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In My Opinion

Emphasize Personal Care
November 11, 2014 10:08 AM by Jimmy Thacker

Many of us have done it. Walked around a big chain department store and looked for things, while employees simply pass us by. No one offers to help and no one wants to be the person to end our search and make us feel better. If you have experienced this, imagine what it must feel like when it happens at a healthcare facility. You are already scared and nervous, worried about the horrible bill you will amass and you walk in and no one smiles, no one offers to help you. Even when you are in your room, there are only staff; no people. 

Personal service is as vital to making a patient feel better as the medicines and therapies we deliver. Taking pride in the service you give means you look professional, act professional, and are still a human being. A little empathy goes a long way. Way back when I was in respiratory therapy school, a teacher taught me that I should treat every patient like they were my mother or father. Doing that has often gotten me some nice comments on patient satisfaction surveys, and now that I am older, I simply treat others as I would expect them to treat me if the roles were reversed. Hmmm, where have I heard that before? 

In my opinion, it is easy to get caught up in the onslaught of hurried and stacked treatments, obligations that take you away from patients, meetings, and other things during your shift. Just remember, at one point, the role will likely be reversed, and how you treat others has a nasty way of coming back to haunt you when you are the one being treated. Call it fate, karma, or whatever you label you choose to assign, but let's always remember the "care" part of healthcare. In these days of chain hospitals owned by corporations, be the exception. Be the one who prides himself or herself on personal service. Do not follow the example, set it. You will get much more respect that way, and when you are the one in the hospital bed, you may see your example being lived out by the one saving your life. 

That's just my opinion, Jim Thacker, MBA, MHA, CRT, AE-C Wellington, MO

It's Time to Quit Smoking
November 3, 2014 10:24 AM by Jimmy Thacker
The third Thursday of every November has become a challenge day for many. On that day, which falls on the 20th this year, the Great American Smokeout encourages all smokers to quit. I doubt there are few of us that do not realize the health benefits. Patients know them, too. But still, it is hard to quit, though some do not understand the difficulty. I laugh at any smoking cessation class run by someone who has never smoked. How is it possible to take that person seriously? There are many facets to quitting permanently, and I feel that only a smoker understands them all.

Not that I do not appreciate the non-smoker's efforts. I do. It is nice you are concerned enough to teach a class that most others would not consider. When it comes to smoking, it really is a great thing to be a quitter. That is a term we associate with everything bad about society, but in this case, it is the best outcome possible.

I encourage all smokers, both working in the medical field and non-medical people, to consider quitting on the 20th of this month. You likely know the facts. In 20 minutes your heart rate and blood pressure drop. In 12 hours, your carbon monoxide level drops to near normal. Within three months your circulation improves and lung function starts to normalize. Nine months in, your shortness of breath starts to improve and as cilia start to function normally, that nagging cough starts to fade away. After a year you have cut your risk of coronary heart disease in half compared to what it would be had you continued puffing. In five years, your risk for some cancers fall and your risk of stroke goes down to that of a non-smoker's. With so much to gain, I ask you to consider quitting this year.

In my opinion, we are a nation of addicts and tobacco is one of the most abused drugs. If you do smoke, quit. If you do not smoke, encourage those around you who do to quit. Be careful not to nag or harass them about it, but instead, find out what you can do to support them. Smokers go back to cigarettes a lot of times when something upsets them. Do not let that "something" be you.

Like your mother taught you, if you have nothing good to say, do not say anything at all. Just be there. Understand the former smoker may be a little grouchier than usual for a while. Remember the quitter will be going through both mental and physical changes that he or she may not have planned for. For some, smoking cessation means weight gain. For others, it may mean losing social contacts and changing groups of friends. Whatever the cost, quit or help others to quit. Just call once in a while and check up on the quitter. Send a text message congratulating them on reaching milestones. Let the quitter know that he or she is not alone in the fight. That may be the only thing you need to do on Nov. 20 to save a life.

For more information, check out www.cancer.org/healthy/stayawayfromtobacco/greatamericansmokeout/index.

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C
Windsor, Mo.

