Saturday, October 31, 2009

US Nursing Jobs

For the month of October, the POEA has approved 11 different job orders for UAE nursing jobs. The job orders for the said UAE nursing jobs were approved for different recruitment agencies in the Philippines and constitute different nursing positions. Below is the list of all the POEA nursing jobs in UAE for the month of October which includes the position, recruiting agency, date of approval, and number of vacancies for each position..

Registered Nurse --- Int'l Quality Manpower Services Inc. --- 10/5/2009 --- 10
Nurse ----------------- Badilla Corporation ----------------------- 10/5/2009 --- 10
Registered Nurse --- Bayani Consulting Network, Inc. ------- 10/7/2009 --- 100
Nurse ----------------- Universal Staffing Services, Inc. -------- 10/8/2009 --- 58
Registered Nurse --- PNI International Corporation --------- 10/12/2009 --- 17
Nurse ----------------- Universal Staffing Services, Inc. -------- 10/12/2009 --- 10
Registered Nurse --- Focus Int'l Manpower Services --------- 10/14/2009 --- 98
Nurse ----------------- Sentosa Recruitment Agency ----------- 10/16/2009 --- 799
Nurse ----------------- France Asia International Inc. ---------- 10/19/2009 --- 50
Registered Nurse --- ABBA Personnel Services Inc. ---------- 10/26/2009 --- 96
Nurse ----------------- Northwest Placement Inc. -------------- 10/27/2009 ---9

To apply for any of the above mentioned US nursing jobs, all interested US nursing jobs applicants should leave a comment on the comment section at the end of this article and mention the nursing jobs position and recruitment agency you wish to apply to and we will Email you the address and contact infos as soon as possible.

UAE Nursing Jobs

For the month of October, the POEA has approved 4 different job orders for UAE nursing jobs. The job orders for the said UAE nursing jobs were approved for different recruitment agencies in the Philippines and constitute different nursing positions. Below is the list of all the POEA nursing jobs in UAE for the month of October which includes the position, recruiting agency, date of approval, and number of vacancies for each position.

Private Nurse --- Kimobo Int'l Personnel Services, Inc. --- 10/2/2009 --- 5
Staff Nurse ----- Dywen Int'l Manpower Agency -------------- 10/8/2009 --- 39
Senior Nurse --- Dywen Int'l Manpower Agency ------------- 10/8/2009 --- 89
Nurse ------------ Universal Staffing Services, Inc. ------------ 10/22/2009 --- 50

To apply for any of the above mentioned UAE nursing jobs, all interested UAE nursing jobs applicants should leave a comment on the comment section at the end of this article and mention the nursing jobs position and recruitment agency you wish to apply to and we will Email you the address and contact infos as soon as possible.

Singapore Nursing Jobs

For the month of October, the POEA has approved 6 different job orders for Singapore nursing jobs. The job orders for the said Singapore nursing jobs were approved for different recruitment agencies in the Philippines and constitute different nursing positions. Below is the list of all POEA Singapore nursing jobs for the month of October.

Reg'd Nurse -- Emerald Int’l Manpower Services Corp. -- 10/27/2009 -- 14
Nurse Staff -- Jedegal Int’l Manpower Services Inc. -- 10/27/2009 -- 31
Nurse Staff -- Emerald Int’l Manpower Services Corp. -- 10/27/2009 -- 2
Nurse Asst. -- Jedegal Int’l Manpower Services Inc. -- 10/27/2009 -- 14
Nurse Staff -- Fil-HR Manp. Dev. & Serv. Specialist Corp. -- 10/28/2009 -- 16
Nurse Asst. -- Fil-HR Manp. Dev. & Serv. Specialist Corp. -- 10/28/2009--15

To apply for any of the above mentioned Singapore nursing jobs, all interested Singapore nursing jobs applicants should leave a comment on the comment section at the end of this article and mention the nursing jobs position and recruitment agency you wish to apply to and we will Email you the address and contact infos as soon as possible.

Paranormal Ward




So once upon a time I was one nurse to 80 million patients and.....

I just had to start off with that line because that is how every damn post on this blog starts.

But this post has nothing to do with all that.

I had the idea to blog about possible paranormal experiences of health care workers but I put it off for months. I felt like most of the readers on here seem sensible and probably wouldn't care for supernatural stuff.

But what the hell. It's Halloween. Let's rock out with the ghost stuff. Grab your sweets and let's go.

Some of these things really happened to me and some have happened to colleagues and friends. I know I know: Dying brains hallucinate and so do tired nurses.

1.I was a brand new graduate nurse on a cardiac unit once. Didn't know my arse from a hole in the ground nor did I believe in anything stupid like ghosts and supernatural happenings. The older nurses who precepted me set me straight and made me a half decent nurse. They also nearly made me goddamn believer in the paranormal.

Peggy was my mentor and we were on duty together one evening. She had been a nurse for 40 years and was cool as a cucumber. We were looking after a man called John. He had some cardiac problems. John, a 48 year old man, was one bad dude during his life. Real bad. He had been in and out of prison for everything from drugs to rape to violent attacks on innocent people. Nurses always went into that room two at a time and security was outside.

John got better. He was discharged home by his very competent doctor. He was waiting for transport back to maximum security. He may have been an evil dick but he was orientated and with it times 3 normally. No confusion whatsoever.

But all of the sudden we heard him start screaming his head off "Help Help Help". Peggy and I legged it to his room.

"You goddamn bitches better get that motherfucker in black out of my room" says John.

"We don't see anyone in your room John so calm down and tell us what is happening. Are you feeling unwell? Are you have chest pain?" says I.

" NO i AIN'T GOT NO PAIN. Listen to me you fucking whores. That dude is standing right over there in the goddamn corner. He is wearing black and he is looking at me. GET HIM THE FUCK OUT OF MY ROOM." says John.

Peggy and I went through the motions of looking behind the curtains, in the bathroom etc. No dude in black was seen. John, however, thought he saw him and was getting really angry...fearful I think. We tried to reassure him as much as possible and stepped back in the doorway. He had denied any pain etc.

"Anna get the crash trolley" says Peggy quietly.

I couldn't believe what she just said. "He's fine, maybe he has developed an infection and he is confused. Why do you want the crash trolley?"...I giggled.

"Anna that man is seeing the angel of death, the bad one. Get the trolley and put the crash call out." says Peggy. She said this in a very serious tone she gave me a little shove in the direction of the crash trolley we use for resuscitation.

Now I am laughing at Peggy and saying "You are nuts..he's not gonna....

And as I was in mid sentence John's eyes went real wide and he collapsed in his bed. I may have been a newbie but I knew a sudden cardiac arrest as soon as I saw one.

Now I ran for the crash trolley. John did indeed pass away.


2. I looked after a lady named Jane once. She was about 96 and had supposedly been mostly non verbal and immobile following a stroke a year ago. Now she was in the hospital with something else and she was dying. I never heard her speak. One day I was walking by her room. I heard a weak female voice saying "Milly, Milly, come here my love how I missed you"! Hand over my heart I went into that room and she was sat on the end of her bed arms outstretched...a look of pure joy on her face. Her eyes looked like they were watching someone move about the room. I had never seen this woman move let alone speak so after my initial shock faded I asked her Milly was. She didn't answer. She just laid down on the bed and went back to sleep with a smile of contentment.

This happened a few more times and other nurses saw it. I never saw a look of such pure joy on any person's face. As Jane deteriorated, the Milly sightings increased. The medics didn't believe us. Finally I asked Jane's grandson who Milly was. He gave me a strange look and told me that Milly was Jane's little 2 year old daughter, the apple of her eye.

Milly was the only daughter after 4 sons. Milly died at age 2 when she fell out of a second story window while Jane wasn't paying attention. This was decades and decades ago. Jane never got over it and refused to speak about it. She blamed herself. The grandson was shocked that I even knew the name since Jane was no longer verbal. Hell even when she could talk she could not mention Milly without violently weeping.

This is when I started to get that maybe there is something out there that we cannot see. I do not believe that anyone ever dies alone. They come for them. As a nurse you soon realise that when a patient is dying it is like a family reunion of all their deceased loved ones around that bed. The closer they get to death..the more we the living seem like a fuzzy dream, and dad who died in 1930 seems like total reality as he stands over the bed with a smile and a reassuring wink.

