Nursing News

Beyond Initial Screening: Strengthening Healthcare Exclusion Monitoring Programs

Posted on by Joseph Gerard

Diverse team of health care professionalsWritten by Erisa Hughes

Healthcare organizations invest significant effort in verifying the qualifications, eligibility, and professional standing of the people and entities they work with. Credentialing, licensure verification, sanctions checks, background screening, and related due diligence processes all play an important role in protecting patients and supporting regulatory compliance.

However, one limitation affects every point-in-time screening process: a person’s status can change after the initial review.

A provider who satisfies all applicable requirements when hired or credentialed may later become subject to an exclusion, disciplinary action, or other adverse event. Contractors, vendors, administrative personnel, and other individuals connected to federally reimbursed healthcare services may experience similar changes.

For healthcare compliance professionals, this creates an ongoing responsibility. Organizations need processes that provide reasonable visibility into provider and workforce eligibility after onboarding rather than relying exclusively on the results of an initial screening.

A well-structured exclusion monitoring program can help healthcare organizations identify changes, investigate potential matches, maintain documentation, and respond appropriately when new information appears.

Understanding Federal Healthcare Exclusions

The U.S. Department of Health and Human Services Office of Inspector General, commonly referred to as HHS-OIG, has authority to exclude individuals and entities from participation in federally funded healthcare programs.

The OIG maintains the List of Excluded Individuals and Entities, or LEIE, which contains individuals and entities currently excluded from participation in Medicare, Medicaid, and other federal healthcare programs.

The consequences of exclusion can be significant. Federal healthcare programs generally cannot make payment for items or services furnished, ordered, or prescribed by an excluded individual or entity.

The issue also extends beyond circumstances in which an excluded person directly submits a claim. An excluded individual may be involved in clinical, administrative, billing, managerial, or operational activities connected to federally reimbursed services.

This means healthcare organizations should not assume that exclusion screening applies only to physicians or other professionals who provide direct patient care.

Depending on the organization, relevant populations may include:

  • Physicians
  • Advanced practice providers
  • Nurses and clinical personnel
  • Pharmacy staff
  • Billing and coding professionals
  • Administrative employees
  • Independent contractors
  • Temporary personnel
  • Vendors and suppliers
  • Management staff
  • Third-party service providers

Organizations should evaluate job responsibilities and contractual relationships carefully when determining who should be included in their screening processes.

Why Initial Screening Is Not Enough

Pre-employment and pre-contract screening provide important information, but only about a specific moment in time.

Consider a healthcare employee who is screened in January. The search returns no exclusion record, and the employee begins working.

If that person’s status changes several months later, the January screening remains historically accurate. It simply no longer reflects the employee’s current status.

This distinction is important because compliance risk does not end once onboarding is complete.

Initial screening answers one question:

“Was this individual excluded when we checked?”

Ongoing monitoring answers another:

“Has this individual’s exclusion status changed since the previous review?”

A mature compliance program should address both questions.

Screening Frequency Should Be Deliberate

Healthcare organizations should establish and document an appropriate screening frequency.

The OIG advises healthcare entities to check exclusion status before employing or contracting with individuals and to periodically check current employees and contractors.

Because the LEIE is updated monthly, monthly screening is commonly used as a practical way to identify changes sooner and reduce the period during which an exclusion could go undetected.

Organizations should still consider their own regulatory environment.

Screening requirements can vary depending on state Medicaid rules, payer contracts, internal policies, organizational structure, and the services being performed.

For this reason, compliance leaders should work with appropriate legal, regulatory, credentialing, and operational stakeholders when establishing screening intervals.

The goal should be to create a defensible, documented process that reflects the organization’s actual risk profile.

Defining the Screening Population

Determining who should be screened is as important as deciding how often screening will occur.

Organizations should examine which individuals and entities contribute directly or indirectly to federally reimbursed healthcare activity.

A useful assessment may consider questions such as:

  • Does this individual provide patient care?
  • Does the person order or prescribe services?
  • Does the role involve billing or coding?
  • Does the employee perform administrative work related to reimbursed services?
  • Does the contractor support clinical or operational activities?
  • Does the vendor provide goods or services used in federally funded care?
  • Could the individual’s work be included directly or indirectly in a federal healthcare program payment?

Documenting this analysis can help organizations define their screening population more consistently.

It can also reduce uncertainty between departments such as human resources, medical staff services, credentialing, procurement, and compliance.

The Operational Challenge of Recurring Screening

Exclusion screening may appear simple when only a small number of names are involved.

At scale, the process becomes much more complex.

A healthcare organization may need to monitor hundreds or thousands of providers, employees, contractors, and vendors. Every screening cycle may involve collecting names, standardizing records, running searches, identifying potential matches, resolving false positives, documenting findings, and escalating confirmed issues.

Manual processes can create several operational problems:

  • Missing individuals from screening files
  • Duplicate records
  • Incorrect names
  • Inconsistent screening dates
  • Unresolved potential matches
  • Limited documentation
  • Different procedures across departments
  • Delayed follow-up
  • Difficulty demonstrating that a screening occurred

For this reason, exclusion screening should be treated as an organized compliance workflow rather than an occasional database search.

A structured leie exclusion process can help healthcare compliance teams organize recurring screening, document results, and identify potential matches that require additional review.

Technology can reduce repetitive administrative work, but it should not replace professional judgment. Compliance staff remain responsible for interpreting findings, reviewing identifying information, and deciding what action is appropriate.

Potential Matches Require Careful Review

A potential database match should not automatically be interpreted as confirmation that a provider, employee, or contractor is excluded.

Names are not unique.

Two unrelated people may share the same first and last name. Records may also contain spelling differences, initials, previous surnames, abbreviations, or incomplete identifying information.

For that reason, healthcare organizations need a documented process for resolving possible matches.

Depending on the information available and applicable privacy requirements, teams may compare:

  • Full legal name
  • Middle name or initial
  • Date of birth
  • Social Security number when appropriate
  • Employer Identification Number for entities
  • Professional license information
  • Address
  • Business name
  • Other identifying details

The purpose is to determine whether the person or entity identified in the exclusion record is actually the same individual or organization being screened.

The resolution itself should be documented.

Recording why a match was determined to be false is just as important as recording a confirmed exclusion. Without that documentation, a future reviewer may encounter the same result and repeat the investigation unnecessarily.

Provider Identification and NPI Verification

Accurate provider identification is an important part of resolving discrepancies and maintaining reliable credentialing and compliance records.

Healthcare organizations often need to confirm that a provider’s name, professional identity, practice information, and other details match the records maintained across internal and external systems.

This becomes especially important when several professionals have similar names or when records are incomplete.

A reliable NPI search can help compliance and credentialing teams confirm provider information and compare identifiers before resolving possible discrepancies.

NPI data should not be viewed as a replacement for exclusion screening or credentialing. Instead, it can provide another layer of identity verification when teams need to confirm that the person being reviewed is the correct healthcare provider.

Using multiple reliable identifiers can reduce confusion and make investigations more precise.

Data Quality Directly Affects Screening Quality

Healthcare organizations sometimes focus heavily on the screening tool while overlooking the quality of the data being submitted.

Poor input data can create poor screening outcomes.

Incomplete names, duplicate employee profiles, outdated information, spelling errors, and inconsistent naming conventions can increase false positives or make accurate matching more difficult.

Organizations should therefore establish clear data-quality expectations for information used in exclusion monitoring.

Relevant departments may need procedures for updating records when:

  • An employee changes a legal name
  • A provider changes practice information
  • A contractor relationship begins or ends
  • A vendor is added or terminated
  • An employee changes roles
  • A new entity is acquired
  • Provider information is corrected

Organizations should also identify which internal system represents the authoritative source for each type of information.

When human resources, credentialing, medical staff services, compliance, and procurement maintain different versions of the same record, inconsistencies can enter the screening process.

Data governance therefore supports both credentialing and exclusion monitoring.

Establishing a Response Procedure

Organizations should not wait until a possible exclusion is discovered to decide how the situation will be handled.

A written response process can provide consistency and reduce uncertainty.

That procedure may specify:

  1. Who receives potential-match notifications.
  2. Who verifies the identity of the individual or entity.
  3. Which identifiers must be reviewed.
  4. When compliance leadership should be notified.
  5. When legal counsel should become involved.
  6. Whether work activities should be restricted while the matter is investigated.
  7. How potentially affected payments or claims will be reviewed.
  8. How the investigation will be documented.
  9. Who has authority to close the case.
  10. What corrective actions may be necessary.

Not every potential match will result in a confirmed exclusion.

However, every potential match should have a clear path toward resolution.

A monitoring program provides limited protection if alerts are generated but remain unresolved for long periods.

Connecting Exclusion Monitoring With Credentialing and Compliance

Exclusion screening should not operate in isolation.

It is one component of a broader system of healthcare workforce and provider oversight.

Credentialing teams may identify licensing or disciplinary information. Human resources may maintain employment status. Procurement may manage vendor relationships. Compliance professionals may oversee sanctions and exclusion monitoring.

These functions should communicate when information affects another department’s responsibilities.

For example, when a new contractor is added, the information may need to reach the compliance team before services begin.

When a provider changes practice information, credentialing and compliance teams may both need updated records.

When an employee leaves the organization, the monitoring population should be updated so that inactive individuals are not unnecessarily included in future screening cycles.

Organizations may benefit from mapping these information flows to identify where delays, duplication, or communication gaps can occur.

The objective is not simply to create more checks. It is to create a coordinated process in which relevant information reaches the people responsible for acting on it.

Maintaining an Audit Trail

Documentation is one of the most important elements of an effective exclusion monitoring program.

An organization should be able to explain how the process operates and whether the procedures described in policy are being followed consistently.

Useful documentation may include:

  • Screening policies and procedures
  • Defined populations subject to screening
  • Screening frequency
  • Sources reviewed
  • Screening dates
  • Search results
  • Potential-match records
  • Verification documentation
  • Escalation records
  • Corrective actions
  • Program reviews
  • Staff responsibilities

This documentation can also support internal audits.

For example, if an organization requires monthly screening, internal reviewers can verify whether every required population was actually screened during each applicable month.

Auditors can also examine whether potential matches were resolved promptly and whether the supporting documentation is complete.

These reviews can identify operational weaknesses before they become persistent compliance gaps.

Measuring Program Effectiveness

Healthcare organizations should periodically assess whether their exclusion monitoring process is functioning as intended.

Possible measures include:

  • Percentage of required individuals screened on schedule
  • Number of potential matches identified
  • Average time required to resolve potential matches
  • Number of unresolved alerts
  • Percentage of records containing complete identifying information
  • Number of records affected by data-quality issues
  • Time between onboarding and initial screening
  • Compliance with documented procedures

These measures can help leadership identify whether problems originate in staffing, technology, communication, data quality, or workflow design.

They can also help organizations determine where process improvements or additional resources are needed.

Technology Supports Compliance but Does Not Replace It

Automated monitoring can make exclusion screening considerably more manageable, especially for organizations responsible for large populations.

Automation can assist with repetitive searching, recurring monitoring, record retention, data organization, and alert generation.

However, healthcare compliance cannot be fully automated.

Professional judgment remains necessary when evaluating potential matches, interpreting regulatory requirements, deciding which populations should be screened, reviewing unusual circumstances, and determining the appropriate response to confirmed findings.

Organizations should therefore view technology as infrastructure that supports a compliance program rather than as the compliance program itself.

