Addressing Suicide, the Silent Epidemic

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by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

In a world filled with noise and distractions, it's easy to overlook the quiet epidemic that continues to claim countless lives each year: suicide. This profound, troubling issue affects people of all ages, backgrounds, and walks of life. It's high time we recognize suicide for what it is – a profound public health crisis – and come together to address it head-on.

The statistics surrounding suicide are startling. According to the World Health Organization (WHO), over 700,000 people around the world die by suicide each year. Many more attempt suicide. Suicide is a leading cause of death in the United States alone, surpassing car accidents and homicides. It's a crisis that affects individuals, families, communities, and society.

Yet, despite these alarming numbers, suicide remains shrouded in stigma and misunderstanding. Society often tends to blame the victim, viewing suicide as a sign of weakness or selfishness. This perspective not only perpetuates the stigma but also hinders our ability to prevent and address the problem effectively.

To tackle the suicide crisis, we need to shift our attitudes and responses. We must start by recognizing that suicide is the result of complex and multifaceted factors, such as mental illness, substance abuse, social isolation, and life stressors. Suicide ideation or suicide is not a moral failing or character flaw but a symptom of profound suffering.

Mental health awareness and support are crucial aspects of suicide prevention. We must prioritize the destigmatization of mental health issues and make access to mental health services more available and affordable. Trained professionals are essential in recognizing and addressing suicide risk, providing support networks, and investing in research to understand the underlying causes better.

Additionally, communities need to establish programs and initiatives aimed at preventing suicide. Schools, workplaces, and religious institutions can all play a role in identifying at-risk individuals and connecting them with appropriate resources. Suicide hotlines, crisis centers, and counseling services must be widely accessible and well-funded.

Public health campaigns can also contribute significantly to reducing suicide rates. These campaigns should focus on raising awareness, offering support, and emphasizing the importance of reaching out to those in need. It is a fact that the media has a vital role in shaping public opinion, and responsible reporting on suicide can help reduce contagion effects and encourage help-seeking behaviors.

Preventing suicide also involves reducing access to lethal means, particularly firearms and medications. It requires responsible gun ownership and safe storage practices, as well as limiting access to lethal drugs, especially for those at risk.

We need to foster a culture of empathy and support. In our fast-paced, individualistic world, it's easy for people to feel isolated and disconnected. We should prioritize meaningful human connections, actively checking on our friends, family members, and colleagues, and encouraging open conversations about mental health.

It is high time for a paradigm shift regarding suicide. We must see it not as a solitary, selfish act but as the manifestation of deep despair, pain, and suffering. By embracing a more compassionate and proactive approach, we can collectively work to prevent suicide and save lives. Let us not allow this silent epidemic to persist in the shadows any longer. It's time to break the silence, remove the stigma, and, together, create a world where suicide is a rarity rather than a tragic reality.

Do you know anyone who may struggle with suicidal thoughts?

Helping someone who is suicidal requires a compassionate and supportive approach. If you suspect that someone you know is experiencing suicidal thoughts or behaviors, here are some steps you can take:

1. Take it seriously: Do not underestimate the person's feelings or dismiss their statements. Suicidal thoughts are a sign of extreme emotional distress, and it's crucial to take them seriously.
2. Listen without judgment: Create a safe and non-judgmental space for the person to talk about their feelings. Let them express their thoughts and emotions without criticizing or giving unsolicited advice.
3. Ask directly about their thoughts: If it's safe to do so, ask the person directly if they are thinking about suicide. Asking open questions can open a dialogue and allow the person to share their feelings.
4. Keep them safe: If the person is in immediate danger or has a specific plan to harm themselves, do not leave them alone. Stay with them and seek professional help immediately. Remove any access to potentially lethal means, such as firearms or medications.
5. Encourage professional help: Suggest that the person seek help professional help from a therapist, counselor, or psychiatrist. You can assist them in finding appropriate resources and making appointments if needed.
6. Involve their support network: Encourage the person to reach out to friends, family, or other trusted individuals who can provide emotional support. Notify someone in their close network about the situation if the person is comfortable with it.
7. Be patient and understanding: Understand that recovery from suicidal thoughts and feelings is a process, and it may take time. Offer ongoing support and be patient as the person seeks help and begins their journey to healing.
8. Educate yourself: Learn more about suicide and mental health to understand better the challenges the person is facing. Education can help you provide more effective support.
9. Follow up: Continue to check in on the person regularly. Suicidal thoughts may come and go, so maintaining contact and showing that you care can make a significant difference.