On a number of occasions I have walked into a patient's room to see her smiling from ear to ear "My brother Paul who died in the big war was just here visiting me".

This kind of statement always perks my ears up and I take a close look at my patient because 9 times out of 10.......

Sometimes out of the corner of your eye you will kind of see or sense others in the room of an extremely sick patient. It's weird.

I was caring for a dying 87 year old woman not so long ago. She was dying in a really awful manner. The care assistant and I were changing her gown (haemoptysis and maleena). The patient was not really aware of us but my god, she was having a beautiful conversation with someone we couldn't see. I felt like I was intruding on a very emotive but happy family reunion. From what she was saying, it sounded like she was talking her to mother and auntie.

Of course of course...dying brains hallucinate and all that.

Some people claim that the wards are haunted. I have only ever seen things out of the corner of my eye and such. I walked out of the drug room and then walked back in quickly because I forgot a syringe. The room was tidy when I left it but 10 seconds later when I walked back the room every drawer was emptied onto the floor. The staff at that place were convinced it was haunted.

I took care of a little old man who used to pull my ponytail all the time and laugh. He died on my ward. Every time I walked past his bay for a few nights someone yanked on my ponytail.

I worked with a care assistant who swore that she would have reoccurring dreams about an old fashioned horse drawn hearse. Whenever she dreamt this before work there would be a death on the ward.

A very anxious lady named Helen died on the ward downstairs. They took her body away and then the room was empty. But the call bell kept ringing and ringing over and over again. The room was indeed empty!! Maintenance was called in...but they could find no fault with the call bell system. Finally one of the older nurses shouted "for god's sake Helen you're dead, just cross over and stop messing with that bell". It stopped.

There was the nursing home built over the site of a Victorian orphanage where all the Alzheimer's residents saw the same thing: A little boy in a navy suit and a little girl in a green dress running around the facility acting up and being silly and naughty. The nurse's got sick and tired of the residents asking them to deal with those brats in the old fashioned clothes who were jumping on the bed. How could the nurses deal with children they couldn't even see?

There's more but my children are raiding the sweets that I thought I had hidden so well. Happy Halloween everyone.

A Comment That Says It All. Awesome.




I received this comment on the post below this one. WELL SAID ANONYMOUS!!

Anne,

The UK's health care system is totally screwed! You should try to get out. I hate suggesting that because I know you care, but they are asking you to do the physically and humanly impossible. You should have a pharmacist in that hospital AT ALL TIMES. You should have a pneumatic tube system to tube your meds to a tube station on your ward. The overpaid pharmacist who has plenty of time to ass-sit and talk badly to the nurses should be calculating your damn dosages and mixing them. That's what he got all the damn education for, right? There should be a full-time staff of housekeepers to clean beds between patients and wash mattresses and empty trash. There should be a staff of dietary aides to distribute trays and snacks. You should be able to NURSE, and that's it. And you should have the staff to do it safely. Patients are sicker now. Your whole system is antiquated and dangerous to you and your patients.

Your entire profession should be up in arms and banging on your Prime Minister's door and demanding that someone get up off their ass, unstick their head from said ass, and totally wipe the slate clean and start over. That is how screwed up your system is. I would not work in an NHS hospital. I'd serve fries at a fast-food restaurant before I'd go face what you face every day. The powers that be in your organization do not want you. This blog is wonderful, but the people who are not nurses DO NOT CARE. It isn't happening to them, and they don't have to face that nightmare every day. And your nursing leadership DOES NOT CARE. They're not blind to what is happening, Anne. They are simply evil. They see just fine.

I am so thankful I am not a nurse living in the UK. I am so angry for all of you. I read your blog all the time, and I say this as someone who cares about your wellbeing. I am deeply concerned for you and all the nurses in your situation. I hope this does not make you mad. But I know you are not being listened to. Nurses are finally being treated half-decent here in the states (still a long way to go though). Nothing changed until there was mass exodus from the profession. And we are not out of danger yet over here. The powers that be will not listen until all of you make them listen.


I wrote a little bit below Anonymous's comment and I will post that here as well as add some more thoughts:

A pharmacist in hospital 24/7? HA HA HA HA. It would be a cold day in hell before anyone mixed our IV antibiotics for us. A cold and frigid day in hell.

I had several patients on IV Benzlpenicillin 2.4 grams, IV Flucloxacillin 1 gram, and IV metronidazole all at the same time. The Metronidazole comes bagged already (the only IV antibiotic that is ready to go) and was only 3 times a day. So we were lucky with that one. But yeah, holy massive amounts of antibiotics.

But the Benpen and the fluclox was 4 times a day and oh my god..... The benpen alone comes in little bottles of 600mg in powder form that you have to dilute with sterile water and mix and add to an IV bag of saline. It takes AGES and AGES. I feel like I spend most of my time mixing drugs.

Many doses get missed because the nurses can't always screw around mixing them when we have 20 patients all screaming "nurse".

Granted that giving the IV meds are priority because the patient is not getting their doctors' ordered treatment without it and therefore won't get better BUT try explaining that the all the screaming relatives that don't understand why we are not sat at the bedside changing mama's gown the second she spills a drop of juice on it. We get no back up from management with these
people complain. No one explains to them the reality of the situation.

And we don't have anyone to answer the phone either.

Not to long ago I was working on a shift with 2 RN's and 2 kids for over twenty patients. The phone rang non stop. We always tried to answer the phone when we could. Most of the calls are from relatives asking questions we cannot answer. Instead of accepting that they just get someone else in the family to try. They don't seem to get that giving any kind of info over the phone is illegal.

But the one phone is a long way away from the patients. If you think about the logistics of walking away from the patients every 2 minutes to answer the phone you will see what I mean. We already had a least 6 patients who required one to one care, one because he was acutely ill and the others were just extremely confused as well as very mobile. So just those 6 people outnumbered the staff already. One was so confused and mobile that he ended up leaving the ward and was wandering in the street nearby. Had to call the cops.

During all this we were only managing to answer the phone about a third of the time. It was ringing constantly. Lo and behold one caller got real pissed off that he couldn't get through and called management ranting and raving about the nurses not bothering to answer the phone. Management (the same fuckers who decided that we can't have a unit clerk anymore than half day weekdays) apologised profusely to the ignorant man and let us have it. The man (a relative of a stable long term patient) came up later during visiting hours sneering at us because "the chief promised that you girlies will be knocked into line if you don't bother answering the phone".

So yeah. That is how it is. You are right that it is all beyond the grasp of non nurses and that people do not care because they do not live it day after day. Striking isn't the answer because an ignorant public who does not understand the situation would not back us up...they would turn on us even more. They would be bored to tears with this blog and not read very far so a wake up call for them isn't happening in the foreseeable future.

This blog does have a purpose and an ending...I'm just not there yet.

Friday, October 30, 2009

Be Nice To Med Students

We had an admissions meeting this week, and I found out that med students at my school play a "significant" role in choosing who is accepted.

Quote from our Dean.. "Acceptance is based on three equal votes. One from the Ad Com, one from the Faculty, and one student vote. And depending on the faculty member, sometimes the student vote counts more"

Esentially, students at my school can influence someone's acceptance in three ways:

1. An admissions "vote" after interviewing a candidate
2. A recommendation submitted on behalf of a candidate
3. A "blackball" ......aka you are NOT getting in ....

So make sure you are extra nice to med students during your interviews.

CELLULAR BIOCHEM DONE!!!

Well, my first med school class is officially over! Too bad it's not anatomy. So Monday I start Genetics. Yay! Will let you know when I receive an official "Pass"

P=MD Baby

UPDATE: PASSED... it's official!

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Thursday, October 29, 2009

Texting

Last night my lab partner text me. The following conversation ensued. I thought it was cute... so I'm posting:

Him: Do you have any problem with me taking home our skull to study this weekend?

Me: Damn. I was really hoping I could get it first. (Sighs reluctantly)... Ok, but you owe me BIG time. Just don't use it for a Halloween decoration, ok?

Him: Seriously? If you want it I can leave it in the lab and just go in over the weekend.

Me: Ok, that was a JOKE. Don't you know me at all? Can you really picture me bringing home a human SKULL? YUCK!

