Brown Bag It New York

Over 95 community residents were able to spend as long as 40 minutes each with a pharmacist and group of pharmacy students at PULSE of NY’s first “Brown Bag It” event.

Held at the Freeport, Long Island and Wantagh Libraries in partnership with St. John’s School of Pharmacy, members of the community were able to pack up all their medications, vitamins and herbs and bring them in to meet with a pharmacist and have their questions answered – and they sure did!

Patients were encouraged to spend time with faculty and pharmacy students during individual, private consultations learning about their medications. Participants were helped to list their medications on pocket cards and heard about the possible side effects, generic alternatives and the importance of knowing what they are taking and why.

Pharmacy students saw how patients, mostly seniors, often self medicate, often do not know what side effects they are experiencing and don’t ask enough questions or have enough time with their pharmacist to learn about their medications.

Together, the students learned about privacy and including the family in the discussion and when it may, or may not be appropriate to include the patient’s family member in the discussion about illnesses or medications. They also learned about keeping a relationship professional when working in your community.

Kyle Schuessler, a local volunteer paramedic with the Wantagh, Levittown Ambulance Corp took blood pressure as patients waited and spoke about the importance of keeping their medication list on them at all times. Explaining that an ambulance crew can often learn what medical condition an unconscious patient has by their medication list.

Brown Bag It

How many people who are taking 2, 3, 4 or more medications would love to sit down for fifteen or thirty minutes with a pharmacist and just ask questions about the medications they are taking, the possible side effects they may have or, if there is a cheaper, or equivalent generic brand worth exploring? Chances are, many of us would like that opportunity to sit with a pharmacist but may never get it. Not until now.

We held our first “Brown Bag it” event with PULSE of NY and St. John’s School of pharmacy at the Freeport Memorial Library this past week.

It was wonderful to see young people wearing the lab coats escorting community members, usually senior citizens some with their walkers, to a table so they could spend time connecting and communicating. Joined by faculty, the pharmacy students, first, second through sixth year sat and listened and absorbed what the patient’s questions and concerns were and how their professor would gently pry information out of the guest and learn what their questions were through gentle, compassionate conversation.

One gentleman learned that the ringing in his ears, for the last five years may be because of the high does of medication. A few people brought bags, often more than one, filled with medications to show the pharmacist. Others brought their lists or the lists of family members.

While checking blood pressure the conversation would go to medications and medication safety for the guest or their family. More intimate settings were developed while taking the guests blood pressure which made for more informal discussion.

Some pharmacy students even got to practice their Spanish making the room more cultural friendly.

I am grateful for these opportunities where we can empower patients with information and making health care, patient safety and medication use less intimidating.

If you would like to join us, our next "Brown Bag It" is June 22, 2009 at the Wantagh Library.

Organization of the Year

My mom handed me the beautiful cut glass statue which was awarded to PULSE of NY from the Long Island Women’s Agenda as their Organization of the Year.

The statue is wonderful and the recognition is heartwarming, but there are two things that struck me.

One is that we had a table of representatives and volunteers to take the credit for making PULSE of NY successful. I could not be there but wanted to. I woke up so sad that morning that I could not be there at the dinner but instead, was traveling and speaking at a medical conference to try to help those who work in healthcare understand the importance, and how to include the patient and family in patient safety. Finally, we are being recognized in our own community and I couldn’t be there. But thankfully, our hard working support system is taking credit for what they do.

Second, are we finally giving patient safety a voice in the community? A local, Long Island organization, with over 65 members now know that patient safety is being addressed in their back yard?

I love to speak about patient safety and share what I have learned by working with the experts in the field, but I have been saddened that for all the years of work put into it, I don’t feel any safer in my own community health system.

Simply put, a nurse did not wash before touching my son yesterday. When asked to, she said she did already. I told her she touched the door knob to get in (I knew because he wanted the door closed and I thought about the door knob) and she touched the pen, clipboard and before I could keep going, she said “Fine, I’ll wash again”. My son proudly told her “my mom is into patient safety, as a matter of fact, her organization just won an award”.

While washing, the nurse practitioner, in training, asked me some questions about what we do, and I told her briefly what we do. Why should it matter? Why can’t they all just wash?

"Will's Story" Cont.

Will has worked for many years in health care in a major New York hospital. He is a paramedic and has a lot of experience working with people. He is a great listener and hears what is being said and is sensitive to people’s feelings. Will is a pleasure to be around. But he is also sensitive to when people don’t listen to him.

Like all of us, he wants to be heard. As a patient in the hospital, it is even more difficult. As the patient’s voice, I am not there to make the decisions for him, I am there to see that his needs are met, he is kept safe from harm, and he is treated respectfully. Unfortunately I can’t promise anything.

We went through the basically uneventful day with the nurses asking me if Will was a “he” and I was grateful he didn’t know they were asking. His chart and armband read F for female so it was good that they would ask. His facial hair, deep voice and masculine look couldn’t be mistaken for a woman, but no one really wants to make that mistake. “Good, I pass” Will would tell me.

