The Vitamin D debate

It seems we are caught between a rock and a hard place here. We are told to slip, slop, slap in the summer to prevent skin damage from sun yet we need the Vitamin D for healthy and strong bones!

What do we do?

For sometime I have been aware of this and have not used sunblock unless I am going to be out in the sun for extended periods. I never use and SPF factor in my moisturisers either. You see I already have osteoprosis and am on Vitamin D so why would I compromise my health even further?

Most of my day, like many others, is spent inside working. Why would I want an SPF factor in my moisturiser to protect me from the suns rays that I don't get? It doesn't make any sense to me.

While I may have sparked a debate on this, I hope a healthy one, just don't get caught up in all the hyp of generalised research that may not affect you. Research is now linking Seasonal Affective Disorder and other conditions like internal cancers, heart disease, immunity, diabetes, strokes to lack of Vitamin D.

Question? The more we find out, the more we complicate our lives and health.

Now I am not against research. It think it is very valuable and a great way for us humans to understand our bodies and how they work. But lets get a bit of balance here and some common sense.

If our major source of vitamin D comes from the sun, why do we spend so much money on blocking it out when we are not in the sun?

While there are small amounts of vitamin D in some foods like oily fish (especially fish liver oils), salmon, sardines, mackerel, tuna, egg yolks, butter, some cheeses and oysters we cant possiblby eat enough of these to give us our required daily dose of Vitamin D.

So choose for yourself what you want to do.

For me I will continue to do what I am doing and get the maximum amount of Vitamin D from the sun whenever I can.

What about you? What about your residents who never go out in the sun? Think how you can help them naturally as well as through diet and supplements.

Customer Service in health care

I have talked about this often but not using the words customer service. I talk about understanding and listening to the person and their needs and responding appropriately to what the person wants, not what you want to give them. You will also often have heard me talking about "who is paying your wages". It is the same thing.

This came up again when i was out of Auckland recently. It is particularly apparent in nurses from overseas although not exclusively. It includes both registered nurses and caregivers.

So what can we do to address this?

Well my next topic I am going to put on line is "Introduction to Caregiving". This is Customer Service. It will outline what is expected of a caregiver and will come with worksheets. It is not a required topic for District Health Boards but it is an essential topic for care - at all levels.

If you want to give your residents the best care available then your staff need to understand customer servicer, customer relations and social interaction. All of these come together to provide a place where people want to come and live, not fear; where people tell others it is a great place to live so so it sells itself; where staff retention is high and people are clambering to come and work for you; where you can pick and choose your caregivers.

All in all this is a good model of care and should be the industry standard. Who knows, it could do auditors out of a job!!!

And while were talking about the bowels!

When is the appropriate time to give aperients?

In my experience, mostly it is given at meal times in conjunction with other medications often mixed up with food ( and yes I have been guilty of this too).

Did you know that this could affect the efficacy of other medications? Why?

Because aperients are designed to stimulate the bowel thus could influence the efficacy of other medications and speed up the absorption of them.

So when should aperients be given? At least 30 mins either side of medications being given.

Are aperients designed to be given every day?

Well of course not! So why do we give them every day to some people. Do they actually need them every day or do we, as nurses and caregivers, think they do?

Food for thought isn't it?

What is normal bowel habits?

I know this is not something we sit and talk about over a cuppa but how different are your bowel habits to some one else? Do you know? Have you thought about it?

Therefore what is normal bowel habits for people in your care? Are you trying to regulate someone to what you consider normal bowel habits for you which may be abnormal for the person.

Maybe this should be a question that is asked in more depth when a person enters your facility so that you don't give them laxatives when they don't need them.

Next I will talk about when laxatives should be given.

Educating Caregivers on who is paying them

I am working towards helping caregivers have a wider perspective on the care they are giving and how where the money comes from. I am doing this by frequently mentioning through my inservice workshops that the client/resident is actually the person who is employing them because they are paying for their care.

Payment can be directly through their own bank account or indirectly through the taxes they have paid over the years. I explain that the company they work for are only the filter or the bank if you like that collects the money and pays caregivers wages.

I also try to get them to understand that wastage of products like continence pads, are actually paid for by them through their taxes as the overnment subsidises the products.

I do this in the hopes that they will look carefully at the way they not only look after people but also in the way they use products and equipment. If caregivers have a wider understanding of how the money comes in to pay their wages and that they are paying for wastage may help them think a little about the care they give.

I hope to get them away from the government being a bottomless pit and that business have access to unlimited finance. This is not true. The money has to come from somewhere.

Repetition is the mother of skill

I always become really heartened when something positive happens in my day. Last week I got an email from Fiji from people interested in my online training. As this training for caregivers is relevant in all countries, it has inspired me and excited me at the future of online training.

Being able to repeat the training over and over again is a benefit as I know that when ever I attend any training session I only pick up on a small amount of content, I then have to put it into practice and go back for another session to gradually build on my knowledge.

When I learnt to speak in front of a group of people I attended 6 full weekends training. I paid for the first one then I went along and helped in my own time, for another 5 weekends. This is what has given me confidence to speak in front of a group.

I have sat through countless sessions that Gigi Lim has presented on Medications for Clinical Update in the last 5 years and I am still learning things and I know they have been in presentations before.

So the beauty of the online training is that your staff can listen to the same training session several times till they understand the topic. That wouldn't that save you time in not having to repeat yourself.