six hours later
the skein of acrylic yarn
becomes an ocean

I took bee pollen
sat in the sun, watched the dog
realized the time

Just like my Sjoukje..

this horse was talking
about habitat and bars
in my winter dream

Cameron Diaz' Breasts
squirm in satiny confines
netted jelly fish

the V-day bouquet
of carnations and roses
is wilting to dry

Registered Nurse for Cambridge, Canada

CAMBRIDGE MEMORIAL HOSPITAL
Registered Nurse - Temp FT Obstetrics

Job Type: Contract
Location: Cambridge, ON, CANADA
Job Category: Healthcare Support, Nursing
Industry: Healthcare
Number of Positions: 1
Company Website: http://www.cmh.org

JOB DESCRIPTION:

Temporary to full-time position to days and nights including weekends and statutory holidays.

Duties as per job fact sheet.

Posted hours does not constitute a guarantee that shifts won't be subject to change.


QUALIFICATIONS:

-Certificate College of Nurses of Ontario.
-Completion of / willingness to complete perinatal certificate program.
-Minimum of 2 years recent experience in Obstetrical Newborn and post-partum care. -Breastfeeding experience and completion of an approved neonatal resuscitation course
required.
-Preference given to applicants with LDR and Special Care Nursery and Post Partum
experience.
-Regular attendance is required also.


Human Resource Services Program
Cambridge Memorial Hospital
700 Coronation Blvd.
Cambridge, ON N1R 3G2

Fax: (519) 740-4907
Tel: (519) 621-2333 x1328
email: jobs@cmh.org

Email, PDF and Word files are accepted. Please do not email other file formats.

the sound of a saw
wakes me and I look to see
an old tree is gone

Travel Nurses Beware!

My readers come first! Like many of you, I am an avid blog and forum reader. I have recently come across a strain of posts on a nursing forum that have caused me a little heartburn regarding certain travel nursing agencies. The forum is located here. I am not in any way affiliated with the forum other than being a reader.

To be honest, I have not had any experience with the agencies discussed on the forum, nor have the agencies I am contracted with caused me the problems experienced by those on the forums.

Although I do have nursing ads on this site, my first loyalty is to my readers. If any of you have experienced problems with the agencies who advertise on this site, please contact me. I can't do anything about the agency's actions but I can make all of my readers aware of the complaints. To date, I have not had any complaints.

status is normal
except she's moving away
and I will miss her

smell of broiled meat
two men drinking iced vodka
a dim cabin light

we sit at tables
drink bottles of greasy wine
and talk about men

embrace of a snake
round two hundred twenty pounds
living like a boy

Yet another add that I like..

This one makes me laugh.. every time. Reminds me of the Mac adds for some reason.


Mac vs PC



And to make it even better... The UK versions, making fun of Nanny 911!



And yes.. I own a Mac and always have :)

Things I have learned.. so far!

This semester has been interesting. I am doing my internship which consists of 4 days a week of 8 hour shifts.

So far I have taken blood samples (first time) and gotten the majority of them without busting the vein in the process or just plain missing!
I have done ECGs, one on my own, and gotten a good reading.
I have perfected my PEG/NG/Dobhoff feeedings (sounds easy, but trust me, some crushed pills are pains in the butt and can really block up the tube), that and I can now do it in record time (check for residual, flush, give med, flush some more..).
I've swabbed more things for MRSA/VRE/Other than I thought possible in one month time!
I am now mostly on my own, meaning no teacher (from school) following my every move!

It's nice, we get our independence and learn better that way too I find. We are assigned to be with 2 patients right now, we'll get 3 eventually...

My feet hurt, my back aches, and I end up with a massive headache.. BUT I love it!

telephone blinking
a call you didn't pick up
who could it be now

Spinal injury regeneration hope

How cool would this be? Not just for me, but for everyone with a spinal cord injury!

Scientists believe they are close to a significant breakthrough in the treatment of spinal injuries.