The strongest approach combines reliable systems, accurate data, documented procedures, and knowledgeable healthcare professionals.

Conclusion

Healthcare exclusion screening should not be treated as a task that ends after onboarding.

The status of a provider, employee, contractor, or entity can change over time, creating the need for a structured approach to ongoing monitoring.

An effective program begins by understanding the consequences of federal healthcare exclusions and determining which individuals and entities should be screened. It then establishes an appropriate screening frequency, maintains accurate data, verifies provider identity, resolves potential matches, documents results, and creates clear escalation procedures.

Technology can make these processes more efficient, but human oversight remains essential.

For healthcare compliance professionals, the central objective is not simply to perform database searches. It is to build a repeatable, documented process that helps the organization maintain visibility into exclusion status and provider identity throughout its relationships with employees, practitioners, contractors, and other relevant entities.

References

U.S. Department of Health and Human Services, Office of Inspector General. (2013). Updated special advisory bulletin on the effect of exclusion from participation in federal health care programs.

U.S. Department of Health and Human Services, Office of Inspector General. (2026). Exclusions program: List of Excluded Individuals and Entities (LEIE).

 

Author Biography

Erisa Hughes works in digital marketing and content strategy, creating research-driven content across healthcare, technology, and professional services. Her work focuses on turning complex industry topics into clear, practical resources for professional audiences.

 

 

 

Please also review AIHCP’s Health Care Certification and our CE courses as well, to see if they meet your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

5 Scenarios That May Point to an Occupational Health Concern  

Posted on by Joseph Gerard

Occupational Health written on the roadWritten by Deepika,

A patient’s symptoms often play tricks in a way that they act as footprints that don’t necessarily lead back to their origin. In other words, you may know that something has happened, but not where it all began. 

Occupation-related illnesses, although on the rise, are difficult to diagnose. A few reasons include: 

  • Similarities in clinical presentation 
  • Long latency periods between exposure and symptom onset 
  • Multifactorial etiology of chronic diseases 
  • Under-reporting of occupational conditions 

Despite the challenges, the scale of concerns makes it important to incorporate workplace cause-related health screenings. In 2024, 2.5 million non-fatal workplace injuries and illnesses were reported in the US private sector. Healthcare and social assistance recorded 3.4 cases per 100 full-time equivalent workers. 

How to tell if a patient’s workplace deserves a closer look? This article will discuss five distinct scenarios that point towards a workplace cause. 

 

Symptoms Improve During Time Away From Work 

In many cases, a patient’s symptoms have become such an ingrained part of their daily lives that they don’t see anything unusual. Even if the symptoms are recurring, they may not be able to connect them to their workplace. 

One important clue can be what happens when the patient is away from work. Say, coughing, wheezing, headaches, and skin irritation get better during weekends, vacations, or extended time away from work. The same return as soon as the patient resumes their work. 

The above-mentioned pattern calls for a closer look. NIOSH specifically recommends asking patients whether and how their symptoms change after a while away from work. A review of 2,050 physician charts at a large teaching hospital found that occupation was mentioned in only 28% of patient records. 

This is not surprising since it is easy to miss a relevant workplace clue during a clinical evaluation. Hence, the timing adds a worthwhile dimension to the patient’s history. As a healthcare professional, look for the following patterns: 

  • Symptoms getting worse during the work week and easing on weekends 
  • Feeling better during vacations or extended leave
  • Symptoms returning after resuming work 
  • Health issues worsening after a particular shift, task, or workday 
  • Palpable changes after moving to a different work area or performing different duties 

If there is a workplace exposure involved, it doesn’t always have to be obvious. NIOSH also recommends asking patients about new materials or activities introduced at work. Symptoms can fluctuate for many reasons, but a pattern gives it away. 

What to Do 

  • Compare the patient’s work days with their days off. 
  • Pinpoint the timing of the symptoms and their improvement. 
  • Ask directly about any workplace exposures. 

 

Multiple Coworkers Develop Similar Symptoms 

A workplace cause gets more difficult to ignore when multiple people develop similar symptoms. This is especially true if they belong to the same department, work area, or job role. 

The symptoms themselves do not have to be identical. Again, what matters here is the pattern. So, if several people working in the same environment begin experiencing similar issues around the same period, that’s a major sign. 

A 2025 CBS News report illustrated this pattern among Pasadena firefighters who battled the infamous Eaton fire. Captain Dave Marquez from the Pasadena Fire Department said, “For many of us, it was the worst exposure of our careers. Everybody shared similar symptoms.”

The crew had fought the fire for a brutally long 36 hours, and later submitted blood and urine samples to test for toxins. While every similar symptom may not point towards the same cause, a cluster does become good cause for questioning. Useful clues may include the following: 

  • Workers from the same area developing comparable problems 
  • Symptoms appearing after a shared workplace event or change 
  • Employees with similar duties experiencing similar complaints 
  • Unmistakable differences between affected and unaffected workers from different areas 

What to Do 

  • Ask the patient whether their coworkers share similar symptoms. 
  • Note the department, location, shift, or duties shared by the affected workers. 
  • Find out if the symptoms appeared after a specific event or change. 
  • Explore common exposure to dust, smoke, chemicals, equipment, etc. 
  • Record the patient’s account of the cluster and any workplace factors that make further evaluation necessary. 

 

Symptoms Start After a Workplace Change 

If a new symptom appears soon after the patient has shifted their workplace, then that may also serve as an important clue. Such a change may be obvious, such as introducing a new chemical or a piece of equipment. 

On the other hand, it may be a lot more subtle, such as moving to a different work area or changing shifts. The timing matters because it provides healthcare professionals with a specific point to investigate. Common workplace changes worth noting include: 

  • A new chemical, cleaning product, or material being introduced 
  • New machinery or equipment that produces dust, fumes, noise, or heat 
  • A change in work location, ventilation, or indoor conditions 
  • A change in schedule that alters sleep, meals, or recovery time 

Questions in this regard fall within the scope of occupational and environmental health. This branch of study examines how workplace and environmental conditions can influence health. So, those who pursue an occupational and environmental health degree focus beyond the symptoms to understanding exposures and assessing risks. 

Tulane University notes that the curriculum integrates public health principles with analytical methods in chemistry and statistics. Hence, the main focus areas are risk assessment, regulatory compliance, and exposure control. It makes sense since an understanding of the associated risk requires a more systematic assessment. 

What to Do 

  • Try finding out what exactly changed and when it occurred. 
  • Compare the timeline of the workplace change with the onset of symptoms. 
  • Ask what the patient was exposed to in the new environment. 
  • Determine whether symptoms vary with particular duties, location, or shifts. 
  • Document the suspected connection and see if further evaluation is necessary. 

 

A Known Workplace Hazard is Part of the Patient History 

Sometimes, the workplace connection is easier to recognize because the patient has a known exposure as part of their job. This may take the form of regular contact with chemicals, dust, fumes, biological materials, excessive heat, or radiation. 

In a 2025 field-based study, 58 construction workers in Central Florida were followed during a work shift. Then, their symptoms, hydration, and kidney function were assessed. Researchers found that 42% reported at least one heat-related illness symptom, 78% were dehydrated after the shift, and 38% showed evidence of acute kidney injury. 

It’s important to remember that a known workplace hazard is not always the cause behind a patient’s illness. However, when the patient regularly encounters a hazard that could affect their health, that exposure is a specific clinical clue worth investigating. Such a connection is especially important when: 

  • The patient regularly faces a known risk as part of their job. 
  • Symptoms appear mainly during and after the exposure. 
  • The patient has recently started working with a new substance, material, or process. 
  • The intensity or duration of exposure has increased, such as longer shifts or more time in a hot environment. 
  • Workplace protections have changed, including ventilation, hydration practices, etc. 

What to Do 

  • Ask exactly what the patient encounters at work, whether it be heat, chemicals, dust, noise, or another hazard. 
  • Find out how often or how long the conditions last. 
  • Consider whether the hazard affects the patient through breathing, skin contact, heat stress, or another route. 
  • Discuss ventilation, protective equipment, hydration, rest periods, and other controls relevant to the hazard. 
  • Think of further evaluation if the exposure and clinical presentation appear to be connected. 

 

The Condition is Unusual for the Patient’s Age or Circumstances 

It’s possible for a patient’s age, health history, or circumstances to not fit the condition that’s being evaluated. This is the case when a problem appears earlier than expected or has no clear, verifiable explanation. That’s when it’s time to look beyond the most common causes into the patient’s workplace environment. 

In a 2025 AP News report, this connection became a lot clearer. A Nevada dairy worker became infected with a newly identified strain of H5N1 bird flu after exposure at a cattle farm. The illness was mild, with redness in the eye and irritation as its main symptoms. 

However, the patient’s work with cattle provided an important part of their exposure history. The news report stated that at least 68 people in the US had been infected with bird flu the preceding year, with all but a small number having worked closely with cows or poultry. 

The example shows why an unusual condition or presentation may prompt a wider occupational history. As a healthcare professional, you may want to look more thoughtfully when: 

  • A condition appears unusually early for a patient’s age. 
  • The patient has few to no risk factors associated with the condition. 
  • The symptoms or diagnosis are unexpected given the patient’s health history. 
  • The patient’s occupation involves circumstances that may contribute to the condition. 

What to Do 

  • Determine which expected causes or risk factors are present or absent. 
  • Consider the patient’s occupation, daily activities, environment, and recent changes in circumstances. 
  • Ask whether symptoms began after starting a job, changing duties, or encountering a new workplace exposure. 
  • Avoid premature conclusions, treating the workplace as one possible factor. 

 

FAQs 

What are some signs that a health condition may be work-related? 

The most commonly observable signs include symptoms improving with time away from work, multiple coworkers being affected, and a known workplace hazard. If a condition appears to be quite unusual for a patient’s age or circumstances, that is another clue. 

What workplace factors should healthcare professionals ask patients about? 

It’s important to ask about chemicals, dust, fumes, heat, noise, biological materials, ventilation, and recent workplace changes. Also, consider asking whether the patient knows anybody from their workplace with similar issues. 

What should a healthcare professional do if a workplace cause is suspected? 

The first thing to do is to establish the timeline and compare symptoms across work and non-work periods. Then, document the relevant findings and consider appropriate health evaluation. A suspected connection should guide further assessment rather than being treated as proof of causation. 

 

Workplace Clues at a Glance 

What You Notice  What to Look For 
Symptoms improve away from work.  Better on weekends or leave 
Symptoms follow a workplace change.  New task, material, equipment, or location 
Coworkers have similar symptoms.  Shared duties, area, or exposure 
A known workplace hazard is present.  Heat, dust, fumes, chemicals, or noise 
The condition seems unusual.  Early onset or unexplained presentation 
Key questions to ask  Timing, tasks, exposures, and coworkers 
Clinical takeaway  Investigate patterns without assuming causation. 

As we discussed, the context surrounding the symptoms tells the whole patient story. So, when symptoms occur, whether coworkers are affected, and what conditions the patient encounters are all equally important. 

As per a 2026 study of 734 healthcare workers, workload, night shifts, and noise were all associated with occupational fatigue. Again, we see how several workplace factors can influence health at the same time. 

Next time a patient’s condition does not fully explain itself, look into their workplace conditions as well. A few thoughtful questions may reveal connections that are otherwise overlooked. 

