Wednesday, December 31, 2008

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Monday, December 29, 2008

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Friday, December 26, 2008

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Tuesday, December 23, 2008

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Saturday, December 20, 2008

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Friday, December 19, 2008

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Thursday, December 18, 2008

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Wednesday, December 17, 2008

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Tuesday, December 16, 2008

12/16 NPworld.us Nurse Practitioner Jobs









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Monday, December 15, 2008

Happy Holidays!

IF YOU SEE A FAT MAN ...


Who's jolly and cute,
Wearing a beard and
a red flannel suit,
And if he is chuckling
and laughing away,
While flying around
in a miniature sleigh,
With eight tiny reindeer
to pull him along,

Then let's face it...

Your eggnog's too strong!




Merry Christmas and
a Happy 2OO9









.

Saturday, December 13, 2008

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Friday, December 12, 2008

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Thursday, December 11, 2008

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Wednesday, December 10, 2008

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Tuesday, December 9, 2008

Register Nurse Job in ORYX Gas To Liquids Ltd - Qatar

Oryx recognized as leading the world GTL (Gas To Liquids) industry from Qatar. Oryx GTL is a newly formed Joint Venture between Qatar Petroleum and Sasol (South African Company). Recently they open job vacancy for BSN Nurse to fill the Occupational Health Nursing in their company.

Job description :

Supports the company in business activities related to Health and Safety. Provides leadership to ensure safe operation of Oryx Gas-To-Liquid Plant. The Nurse will do their job in order to the developed and implementation of Health and Safety management systems (OHSHAS 18000 standard). Provide thought leadership on the safety strategy for the Company, Assist in the development and implementation of appropriate Emergency Response Plans.

The Nurse also should be able to review contracts for safety requirements, evaluate bids, monitor contractors for performance and make recommendations for improvement. Prepare regular reports on the status of the program, analyzes trends, and make recommendations for improvement.

Education/Qualification:
  • BSN from an accredited School of Nursing.
  • Current RN Licensure in country of origin, BLS Certification
  • Post Graduate qualification in Occupational Health Nursing
  • Excellent English written and verbal skills; very good computer skills for Microsoft word, excel, power point, etc

Experience requirement :
  • 5 years recent experience as a Register Nurse (RN)
  • Previous Management/Supervisory experience
  • Must have at least 4 years as an Occupational Health practitioner in an industrial plant environment
  • CPR Training; ILS/BLS (Basic Life Support)

In order to get professional and expert Nurse, the company looking for candidate (Health and Hygiene specialist) who able to perform skills how to solve problems of intermediate complexity with some advanced knowledge and some degree of evaluative judgment.

The Nurses will work in full time shift, benefit from monthly attractive salary, housing and yearly leave with full accommodation.

If you interest with Nurse job vacancy in this company, Send your CV to this e-Mail address : info@oryxgtl.com. Only those candidate match the requirement will contact soon by this company.

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Saturday, December 6, 2008

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Wednesday, December 3, 2008

Research Abstract with Commentary

Authors’ Abstract

The use of "as needed" or "pro re nata" (PRN) range opioid analgesic orders is a common clinical practice in the management of acute pain, designed to provide flexibility in dosing to meet an individual's unique needs. Range orders enable necessary adjustments in doses based on individual response to treatment. However, PRN range opioid orders have recently come under scrutiny as a source of confusion and as a medication management safety issue. How nurses administer range orders may vary based on their interpretation of the intent of an order, inadequate knowledge of analgesic titration, or exaggerated concerns about opioid safety.

The purpose of this study was to investigate nurses' opinions of the appropriate implementation of range orders. Six hundred two nurses from one large academic medical center and one multihospital system completed an online survey using theoretic clinical vignettes to examine their opinions of appropriate analgesic administration practices.

The majority of participants chose appropriate responses to the vignettes; however, there was a great deal of variability in responses. Those who had attended pain management courses were more likely to have a higher percentage of appropriate responses than those who had not attended courses. Years in practice and educational level were not significantly related to percentage of appropriate responses; however, there was a trend for nurses with a master's degree to have a higher percentage than nurses with other educational preparation. Consideration of opioid pharmacokinetics can provide logic to develop a new paradigm where range orders are replaced with orders that provide more explicit instructions to titrate an opioid to the most effective dose.

Gordon, D. B., Pellino, T. A., Higgins, G. A., Pasero, C., & Murphy-Ende, K. (2008). Nurses' opinions on appropriate administration of PRN range opioid analgesic orders for acute pain. Pain Management Nursing, 9, 131-140.


Commentary by Dana N. Rutledge, RN, PhD, Nursing Research Facilitator, & Mary Welly, RN, BSN, Clinical Educator

This fascinating article documents the difficulty that nurses face in administering PRN opioid pain medications ordered using dose ranges. In the literature review, authors delineate a brief history of safety initiatives that have led to the need to understand dose range administration issues. Changes in The Joint Commission expectations in the past decade have changed ordering habits of physicians, but have not necessarily clarified best practice for nurses.

The clinical problem addressed stems from nurse confusion with PRN range orders in terms of (a) which dose to administer within the range and (b) the total time interval during which the maximum dose can be administered. The study aim was to document nurse opinions of correct practice given 4 specific patient scenarios developed by the authors. The authors note that the “correct” answers (that they determined) are not absolute. In fact, due to disagreement among the researchers, they did not score responses to one of the scenarios. Correctness was based upon drug pharmacokinetics, patient assessment parameters, side and adverse effects and their interpretation, and administration issues.

