Thursday, October 16, 2008
Saturday, May 3, 2008
You know what? It was really quite an amazing experience when I was able to encounter a patient with psoriasis. It's amazing because it's my first time to see a patient with that disorder and this kind of disorder is very rare and doesn't really occur with Filipinos.
Anyway, psoriasis is a "chronic, non-contagious disease characterized by inflamed lesions covered with silvery-white scabs of dead skin (www.answers.com)" just like the picture above.
At first I didn't really think that the disorder was contagious or something like that. I was reluctant to touch the patient and aid him in going down and up his bed because he had scaly white skin and lesions all over his body and he was obese, so he was very heavy to carry. But one of my colleague really had somatic effects. What I mean by somatic effects is that he had bodily manifestations of a psychological induced disorder or disease. He was thinking that psoriasis is highly contagious so he suddenly had pruritis or itchiness on his arms and they really formed bumps. This only proves how powerful the mind really is that it can even trick itself into manifesting false sugns and symptoms of a disease that the person never had in the first place.
Actually, I also felt very sorry for the patient because I could really see my self in his position. I know how painful it is to be shoved away because they are disgusted with you and you are considered an outcast because you are considered contagious and all. This is why we should really educate ourselves with these kinds of things and that we should always be sympathetic because it is not their wish to have such conditions.
Sunday, April 20, 2008
Dede was left by his wife because of his appearance and his two children (an 18 year old boy and 16 year old girl) had to live with his other relatives because he was not able to take care of them anymore because he is incapable of working (since he can't grasp things with his root-like hands) and is forced to live in poverty. He is able to survive by some provisions given to him by his extended family and from being the center of attraction at their village's local "freak show".
Good enough for him an American Dermatologist promised to help him return to his normal life by performing several surgeries to prevent the warts from totally debilitating him and taking his life as these warts could become cancerous.
And here is a picture of him after his first surgery:
Not much change is seen but at least his hands and feet are already starting to look like hands. From being the local village freak-show I do hope that he could achieve his dream of getting a job and returning to a normal life and maybe even find love. Well, Dede, I wish you all the luck!
I really honor the courage that he has. If I was faced with the same affliction I might not have survived at all. I know that many people are disgusted at his sight and are making fun of him but once you place yourself in his position, you would be able to have some empathy for him and you would realize what a strong person he is.
Saturday, April 19, 2008
Disclaimer: This video is not the property of this blog's owner and the video is hosted externally.
To those who have no idea what this video is about this is a video taken from a camera of a student nurse at an operating room at Vicente Sotto Memorial Medical Center (VSMMC) at Cebu City, Philippines.
This video (that was spread on the internet like wild fire on Youtube, emails, and even cellphones) was of a 30 year old homosexual who had an Avon's Black Suede For Men Body Spray (thus the name Black Suede Scandal) allegedly inserted into his rectum when he had sex with a stranger.
What made the video so scandalous and caused such a sensation is when the doctors, nurses, and other operating room staff laughed and jeered at the patient's condition as seen in the video.
But here are are some of my reaction upon some comments of people online regarding the said topic:
- On Medical Malpractice - As defined by Larry Curtis Law Firm is a form of negligence where an injury results from a medical professional’s or medical facility’s failure to exercise adequate care, skill or diligence in performing a duty. We should actually congratulate the doctors for a successful operation. No invasive procedures were done on such an extraordinary case. The operation was a success and there are no complications.
- On Breach of Sterility - The people seen in the video were curious staff from other operating rooms within the operating room complex therefore they are considered sterile. They did not come from outside the operating room. And the people with no gloves were at least 12 inches away from the operating table so as stated by the sterile technique the operation is still considered sterile. Besides the people with out gloves did not perform the operation.
- On Cameras in the Operating Room - Actually in my case, cameras are allowed inside the operating room and we student nurses are indeed allowed to take pictures for the sake of documentation which would be used for future case studies.
- On Breach of Patient Confidentiality - When I reviewed the video footage the patient's identity was not at all exposed. The patient's face was not seen and no distinguishing body marks such as tattoos and birth marks were not captured on film. We wouldn't even know the sex and age of the patient if he hadn't exposed himself to media saying that he was a Florist, he was 30 year old, and he even divulged how that can arrived at his rectum. And yes his consent was asked and he did agree to have the operation filmed because as I reiterate this is a very unusual operation. So the video taking had the patient's consent.
- On the Revocation of the Doctor's Licenses - I think that the people are overly reacting just like the way Filipinos over-reacted to Teri Hatcher's "some doctor from the Philippines" comment. It's not like the doctors killed someone or anything, I agree that sanctions may be imposed on their behavior but revoking their titles for laughing and cheering is way too harsh.
