All About Nursing (25)

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Welcome to All About Nursing with your host, Dr. Joyce Vacherner, executive nurse advisor, Dr. Vacherner. Who will present the significant role nurses play in providing healthcare in a multitude of healthcare settings.

Listen to some of today's key nurses who work and practice in academia settings and talk about the challenges they face in today's modern medical world. Please welcome the host of All About Nursing, Dr. Joyce Vacherner. Good evening.

I'm your host, Dr. Joyce Vacherner, and all about nursing. We're live on the BBM Global Network and in radio. I'm really excited to have a guest with me on my show this evening.

And I'd like to tell you a little bit about her. This is Dr. Bernadette Henrichs, who is the director of CRNA Education and Research in the Department of Anesthesiology at Washington University School of Medicine in St. Louis, Missouri.

She's also professor and director of the Nurse Anesthesia program at the Gold Fargo School of Nursing at Barnes-Jewish College. Dr. Henrichs received her anesthesia training in 1994 from Washington University School of Medicine in St. Louis.

Her master's in 1993 and her PhD in 1999, both from the St. Louis University. Again, I think you're going to find that this is another area of specialization that nurses are really trained in. And I really look forward to being able to have her tell more about the role that she's in and the incredible work that she's leading.

And so let's begin by having you just tell us a little bit about the role that you're currently in and what your job really entails, if you don't mind. Hello, Joyce, and thank you very much for having me. So yes, I am the director of the Medanesthesia program. What that means is a nurse anesthetist is an ICU nurse who goes back for a doctorate degree or a master's degree.

We're all moving to doctorate programs by 2022. But you go back to study nursing anesthesia and then you provide anesthesia in the hospital for surgical patients, or for laboring, you put in epidural for laboring patients. So it's a great career. I worked as an ICU nurse for 15 years and then became a nurse anesthetist.

And so I started the nursing anesthesia program here at Gold Farms School of Nursing. And it's a great career. It's much more advanced than the ICU nurse. Like I said, put people to sleep.

We administer anesthesia while they're having surgery. And we put in finals and epidurals and peripheral nerve blocks for pain post-op. So it's certainly an advanced type of nursing, but it's very rewarding. How long is the program that you must go through to become an nurse anesthetist?

So it is moving from a master's degree to a doctorate degree. We were really a heavy, heavy master's degree program. We had 79 hours in our master's and most master's degree programs are around 30 credits. So moving to a doctorate made sense.

And we will now have 94 credits and it'll be a three-year program. So what that involves is a lot of advanced sciences, a lot of advanced anesthesia principles, and then the operating room. The students rotate through different areas. The curiosal throughout, the pediatric, the obstetric, the neuro patient, the gynecologic patient.

And so they're in the over giving and the seizure they end up giving, probably doing a thousand cases before they graduate in over 2000 clinical hours. That's wonderful. And I think that one of the things we've been talking about is just how many different kinds of roles there are in the nursing profession. And this is certainly a specialization.

And as you've just described, there's a lot of expertise that goes into the kind of training that our listeners can really understand and appreciate that there's a lot of rigor before someone begins to be practicing in this role. Such a curious and I share your love for critical care. That was my background as well. But what led you to really start doing the kind of work you're involved in now?

What made you want to move in that direction? So I was a nice e-commerce for 10 years and I felt like I took care of the most challenging patients and I needed something more challenging. And so I guess you could just say I was getting not necessarily bored, but just I needed something more challenging. And that's when I started looking into, I want to be a nurse researcher.

And when I worked at C.U. the pulmonologist wanted me to work in their department and do nursing research and help with their ICU patients. So that was an option. But I also looked into nursing anesthesia and something about nursing anesthesia attracted me.

I feel like it's the best that you can do in nursing. You have more autonomy than the other professions. And you get to do exciting things. And even under anesthesia, the patient's life is in our hands.

And we manage that patient throughout the case and keep them stable and make sure they wake up. And I think I was just looking for something new. And I have not gotten tired of this at all. This is amazing.

I mean, it's so rewarding to get, I give anesthesia two days a week. And then I teach anesthesia and do administrative duties the other three days. But it's just so rewarding to take care of these patients who are nervous and scared about having surgery. And I think part of that is our nursing compassion.