The University of Cambridge team is developing a treatment which could potentially allow damaged nerve fibres to regenerate within the spinal cord.

It may also encourage the remaining undamaged nerve fibres to work more effectively.

Spinal injuries are difficult to treat because the body cannot repair damage to the brain or spinal cord.

We are very hopeful that at last we may be able to offer paralyzed patients a treatment to improve their condition
Professor James Fawcett
University of Cambridge

Although it is possible for nerves to regenerate, they are blocked by the scar tissue that forms at the site of the spinal injury.

The Cambridge team has identified a bacteria enzyme called chondroitinase which is capable of digesting molecules within scar tissue to allow some nerve fibres to regrow.

The enzyme also promotes nerve plasticity, which potentially means that remaining undamaged nerve fibres have an increased likelihood of making new connections that could bypass the area of damage.

Boosts rehabilitation

In preliminary tests, the researchers have shown that combining chondroitinase with rehabilitation produces better results than using either technique alone.

What often happens in a clinical setting is that you don't get to see the results you would have liked
Paul Smith
Spinal Injuries Association

However, trials have yet to begin in patients.

Lead researcher Professor James Fawcett said: "It is rare to find that a spinal cord is completely severed, generally there are still some nerve fibres that are undamaged.

"Chondroitinase offers us hope in two ways; firstly it allows some nerve fibres to regenerate and secondly it enables other nerves to take on the role of those fibres that cannot be repaired.

"Along with rehabilitation we are very hopeful that at last we may be able to offer paralysed patients a treatment to improve their condition."

'Ground-breaking'

Dr Yolande Harley, of the charity Action Medical Research which funded the work, said: "This is incredibly exciting, ground-breaking work, which will give new hope to people with recent spinal injuries."

Paul Smith, of the Spinal Injuries Association, said medical advances meant that spinal injuries had ceased to be the terminal conditions that they often once were, but they still had a huge impact on quality of life.

However, he warned against raising expectation before the treatment was fully tested on patients.

He said: "What often happens in a clinical setting is that you don't get to see the results you would have liked."

In the UK there are more than 40,000 people suffering from injuries to their spine, which can take the form of anything from loss of sensation to full paralysis.

The average age at the time of injury is just 19.
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/7240898.stm

Published: 2008/02/17 00:01:25 GMT

© BBC MMVIII

line around the block
they all come here to forget
lives lived through others

Neat Collage of My Pics

Marilyn Monroe
had elegant and dividing
crows feet at her eyes

mother picks my lice
snaps them between her thumb nails
a satisfied pop

Nurse Vacancy in North America

Fresenius Medical Care North America (FMCNA) as a health care services with over 2,000 clinics located in communities all across North America currently looking for the Nurses who want to work with them for the position "Charge Nurse". FMCNA is one of medical service for the patients with a singular focus on dialysis and a determination to help the patients lives become a fullest live.

As a charge nurse, you will work in full time job's type. Those applicant has specification bellow they can submit their resume direct to the Fresenius Medical Services which located in Canon City, CO. (North America):

Register Nurse from accredited school (university) of Nursing

At least one year experience in medical surgical department

Has minimum of six months experience in Hemodialysis room

More chances for the Nurses who has experience as Supervisory or Management System

Successfully complete course in CPR certification and get the CPR licence

Job Description for Charge Nurse:
Capable to manage all the staff Nurse on their duty schedule in a safe, efficient, and effective manner. Support the nurses to increase of nursing services to the patients, Active in monthly routine to make meeting between the staff nurse in order to exchange idea among of them about patient's needs or solution to improve delivery of care. Ensure provision of quality patient care on a daily basis and supervise the direct patient care staff.

Report and colaboration to the Director of Nursing Services to discuss personnel and patient care status, issues, and information at least once a month. Assess and make plan in daily patient care needs, develop and distribute patient care assignments appropriately. Check and evaluate the nursing board that made by staff nurses in daily activity during their shift, always confirm to the Director of Nursing if something happen when performing nursing care to the patients.