If you or someone you know is in immediate danger or experiencing a crisis, please seek help right away by calling emergency services in your country or a suicide prevention hotline. In the U.S., Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or text "HELLO" to the Crisis Text Line at 741741. These services provide immediate support and can offer guidance on how to help someone in crisis.

Remember that you are not a substitute for professional help, and it's essential to encourage the person to seek assistance from mental health experts. Your role is to be a supportive, caring, and non-judgmental presence in their life during this challenging time.

Unlocking the Power of Human Kindness: A Beacon of Light in a Complex World

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by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Kindness is a timeless virtue that transcends boundaries, cultures, and languages. It's a simple yet profound act that can brighten someone's day, mend broken spirits, and create a ripple effect of positivity. In a world often marked by complexity and division, kindness reminds us of our shared humanity and the potential for compassion to heal, connect, and inspire. This open-on kindness explores the significance of this universal language of the heart, reminding us of the countless ways in which it can change the world, one gentle gesture at a time.

Kindness is essential for several reasons:

1. Human Connection: Kindness fosters a sense of connection and empathy among people. It reminds us that we are all part of a more prominent human family, capable of understanding and supporting one another.

2. Mental Health: Acts of kindness, both receiving and giving, have been shown to boost mental well-being. Giving and receiving kindness reduces stress, anxiety, and depression while increasing happiness and satisfaction.

3. Positive Impact: Kindness can have a significant positive impact on both givers and the receivers. It can improve relationships, build trust, and create a harmonious and supportive environment.

4. Ripple Effect: Kindness often sets off a ripple effect. When someone experiences an act of kindness, they are more likely to pay it forward, leading to a chain reaction of goodwill and positivity.

5. Alleviating Suffering: Kindness can provide relief to those who are suffering, whether it's through acts of charity, comfort, or simple compassion. It can make the world a better place by reducing pain and hardship.

6. Moral and Ethical Values: Kindness is a fundamental aspect of moral and ethical values in many cultures and religions. It guides individuals and communities in making ethical choices and promoting a just and compassionate society.

In essence, kindness is a cornerstone of our shared humanity, contributing to individual well-being and the betterment of society.

Being kind is a beautiful and straightforward way to make a positive impact on the world. 

Here are some ways to practice kindness:

1. Start with Yourself: Be kind to yourself by practicing self-compassion and self-care. You can't effectively extend kindness to others if you're not kind to yourself.

2. Empathize: Try to understand others' feelings and perspectives. Put yourself in their shoes to connect with their emotions and experiences.

3. Smile and Be Polite: Small gestures like smiling, using polite language, and showing respect can go a long way in making people feel valued and appreciated.

4. Offer Help: When you see someone in need, offer assistance. It could be as simple as holding a door open or helping someone carry a heavy load.

5. Listen Actively: Be a good listener when someone needs to talk. Show genuine interest in what they say and provide emotional support.

6. Random Acts of Kindness: Surprise someone with a random act of kindness, like leaving a kind note, buying someone a coffee, or giving a small gift.

7. Volunteer: Offer your time and skills to help those less fortunate. Volunteering for a cause you care about is a meaningful way to be kind.

8. Practice Patience: In a world that can be fast-paced and stressful, patience is a valuable form of kindness. Try to be patient with others and their shortcomings.

9. Avoid Negative Judgments: Be mindful of your judgments and stereotypes about others. Try to see the good in people and give them the benefit of the doubt.

10. Forgiveness: Forgiving others for their mistakes or transgressions is an act of kindness that can lead to personal growth and healing.

11. Be Inclusive: Embrace diversity and be inclusive of people from all walks of life. Celebrate differences and promote a sense of belonging for everyone.

12. Encourage and Support: Offer encouragement and support to others in their goals and challenges. A kind word can be a source of inspiration.