Dentists in ICU?
October 27, 2014 2:17 PM by Jimmy Thacker

It's 2 a.m. You are making your rounds, and it is time for ventilator checks. You step into the intensive care unit. Something you do not see often (if at all) is a dentist in the ICU. Researchers now know that better dental care can help prevent lower respiratory tract infections, such as ventilator-associated pneumonia. Since the bacteria causing this often begins in the oral cavity, it makes sense that a dentist may be the best person to assess and hopefully stop the bacteria before it involves the lung. 

"Enhanced dental care" is suggested for anyone on a ventilator for over 48 hours. A team in Brazil discovered that there is much less incidence for ventilator-associated pneumonia with enhanced dental care than when only routine care is provided by respiratory therapists and nurses. Enhanced care includes teeth brushing, tongue scraping, removal of calculus, treatment of caries, tooth extraction and application of chlorhexidine four to five times a week.

I do not recall ever seeing a dentist in the ICU in over 30 years, but if he or she can help me care for my patient, the dentist is a welcome and sensible addition to all the other professionals I am used to seeing in there. I have seen barbers, hairdressers, preachers and priests of all kinds, medicine men, and all sorts of health-related people, but not a dentist. I think this is an exciting addition, and should be explored, particularly in rural facilities where extubation protocols may not be as aggressive.

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C

Wellington, MO

'Sexy' Ebola Coverage
October 20, 2014 12:30 PM by Jimmy Thacker
I find the news so funny these days. The "sexy" thing to report on now is every single person affected with the Ebola virus, which many of us never heard of and did not know anything about until recently. Now, we have all the misinformation we want, and we still do not know anything about it other than the President of the United States has appointed a "czar" to oversee it here at home, and that people continue to die from it no matter what we do. The deaths are tragic and I agree all that can be done needs to be done to stop it. But there are other, more pressing matters that did not make the news.

For instance, during all the "ice bucket challenges" that have been made by regular folks and celebrities, did you know that three years ago the cause to ALS was found? Yes, three years ago, and yes, the cause! Not sexy enough to make the news, but it's out there. ALS, which stands for amyotrophic lateral sclerosis, or Lou Gehrig's disease as it has come to be known, has been studied for years and afflicts more than 30,000 Americans. It hits often at the prime of life, and often affects those who you would think healthy, like athletes -- Lou Gehrig was an outstanding baseball player. But I do not recall seeing anything about the cause in the news over the last three years. One would think a horrible disease that ultimately leads to an otherwise healthy person's death would make the news cycle, but this is America, and one would be wrong. Scary news, like Ebola, drives ratings and gives the news people something to talk about, rather than actual science, which is probably tougher to report on.

In 2011, a neuroscientist named Dr. Teepu Siddique at Northwestern University found that ALS is caused when the key protein, Ubiqulin2, stops repairing and disposing of discarded or spent proteins like it should. These proteins cause a blockage, hence the signals needed to talk, move, or breathe are interrupted. The person eventually dies. Though a cure has not been found, this knowledge opens the door to the development of drugs that could help. Surprisingly, the media has remained silent on the topic, though one would think exciting news like this would be all over your television, as would the cause of cancer or other diseases.

The ice bucket challenge came after -- almost three years after. ALS remains in the news as long as it seems desperate and deadly, but this research finding never made the list of things to report. Bad news permeates our media cycles, so this bit of good news never made the cut. Money raised from all those ice buckets challenges and from other sources are going to build a big lab that combines several other labs to study ALS, with little going to actual research on ALS itself as you thought when you poured that bucket of ice cold water over yourself.

In my opinion, this should be our news story now. We should be pressuring the government and anyone else with money to pursue ALS research because it affects so many. I am all for stopping Ebola; I really am. Honestly though, I am perplexed at how Americans love to hear -- and American news loves to report-- tragedy rather than triumph. No reportage on finding a cause for a horrible disease that has killed many, but nightly coverage on a virus that few will ever encounter. Either way you are dead, so why not report something good for a change and offer a little hope, rather than reporting the one wreck at the race? Why do we talk about that one wreck instead the other 499 laps that were just as exciting and great to watch? You want advancement in medicine? You want to have a serious conversation about public health like smoking cessation or the prevention of AIDS or cancers? Report on facts, and report the good news along with the bad. Three years and no news I can find about a cause for ALS, but I could turn on CNN right now and hear about Ebola.