Author Bio

Deepika has over six years of experience as a writer and editor. Passionate about words and learning, she takes an interest in a variety of niches. Her knack for turning complex ideas into relatable narratives allows her to resonate with the reader. When her pen falls silent, you can find her engrossed in a novel or getting her hands messy with fine arts. Through these, Deepika is committed to keeping her curiosity and creativity alive. 

 

References:

  1. Economics News Release. Employer-Reported Workplace Injuries and Illnesses (Annual) News Release. January 2026. US Bureau of Labor Statistics. 

https://www.bls.gov/news.release/osh.htm

  1. Saif Nadia, Socias-Morales Christina, et al. Primary Care and the Working Patient – Occupational Health Principles in Practice. October 2024. National Institute for Occupational Safety and Health. CDC. 

https://www.cdc.gov/niosh/bulletin/2024/primary-care-oh.html

  1. Tan Lanhui, Zhang Ruyi, et al. Multiple exposure sources and occupational fatigue profiles among healthcare workers: a cross-sectional latent profile analysis. 2026. Frontiers. 

https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1811642/full

  1. Chicas C Roxana, et al. Acute Kidney Injury Among Florida Construction Workers: A Pilot Study. March 2025. PubMed. 

https://pubmed.ncbi.nlm.nih.gov/39706579/

 

Please also review AIHCP’s Health Care Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Why Metabolic Health Matters at Every Stage of Life

Posted on by Joseph Gerard

Metabolic health - crossword in ivory tiles against gray textured paperFor many, it shows up as an afternoon crash that makes the couch look irresistible (guilty!), but it can also be a routine blood test that comes back “a little high.” None of these mean that something is necessarily wrong, but they do show that metabolism deserves attention between checkups.

Metabolism is the work of turning food and stored fuel into energy, then directing it where needed. Hormones run that traffic, so it is helpful to think about metabolic and endocrine health together. The same network affects appetite, blood sugar, temperature, sleep, menstrual cycles, and recovery. It also changes as life changes, and often in quiet, ordinary ways.

More than a fast metabolism

People often use “metabolism” as shorthand for how easily someone gains weight. The real picture includes how the body handles glucose and blood pressure, how the liver stores fuel, how well muscle can use it, and a bunch of other factors. Thyroid and reproductive hormones all take part as well.

No single measurement sums up the system. Body size offers some context, yet it cannot reveal a person’s blood sugar, fitness, sleep, or family history. People in similar-sized bodies can have very different lab results and risks.

An out-of-range result starts a conversation, but it’s rarely as simple as numbers on a page. Clinicians look at trends, symptoms, and the person in front of them. A single fasting glucose reading, for example, can be affected by stress, illness, or a poor night’s sleep, which is why most providers prefer to watch a pattern over time rather than react to one number in isolation.

Childhood is where the setting takes shape.

Children are growing, so their need for energy keeps shifting. Puberty can change sleep and insulin response, and that’s no reason to put a child on an adult diet or make the scale the center of family life.

Regular meals, chances to play, a workable bedtime, and neutral talk about food provide useful structure. Teaching a child about what types of food will help them stay full for longer is more helpful than calling a snack bad. Adults can model vegetables and movement without turning either into punishment.

School schedules, neighborhood safety, food prices, and access to recreation shape what families can do. If a child has persistent thirst, frequent urination, unusual tiredness, or an unexpected change in growth, call a pediatric clinician. Those signs have several possible causes, and an assessment is safer than guessing. Family routines built early, like eating meals together without screens or keeping consistent wake times, tend to carry into adolescence and adulthood, making them a worthwhile investment even when the payoff isn’t immediate.

Young adulthood meets the messy calendar.

The first years away from home often replace built-in routines with lectures, shift work, commuting, caregiving, or a tight food budget. Sleep moves around, and hours pass in a chair even when the day feels frantic.

In 2022, 31% of adults worldwide did not meet recommended levels of physical activity. This is a common problem, and advice has to fit the life a person actually has.

Small adjustments can help. Yogurt, eggs, beans, or nuts may make a rushed breakfast more satisfying, while frozen vegetables and canned fish or pulses can rescue a late dinner. A gym membership is optional; walking part of a commute or doing adapted strength work at home can be just as helpful. Even short bursts of movement between meetings or classes, taken consistently, add up over a week in ways that are easy to underestimate.

By midlife, the old routine may land differently.

Sleep, medication, illness, and activity can shift metabolic risk as we age. Poor health is not inevitable, but the body’s feedback may change, as some metabolic conditions stay quiet for years.

In 2023, an estimated 40.1 million people in the United States, or 12% of the population, had diagnosed or undiagnosed diabetes. Genetics, pregnancy history, medication, income, and access to care all affect risk.

Depending on personal history, a clinician may check blood pressure, fasting glucose or A1C, cholesterol and triglycerides, and sometimes liver or thyroid markers. Ask what might explain any change in the result and when to check again. A portal flag is not a diagnosis by itself.

This is often the stage when people first hear the phrase metabolic and endocrine health used together, since hormonal shifts around this time, whether from thyroid changes, perimenopause, or medication, frequently show up in the same panel of tests.

Later life shifts the goalposts.

When senior health enters the picture, preserving strength and independence often matters more than chasing a smaller number on the scale. Muscle helps clear glucose from the blood, supports balance, and makes daily tasks easier. Losing it can leave an older adult lighter but less resilient.

This means a simple meal with enough energy and protein may beat a restrictive “clean” menu. That said, kidney disease and other conditions can change protein needs, so individual guidance matters here.

As for movement, rising from a chair, gardening, resistance bands, and supervised balance work can help maintain function. Older adults who use insulin or certain glucose-lowering medicines need a plan for avoiding low blood sugar. Medication doses may also need review as weight, kidney function, appetite, and activity change. Falls and slow recovery from illness are often overlooked signs of declining muscle mass, and addressing them early tends to be far easier than reversing the damage after a hospitalization.

When to bring it up with a clinician

Persistent thirst, frequent urination, unexplained weight change, slow-healing wounds, repeated shakiness, major menstrual changes, unusual sensitivity to heat or cold, and fatigue that does not improve are worth discussing. They can have many causes, and an online symptom list cannot sort them out.

Metabolic health affects energy and physical function but never acts alone. Needs change with age, while genetics and circumstances always play a role. The aim is to notice meaningful changes early and build habits that survive ordinary life, rather than chasing a perfect routine that collapses the first time work, illness, or family life gets in the way.

 

 

About the Author

This article was prepared by a member of the AIHCP editorial contributor team, drawing on published research and general health education resources. It is intended for informational purposes and does not replace individualized medical advice from a licensed clinician.

 

Please also review AIHCP’s Health Care Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

How to Choose a HIPAA Compliant Phone System

Posted on by Joseph Gerard

Stethoscope on red smartphone on a grey background. Written by Rob Mcmanus,

Finding a HIPAA-compliant phone system will let you communicate with patients without worrying about the safety of their data. Don’t buy one without checking if it actually meets your practice’s needs. Prioritizing safety and learning about the vendor’s rules on recording helps you make a smart decision.

What would happen if a private conversation you had with your patient ended up in the wrong hands? Some of them are probably about health concerns they are dealing with. Patients also often call to ask for medication advice before their next follow-up session.

Ensure you protect all the conversations regardless of what they are about. Having a phone system with the safeguards you need makes your work easier.

Do Phone Systems Need to be HIPAA Compliant?

Yes.  Anytime you’re using a phone to talk about information that’s protected by HIPAA, ensure the systems behind it protect the data.  When you ask yourself these questions, you’ll be able to determine if you need to change your phone system:

  • Does it protect patient conversations?
  • Can unauthorized people access call records?
  • Are all the messages encrypted?
  • Can my team control who accesses the phone?

What Is the Best HIPAA-Compliant Phone System?

It depends. Always consider the size of your practice before you buy a phone system. You might not need to use the same one other healthcare providers in your area use. Focus on ensuring it has all the features you need and is still able to protect data.

A lot of practices prefer to use mobile phones so employees can take calls and text from anywhere. You need to have proper controls when using these. Learning about topics like Google Voice HIPAA compliance will help you know if you’re actually using a safe system.

If you have VoIP, you probably chose it because a lot of your employees are already familiar with internet calling.  VoIP apps often don’t come with the kind of protection you need for your practice. Always look beyond basic calling features as you weigh your options.

What Is the Most Secure Phone for Privacy?

None is automatically safe. If you have a phone with data encryption, you won’t worry about the details in it leaking or being used by the wrong people in case you lose it. All these features are important too:

  • Strong authentication
  • Remote management options
  • Secure messaging apps

Even if you get the most secure phone, you still need to be keen about how you use it. Connecting it to public Wi-Fi makes you more likely to lose data to hackers. Avoid giving apps permissions to things they don’t actually need.

Choosing a HIPAA-Compliant Phone System

Don’t make the mistake of looking for the phone system with the most features or the most affordable one. Your team’s work will be easier once you find a phone system that simplifies communication.

They shouldn’t have to worry about healthcare security by taking extra steps that reduce the time they actually have to serve patients.

Review Your Practice Communication Needs

Consider how your team communicates with patients and ask yourself how many people need to use it.  If some employees work from home, you probably need a different system than a practice where employees are all in one facility. As you review your needs, think about:

  • Whether you want employees in different departments to use the same system
  • If you often send appointment reminders through text
  • Whether you record some calls

It’s always important to think about the direction your practice is headed. Having a system just meant to accommodate a few employees won’t work if your clinic is taking on a lot more patients. You need a scalable system. It will help you avoid redoing the onboarding process or having to transfer data later.

Confirm the Vendor Offers a Business Associate Agreement (BAA)

You should know how your vendors handle protected details. Reading BAAs gives you the information, and it makes it easier to compare vendors. Some of them:

  • Store the information
  • Process it
  • Transmit it via several servers

When you have an agreement, you’ll know whose duty it is to protect the data in different situations. A lot of popular messaging apps actually don’t offer a BAA. Even if you love the features and find them much simpler, it’s better not to risk using them.

Check Encryption and Security Features

You’ll often need to move information when emailing other employees in your healthcare center. Using different networks requires strong encryption. You shouldn’t have to add security protections on your own to make a phone system safer. Get one that comes with the features installed.

A lot of systems made specifically for healthcare providers will work better for you than those meant for regular use. These are some of the aspects you shouldn’t ignore:

  • User authentication
  • Password protection rules
  • Secure data storage

The security features shouldn’t feel like something you think about after looking for the communication tools you need. Make them a priority too. You’ll be able to avoid a lot of data safety issues down the line.

Consider Shared Lines for Team Triage

When you have a busy clinic, your triage nurses should be able to receive calls instead of waiting for only one person to handle each incoming one.

Get a phone system with shared lines. As one of the employees answers a call, another one can respond to text messages. You’ll boost patient satisfaction once you have the tools allowing you to get back to them in just a short amount of time.

Having shared lines makes it easy to route calls to the right department. In case a patient calls to follow up on test results, they can just be connected to the right person. Employees will save time and avoid a lot of confusion.

Control access even if your phone system makes it easy for multiple people to use it at a time. Every employee doesn’t need unlimited access to all the information. Consider everyone’s roles as you assign shared lines.

Understand Call Recording Rules

Recording calls gives you a lot of material you can refer to when training your employees. Healthcare facilities often use the information to learn what their customers want so they can find ways to improve their services. Think about your patients’ privacy before you go ahead and record conversations.

Learn about the laws in your state regarding call recording, too. It will save you from dealing with legal issues later. Your phone system should always store the recorded conversations in a secure file.