Him: LOL, I just wanted to check because I don't want to get any of your crazy eyes


FYI: My lab partners think that I have "crazy eyes"... which apparently are the worst thing you can get next to a visit from the Grim Reaper.

Here's a Clip of the REAL Patch Adams. Nutty, but Adorable.

Patch Adams on Medical Technology

Reverse Psychology

Last night I went to a pharm dinner at an awesome restaurant. My boyfriend and I occasionally hit up these dinners bc it's a cool way to get info on random drugs ... plus you get free dinner from a fancy place that we're normally way too broke to ever go to.

Usually, we expect that the presentation will be highly biased and will promote whatever drug as the new best thing since penicillin. So we go in with our secret decoder rings on to filter out all the BS.

And, yes, I'm aware of all the ethical issues surrounding pharm dinners and perks, and frankly I think its BS. As a physician in training I think I'm savvy enough to know that walking into a drug company meeting I'm not going to find a comprehensive, unbiased description of XYZ drug or condition. And I mean really, the pen thing??? Get real. (although I totally understand doing away with gifts and incentives like trips to Europe for writing 400 scripts in a month, etc.)

But last night we discovered that Eli Lilly is up to a new trick. They didn't try to push a drug on us. In fact, they didn't even MENTION a drug. I don't even know WHAT drug they were promoting. Basically a physician speaker came in a presented current research (not from Eli Lilly either) on metabolic disease prevalence among those with mental illness. We actually learned something. Didn't feel pressures. Didn't need our decoder rings. Had a great dinner. For free.

Eli Lilly, if this is an attempt at reverse psychology... nice work.

Novel Skill As Currency

The other day NPR did a story on economics and monkeys. Essentially a researcher observed that monkeys use "grooming" as a way to sort out their societal hierarchy. Top monkeys get groomed by lower level monkeys and never have to groom anyone. Low level monkeys groom top level monkeys and are never groomed by anyone. Got it?

So they took a low level monkey and taught her an important skill. They taught her to open a jar of apples. All of the sudden, BAM, she became a top monkey and was groomed and pampered and yada, yada... She actually changed her status in society by acquiring a skill novel to the group.

THEN, they trained a second monkey to open the jar of apples. Guess what? The PERCEPTION of the value of the skill went down... and attention and grooming paid to both "skillful" monkeys was significantly less than the first monkey.

Now I don't know if this study seems significant to you all.... but I find this INCREDIBLE. First, it shows that the law of supply and demand in found in nature. And that other groups beyond humans have an economical society. But most of all... it shows that all members of a society are not equal. And that your position in society (according to nature) is based on merit and unique skill and what you contribute to the group. Novel idea, eh?

Point of the story? Find a niche in medicine... (not necessarily a SPECIALTY)... and be good at it. Whatever you want... being the world's expert on Cushing's Syndrome in latino countries, or an expert in clinical symptoms of helminth infections, or start an OB service in rural Alaska. SOMETHING that gives you value and that you can contribute.

My friend Dr. J also gave me this advice a while back... If you have value in medicine, you will always have security... If you contribute nothing, you are always insecure and defensive towards those who do have value.

Wednesday, October 28, 2009

College of Nursing hosts Indonesian visitors


The College of Nursing hosted a group of nurses from Indonesia yesterday as part of their visit to the United States. The trip was arranged through the Indonesian embassy and the Association of Indonesian Nurses Education Centers in Jakarta, the capital city. The association has an annual study visit to the education and service institutions in the developed countries.

The 46 nurses represented several institutions in Indonesia as well as some prospective master and doctoral students. Among the visitors was an alumnus, Mohammed Subu, a 2002 graduate of the Master of Science in Nursing program in nursing education. The group’s goals were to observe the learning facilities for nursing students, and investigate the programs at the University, the education management system and the collaboration between education institution and hospitals. They enjoyed an overview of the College’s history and programs and tours of the state-of-the-art Driscoll Hall with its clinical simulation labs, as well as the University library and later a clinic run by the College faculty for the underserved populations in South Philadelphia.

Getting Involved

For the first few months of med school I shied away from getting involved in any clubs or organizations (except the EM interest group) because I wanted to focus on school. Which was probably a good idea because most of the initial stuff I wasn't really interested in anyway. But just recently I've become involved with 2 really great organizations.

First, I was selected to be a representative for a historical club that organizes lectures on the history of healthcare in our city... as well as the history of diseases, diagnostics, etc. Very cool. Last week there was a cocktail party at a professor's house, and I was announced as a new representative (along with 3 others). I was pretty stoked!

Second, my friend "E" recommended me for a leadership position in the student run-clinic that I spoke of before. So now I'll be participating in that as well... which is damn cool!

The Nursing Times : Where have they been for the last few years?

Can you believe this shit. How can this be news to these people? Bear with me. I have just complete two shifts from hell so I am in a bad mood. I started at 0700 and by 10 AM I hadn't even set eyes on half my patients. The healthcare assistants were missing the fact that people were obviously going into septic shock, they forgot to check the blood sugar on the lady that goes hypo. I was up to my ears in meds etc. I couldn't go 5 minutes without consultants showing up and interrupting me. Every time they did so it pushed me back from carrying out an initial assessment on my patients by another 15 minutes. It got so bad that by 10AM I hadn't even seen half of them and was afraid of walking into a room and finding a corpse.

If a trained nursed has the recommended ratio of 6 patients she can get to all of them and see all of them and get to grips with their situation within the first hour of her shift. But with 21? No way. By 10AM I had no idea what was happening with half of these people and the 4 care assistants that were with me were no help to any of this whatsoever. A registered nurse does not walk onto a ward of 20 people and suddenly "know" everything about the patients by some kind of psychic phenomenon or information osmosis. We get a brief report on 20 people...that takes 45 minutes and then we don't know much until we assess the patient, look at their observations, fluid balances, their doctors notes, talk to the patient, look at the nursing notes etc. It takes about 20 minutes per each patient to do this kind of assessment so I that know what is happening with them. The written info is kept in about 4 different places throughout the ward.

Anyway back to the Nursing Time Article.

This has already been going on for years. This is why nursing care these days is shit. Everyone knows (except the fucktwits who run hospitals) that the decreasing the number of registered nurses and replacing them with untrained kids is a big fat fail. The reasons that RN's cannot function is because we are spread to thin among to many patients and forced to delegate to care assistants who don't know what they don't know and don't care either.

I told you that it was management moving nurses away from the bedside not an over academic nursing profession. Nurses need to be highly educated, they need to be at the bedside, and they are not too posh to wash. University educated nurses are taught that they need to provide basic care in order to assess their patients properly. Assessment is the first step of the nursing process.

These hospitals are saying that there is a shortage of band 5's (registered nurses). This is bullshit. They are not advertising to hire them on the wards. They are only posting ward jobs for care assistants and many newly qualified nurses are on the scrapheap, unable to find jobs.

I told you that this shortage of RN's working at the bedside is down to economics rather than arrogant nurses who supposedly think that they are above caring.


I told you that the "shortage of trained nurses" is/was manufactured by greedy hospital chiefs.


In every post on this goddamn blog I explain how care fails when an RN runs between too many patients and is so swamped handling drugs, assessments, and orders by herself that the care assistants are doing all the actual care, and totally fucking it up. They cannot assess patients, electronic monitoring does not help. The care assistants go through the motions of providing care like it is factory work. Too much gets done incorrectly and or completely missed until it is too late. This is called failure to rescue. The few actual nurses are to swamped to actually assess and plan and implement care. Our hospital patients are getting nothing in the way of nursing input.

It's a total fucking fail and it will kill more people and cost more money if it continues.

I said it here.


I explained it here and in pretty much every other post.

How dare they devalue proper ward nursing and say that someone who isn't trained and registered can take over?

IF this is a good idea then why does research show that a smaller proportion of qualified nurses in the ward skill mix causes higher mortality rates and increased costs?


IF this is a good idea then why do patients of hospitals that employ a higher number if highly educated RN's to work at the bedside have much lower mortality rates.



When they say that they are not creating band 4 protocol based posts to save money....THEY ARE LYING.

And yes RN's do report that we have to do many things that are "beneath our level of training". We have to wash mattresses when we have 3 patients crashing because the care assistants cannot be bothered and we are getting an admission in 5 minutes. You don't look at that and think "Okay, then let's have less real nurses and more irresponsible untrained people who don't have a registration to maintain and don't care on the ward then". You are supposed to look at this and you hire domestics to avoid a multi million pound damages payout when a patient dies because his nurse is washing mattresses.