What other stories are hidden from us? What else do we not know? What other good news is out there that we will never hear because our news media does not find it "sexy" enough and scary enough to make you tune in tomorrow night? Journalism is gone. Reporting news is gone. News shows are now "news entertainment" -- just like professional wrestling is "sports entertainment." Something just isn't right about that.

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C

Wellington, MO

Encourage Staff Members to ExerciseTheir Strengths
October 13, 2014 1:28 PM by Jimmy Thacker
Good supervisors know that there are some people in the department who just "get it" when it comes to taking on new projects. Using a "knowledge management system (KMS)" can help supervisors delegate authority for projects and get subject matter experts involved. The hard part for some is giving the "expert" the authority and freedom to plan, execute, implement and review the project on his or her own.

Cudney, Corns and Long of the Department of Engineering Management and Systems Engineering at Missouri University of Science and Technology in Rolla, Missouri studied what happens when non-supervisory "experts" are allowed to become engaged in projects that they have knowledge in and found what we have always known to be true: supervisors are not always the ones you want running the show.

Not dissing supervisors here, but it is unrealistic to think that one person can know everything, or even have the most knowledge on everything. Better outcomes are found by identifying the person on your staff with the most knowledge and interest in a project, and allowing him or her the freedom to take the project over. The person gets ownership, develops new dissemination circles for faster turnaround time, and receives professional development and training that may otherwise be missed. The best supervisors will acknowledge their limitations and seek out those who may be more experienced or talented on certain projects. This yields the best results possible.

Since the "experts" already have knowledge and interest, supervisors assume the role of gatekeeper. As the expert comes up with ideas, plans and trials, the gatekeeper provides necessary communication between the expert and administration. This requires the expert to keep the gatekeeper informed at all times, but not to the point where micromanagement becomes an issue. Requiring regular progress reports is an easy way to stay abreast of progress, obstacles, future requirements, monetary constraints and staff development opportunities that the project may involve.

In my opinion, this has exciting possibilities not only for healthcare innovation, but for any business. Identifying key people who can develop ideas, implement plans, foresee obstacles, share information and review results is key to growth in any industry. For any industry, but particularly for healthcare, this can result in cost savings and real innovation using the tools already on hand. With so many therapists working who have such a vast array of knowledge based on education and past assignments, it is wreckless and poor management to ignore using our best people in the best ways.

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C

Wellington, MO


New Drug Delivery System
October 6, 2014 9:23 AM by Jimmy Thacker

I found this interesting this week. Researchers at MIT and Massachusetts General are experimenting with a pill that features little needles in it. When the pill is swallowed, the needles scratch the surface of the tissue in the stomach and inject the medicine. Successful trials have been conducted in mice and pigs.

My worry would be scratching the surface of the esophagus on the way down. Still, since most would rather swallow a pill instead of taking an injection, especially if it is needed often (as in cancer treatment), the impact of this technology could make it much easier to obtain compliance in patients without the pain. The stomach lining has no pain receptors, so once it gets there, it just does its thing and provides the medicine. According to studies, more medicine can be delivered this way than by traditional injections, which can allow the drug to be absorbed by other tissue before being processed by the liver. So far, the drug of choice for the studies has been insulin. If perfected, the pill could be adapted for other drugs, too.

In my opinion, this is exciting news. As someone who has had family members survive and die from cancer, deal with diabetes, and have other conditions where shots are frequent and sometimes painful, anything we can do to minimize pain should be looked at closely. This, to me, is an important study, though not purely respiratory, because it will do so much for so many with different afflictions if we can perfect it.

That's just my opinion,

Jim Thacker, MBA, MHA, Windsor, MO

Prep Patients for Winter
September 30, 2014 8:15 AM by Jimmy Thacker

With winter approaching quickly, it is time to remind ourselves that while some fun things occur during the colder months of the year, for people with chronic obstructive pulmonary disease (COPD) and asthma, the risks of winter and the holidays are increased. Winter traditionally starts anywhere from mid-October to early November, depending on where you are. First comes Thanksgiving, then you are wishing people a Merry Christmas, and next thing you know, you are at your hospital's New Year's Eve party. Even for healthy adults, all the contact with others can be a challenge to their immune systems, but when you have COPD and asthma, the risk of something going wrong that lands you in the hospital rises.   Asthma can be triggered by the cold air of winter. Just stepping outside to do some Christmas shopping may trigger an exacerbation. It is important to keep medicines with you at all times, and try things like staying in on colder days, or wearing a scarf over your mouth if you do need to get out. 