13. Gratitude: Express gratitude and appreciation for the kindness you receive from others. Acknowledging their kindness can reinforce the cycle of goodwill.

Remember that kindness is a choice. You can practice kindness in both small, everyday actions and more significant, more intentional gestures. The more you cultivate kindness in your life, the more it will become a natural part of who you are.

Primary Care The Cornerstone of Healthcare: Why is it Important

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by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Primary care serves as the foundation of healthcare systems around the world. It is often the first point of contact for individuals seeking medical attention, encompassing various services, from preventive care to managing chronic conditions. Primary care and its importance cannot be overstated. Primary care is crucial in improving health outcomes, reducing healthcare costs, and ensuring equitable access to medical services.

At the forefront of preventing illnesses and promoting good health is primary care. Regular check-ups and health screenings enable healthcare providers to detect potential health issues early, allowing timely interventions. Vaccinations, lifestyle advice, and health education are integral components of primary care, helping individuals make informed choices to lead healthier lives. Through primary care, communities can reduce the burden of preventable diseases and maintain their overall well-being.

Primary care serves as a patient's medical "home." It fosters continuity of care, enabling healthcare providers to build strong and quality patient relationships. This continuity is essential for managing chronic conditions, as primary care physicians can track a patient's progress, adjust treatment plans, and provide consistent support. This personalized approach results in more effective and efficient healthcare management, ultimately improving the quality of life for those with chronic illnesses.

Timely manner treatments and diagnosis are often the keys to successful outcomes for many medical conditions. Primary care providers are equipped to identify symptoms and risk factors, leading to the early detection of diseases such as hypertension, diabetes, and certain cancers. By addressing these issues promptly, primary care contributes to improved prognosis and a reduction in the long-term impact of these conditions.

The importance of primary care extends to its cost-saving potential. Research consistently shows that robust primary care systems are associated with lower healthcare expenditures. By emphasizing prevention and early intervention, primary care reduces the need for expensive specialist and hospital services. Moreover, primary care providers help patients navigate the complex healthcare system, ensuring they receive the appropriate care in the right setting, further optimizing healthcare costs.

Primary care is vital in addressing health disparities and promoting health equity. It serves as a bridge to healthcare for underserved and vulnerable populations. By offering accessible and affordable care, primary care providers can help reduce disparities in health outcomes, improving the overall health of communities. They are often the first point of contact for individuals who lack regular access to medical services, making primary care an essential component of social and public health efforts.

Diabetes, hypertension, and mental health conditions, among other non-communicable diseases (NCDs), are increasing. Primary care is well-suited to manage the challenge of NCDs through preventive measures, early diagnosis, and comprehensive management. The ongoing relationships between primary care providers and their patients are precious in addressing the long-term nature of many NCDs.

While Primary care is the cornerstone of healthcare systems, It faces several significant challenges in the modern healthcare landscape. These issues impact both patients and healthcare providers. Here are some current problems with primary care:

1. Shortage of Primary Care Providers: Many regions, both rural and urban, need more primary care providers, including family physicians and nurse practitioners. This shortage reduces the accessibility and availability of direct care services, leading to long appointment wait times and, in some cases, forcing patients to seek care in emergency departments.
2. Burnout and Workforce Stress: Primary care providers face high levels of stress levels and burnout due to heavy workloads, administrative burdens, and the emotional toll of dealing with complex and sometimes tricky patient cases. Burnout can lead to reduced job satisfaction, early retirement, and, ultimately, a decline in the number of healthcare professionals choosing primary care as a career.
3. Financial Pressures: Primary care practices may struggle financially due to low reimbursement rates, especially for Medicaid patients. The financial strain can hinder the ability to invest in resources, such as electronic health records or extended office hours, which could improve patient care and access.
4. Fragmented Healthcare Systems: Healthcare systems are often fragmented, making it challenging for primary care providers to coordinate care effectively with specialists, hospitals, and other healthcare entities. A fragmented healthcare system can lead to inefficient care delivery, duplicated tests, and a lack of continuity in the patient's medical journey.
5. Inequitable Access: Disparities in access to primary care services persist, leading to inequities in healthcare outcomes. Underserved populations and vulnerable such as racial and ethnic minorities, the uninsured, and those in poverty may have limited access to primary care, contributing to health disparities.
6. Aging Population and Multimorbidity: The aging population is increasing demands on primary care providers. Older patients often have multiple chronic conditions, leading to complex care management and coordination. Primary care must adapt to meet the unique needs of this demographic.
7. Technological Challenges: While technology can improve healthcare, integrating electronic health records and other technologies can be challenging for primary care practices. These systems can be cumbersome and time-consuming, reducing face-to-face time with patients.
8. Patient Demand and Expectations: Patients' healthcare expectations are changing, and they often demand more immediate access and convenient options like telehealth. Meeting these evolving expectations while maintaining quality and personalized care can be a balancing act for primary care providers.
9. Preventive Care and Health Promotion: While primary care is vital for preventive care, some patients still prioritize acute care over preventive measures. Encouraging a more proactive role in the patient's health can be challenging.
10. Regulatory Burdens: Primary care providers often face complex and time-consuming administrative tasks, such as prior authorizations, billing, and quality reporting. These regulatory burdens can detract from patient care and contribute to provider burnout.