Nurses surveyed came from several hospitals in the mid-Atlantic and Midwestern US. Response rates were 36% of nurses emailed a participation invitation, 11% of nurses who saw a posted invitation. These rates are typical of nurse response rates to similar surveys. When interpreting results, however, one must think about the nurses who chose NOT to respond, and how the non-respondents may be different from respondents. Survey respondents were similar to St. Joseph nurses by education (67% BS or higher; 57% of SJH nurses have a BS or higher based upon 2007 NDNQI data). Respondents were experienced (47% had been in nursing 16 years or greater, and primarily worked medical/surgical or intensive care (69%).

The discussion of results delineates options selected by nurses according to the authors’ determination of “correctness.” A key concept was titration, which is determination of “effective dose by giving graduated increases or decreases in the amount of the drug” (p. 138). Titration of oral drugs is similar to that of intravenous drug titration that may be more familiar to nurses. The authors note that accurate and safe titration may require a more lengthy order set or use of pre-established protocols than is normally used in hospitals.

Implications from the results indicate that a substantial portion of nurses (1/3 to ½) would under medicate or delay medicating patients in pain using PRN range dosing even where a patient exhibited no side effects. Another issue pointed out was that 43% of nurses did not cite sedation as one of three factors to consider when selecting opioid dose, perhaps indicating lack of appreciation of the importance of sedation assessment.

Of interest was the finding that 21% of nurses would give a dose less than what was ordered without calling a physician first. This finding was documented in numerous earlier studies as well, particularly with opioids. It certainly merits discussion among nurses in terms of what this means for nurse/physician communication and for pain management. Authors conclude that “flexibility in dosing made possible by a range order does not include adjusting the dose limits of the order” (p.139).

Do nurses at St. Joseph have a policy or protocol in place to direct practice for PRN opioid range dosing? If so, how many are aware of it? How many practice using it? Are there practice situations that are unclear as to “best” practice? We would urge further discussion by nurses at St. Joseph on your units as to these issues.

NOTE: Policy RX-475 Medication Ordering Procedures (approved 01/08) notes that “medication orders should NOT be written with dosage ranges” unless the order titrates to specific outcomes or doses matched to specific clinical parameters are allowed (such as the scenarios in the Gordon et al. study). Interpretation of dose and frequency ranges in this policy are in section II.C. 2. a. and 3.

A consensus statement about PRN medications is available from the American Society for Pain Management Nursing and the American Pain Society at Gordon et al. (2004). The use of “as-needed” range orders for opioid analgesics in the management of acute pain. Pain Management Nursing, 5, 53-58.

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Tuesday, November 18, 2008

Tips and tricks for searching CINAHL on EBSCO

Burlew Medical library users-- did you know that there are over 130 one hour CE modules on CINAHL via EBSCO? In order to see the full list, just click on the CE MODULE in the lower left hand section of the CINAHL search page and then hit search. According to CINAHL " Each CEU module consists of course material, an interactive review and a competency test with a certificate of completion. As of April 2006, CINAHL education has received International Association for Continuing Education and Training (IACET) accreditation. The American Nurses Association accepts IACET accredited continuing education.

Depending on the course, it can take from one to several hours to complete a CE course. A course must be completed in a single session. You cannot save a partially-completed course and return to it at a later time." I am told that at St. Joseph Hospital in Orange, you would be required to keep your own paperwork regarding these CE's rather than sending the paperwork to Clinical Education. You will also need to do a quick free registration with CINAHL in order to obtain the CE. The topics available range from post traumatic stress disorder to pregnancy in adolescents: fathers. Check it out!!

Tips and Tricks for using CINAHL on EBSCO: ask a librarian




Lbrary users at Saint Joseph Hospital in Orange and Children's Hospital of Orange County-- did you know that you can send the search strategy you used to search CINAHL on EBSCO to the staff of Burlew Medical Library for review? We will receive your questions about searching CINAHL or your search strategy for review by email. Within a short time, we'll either get back to you with a. suggestions as to how to improve your search b. re-do your search for you c. answers to your search questions.

It's very easy to use this "Ask a Librarian" feature. While in CINAHL on EBSCO, simply click on the "Ask a Librarian" icon in the upper right hand corner of your search page. The form that you see here appears. Enter your name, your email and your question. By default, your lit search strategy will be included so that we can review it. It's that simple!!









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Monday, November 17, 2008

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Friday, November 14, 2008

Hilarious Email about Discharging a Patient

Read this hilarious email that was sent to me today:

Hospital regulations require a wheelchair for patients being discharged. However, while working as a student nurse, I found an elderly gentleman already dressed and sitting on the bed with a suitcase at his feet---who insisted he didn't need my help to leave the hospital. After a chat about rules being rules, he reluctantly let me wheel him to the elevator. On the way down, I asked if his wife was meeting him. "I don't know," he said. "She's still upstairs in the bathroom changing out of her hospital gown."

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Thursday, November 13, 2008

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Tuesday, November 11, 2008

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Nurses Job in Al Salama Hospital - Abu Dhabi

Al Salama Hospital is located in the Arabian Gulf in the beautiful city of Abu Dhabi, capital of the United Arab Emirates. The hospital also provides 24 hours Medical Services at the highest standards. Both inpatient and outpatient treatment is of an international standard and is backed by the latest radiology and laboratory facilities.

The General Practitioners in the Outpatient Department are available, day and night, 7 days a week; a 24-hour emergency service operates with a Consultant in each specialty on-call.

To provide to the people in UAE, quality, cost effective health services with care and compassion such that the hospital recently held recruitment for the nurses and others position bellow:
  1. Bio medical engineer
  2. Cardiologist
  3. Dermatologist
  4. Pediatrician consultant
  5. Embryologist
  6. Gyn. and Obs. Specialist "Female"
  7. General practical "Female"
  8. General Practical "Male"
  9. Nurse "Male"
  10. Pathologist "Male"
  11. Admin Assistant
  12. Accountant "Male"
  13. Driver

If you interest to the job vacancies above, You can submit your application in this form : Job Application.