We want to take them under our wings and say, you know, hey, we're going to watch you during surgery. We're going to protect you. And we're going to wake you up at the end of surgery. And so it's a very compassionate way of giving nursing.

I know some people say, yeah, but you only get to talk to them before they go to sleep when you wake them up. But you build a rapport with those patients in that short time. Absolutely. I was just going to clarify too, this is from pediatrics to all ages.

I'm assuming that the program includes correct. Yes, that's correct. Children's Hospital, the students rotate through there. There you have a large group of CRNAs that work there.

And, you know, it's a level one pediatric hospital. But they also rotate through obstetrics, they provide anesthesia and give epidural for laboring patients. And we take care of the very elderly too. There's a lot of elderly having surgery.

So from a very young neonate to a 100 year old patient. Do you find that the nurse and that's just like to specialize in one age group versus another? Or do they like to have the whole age range that they could take care of people in? I think when you first become a nurse in SSCU, you like that variety and you will float around.

But eventually people get settled in different areas. And it seems like there's a group of CRNAs that always want to work at children. But there are some that float. They float back and forth between the level one hospital and the pediatric hospital.

And then there's a large group of CRNAs that only want to do obstetrics. And there's laboring, OB patient. But then there's some who rotate back and forth. So it really varies.

There's some who settle down in their certain area, but there's a lot who float to all the areas. And I was just curious too, the training, I mean, it sounds pretty intense. And so I was very impressed that you continued to practice in addition to your administrative role. And I'm assuming that you've done that to really keep your skills up and stay current as you're teaching.

You want to make sure that you can role model. Is that accurate? Because not everybody does that. That is exactly true.

I think you have to practice in order to be able to teach. I think you're a much better teacher when you practice. Because I give a lot of examples of things that can happen in the operating room. That's pretty awesome.

And I would say I really would tell you that that's amazing that you do that being able to balance your time. So right now this is all about nursing. I'm Dr. Joyce Bachelore.

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You're listening to All About Nursing Live from the Be Giveable Network in Tune & Radio. I'm Dr. Joyce Bachel, the host of the show. And I have a very distinguished guest on this evening, Dr.

Bernadette Hendricks, who is a nurse and estist, and does a lot of teaching as well as practicing. And before the break, we were talking about why she got into the role and how she continues to practice in that role along with teaching and just doing a phenomenal job. What I'd like to do is shift us to talking about something that I know you're very actively involved in and help our listeners better understand some of the things that we're working on when it comes to pain management. And I'm sure people have heard in the news that we had issues with an opioid crisis and thought that this would be a great opportunity to talk a bit more about what is going on and how does that relate to pain management and what does this mean and how can we start to help educate people on things that they can do to prevent themselves becoming addicted to these kinds of things.

So I'll give that back to you. Yes, I would love to talk about that. So there is certainly an opioid epidemic in the United States. And what does that mean?

It means misuse of opioids. Largely a prescription-related problem, but it's even more than that. So if you think about, we have more than 70 million patients undergoing surgery each year. 95% of these patients receive opioids either in the hospital or in the hospital when they go home, they're given a prescription.

And so, unfortunately, controlled prescription drugs are abused at a higher rate than any illicit drug except marijuana. So what is happening with our country, I think what happens is some people get prescribed these opioids and then they end up being addicted to them. Unfortunately, it's not just an issue with patients. Anastheta providers have a high incidence of opioids misuse.

And I think it's a complicated problem, but if you think about the nurse and us getting any anastheta provider getting, we get a box of narcotics in the morning because we're going to be giving our patients opioids. And if somebody is down or depressed or just has that urge to try it, they have a high, high incidence of opioid abuse. And fentanyl is the most common drug that is abused by healthcare workers, but just taking one dose can make a person become addicted and then they just need more and more and more. And most of the time, the abuse is discovered by finding them dead.

And now we see it in patients who are prescribed opioids and sent home. And it's frightening to hear the statistics. One in 15 have chronic use of opioids or abuse. So, opioids are good because they help with pain.

