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Alex 01:27 We’re delighted to welcome back Tim F a rrell, who’s a geriatrician, associate chief for Age Friendly care at the University of Utah and chair of the American Geriatric Society Ethics Committee. All right, and finally we have Yael Zweig, who is a geriatric nurse practitioner at NYU. Tim, welcome back to GeriPal.
This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. I’m going to turn to you Lauren.
Alex: Also returning Rebecca Sudore, who is professor of medicine at the UCSF in the division of geriatrics, and is a geriatric and palliative care doctor. Susan: I’ll just say, I think that could happen outside of the healthcare setting pretty easily and frequently does. Welcome back, Rebecca. Rebecca: Agreed.
Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Alex: Bernie.
I’d also think, is it reciprocity if we prioritize frontline healthcare workers or is it like that instrumental value where actually, we don’t care what they did in the past, we care that they’re able to work in the future. Govind: Yeah. Govind: So you’re right that those often go together. Govind: Yeah. Emily: Yeah.
And I think the crisis that we’re in right now in healthcare delivery, the idea of laying down my badge, I think that’s maybe a metaphor for being a sheriff, but what about being a healthcare provider? I’d be willing to take some time on a mechanical ventilation machine to live longer.”
And that helped them focus on that instead of, say, the blood pressure, the vasopressors or the ventilator settings that day. And then they had to be receiving 48 hours of continuous mechanical ventilation at a minimum and be an adult. I’m just stunned even writing that! We’ve come so far as a field. Eric: And how did you do that?
Abby: This is absolutely a conversation tool and it’s a conversation starter, but then it documents the ability to document that conversation over time and potentially connect dots between care teams when you have this in the electronic healthcare record. It would have a CPR section and then it would have a healthcare proxy section.
In the US, geriatrics “grew up” as an academic profession with a heavy research base. Clinical growth of geriatrics programs has lagged academic research, despite the rapid aging of the population. . And instead of only being focused on the mechanical ventilation parameters that day, we force them to focus on prognosis.
Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
And I think when COVID started, I was in a number of meetings about how we were going to think about CPR from this point forward, given that it was would really expose healthcare workers to easy transmission of this virus that we didn’t fully understand yet. And I wonder, because I read that need part a lot in this article.
Their oxygenation, while important, whether or not we can take them off the ventilator, probably has nothing to do with the big picture, oh, and they’re dying of metastatic pancreatic cancer. ” Don: It was part of the palliative care fellowship, a study of linguistics and communication.
And so here’s a picture of four healthcare providers behind bars. ” The first healthcare provider said, “I said withdrawal of care. And yet, when the reality of breathing difficulties, BIPAP, the talks of tracheostomy and ventilators set in, what had seemed so clear on that piece of paper, no longer seemed so clear.
I think as researchers, we need to do our due diligence to follow that and healthcare providers, of course, ’cause we want to be sensitive. Even when we’re engaging with the healthcare system, there’s a lot of literature that talks about the discrimination that is often Black families face, and then it is true.
Once I was certified, I spent the next six years managing cases over the phone, advising the public and healthcare professionals about how to manage poisonings and suspected poisonings. I developed bilateral pneumonia and was hospitalized but thankfully not put on a ventilator. It was a whirlwind but I learned so much!
Alex 00:54 And Jasmine Santoyo-Olsson, who’s a social behavioral scientist and a fellow in the T32 Research Fellowship at the UCSF Division of Geriatrics. At a high level to sort of step in and start, you know, tinkering with workflows that, you know, are kind of as healthcare is a giant machine in primary care. Is that right?
Healthcare provide. Healthcare companies. Eric 11:54 And also lots of other things we don’t even think about too revolve around this life insurance and whether or not how much you can sue your doctor or healthcare providers for depends if the patient’s still alive or if they’re dead. Insurance companies.
This was the opening paragraph that I wrote in March of 2020 when introducing a podcast we did with Dr. Jim Wright , the medical director at Canterbury Rehabilitation and Healthcare Center in suburban Richmond. Not one elderly person died on a ventilator. Jim: In Virginia, we actually convened a Joint Commission on Healthcare.
We did the Geriatric 5M approach to telemedicine with Lauren Mo. We sometimes take care of patients who are on home ventilators, so coming in for an office visit is not practically feasible. ” Why don’t we say, “All of healthcare is dangerous.” Alex: Hope so. Alex: And that was during the pandemic.
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