Geriatric Case Management – Givens Estates

Givens Estates Presentation

Givens Estates in Asheville, North Carolina is a non-profit retirement community on a large 200+ acre campus that provides a diversity of programs and services.

Karen Sanders, MSN, RN, AHN-BC, HWNC-BC, owner/founder of RN Patient Advocacy NC, PLLC, in Asheville North Carolina was a guest speaker on April 24th, presenting geriatric healthcare topics and patient advocacy services including:

  • Provide consistent follow-up including ongoing communication to support your well-being
  • Attend physician office visits and interpret progress and relevant information
  • Make hospital visits and assists with discharge planning
  • Develop questions for physicians or healthcare providers
  • Interpret test and diagnostic studies
  • Attention to prescriptions and reasons for medications
  • Review medical records when needed

Contact Karen for more information.



nurses let go of stress

Stress Management Strategies for Nurses

Stress… Defined

Stress is caused when the demands placed on an individual exceed the resources he or she has at that time.

What do nurses do in this condition?  

First, let’s review highlights of this presentation.

Causes of Stress

A person’s resources can become drained by demands and pressures at work and at home or a combination of both  (Wright, K. (2014). Alleviating stress in the workplace: Advice for nurses.”  

Nursing Standard. 28 (20), 37).

  • Lack of clear job descriptions

  • Commuting and traffic difficulties

  • Keeping pace with technology

  • Inadequate child care

  • Poor working conditions (lighting, ventilation, noise)

  • Sexual harassment

  • Workplace violence

Consequences of Extreme Stress

Medical errors are the third leading cause of death in the US!  

James, J.T. (2013) A New Evidence-based Estimate of Patient Harms
Associated with Hospital Care. Journal of Patient Safety. September,
Volume 9, Issue 3, p. 122-128.

Strategies for Bringing Yourself into Balance

  1. Create boundaries
  2. Balance work-life
  3. Leverage stress management programs

Coping Strategies


At home and work, communication plays a critical role.  


This term is coined by Deborah Tannin, suggesting that exaggerated conversation styles become intensified under stress, thus adding to miscommunication.


Focused attention with eye contact, asking questions, using empathy, paraphrasing, and summarizing at the end of listening.

Conflict Management

Use “I” message when upset.  Never blame another!

Relaxation Strategies


One of the most effective coping skills available is to provide a profound internal vision and enhance the self-awareness process by journaling.

Social Support Groups

Cope with friends and groups, family members, and others whose company buffers against and dissipates your negative effects of stress.


Reframing is the thought process where a negative perception is substituted for a neutral or positive one, without denying the situation. 

Phoenix Nurses

What is a Phoenix Nurse?

  • A shimmering, radiant, magical bird that lives for several hundred years before bursting into flames and dying
  • Reborn from the ashes and challenges of the past and symbolizes renewal and resurrection

Contact Karen Sanders today for many more tips and suggestions; including tools used by the Phoenix Nurses.


Coming soon: “Becoming an Informed Consumer Advocate When Using the Healthcare System” at OLLI, UNCA, Asheville, NC

I will be teaching this eight week course, “Becoming an Informed Consumer Advocate When Using the Healthcare System” to seniors at the Osher Lifelong Learning Institute (OLLI) at UNCA in March, 2019.  This course will discuss how to advocate for self, family or loved ones in pre-hospitalization settings, hospitals, rehabilitation hospitals, home health agencies, skilled nursing facilities, assisted living, facilities, palliative care and hospice settings. We will identify 50 Golden Eggs of Advocating Wisdom in pre-acute care, acute care and post-acute care settings in finding the care and support you need in navigating the healthcare system.