Sense.ly, a San Francisco startup that has created a virtual nursing app to help physicians stay in touch with their patients and prevent readmission to the hospital, has recently raised $8 million from investors in its most recent round of venture funding. The new funding from investors like the Mayo Clinic will be used to bring the virtual nurse technology to a wide array of clinics and patients.
Designed for both patients and healthcare professionals, the app asks patients to tell the nurse avatar how they are doing by simply talking through a 5-minute “check in.” Patient check-ins are then stored as medical records that only authorized physicians can view. The medical reports also include device data that the app pulls from medical devices and wearables (like Fitbits or Apple watches) that patients use day-to-day.
Using artificial intelligence, Sense.ly’s nurse avatar speaks to patients in empathetic tones about their healthcare concerns, and uses emotional analysis to alert a patient’s care provider when the app detects that a patient is in need of mental health counseling or feeling symptoms of depression or anxiety as a side effect of medications or lifestyle changes.
The Sense.ly app is designed around commonly accepted medical protocols for diagnosis and treatment of chronic illnesses. So far, the company has focused on patients 60 and older who are suffering from health problems like COPD, heart failure, diabetes, and other age-related issues. But ultimately they want the app to work for people from all age groups and populations dealing with a variety of health issues. They are improving their analysis capabilities by adding new protocols and content from partner hospitals and clinics.
Adam Odessky, Chief Executive Officer and founder of Sense.ly, believes in the platform’s potential help people live longer and healthier lives and make quality healthcare more affordable and available. When asked if virtual nurses might “steal” jobs from human nurses in a discussion with TechCrunch.com, Odessky says no: “There aren’t people doing this job already…This is a technology to help medical professionals do their jobs more effectively, and not one that threatens their livelihood.”
Knowing a few simple breathwork strategies can be a valuable tool for nurses during a hectic workday. While you’re probably most familiar with the pursed lip breathing technique you use on your patients who are short of breath, other types of breathwork can be beneficial to you, the clinician, as an active self-care activity. Breathwork can help you feel more relaxed, lessen anxiety, energize you, and experience an overall reduction in stress–all things you need when your job places you in intense situations from time to time. Since breathing can be both an unconscious and conscious activity, a common belief among various mind-body practices is that breathing is a way to balance the sympathetic and parasympathetic branches of the nervous system, enhancing your sense of well-being. The following breathing techniques are easy to use while you’re on the go, and they will help you inhale and exhale your way through challenging situations.
1. The Five Count Breath
This breathing technique is borrowed from Pilates as a way to oxygenate your body and diminish muscle tension (particularly in your rib cage and thoracic spine). Begin with a long inhale through your nose as you count to five. As you take a breath, picture your lungs filling up with fresh, restorative air. Next, count to five as you slowly exhale all the air out of your lungs. Imagine wringing the stale air out of your lungs. If possible, close your eyes while doing this exercise to envision the inflation and deflation of your lungs. Repeat this cycle five to 10 times as needed to reduce stress.
2. Belly Breathing
When your body is tense, your breathing has a tendency to become quick and shallow. Whereas, when you’re in a relaxed state, your breath flows more deeply from your abdomen. The belly breathing technique helps to bring your body back to a state of calm and can be used in settings where you’re trying to remain inconspicuous. In his book, The Anxiety & Phobia Workbook, clinical psychologist, Dr. Edmund J. Bourne, PhD, lists some benefits of belly breathing, such as:
Enhancing the connection between the mind and body.
Increased feelings of tranquility.
A quieter mind.
Belly breathing isn’t difficult to perform. To begin, Inhale through your nose and let the breath first fill your lungs with air and progress to filling your abdomen. If you were to place your hand on your belly, you could see it rise during inhalation. Next, slowly exhale your breath through your nose emptying out as much air as possible. If your hand was on your abdomen, it would now be falling toward your spine. Do this sequence 10-15 times, and you should feel an increased sense of serenity.
3. Alternate Nostril Breathing
This yogic breathing technique may look a little silly doing it in front of others, but it’s meant to bring harmony to your body, integrate the right and left sides of your brain, energize you, and encourage focus. It’s a caffeine boost minus the caffeine. To start, use your thumb to press your right nostril closed while you inhale deeply through your left nostril. When your lungs are full of air, press the left nostril closed using your ring finger and exhale through your right nostril. Continue this cyclical pattern of inhaling through your right nostril and exhaling through your left for approximately 30 seconds to reset your body. Although it might take a few tries to get this breathing exercise right, once you’ve got the hang of it, you should feel more at ease and settled.