For more details you can contact :
P.O Box: 46266 - UAE - Abu Dhabi
Tel: 02-6711220 (line12)
Fax: 02-6711330
E-mail: alsalama@emirates.net.ae.

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Monday, November 10, 2008

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Saturday, November 8, 2008

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Friday, November 7, 2008

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Thursday, November 6, 2008

3 more nursing research articles from St. Joseph Hospital in Orange, California

Efforts led by Dana Rutledge, RN, PhD, Nursing Research Facilitator and the Nursing Research Council at St. Joseph Hospital in Orange, California are reaping rewards. Three recent articles published by nursing staff at St. Joseph Hospital are :

1. Holist Nurs Pract. 2008 Nov-Dec;22(6):324-35.Uncovering and recognizing nurse caring from clinical narratives.

Norman V, Rutledge DN, Keefer-Lynch AM, Albeg G.St Joseph Hospital, Orange, California 92868, USA. Vivian.Norman@stjoe.org

In an exploratory descriptive study using nurse-written clinical narratives,dimensions of Watson's Theory of Caring are reflected in nurses' descriptions of specific clinical events or situations, and narratives of nurses who are lessexperienced differ in terms of the caring dimensions than do those of moreexperienced nurses.

2. MEDSURG Nursing 2008 Oct;17(5):312-316. Medical Emergency team Implementation: experiences of a mentor hospital.

Jamieson Eleanor, Ferrell Carmen, Rutledge Dana N. St. Joseph Hospital, Orange, California 92868, USA. Eleanor.Jamieson@stjoe.org

Rapid response teams (RRTs) provide assessment and early intervention for patients not in critical care.The implementation of RRT using an evidence-based practice framework, which led to decreased resuscitations, critical care transfers, overall mortality, and cost, is described.

3. Journal of Emergency Nursing 2008 article in press. Guesting area: an alternative for boarding mental health patients seen in emergency departments.

Winokur Elizabeth J, Senteno, John M. St. Joseph Hospital, Orange, California 92868, USA. Beth.Winkour@stjoe.org

SJH/CHOC staff may access all of the above articles full text by calling the medical library at 714 771-8291 or via our website http://www.burlewmedicallibrary.org/

Congrats all!!


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Wednesday, November 5, 2008

History was made


What a night! Fantastic! I am not American, but do follow politics to a certain extent and was very pleased when Barack Obama was elected the 44th president of the United States of America!

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Tuesday, November 4, 2008

OIIQ Exam Results...

Results are in, and while not quite the same hype as the USA election, the excitement is right up there!

I... PASSED! I am now officially an RN!

Thank you to all my friends/supporters/classmates/teachers!

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Monday, November 3, 2008





Our very own Victoria Morrison, MSN, FNP, RN and Dana Rutledge, PhD, RN have written a nice article which talks about our exploration into evidence based nursing practice at St. Joseph Hospital in Orange, California as well as this blog. The article appears in the Oct 27, 2008 edition of Advance for Nurses and can be viewed here. Thanks for the recognition!!

Saturday, November 1, 2008

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Happy Halloween!

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Saturday, October 25, 2008

10/25 NPworld.us Karen 'n bill

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Friday, October 24, 2008

Julie's picks from the Nursing Literature Sept 2008



1. Carter-Templeton H. McCoy T. Are we on the same page?: a comparison of intramuscular injection explanations in nursing fundamental texts. MEDSURG Nursing. 2008 Aug; 17(4): 237-40. (23 ref) Burlew carries this journal

2. Steis MR. Fick DM. Are nurses recognizing delirium? A systematic review. Journal of Gerontological Nursing. 2008 Sep; 34(9): 40-8. (41 ref) Burlew carries this journal AN: 2010019926.

3. Howland L. Sullivan-Bolyai S. Bova C. Klar R. Harper D. Schilling L. The research advisory committee: an effective forum for developing a research dynamic environment. Journal of Professional Nursing. 2008 Jul-Aug; 24(4): 241-5. (7 ref) Burlew carries this journal AN: 2010002211 NLM Unique Identifier: 18662660.

4. Aagaard H. Hall EO. Mothers' experiences of having a preterm infant in the neonatal care unit: a meta-synthesis. Journal of Pediatric Nursing: Nursing Care of Children and Families. 2008 Jun; 23(3): e26-36. Burlew carries this journal AN: 2009945721 NLM Unique Identifier: 18492543.

5. Milton D. Pipe TB. Hatler C. Brewer BB. LaMar K. Clark C. Estrada N. Clarifying the role of director of nursing research in clinical settings: expectations and challenges. Nurse Leader. 2008 Aug; 6(4): 29-33. (1 ref) AN: 2010001937.

6. Ehrlich-Jones L. O'Dwyer L. Stevens K. Deutsch A. Searching the literature for evidence. Rehabilitation Nursing. 2008 Jul-Aug; 33(4): 163-9. (13 ref) Burlew carries this journal AN: 2009964891 NLM Unique Identifier: 18686909.

7. Schnautz LS. Rowley D. Hypothermic coma: catapulting evidence-based research into everyday practice. Critical Care Nursing Clinics of North America. 2008 Sep; 20(3): 321-6. (9 ref) Burlew carries this journal AN: 2009997531 NLM Unique Identifier: 18644516.

8. Reavy K. Tavernier S. Nurses reclaiming ownership of their practice: implementation of an evidence-based practice model and process. Journal of Continuing Education in Nursing. 2008 Apr; 39(4): 166-72. (17 ref) Burlew carries this journal AN: 2009897763 NLM Unique Identifier: 18429370.