So, they have acute pain or chronic pain. However, they can become an abusive drug and that's where the danger is. So, just taking prescribed opioids longer than they're ordered or maybe in conjunction with mixing them with drugs or alcohol or taking them for a different reason than what was prescribed or the person just becomes tolerant of it. It's the leading cause of accidental death in the United States and half of those overdoses involved prescription drugs.

So, unfortunately, now more people are dying from drug overdoses than from car accidents. And the U.S. statistics really, it accounts for only 4% of the world's population, but we consume 80% of the world's prescription drugs. Not the frightening thought, I think.

And I think it just shows there's definitely opioids that are abused. And it keeps rising. OPI death continued as a sky rocket in 2015. In the U.S.

alone, over 50,000 people died. In 2016, it jumped to 60,000. In 2017, it was even more than that. So, something needs to be done.

And I think, as Amy C. She's a provider, we can make a difference along with nurses who work in the hospital and surgeons who work in the hospital. But I guess one of the first things I want to ask is, you know, how did, I mean, what contributed to this? I think the pivotal event that spurred a lot of this was an article that was published in 1980 by Jane Porter and Dr.

Herschel Jek. And it was about addiction of narcotics. And they quoted that addiction is rare in patients with narcotics. So, they said it was so rare that it only occurred in about 4 out of 12,000 patients.

And so, healthcare providers, legislators, pharmaceutical companies cited this study, supporting the need to literally prescribe opioids to combat pain. So, treating pain was the primary goal. And people were prescribed opioids. And the sad thing is, you know, they were prescribed a large amount.

They might, you know, say take it twice a day or take it two times a day, but they were given months worth. And, you know, think about surgery. Surgery pain should get better in the, you know, in the state. And it should not linger on past a few weeks.

So, why these people are getting prescribed so much drugs is a sad situation. And then joint commission, the joint commission and the credit hospitals, they started calling pain the fifth vital signs. And they said, you must treat it in the hospital. Patients should, you know, be given treatment for pain.

In 2000, joint commission and connected a campaign to increase awareness of pain. And they said, you know, we have to be aware of this. We have to do all pain. And so, I think that just led to a generation of overprescribing.

And now we realize that, and the pendulum is swinging from overprescribing to very judicious prescribing. Well, we're going to make a break, but we're coming to you live and be able to level network into an in-radio with all about nursing show. And we're going to continue this conversation when we come back. Renison Swamin, Trailblazer, Maverick.

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Before the break, Dr. Brenda Hendricks and I were talking about the over-grade crisis that we have going on in the country, and she was sharing with us some pretty alarming statistics like drug overdose being the leading cause of accidental death in the U.S. and half of those overdoses involved prescription drugs. I mean, it's pretty prevalent in terms of the number of people it's impacting.

I also was just wanting to follow up and ask also of her in depth of impact. It's all age groups. Is that accurate? The adolescents are also being impacted by this?

It is, unfortunately, and its adolescents are more likely than those over the age of 26, which is really sad. I was struck to, as you were talking about, the Joint Commission's fifth vital sign. I think when they started that, they really wanted us to be sure that we were going back in and reassessing whether or not pain medications were working, but it took on a whole bigger life where we started to then get the pain management scores on our patient satisfaction surveys. We're going to then count towards the reimbursement on organization, what it would get based on satisfaction scores.

It was almost like people being pushed to be able to say we're doing everything to take care of your pain when we weren't clarifying that we're not always going to get your pain to zero. You're going to have some pain. Here's what we want to get it to. And in other ways, in a holistic manner to approach pain.

I was just curious if you could say a little bit more about your experience and what we're seeing related to that. Yes. And Joint Commission pretty much said we don't have to worry about opioid addiction. All pain can be treated and we should be treating these people and taking care of their pain.

They have this right. But they pushed it on a hospital so strongly that the patient satisfaction surveys said the nurse and the doctor relieves me of all my pain. That's just not fair. And I tell patients when I see them, you are going to have pain after surgery.

Hopefully we can make it tolerable, but you will have pain. You're being operated on. So too, and if the patients didn't score that high, then the hospital did take a hit, financial hit. And so everybody was trying to reach those goals and say, okay, we've got to relieve their pain.

