Tuesday, June 30, 2009

Nurse Practitioner Jobs ARNP Jobs 6/30

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Thursday, June 25, 2009

Are You In The Know?

Straight from the ACNM Communications Department, here are our top picks for happenings in midwifery for the week:Authors of an Obstetrics & Gynecology article say they encourage midwifery care and “support future randomized trials to compare” home vs. hospital births. The statement comes in response to a letter from certified nurse-midwife Judith Rooks and Our Bodies, Ourselves Executive

Wednesday, June 24, 2009

H.R. 2824 bill on federal support for comparative effective research

Nursing should be aware of the current Federal Bill H.R. 2824 in support of federally funded comparative effectiveness research. A recent NY Times article gives a good description of this. This potentially has a lot of implications for nursing research.

Nurse Practitioner Jobs ARNP Jobs 6/23

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Tuesday, June 23, 2009

Nurse Practitioner Jobs ARNP Jobs 6/23

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Friday, June 19, 2009

SOGC Says No More Automatic Cesareans for Breech Babies

Whether you’re aiming for a hospital, birth center, or home delivery, if you get the news that your baby is in the breech position, chances are you’ll be advised to have a cesarean section. But on Wednesday, the Society of Obstetricians and Gynaecologists of Canada (SOGC) released new guidelines for health professionals that turn the breech issue upside down. They state that health professionals

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Wednesday, June 17, 2009

Say hello to our new blog team

Say hello to our new nursing research blog team!! From left to right are: Kathy Dureault, Stacey Fischer, Victoria Morrison, Dana Rutledge, Vivian Norman and Julie Smith. Not pictured is Theresa Ullrich. We are looking forward to active participation and lots of new blogging from our new team members.

The Article that President Obama is Reading

According to an article in the New York Times, President Obama is singing the praises of Atul Gawande’s “The Cost Conundrum,” which was recently published in The New Yorker magazine. Gawande’s piece investigates the geographic variations in health care cost per person, in particular McAllen, TX—the most expensive place in the US for health care. The piece is certainly impressive, calling

A Journalist Becomes A Nurse: repost

I am probably committing a major blogger no no but I just feel the need to repost this article.

It was written by an editor of The Wall Street Journal. He made a career change into nursing at age 40. Long story short he had only 3 patients and he found it difficult. He says he felt like a moron compared to the other nurses at times. He couldn't cope with the physical or mental demands. He needed cash. He got the hell out and went back to journalism.

Why am I re posting this: I recently read a comment where someone (possibly a journalist) made a comment about nurses being intellectually incapable of handling a debate. Nurse at my university (overseas)were held to higher standards than other students academically. We were told that we had to be better than your average student because of all the life and death responsibility in difficult conditions that we would have. When we graduated we had higher starting salaries than most other new grads started on after 3-4 years of Uni. Other countries do not hold the same kind of contempt for people that go into nursing that Britain does. The class system here has a lot to answer for in my opinion. Many people with degrees in other fields flunked right out of nursing school.

What is my response to non-medical people who are horrified at the idea of their bright child wanting to become a nurse?

Your child can be bright and academic and go to nursing school. The school won't take you if you can't hack it. Your child may even find it difficult. When they qualify they can go to the USA or Australia and make lots more money than you do. They are certainly going to have to use their brain on the job more than you ever did.

Bedside nursing is not a job for stupid people. Really it isn't.Walking onto the ward as an uneducated simpleton who cannot think with the responsibility that an RN has in the 21st century is insane. And it is a good way to get you in a lot of trouble with the law. If you kill a patient and then try to defend yourself by saying "oops I didn't know because I am just a stupid nurse incapable of doing anything but mopping brows" you are not getting off the hook.

Anyway I am rambling. Read on if you can stand it.


This is the kind of stuff we need to see from British Journalists. Unfortunately they do not have the gonads, the brains, or the work ethic and integrity to handle nursing.

Here are some excerpts.