For this job position you will get salary depend on your specification and how many years your experience are, another benefits package is generous compensation that includes medical and dental, 401K match, profit sharing, short and long term disability, tuition reimbursement, and 5 weeks paid time off!

If you are interest to fill the job vacancy as "charge nurse", contact them now :

Fresenius Medical Care North America (FMCNA)
920 Winter Street
Waltham, MA 02451-1457
(781) 699-9000
(800) 662-1237

she rings metal bells
little bronze colored clappers
in time to music

electric guitars
like an old foggy mirror
mullet fantasia

we said we'd drive there
it was warmish and sunny
but we watched TV

Anna writes poems
tan and green wallpaper shreds
a hand bound journal

she starts the car late
four a.m. crunching the road
and she must hurry

Hiring Registered Nurse - for Los Angeles

Type: Travel
Salary: Up to $2,800 per week
Location: California - US - Los Angeles
Job Reference: 35586

Description
This nationally recognized healthcare facility is situated along the Pacific coast near a great seaside resort destination. ICCU DAYS 48HR-24WK.

Because FASTAFF values its nursing professionals, we give you the assignments you want with the benefits you deserve. When you join our team, you know you'll be working for top pay at some of the finest healthcare facilities in the country. FASTAFF works to find work that is professionally fulfilling and personally rewarding. Benefits include: * Pay rates up to $2,800 per week with flexible options * Loyalty bonuses up to $10,000 per year * Friendship has its rewards - Refer a nurse and earn up to $3,000 * Rental car option * Comprehensive, flexible benefits starting Day 1 * Assignments starting at 8 weeks with guaranteed hours * Fully paid travel and quality housing * Free continuing education * Licensing reimbursement programs * One to two years of current experience required, based on specialty


Contact Information
FASTAFF
Name: Placement Specialist
Address: 6501 S. Fiddlers Green Circle, Suite 200
City: Greenwood Village
State/Province: Colorado
Country: United States
Ph: 888-879-0830
Email/URL: hiring@fastaff.com

The A to Z Weight Loss Study

On February 6th- the Nursing Research Council at St. Joseph's reviewed a study published in JAMA in March of 2007 (Vol.297, No.9, 969-977). The study was a randomized clinical trial of 4 weight loss programs in which overweight, premenopausal women. Each group had near 80 participants who were given a book of the diet they were to follow along with 8 weeks of instruction and then followed for 12 months regarding adherence, actual nutrients consumed, affects on glucose, blood pressure and lipids as well as actual weight loss.
The diets were:
Atkins- high protein,fat and very low carbohydrate
Zone- low carbohydrate, moderate protein
LEARN- low fat, high carbohydrate based on national guidelines
Ornish-high carbohydrate,low fat
The outcome was surprising-
The Atkins diet had the highest weight loss average at 10.3 lbs
The Zone diet average was 3.2 lbs
The LEARN diet average was 5.72 lbs
The Ornish diet average was 4.8 lbs

The Atkins diet group had the lowest number of dropouts.
The Atkins diet also higher drops in triglycerides, increased HDL-C, no change in LDL-C and greater decrease in BP than the other groups.

Our discussion was lively-
First we verified that the study was not funded by Atkins Corp.- it was funded by the NIH.
We discussed that perhaps protien and fat created more satiety thus more adherance to the diet.
We are hoping the study will continue to follow the same cohorts to see what the long term effects of the diets might be.
Does the weight loss last?
Is the diet sustainable?
Long term effects on lipids?
We felt one weakness of the study was the inclusion of only premenoupasal women.
Overall though the study design was strong and we believe that the outcomes provide valuable information.

they say film is dead
if women were in star roles
perhaps film would live

Two Little Monkeys

Please take a look at this site, and please feel free to purchase a T-Shirt!
This is one medical issue I have and I know the person in charge of this site, she is a wonderful mom and spokesperson to raise awareness for OBPI (Obstetrical Brachial Plaxus Injuries).
Thanks!

