By Doreen Agnese
I have always been a woman of few words. Always a good student who got A’s on exams, but when my classmates were filling blue book after blue book with elaborate prose, I struggled to fill a single one. While many of my colleagues document patient encounters with lengthy notes, my notes are very brief- but I do believe just as thorough. Despite all of that I find myself here composing a blog. So what do I say? What do I discuss? It turns out that June is National Safety Month. It seems to me as though every month should be a safety month, so I think that this is as good a topic to blog about as any other. We are surrounded by the culture of safety at work, but what else should I be thinking about? Just what is a “National Safety Month?”
Google is a useful tool, and it brought me to the National Safety Council website. It probably comes as no surprise that many deaths are preventable. But what is shocking to me is that there are 140,000 preventable deaths in the United States every year. That’s a death every 4 minutes caused by things like car crashes, poisonings, and falls. What can we do to keep each other and our loved ones safe?
Poisoning? I had no idea that this was the leading cause of unintentional injury and death over motor vehicle accidents! I guess it’s not surprising with the current opioid crisis. Every day, 52 people die from opiods. Perhaps I can be more observant of how many Percocets we provide patients after relatively minor, or even major, surgery. On one occasion before leaving for home after breast surgery, my patient requested a prescription for FEWER Percocets, as the resident had written a script for 90! Ninety! After a lumpectomy and sentinel lymph node biopsy! Most of my patients tell me that they have only taken a few Percocets after their surgeries and have adequate pain relief with Tylenol of Ibuprofen. Rather than leave the mundane tasks of providing scripts for post-operative pain relief to the resident, I can do a better job of providing education so making sure that they provide adequate pain relief to patients without and don’t over-prescribing narcotics. That won’t solve the opioid problem, but at least we can have fewer pills circulating out there.
Every day about 100 people die in motor vehicle crashes and more than 1,000 suffer life-changing injuries. Motor vehicle crashes are the #1 cause of death for children and young adults ages 5 to 24, and the #2 cause of death for adults 25 and older and for toddlers, according to the Centers for Disease Control. What steps can I take to prevent car accidents? The first thing that comes to mind is reducing distracted driving. We have to remember that nothing is so important that we need to check our phones while driving. I can avoid it and encourage my friends and family to not text and drive. What else? I can also remember that it’s better to be late to an appointment than to not make it at all. We are always in such a hurry, which may contribute to aggressive driving and road rage. Maybe it’s OK to slow down (OK, honestly one of my partners often ends up driving behind me on the way into the hospital and often makes fun of how slow I am—driving the speed limit. This one won’t be much of a stretch for me!).
OK! Next…falls. Apparently, more than 30,000 people died in falls in 2015. This is the third leading cause of unintentional-injury-related deaths for all age groups, but number one in those 65 and older. I think that I sometimes lose sight of this, since everyone on the entire surgical floor seems to be at high risk of falls! I already do a few things in the clinic to try to prevent falls. We always have a team member to help the patients on/off the exam tables. Hate to hear a crashing sound when I leave the room. What else can I do? I could encourage my patients to practice Tai Chi. Several studies have shown that Tai Chi can significantly decrease the risk of falls in inactive older adults. One study demonstrated that a three-times-per-week, 6-month Tai Chi program was effective in decreasing the number of falls, the risk for falling, and the fear of falling, and improved functional balance and physical performance in physically inactive persons aged 70 years or older (J Gerontol A Biol Sci Med Sci. 2005 Feb;60(2):187-94).
There are so many other causes of preventable deaths to consider: choking and suffocation, drowning, fires and burns, natural and environmental incidents and so many others. I can’t possibly address them all. I can spend some additional time considering how to keep myself, my family and friends, my colleagues and my patients safe. So as a woman of few words, please consider these. Don’t use your phone while driving, be mindful of overprescribing narcotics, and spend a few extra moments figuring out how you can contribute to a culture of safety, this month and every month.
Doreen Agnese, MD is Associate Professor of Clinical Surgery in the Division of Surgical Oncology at The Ohio State University. She was born and raised in New Jersey. She attended Drew University in Madison, NJ, and completed medical school and surgical residency training at Rutgers Medical School in Piscataway/New Brunswick, NJ. Dr. Agnese completed a surgical oncology fellowship and training in clinical cancer genetics at The Ohio State University. Her clinical practices focuses on care of patients with breast cancer and melanoma and those with significant personal or family history of cancer. She cycles in Pelotonia every year to raise money for cancer research.