- On the Operating Room Staff's Cheering & Laughing - To be fair to the patient, I would also be furious if I were in his position if I knew that a video of me was circulating on the internet but then I would realize that no one would know that it was me. It's also normal for people to be curious and have fun and joke around. In fairness the doctors and nurses were laughing at the situation not at the patient, that is a totally different context. It would be a normal reaction of a normal person to an extraordinary situation. No person was hurt, just a pride that was bruised. But now that we mention it isn't it the patient's fault that he was in this predicament because he had a one night stand with a complete stranger. He was lucky that he wasn't killed by his promiscuity. But that is a totally different issue and that is not my problem. The issue that I am concerned of is the outcome of the health care professionals who are being crucified for an issue that is overly exaggerated.
I know that this post would gather a lot of negative reactions but let me again reiterate the blog's disclosure policy: The views and opinions expressed on this blog are purely my own, as this is a personal blog.
Sun Star - Doctors may lose licenses over surgery scandal
Inquirer - Video scandal grips Cebu hospital
Inquirer - Black Suede scandal
Tuesday, April 8, 2008
I have been browsing the net and I found the site medical-career-training.com and it had a complete list of medical careers like for example being an ultrasound technician. Ultrasound is a routine diagnostic procedure in the hospital so an ultrasound tech will have a lot of job in his hands. But an ultrasound tech's job description is very interesting. He will be able to make a scan of a woman's ovaries & uterus, her baby, to the organs in the abdomen, up to the brain.
What's even more attractive in an ultrasound tech career track is that you may only have to study for 2 years (there's also a 4 year course)! And your pay is very good too! How does a median income of $48,660 per year sound? You have a very nice paying career and a very interesting job too!
So why not check out more information about being an ultrasound tech or better yet find ultrasound schools near you and start your medical career now!
Sunday, April 6, 2008
Before you think that this is just some hoax well you better believe it. This story was shown on Oprah and the story spread on the web and the world like wild fire! Mr. Thomas beatie, 34 years old, a resident of Oregon announced on Oprah his story that he was 6 months pregnant. As proof he even had an ultrasound and hold and behold a health baby girl! But how could a man be biologically be capable of bearing a child? Simple! Thomas was actually a she and not a he. Confused? Well let me enlighten you a bit. Thomas, was born and lived for 24 years as a girl called Tracey. Tracey's mother committed suicide at the age of 12 and only had her 2 brothers and father has role models. Tracey had known by then when she hit puberty that she was a man trapped in a girl's body. Although she won the title of Miss Hawaii Teen USA and had a boyfriend by the age of 17 she knew that she was a transgender and decided to have a sex transplant and hormone replacement when she was with her partner Nancy, who was fully supportive of her. And now she became a he because his breasts were removed (mastectomy) and he grew a beard and his body became more muscular because of testosterone therapy. He still has his female organs retained but he claims that his clitoris looks like a small penis now due to hormone replacement and that he can have intercourse with his wife (yup he is legally male and married).
So why would he want to get pregnant when he wants to be a male? It's because of two reasons. First, he says that, "It's not a male or female desire to have a child. It's a human desire." Second, Nancy can't bear a child because she had to have her uterus removed because of endometriosis.
So Thomas had artificial insemination done. He actually had triplets at the first attempt but had to have the pregnancy aborted because he had an ectopic pregnancy (the fetuses implanted themselves in his falopian tube). The second attempt is his present pregnancy which by the way is normal and would be normal through NSVD or Normal Spontaneous Vaginal Delivery.
The first impact of this story to people would be "Wow! Unbelievable!" The second thing that would rush to some closed-minded people is "What kind of freaks are these!" Society may have great difficulty accepting such situations which society brands as abnormal but time will come when the society will accept these occurrences.
The relationship of Thomas and Nancy is a testimony that nothing can ever be a barrier to true love may it be race, age, economic standing, and in this case gender. Thomas and Nancy are just two happily married couples where the husband is having the baby. Let's just all wish them good luck!
Friday, April 4, 2008
I don't know what is it with them that they want to die that much! There are so many reasons to quit and one reason is good enough to quit! So what are these reasons? Here they are:
- CANCER! What kind of cancer? Adult Acute Leukemia, Adult Chronic Leukemia, Cervical Cancer, Esophagus Cancer, Laryngeal Cancer, Lung Cancer,
Kidney Cancer, Oropharyngeal Cancer, Pancreas Cancer, Stomach Cancer, Urinary Bladder
CARDIOVASCULAR DISEASES Stroke, aneurysms, high blood pressure, and other cardiovascular illnesses.