You wouldn’t want information you just stored for documentation purposes to end up in the wrong hands. Be keen about who has access to each recording.

After you find a phone system with the features allowing you to record calls and keep them safe at all times, you’ll have peace of mind.

Look for Audit Logs and Reporting Tools

It’s important to be able to see who is using your phone system and what they are using it for. Your admin may need to see the information a patient gave earlier before texting back.

When you have a system with audit logs, you can quickly spot any unusual activity. You’ll be able to protect your information and do internal review to figure out if you need to take extra security measures.

Reporting tools analyze the data you store. Get a system with these and use them to check if your system is actually doing what it’s advertised to do. Use the information it gathers to improve how you serve your patients. You might notice things like:

  • Missed calls during busy hours
  • Long wait times before patients reach someone
  • Some departments receiving a lot more calls
  • Peak calling times that require additional staff

It’s much easier to improve when you have reports with such details. A lot of practices struggle to retain patients simply because they aren’t addressing issues that frustrate them. Having additional features on your HIPAA-compliant phone system helps you know where to direct resources.

Ensure the System Works With Your EHR

You probably already have many tools to support your team and help you manage records with less stress. Clinics need phone systems they can connect to:

  • EHR platforms
  • Scheduling software
  • Patient management tools

If you have to transfer data between your phone system and any of these tools, there’s a high risk of making mistakes. Integration avoids costly errors, and it also saves time for everyone.

As you look for a phone system, don’t hesitate to read reviews. These can help you figure out if other healthcare providers like using it. Learn about any potential issues you’re likely to come across.

You’ll feel more confident if you’re able to get a system you can use to organize all your communication history without having to do a lot of manual work.

Finding the Best HIPAA-Compliant Phone System

Investing in a HIPAA-compliant phone system saves you from a lot of the stress you might be dealing with because of using regular messaging apps.

These don’t come with the security features and reporting tools you need in your practice. Go for solutions with data encryption. Having a system multiple people on your team can use for triage also improves efficiency. Check out our page for tips to help your practice stay compliant.

Author Bio

Rob Mcmanus writes about healthcare compliance, cybersecurity, and healthcare technology. He’s been creating practical content for 7 years, helping healthcare professionals stay up to date with industry trends and best practices. When not writing, Rob enjoys reading and planning the next getaway.

 

References:

Federal Trade Commission. (2023). Are Public Wi-Fi Networks Safe? What You Need to Know.

TechTarget. (2024). What is user authentication?

Additional Resources:

Summary of the HIPAA Security Rule. U.S. Department of Health & Human Services. Access here.

Primary Mitigations to Reduce Cyber Threats to Operational Technology. Cybersecurity and Infrastructure Security Agency (CISA). Access here 

 

Please also review AIHCP’s Telehealth Nursing & Triage Nursing Certification program and CE Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

How Hand-Eye Coordination Changes With Age and What You Can Do About It

Posted on by Joseph Gerard

Doctor holding hands with a patient while wearing gloves. Written by Marko,

Aging does a lot of not-so-great things to your body, and one of them is the decline of hand-eye coordination. 

This, much like everything else, happens slowly. It’s not like you’ll wake up one day and not be able to catch your keys. You probably won’t even notice it’s happening, especially at first. But sooner or later, you’ll find yourself taking a little pause before you pour your coffee. 

You’ll type a little slower, regardless of how fast you could do it for most of your life.

This isn’t something to get depressed about. It’s normal, and it happens to everyone. 

But that doesn’t mean you need to sit back and let it happen. Loss of hand-eye coordination is something that happens across more than one system in your body, and it actually starts earlier than you think. The silver lining is that you can interrupt this chain. 

If you practice and train this ability, it’ll behave like a muscle when you exercise.

Why Hand-Eye Coordination Changes Over Time

Hand-eye coordination sounds like something relatively simple, doesn’t it? 

But actually, it’s one of the more complicated things in the human body. 

There’s a lot more to it than just seeing clearly or having your hands be steady. This kind of coordination is what happens when several of the systems in your body ‘talk’ to each other, and if any part of that chain slows down even for a little bit, the whole thing doesn’t work as well as it should, and you’ll notice it. And when you know that it all happens in a matter of milliseconds, it gets even more impressive.

What happens when you reach for a glass on the counter? Think about it a bit. First, your eyes have to see where the glass is, including how far away from you it sits. That information then travels to your brain, where it gets interpreted. The brain then figures out what angle and force you need to reach it. 

Once it has that figured out, it sends signals down to your arm and hand, which tells them when to fire and how hard to squeeze. 

At the same time, your joints and tendons are sending the feedback back up to the brain about where your hand is, which is why you’re able to adjust your movements as you reach for that glass. In the end, the sensory receptors on your fingertips make the final tweaks the moment they make contact with the glass. 

This all happens before you can even blink, and every single step needs a different part of your body to work PERFECTLY. Imagine. All this just to grab a glass.

As you age, every part of this system changes a little. 

The nerves can’t send the signals as fast as they used to, and the eyes can’t detect contrast and judge the depth as accurately. The time you need to react prolongs for just a fraction of a second, but that fraction is enough for you to notice that something isn’t quite right.

  • As humans get older, their reaction time/processing speed tends to decline due to slower neural transmission. – National Institutes of Health
  • Older adults usually have weaker vision because of lower contrast sensitivity and lower depth perception, which negatively affects hand-eye coordination. – National Institutes of Health

Muscles get less flexible and weaker, and cognitive processing (the part that happens in the brain) also takes a little longer to do its job.

The interesting thing about all this is that this doesn’t happen on some sort of set schedule for everyone. You could have 2 people of the exact same age who have completely different coordination abilities. It might just be luck up to some point, but for the most part, this difference comes down to lifestyle. 

If you stay physically active and pay attention to your health in general, you’ll probably have better coordination than someone whose idea of exercise is watching football on TV. To be clear, you don’t have to punish yourself at the gym every day in order to stay active enough. 

A recreational sport such as padel or pickleball will do the trick, and all you need for it are good shoes and a standard Bread & Butter paddle to level up your game.

Weaker muscles and reduced flexibility in older humans are directly linked to reduced hand-eye coordination. – National Institute of Aging

But any sport that forces you to activate all your muscles and is very intensive, and requires constant high focus, will do the trick. The thing to remember is that your body adapts to what you ask of it on a regular basis, which means that a lot of these changes related to aging aren’t inevitable.

But if you don’t use your ‘system’ enough, then they’re a lot more likely to happen.

Everyday Habits That Can Speed Up or Slow Down the Decline of Coordination

You could say that a (small) part of how your coordination changes with time has to do with genetics or even luck, but the way you live your life every day impacts it a lot more.

Physical Activity Keeps Neural Pathways Active

You know how a muscle atrophies when you don’t use it? 

Well, if it atrophies enough, your body will literally resorb it. But if you exercise, your muscles stay strong, and so do your neural pathways.

Exercise keeps them active; it reinforces the actual lines of communication between the brain and the muscles and makes sure those signals stay fast and clear.

Daily physical activity benefits neuroplasticity, which helps maintain motor coordination and neural communication pathways. – National Institutes of Health

When you exercise, your brain works out, too. It constantly sends and receives information about your position, force, and timing. That keeps neural pathways on track. But if you lead a sedentary life, well… You can imagine how things go.

The exact opposite happens, and you don’t want that. 

If you sit for too long and don’t move around, those connections get weaker because they’re not being used. Kind of like how a path in the woods gets covered with grass when nobody walks on it.

Any kind of activity will do. Sports, dancing, walking, as long as you’re moving. The most important thing is to be consistent because neural pathways need regular use to stay active.

Vision Is More Important Than Most People Realize

Nobody thinks about vision being something they could train, but in the sense of being a component in the hand-eye coordination, it absolutely is. If the data coming from vision is blurry or incomplete, every other step in the system suffers. 

Vision is how the brain gets information on distance, speed, and position, which is how you’re able to make precise movements.

So, what to do about this? The first step is to get your eyes checked regularly, especially as you start to age.

What most people don’t realize here is that changes in prescriptions or early signs of some conditions (e.g., cataracts) could show up years before they’re able to notice that something’s wrong. Environment is a factor here, too. 

Having good lighting means that your eyes don’t have to strain too much, plus it becomes easier to judge distance and depth.

Sleep, Stress, and Mental Fatigue Affect How Quickly You React to Speed

If you’re tired or stressed, the brain can’t work as well. That’s a huge problem for coordination because it needs the brain to perform perfectly.

Not getting enough quality sleep is an issue that affects a lot in your body, including your attention span and how quickly you’re able to react. If you’re tired, you might feel clumsy, and that’s not something you’re imagining. It comes from actual neurological delays. Chronic stress works pretty much the same.

Sleep deprivation impairs cognitive and motor performance in humans. – National Institutes of Health

It keeps the brain on alert at all times, which messes up focus and fine motor control.

Basically, your brain can’t do everything at once. 

So, if it’s occupied with worry or tension, it doesn’t have enough resources for the calculations that precise movements need or for concentration. You can probably notice that your coordination is worse at the end of the day. That’s normal because your brain has gone through a whole day of cognitive load, and now it’s low on energy. 

This is why quality sleep is so important.

Eating Well and Drinking Enough Water Helps the Brain Function Efficiently

What you eat and drink affects how well your brain is able to process information and send signals to your body. Even if you’re mildly dehydrated, your cognitive performance will go down a little. In other words, your brain will need more time to figure out the information coming from vision and then coordinate your response to it. 

Drink water all throughout the day and remember that being thirsty isn’t a ‘reminder’ to drink water but a sign of dehydration.

Mild to severe dehydration negatively affects motor and cognitive skills/performance. – National Institutes of Health

Also, be careful with what you eat. Junk food is okay here and there as a treat, but your nervous system needs a steady supply of nutrients like B vitamins, omega-3 fatty acids, proteins, etc. Your diet should include vegetables, fruits, lean proteins, and healthy fats. 

Supplements can help, but they’re not a way for you to cheat on your diet.

Conclusion

Hand-eye coordination isn’t like a bulb that gets dimmer and dimmer until it goes out and there’s nothing to do about that. 

You have a say in this. Yes, your vision will change, reaction times get longer, yadda yadda. But you still have some control over how fast that happens.

As you can see, the advice on how to stay healthy and sharp is pretty boring and basic. You’ve heard it a million times – eat well, drink your water, get enough sleep, and exercise regularly. But the reason why you keep hearing it over and over is that it works. 

In fact, these are the only things that truly work when it comes to being healthy and keeping your hand-eye coordination on point.

Author Bio 

Marko is an adamant and eager content writer with a decade of experience in various niches,  with healthcare being one of them. With his way of implementing storytelling, comparisons, and examples into hard-to-grasp topics, Marko’s able to make complex things sound interesting and relatable – key ingredients to make something understandable. As a hobby, Marko enjoys offroading, board games, and spending time with his family and his dog Cezar.

 

 

Please also review AIHCP’s Nurse Patient Education Certification program and CE Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Medication Side Effects Nurses Should Never Overlook 

Posted on by Joseph Gerard

Stethoscope Over Malpractice Wooden Block On White Desk In Front Of Gray Background

Written by Marchelle Abrahams

Jane Ryde started keeping a record of her husband’s erratic behavior when he was put on Pramipexole to treat his Parkinson’s. The drug falls under a group called dopamine agonists. Prescribed for other conditions such as restless legs syndrome (RLS), it increases dopamine activity and overstimulates the brain’s reward system.