9. Giuliano KK. Polanowicz M. Interpretation and use of statistics in nursing research. AACN Advanced Critical Care. 2008 Apr-Jun; 19(2): 211-22. (13 ref) Burlew carries this journal AN: 2009918227.

10. Ridley RT. The relationship between nurse education level and patient safety: an integrative review. Journal of Nursing Education. 2008 Apr; 47(4): 149-56. (35 ref) Burlew has some online access, no print issues. AN: 2009885996 NLM Unique Identifier: 18468291.

11. Carlson CL. Plonczynski DJ. Has the BARRIERS Scale changed nursing practice? An integrative review. Journal of Advanced Nursing. 2008 Aug; 63(4): 322-33. (66 ref) Burlew has some years. AN: 2009985207 NLM Unique Identifier: 18727758.

12. Ritchey T. Stichler JF. Determining the optimal number of patient rooms for an acute care unit. Journal of Nursing Administration. 2008 Jun; 38(6): 262-6. (10 ref) Burlew carries this journal AN: 2009956418 NLM Unique Identifier: 18562828.

13. Taylor S. Allen D. Visions of evidence-based nursing practice. Nurse Researcher. 2007; 15(1): 78-83. (13 ref) Burlew has some online access, no print issues. AN: 2009700404.

14. Happell B. Conference presentations: developing nursing knowledge by disseminating research findings. Nurse Researcher. 2007; 15(1): 70-7. (44 ref) Burlew has some online access, no print issues. AN: 2009700403.

15. Clancy K. Experiences of a novice researcher. Nurse Researcher. 2007; 14(4): 27-38. (28 ref) Burlew has some online access, no print issues. AN: 2009636063 NLM Unique Identifier: 17702141

16. Singleton J. Levin R. Educational innovations. Strategies for learning evidence-based practice: critically appraising clinical practice guidelines. Journal of Nursing Education. 2008 Aug; 47(8): 380-3. (14 ref) Burlew has some online access, no print issues. AN: 2009993343.

17. Chesla CA. Translational research: essential contributions from interpretive nursing science. Research in Nursing & Health. 2008 Aug; 31(4): 381-90. (54 ref) AN: 2009978376 NLM Unique Identifier: 18231973.

18. Scott SD. Pollock C. The role of nursing unit culture in shaping research utilization behaviors. Research in Nursing & Health. 2008 Aug; 31(4): 298-309. (59 ref) AN: 2009978375 NLM Unique Identifier: 18231975.

19. Tod AM. Bond B. Leonard N. Gilsenan IJ. Palfreyman S. Exploring the contribution of the clinical librarian to facilitating evidence-based nursing. Journal of Clinical Nursing. 2007 Apr; 16(4): 621-9. (37 ref) Burlew has some online access, no print issues. AN: 2009560203 NLM Unique Identifier: 17402942.

TGIF 10/24 NPworld.us Karen 'n bill

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Thursday, October 23, 2008

10/23 NP Hot Jobs NPworld.us Karen 'n bill

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Wednesday, October 22, 2008

One of these things is not like the others...

: 2008 NP Posters Are Here NP Jobs 10/22 NPworld.us Karen 'n bill

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2008 NP Posters Are Here NP Jobs 10/22 NPworld.us Karen 'n bill

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Tuesday, October 21, 2008

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Monday, October 20, 2008

CASP: Critical Appraisal Skills Programme

Do you know about CASP? I just learned about these very useful tools developed by the Public Health Resource Unit at NHS. They provide you with a list of questions to ask when appraising various research study formats. For instance, there is a list of 10 detailed questions to ask when evaluating a randomized cointrol trial. Many of the questions were adapted from Guyett GH, Sackett DL and Cook DJ. Users' guides to the medical literature.II. How to use an article about therapy or prevention. JAMA 1993;270(21):2598-2601 and JAMA 1994;271(1):59-63.

This so simplifies the analysis process!!



Saturday, October 18, 2008

Congrats Irene & Chad & WELCOME Justin!

My friend Irene, who I used to figure skate with had a baby boy one month earlier than expected. Both Mom and Baby are fine and home and Justin is growing and is absolutely too cute for words! I cannot wait to finally meet him (they live in the USA). Here are a few pic of him.



10/18 NPworld.us Karen 'n bill

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Friday, October 17, 2008

10/17 NPworld.us Karen 'n bill

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Thursday, October 16, 2008

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Wednesday, October 15, 2008

10/15 NPworld.us Nurse Practitioner Jobs









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Tuesday, October 14, 2008

Tuesday 10/14 NPworld.us Karen 'n bill

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Monday, October 13, 2008

Happy Turkey Day

Some more funnies!

Five Minutes

A hospital posted a notice in the nurse's lounge saying: "Remember, the first five minutes of a human being's life are the most dangerous." Underneath, a nurse had written: "The last five are pretty risky, too."
----------------------------------------------------------------------------------------

On a busy Med/Surg floor the doctor stops the nurse to brief her on a patient's condition. "This patient is a fellow physician and my favorite golf partner. His injury is serious and I fear he will not be able to play golf again unless you follow my orders exactly." The doctor then began listing orders:
"You must give an injection in a different location every twenty minutes followed by a second injection exactly five minutes after the first. He must take two pills at exactly every hour followed by one pill every fifteen minutes for eight hours. He must drink no more and no less than ten ounces of water every twenty-five minutes and must void between. Soak his arm in warm water for fifteen minutes then place ice for ten minutes and repeat over and over for the rest of the day. Give range of motion every thirty minutes. He requires a back rub and foot rub every hour. Feed him something tasty every hour. Be cheerful and do whatever he asks at all times. Chart his condition and vital signs every twenty minutes. You must do these things exactly as I ordered or his injury will not heal properly, and he will not able to play golf well."