"In 2002, at age 40, I left my job as a page-one editor at The Wall Street
Journal, my professional home of 15 years, to take a giant leap of faith -- in
myself. Like a lot of people, I questioned my purpose after Sept. 11, 2001.
Jolted from the complacency of a comfortable career, I became convinced that I
could achieve selfish fulfillment through devotion to service -- to the
individual, to the community, to the vulnerable.I considered teaching. I
considered law, medicine, pure science and research. But my thinking always
returned to the nurses I had watched care for my mother a few years earlier,
when she lay in an intensive-care unit in her final illness. I marveled at the
way they melded an aloof, precise professionalism with a mysterious human (and
humane) instinct. They seemed to operate in a purer space, beyond worldly
distractions. I would be a nurse."

"My skills were those of any new nurse. With easily shattered confidence, I
could start an IV, administer medications, bathe a bed-bound patient and change
linens, change dressings, insert all sorts of catheters and tubes, read lab
results and electrocardiograms. I knew to be vigilant against infection,
pneumonia, pressure ulcers, medication errors and the many other lurking threats
to hospital patients. On the burn unit, pain control loomed large. I also knew,
as both executor of treatment plans and patient advocate, to keep a close eye on
what doctors ordered. They make mistakes, too.

But in those first months, I felt stupid and slow, and thus dangerous. I
hadn't yet mastered the ruthless efficiency of thought and motion that lent
veteran nurses the appearance, at least, of enviable ease. Next to my crazed
back-and-forthing, they floated around the unit, maintaining a cool composure no
matter what crisis erupted.

.Basic nursing duties were enough to keep me on my feet until dawn: initial
head-to-toe physical assessments; hourly vital signs and other monitoring tasks;
medications; bed baths and dressing changes; regular suctioning.

There could be no skimping, no coasting through a shift because of a
headache or trouble at home. For 12 hours, I belonged to people whose survival
was at stake. A sloppy physical assessment could later explode in disaster if a
potential problem -- a bum IV, an incipient pressure ulcer, abnormal lung sounds
-- went unnoticed. Rooms required meticulous inspection, too, to ensure that
vital equipment was present and functioning: A missing bag mask -- attached to
those blue vinyl footballs you see TV doctors and nurses rhythmically squeezing
in emergencies -- could cause lethal delays.

Good lord, this man only had 3 patients and some of them were no where near as sick as my 10-15. Please please please read the whole article.

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Tuesday, June 16, 2009

Good God, we had a nice week.

A couple of really good things happened this week. First of all I have earned a hell of a lot of comp time for working unpaid hours over the end of my shift. The hospital cannot pay overtime and has demanded that we take the time back. I did a couple of 8 hour shifts. It's not like being at work at all. I loved the 8 hour shifts. I was able to come home and still have part of my day.

I cannot go into to much detail on here but between restructuring at the hospital etc we not only ended up with a few closed beds but extra staff from another unit. Usually we get their patients but not their nurses. It's really true, sometimes managers do not fuck up and the gods of nursing shine down on us. I am sure that the closed beds etc wrecked havoc in the rest of the hospital but on my ward, things were smooth.

Not only did I only do an 8 hour day but I had only 5 patients. Only 2 of them were acutely ill. That's right. A non nursing colleague of mine came onto our ward, looked at the numbers and said "Whew, Annie is going to put her feet up today". No chance my friend. I wanted to see if I could still nurse patients properly when I have a controllable work load and time on my side.

I immediately set out doing everything as it was meant to be done, my patients got a thorough nursing assessment and I caught onto a lot of stuff that was a bit worrying. It scared me to think about how much we miss on our usual rush days. When the consultants came for their rounds I was ready with any info they needed about the patients. I knew those patients inside and out. I knew every drug they were on, everything that happened since admission, every test result, what their normal level of orientation and mobility was like, social circumstances etc. I had a chance to read all their notes. It doesn't take a lot of doing to read up on a handful of people.

Usually the medics can barely find one of us to do the ward round and if they do, we are barely able to answer a simple question about the patient "John Smith? Oh. Is he my patient? Let me look through my handover sheet. You ask if he has passed urine yet......Um I don't even know what he looks like". It's no wonder that they think the nurses are all retarded.

