11 years, published original research, and am in general,
a heckuva nice guy.
- JC, MSN, Psychiatric Nurse
- DP, Student in BSN program
- Dr. BL, PhD.