We've got to give them more pain medicine if they're complaining. And so. Yeah, go ahead. And so now, like I said, the pendulum is swinging from over prescribing to being very judicious, which is unfortunate for people who literally do have chronic pain that will not go away.

Because I think sometimes they have to fight to get some type of pain relief more than they did in the past. You know, I can remember when we would have alert systems that we put in place for patients that were known to come back into the ED that seem to be seeking drugs just in order to relieve whatever pain they had, physical, emotional, whatever it was that they were experiencing. And so, but there's a lot of people that do have chronic pain. And so, you know, how do we balance and kind of get back to helping people know what's a tolerable level of pain and then what are the different holistic approaches you can take so that it's not just about popping some pills.

There's other things that can work. And so I was just curious if you're working with them in the field of anesthesia, what are you all talking about and trying to do to really change that understanding with people that we serve? And that is now the push for all health care providers to treat patients with a multi-modal approach, we call it. And what that means is do a variety of things because that combination works better than just one medicine.

So, for example, years ago, somebody said, I just had an appendectomy, I'm hurting, we would give them morphine. If they still complain, we gave them morphine. They still complain, we gave them more morphine until they were only breathing four times in and we said, I can't have anymore. Now the approach is the surgeon should put local hemeesthetic in the incision when he's sewing the incision up.

And then anesthesia providers can provide peripheral nerve blocks. So, an appendectomy, we could block that area. Just like if you had surgery on your arm or your leg, we could block that area and we can put pain catheters in that. We'll take care of that pain for up to four days or we now have long-acting group of pain that can last for four days.

So, we're trying to do as many blocks as we can. And then if they still have pain, move to non-obioids. Give acetaminophen around the clock or give non-steroidy and pain flamethories such as ibuprofen around the clock. Try to do those measures first and also along with that maybe non-medications such as IC area or what a heating pad on it.

If that helps, physical therapy started earlier. Sometimes mobilization will decrease the pain. It might hurt initially more, but eventually it'll help heal faster and decrease the pain. And even relaxation techniques are music therapy, or acupressure, or acupuncture.

And then if you can't control the pain, the last thing we should go to is opioids. So, that's a totally different shift now than it was five, ten years ago. Well, I think that's great. And as you were talking, I was thinking about having been a diploma nurse and started nursing school a long time ago.

The art of nursing with pain management, we used to be taught, is when you get the patient, their medication, is that you also have them take some slow deep breaths. You get them comfortable in the bed. You try to put some music on to relax them so that it can help the medication to really work. But we seem like we've moved away from that as we've gotten busier in our practices.

So, we are coming to you live from VBM Global Networking Tune in Radio. This is all about nursing. And I'm Dr. Joyce Batch, the host of the show, and we'll be right back.

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You're listening to all about nursing live and the BDM Global Network and Tune in Radio. I'm Dr. Joyce Bachel, the host of this show. And just before the break, I was starting to share that there was a lot of push when I was in nursing school initially years ago to really look at the art of nursing being around how you would get paying medication to a patient and help to soothe them, get them comfortable, dim the lights, have them take some deep breaths, you know, music therapy.

And I think we've lost some of that, but it seems like some of that would be important for us to try to bring back. And I was just curious if you're seeing that as you're doing the work that you lead in the anesthesia field. We are talking about that all again. When we talk about multi-modal approach, we actually list those types of things.

We say, you know, try, look when aesthetic in a regional block if you can, and non-steroid any inflammatory drugs. I mean, I see the minimum, but then we also say relaxation techniques, music therapy, things that you know will calm you down and get your mind off of the pain. You don't think about it, it doesn't hurt as much either. So we are coming back to that.

I don't know how much is used in the hospital. I think nursing tries. Nurses always are passionate and want to help their patients. Sometimes I think, you know, it gets busy on the floors and they don't have as much time as they would like to spend on it.

But it is, we are definitely looking for other ways than opioids to treat patients pain. So for our listeners, if they are, in fact, going to become a patient or they have a family member that's going to become a patient or they're going to have some kind of health care procedure. What kinds of things would you recommend that they think about and stay and do when they're going to be meeting with their physicians or under-spectitioners, or whatever they're seeing for their care? I feel that if patients are having surgery, they have to take an active role in their recovery.

