BNP or BMP??

My mother had a blood test this week to check her BNP level. A few weeks ago, she went to the lab to have a BMP done. When I talked to her on the phone tonight, she wanted to know what the difference was between the two tests. Good question since the tests sound so similar but in fact they are quite difference. A BNP is B-type natriutetic peptide, a blood test that helps doctors determine if people with difficulty in breathing, edema, or fatigue have lung or heart disease. An elevated BNP is associated with congestive heart failure (CHF).  A BNP can also be used to track the progress of CHF patients. A BNP that remains elevated suggests that the treatment the patient is receiving for CHF is not effective.

Visiting Nurse Journal: Christmas

I’m glad Christmas is over. As I visited each of my patients during this holiday season, I saw how hard it was for them to celebrate Christmas. For the elderly, Christmas is a harsh reminder of the losses they have faced in their lives. Most of them don’t bother with decorations now. Only two of my patients had Christmas trees: one was in the home where my patient lived with her son and another was in a home of an elderly couple who was looking forward to their only child spending Christmas with them. Christmas is a lonely time for the elderly who live by themselves. Some of my patients had places to go for Christmas but didn’t feel they had the strength to be a part of a large family gathering. Loneliness, isolation, and sadness keep the elderly company during this time of year. During my visits, I encourage them to share their memories of past Christmas’. One lady told me of the excitement she had as a child when she received a stocking filled with an orange, an apple, some walnuts, and two pennies. She recalled that time as being such a happy one. Another woman told me of Christmas in Austria where she grew up. Children would go house to house at Christmas to ask for candy. These memories bring a smile to their faces. I laugh with them as they tell me a funny incident from their childhood. I hug them as I leave ever in awe of the time we have just spent with each other.

Please Santa, Bring Some Presents for My Patients

I wrote out a Christmas “wish list” for my patients today since we were told to get it in to the social worker by November 1 this year. Anonymous donors in our community go Christmas shopping for the patients that we have selected for gift-giving. I’ve chosen three patients that meet the financial need criteria that we go by.

My patients have either no family or family that sporadically pops in and out of their lives. They don’t stay long enough or seem to care enough to make a difference. One of the patients on my list finds more comfort from the birds in her yard than she does from the people in her life. For her, I put bird seed on her list. More than anything she wants her birds taken care of. 

The other woman on my list sleeps on an old sleep sofa surrounded by piles and piles of bags. I have never been able to figure out what is in those bags. She never wears more than an old nightgown and a stained sweater. I worry about her being cold. She needs soft flannel sheets for her bed.

The last person on my list is a man I’ve been taking care of for about a year. He always has a big smile for me when I visit him but he has trouble speaking because of a stroke. Most of his basic needs are met by an assortment of community services. He just doesn’t have any one who will bring him anything special. I think he’d be thrilled with a simple food basket with fresh fruit, small boxes of cookies, and a bag of hard candy. We don’t have as many donors as we used to. Times are hard. I wish we could do even more to make the holidays special for these folks. Oh Santa……

Obama Supports the Nursing Profession

 Obama has a long history of supporting the nursing profession. As an Illinois senator he worked on such issues as limiting mandatory overtime for nurses and improving nurse-patient ratios. His commitment to improving health care and addressing issues close to the heart of nurses has won him the endorsement of the American Nurses Association. Obama for Nurses issued this statement as one of many that shows just how Obama plans to improve working conditions for nurses. This will have a direct impact on the delivery of health care.

The nursing workforce shortage ranks as one of the most pressing issues facing our health care system. Nurses play a critical role in every aspect of patient care and also serve as administrators and executives in clinical and policy settings. Yet, too many young adults are choosing not to enter the nursing profession, and a significant number of current nurses are switching careers or retiring early. Barack Obama will improve working conditions including limiting mandatory overtime,improving nurse-to-patient ratios, providing additional support to training and incentive programs, and con tinuing to recognize and support nurses’ right to organize. In addition, Obama supports reauthorization ofTitle VIII training programs with greater financial incentives for students and nurse faculty, including scholarships and loan repayment. Obama also supports adequate funding of the Nurse Reinvestment Act.   

                                              

Nurse Talk: Constipation in the Elderly

       

Anna, the eight-six year old patient I saw today told me that she takes a fiber pill with a glass of water twice a day and a stool softener once a day and yet she still doesn’t go regularly. I’m not surprised. Like many seniors, she also takes an iron pill for anemia, a pain pill for her arthritis, and a diuretic for her congestive heart failure. Each one of these meds can cause constipation. Her husband takes an anti-parkinson’s pill and an anti-depressant. His meds can also cause constipation.

Old People in Cold Houses

My elderly patient sits in the dark with a knit cap on her head and a wool scarf wrapped around her neck. Even though it is only October,  I suspect she is already trying to save on fuel costs. She, like some of my older patients, lives in a big old house built in the early 1900’s. Last year I had a patient who sat in his kitchen all day during the winter. The doors to his kitchen were closed and he kept an electric heater on  to take the chill out of the air. When his temperature started to run low, I had him put on a hat and a heavy sweater and drink some hot fluids. I insisted he turn the heat in his house up higher. He was just too close to becoming hypothermic.

Sweaty Living

 

Everyone has sweaty hands from time to time. Remember that scary ride on the roller-coaster or that near-miss while driving?  I bet you had sweaty hands. If you did it would be quite natural.  Sweating is our autonomic nervous system’s response to fear and anxiety. But what if your hands were sweaty all the time even when you aren’t afraid or anxious?  What if everything you do with your hands, you do with wet hands? Can you imagine your feet sweating so much that sweat sprays out of your flip flops? And what about driving, playing a video game, using the computer? Could you do them with sweaty hands?  People who sweat too much have a condition called hyperhidrosis.

Breast Cancer Awareness: A Poem

       

I am very aware of breast cancer this month. 

My patient is dying of it.

My supervisor just found out she has it.

My neighbor survived it.

My mother-in-law died from it.  

Breast cancer.

When was my last mammogram?

I can not remember when.

I am a nurse who should know better.

Hear the wisdom of breast cancer sisters.

Get one now. Get one now.

And for your dying patient, comfort

For your supervisor, encourage,

For your neighbor, rejoice,

And for your mother-in-law, remember.

                                      Chris W. RN

                    

Visiting Nurse Journal

My new patient isn’t doing very well. There is so much going on with her. She’s having trouble swallowing and her lungs remain totally congested. More cancer treatments loom in her future. Although I am seeing her everyday, alot of my work is done behind the scenes.

Visiting Nurse Journal

A dog bed caught my eye. I was at my first patient’s house where I was doing a home health aide supervision for another nurse. The dog bed was in the living room. I didn’t see any dog around though. I was able to take a closer look at the dog bed when my patient came out of the shower and slowly walked into the living room with her walker. In the center of the dog bed was a 5×7 photo of a blond cocker spaniel. Next to it was a green tennis ball. This was a memorial to Lady, the late great dear pet of this elderly woman.