RESPIRATORY DISEASES Smoking is cited as a risk for dying of pneumonia, chronic bronchitis, or emphysema.
- OTHER ILLNESSES:
A report recently published in the American Journal of Epidemiology suggested that smoking increased the risk of developing non-insulin-dependent diabetes mellitus (NIDDM) by more than three times.
Studies have pointed to smoking as a risk in vision loss among older people, mental impairment later in life, Alzheimer's disease and other forms of dementia.
- EFFECT ON PREGNANCY Pregnant women who smoke can pass nicotine and carbon monoxide to their baby through the placenta leading to fetal injury, premature birth, or low birth weight.
> Number of deaths per year attributed to tobacco in the United States: 400,000 *.
> Number of deaths per hour: 45.
> Number of deaths due to:
Cardiovascular disease: Almost 180,000. *
Obstructive lung disease (chronic bronchitis and emphysema: 65,000 *.
> Risk for a smoker dying of lung cancer, compared to a never-smoker:
Male: 22 times
Female: 12 times
> Number of scientific studies on the health effects of tobacco, approximate: 50,000.
> Percentage of United States adults who smoked in 1993: 25 *
> Percentage in 1965: 42 *
> Number of years of life smoking costs the average smoker: 7 *
> Number of identified carcinogens in tobacco smoke: 43
> Estimated 1993 health care costs due to smoking, according to Centers for Disease Control and Prevention: total $50 billion. This figure includes:
$26.9 billion for hospital costs
$15.5 billion for doctors
$4.9 billion in nursing home costs
$1.8 billion for prescription drugs
$900 million for home-health care expenditures
And another important fact to know is that smoking by parents following the birth of babies is linked to sudden infant death syndrome, or cot death, and higher rates of infant respiratory illness, such as bronchitis, colds, and pneumonia.
Whenever a smoker smokes in public like the public transportation i never hold back on showing my great disgust and annoyance. if you want to die do it alone don't drag non-smokers with you!
Thursday, April 3, 2008
It was in the OB Ward when I was on duty that I first heard of the "Milk Code". Executive Order No. 51 (Philippine Code of Marketing of Breastmilk Substitutes) or more commonly known as the "Milk Code" protects babies from dying by barring milk companies (like Nestle) from promoting their product as a substitute for breastfeeding which of course is morally wrong!
The milk code clearly states that breast milk should exclusively be given to babies younger that the age of one and that milk substitutes is a big no-no! Why? Because failure to breastfeed leads to the deaths of 16,000 children in the Philippines each year and 1.5 million infants die around the world every year (from The Manila Times and Baby Milk Action).
So why is breastfeeding so important that taking it away may lead to the numerous deaths of infants around the world? Here are the reasons:
- The babies immune system is still inactive and they only get their protection from a great number of childhood diseases EXCLUSIVELY from breast milk, specifically from the colostrum. Antibodies are passively given from the mother to the baby. Without these antibodies babies could die!
- Breast milk is the ONLY COMPLETE source of nutrition. Artificial food supplements that Nestle and other milk companies could never be a substitute no matter how many minerals and vitamins they add to their formulas.
- Formula milk is NOT STERILE! It’s been proven that some infant formulas contain enterobacter sakazakii, a highly lethal pathogenic microorganism. Milk formula labels don’t have warnings on these (from UNICEF).
- ONLY breast milk contain necessary growth factors that help babies develop physically, mentally, and emotionally!
- Bottle feeding will confuse the baby and will prefer to be bottle fed than breast fed making it very difficult to return to breast feeding.
So why is Nestle an INFANT MURDERER? It's because their infant formula advertisements present artificial feeding as healthy and comparable to breastmilk therefore discourages mothers to breastfeed. Health claims such as “contains all the nutrition babies need for all-around visual, mental and psychomotor development” or “helps your baby fight against harmful free radicals of the environment” manipulate mothers. “Formula milk does not provide babies immunity from infection. It provides inadequate level of nutrition making babies susceptible to infection, malnutrition and death” stresses Sterken, a key player in the 20 country two-decade international boycott against Nestle & breast feeding advocate (from UNICEF). And with all said, Nestle even has the audacity to counter and challenge not only the Milk Code of the Philippines but of the codes of the World Health Organization (WHO) and United Nation's Children's Fund (UNICEF)!