Cold and flu season reduce a healthy person's health by typically 10 percent. Not a big deal when you are normally operating at 100 %; much bigger when you have breathing problems that affect you. One main cause is contact with others. Your grandkids come to say hello and hug you, people are in and out all day, and there you sit, with your COPD, getting all those germs on you. If you do not wash them off, all that hand-shaking may be forgotten. You touch your mouth, eyes, or nose and you create an entry way for a pathogen that may keep you in the hospital for a while. 

In my opinion, winter is a fun time, but can take a terrible turn if we do not educate our patients on the dangers of winter, particularly those who already have compromised breathing. As therapists, we should be taking the time to discuss these issues with our patients so we can help them have a hospital-free winter. That is how you care for your community. 

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C Wellington, MO

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Flu Shots Save Lives
September 22, 2014 10:10 AM by Jimmy Thacker

It's that time of year. Time for the annual flu shot. Healthcare workers usually get them, in fact, most hospitals require them if you want to work through the winter. But what about patients? Many cannot afford the flu shot, and may not be aware that places like health departments and other service organizations offer them for free or at a low cost. It may amaze some that people can be so "out of the loop," but some are. Not everyone gets a newspaper, has access to transportation, or is in a situation where they can schedule the short time it takes to vaccinate themselves. 

Many may think the flu shot is not necessary. Strains of the flu shot in recent years has been both carcinogenic and mutagenic, though the chances of getting cancer or some mutation from the shot is indeed very low. Still, it may be a risk factor that a person does not want to take. There is, and always will be, the argument that "the only time I get the flu is when I take the flu shot." According to every medical facility and practitioner I know, that is not possible, but the stigma associated with the shot is there. Seasonal flu can come at any time, but the peak of flu season in the U. S. is from December to February. The CDC recommends any person over the age of six months get the shot unless your doctor gives you a reason not to.

This year's batch will protect against an A/California/7/2009 (H1N1)pdm09-like virus, the a/Texas/50/2012 (H3N2)-like virus, the B/Massachusetts/2/2012-like virus, and offer some protection against the B/Brisbane/60/2008-like virus. 

In my opinion, for those in direct patient care, it is absolutely necessary to get the vaccine. Argue all you want, but one of your responsibilities is to protect those who you are providing care to, and we all know that not everyone shares that burden with us. Though you may wash hands frequently, stay healthy, eat right, and do everything else to try to avoid the flu, the person next to you may not. Even if you do not contract the flu yourself, at some point during the year, you are likely to become a carrier. For those not in critical or direct care, the flu shot makes sense for most. The shot will not protect you against every strain of flu, and is no guarantee that you will have a flu-free winter, but it may give you just enough immunity to escape the flu or at least minimize its impact. Our patients need to be educated, too. Ask them if they have had their flu shot. Research places in your community where flu shots are given, with and without insurance, and at low cost for those who need it. Taking care of people does not end when they walk out our hospital doors. Part of health care should be to do everything possible so they do not come visit us again, and flu education may be a key to doing that this winter.

That's just my opinion, Jim Thacker, MBA, MHA, CRT, AE-C Wellington, MO

Rural Hospitals Are An Endangered Species
September 15, 2014 9:35 AM by Jimmy Thacker

Today, I watched my Kansas City Chiefs lose to the heavily favored Denver Broncos. They tried, and they kept it close. In the end, all that matters is that they lost. I fear that rural hospitals are in the same situation. Whereas these bastions of care used to dot the landscape, times are tough for rural facilities. Some have been bought out by corporate systems, and have probably improved from the infusion of money and talent. Still, many are left without access to quality care because the sheer numbers of hospitals are declining. Politicians have done little to save them, and regulations and technology have left the small, country hospital out in the cold.