They must get involved. And what that means is, informed a surgeon that they don't want opioids, there's other techniques, but they should also have that attitude that they're going to have early mobilization. They're going to get up in the chair. They're going to get up and walk, start moving around.

They're going to start physical therapy as early as they can. They're going to use the technique of ice and elevation for the surgical sites. But also just letting the surgeon know that they want other techniques done besides opioids. If it is a pretty significant incision or lots of pain and they do need opioids, I think they need to take the active role of trying to take as little as possible, try using the seat of medicine and non-steroids when they can.

And if they do need them, try to taper off as quickly as possible and then destroy them medications if they have any leftovers. Because oftentimes you get more than what you need. The push now is for surgeons to only prescribe four or five days worth. And so if you don't need all those pain medications, please don't leave them in your medicine cabinet.

That's just the chance for somebody to steal them who has a problem. They come over to your house and they see them in your medicine cabinet and they can steal them. Or even little kids can get a hold of them. Lawgreens often have days where they will collect opioids prescribed medications that you no longer need.

So definitely try to take as little as possible and taper them as quickly as possible. And as you were talking, I was thinking that this applies to if you're going to go to the dentist and other places for service because those are other opportunities where sometimes you're given prescriptions if you've got a major dental procedure. And I think that's something else for people to be very much aware of. And the other thing I was thinking about as you were talking is that I had a chief nursing officer who was sharing with me that they were doing spot checks of nursing as urine for drugs.

And when they found some medication and a certain drug in their urine, but it was a prescription that was like an old prescription. They were not currently supposed to be on that prescription that they were starting to take action with those nurses. And I had not heard that before. And I thought as you were talking that a lot of people do say things in their medication cabinet thinking maybe later on I might need this at some point.

So I think the recommendations you're giving are pretty significant for people to be listening to. Bernadette, I was curious, what is there anything else that you would like to share that surgeons are really trying to also do to combat the boy-grained crisis. Are you seeing them really engaging on this? Well, surgeons are certainly part of the health care team that are involved with anesthesia providers also trying to give less opioids as they can.

So they're aware of this too. And I think we will see this trend of them prescribing less opioids. And if the person runs out of their prescription, they're not supposed to just rebuild it. They're supposed to see the patient now and see what's going on with their pain and not just prescribe more medications.

But they are taking an active approach to putting local anesthetic into the incision. They're all about trying to get the patient into the hospital, giving their surgery and get them home as quick as possible. And you can do that in a much better way if you don't prescribe opioids or if you prescribe only a little bit. Because opioids, like I said, they work great, but they have so many side effects, respiratory depression and constipation and ileus.

So your stomach doesn't move through like it should and rashes and addiction and sedation. And the elderly can fall from being sedated and elderly get very confused. So I think surgeons are also more aware of this now. And because they're not being pushed by joint commission to treat pain as a fifth vital sign, they realize the dangers too.

So they're taking an active approach also along with the anesthesia providers who do a lot of the pain blocks before surgery or we sometimes do them after surgery. And if you can have some type of peripheral pain block, you can definitely decrease the amount of pain medicine that you're taking. And people are being sent home with pain pumps that have no opioids in them, just local and aesthetic. And they take the catheter out after three or four days, they take it out on their own.

And this is the surgery, the surgeon's area, all with them too. They work with anesthesia to put these pain blocks in. So I think overall we're getting the messaging, we're trying to get the message out there that opioids are not good and people do much better without them, even though sometimes they are necessary. And anesthesia providers, we definitely have to take an active approach too.

If people come in and say, hey, I had a history of substance abuse and I don't want opioids, we've got to be and invite them and help them get through their surgical pain. There was a sad story published not that long ago in Anesthesiology News, and it was a story that Anesthesiologists wrote about his son. He said his son was in a motor vehicle accident. He had been a substance abuse user and he went to rehab, got himself off of the opioids and was doing well, but then got to get it.

And when he came into the ER, he, from his cracks, and he refused, opioids, he said, do not give me them. I won't get addicted again. And they didn't, but however, he needed surgery. And during surgery, he received opioids during the surgery when he was asleep unconscious.