The nurse left the doctor and entered the patient's room. She was greeted by anxious family and an equally anxious patient. All asked the nurse what the doctor had said about the patient. The nurse started, "The doctor said that you will live." Then quickly reviewing the orders, the nurse added, "But you will have to learn a new sport."
-----------------------------------------------------------------------------------------

A nurse dies and goes to heaven. She is met at the Pearly Gates by St. Peter who asks her questions about her life. Over St. Peter's shoulder the nurse spots a man in a white coat sitting on a cloud with a stethoscope around his neck.
"Oh brother!", she cries. "Is that a doctor?"
St Peter glances over his shoulder and says, "No, that's God. He just thinks he's a doctor."

Saturday, October 11, 2008

10/11 NPworld.us Karen 'n bill

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Friday, October 10, 2008

Oct 10th NP hot jobs NPworld.us Karen 'n bill

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Thursday, October 9, 2008

10/09 NPworld.us Karen 'n bill

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Wednesday, October 8, 2008

Due to school dealines
and other obligations
Haiku Nurse will not be posting
until late November

thanks!

Tuesday, October 7, 2008

10/07 NPworld.us Karen 'n bill

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Monday, October 6, 2008

rain and rain and rain
the patio roof should hold
but one drip gets through

10/06 NPworld.us Karen 'n bill

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Sunday, October 5, 2008

do you serve refills
I should like some more soda
and another life

Saturday, October 4, 2008

10/04 NPworld.us Karen 'n bill

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an awkward distance
how you show me your jacket
but not how you are

Friday, October 3, 2008

10/03 NPworld.us Karen 'n bill

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i thought i was poor
wallet full of coins and cards
Cerulean blue sky

Thursday, October 2, 2008

10/02 NPworld.us Karen 'n bill

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our neighbor stops by.
what ever made you want birds?
he asks. my love says, free eggs.

Wednesday, October 1, 2008

his hair is bound back
a frayed, brown, greasy ringlet
two teeth stained yellow

Wed Oct 1st NPworld.us Karen 'n bill

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Tuesday, September 30, 2008

when the sun drops dark
the chickens all make a fuss
not wanting to sleep

9/30 NPworld.us Karen 'n bill

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Monday, September 29, 2008

9/29 NP job on NPworld.us Karen 'n bill

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tiny ripe apple
pinot noir red and the size
of a baby's foot

Sunday, September 28, 2008

plate with wax paper
reheated slice of pizza
cold pint of amber

Saturday, September 27, 2008

monkey in zoo cage
too-long finger curved to nose
sitting on concrete

9/27 NPworld.us Karen 'n bill

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Friday, September 26, 2008

On a Lighter Note...

Two nuns, Sister Catherine and Sister Helen, are traveling through Europe in their car. They get to Transylvania an are stopped at a traffic light. Suddenly, out of nowhere, a tiny little Dracula jumps onto the hood of the car and hisses through the windshield.

'Quick, quick!' shouts Sister Catherine. 'What shall we do?'

'Turn the windshield wipers on. That will get rid of the abomination,' says Sister Helen.

Sister Catherine switches them on, knocking Dracula about, but he clings on and continues hissing at the nuns.

What shall I do now?' she shouts.

'Switch on the windshield washer. I filled it up with Holy Water at the Vatican ,' says Sister Helen.

Sister Catherine turns on the windshield washer.

Dracula screams as the water burns his skin, but he clings on and continues hissing at the nuns.

'Now what?' shouts Sister Catherine.

'Show him your cross,' says Sister Helen.

'Now you're talking,' says Sister Catherine.

She opens the window and shouts,

'GET THE FUCK OFF THE CAR!'

9/26 NPworld.us Karen 'n bill

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roses are wilted
street sweeper eats the petals
a watery path

Thursday, September 25, 2008

9/25 NPworld.us Karen 'n bill

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a comb wound with hair
is on the kitchen table
noodles in a fork

Wednesday, September 24, 2008

she plays gemeinhardt
split E open hole B note
silver thin wall head

Research Abstract with Commentary: Value of Nurse Internships

Abstract: New Graduate Transitioning: Necessary or Nice?

This study investigated the influence of personal factors, orientation, continuing education, and staffing shortage on the satisfaction, intent to leave their job, and intent to leave the profession of a random sample of new graduate nurses from varied facilities and geographic locations. It further examined the influence of personal factors and orientation on turnover rates among new graduate nurses. The findings indicate that orientation programs are essential to the retention and satisfaction of new graduate nurses. Given current economic constraints, this study supports nurse executives' ability to advocate for and receive funding for transition-to-work programs as well as the placement of new graduate nurses in well-staffed units.

Scott, E. S., Engelke, M. K., & Swanson, M. (2008). New graduate transitioning: Necessary or nice? Applied Nursing Research, 21, 75-83.

Commentary by Dana N. Rutledge, RN, PhD, Nursing Research Facilitator

This timely study begins to fill a gap in nursing literature related to what factors can predict new graduate job and career satisfaction as well as actual job turnover. A well developed framework predicts that (a) anticipatory socialization (characteristics of education, experience, and expectations) can predispose or protect the new graduate from reality shock, and (b) organizational socialization (things that happen to the new nurse in the first two years of nursing such as orientation, unit culture, staffing) can enhance or inhibit work adjustment. The outcomes of job and career satisfaction, intent to stay, turnover can be predicted by factors within each of these two categories.