Help protect our babies from greedy unethical companies like Nestle! Join the boycott and spread the word that breast milk has no substitute! For student nurses and nurses, or any medical professionals working in the hospital especially in the Philippines, always confiscate milk bottles from mothers! We are the empowered deputes who will enforce the Milk Code. If the mother says that she is only using the bottle but the milk is breast milk and not formula, inform her to use droppers or tablespoons instead because again, using baby bottles for infants below age confuses them and makes breast feeding difficult.
Breast Feeding Resources:
Monday, March 31, 2008
Listening to music that induces relaxation, before taking a test has been proven to temporarily enhance IQ and improve scores. Music also has unending benefits on our health.
With regards to health, it has been proven that music reduces blood pressure and music is also used as a form of therapy to pain and to calm patients in mental hospitals.
Mark Tramo, a neuroscientist at Harvard Medical School, commented on a study which "showed that the heart muscle of people exercising on treadmills didn't work as hard when people listened to music as it did when they exercised in silence."
That is why I spent some time creating my perfect workout playlist and here it is:
- Any songs from Britney Spear's Blackout (yup I love it!)
- Stronger - Kanye West
- Elevator - Flo Rida Feat Timbaland
- I Got It From My Mama - Will.I.Am
- Low - Flo Rida feat t-Pain
- Feedback - Janet Jackson
- pump it - Blackeyed Peas (or any songs from them actually)
- Sexy Back - Justin Timberlake
- Like This - Mims
- Dance Like There's No Tomorrow - Paula Abdul
- Easy - Paula DeAnda
- Aikoi - Kajiura Yuri
- In the Church - Kajiura Yuri
- 19 Sai - Suga Shikao
- I'm Coming - Rain (Bi)
- Fergilicious - Fergie
- Tokyo Drift - teriyaki Boyz
- Get It On the Floor - DMX
- Show Me The Money - ???
- Not Gonna Get Us - t.A.T.u.
- Any Song from Panic! At the Disco!
- Please Don't Stop the Music - Rihanna (or any other of her songs like Break it Off, etc)
- I'm A Scatman - Scatman Jack
- maria - Kim Ah Joong
- Outta My Head - ashlee Simpson
- Me & You - Cassie
- Die Another Day - Madonna
- Do It Well - Jeniffer Lopez
- Push It - Salt & Pepper
- Fighter - Christina Aguilera (or her other fast tempo songs)
- The song must have a fast tempo with a nice beat to it that would want you to move more
- A song that you personally love (therefore don't just copy other people's workout playlist)
- A song where you lose yourself making you forget your fatigue and make you go an extra mile.
So what is colon cancer? To know that we must first define what cancer is.In a normal body function, rapid division and multiplication of cells are needed to regenerate and heal the body. But there are times when the growth is uncontrollable and spreads (metastasizes) into other parts of the organs where it continue to divides and replaces normally functioning cells with abnormal cells. Cancer cells multiply so fast that they may occlude blood vessels and steal blood flow by forming their own vasculature stealing normal organs their blood supply thus the organ dies. And for the people who are confused, tumors are abnormal proliferation of cells and there are two kinds of tumors, benign and malignant. Benign is non-cancerous and does not spread so it can be safely removed by surgery. The dangerous kind of tumor is a malignant tumor as it is cancerous. Even if the malignant tumor is removed, remaining cells could still multiply at a more rapid rate that is why chemotherapy (the use of medication to kill cancer cells) is also required to kill cancerous cells, but unfortunately it also kills normal cells but that would be a different topic.
I'm not sure if Mrs. Aquino's cancer is malignant or benign, but I'm guessing that it is malignant because she wouldn't have let the whole Philippines know that she had cancer. So let me share the some relevant information as to what causes colon cancer, signs and symptoms of colon cancer, what the treatment is, and what the preventions are. These are very important to know as this could save your life one day.
So what causes colon cancer? It's still unknown but it is believed that a high fat diet increases one's risk for colon cancer. Why? Breakdown of fat leads to the formation of carcinogens (cancer causing substances). Although cancer is not contagious, it is hereditary so if you have any relatives with any kind of cancer then you are at high risk for cancer.
Symptoms of colon cancer are numerous and nonspecific. They include fatigue, weakness, shortness of breath, change in bowel habits, narrow stools, diarrhea or constipation, red or dark blood in stool, weight loss, abdominal pain, cramps, or bloating. Other conditions such as irritable bowel syndrome (spastic colon), ulcerative colitis, Crohn's disease, diverticulosis, and peptic ulcer disease can have symptoms that mimic colorectal cancer (from medicinenet.com).