When it comes to the current political and social terrain, everyone agrees it’s like a bad case of vertigo. At some point, you’ll discover the Breaking News hang over. You’ll declare it’s time to engage some form of ballast to prevent yourself from getting swept away with every tsunami. It feels like we aren’t allowed to recover from a previous informational shockwave and we are getting hit with the next “almost unbelievable” revelation. At present, we are getting layered with daily compounding stress and trauma. Everything from human rights marches, water protecting, presidential satires, immigration contentions to unveiled conspiracy and corruption. Now add a second helping of Fukashima Cesium 137 radiation and we have the cherry on top of the daily disasters. Before you become the next piece of collateral damage from the daily barrage on your mental, emotional, and spiritual well-being…STOP!
1. Stay centered
Reserve time to reflect on your personal social and political values. If you find yourself needing to change your personal position on something; do it. You’re allowed to change your mind at any time. Knowing that there are some politicians out there that change their views on the daily should release you from any anxiety from taking a firm stance from your personal philosophy. You’ll want to have some certainty about your core beliefs before jumping back into the tempest to get tossed around by a rogue wave between views.
2. Know that there is empowerment with action
Work toward a solution within your own community. Do some research on what initiatives are underway that match your values. No matter how small an action, know many small actions amount to big change. Take a small piece to the very large puzzle. This is a great way to engage and contribute without getting overwhelmed and burnt out. Many hands make work light. Determine what you are most passionate about and seek out the like-minded folks focused on solutions. You may be inspired to start your own initiative toward a better world.
3. Periodically disengage
Give yourself a time limit to keep informed, for instance, 30 minutes in the morning and 30 minutes in the evening. If you’re the type to get glued to media for hours, set a timer and adhere to it. Be kind to yourself and don’t engage in the information mayhem before bed. You clearly want to prevent your mind from reeling and creating a perfect trifecta: fear, anger, and sleep deprivation. Keep a lid on high intensity topics at work and out socially unless it is within the context of a solutions think tank. The days of singing “Isn’t it awful” are over so commit to discarding any notion of an arcane construct that contributes to being stuck in the current state. Giving yourself some breathing room on topics will support a rational perspective.
4. Have a daily stress management practice
Walk/exercise, meditate/pray, laugh, and spend time face to face with friends…whatever gets you to higher ground. We are not made of steel and we are not meant to absorb this much information and vicarious distress. A balanced self-care practice can offset what you’re being exposed to.
5. Remind yourself that we are all part of one global humanity
As nurses, we know we are facilitators of healing, protectors, and advocates. We also know that anyone who has passed the NCLEX is capable of remarkable critical thinking. This is what needs to be elevated to the forefront now. Realize that we are being presented with another vitally important opportunity to put our extraordinary presence to practice for the betterment of all.
It’s a new year and like most folks, you’re probably embarking on an inclined treadmill like the ramp to the SS Fabulous Me. Along with the New Year party favors, gym memberships have been exploding in full spandex regalia.
Before you beat yourself up for …well, just about everything not perfect with your body, read on. Some new information may be just the thing that turns it around for you.
Everyone agrees that it’s a lot easier to maintain health than to chase after it once things go rogue. But, if you’re not in tip top shape and find yourself staring in the mirror vowing swift and definitive action, know that you’re in good company.
Science shows that there is no one nutritional and movement approach that will work for everyone. Why? Hormones, metabolism, and what is consumed matters and can vary greatly between individuals. Determining where your endocrine system is on the spectrum of its complex symphony plays a huge role in how effective your efforts will be. Higher than normal insulin levels from insulin resistance (pre-diabetes or Type II diabetes) tell your body to store fat. High cortisol levels from stress also tell your body to store fat. Sugars go on to be stored as fat. So, the outdated mantra of calories in and calories out will not apply when hormones are not balanced. Those same calories behave differently in a metabolically broken individual than they do in a metabolically sound person.