Using already collected data (this is called secondary analysis) from a random sample of North Carolina new graduates (< 2 years from graduation from initial RN program), researchers evaluated how this model worked with 329 nurses. They adequately described the variables they used, and ran multiple analyses to look for relationships in the model. One of the drawbacks of using already collected data is that not all factors the researchers wanted to evaluate were measured, and some that were measured contained “missing” data. However, they were able to draw several important conclusions.

Besides the finding reported in the abstract (above), the following were reported:
· Among new nurses, 54% were dissatisfied with their current job, 55% had already left one job, however, 71% were satisfied with nursing as a career.
· Orientation offered to these nurses ranged from < 1 week to 1 year (huge variability!!). The quality and quantity of orientation were associated with turnover (better/longer predictive of less turnover).
· The strongest predictor of job satisfaction was frequency of staffing shortage on a unit. Nurses reporting weekly shortages were 6 X more likely to be dissatisfied than those with less shortages.

These findings point to the need to give our new graduates the most satisfying orientation possible, and that longer orientation lengths may contribute to job satisfaction, and subsequent retention.

9/24 NPworld.us Karen 'n bill

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Tuesday, September 23, 2008

9/23 NPworld.us Karen 'n bill

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up-ended table
metal legs folded under
looks like an old man

Monday, September 22, 2008

9/22 NPworld.us Karen 'n bill

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sack of joint compound
steel attic ventilator
five gallon shop-vac

Sunday, September 21, 2008

box office at two
doors open at two thirty
but I'm there at one

Saturday, September 20, 2008

today a cold day
sun through leaves turning brown, red
I wear a sweater

9/20 NP jobs NPworld.us Karen 'n bill

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Friday, September 19, 2008

he called me MRS
and I told him to shove it
trees are dropping leaves

9/19 NPworld.us Nurse Practitioner Jobs







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Thursday, September 18, 2008

next door they play wii
pretending to be a band
simulated life

9/18 NPworld.us Karen 'n bill

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Wednesday, September 17, 2008

addictive learning
he scans the computer screen
for precise info

OIIQ Exam



Well, the time has come! I am taking the OIIQ Boards this coming weekend. The OSCEs are Sunday and the written is Monday. I do not feel prepared at all, and frankly fully expect to fail it this time around.. which if I do, is a huge waste of $500! BUT really, the prep book they sell us I find to be very lacking and has mistakes in it! (mainly b/c it is translated from the French).

The OSCEs are 16 scenarios, and the written is 100 short answer questions.. INSANE!

Wish me luck, those who pray, well pray away for me! All this stress to become part of the Order of Nurse and be able to write RN after my name!

9/17 NPworld.us Karen 'n bill

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NPworld.us Nurse Practitioner Jobs 9/17







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Tuesday, September 16, 2008

celebrity death
and stray tragic accidents
always front page news

NPworld.us Nurse Practitioner Jobs 9/16







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Monday, September 15, 2008

9/15 NPworld.us Karen 'n bill

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NPworld.us Nurse Practitioner Jobs 9/155







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ten black powerlines
the pole is lashed up with wires
tall opposition

Sunday, September 14, 2008

fliers for cell phones
monthly subscription to talk
life is a fees list

Saturday, September 13, 2008

9/13 NPworld.us Karen 'n bill

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Job for Nurse in Al-Omooma Hospital Kuwait

Al-Omooma Hospital service offerings include gynecology, Obstetrics, and assisted reproduction. This is Private Women’s Hospital in KUWAIT, located in Reggae Region. The Hospital is built in compliance with AIA healthcare facilities standards and equipped with state of art technology appropriate to the provision of quality patient care services. Recently they are looking for the Nurses who want to work with them as Manager in Patient care services.

The Hospital will be operational in February 2008, For the Nurses who are interesting to the Job position and match with the require qualification bellow :

  • BS Nursing or Midwifery & Diploma in Nursing Management

  • Minimum of 5 years in an obstetrics service

  • Minimum of 3 years in a senior management position


  • Job for Nurse in Al-Omooma Hospital Kuwait

    They can submit their job's application or updated CVs to the email : omooma@theadvisorygroup.org

    The Nurses who are working with them as position Manager in patient care services will be responsible to her job, such as Nursing staff management, patient care management, and performance monitoring & improvement.

    Friday, September 12, 2008

    a precious haiku
    about flowers and blue sky
    fist clenched resistance

    9/12 NPworld.us Karen 'n bill

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    Thursday, September 11, 2008

    paper folds over
    cash register bings and shuts
    gimme my cookie

    9/11 NPworld.us Karen 'n bill

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    Wednesday, September 10, 2008

    steam from the pot curls
    smoke from oven grit spreads wide
    faucet spray fragments

    9/10 NPworld.us Karen 'n bill

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    Tuesday, September 9, 2008

    zigzag hook hanger
    aunt Eleanor's book of quotes
    a stamped and cut tin mask

    9/9 NPworld.us Karen 'n bill

      ----- Original Message ----- From: bill@advancedpracticeclinicians.us To: bill@NPworld.us Sent: Tuesday, September 09, 2008 9:12 AM Subject: Thank you! Your jobs on NPworld.us Karen 'n bill  ...   Nurse Practitioner Jobs Advanced Practice Clinician, Advanced Practice Providers Nurse Practitioner Jobs

    Monday, September 8, 2008

    adobe flash script
    controller false notify
    error has occurred

    NPworld.us Nurse Practitioner Jobs 9/8

      ----- Original Message ----- From: bill@advancedpracticeclinicians.us To: bill@NPworld.us Sent: Monday, September 08, 2008 9:57 AM Subject: Thank you! Your jobs on NPworld.us Karen 'n bill  ...   Nurse Practitioner Jobs Advanced Practice Clinician, Advanced Practice Providers Nurse Practitioner Jobs