In her husband’s case, the impulsive behavior manifested as addiction to pornography. When she read about the side effects, doctors assured her it was “uncommon.” But her husband’s heightened sexual urges proved otherwise.

Ryde tells the BBC that her late partner would have been “horrified” by his own behavior. “You have to go into these things with your eyes open. If you’re not given the details, you don’t know what to look out for.” – Jane Ryde.

Side effects that have been deemed “uncommon” or “rare” should no longer be treated as such. When a patient presents an ailment that doesn’t correlate with their illness or diagnosis, the next step is to take a closer look at their medication.

Below, we’ll discuss medication side effects nurses should never overlook.

Pramipexole

Following a BBC probe into the side effects of Parkinson’s medications, the Medicines and Healthcare products Regulatory Agency (MHRA) decided to take a closer look. 

The BBC’s investigation found that around one in six people with Parkinson’s disease who take these medications develop impulse control disorders (ICDs). This tracks another 2021 study published in Frontiers in Psychiatry.

Impulse Control Disorders

Study researchers concluded that as understanding of ICDs grows, more personalized and effective treatment strategies should be developed. 

Studying ICDs in people with Parkinson’s disease may also offer valuable insights into the biology of addiction. 

Biologic Drugs 

Biologic drugs are used to treat autoimmune diseases and other chronic conditions. Unlike traditional medications, biologics are made from living cells or organisms rather than through chemical synthesis. 

A Boston optometrist noticed their patients had similar ocular complications. They had one thing in common: biologic drug prescriptions.

Dr. Sarah Lopez, an assistant professor at the University of California, tells Healio that when a patient develops new or unexplained symptoms, nurses should review their medication list, as a biologic drug may be the underlying cause. 

Most biologic medications can be identified by their names, which  end in -mab, -cept, -fusp, or -kin, or include the word “interferon.”

Mirvetuximab  

About 59% of patients on mirvetuximab experience side effects, such as dry eyes and sensitivity to light. Tisotumab has a similar rate, although it is more likely to affect the conjunctiva than the cornea. 

Patients with dry eye disease often complain of scratchiness, eye irritation, burning eyes, itchy eyes, and blurry vision. It’s also advisable that patients stop wearing contact lenses while being treated with antibody-drug conjugates. 

Mountain View Optometry advises patients to seek treatment for dry eye symptoms as it can develop into an eye infection.

Statins

Touted as a miracle that lowers cholesterol, statins have indeed saved millions of lives. They’ve reduced the risk of heart attacks and strokes. However, recent research has brought the effectiveness into question. Namely, the side effects.

Muscle pain. Weakness and exercise intolerance. These are the trade-offs some patients report. Medical X Press reports that a recent McMaster University study may have uncovered the “why”.

It paves the way for future treatments that could make statins easier to tolerate without reducing their heart-protective benefits. 

Challenging Conventional Wisdom

The study identified an immune and metabolic pathway that appears to drive statin-related muscle damage. It challenges previous assumptions about how these side effects occur. 

According to senior author Professor Jonathan Schertzer, statin-associated muscle symptoms affect an estimated 7% to 29% of people taking these medications. 

Researchers have long known that statins can sometimes cause muscle problems, but the biological reasons behind these side effects have remained unclear until now. 

GLP-1 For Weight Loss

The popularity of Glucagon-like peptide-1 (GLP-1) receptor agonists has soared in recent years. Originally developed for type 2 diabetes mellitus, GLP-1s are also licensed for weight loss. 

However, it appears that Ozempic face isn’t the primary side effect with prolonged use.

Lesser-Known Side Effects

Digestive problems account for about half of all side effects reported to the UK’s MHRA through the Yellow Card Scheme for tirzepatide, semaglutide, and liraglutide.

An April 2026 study published in Nature suggests that some patients may be genetically more likely to experience nausea or vomiting while taking these medications.

Skin and nervous system side effects are also commonly reported. In people using semaglutide to manage diabetes, dysesthesia has since been added to the drug’s list of known side effects.

We can’t talk about medication side effects without mentioning the foundation of medication administration. The two are intricately connected.

The ‘5 Rights’ of Medication Administration 

All nurses are taught this module in nursing school. Right patient. Right drug. Right dose. Right route. The right time still holds weight.

Developed to reduce medication errors and make drug administration safer, these principles have long been a cornerstone of clinical practice. Yet medication errors occur, showing that a more comprehensive approach is needed. 

Currently, the FDA receives more than 100,000 reports annually associated with suspected medication errors. As a nurse, you should consider the following:

Similarly Named Medications 

Similar names. Different effects. That mistake can cost you dearly. 

To reduce confusion, prescribers should use full generic drug names. Include the reason for the prescription. Document orders clearly to prevent errors caused by poor handwriting or abbreviations. 

Dosing

Nurses must use the correct units when calculating medication doses to avoid potentially life-threatening errors. For example, administering 5 mL of morphine at a concentration of 20 mg/mL instead of the prescribed 5 mg could be fatal. 

The Institute for Safe Medication Practices (ISMP) stresses that patient weight must be measured and documented in metric units (kilograms or grams).  

FAQs

1. Why should nurses pay close attention to medication side effects?

Medication side effects can sometimes be mistaken for new illnesses or worsening disease. 

2. Which medication side effects are most commonly overlooked?

Some of the most commonly missed side effects include impulse control disorders linked to dopamine agonists. Dry eyes and light sensitivity caused by certain biologic drugs. Muscle pain from statins. Digestive and skin symptoms associated with GLP-1 medications. 

3. When should dry eyes raise concerns?

Dry eyes may seem like a minor complaint, but they can be a side effect of biologic medications such as mirvetuximab.

4. How can nurses reduce the risk of medication-related harm?

Following the “Five Rights” of medication administration remains essential. Nurses should also verify generic drug names. Document patient weight in metric units. Watch for unexpected symptoms after new medications are prescribed.

 

Medication Side Effects: Key Statistics 

Stat Figure Source
Reports of suspected medication errors received annually by the FDA  100,000+  FDA
Parkinson’s patients taking dopamine agonists who may experience impulse control disorders  1 in 6 (17%)  Frontiers in Psychiatry
Patients taking mirvetuximab who experience eye-related side effects  59% Healio.com
People taking statins who experience muscle-related symptoms  7%–29%  McMaster University study

 

Foundational Principles

The universal ethic of nursing is built on the “Six Cs of Caring”: Compassion, Competence, Confidence, Conscience, Commitment, and Comportment. 

As long as you follow this mantra and the 5 Rights of Medication Administration, you will be one of the first to spot when something is wrong. A patient may dismiss something as simple as a tremor. You know better. And chances are, you’ll also know the culprit.

Author bio

Writer by day, dream catcher by night. Marchelle Abrahams cut her teeth in the infancy of the internet when the dial-up sound of the modem was more than a soundbite at a rave. Not a Millennial and not a Boomer, Marchelle is an in-betweener, making her a special breed of human. As a qualified journalist, Marchelle believes her superpower is stringing a few words together and people reading them. That, and the ability to take her kids on with her unique brand of gnarly comebacks. 

Please also review AIHCP’s Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Is a BSN to MSN Worth It? Real Talk for Nurses in 2026

Posted on by Joseph Gerard

doctor holding stethoscopeWritten by Agwalogu Bob,

Healthcare is evolving. Facilities are adopting new tools, patient-centered care is becoming important, and technologies like data analytics and AI are increasingly becoming a normal part of clinical workflows. Because of this, and many other changes happening across the industry, the demand for nurses with advanced qualifications has never been greater.

If you’re a registered nurse who already holds a Bachelor of Science in Nursing (BSN), this could be your opportunity to step into leadership. But it also means going back to school for your master’s degree.

As of 2024, more than 17% of nurses in the U.S. held a master’s degree, meaning you’d be joining a growing group of highly qualified professionals. But the real question isn’t how many nurses are doing it. It’s whether you should.

Read on to find out whether investing in an MSN is worth it for nurses who already have BSNs in today’s landscape.

What Is a BSN to MSN Program?

A BSN to MSN program is one of the most direct ways to earn a Master of Science in Nursing as a registered nurse. Since you already have a Bachelor of Science in Nursing, you can progress into graduate-level nursing education and advanced practice preparation without starting from scratch.

Most of these MSN programs run about 1.5 to 3 years, and many of them are offered entirely online. This is a big deal for working nurses who can’t just quit their jobs and sit in a classroom.

When you do a BSN to MSN program, you don’t just get to earn a generic master’s degree. You choose a specific track that aligns with your career goals.

Common MSN specializations include:

  • Adult-Gerontology Nurse Practitioner
  • Clinical Nurse Leader (CNL)
  • Family Nurse Practitioner (FNP)
  • Nurse Educator
  • Nursing Administration and Leadership
  • Psychiatric-Mental Health Nurse Practitioner (PMHNP)

This mix of online flexibility and specialization means that you can tailor your education toward specific advanced practice or leadership roles.

What are the Benefits of Getting an MSN?

No one goes back to school simply because they enjoy doing assignments. So, what are the upsides if you decide to go for an MSN after your BSN? Here are the top ones.

Higher Salary Potential

The financial ROI is possibly the biggest driving force. While the salary of registered nurses is pretty decent, an MSN unlocks a whole new level of earning power.

According to the U.S. Bureau of Labor Statistics, advanced practice registered nurses (APRNs), who are typically MSN holders, earn significantly more than traditional registered nurses. In fact, 2024 U.S. BLS data show that most of these professionals earn more than $132,000 per year.

More Career Opportunities

If you’re tired of 12-hour floor shifts or want to move beyond bedside nursing, an MSN degree is your ticket.

Once you earn your MSN degree, you’re one step closer to nursing leadership and administration roles where you oversee entire departments. You could also transition into teaching through an MSN nurse education online program if that’s where your passion lies.

According to Walsh University, this program expands your understanding of clinical procedures, nursing skills, and clinical reasoning, allowing you to positively impact the future of nurse teaching.

Greater Autonomy and Responsibility

As a regular nurse, you know the reality of always having to wait on a physician or someone more senior for every minor order change. 

Earn an MSN, and you can have greater autonomy and clinical responsibility. In many states, as an advanced practice nurse, you can evaluate patients, diagnose illnesses, order tests, and prescribe medications completely on your own.

Strong Job Demand

Demand is another big reason to consider a BSN to MSN program. With a Master’s in Nursing, you are open to a wide range of nursing specializations, including options in education. It’s just a matter of picking an in-demand specialization that matches your passion.

Additionally, the U.S. BLS predicts that nurse practitioner roles will be one of the fastest-growing in the country, with 40% more employment than other occupations. This strong outlook means that with your MSN, your career is essentially future-proof.

The Downsides of BSN to MSN

It will be wrong to paint the picture that doing a BSN to MSN program is without challenges. It has. Here’s what you should look out for:

  • Tuition and Financial Costs: The honest truth is that graduate nursing school is expensive. Even with employer reimbursement programs, many nurses still take on loans. And even though many MSN specialties lead to a dramatic salary increase, it doesn’t happen overnight.
  • Time Commitment: Working while studying is tough. There’s really no soft way to say it. Even if you’re doing the online approach, you still have to balance your shifts, family responsibilities, clinical rotations, exams, and more. Some nurses manage beautifully. Others struggle hard.
  • Increased Stress: MSN comes with increased autonomy and responsibilities. The problem is that some of these roles bring higher stress. You have to deal with difficult decision-making, administrative pressure, legal liabilities, and even burnout risks.

