NURSE'S NOTES-A REFLECTION AND UNDERSTANDING OF RETIREMENT

 

NURSE'S NOTES-A REFLECTION AND UNDERSTANDING OF RETIREMENT

I began my journey into the world of healthcare when I was 16 years old. My first job was as a Nurse's Aide at a local hospital. The year was 1969. I retired at 65 after devoting nearly 5 decades to the profession I loved. 

Retirement along with the loss of loved ones over the years and the loss of being needed has certainly made the journey a challenge but, in reflection I must admit, much could have been different if I had only realized to stop and, as they say, smell the roses 

I spent years working, often two jobs while earning degrees to advance my career, being a wife and raising my kids. In retrospect I wish I had cultivated attachments more. Yes, I managed to find a way to be at all the ballgames, to tuck them in at night, to have a "date" every so often with my husband, to visit, on occasion, people we knew but long term lasting friendships never really were part of my life back then, I didn't have the time,  

I retired early. Even though my age said I was 65 years old I still had plenty of gas in my tank and now wish I wonder if I should have retired when I did. The why of said retirement was not even a blip on my radar. From when I began the journey into caring for others I promised myself and my family that when they needed me I would be there for them. I always felt if I cared for strangers over the years the least I could do was care for family when they needed it. So, there I was at 65, retired and caring for family. First my husband then dad and mom and in between I helped my daughter with her babes. So, once again, during the early part of retirement I found myself still needed and still able to offer myself in the service of others, I had a purpose. 

Now sitting here at 73 years old I am no longer needed, I have no purpose. Many loved ones have passed and I find myself utterly alone. Is it grief I feel? Is it regret? I think it is a bit of both. I do not regret my devotion to my family nor do I regret all I accomplished but, I do regret that I did not learn how to cultivate something in my life that would bring a bit of joy in my latter years 

A unique type of grief

After decades of service to others a retired nurse may experience a uniquely complex emotional journey that merges personal bereavement with the long-term habits, identities, and emotional compartmentalization developed over a lifetime of professional caregiving. Whether grieving the loss of a spouse, a family member, or navigating the collective weight of their past patient losses in retirement, their background dramatically changes how they process sorrow.

So, here we are trying to understand an old retired nurse and her feelings of loss and grief

The Unique Dynamics of a Retired Nurse's Grief

Retired older nurses face a high and often unrecognized risk of late-life depression driven by a sudden loss of professional identity, social isolation, physical decline, and the emotional burden of a career spent caring for others

Why Retired Nurses are Vulnerable

• Loss of Identity and Purpose: Decades of structured shifts, clinical responsibility, and a strong identity as a "caregiver" vanish overnight upon retirement.
• The "Helper" Paradox: Healthcare professionals are trained to take care of others and often struggle to ask for help, recognize their own symptoms, or admit vulnerability due to professional stigma.
• Cumulative Burnout and Grief: Years of handling patient suffering, high-stress environments, and loss can surface or deepen once the adrenaline of working life stops.
• Physical and Social Changes: Joint pain, fatigue, sleep disturbances, and a shrinking social circle compound the transition out of the workforce.
• The "Expert Caregiver" Trap: Nurses spend their careers being the strongest person in the room. In retirement they often default to managing the any crisis, organizing logistics, and suppressing their own feelings to care for other family members, delaying their own emotional healing.

• The Weight of Medical Knowledge: Knowing exactly what is happening biologically to a declining loved one can trigger unique distress. They may struggle with clinical regrets, second-guessing medical decisions, or feeling a false sense of responsibility that their clinical skills "should have been able to fix" the situation.
• Delayed and Disenfranchised Grief: Nursing culture traditionally rewards compartmentalization—putting personal feelings in a box to finish a shift. In retirement, without the structured distraction of a demanding job, these long-buried boxes of "professional grief" from cumulative past patient losses can burst open alongside fresh personal losses.
• Neglect of Personal Health: Having historically prioritized everyone else's well-being, retired nurses are highly vulnerable to neglecting their own physical health, pushing through exhaustion and ignoring new or worsening chronic conditions

 

 

MEDICAL EXAM OVERUSE

  Medical exam overuse occurs when tests are ordered with little or no clinical benefit, increase spending without improving health outcomes or carry a risk of harm that outweighs the potential benefit of doing said exam. 

