EP 174: Best Healthcare Coverage For Nurses With Zack Young

EP 174: Best Healthcare Coverage For Nurses With Zack Young

by | Jul 29, 2022 | Podcast

Best Healthcare Coverage For Nurses With Zack Young

Every travel nurse and healthcare professional must find the best healthcare coverage. But did you know that there are different healthcare coverage that you should know of?

What’s the difference between healthcare insurance and healthcare coverage?

Health coverage includes preventive medicine, prescription drugs, and ER visits, while health insurance covers your medical services.

Now to get a clearer picture, let us welcome our guest for today’s podcast, Zach Young. 

Zach Young is a health advisor helping traveling healthcare workers find affordable coverage! He loves passive income projects and setting up financial freedom.

If you want to do the same and learn more about health coverage, join us as we tackle another exciting episode for Cup of Nurses. 

QUESTIONS FOR GUESTS

The questions below are some we’d like to tackle. We always go off-topic, so we don’t expect to hit them all. If you have any ideas, please let us know.

We look forward to our conversation!

  1. Can you tell us a little bit about yourself? 
  • What is a Licensed healthcare advisor? 
  • What made you get into health advising?

2. What does health mean to you? 

3. Why is it so important to have the best health care coverage? 

  • What are some common misconceptions or questions you get asked about health coverage?
  • Speaking for the travel healthcare professionals that don’t have coverage from the hospital, what are our best options?
  • Why should I get health coverage even as a young, healthy 20-year-old?

4. How has being a licensed healthcare advisor helped you throughout life? What are some things you take away from it that you incorporate into your daily life?

5. You’re big into time. We can see it’s important to you; how do you maximize your time, and how do you do it?

6. You’re into other ventures and want your money to work for you. Do you invest in anything? 

ENDING QUESTIONS

Before we end the show, we have one last question we like to ask all our guests.

If you had the opportunity to have a Cup of coffee with anybody one last time, who would it be & why?

Connect with Zach through Instagram at @youngz1220 and Facebook page at https://www.facebook.com/zachary.young.549 for more on healthcare insurance coverage!

Want to have that financial freedom? Click on the full episode here. 👇

TIME STAMPS:

00:00 Introduction
01:39 About the Guest
03:04 What is being health
04:36 What is the problem with our current healthcare?
09:36 Where does the expenses coming from?
12:31 What is the best coverage?
14:31 The pros and cons as a health advisor to medical professionals
19:20 What does Pre-authorization mean?
20:49 Why hospital expenses has gone up?
2:29 Things you should be looking at in a health coverage
24:25 What does a Co-pay mean?
28:06 Talking about Universal Care
31:52 Insurance Tax
35:29 What does the future of healthcare looks like?
38:07 What other things that you do?
39:33 Leveraging Time and Money
44:58 The value of time
47:08 The emerging education system
49:51 Wrapping up the episode

EP 173: Determining Fluid Status in Patients

EP 173: Determining Fluid Status in Patients

by | Jul 22, 2022 | Podcast

Determining Fluid Status in Patients

Maintaining the correct fluid balance in the body is crucial to the health of our patients. Knowing how to check for fluid status in patients will help determine if they are overhydrated or dehydrated. 

That said, learning how to determine fluid status in your patients is essential, and you will learn all about it in this post.

Assessing a patient’s fluid status is a critical skill you will regularly do as a nurse. It involves evaluating if a patient is hypovolaemic, euvolemic, or hypervolaemic.

Hypovolaemia vs Hypervolaemia 

Hypovolaemia refers to a deficit of fluid in the body. Causes include:

  • Poor fluid intake.
  • Excessive fluid loss (e.g., vomiting, diarrhea, hemorrhage, excessive diuretic therapy).
  • Third, space loss of fluid.

Hypervolaemia refers to an excess of fluid in the body. It is also known as fluid overload. Hypervolaemia is expected in the elderly and those with renal or cardiac failure.

It can be caused by excessive fluid intake or inappropriate fluid retention (e.g., heart failure, renal failure). It is also why checking patients’ fluid status is crucial. 

