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At the beginning of my career I was more focused on few respiratory conditions and diseases such as Asthma, COPD, Cystic Fibrosis and Acute Respiratory Distress Syndrome.  With more experience, I am more exposed to variety of conditions that directly and indirectly impact the respiratory system.  In my journey I have realized that bronchiectasis is a common condition which I did not pay much attention to as I viewed it a “secondary consequence” or complication.  This condition involves abnormal widening of airways.  In my attempt to better understand this condition, I searched the web; Here is a list of great resources that will help you review this condition:

CHEST: http://hubs.ly/H07C_730

The Lung Association:  https://www.lung.ca/lung-health/lung-disease/bronchiectasis

British Lung Foundation: https://statistics.blf.org.uk/bronchiectasis

European Respiratory Society: http://www.erswhitebook.org/chapters/bronchiectasis/

#PulmonaryFunctionTesting

#RespiratoryTherapist

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On June 14, 2017, CBC’s World News reported that “5 people, including Michigan health chief, charged in Flint water probe”.   The investigation follows the poor quality of water in Flint where more than 100, 000 people were exposed to high levels of lead.

This topic may not be related to respiratory health but does speak to our accountability and actions as individuals with power and influence over other’s health.

Take the time to review:
-CSRT’s Standards of Practice at http://www.csrt.com/standards-of-practice/ and

-CRTO’s Stands of Practice at http://www.crto.on.ca/pdf/Standards_of_Practice.pdf
Resources:

– CBC World Newshttp://www.cbc.ca/news/world/flint-water-health-chief-charged-1.4159883

-CNN-Flint Water Crisis Facts http://www.cnn.com/2016/03/04/us/flint-water-crisis-fast-facts/index.html

 

Farzad ‘Raffi’ Refahi

June 14, 2017

I was given the chance to share my thoughts and views in the Leadership Forum of Canadian Society of Respiratory Therapist in the 2017 annual conference.  I spent few months studying and preparing a list of recommendations to remind managers of ways to improve their workforce (relating to different generations).  In this post however, I will share some advice for employees, staff and students.

As you know, there are several factors that influence the characteristics of individuals such as gender, cultures, politics, race and ethnicity, educational background, age and many other factors.   While individuals are grouped in various categories so they are better understood, each individual is unique.

Check out this quick chart with the list of the recent Generations:

Cohort	Veteran (Traditionalist)	Baby Boomer	Generation X	Generation Y (Millennial)	Generation Z
Age*	74-92	57-75	36-56	17-35	7-21
DOB	1925- 1943	1942-1960	1961-1981	1982-2000	1996-2010
*Age in 2017

Veterans grew up during wartime and scarcity.  In order to survive and be successful, they had to be make calculated decisions, and had to work hard at their job.  Change was associated with risks, which they may have not recovered from.   Thus calculated decision making and royalty was the key to success.  There are few existing biases and negative stereotypes out there which include Veterans being out of touch, Baby Boomers being workaholics, Generation Xers being slackers and Generation Y being demanding and disloyal.     I hope that by explaining the experience and mentality of the individuals from different generations, it would lead to better understanding, empathy, and communication between people.   I like to promote a culture of respects for everyone (regardless of their generation).

Baby Boomers are stereotyped as being workaholics.   Just like Veterans, working hard lead to success!  While Baby Boomers also had to work in a hierarchical structured workplace, they may not fully agree with this Top-Down structure.  They enjoy having more options and more influence in the decision making.

Generation Xers are stereotyped as being Slackers.  This generation cohort grew up taking care of themselves as both their parents were working.  Keep in mind that there was an increase in divorce rates.  It is not surprising that Generation Xers grew up being resourceful and independent.  In addition, this generation was introduced to computers and access to information.  They watched as corporations failed and had to laid-off staff.   With a lack of full trust in institution and organizations, Generation Xers are careful in their relationships with organizations or employers.  Generation Xers are resourceful, calculated, and may not be dedicated to a single employer/organization.  This generation values work-life balance.