Addressing these challenges in primary care requires a multifaceted approach that includes policy changes, workforce development, improved reimbursement, increased use of technology, and a focus on health equity. It is essential to recognize and address these issues to maintain the integrity and effectiveness of primary care.  Primary care is the linchpin of healthcare systems, ensuring that individuals receive accessible, comprehensive, and cost-effective medical services. It is crucial in preventing illness, promoting health, reducing healthcare costs, and addressing health disparities. The importance of primary care extends to individuals, communities, and nations, contributing to better health outcomes and a higher quality of life for all. As healthcare systems evolve, it is imperative to continue supporting and investing in primary care to ensure the well-being of present and future generations.

Empowering Parkinson's Care: Harnessing Smart Watches for Patient Management

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by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

I recently came across an article about how Apple Watch is making progress in identifying and helping the medical community understand if the treatments for Parkinson's are working. 

According to new studies, data from a smartwatch could also help predict Parkinson's disease up to seven years before symptoms begin occurring. Researchers believe that Artificial intelligence (AI)

could help screen for the disease earlier than current methods allow. An earlier diagnosis of Parkinson's' disease can be crucial. Early symptoms of Parkinson's include tremors, loss of smell, and trouble walking or moving.

Through Apple's open-source ResearchKit APIs and Research app for iOS, these tools, when used in conjunction with Apple Watch, can help doctors and researchers detect and treat Parkinson's and other diseases.

StrivePD, in Integration with HealthKit and the use of Apple Watch, provides passive metrics that augment self-reported logs for a holistic view and daily healthcare journey.

It helps to visualize tremors and dyskinesia detected by the Apple Watch. 

Browse interactive charts to review symptom data over time and in the context of your medications and physical activities.

Track daily physical activities to help reach weekly fitness goals

Explore logged medications, symptoms, activities, and influences together over the day in an easy-to-read chart view

Activity Tracking: Apple Watch and other smartwatches can monitor physical activity, such as steps taken and distance covered. Individuals with Parkinson's can benefit from tracking their activity levels to ensure they stay active, essential for maintaining mobility and overall health.

Fall Detection: Apple Watch has a fall detection feature that automatically calls for help if it detects a fall—people with Parkinson's may have an increased risk of falls.

Heart Rate Monitoring: Smartwatches like the Apple Watch can continuously monitor heart rate. Changes in heart rate may provide insights into the progression of Parkinson's disease or the effectiveness of medications.

Voice and Speech Analysis: Parkinson's disease can affect speech and vocal patterns. Some researchers have explored using smartwatches to analyze voice data for early signs of the illness or monitor its progression.

Medication Reminders: 

Smartwatches can be programmed to provide medication reminders for individuals with Parkinson's disease. Particularly help to manage medication schedule and establish good logging habits to review changes over time. Patients with Parkinson's require precise timing for the medication. 

Gait and Balance Analysis: Some studies have explored using accelerometers in smartwatches to analyze gait and balance, which are affected in Parkinson's patients. Changes in parameters can be indicative of the disease's progression.