Assessment Findings Determining Fluid Status in Patients

  • Bleeding from any source
  • Vomiting: frequency, volume, presence of blood
  • Stools: frequency, volume, presence of blood
  • Fever and diaphoresis
  • Urine output: color and volume
  • Heart rate
  • Lung sounds
  • Pre-syncope/syncope
  • Mucous membrane – Wet or dry?
  • Skin tugor – skin tenting 
  • Capillary refills <3 seconds
  • Oral intake
  • Daily weight 
  • Fluid restrictions
  • Fluid overloaded symptoms:
    • shortness of breath
    • Orthopnoea
    • paroxysmal nocturnal dyspnea
    • leg swelling

Labs of Fluid Status in Patients

  • Full blood count – May reveal raised hematocrit in hypovolaemia  
  • Urea and Electrolytes – Urea/creatinine will be raised in hypovolaemic patients and those with acute or chronic renal disease. Electrolytes such as sodium may be low in hypervolaemic patients (e.g., dilutional hyponatremia).
  • Urine and Serum osmolality – consider if suspected SIADH or DI. 
  • BNP is a marker of cardiac stretch under the effect of fluid overload.

Passive leg raise

If a patient has a blood pressure cuff, and you want to see if the patient will be fluid responsive, a passive leg raise is easy to check. Passively raise the patient’s legs to at least 45 degrees and check a patient’s blood pressure before and after the leg raise.

You can also lift the foot of the bed and see if there are changes in the blood pressure. This motion acts as a mini fluid bolus because you are forcing the blood to go from the legs into the core. 

Orthostatic 

Orthostatic hypotension, also called postural hypotension, is a form of low blood pressure that happens when standing after sitting or lying down. To check orthostatic:

  1. Have the patient lie down for 5 minutes.
  2. Measure blood pressure and pulse rate.
  3. Have the patient stand.
  4. Repeat blood pressure and pulse rate measurements after standing for 1 and 3 minutes.

A drop of 20 mmHg in the systolic is supportive of hypotension.  

Jugular venous pressure (JVP)

JVP provides an indirect measure of central venous pressure. The Internal jugular vein runs between the medial end of the clavicle and the ear lobe. 

To check this position, see that the patient is in a 45-degree place, turn their head slightly to the left, and assess the vein. 

A raised JVP indicates the presence of venous hypertension/hypervolemia. It can also be indicative of Right-sided heart failure. 

Patients with a Central Venous Pressure (CVP) 

These patients have access to the central venous system and peripheral arterial line. When you have a Central Venous Pressure (CVP), you can measure the patient’s preload. That will directly correlate with the patient’s fluid status. 

A CVP is good for checking where your patient’s fluid level is moving. A normal CVP is between 8 to 12 mmHg. 

Systemic Vascular Resistance (SVR)

If you don’t have a Swan, you can still check an SVR by Non-Invasive Continuous Measurement. SVR is the afterload, the pressure the heart is working against to push blood across the body.

A normal SVR is between 900 and 1440 dyn/s. If your SVR is below 900, you will be more dilated vascularly; if above 1500, you will be more clamped down. 

So if you have a patient that needs fluids, you will have someone with a high SVR because the body is clamping down to increase volume to help maintain blood pressure.

Maybe your patient is low BP, but the SVR is down, well, that can be a sepsis issue, and we can fix the SVR with vasopressors. 

Swan-Ganz catheterization

Swan-Ganz catheterization is also known as right heart catheterization. The tiny catheter is placed into the right side of the heart and the arteries leading to the lungs.

This catheter monitors the heart’s function, blood flow, and pressures in and around the heart. 

One way to check fluid status on a Swan is by looking at the cardiac index. The index relies on cardiac output and turns cardiac output into a normalized value that accounts for the patient’s body size. A normal Cardiac Index is 2.5 – 4.0L/min/m2

Here’s how you can determine the fluid status in your patients correctly. Click here for the full episode 👇

TIMESTAMP:

00:00 Introduction
01:21 Hypovolaemia vs Hypervolaemia
03:36 Assessment findings to determine fluid status
13:28 Passive leg raise
15:13 Orthostatic
17:02 Jugular Venous Pressure
18:06 Central Venous Pressure
24:55 Systemic Vascular Resistance
28:24 Swan-Ganz catheterization
33:07 Wrapping up the episode

EP. 172: 5 Skills for Better Nursing Communication

EP. 172: 5 Skills for Better Nursing Communication

by | Jul 15, 2022 | Podcast

5 Skills for Better Nursing Communication

Better nursing communication is essential in patient care, but it is also as important when communicating with colleagues and other healthcare professionals.