    Sunday, September 7, 2008

    one branch is longer
    the round shaggy maple tree
    defies pruning sheers

    Saturday, September 6, 2008

    I hold the wood frame
    while he unrolls wire mesh
    in time, a bird cage

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    Friday, September 5, 2008

    searching for templates
    it's supposed to be easy
    my day shot to hell

    GREY MATTERS: a practical search tool for evidence based medicine


    The Canadian Agency for Drugs and Technologies in Health (CADTH) has developed a new, free tool to assist in the process of identifying "gray literature" for evidence based medicine. While this is oriented towards EBM, it does have applicability to Evidence Based Nursing. First off, what exactly is "gray literature"? Gray literature is defined in wikipedia as "... a term used variably by the intelligence community, librarians, and medical and research professionals to refer to a body of materials that cannot be found easily through conventional channels such as publishers, "but which is frequently original and usually recent" in the words of M.C. Debachere". It goes without saying that gray literature usually does not appear in customary databases such as Pubmed and CINAHL. There are several resources for identifying gray literature but none are quite as comprehensive as the newly released tool from the CADTH GREY MATTERS: a practical search tool for evidence based medicine.
    To access this tool, scroll down the page to Information Services and follow instructions to download the document.
    While most of us would never go through this intensity of research for clinical topics, if you are developing a meta-analysis or systematic review, this could be useful. This tool will help you search for evidence based topics in both the international and US grey literature.

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    Thursday, September 4, 2008

    when I park at home
    the cat is there to greet me
    and share of his day

    Taking research posters to the units

    The Nursing Research Council at St. Joseph Hospital in Orange, California is activating its plan to take research to the units. Members of the Research Council were charged with finding a current nursing research article which might have special application to their specific unit. Leaders of the Nursing Research Council developed a template poster which summarizes a key article into the following sections:

    The Research Question
    • Methods

    • Results

    • Discussion

    • Implications for SJH Nursing Practice

    Of special note is the section noting implications for St. Joseph Hospital nursing practice. An effort is made to show how the practice implications may mesh with our hospital's values and with our Watson nursing model. The posters will be placed in a unit's lounge area and are intended to make the salient points of a complex research article more accessible and increase interest in nursing research. This photo shows team members at a working meeting in which they identified an article of interest and then summarized it into this reseach poster template.












    Wednesday, September 3, 2008

    knitting through a glass
    sand running through my fingers
    branches rasp the glass

    Student Nurse Humour

    A male patient is lying in bed in the hospital, wearing oxygen mask
    over his mouth and nose.
    A young, student nurse appears to give him a partial sponge bath.

    'Nurse', he mumbles, from behind the mask. 'Are my testicles black?'

    Embarrassed, the young nurse replies, 'I don't know, Sir I'm only here
    to wash your upper body and feet.'

    He struggles to ask again, 'Nurse, please check. Are my testicles
    black?'

    Concerned that he may elevate his blood pressure and heart rate from
    worry about his testicles, she overcomes her embarrassment and pulls
    back the covers. She raises his gown, holds his manhood in one hand and
    his testicles in the other. Then, she takes a close look and says,
    '...there's nothing wrong with them, Sir!'

    The man pulls off his oxygen mask, smiles at her and says very slowly,
    'Thank you very much. That was wonderful, but listen very, very
    closely...

    'A r e - m y - t e s t - r e s u l t s -b a c k?

    9/3 you're NP job posted on NPworld.us thank you, bill

      ----- Original Message ----- From: bill@advancedpracticeclinicians.us To: bill@NPworld.us Sent: Wednesday, September 03, 2008 8:51 AM Subject: See you're NP job posted on NPworld.us thank you, bill  ...   Nurse Practitioner Jobs Advanced Practice Clinician, Advanced Practice Providers Nurse Practitioner Jobs

    Tuesday, September 2, 2008

    what world is this where
    all the women are called ma'am
    and art is for sale

    Our House Flooded

    Some of our readers have e-mailed asking why we are settled in South Georgia again this school year. The answer is becoming less and less clear given what happened the weekend before last and what is going on right now.

    The weekend before last we were visited by Tropical Storm Fay which decided to stick around for two and a half days before moving on. The storm moved through at about 4 mph and dropped 25 inches of rain in two days. I felt like it would never leave. By the time it left our living and tv rooms had an inch of water on the floor.
    See all that red just above the Florida line where the arrow is pointing. Yeah. That's where we live.

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    Monday, September 1, 2008

    on the way to work
    see the Obama sticker
    phallus fills the M

    Sunday, August 31, 2008

    Saturday, August 30, 2008

    ordered fried chicken
    on a plate with mac and cheese
    bones are in the trash

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    Friday, August 29, 2008

    CINAHL on EBSCO


    Beginning in January 2009, CINAHL, the nursing and allied health database will no longer be available on the OVID platform. Instead, CINAHL will be exclusively offered on the EBSCO platform. Burlew Medical Library is now offering access to EBSCO CINAHL via our library web site (password protected for staff of St. Joseph Hospital, Orange and Children's Hospital of Orange County). I will begin to showcase a variety of "tips and tricks" for searching EBSCO CINAHL so that everyone can prepare themselves for this transition. As a beginning, here are some links to EBSCO provided tutorials/online help:
    a forced perspective
    buildings tall as sci fi beasts
    sun glints off windows