The rounds went well. My patients were happy. I felt like they were getting the safest care I can provide. The drug rounds took 15 minutes rather than the usual 2 hours. Less patients means less people phoning and less time running to the phone.

Not only did we have a 1 to 5 ratio but we had an extra nurse to coordinate. She wasn't from our unit and there wasn't much happening so she busied herself with the important jobs that never get done basically.

I had one extremely sick woman who needed many interventions. The family made a point of thanking me for taking such good care of her, and they told me that knowing that she is getting good nursing care makes their sad situation bearable. They said that they thought that I had worked really hard and that they appreciated it, especially considering the horror stories that they heard about the place.

Of my 5 patients only one needed to be fed and the HCA and I fought over who was going to do it.

5 patients isn't always going to be easy. Had they been critically ill I would have been run off my feet. It's not always the number of patients you have but the acuity as well. I was lucky in the fact that I had a smaller than normal number of patients who were not very acute. Woo hoo.

And that's it. Soon the new units/beds etc open, all the beds will fill at lightening speed and the nurses we have will all be spread out even more thin than we are now. I got a letter from management addressing my concerns about the usual state of the staffing ( I last wrote to them months ago). He was pleased to inform me that we are getting 0.5 of a cadet. Uh uh.

Monday, June 15, 2009

Fluids and Electrolytes Nursing lecture

Complete Fluids and Electrolytes Nursing lectures

Contains detailed explanation on the colloid, osmotic pressure, etc.

Hyponatremia, Hypernatremia, Hypokalemia, Hyperkalemia etc.

Principles of Sterile and Aseptic Technique Nursing lecture

This nursing lecture contains a detailed explanation on the Principles of Sterile and Aseptic technique. Sterile and Asepsis has been differentiated. Famous people and advocates of these principles are also discussed in this nursing lecture
    • Ignaz Semmelweis – handwashing
    • Louis Pasteur – germ theory
    • Robert Koch – use of bichloride of mercury as an antiseptic
    • Joseph Lister – Father of modern Surgery
    • Gustav Neuber – used mercuric cholride in cleaning his apron
    • Louis Pasteur
    • Ignaz Semmelwies
    • Joseph Lister
    • Gustav Neuber
    • Robert Koch
    • Airborne
    • Droplet
    • Contact
    • SKIN
    • HAIR
    • Air
    • Community Acquired Infection
    • Communicable Infection
    • Spontaneous Infection
    • Nosocomial Infection – Exogenous and Endogenous
    • Air-Conditioning System
    • Laminar Air System
    • Doors
    • Traffic and Movement
    • Lint
    • Protective barriers and personal protective equipment
    • Prevention of puncture injuries
    • Management of puncture injuries
    • Oral Procedures
    • Care of specimens
    • Decontamination
    • Laundry
    • Waste
    • Handwashing
    • No touching of mucous membranes
    • Prophylaxis
    • Know what is sterile
    • Know what is unsterile
    • Keep the two apart
    • Remedy the contamination immediately
    • NO compromise on Sterility

Sterilization and Disinfection Nursing lecture

This nursing lecture contains different sterilization and disinfection methods. It also compares the two and cites disadvantages and advantages.

# Terminologies  Antiseptics  Disinfectants  Disinfection  Microorganism  Pathogenic Microorganisms  Sterilization nursinglectures.blogspot.com
# nursinglectures.blogspot.com
# Methods of Sterilization  A. Physical Sterilization 1. Moist Heat – kills all bacteria by coagulating or denaturing of the protein of the bacteria a. Boiling (non-pressure sterilizer) b. Saturated Steam under pressure (AUTOCLAVE) nursinglectures.blogspot.com