Like the Chiefs, it has been a good run. I love small hospitals. I always liked everyone knowing everyone else by first name. I liked when people asked about my kids, and I heard their stories of how the soccer game went or when the next county fair was from the guy or gal who was showing pigs. I think patients liked it, too. True, the bigger hospitals are blessed with the latest and greatest equipment. True, the bigger places have an abundance of doctors and specialists that can better treat many. But for a patient, the benefit of being close to home, of being taken care of by the same person you saw in the grocery store last week, has given way to a cold, sterile, institutional recovery period when you are ill.

It is difficult to get talent to a small hospital, too. Usually the pay is less, the excitement is lower, and the prestige is just not there. As healthcare has turned into a business more than a calling, the bigger places flourish while the small, rural hospital continues to fall further behind. There is no competition here. Money is power, and the bigger places have both.

In my opinion, it is sad to see the small facilities go. I admire anyone who takes on a job where you have to be both the respiratory therapist and the janitor; the clinical nurse and the mental health nurse; the doctor and the caretaker of the budget.

I remember a day when I got interviewed by the hospital administrator in Arkadelphia, Arkansas. He did all his own interviewing because he wanted to know who was being hired. I was very young then, but thought he was the coolest guy ever, and I enjoyed working for him. Now it is all about online applications on websites that seldom work and human resource people who have their own agendas.

Now you can work at a hospital for years and never even know the administrator's name, let alone recognize him or her when they grace you with their presence. I have said before on here that we need to put the "care" back in healthcare, and I stand by that. I hope that departments are more accessible and that noone works for a respiratory manager they do not know or cannot call a friend. It is when we invest ourselves in our community, when we invest ourselves in each other, and when we invest ourselves in our patients rather than getting "x" amount of treatments done that we have real healthcare.

Otherwise, it is just the health business, and like any other business, success and failure are only separated by a very fine line because there is only monetary investment, not personal investment. I am old-fashioned in my thinking, I know. Many of you will disagree with me; I know that, too. I respect that. I am not saying that bigger facilities are bad. I am only suggesting that in this hurry up world we focus on numbers more than the people we all say we want to help and heal, and this old man thinks that is sad.

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C, Wellington, MO

Get Ready to Toot the Respiratory Horn
September 8, 2014 4:19 PM by Jimmy Thacker
Noone likes to toot their own horn, but with all the competing services, we literally fight for survival in healthcare. As respiratory therapists, it is our job not only to care for our communities, but to let them know that we are available, in many cases 24 hours a day, seven days a week. Respiratory Care Week is October 19-25. What better time to do a little public relations and marketing?

There are many things you can do to increase awareness of your department. Hold an open house and highlight the impact you have on the community with conditions such as asthma, COPD and post-operative care. Show off your department. Clean it up first, but allow the community to come in and tell them about your ventilators, your nebulizer systems and your specialized equipment, such as those for pediatric and neonatal patients. Make a video and give a speech. Arrange with the local health department or school to show your video, and highlight the "normal" day of a respiratory therapist. Enlist doctors and nurses to help out, and appear on the video explaining why respiratory care is vital.

The fact is, no one thinks about us until they need us. Those who know us, know us well; everyone else knows nothing about us. Respiratory Care Week is your chance to change that; your chance to shine. It is your chance to form bonds with the community, the hospital or clinic staff, and each other. Use this opportunity to show your stuff.

For directors, it is also an opportunity to show your employees a little appreciation. No CEO or COO is going to let you give everyone the day off, nor are they going to let you give everyone a raise. That does not mean that you cannot do something meaningful. Thank your staff. Individually, one at a time, face to face. Let them know you appreciate the overtime, the call ins, and the excellent care they provide. Even if there are therapists in your area not working for you, give them a shout out and check in with them. You never know what they may be up to and how it may apply to you. Don't try to recruit the competition, but be mindful of who is in your area; you never know when you may need them.

For employees, re-commit yourself to your personal and professional growth. Get back in school. Take that NALS class that everyone else says is too hard. For departments, use the time to reflect on the past year. Clean the department. Inventory your stuff. Review the schedule and make sure it works for everyone. You have a week, and I know respiratory therapists can accomplish a lot in seven days.