Burnout, in particular, is a really big issue among nurses. The Journal of Emergency Nursing reveals that more than 10% of registered nurses globally have experienced burnout at one time or another.

So, does that mean you shouldn’t consider advanced nursing qualifications? Definitely not. Listing out these challenges helps you prepare for them.

Factors to Consider Before Enrolling in an MSN Program

So, how do you know whether an advanced qualification in nursing is a good idea or not? While the yardstick is different for everyone, before applying, answer the following questions:

  • Do you actually want the daily duties of an MSN role?
  • Can you afford the program?
  • Does your current employer offer any form of tuition support?
  • Will a degree program fit around your current shifts?

Also, if you can, talk to other nurses who have already earned their MSN, especially alumni of the schools you’re considering.

FAQs

Is it better to have a BSN or an MSN?

It depends. If you want to do direct patient care but take on minimal leadership responsibilities, then a BSN is enough. However, if your long-term goals involve advanced specialization and practice, decision-making leadership, or nursing education, then you definitely need an MSN.  

What can you do with an MSN that you can’t do with a BSN?

There are many different things you can do as a nurse with an MSN that you can’t do with just a BSN. The most important is full practice authority. This means that you have the authority to diagnose conditions, interpret the diagnosis, and even begin treatment without waiting for a physician.

Do MSNs get paid more than BSNs?

Absolutely. While a registered nurse with a bachelor’s degree definitely earns a good salary, a nurse with an MSN earns more. The U.S. BLS puts this figure at $132,000+ per year as of 2024.

Key Figures at a Glance

Context Figures
Nurses in the U.S. holding a master’s degree 17%+ as of 2024
Median annual salary for MSN holders $132,000+
Projected job growth of nurse practitioners 40%
Nurses experiencing burnout globally 10%+
Typical MSN program length 1.5 – 3 years

So, is a BSN to MSN Worth It?

For the right nurse, with the right goals? Yes. But BSN to MSN isn’t for every nurse.

Unsure about your long-term direction? Then spend some more time as a registered nurse with a BSN. Once you’re certain of your future, you can then make your move with confidence.

 

References

Robert Rosseter. (2026). Nursing Workforce Fact Sheet. American Association of College of Nursing. Retrieved from the AACN website.

  1. S. Bureau of Labor Statistics. (2025). Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners. Retrieved from the U.S. BLS website.

American Association of Nurse Practitioners (AANP). (2025). Issues at a Glance: Full Practice Authority. Retrieved from the AANP website.

  1. S. Bureau of Labor Statistics. (2025). Fastest Growing Occupations. Retrieved from the U.S. BLS website.

Valdez A. (2024). Journal of Emergency Nursing. Burnout or Exploitation? Resiliency is Not the Solution. Retrieved from jenonline.

 

Author Bio

Agwalogu Bob believes great content doesn’t just inform, it resonates, and then sticks. For over eight years, he’s been helping agencies across four continents craft just that kind of content: sharp, engaging cut-through-the-noise copy across SaaS, finance, tech, health, and lifestyle.

When he’s not putting pen to paper, you’ll likely find him scouring the internet for funny memes.

Connect with him on LinkedIn or Medium.

 

 

Please also review AIHCP’s Health Care Leadership Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Vision and Vestibular Rehab After Concussion Explained

Posted on by Joseph Gerard

Brain Injury word cloud on a white background.Written by Dr. Elias Thorne,

Concussions are incredibly common, and while more is being done to raise awareness about the dangers they pose to long-term health, there’s still much more that the healthcare sector must do to educate people about possible outcomes of head injuries, while also ensuring clinical staff are up to speed with the symptoms and rehabilitation options available to patients already in the system. Symptoms of persistent dizziness and visual issues are especially common in the aftermath of a concussion, although it’s reasonable to claim that such side effects used to be dismissed as minor, resulting in little to no direct treatment. With time and research into concussions, it’s become apparent that recommending a patient sit passively in a dark room simply isn’t sufficient.

The known impact of mild traumatic brain injuries (mTBI) on the overlapping systems governing sight and balance comes from patient self-reporting. Here, the problem is that clinicians have to rely on what they’re told about the symptoms, rather than being able to fire up the CT scanner and use it to pull up unambiguous evidence of the damage that’s been done. The vestibular and ocular systems have a fragile symbiosis that seems easily sent off-kilter by mTBIs, and as we expand our understanding of this relationship and how it can be disrupted, we’re also developing improved frameworks and techniques for rehab.

The top-level goal of visitation and vestibular rehab is to bring these systems back into alignment, essentially righting them after the disruption of a concussion, so it’s not necessarily a swift or linear process. Even so, understanding what’s involved helps elucidate the inner workings of clinical steps and decisions in this context.

The Mechanism of Post-Concussive Sensory Mismatch

The primary purpose of the vestibular system is to give the body a real-time sense of where the head is in three-dimensional space, with a complex configuration of semicircular canals and otolith organs in the inner ear delivering the necessary data for the brain to interpret this status. The interaction with vision occurs in the provision of secondary confirmation of what the vestibular system tells us, which is why confusion can occur in a moving vehicle. If our ears tell us our head is stationary, but our eyes tell us it’s moving rapidly, the result is dizziness and nausea, at least for some people.

Similarly, a concussion intervenes between what our eyes and ears tell us, resulting in a range of symptoms, including a sense that the world is lagging, a little like a video game, or that we’re on unstable ground, perhaps mimicking the feeling of being on a boat. This is often the result of a faulty Vestibulo-Ocular Reflex (VOR), which is the mechanism that keeps your vision stable while your head is moving.

If the VOR is impaired, the brain has to work overtime to make sense of the conflicting data. This leads to the profound cognitive fatigue that characterizes the post-concussive state. It is not just that the eyes are tired; it is that the processor is overheating as it tries to reconcile the mismatched inputs.

Comparing Vestibular Therapy and Clinic-Based Vision Rehab

While they are often grouped together, vestibular therapy and vision rehabilitation target different components of the recovery puzzle. Vestibular therapy focuses on habituation, gaze stabilization, and balance training. It is about teaching the brain to ignore “false” signals and rely on the accurate ones.

Vision rehabilitation, specifically Neuro-Optometric Rehabilitation, addresses the motor aspects of how the eyes move and work together. This includes addressing issues such as Convergence Insufficiency (CI), where the eyes struggle to converge to focus on near objects, and saccadic dysfunction, where the eyes jump and skip during reading.

Clinicians are increasingly using computer-guided protocols to provide high-resolution feedback during these sessions. These tools allow for the precise measurement of reaction times and accuracy that the human eye simply cannot track. You can view this concussion clinic to see how these specialized assessments are integrated into a cohesive recovery plan for patients struggling with these specific deficits.

Research has shown that early office-based vergence and accommodative therapy significantly improves symptoms compared to a “wait and see” approach. The shift toward active intervention within the first two weeks of injury is perhaps the most significant change in concussion management in the last decade.

Computer-Guided Protocols and Evidence-Based Interventions

The digital evolution of rehab has changed the way we quantify progress. In 2026, we are no longer relying solely on a patient saying they “feel better.” We are looking at objective data from force plates and eye-tracking software.

These computer-guided systems provide a level of consistency that manual testing lacks. For instance, a patient might perform a gaze stabilization exercise while a sensor tracks their head velocity. If they can maintain focus at 120 degrees per second but lose it at 150 degrees per second, the clinician has a specific, measurable target for the next session.

Current clinical protocols suggest a specific hierarchy of intervention for maximum efficacy:

  • Address acute BPPV or mechanical inner ear issues first to clear the signal
  • Implement gaze stabilization exercises to reinforce the connection between the inner ear and eye movement
  • Progress to dynamic balance tasks that incorporate cognitive load to simulate real-world environments

This progression ensures the patient is not overwhelmed too early. If you try to do complex vision therapy while the vestibular system is still sending “spinning” signals, you will likely induce a symptom spike that sets the patient back several days.

Clinical Training Pathways For The 2026 Landscape

For healthcare providers looking to bridge the gap into specialized concussion care, the requirements are becoming more rigorous. It is no longer enough to be a generalist physical therapist or optometrist. The complexity of the 2026 patient requires a multidisciplinary understanding of neurology.

Advanced courses now focus heavily on central causes of dizziness and cervical integration, acknowledging that the neck often plays a massive role in “dizzy” presentations. Proprioceptive sensors in the upper cervical spine are frequently damaged in the same whip-lash motion that causes a concussion.

If the neck tells the brain the head is turned five degrees to the left, while the eyes and ears say it is centered, the result is dizziness. Training pathways now emphasize this “Cervicogenic” component, requiring clinicians to be as proficient in manual therapy as they are in vestibular habituation.

Outcome Measures And The Role Of Patient Education

Success in rehab is defined by the patient’s ability to return to their life. While objective metrics are vital for the clinician, the patient cares about whether they can look at a computer screen for an hour without a migraine.

We use the Dizziness Handicap Inventory (DHI) and the Post-Concussion Symptom Scale (PCSS) to track the subjective experience. However, patient education remains the most powerful tool in the shed. When a patient understands that their dizziness is a “data mismatch” rather than permanent brain damage, their anxiety levels drop.

Lower anxiety leads to better autonomic regulation, which in turn speeds up the healing process. It is a virtuous cycle. We must teach patients how to “pace and space” their activities, ensuring they are pushing into their symptoms enough to provoke adaptation, but not so much that they crash.

Multimodal Integration Of Sensory Systems

The most effective treatment plans are rarely monochromatic. They are a blend of physical therapy, neuro-optometry, and, sometimes, occupational therapy for environmental modifications. The goal is to create a controlled, “sensory-rich” environment.

In a 2026 clinical setting, this might look like a patient performing balance tasks on an unstable surface while wearing strobe glasses that limit visual input. This forces the brain to up-weight the vestibular and somatosensory systems. By stripping away one sense, we strengthen the others.

This interprofessional approach ensures that no stone is left unturned. If a patient is plateauing in vestibular rehab, the neuro-optometrist might find a latent vertical heterophoria (a slight vertical misalignment of the eyes) that was sabotaging the balance work all along.

Visual Strain And The Mechanism of Post-Concussive Dizziness

There are over 400 patients seeking specialized neuro-rehab every day because their eyes and ears no longer speak the same language. This sensory mismatch is the primary engine behind the chronic nausea and “spatial anxiety” that keeps high-performing professionals away from their desks. When the vestibulo-ocular reflex is disrupted, the brain cannot differentiate between the world moving and the head moving.

Visual strain in these cases is rarely due to eyesight quality or basic refraction. It is a functional deficit in the brain’s integration of focal and peripheral data streams. If your peripheral vision is “too loud,” every movement in your environment feels like a personal threat to your balance.

Clinical research confirms that 82 percent of post-concussion patients suffer from specific oculomotor issues that cannot be resolved through rest alone. These patients require a deliberate recalibration of the neural pathways that govern gaze stability.

Measuring Success Through Integrated Symptom Tracking

We no longer rely on a patient simply saying they feel better, as subjective reporting is notoriously unreliable during neurological recovery. Modern clinics use force plates and infrared eye-tracking to provide a digital “scorecard” of progress. This allows us to adjust the difficulty of rehab exercises in real time, ensuring the patient is always in the “Goldilocks zone” of neuroplastic change.