#  2. Dry Heat – recommended for use only where direct contact of material with steam is impractical of not available a. Dry Heat Autoclave (hot air oven) – used for oil, ointment, and powders. nursinglectures.blogspot.com
# nursinglectures.blogspot.com
#  B. Chemical Sterilization  Accomplished by use of ethylene oxide gas  Ethylene oxide is a chemical agent that kills microorganisms, including spores, by interfering with the normal metabolism of protein and reproductive processes, resulting in death of cells nursinglectures.blogspot.com
# nursinglectures.blogspot.com
# Shelf-Life  1. Condition of Storage  Free of dust, dirt and vermin  Paper-wrapped/muslin-wrapped items good for 30 days, open shelving 21 days  Protect from extreme temperature nursinglectures.blogspot.com
#  2. Material used for packaging  Muslin and paper wrapped items may be stored for 24-30 days, afterwhich re- sterilization is required, but if sealed in airtight plastic bag, following cooling or aerating, shelf life can be prolonged from 6-12 months nursinglectures.blogspot.com
#  3. Seal of the package  Tape sealed packages wrapped in non- warm fabrics or plastic film can be stored for 3-4 months  4. Integrity of the package nursinglectures.blogspot.com
# Disinfection  It differs from Sterilization by its lack of sporocidal power  Used in the OR to kill microorganisms on inanimate surfaces and objects that cannot be sterilized nursinglectures.blogspot.com
# Limitations of Chemical Disinfection  Doesn’t KILL SPORES  Real STRENGTH not known  LONG TIMING  DIFFICULT to submerge some articles  NOT SUITABLE for some materials  Can cause IRRITATION to tissue  ABILITY to disinfect is limited to max concentration nursinglectures.blogspot.com
# Uses for chemical disinfection  WOVEN  CATHETER  ENDOSCOPIC Instruments  POLYETHYLENE  EYE Surgery nursinglectures.blogspot.com
# Pointers when Using Chemical Disinfection  Free from blood, secretions  Rinse and dry under sterile conditions  Solutions may be rinsed off if practical nursinglectures.blogspot.com
# DISINFECTANTS  Formaldehyde (Formalin)  Glutaraldehyde (Cidex)  Phenol 100%  Lysol  Zephiran Chloride 17% nursinglectures.blogspot.com
# ANTISEPTICS  Hexacholorophene - neurotoxic  Betadine –watch out iodine sensitivity  Mercurochrome  Aqueous Zephiran  Chorhexidine Gluconate nursinglectures.blogspot.com

Operating Room Team Members Nursing Lecture

This nursing lecture contains an introduction to the different Operating Room Team members. The .sterile team members work aseptically and the non-sterile team members avoid contaminating the sterile field

    • Anesthesia Provider
    • Administers anesthetics
    • CNRA
    • Oversees the PACU
    • CPR
    • Pain therapy
    • consultants
    • Monitors and coordinates activity within the room
    • Controls physical and emotional atmosphere
    • Application of nursing process
    • Creation and maintenance of safe and comfortable environment
    • Provision of assistance
    • Identification of any potential danger/stress
    • Surgeon
    • First Assistant
    • Visibility of SS
    • Close wounds
    • Apply dressing
    • Handles tissue
    • Uses instruments
    • Scrub Person
    • Maintains integrity of
    • Sterile field
    • May be an RN, LPN/
    • LVN or an ST

Surgical Positioning Nursing Lecture

This nursing lecture includes an introduction to studying Surgical Instrumentation. It contains topics on classification of surgical instruments, proper handling and use. Contains images and explanations.