We all know how important respiratory care is. Let's show everyone else. Respiratory Care Week can be just another week going by on the calendar, or it can be something meaningful to both the department and the community. It's up to you. We struggle daily to stay relevant in healthcare. We are working on getting bills and laws passed to acknowledge our accomplishments.

My father was a preacher. He used to say there is an "I" right in the middle of revival, meaning that until you revive yourself, you cannot revive anyone else. We face the same dilemma. Unless we toot our own horn once in a while, everyone else in the hospital who toots theirs gets a little of our glory later on. Toot your own horn. For one week, toot it loud and toot it often. Let people know why you matter, the hours you work, the lives you save. Let your CFO know how you contribute to the "bottom line" when you work. Let doctors know that you are there for them, and are open to their suggestions on how to improve care. Invite your CEO and/or COO to lunch, and talk to him or her about your accomplishments over the last year. Better, invite him or her to lunch with all your staff; it may be the first time they have met. Toot your own horn a little. You've earned it.

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C
Windsor, Mo.

Make the Right Impression on Patients
September 2, 2014 8:23 AM by Jimmy Thacker

As medical professionals, it is important that we project a certain image to our patients. We need to be professional, intelligent, curious and caring -- all at the same time. The biggest detractor we face is our interactions with other professionals, which are sometimes in a very unprofessional manner. The therapist at the nurses' desk chatting with the nurses are noticed by those family members on the way to the ICU to visit their loved one on the vent. The loud music from the department's radio is heard not only by staff, but by visitors on the way to see friends and relatives. Instances like this cause our patients and visitors to form opinions of us. We need to make sure we are putting our best foot forward and realize how we spend our "down time" appears to the communities we serve.

Now, I am not suggesting that chatting with others is bad, nor is music on the department radio. We do need to understand that we see people at their worst; unlike us, they are not having a good night -- otherwise they likely would not need our services. I used to work nights. It was common for me to have a radio on in the department. I just didn't let it get so loud that visitors would hear it. I like to talk to people, especially smart people. Some of the smartest people I know work in healthcare, so talking to them was always a pleasure. Still, I tried to be mindful of who else was listening or watching my interactions with my colleagues. 

     We are in the unenviable position now of fighting for professional survival. Respiratory therapists have to justify their existence to have their services ordered and paid for by insurance companies. Other healthcare workers are also under a microscope with rising costs and lessening reimbursement.

We do not help ourselves by appearing to be anything less than the caring professionals our patients are counting on to save their lives.

Most of us have learned this and have a handle on it. So let's do this: let's police our own. If you see a colleague acting out inappropriately, correct him or her. Explain the problematic behavior and why you feel it undermines the impression you want your clients to have of you. Responsible, mature colleagues will be shocked and correct themselves. Those who do not may need more aggressive correction from management. Either way, as the old saying goes, "You only get one chance to make a first impression." Let's make sure the impression we leave is the one we like. 

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C, Wellington, MO

U.S. Needs to Get Serious about Smoking Cessation
August 25, 2014 8:29 AM by Jimmy Thacker
Let's imagine a better world for a minute. Imagine a United States that actually wanted to cut down on smoking. Imagine what kinds of programs would be instituted. Graphic images on cigarettes, ads educating the public about the risk of not only lung cancer, but of stroke and other diseases. We could imagine that, and we could have had that years ago, but the CDC and seemingly everyone else has to have their say first. Approval has to come from everyone it would seem. Meanwhile, while the U.S. has been talking about curbing smoking, the country of Uruguay has actually been doing it. For six years now!

Uruguay has seen a decrease in smoking in both males and females over the last six years, when they implemented a new, tougher program. These featured graphic pictures on packs of cigarettes, getting rid of misleading terms like "light" and other sub-brand names such as colors (reds, blues, etc) that suggested a different, safer smoke. A wonderful public education program that links smoking cigarettes to not only lung disease, but heart disease and stroke, has opened the eyes of many. Smoking bans are in place almost everywhere and are very popular, so much so that even smoking in cars with passengers is now under the microscope. Six years into the new program, Uruguay is saving lives, while the United States continues to "talk" about how to save lives.