I am heading into another shift from hell today. Bear with me.

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Tuesday, October 27, 2009

Productive ward. Again. Kill me please.

Productive ward: releasing time to care is back in full swing on my unit.

Apparently the ward would run as smooth as silk if only nurses understood how to tidy cupboards and work more efficiently.


The physical ward layout (appalling), the chaos, the constant interruptions and the massive lack of qualified staff make the idea of working efficiently a joke. The closest we can come to being efficient is taking dangerous short cuts just to ensure that we can actually assess everyone and get all the drugs out and administered without a fatality. All registered nurses are forced to do this on a daily basis because of the working conditions that they cannot control. Anyone who says that this isn't true is a liar.


Even if we could tidy and reorganise the cupboards we would still be up and down that ward constantly, wasting precious minutes. The thing needs to be redesigned and rebuilt to be truly workable. Half our supplies are always missing and require the ward staff to abandon patient care to obtain things constantly throughout the shift. Productive ward isn't going to fix this mess, it just puts more culpability onto the nurses. Pharmacy, and equipment /central supply are 9-5 Monday to Friday. And even during 9-5 they are fucking useless. They cause is more work than any patient ever did. Their worldview is that the lone RN on a ward with 20 something patients is there to make their job easier. God how I hate them.


Let me give you an example of something that happens about 100 times during an 8 hour shift. The lab calls me at 4PM and tells me that my patient's most recent blood results are barely compatible with life. My job is to inform the doctor who is covering. He orders a medicine. Of course pharmacy won't allow us to keep it in stock. To get the medicine I have to ring pharmacy, leave a message, wait for them to call back and then argue with them for about 15 minutes. They are pissy because they are supposed to finish work for the day at 5PM. They stomp their feet and say that they will not bring said drug to the ward. I have to walk the written doctor's order for the drug to pharmacy.


I get there and they ignore me for another 15 minutes while I bang on the glass. I. am. Serious.


They say that they will ring me as soon as the drug is ready. I reiterate the fact that I need this drug NOW. I cannot sit there however. I have many other things going on with my other patients that are almost as high a priority.. 30 minutes sat in pharmacy could seriously harm my patients who are now nurseless. Pharmacy promises me that they will bring the drug to me asap. If I send a care assistant rather than go down there myself it is bound to get all fucked up. 99% of the time we cannot get through to them via phone as they have it permanently on voicemail.


Back to the ward now. I need a special pump to deliver this med that we also are not allowed to keep on the ward as per central supply's dumbassness. I call central supply. A grumpy man who is obviously eating something chewy answers the phone. I tell him what I need. Very slowly he responds with "Well you will just have to come down here and get it".


But I cannot. I am hoping to get this drug administered ASAP as soon as that slut from pharmacy gets her ass here (and she had better hurry I swear to god).


I tell Dick from Central Supply that I am in no position to leave the ward (yet again) and my care assistant is trying to stop my alcohol detoxer from attacking the other patients (so am I while I am on the phone).


He chews whatever the fuck he is eating and slowly responds with "sigh sigh siiiigghhh. I will bring it up if I must. You had better go around your ward and find every piece of equipment that belongs to central supply. Clean it and label it before I get there and put it on a trolley so I can bring it back with me. I don't wanna make two trips. I'll be there in 15 minutes so have it ready for then."


Yeah right Dick. I am chasing pharmacy right now. There is now only myself and a care assistant on the ward. The other RN is now in recovery picking up her post op patient and the other care assistant had to escort a dementia patient to the CT scanner because the staff down there don't want to deal with it. I have a patient who has blood results that show that she needs this drug infusing via this particular pump NOW. I have an alcohol detoxer who is beating the care assistant, trying to beat other patients and myself and we cannot get her doctor to come up here and prescribe sedation. I have 20 other patients as well. I had over 15 IV antibiotics due in the last hour that I haven't even begun to mix. I have a que of angry relatives that want to know exactly what it is we are doing for their loved one. I will certainly be ignoring Dick from Central Supply's request.


And pharmacy still is not here. I ring them. I get voicemail. I can't go down there and neither can my care assistant.
You leave one person on the ward and a crash occurs you are fired.

Now the doctor who prescribed the drug for the patient with scary blood results is on the ward. He looks at his patient. His face turns the colour of a tomato. He glares at me. "Why the hell hasn't the drug I ordered been started yet? What the hell are you doing? Do you not understand that it is priority?" he screams.


Yes I do doc. But I cannot give what I don't have or pull syringe pumps out of my ass. I have already been ignoring many sick people over the last hour trying to pull this together. By the way...do you see that patient over there beating the healthcare assistant? See the scratches on my arm? Her doctor is tied up somewhere...will you prescribe her some sedation? Benzos not appropriate I know...how about haldol...anything?


"No. Not my patient. Get the anti -scary- blood- results- drug up now and call security for your combative patient."


The he left. We did call security actually. Those are the porters. They informed us that they are too busy.


OMG where the fuck is that slut from pharmacy. Their phone is still engaged. I cannot leave the ward. Dick from central supply showed up with the pump, took one look at the alcohol detoxer who was licking the floor and trying to hit anyone who came near and left quickly.


Now I have my pump. But where oh were is that slut from pharmacy.


I run to the end of the ward and peer down the hallway. There is the slut from pharmacy. She is holding what looks like the box containing the drug I need. She is stood talking with her friend from medical records that she has obviously run into on her way here. I walk over to her. I grab the box out of her hands. "Is this for ward R" I say. "Yes" she says whilst looking shocked that I just grabbed something out of her hands roughly. And off I go back to my ward whilst shouting "I needed this an hour ago".

"Those nurses really have an attitude don't they" she says to her friend.

Now I move at the speed o0f light getting the drug out mixed, ,measured, drawn up and doing my maths calculations. My other RN is back from theatre and quickly she checks my arithmetic. I get the drug up and grab a set of obs on my patient. Finally after over an hour of bullshit she is getting the treatment that the doctor ordered. What if I had dropped the ball on this an hour ago? What if I hadn't notified her doctor of her blood results or stayed on pharmacy's ass, multitasked, moved quickly and ignored my other patients calls for help to get this patient her treatment? The brilliant doctor and his brilliant treatment orders go nowhere if they are not implemented. And implementation of treatments is totally the domain of the registered nurses. It takes knowledge and you have to fight! Diagnosing and prescribing (the doctors domain) is only the first step of a very complex process of caring for hospital patients.


Now I brace myself to settle down this detoxer (she has already taken a chunk out of my upper arm) so we can get back to caring for all the patients...but in 10 minutes it will all start again and we will be looking for things.

This is how bad things are during 9-5 hours. You should see what it is like trying to get what you need out of hours.

But they want us to understand that if we tidy cupboards on the ward all will be well. Productive ward will not in any way shape or form deal with the bullshit from central supply and pharmacy. It will not address the fact that we are running these wards with so little staff that we can barely address 1% of what we should be doing. But this is their "solution" to problems that they do not understand.

Now that productive ward is back in full swing our ward sister has been forced to put a cork board up at the nurse's station. On it she has been forced to put little motivational messages. We are supposed to add to these messages by writing our feelings onto the board. The messages say things like:

Releasing time to care: I will understand that I am here for the patients

Working more efficiently so every shift will be a joy!.

Helping the ward to be more organised so that we can spend time with the patients.

Every single member of ward staff is supposed to grab a colourful marker, some nice paper and add their happy visions about the productive ward to this board. I haven't added mine yet. Do you guys have any suggestions for me?

I was thinking about stealing this from mental nurse and posting it on the happy happy joy joy board.

Monday, October 26, 2009

A New Obsession

Something strange is happening to me. It happens all the time. I can't control it. It's all I can think about. During lecture. While studying. While eating lunch. You know what I'm talking about. Sleep. Yes, folks. Sleep.

Its not that I'm getting so little. Usually at least 5 hours at night, and maybe an afternoon nap for an hour. It's just that I'm stressed I guess.... and maybe sick... so therefore chronically fatigued. But I find myself zoning out during lecture.... fantasizing about how I could just duck down between the rows and prop my head on my backpack, my sweatshirt over me for warmth... and just catch a 10 minute cat nap. Maybe I could sneak to the student lounge while everyone else is in class. Or out to my car... the parking garage is pretty dark... and I could turn the heater on and be toasty warm. Ooh.. I even have contact solution in my bag...

