When you’re driving among heavy traffic, do you ever suddenly find yourself in a right turn-only lane? And you have like 50 feet to get over to the left, or you are forced to turn right? Who in the world thought this design was a good, quality idea? In, like, every state, you can make a right turn even at a traffic light — after stopping. 

But in Florida, where I live, the people think if it’s a right turn-only lane, they can just barrel right through no matter what the traffic is doing because obviously, they are in a right turn-only lane! I truly do not think anyone field-tested this idea.

Speaking of which, we should not even discuss the cutting our own kids’ hair before picture day idea. 

However, the worst “good idea” of them all is the sugar-free gummy bears. 

These not only caused me a near-death experience but forced my family to ostracize me in my OWN home! How could these adorable, colorful innocent-looking candies cause such an acute gastronomical, satanic disaster?

I am somewhat addicted to gummy bears, and I, like half the country, made a New Year’s vow to cut down on sugar. So, imagine my delight when I saw this package of sugar-free ones. Surely, they could do no harm, right? As it turns out, I must have had a hidden desire to do research on dysentery.

I mean, people who have a colonoscopy scheduled would do better to eat these instead of drinking the usual gallon of foul-tasting liquid cleanser we normally consume. I’m talking power washing your colon. Like starting a new health craze called the gummy bear cleanse! 

OK, so about 15 minutes after a handful of this fruity little snack, the cramps start to come, subtly at first. But then, it was as if my intestines were giving birth to Khaleesi’s three fire-breathing dragons. Then the foulest of noxious fumes start issuing from me (hence, my family forcing me out of their presence to isolate in my bedroom). But there was no escape from myself. 

Of course, then the tidal wave starts, and I spend the next day or so wondering why I didn’t buy that padded toilet seat for Christmas. Hey, it’s good to know you can read “War and Peace” in one sitting. Oh, and I added a new meaning to Johnny Cash’s song, “Ring of Fire.” (Thank goodness for wet wipes).

At this point, I am bargaining with God. Make it stop, or let me die. I will add, though, if you know people who get COVID and don’t isolate, give them this “treat,” and they won’t be able to leave the house for days. Forced social distancing!

I mean, like, did they have a focus group before mass producing these things or just think having a sugar-free snack with a ship’s load of maltitol in it was a good idea? Seriously, if they tried it first, they would not have produced it unless they wanted to cause severe pain, suffering and utter humiliation.

The LTC quality angle

… So, what the heck do right turns on red and evil gummy bears have to do with our profession? Well, sometimes we think we have a great idea to implement “quality improvement,” but we don’t go through the whole Quality Assurance and Performance Improvement process or use evidence-based processes. 

For example, instead of going through a QAPI process to get to a root cause related to outcomes you aren’t happy with, you just throw spaghetti at the wall, so to speak. As those who have been in the trenches a long time can tell you, we know that doesn’t work. 

Or you decide to improve your approach to hydration and fluid maintenance, and you “create” a process instead of using a proven, evidence-based clinical process like the one you can easily get and implement from the Society of Post-Acute and Long-Term Care Medicine (AMDA). 

This new year, let’s vow to improve our quality using evidence-based processes, apply for an AHCA/NCAL Quality Award and stay away from right turn-only lanes — and anything with maltitol. Curse you, Haribo!

Just keeping it real,

Nurse Jackie

The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, Senior Director of Clinical Innovation and Education for Mission Health Communities, LLC and an APEX Award of Excellence winner for Blog Writing. Vance is a real-life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.

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