Tremor Monitoring: While not as accurate as clinical assessments, smartwatches with motion sensors can track hand tremors to a certain extent, providing a tool for self-monitoring and sharing data with healthcare providers.

Sleep Tracking: Sleep disturbances are common in Parkinson's disease. Smartwatches can track sleep patterns, helping individuals and their doctors understand and address sleep issues.

Continuous health monitoring throughout the day is crucial for Parkinson's. Parkinson's symptoms don't always manifest in clinical settings. 

While the Apple Watch and other smartwatches continue to be explored for their potential to assist in the early diagnosis and monitoring of Parkinson's disease, they are not intended as a diagnostic tools. 

It's important to note that while these features can be helpful for individuals with Parkinson's disease, they are not a substitute for professional medical evaluation and diagnosis. Suppose you or someone you know is exhibiting symptoms of Parkinson's disease. In that case, it's crucial to consult with a neurologist or a healthcare professional for a thorough assessment and an accurate diagnosis. Smartwatches and other wearable devices can complement traditional medical care by providing additional data and insights, but they should not be relied upon for a definitive diagnosis of Parkinson's disease.

The Financial Burden of Diabetes: A Growing Crisis

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by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

Chronic high levels of blood sugar is a metabolic disease known as diabetes.   Diabetes itself is a global health crisis. While its physical toll on individuals is well-documented, the financial burden of diabetes is often underestimated. 

The prevalence of diabetes has been on the rise for several decades. As of 2018, according to the International Diabetes Federation (IDF), approximately 463 million adults were living with diabetes worldwide, and this number is projected to increase to 700 million by 2045. The reasons for this epidemic are multifaceted, including sedentary lifestyles, poor dietary habits, and genetic predisposition.

Living with diabetes can be financially overwhelming for individuals. People with diabetes require regular medical check-ups, medication, and often insulin therapy. The cost of these essentials adds up quickly. Frequent doctor visits, lab tests, and prescription drugs can strain an individual's budget, especially if they lack adequate health insurance.  Kidney disease, heart disease, and vision problems are among the long-term complications of diabetes, which further exacerbate the financial strain.

The American Diabetes Association reports that, as of 2019, the average medical expenses for a person with diabetes are 2.3 times higher than those without the condition. A significant contributor to the high patient costs of diabetes management is the need for supplies. These supplies are required to optimize medication delivery and safe glucose monitoring. Depending on the glucose-lowering regimen, most diabetic patients must check their blood glucose levels between one and four times daily. More frequent monitoring is required in high glycemic variability, illness, and symptoms suggestive of hypoglycemia.

The costs associated with managing diabetes can lead to significant out-of-pocket expenses, causing financial stress, debt, and even bankruptcy for some individuals. Unfortunately, not all supplies are covered by medical insurance. The situation is much more dire for those without health insurance coverage. The financial burden of diabetes extends to the families of those affected. Caring for a patient with diabetes can be emotionally and financially taxing. Families may incur additional expenses for caregiving, prescription drugs, and special dietary needs. Furthermore, fearing future complications can affect the family's long-term financial planning.

Diabetes places a significant strain on healthcare systems. The costs of managing diabetes-related medical conditions and complications are substantial. Governments, private insurers, and individuals bear these costs. The IDF estimates that diabetes accounts for over 11% of global healthcare expenditure, with over 80% being direct healthcare costs.

Moreover, diabetes-related hospitalizations, which often result from complications such as heart disease or kidney failure, are a considerable financial burden. Preventing these costly hospitalizations through proper diabetes management and education is essential for reducing the economic impact on healthcare systems. Diabetes financial burdens are not limited to individuals and healthcare systems. This financial burden has broader societal implications. Diabetes can reduce workforce productivity due to absenteeism and presenteeism, where individuals are at work but not fully productive due to their health. The loss of income for both individuals and society can be substantial.

Moreover, the indirect costs of diabetes, such as reduced quality of life and increased social welfare payments, further exacerbate the economic strain on society. Additionally, the financial burden of diabetes extends to lost tax revenue and increased government spending on healthcare programs, which can hinder a country's overall economic growth.