The nurses and aids were gentle all day and I waited until the night shift to meet the new team coming on. Will was taking his medication, walking and doing everything he was supposed to do. Will is a good patient. The incentive spirometer, he would blow into to keep his lungs clear was within reach and he used that often too. Moments after Will used it and placed it covered, to keep clean, on the night table, a large man of about 50 came in dressed in white scrubs and was introduced as the night nurse. Towering over Will’s bed, Dan exchanged some pleasantries, asked Will about his comfort and pain and reached for the spirometer.

Uncovering it, I said “please don’t uncover it” Will said “I did it, leave it alone” but still, Dan, the night nurse insisted on uncovering it to show Will how to use it. I felt my heart sink and saw the expression on Will’s face. Complete lack of respect for the patient’s request.

When Dan left, Will and I looked at each other. I failed to protect his needs. What was I there for if I couldn’t protect him from something as simple as having someone touch his things? Should I have wrestled Dan to the ground? Should I have screamed and yelled at him “STOP”?

Will and I spoke about his feelings of not being listened to. He has had this happen before and it is part of the life of a transgender man. We wondered if Dan too was uncomfortable knowing that he would be the nurse for this man that may confuse him. But a nurse, in a hospital, can this really be an issue?

It made me rush back early in the morning to be sure Will was treated well over night. I was there when Will awoke and he told me that Dan was special. A conversation later with Dan helped me understand why he was so special. He is new at nursing, only 3 months. Retired from the police force and ran a department in New York City for years. This man was a gentle giant who wanted to do the right thing. In his past life, he was used to getting what he wanted. It was survival. But now, at the bedside of a patient who has very different needs than others may have, how could we make him aware that the patient, in this case Will, needs to be in control or at least shown respect of his body, and his possessions.

The morning went well and Will and Dan got along wonderfully. They had more in common than they realized at first.

Unfortunately, in real life or at the bedside, we don’t know how to make our needs understood in the first seconds of meeting someone. Maybe we all have to slow down and take the time to learn them.

On My Own

This guest post was submitted by William following his surgery and is part of a series of posts about his hospital experience.

As my surgery date neared, all my fears bubbled up. How would I explain to those people taking care me how different I am? Will they be able to understand and respect those differences? Am I going to be the patient they are all talking about on their lunch break, or when they are home with their families over dinner?

The more I thought about my concerns, the more I knew I needed someone on my side to help me answer questions and demand the respect and compassion I deserve as a human being going through any medical procedure.

I knew I didn't need help with infection control, or understanding what was happening to me. I had enough background as a Paramedic and hospital technician to cover those areas. But I knew I would need rest and I knew I would need privacy. I knew staff charged with taking care of me, by nature of the surgery I was having, would naturally refer to me using female pronouns. What I needed was someone there to help me with that. I have always found it stressful when someone used female pronouns in reference to me, even as a young child. Since my transition began, that has happened less and less, and I am happy to be living my life as the man I am now.

Thankfully, what I needed is Ilene's work. She has turned her own tragedies into efforts that have improved the outcomes for many, and quite possibly avoided more tragedies from happening. Ilene offered to be my patient safety advocate, and I gratefully accepted her help. She sat vigil by my side the day of my surgery.

Communicating with staff was easy with her there. She told them all I am a man and I never had to deal with the stress of explaining my masculine appearance to anyone. Even though medicine hasn't completely caught up to the idea of a female bodied man, the staff at the small community hospital, because they were educated by my advocate, were respectful and courteous. They always used male pronouns with me and afforded me the privacy I needed.

It was only after Ilene left that anyone questioned me about who I am:

I was walking around the unit, and as I turned the corner a young woman was walking out of my assigned private room. I commented,”You must be looking for me.” “Maybe,” she replied hesitantly. I put my arm forward to show her my ID band. “I'm Will.” The young woman told me she was from the dietary department, and she is a nutrition student. She asked how my appetite was, and if I had any special dietary needs or requests. “No thanks,” I replied, “I am eating well.”

With that she nodded and then a perplexed look spread across her face. Her face became flushed, and she posed the question in the best way she could: she was doing her job, ensuring she had the right patient. I sensed her embarrassment as she spoke,” I'm sorry, may I ask you a personal question?” I nodded and braced myself against the wall in the hall. “Are you a woman?”
“No, I'm a transgender man.”

Later that day, my catheter was removed, and the nurse had asked me to urinate into a “hat” placed in the toilet to keep track of my urine output. The hat was full, it was change of shift for the ancillary staff, and I needed to empty my bladder. I pulled the cord in the bathroom. Staff quickly responded. I asked the woman if she could empty the hat for me and be sure to record my urine output. She donned gloves and emptied the hat, then tossed it into the trash can. “Here we go again, I thought,” as she pointed to the urinal bottle hanging in the bathroom, she explained I could use the bottle. “No I can't,” I tried and was interrupted. “Yes go ahead and put it in there, OK?”

“No, I'm a transgender man. I am female bodied. I cannot just put it into the bottle, I need the hat.” She never replaced the hat. No one ever asked me about my urine output.

She didn't listen to me. Maybe she knows Pink Lady.