  1. http://nursinglectures.blogspot.com
  2.  1. Optimize Exposure for the SURGEON  2. Minimize the for adverse physiologic effects  3. Facilitate by the ANESTHESIA provider  4. Promote for the patient nursinglectures.blogspot.com 2
  3.  The Anesthesiologist has the on of the patient  The patient is until the anesthesia provider indicates it is safe to do so. nursinglectures.blogspot.com 3
  4.  Patient is  Patient is Assessed for Mobility status  OR bed is securely locked  The anesthesia provider guards the  Body exposure should be minimal  Don’t Cross Ankles(causes DVT) nursinglectures.blogspot.com 4
  5.  Respiratory Considerations  Circulatory Considerations  Peripheral Nerve Considerations  Musculoskeletal Considerations  Soft Tissue Considerations nursinglectures.blogspot.com 5
  6. nursinglectures.blogspot.com 6
  7.  OPERATING BED nursinglectures.blogspot.com 7
  8.  Safety Belt (Thigh Strap)  Lift Sheet (Draw Sheet)  Upper Extremity Table  Shoulder Bridge ( Thyroid Elevator)  Shoulder Braces / Support  Body Rests and Braces  Body (Hip) Restraint Strap  Headrests nursinglectures.blogspot.com 8
  9.  Anesthesia Screen nursinglectures.blogspot.com 9
  10.  Armboard nursinglectures.blogspot.com 10
  11.  Positioning for Anal Procedures with Adhesive Tape nursinglectures.blogspot.com 11
  12.  Stirrups nursinglectures.blogspot.com 12
  13.  Surgical Vacuum Positioning System nursinglectures.blogspot.com 13
  14.  Supine (Dorsal) Position nursinglectures.blogspot.com 14
  15.  Trendelenburg’s nursinglectures.blogspot.com 15
  16.  Reverse Trendelendurg’s nursinglectures.blogspot.com 16
  17.  Fowler’s Position nursinglectures.blogspot.com 17
  18.  Lithotomy Position nursinglectures.blogspot.com 18
  19.  Prone Position nursinglectures.blogspot.com 19
  20.  Kraske (Jackknife) Position nursinglectures.blogspot.com 20
  21.  PILONIDAL SINUS nursinglectures.blogspot.com 21
  22.  Knee-Chest Positions nursinglectures.blogspot.com 22
  23.  Lateral Positions nursinglectures.blogspot.com 23
  24.  Kidney Position nursinglectures.blogspot.com 24
  25.  Beach-Chair Position nursinglectures.blogspot.com 25
  26.  Dorsal Position  Dorsal Recumbent  Fowler’s Position  Sitting Position  Lithotomy  Trendelenburg  Reverse Trendelenburg  Prone  Kraske  Knee-Chest Position  Sim’s  Kidney  Chest Position nursinglectures.blogspot.com 26
  27. Visit: http://nursinglectures.blogspot.com For more Free Nursing lectures on MS, OB, Psych, OR, And more…. nursinglectures.blogspot.com 27

Perioperative Nursing Introduction to Operating Room Nursing lecture

Introduction to Operating Room Nursing lecture. Contains detailed lecture on the perioperative period, classification and types of surgery, etc.