What makes an effective way of communication? And what can you improve to be better at communicating? Here are five skills that you must learn. 

Better Nursing Communication is a Must

Communication with friends, family, and coworkers is crucial for success. It gets your message across to others and allows you to understand what others need and want.

Without proper communication, personal progression is impossible. It’s just as necessary for the speaker to get the message across as it is for the listener to understand. 

1. Non-Verbal Communication

Communication begins with nonverbal cues. How often have you looked at someone and known they were open to a conversation, or even that time someone seemed that they didn’t want to be bothered. The nonverbal cues are the first things we notice. 

Nonverbal communication is used throughout a conversation; think about:

  • Eye contact
  • Tone
  • Posture
  • Body language
  • Facial expression 

 

2. Active Listening

Listen to understand, not just to respond. Really think about that because often, when someone is talking, we are already thinking of a way to respond. This leads to missing the whole picture or the other person not feeling understood.

It’s good to repeat a portion of what the person is saying to ensure that the intent is clear and that there are no misunderstandings.

Not everyone is coming to you for a solution sometimes. People just want to be heard and understood, not told what to do in response. 

3. Inspire Trust

Keep your word. Don’t make promises you can’t keep, no matter how small. People tend to remember you for your best actions and for how you didn’t follow through with what you said. 

Be honest; don’t say you can if you can’t do something.

An excellent way to build honest trust is to be open with your flaws. Share your mistakes and show your vulnerability. We are all human.

This is important when speaking with management. You might not see them every day, but it is essential not to sugarcoat things and really talk about how you feel about the unit environment.

4. Cultural awareness makes better nursing communication 

People come from all walks of life, even your coworkers and managers. Don’t judge them on what they do. Don’t be ignorant, be open. Instead of judging, ask to learn about the things you don’t understand. 

5. Verbal Communication 

Verbal communication is the most important. It’s the primary way we get our message across. 

Know what you are going to say and why. Is it going to be a serious conversation with a manager, or are you just catching up with a friend? 

The most important thing to remember is to just talk to people. Talk to your coworkers and make them more than just a body to help you with turns. Share with them things about you and your stories, and ask them questions.

Do you want to learn how to communicate better as a nurse? Click on the full episode here 👇

TIME STAMPS:

00:00 Intro
01:12 Episode Introduction
02:43 I. Non-Verbal Communication
07:13 II. Active Listening
12:37 III. Inspire Trust
16:51 IV. Cultural Awareness
27:03 V. Verbal Communication
33:49 Wrapping up the episode

EP. 171: NICU Nursing & Building Good Habits with Alexis Correa

EP. 171: NICU Nursing & Building Good Habits with Alexis Correa

by | Jul 8, 2022 | Podcast

NICU Nursing & Building Good Habits with Alexis Correa

Having a baby is exciting, but sometimes, some babies are born with difficulties adjusting to life outside their mother’s womb. NICUs and NICU nursing were created to provide a similar environment for these babies to thrive and survive.

Any preterm birth, a difficult birth, or congenital disabilities in babies can make this adjustment changes more challenging. But with proper care in an environment where they are safe, secured, and monitored, they can also overcome these challenges. 

What is NICU?

NICU stands for newborn intensive care unit. It is a special nursery in the hospital where sick or premature newborn babies are provided with around-the-clock care. 

The NICU is equipped with advanced technology and trained healthcare professionals like NICU nurses to provide the best care for the hospital’s tiniest patients. Some NICUs may also have areas for babies who are not necessarily sick but need specialized nursing care. 

In today’s episode, we would like to introduce you to Alexis Nicole, a registered nurse with experience working in the ER, OB & NICU. She is also the creator of the Nurse Nook.