In my opinion, we have neither the federal, state, or local concern to do anything about our smoking rates, which is on the rise. We look for substitutes like electronic cigarettes rather than solutions like bans. We lack any professional organization with enough respect or clout in our society to make a difference. The U.S. likes to think we are miles ahead on many things, but curbing one of our deadliest habits is not one of them. The United States needs to get serious about curbing the smoking habit, and then, rather than "talk" about it more with governmental agencies and companies who stand to lose money when everyone quits, actually "do" something. It would be a nice change.

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C

Are You a Workaholic?
August 18, 2014 8:25 AM by Jimmy Thacker
A new addiction is hitting us now. Workaholism is an acceptable addiction in society, but costs money, productivity, relationships and enjoyment of life. In Japan, it is called "karoshi," which means "death by work." Ben Franklin thought we would be advanced enough that by now we would only work 4 hour work weeks. In 1933, the Senate passed a bill for a 30 hour work week, which President Roosevelt vetoed. In the last 20 years, the hours we work in a week has steadily risen. Some will question what "work" is, but for this blog, we will call it anything that contributes to your employment, your employer's bottom line and time away from your own interests. For some, this is not clear enough, because their only interests are only work.

In the United States, the top 0.1% of the people, around 14,000, hold 22.2% of the wealth. The bottom 90% of us hold only 4%. That creates a class system and the rich keep getting richer, and the poor get poorer. Some extra work is needed to change classes, but is it fruitless? Most people are brought up to think that hard work pays off. Actually, it does not in some cases. Warren Buffet works three hours a day, but is the richest man on the planet. Bill Gates is a college dropout. George W. Bush and Ronald Reagan were high school dropouts, but became popular presidents of this country. Workaholics are also ineffective. They are less productive and pose a higher risk to their employers, especially in health care, which demands you pretty much bring your "A-game" every day.

Are you a workaholic? Answer these questions: 1) Is work a regular part of your evenings and weekends (your "time off")? 2) Do you spend less time with family or regular activities than you used to, like church, exercise or reading? 3) Do you talk faster, walk faster, and feel like you have to "catch up" constantly? 4) Are you developing health issues from too much work such as joint pain, stress-related injuries, chronic headaches, etc? 5) Have you lost your focus and have trouble completing tasks before starting a new one? If you answered yes to any or all of these, you may be a workaholic. The News Tribune says that workaholism makes us sick, stressed, stupid, off balance, and disengaged. Many other sources, including Psychology Today and Inc. agree. Young adults are the most severely affected, and often become even more stressed if they are denied the opportunity to work extra.

In the medical field, you have to be on every day. You never know whose life will depend on it. But here are 13 things you may not know about your work environment. 80% of people are dissatisfied with their jobs. The work is not challenging or you just don't feel like it means anything. The average person will spend 90,000 hours working over their lifetime. Couples in which one partner spends more than 10 hours extra at work are twice as likely to divorce. Americans hold seven or eight different jobs before the age of 30. The economy dictates how many jobs they hold after 30. 25% of workers in the U. S. say their work is their highest source of stress. 13 million days are lost yearly to stress-related issues and we spend many more days just "dealing" with stress in our own way while at work. Americans spend an average of 100 hours a year commuting to work. Obviously the city people deal with this more than the rural folks. Women still make around $0.80 per dollar a man is paid for the same job. 15% of women at the director level slept with their boss, and 37% of them were promoted afterward, which explains why it is hard for you to get promoted, leading to more stress. Half of Americans gain weight at their jobs due to stress. 64% of Americans cancelled or changed their vacation plans last year because of work. Americans only use 57% of their vacation time, giving more time to employers than to their families. 25% of people check in often with work while they are on vacation and 59% check in on holidays such as Christmas and Thanksgiving. Work is everywhere thanks to technology, and it is slowly killing us. 

In my opinion, no other industry needs to police our own people more than health care. We cannot care for others when we do not care for each other. How many therapists do you know who work multiple hospitals? How many nurses are in such high demand they work nonstop for days in a row before taking a breather? How many doctors seem to be constantly "on call" with little or no down time to rest? The medical field is great. It offers opportunity, growth, and the ability to be mobile and have a flexible enough schedule that we should be enjoying life. But are we? If not, you are missing the point of living.

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C

Wellington, MO.