Preventing and effectively managing diabetes are essential steps in mitigating the financial burden. Education and awareness campaigns about healthy lifestyles and regular health check-ups can help reduce the incidence of diabetes. Encouraging physical activity and promoting a balanced diet are crucial public health strategies.

For individuals already living with diabetes, effective management can reduce long-term complications and associated costs. Regular monitoring, medication adherence, and lifestyle modifications are critical. Investment in preventive healthcare, early diagnosis, and access to affordable medications is essential for addressing the financial challenges of diabetes.

The financial burden of diabetes is a multifaceted issue that affects individuals, families, healthcare systems, and society as a whole.  It is not a secret that the prevalence of diabetes continues to rise; therefore, it is imperative to address this crisis through prevention, education, and improved access to healthcare. By doing so, we can reduce the economic strain of diabetes on individuals and society and enhance the quality of life for those affected by this chronic condition.

Understanding EVALI: Vaping-Related Lung Illness

by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

EVALI, short for e-cigarette or vaping product use-associated lung injury, is a relatively new and concerning health issue that has emerged in recent years. It has garnered significant attention from public health authorities, medical professionals, and the general public due to the severity and sudden onset of the illness. 

Inhaling vapor that is produced by electronic cigarettes or other similar devices is known as vaping. Vaping has gained popularity over the past decade. The vaping devices work by heating liquid nicotine, flavorings, and other chemicals in an aerosol form that users inhale. Vape devices were initially marketed as a safer alternative to traditional tobacco smoking, with many believing it could help people quit smoking altogether. However, concerns have grown regarding the safety of e-cigarettes.

EVALI first came to the attention of public health officials in the United States in the summer of 2019 when a series of cases involving severe lung injury were reported across the country. Many patients presented with symptoms such as cough, chest pain, shortness of breath, and fever. As the number of cases continued to rise, it became clear that EVALI was a severe public health concern.

Research and investigations into EVALI have revealed that the illness is primarily associated with the use of vaping products containing tetrahydrocannabinol (THC), the psychoactive compound found in marijuana. The exact cause of EVALI remains complex and multifactorial, but several factors have been identified:

1. Contaminants and Toxins: Many cases of EVALI have been linked to vaping products contaminated with harmful substances, including vitamin E acetate, which is used as a thickening agent in some vape oils.
2. Chemical Exposure: The inhalation of various chemicals, including diacetyl, formaldehyde, and acetaldehyde, found in some e-cigarettes, may contribute to lung damage over time.
3. Black Market Products: Some EVALI cases have been associated with the use of illicit or black-market vaping products, which may contain unknown and potentially harmful ingredients.

The symptoms of EVALI can range in severity, and they often mimic those of typical respiratory illnesses. Common symptoms include:

1. Cough
2. Shortness of breath
3. Chest pain
4. Fever
5. Nausea
6. Vomiting
7. Diarrhea

In severe cases, EVALI can lead to respiratory failure and, in some instances, death. It is crucial for individuals who experience these symptoms, especially if they have a history of vaping, to seek immediate medical attention.

The treatment of EVALI largely depends on the severity of the illness. Mild cases may require only supportive care, such as rest and hydration, while more severe cases may necessitate hospitalization and oxygen therapy. Quitting vaping is a crucial step in recovery for those diagnosed with EVALI.

Preventing EVALI starts with avoiding the use of e-cigarettes and vaping products, especially those obtained from unregulated sources. For individuals who are already vaping or considering it, here are some preventive measures:

1. Choose Trusted Products: If you choose to vape, use products from reputable manufacturers and retailers. Avoid black-market or homemade vape liquids.
2. Educate Yourself: Understand the potential risks associated with vaping and be aware of the symptoms of EVALI.
3. Don't Modify Products: Avoid modifying or tampering with vaping devices, as this can increase the risk of exposure to harmful chemicals.
4. Seek Support to Quit: If you are currently using vaping products, seek help and support to quit. Many resources are available to assist individuals in overcoming nicotine addiction. For those who are now vaping, EVALI serves as a compelling reason to stop vaping. Many resources are available to help individuals overcome nicotine addiction, and healthcare professionals can offer guidance and support to those who seek to quit.