http://www.twolittlemonkeys.org/AboutUs.htm

dreamt of all the books
in old Alexandria
never caught fire

they share a wood stool
two women in wig and dress
sisters now as fools

2008 Western Institute of Nursing Conference in California

2008 Conference will be in Southern California!
The 2008 WIN conference will be held on April 17-19, 2008 at the Hyatt Regency Orange County in Garden Grove, California. The conference theme is, “The Circle of Nursing Knowledge: Education, Practice and Research.” Visit the WIN website for more information. Our very own Dana Rutledge, RN, PhD and Beth Winokur, RN, MSN, CEN each have abstracts to be shared at this conference.

you've been awarded
an email that pays you cash
and you do nothing

THE 24TH EDITION of the ICIRN Essential Nursing Resources list

THE 24TH EDITION of the ICIRN Essential Nursing Resources list is presented as a resource for locating nursing information and for collection development. The list includes print, multimedia, and electronic sources to support nursing practice, education, administration, and research activities.
Open access PDF version, Nursing Education Perspectives, 2007 Vol. 28, No. 5, pp. 276-285.
http://nln.allenpress.com/pdfserv/i1536-5026-028-05-0276.pdf

Open access HTML version:
http://homepages.nyu.edu/~skj1/essentialnursingresources2007.html

Please answer our quick SURVEY on your use of Essential Nursing Resources:
http://tinyurl.com/2l4qdn

THIS LIST was compiled from the contributions of the following representatives of the Interagency Council on Information Resources in Nursing (ICIRN) member agencies:
Richard Barry, Ysabel Bertolucci, Leslie Block, Warren G. Hawkes, Susan Kaplan Jacobs, Aurelie Knapik, Polin P. Lei, Susan Pierce, Juliette Ratner, and Annelle Tanner.
Interagency Council on Information Resources in Nursing
For more information about ICIRN, visit http://www.icirn.org/

Stupid Bitch Matrons

Bring Back Matron you say? Oh they are back all right.


At my hospital we always had a saying..."Matrons are like ghosts...we know they exist but we never see them."

Who are the modern matrons? They are highly trained and highly educated nurses who take on clinical specialist/ management roles. Highly trained and highly educated nurses are great at the bedside. Research has shown that patients have a higher survival rate when they are receiving total care by a degree educated RN. Even better if she has a manageable number of patients.

Many of our modern Matrons, however, are as useless as tits on a bull. They have no soul. They have no interest in patients. I would rather eat c-diff positive shit than bestow the honourable title of "Nurse" onto one of these people*.

I have posted the stats regarding Nurse patient ratios. I have posted research into medical errors. I have posted about some of the insane practices that were happening on my ward and continue to occur almost daily. It doesn't take a rocket scientist to figure out that people do and can get hurt. At the very least is the little 90 year old man sat staring at a tray off food he cannot feed to himself..whilst his nurse is busy elsewhere. If anything makes me feel like going postal, it is that scenario. Staff nurses are not perfect and they do make mistakes, but many of the mistakes that happen are down to system errors that could have been prevented.

My ward was opened to another specialty and now takes 3 or 4 different specialties. We are the (now 40 bed) dumping ground for EVERYTHING. This was the result of a management decision that was not thought through. As usual we are left worse off than we were prior to said management decision. None of the RN's were cross trained and fuck up after fuck up occurs daily. The nurses are stuck with too many patients, no back up, no support in a specialty in which they have little or no experience.

The Matrons know the situation. There are many many highly paid matrons at my hospital. One for each specialty. Did any of them come to the ward to provide guidance and leadership or help out during the restructuring? HELL NO. They basically disappeared into thin air. Totally fucking AWOL.

Did they put on a pinny and come and help out on the ward? HELL NO.

Did any of them come anywhere near the ward or a patient? HELL NO.