Everyone agrees across the board that refined sugar is detrimental to all health efforts. Almost 80% of all processed foods in the grocery store have some form of sugar added to it, whether hidden under a stealthy proper noun or announced with a brazen neon label. You must become an informed consumer and your own best health advocate. Consider taking refined sugar out of your diet entirely while you are working on your newest health goals. I know…a herculean undertaking. But, considering you want health rewards, it will be tough to do it with a hijacked brain. If you decide to go the no refined sugar route, you are urged to stay away from artificial sweeteners, which come with a whole other set of problems. Although sugar substitutes are low on the glycemic index, they will still spike insulin.
It may help you to know that different types of sugars are metabolized differently in the body. So, it pays to become acquainted with a bit of biochemistry at the outset. In a healthy, metabolically stable person 120 calories of glucose hums through the system wreaking little to no havoc. On the other hand, 120 calories of fructose (as in high fructose corn syrup) is metabolized very differently than glucose and exactly like ethanol. Because the liver doesn’t like fructose any more than it likes a six-pack of beer, it’s showing up as non-alcoholic fatty liver disease. This is very different from eating a piece of fruit which accompanies its own fiber. Suffice to say, there’s a whole world of biochemical reactions that the average person is not privy to unless you’re sifting through reams of empirical data and reading research journals. Still, these details are important to know as part of the informed decisions you will make about food, movement, and treatment if you find yourself within metabolic disease.
Consider viewing this lecture about sugar by Dr. Robert H. Lustig:
It covers everything you absolutely need to know about sugar. As a big plus, some parts of the biochemistry will exercise your gray matter the way you want to challenge your glutes.
The real skinny according to Dr. Lustig:
Exercise works because it improves skeletal muscle insulin sensitivity.
Exercise works because it reduces stress and the resultant cortisol release.
The TCA cycle runs faster and detoxifies fructose, which improves hepatic insulin sensitivity.
Since it is estimated that one third of Americans will become insulin resistant and may not even be aware of it, they will go on to develop metabolic illness and Type II diabetes. It’s time to know more to help ourselves, our patients, and our families.
Dr. Jason Fung, a nephrologist from Toronto, Canada, has taken a deep and concerning look into the current treatments for insulin resistance and Type II diabetes. He finds that current treatments for Type II diabetes are ineffective at restoring health. He also publishes that Type II diabetes needs to be treated differently than Type I diabetes as they simply are not the same illness. His findings and recommendations have garnered international attention and can be found in his book, The Obesity Code.
If you’re not feeling compelled to read Dr. Fung’s book, you can watch this informative interview that Dr. Mercola held with him about healing your body through fasting:
As you move toward new year health goals, take the following steps:
1. Determine at your starting point if your metabolism is functioning properly or if you are dealing with other considerations. A metabolic or hormonal dysregulation such as insulin resistance, metabolic syndrome, Type II diabetes, and adrenal fatigue will impact the normal processing of energy and fat storage/release.
2. Conduct some personal research, such as the links suggested here and get support from reliable specialists that can help you land on what the best approach is for you.
3. Proceed with online support groups. They go a long way with not having to go it alone and re-invent the stationary bike wheel. The connection to others sailing on the same boat is exceedingly valuable.
Working nights? You’re certainly not alone. According to the Bureau of Labor Statistics, more than 15 million Americans work a permanent night shift or regularly rotate in and out of night shifts.
If you’re working nights, you’ve probably heard warnings about how your alternative schedule could negatively affect your health and well-being.
But your schedule is your schedule and perhaps you can’t change it right now, or perhaps you don’t want to. With that in mind, let’s live in the nocturnal moment and talk about ways you can get better sleep and make the most of the work-life balance you’ve got.
1. Jump-start your night.
As night falls, get some exercise, expose yourself to bright light, and take a hot shower – each of these tricks can help you to feel alert and ready to take on the world.
2. Time your caffeine.
Drinking a cup of coffee at the beginning of your shift will help promote alertness. But don’t consume caffeine for the last 4 to 6 hours of your shift or it may be harder to get to sleep when you get home.
3. Block out and black out.
Just because the sun is coming up when you’re heading home to bed, doesn’t mean you have to take any notice. Wear dark, wrap-around sunglasses to block the morning rays that can wake you up. Keep those glasses on until you’re in the dark sanctity of your blackout-curtained bedroom. Blackout curtains are a must because, even if your eyes are closed, sunlight in your room rouses you. Add earplugs and an eye cover and your sleep is covered.