How Does Your Boss Stack Up?
August 11, 2014 10:06 AM by Jimmy Thacker

One of my favorite people to "read" is Peter Economy. You can often find his work in "Inc." magazine. Recently, I read a post of his on the Seven Things Every Great Boss Should Do. Here is his list. If you are a supervisor, see how you stack up. If you are an employee, this may help you determine the kind of boss you deserve to work for.

Acknowledge. Everyone likes a pat on the back once in a while. I remember working for an administrator who would serve cake and punch at the monthly "employee of the month" ceremony, held in the cafeteria in front of everyone else on the staff who was available to attend. His handshake meant much more to me than the little bit of a bonus I received, the parking space I never got to use, or the certificate. Just shaking my hand in front of my colleagues was acknowledgement that he thought I did well and wanted everyone else to know about it, and motivated me to try to do even better.

Motivate. Enlist employees to produce results. Rather than wasting time assigning blame, get them to think through problems and come up with results that meet your high standards. Never lower the standards, but instead motivate employees to reach and exceed the standards you have in place. I think supervisors are surprised how smart some of their employees are. If you give a problem to the group, it is likely the group will solve your problem.

Communicate. The days of departmental meetings have gone in many facilities, and that's too bad. If you cannot have meetings, at least call your employees in once in a while to talk to them. Ask them what is going on in their world. It may be different than what is going on in yours. Does your night shift get the same respect from the doctors as you do? If not, why? Effective communication can often give you a heads up on potential problems, long before your dirty laundry is aired out for everyone to see. It can also be a way of modifying behavior, if needed, and save a good employee from going bad. Employees do not like feeling as if they cannot speak, or they are not listened to. If they feel that way, it is your fault, not theirs.

Trust. If you do not believe in your employee, why did you hire them? Trust goes back to communication, but it also brings an element of support. Supervisors have to get employees the support they need, and trust they will use resources well to meet standards.

Develop. This one is the thing I see the least in departments. Develop the next leader. Yes, train someone to take your job. Someday. A smart administrator may realize your employee can do your job, but will also realize the reason your employee can do it is because you trained him or her. Development takes work. You must know what each employee's strengths and weaknesses are, and train them accordingly. Some people are clearly not meant for leadership roles. But some are, even if you are not a good enough boss to see it in them. They can lead and do great things for your organization, or the one you are competing with; your choice.

Direct. Once you know strengths and weaknesses, assign tasks that will develop those traits. Yes, give your employees tasks. If they are interested in developing into great employees, they will accept the challenge and flourish. If they only want to be good employees, then look for their replacement. We do not need good therapists and leaders, we need great ones!

And finally, partner. Your department should be an exclusive "club" that your therapists belong to. Not everyone is allowed. As a part of that club, members should always be looking for ways to excel, ways to improve both in and out of the department. We do serious work; being a member of a club can be fun. There is a camaraderie that develops into trust and leads to accountability. Once you have that in your staff, then you can provide the very best care for your patients while employing a worthy group of professionals that can take on any challenge day or night.

That's just my opinion,

Jim Thacker, MBA, MHA, CRT, AE-C

Wellington, MO

New Drug in COPD Arsenal
August 4, 2014 8:06 AM by Jimmy Thacker

The FDA has approved a new tool for fighting COPD. Olodaterol (Striverdi Respimat) is a once-daily spray made by Boehringer Ingelheim. It is a maintenance drug that will be used to deal with the third leading cause of death among Americans. Olodaterol, a long-acting beta adrenergic agaonist (LABA) helps the muscles in the airways and lungs stay relaxed. Side effects may include a runny nose, bronchitis, cough, upper respiratory tract infection, urinary tract infectino, rash, diarrhea, dizziness, back pain, and other joint pain. "Olo" has not been approved for use in asthmatic patients because of a lack of research for that population thus far. It is not to be used as a rescue medicine.

In my opinion, it is good that we continue to find new ways to fight breathing diseases and conditions. Many of our patients suffer debilitating issues with their breathing, and often some of us can get them back on the right path. Olo may help you in your practice to ease that suffering.

That's just my opinion,
Jim Thacker, MBA, MHA, CRT, AE-C
Windsor, Mo.



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