Thursday, November 8, 2007

Turn and Face the Strange

Today in class we learned a new term. It's "brain attack." Many of you know this as a stroke. Medical people have been calling this a cerebrovascular accident, or CVA, for years. Then someone decided that since most things that cause a stroke are things a patient can control, then it's really not an accident.

The problem is getting used to the new term. Our instructor even struggled through the lecture trying to say "brain attack" instead of CVA. I, too, am struggling to try and adapt to the new terminology. I ask myself "why can't they just keep saying CVA and leave it at that?"

We live in a world where technology changes rapidly, new things are being discovered and what we used to think was absolute is now shaky. It can be unnerving to try and adapt to the new knowledge. It is my belief that as humans, we would like to trust that the information we have is the final word. As we get older, it becomes more difficult to take in new information and rearrange what we already know.

This is frustrating when trying to educate a patient about their medical problems. For years diabetics were told that they can't have sugar of any kind at all. Now it has been shown that by allowing diabetics to have a little sugar now and then, they are more likely to stick to their diets. If you talk to someone who has been a diabetic for, say, 20 or 30 years, they can't wrap their brain around this new idea.

I've noticed that a person's age can give me a snapshot of what the popular medical beliefs were at some period on their lives, usually young adulthood. Once I understood this I realized that I am experiencing the same thing. The most recent example I know of is when low-carb diets were all the rage the past 10 years or so. When I was a young adult HIGH-carb diets were recommended. The thinking was that carbs are instant energy and we burn them more quickly. Fats are bad because our bodies have to process them into a form that can be more easily used for energy.....and this was bad. I was convinced I was right and refused to cave in to the low-carb diet fad and kept on eating the same way I always have.

Nowadays more and more experts are confirming what I thought; low-carb diets aren't a magic bullet after all. One great flaw in the diet is that it's one that is almost impossible to stick with. Not only that, but we need carbs, and most foods that are sources of carbs also have lots of B vitamins that our bodies need as well. The important thing is all things in moderation; that message has not changed. Eat a little bit of everything. I feel vindicated in a small way.

Where do we go from here? How do we educate patients and get them to accept the new information? I do my best to try and win them over. Like me, they've been on this planet long enough to realize that what I am telling them today will change again in a few years. How can they trust that the information I am giving them is accurate? How long do they have to remember this bit of information before exchanging it for a new bit of information? It's exhausting to keep up with.

I don't have the answer to these questions. I cope by focusing on results. I say go with what works. I am a fan of research. If research shows that a certain treatment has good results, then that's what I feel is best. I don't think we even have to understand why or how it works. The important thing to know is that it works, consistently, and that it causes no harm.

I fall back on the oath we take as nurses and our purpose for being here.......first, do no harm.

I would add keep up on medical research and keep an open mind.

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