And then something snaps me back to lecture... I take another sip of coffee in vain... and drag my tired butt around for the rest of the day. Nap-less.

One last reason why ortho is off my list

Bone saws + Bone dust = Disgusting!

Today we (well, not me as I was huddled in the corner trying to keep the bone dust out of my hair) used the bone saw to actually remove the skull. Circumferentially. Like a bowl. It just "popped" off. Then we just "popped" out the brain. Oh dear.

The point is that I do NOT like the smell of a saw burning through bone. It's white powder that permeates the air. And your hair. And eyes. And nostrils. And I swear I felt grit inside the roof of my mouth. Which means I could actually have cadaver dust in my mouth. Which is pretty much the grossest thing I can imagine next to having cadaver juice in my mouth. Which means I will not be considering ortho. Ever. Without a doubt.

Hello Lover...........




Well since ADoc2Be brought it up, and I never miss an opportuity to discuss shoes, here's a picture of my recent Christian Louboutin obsession. I'm 5'10" and would NEVER let that stop me from wearing these lovelies.

The real question is whether I can get away with wearing these with scrubs in the emergency department....

Please. Shut Up.

It's interview season. And around my school there are tons of nervous applicants all in black suits (what's up with THAT?...) milling around the halls or in our student lounge waiting for their next scheduled appointment. It's pretty cool... you get to chat a little and encourage them... give them pointers about certain interviewers.

But today I almost told a girl off. She was sitting in the lounge (with her black suit of course)... and loudly having a conversation with some other candidates who were noticeably more well behaved. At some point I pulled out my iphone and started recording what she said... because I knew no one would believe me. The diatribe went something like this...

Black suit girl (LOUDLY) "Yeah, I'm from California... where I worked as an EMT for company X... who were all FUCKING MORONS!!! I mean, every loser guy who can't get into college decides he wants to be an EMT... so I had to compete with all of THEM to actually get a job. SERIOUSLY, I could not handle that job. It FUCKING SUCKED!!! I'm used to a job where I can go where I want, when I want, and I don't have a schedule or a supervisor. I can't deal with having to show up at a certain time, when someone tells me to...."

Let's just say this lovely talk went on for about 20 minutes. As I sat there, I got progressively more steamed. Not to say that I don't do my fair share of bitching about morons. But not LOUDLY, WITH PROFANITY, and on my MED SCHOOL INTERVIEW! I thought about asking her her name so I could send the Dean a "grossly offended" blackball email. I considered asking her shut up. I considered ripping out her recurrent laryngeal nerve.

In the end I figured it wouldn't matter. She couldn't possibly behave herself on an interview. She couldn't possibly end up here. If she does, I can always resort to my laryngeal-nerve-severing ninja moves.

Sunday, October 25, 2009

Ok Let's talk about HER

Her. The one I mentioned before. I'm sure everyone else is just as obsessed as I am. Dr. Kenton-Hadley. I only just met her recently, but I'd heard about her for years. My friend T who's now in med school in Texas used to work with her and he would always gush about her. She's SOOOO amazing. Beautiful. Smart. Accomplished. He'd come back from his project and say crap like "Maybe someday you'll be like her.... if you're lucky... and if you miraculously get beautiful and smart" And I'd think "Yeah, yeah. Whatever, Jerk."

Because truthfully, while I find some qualities I like in nearly every woman, it's a rare thing to find someone I truly look up to. A women who you say "Damn, I'd give a kidney to be like her". It just doesn't happen. At least to me.

Then I met her. And she is. Beautiful. Smart (and kind of a smart-ass). Accomplished. Philanthropic. She went to Harvard. She's been in People magazine. She saved our city after a Hurricane (only a slight exaggeration). And she has fabulous shoes. Lovely all around. And she makes me stupidly nervous like I'm talking to some guy I have a crush on. She's like a goddess around here.... Everyone (students, professors, and staff alike) talks about her like she just invented sliced bread. Knowing her, she probably did.

And as for the kidney thing... I would seriously consider it... even for the shoes alone.

It's Halloween

And people are dressing up their .... Dogs!!! Here's my friend Ally's dog (she's a Vet). He won the costume contest... as a Starbuck's Latte! Adorable, yes????

Saturday, October 24, 2009

Oh... so phe-nom-enal!!!

So I've seen patients in the past. Fake patients faking it. Fake patients with real scenarios. Observed real patients. But today, TODAY I had my OWN REAL PATIENTS.... with real diseases!!! It was awesome.

I work at a free community clinic started by medical students from my school several years ago. Essentially there are tons of medical students and 1 or 2 attendings supervising everything. First year medical students take on the role of 3rd years, and 3rd year medical school students take on the role of the resident. We work up the patient and present it to the attending... who just happened to be Dr. Kenton-Hadley. She's basically my idol (except for Carrie Bradshaw and Carla Bruni of course)... and I want to be her. Am I obsessed? Definitely. I don't think she's acutely aware of my obsession... unless she noticed that I was hyperventilating while I presented my cases to her. More on Dr. Kenton-Hadley later.

I had two patients today. One had gout. The other was not happy about what she suspected to be a possible pregnancy. She was pregnant. And I told her. (well sort of... through a translator bc she didn't speak English). All in all, it was awesome.

Not going to lie though, paperwork sucks. Guess I better get used to it.

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Friday, October 23, 2009

Women Would Be Better Off If Reform Passes

While President Obama and congressional Democrats discuss the public option and the absence of bipartisan support for health care reform, a front-page article in Monday’s edition of Politico proposes that highlighting the particular importance of proposed reforms to women may be the key to successful reform.Women have a lot to gain if health reform legislation passes. Protections mentioned in

Video available: Promoting Dignity through Volunteerism

See the link below to access the October 5th video recording from Promoting Dignity through Volunteerism in the Driscoll Hall Auditorium. Thank you again to our panel!
http://vumslx.vuad.villanova.edu/mediasite/Viewer/?peid=7aa3372b22f74a27bab4d8c0756f0868


Patricia K. Bradley, PhD, RN
Barbara Ott, PhD, RN
Elise Pizzi, MSN, CRNP
Faculty, College of Nursing Villanova University
Hear this faculty panel discuss how they integrate their clinical expertise to uphold and promote the dignity of the individuals and groups with which they volunteer. Their volunteerism includes working with African American women with breast cancer, underserved immigrant populations in clinics, and those in the midst of ethical issues related to their health.

New Family Nurse Practitioner Option


The College of Nursing has received approval for its Graduate Nursing Program’s new Family Nurse Practitioner (FNP) option from the Pennsylvania State Board of Nursing. The establishment of both a master of science in nursing (MSN) degree and post-master’s certificate option was approved. Students can enroll in the FNP option starting in January 2010.


Why add the FNP option to the existing adult, pediatric and geriatric nurse practitioner (NP) specialties at Villanova? The FNP program was developed to meet the need for increasing numbers of nurse practitioners who can care for patients across the lifespan. “Family nurse practitioners are the most versatile NP population as they can meet the health care needs of a wide range of patients in a variety of practice settings,” explains Elizabeth Blunt, PhD, RN, APN BC, assistant professor, coordinator of the NP programs and an FNP herself, “Our students have been asking for this option so they have flexibility in employment options including sites such as nurse managed health centers, retail clinics and emergency department and urgent care centers.”


The FNP option is 47 credits with 730 clinical hours for the MSN degree, or students may complete an FNP post-master’s certificate of varying credits –up to 36—depending on education background. Students will benefit not only from the partnership with faculty who bring their current clinical experiences and mentorship into the classroom but also the integration of procedures such as suture workshops into the curriculum. The FNP option is structured so that nurse practitioners with a population focus in an area other than family can complete the FNP requirements, usually within one year.

Thursday, October 22, 2009

Oh Dear...


So here's one of the Navy's ships. It's name? HSV II Swift! Which is supposed to stand for High Speed Vessel II... and Swift no less....

Don't they have docs in the Navy that should step in and say "Uh, guys... not a good idea"?