But that was enough to put his brain to get this addiction going. And he woke up with real glassy eyes and said, Dad, I need drugs. He went home and he ended up taking an overdose of drugs and died two weeks later. Wow, that's a very powerful story.

This is all about nursing. I'm your host, Dr. Joyce Vadchelor. We're live on the BVN Global Network Continuing Radio.

It's time to take a short break and then we'll come back and discuss that more. Thank you. Welcome back everyone. You're listening to all about nursing life and the BVN Global Network and in radio.

I'm Dr. Joyce Vadchelor, the host of the show. And just before the break, Bernadette was telling us a pretty powerful story of an anesthesiologist son who was in a motor vehicle accident and refused opioids in the emergency department and was very fearful about becoming addicted if in fact he had them. And then during the surgery while he was sleeping, obviously they unfortunately used the fentanyl and it caused him to then become addicted.

And then you were sharing with us that he died of an overdose a couple of weeks later. And that whole thing about that you were describing that the brain was somehow triggered. I've heard people talk about that before and it's just is it the power of the drug that just makes the brain kind of trigger like that? Yes, I know the hypo campus is one area of the brain but it just has that it's that mechanism of making people happy.

And it remembers that hey this made this person feel very good. You get that euphoria. And so the drive is so strong that just giving somebody an opioid will trigger that whole process. And there's bad stories where people were you know went to rehab and were clean for 10 years and then something triggered it and they ended up going right back to opioids and so many of them.

Like I said so many of them are found dead. Well that's a very powerful example of why we need to really get on top of this very serious issue. You had shared and I was interested to that you've been talking about a major hospital that you're working in. CRA days are doing pain management in a lot of other areas including the rules and I was just curious if you could talk a bit more about what CRNAs are really trying to do in a variety of settings.

So in the large half of us we are part of a team so we work with the MSC Biologist. So we're all working on that goal of trying to decrease the opioids when we have these patients and we take care of them for surgery. And that does involve giving blocks. We do that, the NSCs, all this do that.

And then doing the multi-modal approach making sure like if we can give IVAC to menafine and IV non-steroid anti-inflammatories and then they can be sent home on that. And trying to really minimize the amount of opioids that we get. CRNAs are also the main provider in rural hospitals and they're the only providers so they are on the front lines and a lot of these rural hospitals unfortunately rural areas have an increase in the number of opioid addicted patients. So they are seeing these patients in those rural hospitals come in for surgery or for injuries through the ER.

And so the push with them too is the same thing to a multi-modal approach try to block as many patients as you can. Even if you have tons of electomy you can put a block in for tons of electomy years ago. We never thought about doing that. But the push now is to try to do a block if we can.

And terminal surgery we certainly can put blocks in any extremity, the arm or the leg. And so do that and then again try non-obioid, try those revaxation techniques and patients should certainly be involved with this. And music therapy, anything to distract them from their pain. Again early mobilization moving around.

I think sometimes that takes your mind off of it too just by going out taking a walk. And so the CRNAs that work in the rural areas are definitely a big part of this too. And then recognizing that if somebody does have a substance abuse problem to avoid giving them opioids. We don't want to trigger their brain to go back to abusing drugs.

You would think that with so many organizations spending money on electronic health care records that there would be a way to have the technology helping us to flag patients that are at risk. And going back to thinking about that, NCCL just son, there should have been big red flags on that chart saying do not give. And I'm just curious if we've been thinking about working with some of our big vendors to really look at ways that the technology could really reinforce a lot of what you're saying we need to be doing. Because I think about just rural areas many times as you said it.

You've got CRNAs there and you've got temp doctors that do float around. It's not always permanent people. So the risks are higher if we don't have something that helps to stabilize that kind of knowledge that needs to be there all the time. With the electronic records we should be able to flag these people.

We certainly flag things like abstracted sweep up because that alerts us that we have to be cautious with what we do for these patients. So we should definitely be flagging those with stuff into these problems too. And then I was thinking too it's almost like a nurse is in general need to be really knowledgeable about this because there's a lot of pre-op teaching that occurs in physician practices and clinics and other outpatient areas. I'm not sure we've gotten that word out there as much as perhaps we need to.

