Q: A common condition that can cause chronic coughing is post-nasal drip. This is when there is increased mucus in your nose or sinuses due to allergies or infections. This mucus drips down the back of your throat and irritates your throat, which causes you to cough reflex.  If you think this may be the cause of your cough, talk to your doctor to get treatment for the allergies or the infection. GERD, also known as acid reflux or hyperacidity, is a chronic case of heartburn where stomach acid flows back into your esophagus. This causes irritation to this area, which can make you have a chronic dry cough. Look for symptoms of GERD, such as a burning sensation in your chest that can spread along your throat, along with your cough.  If you notice these symptoms along with your cough, see your doctor about treating the GERD. This will help reduce your cough as well. Coughing can make your GERD worse, so treat your GERD as soon as you can to help make you feel better. There are a few other conditions that may cause a chronic cough. These conditions have coughing a major symptoms, but typically occur because of other medical conditions. If you fall into any of these categories, call your doctor if you have a persistent cough.These conditions include:  Chronic bronchitis, an inflammation of the bronchi which are the airways of the lungs, caused by irritants, smoke, cold air, pollution, and fumes. Congestive heart failure (CHF) caused by underlying heart problems that produces a dry, deep, persistent cough due to fluid in the lungs. People with this condition also frequently cough up mucous or sputum. The inhalation of a foreign object or chemical.  Asthma causes a chronic cough indicating that you need use an inhaler or nebulizer treatment. There are some infections that cause chronic coughing including Tuberculosis, pneumonia, whooping cough, and bronchitis. Please see your physician as soon as possible if you suspect any of these. If you are a smoker, then you may develop a cough as a result of smoking. This is a chronic condition that would need to be evaluated by your physician if the character of the cough changes. Try to quit smoking if you are a smoker. If you experience a less severe cough or have less severe cough symptoms than those described, you may be able to treat your cough at home before you call your doctor. These home remedies help treat underlying causes of coughs, such as colds or common respiratory disorders, as long as you don't have any serious symptoms. However, if these home remedies do not work after five to seven days, you should see your doctor immediately. Common home remedies include:   Rest Drinking lots of fluids, preferably water Over-the-counter (OTC) medications, such as pain relievers, cough suppressants, decongestants, expectorants, and antihistamines
A: Recognize post-nasal drip. Notice a cough caused by gastroesophageal reflux disease (GERD). Check for other conditions that cause chronic coughs. Watch for smoker's cough. Consider home remedies.

Q: Patients are less likely to act out if they feel you are truly listening. In some cases, the patient’s concerns may sound irrational or be a reflection of their symptoms. For example, they may be having a delusion. Even if this is the case, listen to what they have to say.  Show the patient that you are listening by nodding and giving affirmative responses. Summarize what they are saying to you, so that they know you understand them correctly. Avoid dismissing their concerns or discounting their experience. Wherever possible, try to address and solve their concerns. It’s important that the patient knows you care about how they feel. Not only will your empathy help them work through the situation, it also helps you keep them calm. You could say, “That sounds really stressful,” or “I can understand why you’re so upset.” Sometimes a patient will resist complying with treatment or the rules of the facility. When this happens, acknowledging their feelings and giving them options can help guide them toward your desired outcome. Options allow the patient to feel that they have some control in the situation. You could say, “It sounds like you don’t want to go to group today. It’s important for your treatment plan that you participate. If you don’t want to go to this session, you can go to the afternoon session or I can schedule you a private session to discuss your treatment plan.” It’s easier to treat the patient if you understand their personality and adapt your treatment to it. That is because how each patient accepts and approaches treatment differs. There are four different personality traits that can affect how the person approaches treatment:  Dependent: A person that feels dependent on others will expect help and possibly even a full recovery. They will often be compliant, but may not take action on their own. Histrionic: A person who has a histrionic personality may be more dramatic in how they present themselves. They may exaggerate their symptoms to seek attention. Antisocial: These patients may resist treatment and display disdain for their medical team. Paranoid: Paranoid patients may resist treatment because they don’t trust the doctor or doubt what they’re being told. Lying may appear like a good option when a patient refuses to comply, but it will make things worse in the long-run. Examples include hiding medication in the patient’s food, promising not to restrain them and then doing it, or promising a reward but not delivering. This will cause the patient to distrust you and resist you more strongly in the future. If the patient’s treatment plan suggests following along with a delusion they’re having, you should lie when appropriate to avoid questioning the delusion. Unfortunately, biases exist against psychiatric patients, especially those who harm themselves. This can prevent the patients from getting the care they need to recover from their conditions. In some cases, patients are discharged earlier than they should be because of negative perceptions on the part of staff. Good records are essential to providing excellent care. Each care giver should document the patient’s diagnosis, treatment, and related information, such as recurrence of symptoms. This ensures that the patient’s treatment team knows their full medical history, so that tailored care can be provided. Additionally, good documentation protects you and other staff in the event of a malpractice claim. In some cases, you may not be able to involve relatives because of HIPPA laws. However, whenever possible, invite relatives to participate in the patient’s treatment. This will improve the patient’s outcome, especially after they go home.  Invite them to a special family therapy session. If allowed, show them the patient’s treatment plan.
A: Listen to the patient’s concerns. Respond to the patient with empathy. Give the patient options. Adjust your treatment to fit the patient’s personality. Never lie to the patient to gain compliance. Treat psychiatric patients as well as you would any other patient. Keep detailed documentation. Involve the patient’s relatives in their treatment when possible.

Q: Despite the stereotypes and common misconceptions, there are no real meaningful differences among generations in the workplace. In fact, Millennials have many of the same career goals than any other generation. Many people have the notion that Millennials jump from job to job more quickly than the average worker. While Millennial’s aren’t as stagnant in their jobs as Boomers, the fact is that Millennials usually tend to stay longer at one job than their Gen-X counterparts. Remember that no generation can be summed up by blanket statements. Just because you meet a lazy or ineffective worker that is of Millennial age doesn’t mean that all Millennials are like that one person. Keep an open mind and remember that, when it comes down to it, Millennials are basically the same as you!
A: Recognize that many stereotypes about Millennials are untrue. Debunk the belief that Millennials job hop at an abnormal rate. Help fight against harmful Millennial stereotypes.

Q: Put it into a medium-sized bowl. Set it aside while you prepare your pasta.
A:
Place the avocado, garlic, lime juice, cilantro, salt, and pepper into a food processor or blender. Process the ingredients until smooth and creamy. Scrape the sauce out of the blender or food processor with a spatula. Cover the bowl with plastic wrap to prevent the avocado from turning brown too quickly.