As the vaping industry continues to evolve, so does our understanding of the potential health risks associated with these products. EVALI has quickly become a severe public health concern, raising essential questions about the safety of vaping and the need for better regulation in the industry.

EVALI is a stark reminder that the vaping industry and public health are inextricably linked. The rise of vaping-related lung injuries demands immediate attention from all stakeholders involved. Manufacturers, regulators, healthcare professionals, and the public all have roles to play in addressing this crisis. By promoting education, accountability, and regulations, we can work to reduce the risks associated with vaping and protect the well-being of individuals in our communities. EVALI serves as a wake-up call for us all, and it's high time we heed its warning.

Having a Conversation with Chat GPT

Business Insider 2023

by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

One day, I wanted to know how chat GPT works, so I wrote the following on the conversation:

The day I graduated with my BSN in nursing, someone attending my graduation party said: I think you are so smart. Why didn't you go to medical school?

Chat GPT answered:

"It is, unfortunately, that someone's comment at your graduation party left you feeling that way. It's essential to remember that choosing a career path, like nursing, is a significant accomplishment and a matter of personal choice. Nursing is a highly respected profession that plays a critical role in healthcare, and it requires its own unique set of skills and knowledge. Both nursing and medical school are valuable in their own right, and your decision to pursue a BSN in nursing should be celebrated. Your dedication to patient care and the difference you'll make in the lives of those you care for is something to be proud of. Don't let one comment diminish your achievements and the important role you'll play in the healthcare field."

I was like, wow. Chat GTP said in a few words what I've wanted to hear from a human being. For the longest time, I've been asking myself if I could make a difference in my current role as a nurse practitioner. I know deep inside I can; it's just that some days, I perceive myself as somehow not being good enough. Honestly, I cannot blame others in charge for making me feel that way because we are the ones who allow things to get to us. 

It is easier said than done. Now, how can someone like me feel "not good enough"? I am an immigrant from Colombia, and English is my second language. I wanted to be a physician since age 5. I lost my mother at age 17; being the only child and not having any family support, I started medical school in Colombia but couldn't continue beyond 2nd year due to financial difficulties. I could not continue to pay for my education alone, so I came to the U.S. when I was barely 21, dreaming of continuing my studies. Once again, all I could afford was to go to nursing school. Well, let's rephrase that. I fell in love with nursing while working as a cardiac stress technician at a busy cardiology practice in Florida. The community college was right across the street, and it was super convenient to work during the day and go to school at night (so I finished my pre-requisites); finally, after so much work, I completed my BSN, and my dream of becoming a provider grew stronger. I admired my instructors for being great teachers and working at the same time as nurse practitioners in different medical practices. I got married, became pregnant, and there I was, working on my MSN in nursing education, but the dream did not end there. I had to complete my family nurse practitioner program, which I proudly did during the middle of a world pandemic. Here I am 3 years later, loving what I do but still hearing echoes of how smart I am and why I did not attend med school.

Are you becoming a doctor any time soon? I hear the question often. Deep inside, I think: Am I not good enough as it is? I am trained to provide comprehensive primary care to all ages. This reminded me of when I went back and forth with a patient, asking where the doctor was. I am here. I am the provider that will be taking care of you, but where is the doctor? She kept asking. I am the provider that will care for you today, but you said you were a nurse? So where is the doctor -she replied... I am a nurse practitioner, and this is what I do; finally, after much explanation of my credentials and my job description, she hinted: I thought I was making an appointment with a doctor; it is ok. I will let you take care of me this time. 

So, I asked for more time. Hey, chat GPT, I am a nurse practitioner; should I go to medical school?

Chat GPT: "The decision to attend medical school is significant and should be carefully considered. As a nurse practitioner, you already have a valuable and respected role in healthcare and can provide a wide range of primary care services. Medical school would require substantial time, effort, and financial resources.

Chat GPT went on and highlighted some factors to consider when deciding whether to pursue medical school.

Well, chat GPT, thank you! Indeed, it was a pleasant conversation. I will consider the above advice. For now, I will continue to celebrate and embrace my current achievement of being a nurse practitioner.