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Homogenous People

The other day I was talking to a girl at school and I could not remember her name. So I went home and checked out our little class book which has everyone's pictures and a little blurb about them. "Ah, Sophie. That's her" I thought. But then I came to Alain. That looks like her too. Shit. They really look alike. So I got the brilliant idea that I should briefly review our entire class book to see if I'm getting other people mixed up. Crap on crap. There are like 7 sets of girls that look practically identical to each other.

2 girls with curly brown hair that are super friendly and smily and the same height. Can't get them straight. I really have a tough time with these ones... because one is really nice to me and one I guess I haven't met... so she doesn't really talk to me. For a while I was thinking that she/they was just one really moody person.

4 blond tiny girls with med length straight hair. All pretty. No way this is getting worked out any time soon.

Then there's a girl in my lab who I talk to occasionally. She is a cute girl, but doesn't have any striking features like green streaks in her hair or a wart on her nose so I can easily identify her. I swear I had a full-on conversation with another girl last week thinking it was her. Oops.

I think the real problem here is that I can't recognize people for shit. In fact it's become so bad that I actually had to give myself a game-plan for what to do in case I get stuck in an embarrassing situation. I would explain it here... but then I'd be giving away my tricks... and everyone would know when I'm having a dumb-ass moment.

Professor Thomas

Professor Thomas is our school's confidant. Kind of a mix of a professor, a counselor, a priest, a dad, and a great resource. Supposedly you can tell him anything and he won't report it to the Deans office. Anything like "I spent my financial aid money on hookers" or "I can't study without speedballing" and supposedly if you do whatever he says it will remain confidential and you can come back to school after you get yourself straightened out. Which is pretty damn cool. Because in recent years I have become more and more aware of friends and classmates of mine who have severe drug problems and NO ONE EVER KNOWS. It's incredible at how good people are at staying stealth.

Ok, the point of this post was to discuss something that Professor Thomas told a group of us the other day. Basically he said that our school has only kicked out 5 (yes, F-I-V-E) students for poor academic performance. Ever. Like since dirt was young. Every single other student who has failed or was borderline was remediated by repeating a year or whatever (that's a $70k boo-boo I wouldn't want to make!)

To this, my classmates astutely pointed out that "Well, still... you don't want to end up as #6". And Professor Thomas said "Don't worry...It can't happen on accident. You really have to work HARD to get kicked out. Probably harder than you'd have to work to stay in."

Good to know.

Wednesday, October 21, 2009

Sucks for them...

Funny. Another blog I read White Coat mentioned this a few weeks back... and I kinda laughed. Then I got invited to a pharmaceutical dinner put on by Eli Lilly and the asterisk says "If you are a physician from the state of Minnesota or Massachusetts and have already fulfilled your $50 annual limit, we look forward to seeing you next year"

Sucks for them....

Peeling Back the Pink of Breast Cancer Awareness

by Melissa Garvey, ACNM Writer and EditorLast weekend the National Breast Cancer Coalition (NBCC) launched an Emerging Leaders workshop—a program designed to train the next generation of breast cancer advocates. I attended as an ACNM staffer and was struck by the parallels between breast cancer advocacy and birth advocacy.What I found most fascinating was the amount of misinformation about breast

Monday, October 19, 2009

Nursing Questions

Here are some sample nursing questions on Cholecystectomy,Appendectomy,Thyroidectomy,CS operation and Gastrectomy. Visit our site often for more Nursing lectures. Subscribe to our RSS feed for instant Email updates.



Getting Pimped

When you get pimped in medicine (AKA Shame-based learning), it means that your upper level, attending, or your professor basically tears you a new asshole in front of your peers by firing off a million questions designed to put you on the spot and make you look like a dumb ass in front of everyone. Well, I should clarify. That's what pimping IS, not what it's supposed to be. If I were an attending defending pimping, I'd probably say something to the effect of "it's the Socratic method of teaching, used in an attempt to facilitate group learning and discussions, etc. etc." Whatever. It sucks.

As I'm sure you've summoned, I'm not really a fan of getting pimped... but as I've gotten older I have to say I'm much better at dealing with it. For instance, I have no problem repeatedly stating that I have no idea what he/she is talking about. I know that there is so much to know in the world that it is OK to say "I don't know". Plus, admitting that you have no idea early on in the pimping session makes it much less enjoyable for the pimper (or maybe just pimp?) to continue his tirade. Additionally, I have no issue with telling somebody to get off my case. Usually I can ward off pimping pretty well. Not to say that a really good pimp couldn't still make my adrenaline surge or even prompt a few tears... but they'd have to be the world's biggest a-hole for that.

So some people advocate that they like professors who pimp because they make you think, they make you uncomfortable, and put you on your toes. I couldn't disagree more. For me, being in utter terror of not having the right answer never contributed positively to my learning processes.

Interestingly, the ones who pimp the most usually seem to be incredibly mediocre, unaccomplished and on their own narcissistic ego trip... out to demonstrate to the group that they know at least one thing that the pimpee doesn't know. It's totally not necessary. I have met some of the most accomplished, amazing, noble prize winning professors and NOT ONE of them ever did this crap to me. According to Buddha's requirements for being a great teacher, one must be deeply compassionate with their students and have ultimate patience. No where on the list does it mention "Pimp your students until they vomit from sheer panic".

Which happens. There are tons of stories about med students and residents getting so stressed out by pimping sessions that they actually pass out, have anxiety attacks, or burst out in tears. Two stories I've heard about at my school include a girl who passed out in anatomy lab after getting pimped (Yuck... hopefully she missed the cadaver), and a guy who passed out during a group learning session after getting grilled. I mean really. What can this possibly accomplish? Since when are "knowing the right answer in 1 second" and "being resourceful and intelligent" synonymous?

A Surgeon's Thoughts on Oncology

Since it's Block III, we have switched anatomy professors again. Our new one seems ok, decent guy, albeit a bit forgetful. Today he asked me to sit down with him and chat for a few minutes... apparently he likes to get to know each student on an individual level. Which I think is pretty nice. So he asked me where I was from, what I have done previously, yada yada. Then I told him how much I like EM, but I was trying to keep my options open. Then I mentioned how I was liking my pancreatic cancer research. He got wide eyes and said "so you like oncology?" I shrugged and said " I don't know, maybe"... then he gave me a funny look, waved his hand and said "Uh. Oncology is like pissing into the wind. Really." Not so encouraging... but funny nonetheless.

Evaluating the Use of Standardized Patients in Undergraduate Psychiatric Nursing Experiences

New article published by our faculty and lab director about the use of SPs (standardized patients):

Robinson-Smith, G., Bradley, P., & Meakim, C. (2009, November). Evaluating the use of standardized patients in undergraduate psychiatric nursing experiences. Clinical Simulation in Nursing, Vol(5). doi:10.1016/j.ecns.2009.07.001. This is an online journal.

From the abstract: Results suggest the SP interviews increased the overall perceived student self-confidence, critical thinking, and satisfaction with learning. Findings highlight strong and weak areas of perceived clinical skills in students and provide guidelines for teaching psychiatric nursing content.

Physical Therapist Jobs US

This is the perfect opportunity for all Filipino Physical Therapist who are qualified to work in physical therapist jobs in the US. The Philippines Overseas Employment Administration has approved for recruitment a job order for more than 300 physical therapist jobs for the US. The job orders for the said physical therapist jobs for the US are for the different recruitment agencies whose names, date of approval, and the number of vacancies for physical therapist jobs for the US, are listed below.

Al-Siq Int'l Placement and Manpower Services, Inc. --- 9/30/2009 --- 11
Greenfields Int'l Manpower Services, Inc. ----------------- 9/25/2009 --- 10
Reliable Recruitment Corporation ---------------------------- 9/25/2009 --- 15
Health Carousel Philippines Inc. ----------------------------- 9/24/2009 --- 154
Aquavir International, Inc. --------------------------------------- 9/17/2009 --- 1
Global Recruitment Connections ----------------------------- 9/16/2009 --- 30
Aguila Management & Resources Corp. ------------------- 9/10/2009 --- 78
21st Century Manpower Resources Inc. ------------------- 9/10/2009 --- 18
Industrial Personnel & Management Services Inc. ---- 9/9/2009 ---- OPEN
EDI Staffbuilders International Inc. -------------------------- 9/8/2009 ---- OPEN
Kimobo International Personnel Services, Inc. ---------- 9/1/2009 ---- 19

For comments or questions on the above mentioned physical therapist jobs in the US, just leave a comment on the comment section of this article and your concerns will be addressed the soonest possible time.