Nurse Nook is a Youtube Channel and brand created to share Alexis’ personal journey as a nursing student and nurse. She shares both experience and inspiration along the way. 

QUESTIONS FOR GUESTS

The questions below are some we’d like to tackle. We go off-topic, so we don’t expect to hit them all. If you have any ideas, please let us know. Looking forward to our conversation!

  1. Can you give us a little background about yourself? 
  2. What is it like being a Neonatal ICU nurse? 
    • What is it like being a nightshift nurse? We have our struggles, doing it for about five years. 
  3. How do you manage your nursing and social media career?
    • What are the dos and don’ts for using social media as a nurse? 
    • How do you stay motivated and productive as an influencer?
  4. What piece(s) of advice has resonated with you the most along your journey as a nurse?
  5. Can you recall the time in your career when you opened your mind to mindfulness?
  6. What are the healthy habits you follow in your daily routine?
  7. What is your favorite self-help book? 
  8. What is your current obsession?
    • Talk to us about therapy 

ENDING QUESTION

Before we end the show, we have one last question we like to ask all our guests.

If you had the opportunity to have a Cup of coffee with anybody one last time, who would it be & why? 

You can follow Alexis on her Instagram @aalexisnicole or subscribe to her YouTube Channel The Nurse Nook

What does it take to be a NICU nurse and how can you build good habits? Check out the full video here 👇

TIME STAMPS:

00:00 Intro
01:54 About the guest
04:11 The difference between working with pediatrics and with adults
07:01 What does a NICU shift look like?
11:45 Reasons why there are NICU patients
16:29 Neonatal Abuses
18:32 How to deal with stress and trauma?
22:50 Keeping work and life balanced
27:33 Advice for nurses
30:19 The dynamics of the NICU floor
33:19 How and why did you start making videos?
38:24 The Do’s and Don’ts of a Nurse Content Creator
42:02 How to keep of things you want to do.
45:15 How did you discover mindfulness
47:03 Benefits for nurses that you should know
51:07 Wrapping up the episode

 

EP 170: Understanding Diabetes with Kimberly Ellis

EP 170: Understanding Diabetes with Kimberly Ellis

by | Jul 1, 2022 | Podcast

Understanding Diabetes with Kimberly Ellis

Understanding diabetes and how it affects the patient is essential. Diabetes is a long-lasting health condition that affects how the body turns food into energy. The food you eat is broken down into sugar and turns into glucose. It is then released into the bloodstream.

When the blood sugar goes up, the pancreas is signaled to release insulin, which is the key to letting the blood sugar into the body’s cells and used as energy. 

When you have diabetes, your body does not make enough insulin. It cannot use insulin well, either. Too much blood sugar stays in your bloodstream when insulin isn’t enough or if the cells stop responding to it.

It could lead to serious health problems like loss of vision, heart disease, and even kidney problems.

In this episode, we welcome our guest, Kimberly Ellis. She is a Family Nurse Practitioner specializing in diabetes education and management, chronic disease prevention & management.

She is also an expert in patient and provider engagement and culturally responsive care in marginalized communities. Kim also has a decade of experience and knowledge in Primary Care, Long Term Care, Medically Assisted Weight Loss Clinics, and Community Health.

Her consulting firm, Ellis Diabetes Education & Consulting, LLC., assists health organizations in developing Clinical Initiatives, Strategies, and Implementation aligned with the Quadruple Aim of Healthcare to improve health outcomes in their unique demographic.

QUESTIONS FOR GUESTS

The questions below are some we’d like to tackle. We go off-topic all the time so we don’t expect to hit them all. If you have any ideas please let us know. Looking forward to our conversation!