4. Avoid alcohol.
A glass of wine or beer may help you fall asleep, but you’ll likely pay for it later as alcohol disturbs the second half of your sleep. Go with grandma’s advice and sip warm milk instead.
5. Step away from that device.
Smartphones, tablets, and computers (as well as energy efficient light bulbs) all emit blue light that boosts wakefulness – not great when you’re hoping to catch some z’s. If possible, avoid using devices for one hour before you’d like to fall asleep. Charting until the last moment? Try blue-light-blocking or “sleep” glasses. Yes, you’ll look a little funny during hand-off, but isn’t sleep worth it?
6. Try melatonin (but not so much)!
Whoa, that melatonin in your medicine cabinet is 5mg per dose. Research in the journal Work shows you only need about 0.3mg to fall asleep faster. So grab a pill cutter, trim those tablets, sleep better, and save yourself money to boot. Older shift workers may particularly benefit from taking melatonin as the body’s natural melatonin production lessens with age. Quick review: the pineal gland in your brain produces melatonin in response to darkness – it’s a biological marker of night and makes sleep inviting.
7. Create rituals.
Tell your body it’s time to sleep with calming, soothing habits. Read a book, listen to soft music, or gently stretch. Write down things that are worrying you and tell yourself you are setting them aside while you rest.
8. Use your nose.
There is evidence that certain smells can improve sleep. Lavender, for instance, can decrease heart rate and blood pressure, potentially putting you in a more tranquil state. Vanilla, valerian, and jasmine are other possibly soporific options. If you enjoy scents, try soaps, lotions, or oils to find what works for you.
There you have it: 8 tips for the Holy Grail of sleep – those blissful 8 hours. Hope to see you in dreamland.
Big thank you to the National Sleep Foundation, the American Psychological Association, and the peer-reviewed journals Work and Sleep Medicine Clinics for the useful resources that informed this blog.
It’s no secret a busy nurse will spend most working hours indoors. During the winter months, you will probably arrive at your job as the sun is coming up, and you leave when the sun is going down. However, remaining in the same environment every day can lead to feeling bored, tired, or unmotivated. With just a few minutes a day, going outside can improve your mental and physical well-being and help you take on any challenge. Here are a few reasons to get outside each day.
1. Enhanced immune function
A recent study published in Scientific Report by Georgetown Medical Center proposed exposure to sunlight may strengthen your immune system by way of mechanisms that are entirely independent from Vitamin D. Researchers suggest the visible, blue-light from the sun might trigger critical immune cells and increase their motility. While this is still an emerging area of study, it looks like your immune system would certainly benefit from some regular time in the sun.
2. Reduced stress
Are you feeling burned-out and overwhelmed? Depending on the setting you work in, it can be challenging to find convenient, green spaces to get some fresh air. However, heading outside at least once during the day is worth the effort. Research shows even a five-minute nature fix helps lower levels of the stress hormone cortisol. Can’t get outside? As you’re walking by a window, stop and gaze out for a moment. Reports show that viewing nature through a window can also lower your stress levels.
3. Increased PMA
Positive mental attitude: Who doesn’t want to approach life with more positivity and less negative thinking? One study found that more frequent exposure to natural elements correlates with lower feelings of depression, greater workplace satisfaction, and commitment. Furthermore, a brisk trip outside boosts your mood and increases your creativity, which, when dealing with a variety of personalities, can come in very handy.
4. Better sleep
If you have trouble sleeping, that’s all the more reason to make stepping outside during the day a priority. A study conducted by St. Louis University demonstrated the power of natural sunlight to help set your body’s internal clock to signal when you need to eat and sleep. If your sleep problems are severe, you’ll require more exposure to sunlight than the five-minute stress relieving recommendation mentioned earlier. In fact, the study suggests you’ll need 30 to 60 minutes of direct sunlight for sleep patterns to change drastically.
5. Improved energy
Are you feeling drained during the work day? The answer to feeling depleted may lie in getting outside your physical workplace. Studies show that people who connect with nature tend to feel more energized and revitalized–two key factors to help make your job easier. Furthermore, the energizing effects of going outside seem to be amplified with social interaction. So, whenever possible, grab a colleague and head outside for a change of scenery.