  1. The branch of medicine that deals with the diagnosis and treatment of surgery, deformity or disease by manual or instrumental means.  3 phases : (Perioperative phase) Pre-Operative Intra-Operative Post-operative nursinglectures.blogspot.com
  2. nursinglectures.blogspot.com
  3. Identification of physiological, psychological, sociological needs of patient and implementation of nursing care Based on the knowledge of the natural and behavioral science In order to restore, or maintain the health and welfare of the patient during and after the surgical intervention nursinglectures.blogspot.com
  4.  Correct deformities or defects nursinglectures.blogspot.com
  5.  Repair Injuries nursinglectures.blogspot.com
  6.  Alter form or structure nursinglectures.blogspot.com
  7.  Diagnose and Cure Disease Process nursinglectures.blogspot.com
  8.  Relieve Suffering nursinglectures.blogspot.com
  9.  Prolong Life nursinglectures.blogspot.com
  10. nursinglectures.blogspot.com
  11.  Preserve Life  Maintain Dynamic Body Equilibrium  Undergo Diagnostic Procedures  Prevent Infection and Healing  Obtain Comfort  Ensure ability to earn a living  Restore or reconstruct organ that is malformed  To alter cosmetic appearance nursinglectures.blogspot.com
  12. Congenital Acquired Trauma Anomalies nursinglectures.blogspot.com
  13.  According to Purpose 1. Diagnostic – to establish presence of disease 2. Exploratory – to determine extent of disease 3. Curative – to treat disease condition 4. Ablative – involves removal of an organ 5. Constructive – involves repair of congenitally defective organs 6. Reconstructive – involves repair of damaged organ 7. Palliative – to relieve distressing signs and symptoms, not necessarily to cure nursinglectures.blogspot.com
  14.  MAJOR SURGERY – HIGH RISK 1. Extensive 2. Prolonged 3. Large amount of blood loss 4. Vital organ may be handled or removed 5. Great risk of complication  MINOR SURGERY 1. Generally not prolonged 2. Leads to few serious complications 3. Involves less risk nursinglectures.blogspot.com
  15.  Emergency – to be done immediately to save life or limb  Imperative – to be done within 24 – 48 hours  Planned / Required – necessary for well-being  Elective – not absolutely necessary for survival, delay or omission will not cause adverse effect  Optional – Requested by the client usually for aesthetic purposes  Day (Ambulatory) - done on an outpatient basis nursinglectures.blogspot.com
  16.  Obstructions – impairment to the flow of vital fluids nursinglectures.blogspot.com
  17.  Perforations – rupture of an organ nursinglectures.blogspot.com
  18.  Erosions – wearing off of a surface or membrane nursinglectures.blogspot.com
  19.  Tumors – abnormal cell growth of tissue that serves no physiologic function in the body nursinglectures.blogspot.com
  20. 1. Malnutrition 2. Obesity 3. Presence of disease such as : Cardiac problem, URTI, Renal diseases, DM, Liver Diseases 4. Age 5. Concurrent or prior pharmacotherapy 6. Nature of the condition 7. Location of the condition 8. Magnitude and extent of surgical procedure 9. Mental attitude of the person toward surgery 10. Caliber of the professional staff and health care facilities nursinglectures.blogspot.com
  21.  Stress response is elicited  Defense against infection is lowered  Vascular system is disrupted  Organ functions may be disturbed  Lifestyles may change nursinglectures.blogspot.com
  22.  Prefixes – A, Ecto-, Intra-, Inter-, Pan-, Peri-, Poly-, Pseudo-, Retro-  Suffixes – Algia, -centesis, -copy, -ectomy, - itis, -lith, -logy, -lysis, -oma, -ostomy, -pexy, - plasty, -rrhapy  Rootwords – Adeno, Arthro, Auto, Blephar, Cardio, Cephalo, Cerebro, Cheil, Chole, Cholecyst, Choledocho, Chondro, Colpo, Costo, Cranio, Gastro, Hepar, Hyster, Lapar, Nephro, Oculo, Oophoro, Orchi, Osteo, Oto, Phlebo, Pyel, Salphingo nursinglectures.blogspot.com

A Powerful Comment

I believe every word of this comment that I am going to post below. These problems are more common than you think. A young male patient attacked my charge nurse and gave him a fracture and the judge let the lad off the hook. He attacked the charge nurse because it was "taking to long" to get discharged. The nurse was tied up giving IV meds to an unwell patient. What was management's response? "What did you do to make the patient so angry that he needed to do that?" Came from the same people who don't understand about staffing the wards properly. They don't see nurses as human beings....kind of like the members of the general public who walk onto a short staffed ward and start raving about the fact that grampa hasn't had his 8AM antibiotic yet (it is 8:03). "Are you nurses too stupid to understand that drugs need to be given on time?"

This comment was placed on this blog under the Why don't nurses smile? post.

Nurse Nancy said...
I used to work in A&E in a very busy city
centre hospital. (I had 15 years experience of working in A&E.)There used to
be 2 hospitals with A&E depts but it was decided that the city really only
needed one. They therefore closed one down and now all the patients had to go to
one department. Same number of staff on duty though.

Who would have thought that waiting times would get longer, that patient
care would suffer, that the staff turnover would increase as people could not
cope and left and that the general level of violence towards staff (due to long
waits etc)would double. I particularly recall one shift where I was the nurse in
charge with 5 other staff nurses working with me. We had four critically
injurred patients from an RTA each requiring their own individaul nurse and Dr.
This meant that there was just me and another staff nurse and a HCA to care for
all of the walking wounded who now had an even longer wait because all of the
medical staff were tied up in resus with the RTA.