This problem is driven by factors such as lack of knowledge about test utility, defensive medicine, financial incentives, and patient demand. Overuse leads to wasted healthcare resources and can result in the overtreatment of conditions that might never have caused harm. 

EXAMPLES OF OVERUSE EXAMS

SINUS CT SCANS: Ordering CT scans for every case of uncomplicated acute sinusitis is often considered overused, as other treatments are more appropriate. 

ALLERGY TESTING: Certain diagnostic tests for allergies, such as indiscriminate immunoglobulin G (IgG) or immunoglobulin E (IgE) testing, are frequently cited as overused

SOME CANCER SCREENINGS 

     PSA- While screening is important for some excessive or inappropriate screening can lead to the overdiagnosis of indolent cancers. 

MAMMOGRAMS:

  The United States Preventive Services Task Force (USPSTF) recommends biennial (every two years) screening mammography for women 70-74 and they are not recommended after 75

There's a great deal of waste and abuse in our Medicare system. Medicare waste refers to the inefficient or improper use of resources within the Medicare program, leading to unnecessary costs. It encompasses a range of issues, from excessive or unnecessary services to outright fraud. One area that is a huge issue is over-ordering of diagnostic tests and medications.

Concerns about over-ordering of diagnostic tests in seniors over 70 are significant and increasing. Over-ordering of diagnostic tests in seniors over 70 is a complex issue with significant consequences. Addressing this challenge requires a multi-disciplinary approach that includes educating both physicians and patients.

For example:
Mammograms for women over 72 with a history of normal screenings and no symptoms no longer need testing.

PSA testing for men over 70 is no longer recommended, depending on risk factors and history

Over-ordering of medications, or polypharmacy, is a significant concern for seniors over 70. This is defined as the regular use of multiple medications, typically five or more, for various health conditions.  

Here's a breakdown of the key aspects of polypharmacy in older adults:

1. Prevalence and risks

• Increased Risk with Age: As individuals age, the likelihood of developing chronic conditions and being prescribed multiple medications rises significantly.
• Adverse Drug Events (ADEs): The risk of ADEs increases with the number of medications taken. These can range from minor side effects to serious drug-drug or drug-disease interactions.
• Falls and Cognitive Impairment: Polypharmacy is associated with a higher risk of falls, fractures, kidney impairment, frailty, and cognitive dysfunction.
• Reduced Quality of Life: Taking multiple medications can impact a senior's daily life, affecting their ability to participate in social activities or exercise due to side effects or complex dosing schedules. 

2. Contributing factors

• Multiple Healthcare Providers: Seniors often see multiple specialists, who may prescribe medications without full awareness of other medications the patient is taking.
• Chronic Conditions and Guideline-Driven Care: Guidelines for managing individual diseases often recommend specific medications, which, when applied to patients with multiple conditions, can lead to polypharmacy.
• Prescribing Cascade: Side effects from one medication can be mistaken for a new condition, leading to the prescription of another medication to address those side effects, creating a cascade of prescriptions.
• Automatic Refills and Lack of Review: Medications may be refilled automatically without regular review to ensure continued necessity.
• Patient Expectations: Patients may expect or even request medications for every ailment, contributing to over-prescribing.
• Marketing and Promotion: Pharmaceutical marketing and direct-to-consumer advertising can encourage patients to inquire about specific drugs, even if they aren't the best option. 