Recruitment Agencies for US Nursing Jobs

For all the qualified nurses who want to work in US nursing jobs, below is a list of recruitment agencies that recruits qualified applicants for US nursing jobs. This list of nursing jobs recruitment agencies specialize in recruiting foreign trained nurses for various nursing jobs positions in the USA.

ADEX Medical Staffing – full service agency.

ALDA Professional Placement Services - assist with placement in various countries.

All About Staffing, Inc. - an affiliate of HCA Hospital, no agency fees, visa sponsorship.

ASMCI USA – assist with NCLEX, IELTS or TOEFL preparation, no agency fees.

Assignment America –affiliated with Cross Country, offers full service assistance.

Bonacare USA - full service agency specializing in recruiting nurses from Korea.

Cambridge Healthcare – CGFNS certification requirement, assist with NCLEX and visa filing.

Carex Global Recruitment – full service international agency, no agency fees.

CBH Healthcare Recruiters – full service agency includes on the job training.

Christine Paris Enterprises USA Inc. - full service agency, placements also in Australia and UK.

CMS (Comprehensive Medical Staffing) – full service agency, assist with filing application.

CNERGI – offers reimbursement for immigration costs, no agency fees.

DB Healthcare – full service agency includes visa filing and reimbursement of requirements.

DirectSource Healthcare – works with recruitment firms & assists with nurse placements.

European Medical Staffing – full service agency, not limited to European RN recruitment.

Global Healthcare Resources – full service agency, focuses on cultural transition program.

Global Nursing Solutions – full service agency, refund of NCLEX/IELTS fees.

Global Nurse Recruiters Corporation – full service agency, reimbursement of immigration fees.

USA Global Nurses Network - full service agency specializing in recruiting Indian nurses.

GlobalNursesOnline.com – full service agency, placements in the US and UK.

Global Nursing International – full service agency, full benefits package

Global RNSource – specializes in California placements.

GlobeMed Resources – reimburses cost of exams, immigration, & travel, focus on Indian RN.

HCCA International – full service agency since 1973. Full benefits package.

Healthcare Resources International – assistance with immigration process and placement.

HealthStar International – full service agency, over 450 nurses placed in the US.

HMI (Health Management) – CGFNS and IELTS required for placement.

Institute of California Bilingual Medical Staffing – specializes in bilingual RNs from Mexico.

International MedLink – full service agency, CGFNS required, unique Vanderbilt training.

Job2Career – full service agency, very established presence in India.

JUNO Healthcare Staffing - NCLEX or CGFNS required, assistance & placement.

Kennedy Healthcare Recruiting – full service international recruiting agency.

Medliant – full service agency, reimbursement of immigration fees, travel, etc.

Nurses to USA – full service agency specializing in nurse recruitment in the Philippines.

Nursing USA, Inc. - full service international recruiting agency.

O'Grady Peyton International - full service agency, over 25 years of experience in recruiting.

Onward Healthcare – agency with per diem, travel and international recruitment programs.

Pacific Link Healthcare – full service international recruiting agency since 1999.

PPR Healthcare - agency with travel, permanent & international recruitment programs.

Premier Healthcare Professionals – agency with travel and international programs.

Professional Healthcare Resources – agency specializing in hospice care placements.

RCM Health Care Services – full service international recruiting agency.

RN India – full service international agency specializing in recruiting RNs from India.

RYMEK – full service international agency specializing in recruiting RNs from the Philippines.

Sentosa Recruitment Agency – direct hire for Sentosa Healthcare, full service agency.

Strategic Nurse Staffing - specializes in placement of international RNs throughout US.

Stateside Nursing International – full service international recruitment agency since 1996.

TGS Health Care Solutions, LLC – full service international recruitment agency.

Transpacific Nursing – full service international recruitment agency.

Universal Worker – full service international recruitment agency.

US Medical Staff Inc. – full service international recruitment agency.

Vital Care Solution, Inc. - agency focused on placements in CA.

Wilson Staffing Network – agency with domestic & international recruitment programs.

WorldWide HealthStaff Associates Ltd. – full service international recruitment agency.

Worldwide Resources Network, Inc. - full service international recruitment agency.

Sunday, October 18, 2009

That's DOCTOR to you

Friday night my boyfriend and I went out with some friends of ours. He's a physician, she's a dentist. They live in a gated condominium with a security guard at the gate. Upon arriving, we told the guard that we were going to see our friend, Felix Ortiz. He stared at us blankly and suspiciously... as if we were secretly planing a terrorist attack. Again we told him.... "Felix Ortiz... on the 7th floor" Still nothing... "We can call him if you like?" Finally he rocks back on his heels and says "On the 7th floor? Well, that's DOCTOR Felix Ortiz".

Excuuuussseee me.......!!

I Love My iPhone...


I love my iPhone.... but not as much as a friend of mine who just got married in New York. Here's a pic of his groom's cake. Awesome, eh?

Now... to tie this into my pre-med blog... I just have to say that having an iPhone totally rocks... and rocks in medicine. I've been an iPhone junkie for a few years now... and it changed my life~

If you don't have one, you might want to consider it. The applications are endless... Epocrates, drug guides, medical dictionaries, translators, BMI calcs, vision acuity checks, even Pub Med! Not to mention you have your phone, GPS, calendar, email, internet at your fingertips!

Sick Again?

I don't know what the heck is going on, but I was sick for over 2 weeks in the middle of September, and now I am sick again. Head cold, sore throat and an ear infection from hell. Uh, I cannot afford this right now.

Coming back to the bedside: Nurse Amnesia

I really like Nurse Ratchet and her most recent blog post really struck a chord with me.

http://nurseratchet666.blogspot.com/

Ok, so I've had a wake up call. Last night I worked on the "Assessment/admissions/somewhere you go so you don't break the 4 hour target" ward. It's the first time in years that I haven't done my overtime either in A&E or my own team. And strangely enough I really enjoyed it - and realised how far removed I've become from real life. Jeez - it took me 'till 0300 hrs to catch up - they'd had such a busy day that pretty much every one of my patients (and I only had 5) had fluids running behind, IV AB's not given,hourly urines not done - not to mention the very demanding patient who was in tears as her fan had broken.

I have to say that I neglected her, and her "lesser" needs to sort out the chap with neutropaenic sepsis, and the woman I had going to Theatre for a laparotomy, and the ALD with the pump that kept turning off, meaning her drug regime was about 6 hours behind. Bloody hell it's hard. I left the demanding patient for an unacceptable amount of time while I dealt with my poorly patients, but managed to catch up, as I said, by the morning.It's really really hard to work in these places, not helped, I am sure, by my lot telling you that you have to churn the patients out, and get them in. I saw some really good examples of good nursing last night, my hat is firmly off.I am eternally glad that I have done my time in these places, and that I actually don't need to spend every day going home handing over everything I haven't done anymore, because there hasn't been time.It's a scary old place, and it's only September.


Nurse Ratchet had 5 patients.

I am glad that Nurse Rachet enjoyed her shift and I am glad that she go her "wake up call". I think that many other senior decision makers in the NHS need to get a similiar wake up call.

It is damn hard to work on the frontlines. People do forget just how bad it is on the wards. It's similar to the kind of amnesia you get post childbirth. While you are in the throes of a 40 hour labour with a breech baby and no anaesthetist to do an epidural or c section ...well it is so bad that you want to die. You lose your mind from the pain and wonder just who the hell is doing all that screaming.

But a few months after the delivery you are telling your pregnant friends that "it's not that bad". And you cannot remember what it felt like. Your husband remembers and practically needs therapy and a shrink after watching you go through that, but you cannot remember much at all. Then when baby number two comes along and those intense contractions begin again you finally remember how bad it is and wonder what the hell made you do this again. "Oh shit here we go, what the fuck was I thinking? How could I forget this pain".

