Saturday, February 19, 2011

An eye-opening experience

I mentioned in my last entry that I was going to our town's free clinic for my Community Health clinical this week.  I was there for most of the day Thursday and really enjoyed my experience there.  They're a small clinic and are mega busy, but pretty darn efficient.  The staff that I met were great...very friendly, very receptive to a newbie observer taking up space and their time, even though they often met themselves coming and going.  The 2 RN's I met that day...well, one of our TNI lab supervisors said something once about certain skills that RN's don't typically do, but they're not below an RN's realm...yeah, the 2 RN's at the clinic that day, there were no skills that were below their realm.  They saw patients, gave shots, filled scrips, handed off meds, educated patients, took phone calls, called in scrip refills, made follow-up appointments with other providers, cleaned the rooms between patients, charted, filed files, assisted the PA...they did it all.  And unless they took a quick 5 minutes to inject some nutrients into their veins, I didn't see either of them take a lunch break.  They were ON and going the whole time I was there.

But that was not the eye-opening experience to which my title refers...

In classes...and in the news...and just about everywhere you look/'ll see/hear stats about how prevalent certain medical conditions are in the US.  That our diet and sedentary lifestyle put us at risk for diseases like hypertension, hyperlipidemia, type II diabetes, and others.  I hear the stats, I see the news stories, and knowing what I know about the patho behind these diseases, I believe it.  But until Thursday, I had not really experienced it.

Going off my personal medical status and the general medical status of my family...we don't have those diseases.  Some of my elderly relatives are on HTN meds and are told to watch their cholesterol levels...but that's to be somewhat expected based on their age alone.  But myself, for age 34, I'm not overweight, no HTN, no high cholesterol, no sugar issues.  I (mostly) eat right, I get out and exercise, I keep track of any health issues that pop up...essentially, I take care of myself.  Now that's not to say I NEVER have sugar or fried foods or caffeine...because I certainly do (too much of it lately, I admit).  But I recognize when I've been not-so-healthy and then I make adjustments accordingly to get back on track.  I can say the same of my husband and kiddos, my sister, my parents, and several members of my extended family.  While we're not perfect, we do take care of ourselves.

I observed the triaging of about 15 patients at the clinic on Thursday...and I was quite surprised that maybe 12-13 of the 15 were on medication for not just one, but often all 3 of the diseases I mentioned above.  Their scrip lists were populated -- Metformin, various statins, ACE inhibitors, and beta blockers, HCTZ, potassium, plus several on Proventil and Advair.  One patient was on 14 different meds!  Little naive, living-in-a-bubble me was floored.  Seeing the same drugs over and over again, patient after patient, the only difference being the start of the drug name -- -statin, -olol, -pril...-statin, -olol, -pril...-statin, -olol, -pril...changed this statin for that one, taken off metformin and put on janumet...and so on.

I know genetics plays a role in some people, that they can lead a perfect life regarding diet and lifestyle, and still require meds for "preventable" diseases...but I have a strong hunch that many of the patients I observed that day were not in that category.  They could probably reduce or eliminate the need for many of those meds if they made some lifestyle changes...but I saw no real desire to do so.  Most were overweight, most were smokers, most probably don't eat too many fresh fruits and veggies (OK, that one was an assumption...but it's based in reality).  It's easier to take a pill (or 5) than to quit smoking, eat better, exercise more...??  And like I said, I know that is common...plenty of people want a quick fix to the superficial problem instead of looking for a deeper fix for the entire issue.  People demanding antibiotics for viral illnesses, taking Tylenol for slight fevers...don't let the body take care of itself, no, throw drugs at it and fix it yesterday.  It's common...but also sad.

OK, so that got a little soapbox-ish there.  But yeah, the main crux of this entry is my being a bit surprised at my first experience with a medical reality.  I suppose I better get used to it...but at the same time, I hate having to get used to it.  Because that means that many people would rather depend on "unnecessary" medications to keep them alive and somewhat healthy and functioning, than to make some health-based changes and stay off the meds.

Welcome to the medical field, newbie.  You're in for a bumpy ride as your naivety is continually de-flowered.  :-)


  1. Yes, I find myself saying OFTEN - you DON'T need tylenol/ibuprofen for every little fever... a fever helps a body fight an infection...doesn't cause brain damage and actually your body self-limits a fever. Tyl/ibu are the number ONE cause of liver damage in north america..."since one or two works so well - let's just take a BUNCH"...people don't realize. As for the is so sad...trending towards the "magic wand" of medicine....

  2. I'm seeing a lot of this on my vascular surgery rotation. People who are overweight, smoke, and don't give a rip about their diabetes are losing their feet and legs.

    Honestly I don't think people actually realize what HTN and DM are doing to their bodies. They think it's just a number. IMO the best thing we can do for them is say, hey, HTN is actually really BAD for you, and here's why, and here's how you can fix it. And if you keep eating 15 donuts at once, your legs could rot off your body, and life as a blind dual amp is a whole lot harder than keeping an eye on your blood sugar...

  3. Good personal observations and your right, but don't consider it naive as a nurse you will always be learning.

    I think the nurses who hunger for knowledge are the ones you see transferring to new units or hospitals during their career to learn and be exposed to new things.