The two if us also had 17 other trolley patients to care for, all of who
were acutely ill or injured, as well as trying to carry out dressings etc for
the walking wounded who actually did get seen. On top of all this we had to try
to get patients to x-ray - some of who were unsafe to be left on their own - eg
patients with dementia who had fallen and fractured things and had no relative
or care home staff with them.

Whilst i was running round the department with a broom up my arse sweeping
the floors as well i was approached by a woman who was concerned that her son
who had been brought in by ambulance had still not been seen by a dr having been
there for 3 hours (he was drunk and agressive). I have to admit that she did not
think that i was taking her concerns very seriously decided that the best course
of action was to shout at me that I was a fucking blonde haired cunt and punched
me in the throat causing me to fall back through a curtained trolley bay onto
the lap of some poor old man. Her and her son decided not to hang around after
that so at least we were one patient down.

I remember standing in the middle of this heaving and chaotic department
and thinking would anyone notice if i just sat in the middle of the floor and
had a nervous breakdown. What happened to the nice lady who assaulted me? She
got a conditional discharge for 6 months (let off in other words) and had to pay
me £50 compensation at a rate of £2 a week. What happened to me. I now
work in the civilised realm of a primary care trust as an advanced nurse
pracitioner for the elderly - nice work if you can get it!!

15 June 2009 06:21

Direct Quote from an NHS Pen Pusher.

No, I am not going to post the identity or link or any such thing. If you don't want to believe it then that is fine with me. This is a direct quote word for word from an NHS pen pusher.

"I have worked in the NHS for nearly 10 years. I am one of
those non-clinical, overpaid bureaucrats who are regularly slated in the press.
I totally agree. I got into the job by accident, stayed because of the
security/salary/maternity pay/benefits . I'm desperate to
do something more useful than sitting at a desk, sending the occasional email
and trying not to fall asleep at meetings.The trouble being that there are NO
part-time jobs ANYWHERE.So I should be grateful for my job, I suppose.But some
days I want to phone up The Sun and tell them how scandalous it is that people
like me get paid to do nothing but push paper around, --make up-- write business
cases and go to meetings 'for information'.

Militant medical nurse is not at all shocked. This person is not a nurse manager by the way (for those of you who want to blame all the problems we have on the ward on different factions in nursing). The author of this quote is just a pen pusher.

Isn't it nice to know that when we are running our asses off , not taking breaks in order to up the chances of getting around to all of our patients and getting interrupted every 30 seconds for 14 hours straight ......that some pen pushers are getting paid to do sweet fuck all..................

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Sunday, June 14, 2009

Free Nursing Lectures | Best Nursing lecture resource on the web!

Hi, Welcome to Nursing lectures! I am glad to share with you the
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Study Tips for Nurses - Highly Recommended
Discover ways to increase your learning fast. Tips to improve your grades and achieve success.

OPERATING Room Nursing Lectures
covers topics in Introduction to Surgery, OR Team Members, Surgical Anesthesia, Sterile Techniques, Surgical Instrumentation, etc.

Medical Surgical Cardiovascular Nursing lecture on Nursing lectures - covers topics in Cardiovascular System. Includes Angina pectoris, Myocardial Infarction, ECG, Diagnostic tests, Lab Values, etc.

Obstetric Nursing on Nursing lectures - includes lecture in the intrapartal period, theories of labor, 4 P's of labor,etc.