Did they return our phone calls? Rarely.

Have we ever seen them act like a nurse? HELL NO.

Would any of them be able to name a patient on our ward? Nope.

Once, two years ago, a Matron did come to the ward to help us put because we were so short. This is the only time we recollect that this has happened. I was overwhelmed with really sick patients. Matron informs me that A. She does not remember how to do a drug round and will not do it. B. She is not comfortable with IV meds and will not help with that. C. She volunteered herself to answer the phone and call lights. So I got left with all the hard stuff, and supersuck (who makes double my salary) did fuck all.

That was the last time we saw a Matron (or a Nursing Leader) on the ward in a clinical capacity. They stay far far away and leave the staff nurses to suffer alone. We have written letter after letter about the conditions on these general wards and they are ignored, or Matron shrugs her shoulders and says "we feel so bad for you".

What.The.Fuck?

Don't feel bad for us...you are a highly paid nurse...get your arse to the floor and help us...be a goddamn nurse...provide some goddamn leadership by example. Come up with a plan for cross training the staff. Back us up when we are getting threatened by the chief nurse for complaining when we are one nurse to 24 patients. At the very least come and help us feed patients when YOU KNOW that we are 2 nurses to 15 feeds and everything else that is happening simultaneously. I have worked with bedside nurses who have masters degrees and chose to work at the bedside. The situation is so bad, it should be all hands on deck. Fuck whatever it is that you do all day. I have yet to see anything that you "do" benefit a patient.

I don't know what they do in that office all day. I don't know why they hate their nurses. I don't know why whatever the fuck they are up to in that office is so much more important than the patients and the staff.

I do know that despite the fact that they know how short we are working, they love to re-arrange our paperwork and make it more complex. Certain forms have gone from 5 pages to 20. I know that they are trying to redesign our care plans because the current ones are never filled in properly. I informed the Matron that it doesn't matter what structure our paper work takes...it is going to be FUCKED because of time constraints and overwhelming nurse patient ratios. I must not have got through.

When do we see Matrons? When there is an inevitable cock up. Then they are down to the ward like flies to a horses ass to ensure that all blame is directed onto the staff nurse and the hospital does not appear negligant or liable. Then the same error happens again with a different nurse because these are SYSTEM errors not NURSE errors. Once again Matron comes down hard on the individual member of staff without troubleshooting the problem. Fucking worthless whores. I saw it happen to too many of my colleagues and I got the hell out before the day came when it was my turn.

As far as I am concerned, most of our so called nursing leadership are traitors to nurses and patients alike. Don't even get me started on the NMC, the RCN or any of the other worthless pieces of crap who refuse to address the real issues. I'd like to see them all lined up and shot*.

*if there are any Matrons out there reading this that care about patients and support their nurses than I apologise to you personally. The rest of you are overpaid stupid worthless bitches.

*Nurse Anne is a non-violent pacifist and she does not believe in shooting our so called nurse leadership for their crimes. She just fantasizes about it.

she arches her back
says, My bacon is achin'
someone give a scratch

throat dry as menu
magnetized to a fridge door
in a tidy house

quinn raises her hands
swivels her hips in knit dress
he likes to watch her

Nurse/ Patient Ratios: The Facts

http://query.nytimes.com/gst/fullpage.html?res=9405E6DD1530F93AA25752C1A9649C8B63

In the journal article, University of Pennsylvania researchers analyze why nursing care means more to hospitalized patients than pillow plumping and good cheer.

They culled data from more than 200,000 patients and 10,000 nurses to calculate that for every additional patient a nurse is assigned to care for, the odds of a patient's dying within a month of hospital admission rises 7 percent. In other words, when your nurse cares for seven other patients on a shift, your chances of dying from whatever ails you are about 30 percent higher than it would have been if your nurse had only three others.