Success is defined by the ability to handle increased cognitive and physical loads without a symptom “crash.” By tracking these metrics weekly, we can provide patients with a concrete timeline for their return to life, significantly reducing the psychological burden of the injury.

Precision Medicine In Neurological Recovery

The future of concussion care is moving toward precision medicine. We are getting better at identifying “phenotypes” or clinical trajectories early on. Some patients are primarily “vestibular-ocular,” while others are “autonomic/exertional” or “migraine-associated.”

Identifying these subtypes in the first week allows us to skip the trial-and-error phase. A patient with a clear vestibular-ocular profile should be in specialized rehab by day ten, not month three. The evidence is clear: the longer these systems remain uncalibrated, the more the brain “hard-wires” the maladaptive patterns, making them much harder to break later on.

About The Author

Dr. Elias Thorne is a clinical neurologist specializing in traumatic brain injury and vestibular disorders with over a decade of experience in multidisciplinary rehabilitative settings. He has consulted for professional athletic organizations and currently contributes to the development of integrated sensory-motor protocols for post-concussion recovery. His work focuses on the intersection of neuroplasticity and digital health interventions.

References

Melissa Biscardi, Zane Grossinger, Angela Colantonio, Mark Bayley, Tatyana Mollayeva (2024).  Efficacy of restitutive interventions for oculomotor deficits in adults with mild traumatic brain injury: a systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/38433498/

Traumatic Brain Injury Center of Excellence. (2026). Assessment and Management of Dizziness and Visual Disturbances Following Concussion/Mild Traumatic Brain Injury: Guidance for the Primary Care Manager. https://health.mil/Reference-Center/Publications/2026/02/04/Assessment-and-Management-of-Dizziness-and-Visual-Disturbances-Following-Concussion-Mild-Traumatic-Brain-Injury 

Tara L Alvarez, Mitchell Scheiman, et al (2026). CONCUSS randomised clinical trial of vergence/accommodative therapy for concussion-related symptomatic convergence insufficiency. British Journal of Sports Medicine, Volume 60, Issue 5 https://bjsm.bmj.com/content/60/5/340

 

 

Please also review AIHCP’s Nursing Management Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

3 Key Takeaways from Urban Accident Data for Healthcare Professionals 

Posted on by Joseph Gerard

ER doctors rushing a patient into a hospital roomwritten by Deepika,

All roads deserve equal quality of construction, but that statement is still an idealistic one. Reality bears testament to the unparalleled performance and function of urban roads. In that sense, the United States presents a tough challenge to its counterparts. With over 4 million miles of roadway, the country boasts the world’s largest road network. 

Sadly, such a feat almost gets nullified when one thinks about how unsafe urban roads across the US are. Up until 2015, rural roads were deadlier. From 2016 onwards, urban roads have maintained a notorious reputation for accidents and fatalities. 

Shockingly, pedestrians and cyclists tend to suffer severely, with 20% of all annual fatalities belonging to these categories. For healthcare professionals, these stats carry vital insights into changing injury patterns and community health programs. 

Since public health specialists and nurses encounter the consequences of road collisions almost daily, there’s much to learn from current urban accident data. This article will share three key takeaways that can help strengthen clinical practice and public health efforts. 

 

Initial Assessment May Not Reveal Long-Term Injury Impact 

A significant number of accident-related deaths do not happen on the spot. They do not even occur immediately upon hospitalization, but are a result of neglecting the long-term injury impact. Even if death is not in the picture, many symptoms appear later on. 

One documented case is that of a 21-year-old man involved in a car crash. Initially, no obvious internal injury was detected. However, he returned two days later with abdominal pain and vomiting. Scans revealed free air in the abdomen and fluid in the pelvis. 

Further surgery showed a rupture in the sigmoid mesocolon, causing ischemia and perforation. The patient had to undergo additional surgery, eventually being discharged after 20 days. This case was one of delayed manifestation over 48 hours, but trauma science would categorize it as an early delayed presentation. 

There are injuries that surface weeks or months later, sometimes with serious long-term consequences. For instance, consider Atlanta, Georgia, a US city infamous for dangerous roads and compromised driver safety. In a metropolitan where traffic-related deaths outpace homicides, it’s not uncommon for victims to suffer from injuries that show their full effect in the long run. 

With this downside, there are also insurers to worry about. As the Atlanta Personal Injury Law Firm notes, insurance companies often get the injured individual to sign off on settlements for injuries that prove to be far worse later. By that time, the injured’s life is permanently changed through no fault of their own. 

While legal matters fall outside the scope of clinical care, the reality emphasizes why accurate documentation and conservative discharge planning are essential. Based on urban injury patterns following an accident, healthcare providers should:

  • Document an injury thoroughly rather than initial symptoms 
  • Provide clear written instructions about delayed neurological or musculoskeletal symptoms 
  • Encourage follow-ups even when imaging results are initially negative 
  • Consider close observation in cases that involve high-force impact 

 

The Nature of the Impact Should Guide Clinical Suspicions 

Since not all crashes impact the injured the same way, they seldom produce predictable injury patterns. Take the example of cyclists and pedestrians we mentioned in the intro. Despite making up a smaller percentage of road users, they are the most vulnerable should an accident occur. 

Without any structural protection, these two categories of individuals often sustain impact in a way that predisposes them to serious internal injuries. Different injury mechanisms carry different risks, which is why it’s important to let the type and force of the impact itself frame the diagnostic process. 

A compelling case recorded in 2024 was that of a 66-year-old woman involved in a bicycle collision. She initially displayed signs of a fractured clavicle due to blunt force trauma, with no neurological symptoms. It was only after six weeks of the accident that her progressive pain and weakness were found to be the result of cervical epidural hematoma. 

So we see how a seemingly stable situation turned out to be a potentially life-threatening condition. With delayed complications, there is something far deeper at play with the injury mechanism itself. Even though the injury itself was a clavicle fracture, the mechanism involved cervical force transmission. 

In other words, the blunt force traveled through the neck and along the upper part of the spine. Healthcare professionals cannot afford to let even a localized fracture slide by. Coming back to the two most vulnerable groups, the impact on these does not dissipate through a vehicle frame. 

Not only does it transfer directly to the body, but the head, neck, and spine often absorb the most force. Since mechanism is a risk multiplier, healthcare professionals can take the following actionable steps:

  • Document the entire mechanism in detail, including the direction of impact, whether the patient flew to a distance, and if the head or shoulder was struck. 
  • Educate patients about worsening symptoms, new weaknesses, and numbness or tingling, so they can report them at the earliest. 
  • Schedule reassessments, especially if the impact was high-force and anticoagulation was involved. 
  • Never rely on the most obvious cause or the patient’s immediate complaint. 

 

Oversimplification of Crash Events Is a Real Danger 

In the previous section, we magnified the risks associated with pedestrians and cyclists. That doesn’t mean the victims of car accidents leave unscathed. The real danger for them is that of oversimplification of crash events. 

In many cases, pedestrian and cyclist injuries may be visibly severe depending on the impact. Car occupants may be labeled as ‘minor’ cases, mainly because they’re believed to benefit from seatbelts, airbags, and crumple zones. 

While this may create an impression of containment and safety, it’s often only a distortion of reality. In a 2025 case, a man in his seventies was involved in an auto crash that initially appeared to be minor. In the emergency department, only a small laceration to the forehead was discovered. 

He was discharged after a routine evaluation. When he returned the next day with left-hand paresthesia, the assessments that followed revealed a cervical spine fracture. Again, we see the previous two points at play, but this time, in the case of an auto crash that even seemed minor. 

Modern vehicles are indeed designed to absorb and redistribute impact. However, healthcare professionals must remember that terms like ‘low-speed impact’ or ‘minimal vehicle damage’ are for insurance and police reporting purposes. They can never be reduced to determine a crash victim’s condition. 

For car occupants, the danger is not the crash itself, but in allowing the narrative around it to dictate clinical decisions. Based on what we’ve discussed, here’s what health specialists can do:

  • Without fail, separate the crash narrative from the patient assessment process. 
  • Ask relevant, physics-oriented questions that clarify the use of restraints, sudden deceleration, or airbag deployment. 
  • Resist the assurance that comes from the appearance of the vehicle post-accident. 
  • Be extra cautious in the case of older adults. 
  • Ensure multiple examinations are done over a specified period for maximum assurance. 

Developing neat and convenient crash description phrases may work for insurance adjusters and vehicle repair services. Since medicine deals with physiology, mere paperwork is futile. 

In a nutshell, no accident is ever just a ‘fender bender’ for healthcare. No matter who the victim is or what their immediate state is, healthcare providers are obliged to dig deeper. The data and trends this article has discussed can help you resist shortcuts and take the highway of true clinical assessment. That’s the key to making safer and smarter decisions for desired patient outcomes. 

Author Bio 

Deepika is a budding content creator who enjoys exploring various niches, be it lifestyle or healthcare. With a knack for breaking down complex topics, she strives to make information relatable and accessible to everyone. During her leisure, Deepika enjoys reading novels and practicing fine arts to keep her creativity alive.

 

 

Please also review AIHCP’s Health Care Manager Certification program and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Living With Perimenopause: Practical Support for Changing Body and Emotions

Posted on by Joseph Gerard

Nurse, portrait or laptop with medical student books, research education studying or hospital learning university. Smile, happy or healthcare woman with technology in scholarship medicine internship.Written by Dr. Sci. Jelena Veličković,

Every year millions of women experience perimenopause as a major biological transition; however, this time is often misinterpreted or regarded with low importance by society and healthcare providers. The cyclical change in estrogen and progesterone levels experienced during this time influences almost all of the major systems in the body, such as temperature regulation, cognition, sleep, and mood changes, and some aspects of cardiovascular and lipid metabolism (Santoro, 2016). Perimenopause is even more unpredictable since body changes occur in varying levels of severity from one month to another. This is a natural biological event, but it is not necessarily an easy or insignificant one since it tends to influence daily living for many women. Taking women’s experiences seriously can make the difference between care that helps and care that dismisses what they are going through.

What is Perimenopause?

Perimenopause is the transitional phase leading up to menopause, experienced between the ages of 40 and 50. However, it can begin earlier or later for some women. During the phase, there is more variability in the levels of estrogen, progesterone, FSH, and LH. This is far more unpredictable than the pre-reproductive phases of estrogen or the phases of estrogen that occur after menopause (Talaulikar, 2022).

Menopause is diagnosed retrospectively after 12 months of amenorrhea, whereas perimenopause is a dynamic process that takes longer between four to ten years with more variability in the pattern of menstruation as well as hormone secretion patterns (Harlow et al., 2012). A Staging of Reproductive Aging Workshop (STAW +10) proposes markers for early or late perimenopause through variations of menstruation pattern length or endocrine features, allowing practitioners to classify women for stages of reproductive aging. This is all related to the physical discomfort that women may go through as their ovaries become less active with the onset of perimenopause. These endocrine changes affect thermoregulation, neurotransmitter activity, circadian rhythms, cardiovascular function, and lipid metabolism.

Physical Symptoms of Perimenopause

Even though every woman’s experience is different, some of the physical symptoms occur at such a high rate that they are clearly documented by research studies. This is what causes the differences in the transition of the perimenopausal woman.

1. Vasomotor Symptoms (Hot Flashes and Night Sweats)

They are frequently listed as the most common symptoms of perimenopause. Women can have them in various ways like getting sudden hot sensations, turning red in the face, experiencing heart palpitations, or having a feeling of warmth radiating over the body. Night sweats could also interfere with the woman’s sleep. This could then result in other issues such as fatigue, irritation, or mood swings, which would then impair one’s work performance since one could feel self-conscious in their work or social setting (Thurston, 2018).