Specialty Nursing lecture - covers Nursing informatics, Special senses lectures and new topics and subjects for Nursing

Thursday, June 11, 2009

Why Midwives Need to be on YouTube

According to this morning’s New York Times, there’s a new childbirth educator on the loose—YouTube. On the same Web site that broadcasts cute kittens, teenage pranks, and music videos, women are perusing for footage of real, unedited birth experiences.In the article, professor Eugene Declercq of Boston University gives an interesting explanation as to what may be behind this emerging trend. He

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Wednesday, June 10, 2009

Smoking and Alcohol Intervention before Surgery: Evidence for Best Practice

Research Abstract and Commentary

Smoking and hazardous drinking are common and important risk factors for an increased rate of complications after surgery. The underlying pathophysiological mechanisms include organic dysfunctions that can recover with abstinence. Abstinence starting 3–8 weeks before surgery will significantly reduce the incidence of several serious postoperative complications, such as wound and cardiopulmonary complications and infections. However, this intervention must be intensive to obtain sufficient effect on surgical complications. All patients presenting for surgery should be questioned regarding smoking and hazardous drinking, and interventions appropriate for the surgical setting applied.

Tonnesen, H., Nielsen, P. R., Lauritzen, J. B., & Moller, A. M. (2009). Smoking and alcohol intervention before surgery: Evidence for best practice. British Journal of Anaesthesia, 102, 297-306.

Commentary by Dana Rutledge, RN, PhD

In this article, Tonnesen and colleagues systematically reviewed literature on the effects of smoking on postoperative pulmonary and wound complications and the effect of hazardous drinking (2-3 drinks/day) on postoperative morbidity. Their review used a research or review method called meta-analysis, whereby reviewers analyze results from individual studies in order to integrate or synthesize results as a whole. Figure 1 below shows their findings regarding the complications found associated with smoking and alcohol for all types of surgeries, in all settings.

The authors then reviewed literature on the effects of preoperative interventions (smoking/alcohol cessation) to evaluate effects on postoperative outcomes. They found that smoking interventions are most likely to enhance wound healing and pulmonary complications, and that they could not state what the “optimal” length or duration of smoking cessation necessary to guarantee success. However, Tonnesen and colleagues found that even short-term interventions led to positive results (on average).

Alcohol cessation interventions are less clear in terms of effect since alcohol use is often not defined similarly across studies, and interventions differ. However, based upon the studies reviewed, Tonnesen et al. support interventions that lead to even short-term abstinence because liver and other organ dysfunction improves after 1-2 weeks of alcohol abstinence.

Based upon these findings and the fact that about 80% of pre-operative patients want help in changing their lifestyle prior to surgery, Tonnasen et al. recommend the following:
• Patients should be screened pre operatively for tobacco and alcohol use in order to determine whether they are daily or non-daily smokers and hazardous (> 2-3 drinks daily) or non hazardous drinkers. This identifies high- and low-risk patients.
• Interventions should be carried out between the referral date for surgery and the date of the operation.
• For both smokers and hazardous drinkers, weekly individual counseling enhances preoperative cessation. Smoking cessation programs from 3-8 weeks may be successful and must include personalized nicotine substitution schedules, diaries of tobacco consumption, advice on smoking cessation, benefits and side-effects, how to manage withdrawal symptoms and weight management strategies. Length of alcohol cessation programs varies but should include personalized alcohol withdrawal symptom treatment, supportive medications, diaries of alcohol intake, advice about alcohol cessation, benefits and side-effects, and management of withdrawal symptoms.

This article documents systematic development of evidence-based recommendations about preoperative care of patients. Nurses at St. Joseph who counsel patients undergoing surgeries should be aware of these recommendations, and help their patients seek smoking and alcohol cessation programs to assist them in preparing for surgery.

Figure 1. Postoperative complications associated with smoking and alcohol use
Postoperative complications attributed to smoking
• Impaired wound and tissue healing
• Wound infection
• Cardiopulmonary complications
Postoperative complications attributed to alcohol
• Postoperative infections
• Cardiopulmonary complications
• Bleeding episodes

Tuesday, June 9, 2009

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Monday, June 8, 2009

An Inside Look at the PAC Reception

by Heather Bradford, CNM, ARNPChair, ACNM Government Affairs CommitteeWhile at the Annual Meeting, I had the distinct honor of introducing US Representative Jim McDermott (D-WA) as the keynote speaker at the Midwives-PAC Reception on Sunday night at the Seattle Convention Center. He was welcomed by a roaring crowd of over 60 midwives and 100 nurse-midwifery students who, with standing room only,

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