Nurses in the UK average about anywhere from 1-10 to 1-20. It can be anything the managers want it to be and believe me, they want to divert as much money away from decent staffing as they can. When patients complain about waiting for a call bell to be answered, the managers forbid the nurses from talking about and explaining staffing levels because they "will not admit liability". They lay the blame with the nurses and nurses get a bad reputation. This is a fact.

http://www.nursingadvocacy.org/news/2002may30_nejm.html

May 30, 2002 -- In today's issue of the New England Journal of Medicine (NEJM), researchers Jack Needleman of the Harvard School of Public Health in Boston and Peter Buerhaus of Vanderbilt University’s School of Nursing in Nashville, Tennessee found that nurse short-staffing leads to deadly consequences for patients.

The study analyzed discharge data from 6 million patients and financial data and staffing surveys from 800 hospitals in 11 US states. When nurses were short-staffed, patients suffered up to 25% more life-threatening complications including infections, bleeding, pneumonia, shock, cardiac arrest, and "failure to rescue," all of which contributed to an increased length of hospital stay





http://www.massnurses.org/safe_care/Safe_Staffing/news/2005/PhysSurv.htm

78% of MDs believe RN staffing levels are too low, 82% believe quality is suffering, an alarming 1-in-5 doctors report patient deaths due to nurses caring for too many patients

(this article comes from the USA, where general ward nurses have 1-8 as opposed to the 1-10,20 etc that we have in the UK.)

http://www.crnbc.ca/downloads/402.pdf

AS RN to patient ratios decrease from 1:4 to 1:10, the number of post op surgical patient deaths climbs dramatically. (aiken, Clarke, Sloan,Solkalski and Silber 2002).

UK nurses average anywhere from 1:10 to 1:20 on general medical and surgical wards.


http://allnurses.com/forums/f300/don-t-blame-nurse-fix-system-266262.html

The Allnurses.com discussion forum cites numerous first-hand stories of how nurses have blamed themselves, or have been blamed by hospital administrators, for dangerous and sometimes fatal medical errors. In most cases, these incidents reflect far more on deficiencies in the systems in which nurses must work.

At least four out of five medical errors are probably due not to negligence or carelessness, but to deficiencies in the system in which doctors and nurses must work. The ISO 9001:2000 standard and its health care specific modification, IWA‑1, recognize that people work in a system, and that a deficient system cannot deliver good quality no matter how skilled or careful the workers might be.

It is a general rule in industry that only 15 to 20 percent of trouble comes from negligence, carelessness, and incompetence. The rest is due to deficient organizational systems that make trouble almost unavoidable. W. Edwards Deming's 85/15 rule says that 85 percent of all defects and errors are the fault of the system in which people must work, while 15 percent results from carelessness and negligence. Frank Gryna cites an 80:20 ratio, with 80 percent of errors and mistakes being "management-controllable" and only 20 being "worker-controllable." [1]

(i.e.organizational problems such as a NHS managers who have no clinical experience, a bad attitudes towards nurses and ignorance regarding nurse patient ratios. Total hospital wide system failures that cause the nurse to have to spend time away from patients i.e. chasing pharmacy up to do their jobs)



http://www.hbs.edu/research/facpubs/workingpapers/papers2/0203/03-059.pdf

Recently conducted large scale research found that:

In a given unit the optimal workload for a nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission. A workload of 8 patients versus 4 was associated with a 31% increase in mortality. Higher nurse staffing levels resulted in reduced numbers of urinary tract infections, pneumonia, upper gastrointestinal bleeding and shock in medical patients and lower rates of "failure to rescue" and urinary track infections in major surgery patients

(What have I said regarding the ratios we are working with at my hospital? According to this research even 1:8 is bad on a general ward...let alone the 1:20 that happens on mine).

This paper from Harvard is an excellent explanation as to why working conditions and piss poor management causes nursing care to be so bad.

http://www.hbs.edu/research/facpubs/workingpapers/papers2/0203/03-059.pdf

the bra straps come off
the weight of expectation
one then the other