3. Addressing the issue

• Deprescribing: This proactive process involves identifying and discontinuing or reducing the dose of medications that are potentially inappropriate, no longer necessary, or whose risks outweigh their benefits, according to the National Institute on Aging (.gov).
• Medication Reconciliation: This involves creating and maintaining an accurate and up-to-date list of all medications a patient is taking, including over-the-counter drugs, supplements, and traditional remedies, especially during transitions in care.
• Patient Education: Seniors and their caregivers need clear information about their medications, including purpose, dosage, administration, potential side effects, and risks of drug interactions.
• Involving Pharmacists: Pharmacists, particularly those with specialization in geriatric care, can play a crucial role in medication management, conducting reviews, identifying discrepancies, and educating patients.
• Shared Decision-Making: Discussions about medication use, including deprescribing, should involve the patient, family (if appropriate), and healthcare providers to align decisions with patient preferences and goals.
• Technological Aids: Tools like medication management apps, smart pill dispensers, and electronic health records can help improve adherence and simplify complex regimens, according to Washington State University.
• Policy and System-Level Changes: These include improving information and training for healthcare professionals, encouraging regular medication reviews, and promoting value-based payment models that reward deprescribing when appropriate. 

4. Importance of communication and continuity of care

• Open Communication: Effective communication between all healthcare providers involved in a senior's care is essential to avoid conflicting prescriptions and ensure a comprehensive understanding of the patient's medication regimen.
• Seamless Transitions of Care: Accurate medication reconciliation and clear communication during transitions (e.g., from hospital to home) are crucial to prevent medication errors and ensure continuity of care. 

In essence, addressing medication overload in seniors requires a multi-faceted approach, involving improved patient education, proactive medication management strategies like deprescribing and reconciliation, and a collaborative effort among patients, caregivers, healthcare providers, and policymakers

HIDE N SEEK

 

Oh this is just too darn cute and made me smile remembering how our sweet Sophia just loved to play Hide-n-Seek. She wanted to play it for hours, didn't matter that I couldn't get into the really neat hiding places. 

WHY PEOPLE WEAR A RED POPPY

 

Have you seen people wear a red poppy and wonder why?

It is a symbol of both Remembrance and Hope for a peaceful future.

Poppies are worn as a show of support for the Armed Forces community.

Millions of people around the world wear red poppies during November to commemorate the anniversary of the 1918 armistice

DIFFERENCE BETWEEN VETERANS DAY AND MEMORIAL DAY

 

Do you know the difference between Veterans Day and Memorial Day?

Veterans Day Honors all veterans who served in the military, in wartime or peacetime while Memorial Day honors those who died in service

Veterans Day was originally called Armistice Day and was celebrated to commemorate the end of World War I in 1918. In 1954, Congress and President Dwight D. Eisenhower changed the name to Veterans Day to honor all veterans.

WITH GREAT RESPECT AND GRATITUDE I THANK ALL VETERANS!!

P.O.W RECOGNITION DAY -- THIRD FRIDAY IN SEPTEMBER

 

National POW/MIA Recognition Day is observed on the third Friday in September.

We honor the brave men and women who were prisoners of war and those still missing in action. Their courage and sacrifice will forever be remembered, and their families' strength will never be forgotten.

THE LOST ART OF COMMUNICATION

 

Two ways to surprise a friend or loved one that will make them happy and cost you nothing but a bit of time.

1. Give a friend or loved one a call.
2. Go visit a loved one, especially one who may be homebound and lonely.

Many people in today's society have lost the ability to communicate and sadly, many young people will never learn the basic principles, joy and importance of communication. Instead of being connected to each other people have created a bond with the online world which robs them of the most important aspects of interpersonal communication; tone of voice and body language. Less than 10% of effective communication comes from words while about 90% comes from tone of voice and body language.

Letters no longer written or received, notes to a friend no longer a fun thing to do, phone calls and visits to friends and family seldom done leaving many people forgotten and completely alone in a world numb to the feelings, needs and intention of others.

The process of putting your thoughts and feelings into words then taking the time to write them down or make a phone call is far more personal and thoughtful and creates a stronger bond than clicking a like button, texting or emailing and are much more appreciated by the receiver.

It seems, in today's world, if you are not posting about your life online many people think you have no life. Many people think having hundreds of so-called friends increases their self worth. Most importantly many people feel it is important to post every aspect of their life rather than share the events of their life with a phone call or face to face interactions with their loved ones.

Social media does have a place in our society. Connecting with vast numbers of strangers for business purposes is certainly a positive outcome. The ability to share photos and events with those far away certainly is a positive aspect but this does not negate the importance of actually talking to or visiting with those we claim to be near and dear.