    Thursday, August 28, 2008

    even though it's nice
    the sun is lovely, shining
    you watch your TV

    8/28 NP jobs NPworld.us thank you, bill

      ----- Original Message ----- From: bill@advancedpracticeclinicians.us To: bill@NPworld.us Sent: Thursday, August 28, 2008 2:23 AM Subject: See you're NP job posted on NPworld.us thank you, bill  ...   Nurse Practitioner Jobs Advanced Practice Clinician, Advanced Practice Providers Nurse Practitioner Jobs

    Wednesday, August 27, 2008

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    Tuesday, August 26, 2008

    ferns and blackberries
    flourish on the shady side
    now that rain is in

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    Monday, August 25, 2008

    cat's head on keyboard
    paws on Caps Lock and Enter
    contented purring

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    Sunday, August 24, 2008

    his new sunglasses
    block blue rays from the sun
    he sees only gold

    Saturday, August 23, 2008

    then the rain set in
    newspapers folded on heads
    we ran for cover

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    Friday, August 22, 2008

    the baby chicken
    nestles in your open palm
    like sun on the lawn

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    Thursday, August 21, 2008

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    the jasmine won't bloom
    because first it is too hot
    then it is too cold

    Wednesday, August 20, 2008

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    crapemyrtle flowers
    fold over with brown edges
    as the rain sets in

    Tuesday, August 19, 2008

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    Brother Silvestro
    stands footless on cold limestone
    fingers like broomsticks

    Monday, August 18, 2008

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    birds fly from his mouth
    when I dream I see children
    they hang dead from trees

    Sunday, August 17, 2008

    careful opening
    the full can of wood primer
    i can't help but spill

    Saturday, August 16, 2008

    in the distance: flash
    one-one-thousand up to ten
    then the thunder boom

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    Friday, August 15, 2008

    The Main Event


    I love watching Olympic Gymnastics, and this year was no different! The showdown for the Team event was USA vs China. China won, with USA in 2nd and Russia in 3rd. The AA was next, another showdown but this time the top two spots would be USA vs USA.

    Nastia Liukin came out on top, Shawn Johnson in 2nd and Yang Yilin from China in 3rd.

    Nastia: Silver Team, Gold AA, Silver Bars, Bronze Floor, Silver Beam

    Shawn: Silver Team, Silver AA, Silver Floor, Gold Beam

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    it is hot outside
    but when it is not hot outside
    the rain is falling

    Thursday, August 14, 2008

    great grandpa's buffet
    is missing a door, a foot
    and stores the TV

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    Wednesday, August 13, 2008

    since we moved the shed
    slugs and beetles slip from soil
    and surprise our toes

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    Tuesday, August 12, 2008

    we don't feed him scraps
    this dog has his own sofa
    bathed in fresh sunlight

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    Monday, August 11, 2008

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    paper crane can't fly
    when needled it bleeds out air
    its brain is folded

    Sunday, August 10, 2008

    mobile in a breeze
    stings strung on hooks and pinned through
    origami cranes

    Saturday, August 9, 2008

    by the potted plant
    green paper blue flower print
    origami crane

    Friday, August 8, 2008

    origami crane
    in an origami box
    must fold in his wings


    (missed a couple days due to school deadline - apologies)

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    Thursday, August 7, 2008

    Nurses Job and Career Opportunities in Singapure

    One of health care company (ParkwayHealth) in ASIA recently held for Nurses Recruitment (The Nurses which looking for good job or career opportunities) to join with them as Nursing Staff in order to increase the hospital services for the patient demand. ParkwayHealth owns Mount Elizabeth Hospital, Gleneagles Hospital and the East Shore Hospital and plans to launch the Novena Hospital in 2011.

    ParkwayHealth company right now they have a total of 15 hospitals around the region providing 3,277 beds and the expertise of 1,500 accredited medical professionals in a wide range of specialist fields. The Nurses who match with the following job requirements bellow, They can send their job application to the email : prnn@parkway.sg.

  • Assistant Nursing Administrator (Operating Theatre)

  • Nurses Job Responsibilities are :
    1. Responsible for the effective and efficient running of the operating theatres
    2. Manage the organization, administration, co-ordination and evaluation of peri-operative care in the operating theatre
    3. Provide high quality nursing care, thereby ensuring competent, personalized, specialized and cost-effective care is provided by nursing staff to patients
    4. Lead and direct clinical/service quality activities
    5. Provide nursing leadership to lead, supervise, coach and support nursing staff to deliver nursing care towards meeting organizational goals
    6. Nurture the development of staff through mentoring and role modeling

    Nurses Job Requirements :
    1. SRN Certificate from an accredited School of Nursing
    2. Post graduate Nursing Specialty Certificate/Degree
    3. Diploma/Master in Management Studies or its equivalent is preferred
    4. At least 7-8 years’ experience in a supervisory capacity with demonstrated executive ability and leadership, of which 2 years must be spent as Senior Nurse Manager
    5. Posses good interpersonal and communication skills
    6. Computer literacy – MS office

  • Senior Nurse Manager (Operating Theatre / Anaesthetic) / Nurse Manager (Medical & Surgical / Operating Theatre / Anaesthetic)

  • Nurses Job Responsiblities are :
    1. Responsible and accountable for the overall performance of the unit
    2. Provides nursing leadership in the management of patient care in the operating theatre/wards
    3. Facilitate safe and efficient use of resources
    4. Nurtures the development of staff through mentoring and role modeling

    Nurses Job Requirements :
    1. Registered Nurse with Bachelor’s Degree preferred
    2. Diploma/Degree in Nursing Management
    3. Working experience as Nurse Manager or related Managerial experiences in an acute care hospital
    4. Possess professional license to practice nursing in Singapore
    5. Positive work attitude and leadership qualities
    6. Good interpersonal and communication skills
    7. Those with at least 8 years’ clinical experience may be considered for the Senior Nurse Manager position