Do you know if there's work going on with some of the other nursing specialties to sort of spread the... I think we have a long way to go. I don't think we even have the tip of the iceberg yet. At our hospital, at the big level in hospitals, the nurses are starting to hear that because they play a powerful role even in the inpatient.

Absolutely. They shouldn't just immediately grab an opioid that might be ordered because there's probably also an end set that's ordered. And I'd be a seat of minutes in that order. And they can work on, like you said, years ago, making the room quiet, turning them, getting them comfortable, dimming the lights, putting on maybe their favorite music, trying to mobilize them quicker.

I think the area, putting a keypad on the area. So I think we are getting the message out there but we have a long way to go. I would say in the last year I've heard it much more than I've ever heard it. Well, thank you.

This is all about nursing. I'm your host Dr. Joyce Bachelor. We're live on the B-Mim Global Network in Tune Radio and we'll continue the conversation when we come back.

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We're live on the B-Mim Global Network in Tune Radio and prior to the break we were talking about the OPA crisis and really what kinds of things can be done and the role that the nurse and estus are playing particularly in rural areas. And I was really struck as you were discussing this, that this is something that probably needs to be getting done in a broad sense of like all nurses. And it might be helpful to just kind of summarize again like just why this is such an important topic for us to be focused on. The most recent study that you wanted to share a little bit more of.

I think every person has to play an active role in this. For one, just recognizing that somebody seems like they're impaired. But also as they become a patient in the ER, in the hospital for surgery or for some procedure and realize that OBIs are very addicting and tell you're certain that you don't want OBIs. And you would prefer a block or a local aesthetic instead.

A recent study showed that 57% of patients having surgery preferred a non-OBI and would rather experience post-surgical pain than the risk of OBI adverse events. So I think you don't want to become addicted. So it's important for us to speak up if we're in that role, if we're in that situation. And 30% of patients feared OBI addiction, which shows me that the word is getting out there, but I think there's still a lot more that we have to get out into the public and tell people, OBIs are very important.

OBIs are very addicting and they have lots of complications. And so play an active role. If you can avoid OBIs, avoid them. Do relaxation techniques and music therapy and early mobilization and ice or heat pads or whatever helps.

And do as much as you can to inform your surgeon and inform your anesthesia provider that you really don't want OBIs. And if you do have to take them, try to taper them as quickly as you can and get rid of your leftovers, bring them to the Walgreen Darts. You can mix them in coffee grounds. You don't want somebody going into your medicine cabinet and taking them, which happens.

Unfortunately happens quite a bit. As you were talking, I was thinking too that I'm sure there are apps that you can download on your phone that have different relaxation techniques that you can do. I mean, it's really pretty easy to find those these days. And so I think the guidance and the advice you're giving is really good.

And for many people that are potentially going to be the ones overseeing the care of their loved ones, that they're not afraid to speak up like the dad, the anesthesiologist, I'm sure, was vocal around what was going on with his son. But if he's not in the operating room at the time, that had to be tragic to end up seeing that kind of thing happen when you're in the field and you know better. And so I really appreciate that you shared a lot of this great information this evening. And is there anything else that you would want people that are listening to be aware of before our show ends this evening?

I think knowledge is power so read as much as you can on this, especially if you know that you have to go have a surgery cooperation done. But you know, even ending up in the ER, just try to learn as much as you can about it and be smart, take an active role as a patient. And I think that the statistics that you started off with at the beginning of the show are things that people can also find pretty readily on the Internet. They want to make sure that they've got that kind of information with them when they're going in to talk to their providers so that people can see that they are very much informed and don't want to be part of the statistic.

And you know, at the beginning you said more than 70 million patients undergo surgery each year and 99% receive opioids. That's just like red flags flashing. So thank you so much for being on the show. This has been highly educational.

And I hope our listeners are going to take away some great information about what they need to be doing to protect themselves, their loved ones. And thank you so much. Really appreciate you. So you're listening to All About Nursing Live at the VVN Global Network, TuneIn Radio, Dr.

Joyce Batchler, host, and TuneIn Next Week. Thank you very much. You've been listening to All About Nursing with your host, Dr. Joyce Batchler.

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