Millennials (Gen Y) are stereotyped as demanding and disloyal.  Just like Generation Xers, Millennials are cautious about their relationship with organizations and employers.  Grown up with instant access to computers, technology and information, this generations has higher expectations.  Unlike the experience of Generation Xers, the parents of Millennials provided a lot of options to them, and included their children in more decision making.  Thus, for Millennials and Generation Z, sharing their thoughts has been a normal part of their life.

Generation Z receives similar negative stereotype as Millennials.  Just like Millennials, individuals from Gen Z are educated, enjoy instant access to information and opportunities.

To improve communication and to reduce the chance of perceived disrespect between generations, keep the communication style more formal and proper for older generations.  Younger generation is comfortable with less formal communication and in less formal settings.     Older generations value being heard as they like to pass on their knowledge and wisdom.   Younger generation also enjoy sharing their thoughts and ideas despite having less experience than older generations.

Staff, students and employees need to realize that one size does not fit all, and they need to look at things through different lenses.  Everyone is unique.  Each person deserves a chance to work where they feel respected.

This post is meant to be short, simple, and to serve as a reminder.  If you require additional information or have additional questions, feel free to get in touch with me.

Image credit: http://maxpixel.freegreatpicture.com/Models-Old-Communication-Generations-Phone-1662191

Farzad Raffi Refahi  May 18, 2017

This is the third part to a series of posts, titled ‘Improved’, aimed to assist with development and improvement of Respiratory Therapists and other Healthcare Providers as individuals and as clinicians.

I share recommendations and advice from Mr. Piyush Jadav, a healthcare professional with educational and work experience as a chropodist.  In my conversation with Mr. Jadav, I asked for any recommendations for clinicians who either work 12 hours long day/night shifts/ acute care, and/or to those who work sedentary 9 hours shifts/diagnostic/patient education.

In time for foot health month, this post is released in May.

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Footwear Advice for Clinicians/Hospital Workers

First off, when speaking about footwear; the most important thing is comfort. I have told many patients about what footwear is the best or most appropriate for them. The biggest issue with compliance has to deal with the level of comfort.

When speaking about footwear, at the most basic level there are 3 shapes of “lasts”. A last is the structure on which a shoe is built around.

 

1. Straight last
   1. most appropriate footwear is motion control (high torsional stability,  stiff heel counter)
   2. Most appropriate for patients with over pronation, low arch profile
2. Semi Curved Last
   1. most appropriate footwear is cross-trainer (medium torsional stability, EVA midsole (dual or single))
   2. most appropriate for patients with mild over pronation
3. C- shaped Last
   1. Most appropriate footwear is cushioning/running shoe/minimalist shoe
   2. Most appropriate with patients with high degree of supination, high arch profile

With respect to hospitals, these same examples can be applied. Mesh/net material in shoes is usually not allowed in some departments due to risk of infection and lack of protection. Shoes that are used for long periods of walking in the hospital or clinic setting should not be used to recreational activity. Footwear that is meant for running/exercising are designed to absorb more force due its high demands.

Look for footwear with either Velcro or laces which provide stability to the midfoot as well as the ankles. Slip on shoes provide little to no support and have a shorter lifespan.

The best time to try on shoes is closer to the evening because one’s feet do swell slightly during the day. This will ensure a proper fit.

Also, try to change socks at least once a day. Try to designate a pair of shoes for work only, allowing them to breathe overnight. This will prevent excessive odour and moisture from building into the shoe. Never wear your shoes without socks, this can harbour excessive moisture and may contribute to athlete’s foot.

A typical clinician/hospital worker can be on their feet for 8-12 hours per day. Standing for long periods of time has been linked increased pressure on peripheral blood vessels. In addition, this can lead to varicose veins or “bulging veins”. Some of the first symptoms may include cramping, muscle aches and mild swelling. An inexpensive option to help with this would be to use mild compression (10-15 mmHg) stockings which may help with relieving symptoms, which can be picked up without a prescription from the pharmacy.

Written by:

Piyush Jadav, B.Sc., D.Ch
Registered Chiropodist

Primary site of practice:
Uptown Health Centre
9325 Yonge St Richmond Hill, ON L4C 1V4
(905) 508 -8876

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