  • Can you give us a little background about yourself? 
    • What got you into nursing? 
    • Is there a reason why you pursued the nurse practitioner route? 
    • What made you specialize in Diabetes education?
  • With diabetes and even nondiabetics, we pay attention to the Hgb A1c.
    • What is it?
    • How do we use it to predict diabetes?
  • How is diabetes developed over time?
    • What is prediabetes? 
    • “According to the CDC, more than one-third of American adults are categorized as “pre-diabetic.”  That’s 88 million people!  The sad part about it is that a large number of people do not even know that they have prediabetes.” [1] 
  • We love talking about prevention. 
    • Illnesses affect everyone individually, and the only way to prevent them is for the individual to do something about it. No one can help you better than you can help yourself. Good health is our own responsibility. 
  • Key risk factors
  • Age 45 or older
  • Overweight/Obese
    1. How does being overweight lead to diabetes? Can we touch base on the physiological process of how obesity leads to diabetes?
    2. How does insulin resistance fit into this picture?
      • Obesity causes stress in a system of cellular membranes called the endoplasmic reticulum (ER), which in turn causes the endoplasmic reticulum to suppress the signals of insulin receptors, which then leads to insulin resistance.
      • The endoplasmic reticulum is a network of membranes found inside cells. It is responsible for processing proteins and fats.
      • As you enter a state of overnutrition, as we often do living in our supersized society, all of those nutrients that come in need to be processed, stored, and utilized. The ER factory is overworked and starts sending out SOS signals.
      • These SOS signals, he said, tell cells to dampen their insulin receptors. Insulin is the hormone that converts blood sugar to energy for the body’s cells.
      • When there’s too much going on, the cell knows that insulin is out there but doesn’t want insulin receptors signaling for more insulin because there’s already enough on board. This has a downside because insulin soon loses its ability to help clear sugar from the body [2].
    1.  
  • A sedentary lifestyle (physical activity <3x/wk)

Questions About Diabetes

  1. How does a sedentary lifestyle contribute to diabetes/prediabetes? 
    • Is it because it leads to obesity or is there a different underlying reason?
    • A low amount of activity leads to more circulating glucose and metabolism change. Activity leads to an increasing amount of work on our muscles and body leading to a higher demand for nutrition, our body uses up and needs the circulating glucose [3].
  • First-degree relative with Diabetes Type 2
  • A personal history of gestational diabetes

When someone develops gestational diabetes, does that just show that the person is more likely to develop diabetes based on a genetic predisposition? 

  • A personal history of Polycystic Ovary Syndrome (PCOS)
      1. How does PCOS play a role in a higher likelihood of diabetes? 
      2. Is it directly related to PCOS causing insulin resistance?
  • Racial Group: African American, Hispanic/Latino, American Indian, Pacific Islanders
  • Is diabetes reversible? 
  • What are the keys to proper diabetes management and something everyone should know?

ENDING QUESTION

Before we end the show, we have one last question we like to ask all our guests. If you had the opportunity to have a Cup of coffee with anybody one last time, who would it be & why? 

Catch more on Kimberly through her socials, and connect with her on Instagram at @thediabetesNP. Visit her Facebook page at Kim E., the Diabetes NP, or check her YouTube channel, Kim E., the Diabetes NP here.

For more information on diabetes management, you can visit her website at https://www.ellisdiabetes.com/. Or check out her LinkedIn profile at https://www.linkedin.com/in/thediabetesnp/.

Want to learn more about diabetes? Click on our full episode here 👇

TIME STAMPS:

00:00 Intro
02:03 About Kimberley
04:00 Common Problems In Communities
08:18 What Made Kimberly Specialize In Diabetes Education?
10:17 The Difficulty In Educating People About Diabetes
12:44 The Physiology Of Diabetes
16:14 Does Glucometer Really Help Detect Diabetes?
18:33 Why Is It Crucial To Prevent Diabetes?
20:28 When Is The Ideal Time To Check Your Blood Sugar?
23:01 What Should A Person With Prediabetes Do?
26:23 Is Diabetes Reversible?
30:10 Frequent Misdiagnosis of Diabetes
32:51 Ethnic Groups And Cultures Susceptible To Diabetes
34:47 About Gestational Diabetes?
38:09 Diets To Help You Avoid Diabetes
42:34 Improving Eating Pattern
44:23 Kimberly’s Role As A Healthcare Provider
47:11 How Can We Raise Awareness About Diabetes?
48:55 What healthcare professionals are lacking?
54:06 Wrapping up the episode