People who haven't been on the wards in awhile not only have nursing amnesia but they don't realise all the changes in healthcare delivery and pace that have taken place. Our site/bed /nurse managers have long forgotton just how hard it all is, and unlike Nurse Rachet, they will not be returning for a shift to find out. Site managers and bed managers are trying to work with what they have as far as staffing goes. It's the folks above them that are making all the bad decisions, and many of them are former nurses. They are all suffering from nurse amnesia. They are incapable of making intelligent staffing decisions. Their minds are on budgets.

I remember my last maternity leave. I stopped into work with my beautiful new baby to show him off while I collected my post. I looked around the ward and thought things like "this doesn't look to bad" "They don't look crazy busy " and "Why the hell was I so stressed when I did this".

I came back from maternity leave ready to go, ready to be supernurse and really believing that the little voice in my head who told me to brace myself was my mind playing tricks on me......nah...it won't be that bad!!! My first day back after 6 months was as the sole RN for 24 medical beds. And it got steadily worse from there. It wasn't until I came back that I actually remembered just how bad it truly is on a short staffed ward.

But we do not allow the bedside nurses (including sisters) to have any kind of say in how the wards are staffed and run even though they are the only ones who could do so intelligently. The only "nurses" who get to have a say are the ones who left bedside care years and years ago and whose main priority is making friends with the business managers.

Why?

Saturday, October 17, 2009

Bahrain Defence Force Royal Medical Services

Bahrain Defence Force Royal Medical Services which located in West Riffa - Kingdom of Bahrain, looking for Registered Nurse / Midwife to fill job vacancies on position Nurse-Intensive Care Unit(ICU), Nurse-Kidney Dialysis Unit(KDU), Nurse-Medical / Surgical Wards, Nurse-Midwifes, Nurse-Neonatal ICU and Nurse-Paediatric.

BDF medical is healthcare provider for the army people, in order to support government mission to increase level of healthy community in Bahrain, they are also opening a private practice for the patients around Middle East. The professional medical team such as doctors and nurses are came from many countries who join and work as BDF medical staff.

Right now they have medical department facilities like Specialitiesand Clinical Services, Anaesthesia & ICU, Dental & Maxillofacial, Dermatology, Emergency Medicine, ENT, General Surgery, Internal Medicine, Neuro Surgery, OBS & Gynaecology, Ophthalmology, Orthopaedic, Paediatric, Psychiatry, Primary Health Care, Urology, and Vascular Surgery.

Jobs recruitment for the nurses will be expire on 31-12-2009. The applicant who want to submit their resume (CV) must have experience in the relevant speciality.

Job Qualification for the nurses :
  • Interesting candidate must be BSc. in Nursing
  • Has certificate of registration as Registered Nurse / Midwife.
  • At least 2 years experience
  • Able to speak English

Bahrain Defence Force Royal Medical Services offer the nurses who work with them with attractive salary according to qualification and experience, yearly return ticket air passage to the country of origin, 40 days paid leave per year and free shared accomodation.

For more or others information of job vacancy in Bahrain Hospital, you can find the official website here : Bahrain Private Hospital.

Friday, October 16, 2009

Ortho is Officially Off the List

Spend the better part of the morning watching a hip replacement... and can I just say YUCK! Not the field for me, that's for sure....

Here's a sampling of the things I heard this morning from ortho docs...

"So we're just going to take this thing here that looks like a cheese grater... and sort of shave off some of the acetabulum."

"Us ortho guys like to say 'When all else fails, examine the patient' "

"You might wonder if he needs all this bone marrow" (posed by the surgeon as he spills all the patients femur marrow onto the operating table..) "and the answer is Nah, he doesn't need it"

"This guy's bones are really strong, so I'm actually breaking a sweat" As he rams the rasp into the center of the femur.

Good thing I didn't pass out in front of the whole class. It was touch and go for a minute there.

Thursday, October 15, 2009

A Plastic Hood, Cancerous Mist, and the Rainbow Chant




If you've never done it, you will soon. As demonstrated here by a very brave Canadian OT student, this was by far the most ridiculous experience thus far in medical school (BLS takes 2nd place). So today we were required to get fitted for a N95 respirator... some red tape, non-liability, bureaucratic BS so they can never say we weren't properly instructed on mask use should we come down with some nasty strain of TB.


Here's the bad part. I could NOT stop laughing. The instructors seemed so serious, and kept walking around spraying the inside of our hood with increasing concentrations of saccharine. Then they'd say "Can you taste or smell that?" Which of course I could... but I didn't want to be there for six hours... so I said no. And so did everyone else. The worst part? At one point they made us recite this diatribe about rainbows... and I could barely squeak out 2 lines without cracking up laughing. The instructors were not amused to say the least.

Call for Nominations: College of Nursing Medallion



Each year the College of Nursing recognizes the achievements of its alumni with its highest award, the College of Nursing Medallion. Recipients are selected from among your nominations, a critical step in the process.

We encourage you to take the time to nominate a fellow Villanova Nurse before the deadline of November 19, 2009. Previous honorees have been nurse managers, executives, clinicians, community volunteers and educators.

We look forward to reading your nominations and honoring yet another distinguished group of Villanova Nurses.
Know the perfect candidate? Read more about criteria and find the nomination forms at
www.villanova.edu/nursing/about/medallion.htm



Dean Fitzpatrick elected to CGFNS Board


M. Louise Fitzpatrick, EdD, RN, FAAN, Connelly Endowed Dean and Professor of the College of Nursing, has been elected to the Board of Trustees of the Commission on Graduates of Foreign Nursing Schools (CGFNS). She will serve a four-year term beginning January 2010. Dr. Fitzpatrick has served three years on the CGFNS Committee on Appeals.

CGFNS, based in Philadelphia, is an internationally recognized authority on credentials evaluation and verification pertaining to the education, registration and licensure of nurses and health care professionals worldwide.

Another Safe Staffing Video

I wish I would have posted this below with the other testimony videos.

The man in this video has been a bedside nurse for 6 months. Now he is getting the hell out. Listen to him speak about what happens when you have 6 patients and one goes bad. Now remember that we have 10-15 patients per registered nurse in the UK and rarely a floating a charge nurse. On my ward we never have a floating charge nurse.

http://www.youtube.com/watch?v=kVpJ-icOk1I&feature=related

Take in what these people of saying and spread the word. I am so sick and tired of assholes who think nurses are leaving the bedside because they think they are "above" shit and piss. Shit and piss are probably the best and easiest part of the job when you are a hospital nurse. Those are not the reasons we leave.

BY THE WAY: If any of my dear readers are retired from the bedside nurses who cannot seem to get why today's nurses are freaking out over taking more than 6 patients please look at the testimony in my post below from nurses who trained when you did and are still at the bedside. If you are one of these people who think that the crux of the problem is that today's nurse training is "crap" you especially need to click on this link and get yourself an education.

I'll show you where the caring is when I pull my shoe out of your backside.

Have a great day ya all.

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Wednesday, October 14, 2009

Anatomy Might Be Easier If You Know These Things In Advance

1. You don't have to know everything. I started hyperventilating when I saw my Netter's atlas for the first time, thinking I had to memorize everything on those plates. You don't. You are only responsible for a fraction of the material.

2. In anatomy lab, the body doesn't remain uh, organized. The body parts are all over the place! For instance, you are supposed to be identifying say... oh... a ureter. But the kidney has been displaced to XYZ location... possibly in the thoracic cavity or maybe just in a big pile of cadaveric nastiness on the table. So you don't have a point of reference... and you're thinking "Well, this could be the gonadal artery... or maybe some kind of crazy nerve... originally attached to... the posterior abdominal wall? the spleen? the stomach... no scratch that... wait, where's the damn kidneys? shit!" Mind you... this thinking process has to be completed in approximately 30 seconds while you are deciding which answer to write down.

3. Contact lenses + Anatomy lab = sad face. At least for me. My lab partners don't seem to have problems with their lenses, but mine feel horrible. The best way I can describe it is like getting icy-hot in your eye.

4. The better you know the theory of the body, the less time you have to spend in lab with the dead people. Lots of students spend tons of extra time in the lab reviewing things... and I initially went as well thinking I needed the practice. But I hated every minute of it. I hated the required time I had to spend in anatomy, let alone spending non-required time there. This block I couldn't bring myself to go in beyond the required dissections, and I thought for sure I was going to get my butt kicked on the practical... but I didn't. You can actually figure almost everything out if you have a working knowledge of what's what.... even sight unseen.