2. Irregular Menstrual Cycles

Changes in the menstrual cycle can be an early sign of perimenopause. Some women experience shorter cycles, more menses, or periods of amenorrhea, whereas some women experience longer cycles or spotting. In later stages, breaks between periods grow, often 60 days or more without a bleed. That shift points to shifting estrogen levels from the ovaries, tied closely to what’s called STRAW+10 (Harlow et al., 2012).

3. Interruption of Restorative Sleep

Most women experience disruption to their natural sleeping patterns; during perimenopause, sleep disruptions occur between 50-60% of the time. It has been found that these sleep disturbances may exacerbate anxiety and contribute to increased levels of mood fluctuation. Contributing factors to these sleep disturbances include: hot flashes, night sweats, body rhythm changes, anxiety, and disturbed sleeping patterns (Kravitz & Joffe, 2021). The poor sleep quality associated with these factors increases irritability, difficulty with cognitive function, and stress reaction, and can create additional challenges for women who were already vulnerable to poor quality sleeping patterns before menopause occurred.

4. Musculoskeletal Pain

Muscle and joint issues, like tightness, soreness, or general aches, are often linked to perimenopause today. Studies found about 7 out of 10 women go through this (Lu et al., 2020). Newer findings point to what’s called a “menopause-related musculoskeletal pattern,” involving weaker muscles, thinner bones, plus greater chances of developing joint wear (Wright et al., 2024).

5. Urogenital and Sexual Changes

A drop in the levels of estrogen causes related signs and symptoms that affect the tissues of the vagina, vulva, bladder, or urethra. Some of the signs include dryness, irritation, painful sexual intercourse, or more frequent urination. These signs are related to low levels of estrogen in the area; collectively, they are referred to as the genitourinary syndrome of menopause (GSM). These signs affect sexual health, self-confidence, and daily functioning (The North American Menopause Society, 2020). Some of the signs may also be linked with other gynecologic conditions, such as uterine fibroids, painful or irregular bleeding or pressure in the pelvis.

These somatic complaints indicate real physiological phenomena, as opposed to psychological attribution, which further verifies the need for experience verification of women in such a transition.

Cognitive and Emotional Changes During Perimenopause

The hormonal changes in perimenopause affect memory, mood, and stress responses. These cognitive and emotional changes often come out of the blue and may fluctuate from month to month.

1. Cognitive Fog and Attention Difficulties

Women frequently face “brain fog” symptoms during the peri-menopause phase. These issues can include poor focus or inability to concentrate, difficulty organizing their ideas, and a feeling of having too many simultaneous thoughts; problems with effective communication, notable barrier to completing multiple tasks simultaneously, and inability to easily find or recall appropriate words when talking about something to a third party. Current research indicates that women’s cognitive difficulties during this stage of their lives are due to small disruptions in both attention and short-term memory rather than an actual cognitive disability of the brain (Greendale et al., 2009). Consequently, when women’s cognitive difficulties interfere with appropriate functioning in their daily activities or with the demands of their job, women may develop feelings of anxiety and doubt about their cognitive abilities.

2. Mood Swings

Estradiol influences neurotransmitters such as serotonin, dopamine, and norepinephrine which play a part in how we feel emotionally about ourselves. When estrogen levels fluctuate, mood may fluctuate, which can lead to increased feelings of agitation, depression and anxiousness or intensity of response to external pressure. Also, some women that had previously been able to cope with their emotions may experience rapid changes in their mood that do not coincide with their current situation (Han et al., 2023).

3. Anxiety and Emotional Reactivity

Alteration in the HPA (hypothalamic-pituitary-adrenal) axis may cause worsening of anxiety symptoms by increasing the recognition of agitation, anxiety and emotional reactivity. For example, an increase in these feelings may develop in women that had previously never experienced the feelings of anxiety prior to going through the menopause transition. The likelihood of developing these vulnerabilities can also be exacerbated by both poor sleep quality and the added stress of day-to-day living (Han et al., 2023).

4. Increased Vulnerability to Stress

Life’s hectic years sometimes line up with perimenopause. Many women balance jobs, kids’ needs, helping older relatives, or dealing with personal health stuff. Hormone shifts during this phase can amplify tension – making it tougher to cope, no matter how steady daily pressures stay. Knowing these reactions come from physical changes helps ease guilt. It opens space for gentler, kinder choices when tending to your well-being.

These mood and cognitive shifts are real and biologically based. They demonstrate the importance of support in all contexts – at home, at work, and in healthcare facilities.

How Perimenopause Affects Daily Life and Relationships

Women can face mood swings and exhaustion during perimenopause despite being responsible for work, family, and other obligations. With fluctuating symptoms, simple activities become hard to cope with. While a woman may have phases where she feels competent to deal with her responsibilities, she may experience phases of feeling emotionally or physically overwhelmed, which can influence her self-confidence. Poor sleep and sudden hot flashes can worsen her level of concentration and patience. A study among middle-aged women portrays a picture where women dealing with severe vasomotor symptoms or anxiety often experience greater difficulty with daily activities and social interactions as well as social encounters. At work, some women may become distant or less engaged in activities because she remains uncertain if others will see her as inconsistent in her roles. With her relationships, a woman with perimenopause symptoms can be perceived as impatient or distant emotionally rather than being exhausted because of hormones, which can become a common issue if misunderstood. Research suggests doctors and nurses can help with such relationships by making emotions sound more common, describing symptoms, or admitting reactions to stressful situations. Speaking freely without shame and developing methods to cope with stressful situations can make a huge impact in making coping with symptoms a less complicated situation without disturbing emotions and everyday life skills (Avis et al., 2009).

Barriers to Seeking Support

Even though many of women go through perimenopause signs, plenty wait before getting help. They often link those changes to pressure, getting older, or feeling like they’re not doing enough, instead of seeing them as part of shifting hormones, which means care might come late. Shame about growing older, fear doctors won’t take them seriously, and habits that tell women to tough it out can make things harder to talk about. If someone’s working full-time or looking after others, admitting struggle might feel risky, as if it shows they can’t handle their duties. These hurdles might leave women feeling alone during perimenopause, despite how widespread and medically acknowledged the signs are. More awareness, open conversations, and supportive healthcare can make women feel safe to seek help sooner.

How to Provide Support to Women During Perimenopause

Supporting someone through perimenopause means listening carefully, remaining patient, and exploring how physical changes may correlate with changes in emotional state, relationships or stress levels. Many women who are experiencing this phase of life may also be working and taking care of others or attempting to live up to their own expectations; the combination of these factors increases the likelihood of experiencing greater symptoms. The support provided can be of tremendous value when life becomes overwhelming.

1. Listen Without Minimizing

Women often say they’re brushed off when talking about perimenopause. Comments like “we all go through this” or “that’s just getting older” might downplay real struggles. But paying close attention, repeating what you hear, and treating their feelings as valid builds trust. When people feel heard, it lessens guilt and makes them more likely to share openly.

2. Encourage Symptom Tracking

Tracking symptoms can give a greater sense of control and clarity. Using a symptom diary or a mobile app enables the user to identify potential triggers for these symptoms and track any cyclical patterns associated with them and, consequently, help the user effectively communicate with their doctor about their concerns. The act of tracking symptoms also assists women in becoming more aware of their own bodies and help them collaboratively make decisions together with their healthcare providers.

3. Support Sleep Hygiene

Sleep disruption is one of the most challenging aspects of perimenopause, affecting emotional stability, concentration, and overall functioning. Supportive measures that can improve sleep quality include:

  • maintaining a consistent bedtime and wake time
  • practicing relaxation strategies before bed
  • minimizing caffeine and alcohol in the evening
  • reducing screen exposure before sleep
  • keeping the bedroom cool to offset night sweats
  • choosing breathable fabrics or menopause friendly bedding

Sticking to a regular schedule, cutting back on things that keep you up, or tweaking your bedroom setup often helps. Once rest gets better, lots of women notice sharper focus, feeling more even-keeled, and handling everyday challenges with less struggle.

4. Foster Healthy Lifestyle Habits

Lifestyle changes can ease symptoms and enhance overall well-being. Staying active helps control body temperature, lifts mood, also keeps muscles and joints strong. Practices like yoga or tai chi, along with meditation and slow breathing,  can reduce stress and support better emotional balance. Eating whole foods, drinking enough water, eating at steady times can also help balance energy levels and reduce physical discomfort. Even though daily habits won’t eliminate symptoms completely, studies show that they can bring noticeable improvements for many women (Innes et al., 2010; Nguyen et al., 2020; Khan et al., 2023).

5. Promote Shared Understanding in Relationships

Spouses, kids, or relatives might see mood shifts or low stamina as personal issues instead of signs tied to hormonal changes. Getting loved ones informed about perimenopause can reduce blame, improve communication, and create a more supportive home. Once they understand the hormonal cause they are more like to respond with patience and empathy instead of frustration.

6. Encourage Medical Evaluation When Needed

Even though perimenopause is a natural life stage, certain symptoms require medical evaluation:

  • heavy or prolonged bleeding
  • significant mood changes
  • persistent pain
  • functional impairment

To find out what else might be wrong, a medical professional may perform blood tests, such as checking thyroid, estradiol, FSH, LH, or metabolism.

When to Refer for Clinical Care or Specialized Support

Healthcare professionals should encourage referral when:

  • Symptoms seriously interfere with day-to-day functioning
  • Bleeding patterns point to endometrial pathology
  • Mood symptoms point to depression or anxiety
  • Cognitive changes are severe or progressive
  • Vasomotor symptoms disrupt sleep and quality of life

Evidence-based interventions include menopausal hormone therapy, cognitive-behavioral therapies for menopausal symptoms, non-hormonal medications, lifestyle strategies, and integrative health approaches (The North American Menopause Society, 2023).

Improving Quality of Life for Women Living with Perimenopause

Since hormone fluctuations vary from person to person perimenopause hits each woman differently. Daily routines, stress, and environment also influence how symptoms show up. Understanding what’s happening in the body helps, but noticing changes in focus, mood, or energy is just as important. Support from loved ones works best when it comes from listening rather than assumptions.

This phase is about more than hormones alone. It affects the body, emotions, and mental well-being, shaping daily life and relationships. When guidance is based on reliable information instead of myths, women can manage symptoms more confidently. Feeling heard, respected, and gently supported plays a key role in maintaining quality of life.

Author Bio

Dr. Sci. Jelena Veličković is a molecular biologist and geneticist specializing in medical and forensic genetics. With over ten years of experience in clinical diagnostics and academic research, she has authored peer-reviewed studies in prenatal genetics, thrombophilia, oncogenetics, and molecular biology. Her work spans international research centers and clinical laboratories, where she has advanced molecular diagnostic methods including PCR microbiology, liquid biopsy, and NGS analysis. She is committed to applying evidence-based genetic insights to enhance diagnostic accuracy and support clinical decision-making.

 

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https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1162501/full

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Additional References

Cleveland Clinic. Perimenopause Overview. Access here

Healthline. Perimenopause: Feeling Like “I’m Dying”? Access here

Ohio State University Wexner Medical Center. Why Perimenopause Affects Your Mood. Access here

American Society for Reproductive Medicine. Menopausal Transition: What Is It? Access here

 

 

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