The treatment for colon cancer, like any other cancer is surgical removal to prevent the metastsis or spread of cancer cells to other organs. But treatment does not mean that you will be treated immediately. Factors as to how much the cancer had progressed plays an important role. This is why prevention is better than treatment because one only notices that one has cancer when it is already too late when the cancer has already grown and spread causing the signs and symptoms.
Preventing cancer entails a healthy lifestyle like eating healthy avoiding fatty foods, carcinogens like charred meat, drinking too much alcohol, etc. But the best prevention is early detection. It is recommended that all individuals over the age of 40 have yearly digital examinations of the rectum and their stool tested for hidden or "occult" blood (from medicinenet.com).In a digital rectal exam a doctor inserts his finger through your anus and feels for polyps (abnormal growth). For males, a digital rectal exam is like hitting two birds with one stone as the prostate gland can also be checked for prostate cancer at the same time.
Other early detection procedures are flexible sigmoidoscopy and colonoscopy. Here a video camera is inserted to see how your colon looks checking for abnormal growths and other anomalies.
For more information please visit this site: medicinenet.com
Saturday, March 29, 2008
For years now I have always been told that my handwriting is like a doctor's. This is meant to be a joke of course, but can also be misunderstood for an insult. It is true that I had my own share of horror and eye strain from trying to read and make sense of the scribbles and marks written by doctor's on their Doctor's Order.
In fact I always have to team up with my other duty mates to help me break the secret of the doctor's handwriting. But we always end up making mistakes. It amazes us though that my clinical instructors are able to understand this foreign handwriting. We always ask our CI's in wonder how in the world do they understand those scribbles and doodles? Their answer? Lot's of experience with doctor's orders. But even the experienced staff nurse also makes mistakes because there are doctor's handwriting are so encrypted to the point that deciphering it is no use. Just a thought: Doctor's should get into the date security business.
But what is so important about doctor's having legible handwriting? Simple, a misunderstood order could lead to death of a patient. Don't believe me then take some time to read this article from BBC News: Health Doctor's Scrawl Blamed For Patient's Death. As the article shows a poorly written order or prescription could lead to a patient's death.
But let us not flame our doctors because it is not their fault too that they have such illegible handwriting. We also have to think that they have a lot of patients to take care of that is why they have to do their charting very quick. But how come nurses are able to have more legible handwriting when nurses are the ones who are with the patient 24/7 and are always documenting every procedure they do for every patient?
But there is nothing we can accomplish with complaining that we can't understand the doctor's handwriting. What we can do is look for a solution. The best solution with this problem is electronic orders or prescriptions. The orders and prescriptions are just flashed into the monitor with beautiful and neat computer generated text. This may be already true to First World Countries like USA, Canada, and the UK. But in the case of the Philippines? We can't do anything but pray that the doctor writes in print or we nag them to death to interpret their handwriting or our license is on the line. Wait, I don't have a license yet.
Monday, March 17, 2008
The low humidity in airplane cabins tends to dry out the sensitive mucus membranes in the upper airways where viruses and bacteria can take hold.
What To Do:
* Keep drinking. Ideally, have 8 ounces of water or fruit juice for each hour of your trip.
* Stick to bottled or canned water and juices, and limit alcohol or caffeinated drinks, which can be dehydrating.
* Consider skipping drinks that may be made from airline tap water, such as coffee or tea. Also, ask for your drinks without ice when traveling from countries where water safety is questionable.
Blood clots (deep venous thrombosis, or DVT) can develop in the deep veins of the legs, especially on long flights. They can lead to a potentially deadly embolism, sometimes days after the trip. At particular risk: individuals who have had recent orthopedic surgery in their lower limbs, those with vascular or circulatory problems, some cancer patients, the severely obese, smokers, pregnant women and those on hormone replacement medication or contraception pills, and those with a family history of blood clots, says Dr. Phyllis Kozarsky, a consultant to the Centers for Disease Control and Prevention (CDC).
What To Do:
* Stretch and walk around, if you can, every hour or so.
* Do in-seat ankle extensions and flexes, wiggle your toes, move your arms and legs around.
* If possible, get your legs above your heart—easiest if you are in a first-class sleeper, but also possible in a bulkhead economy-class seat, where you can put your feet up on the wall in front of you.
* Avoid sitting with your legs crossed or sleeping for long periods of time.
* Ask your doctor about prescribing medical graduated compression socks if you are at risk for blood clots.
Those who experience the symptoms of DVT—swelling, warmth, redness in the leg, or pain that is noticeable or worse when standing or walking— should notify a flight attendant. (And do not massage the leg, which could be dangerous.)
The Federal Aviation Administration reports that 75% of commercial airliners now use air filters that can intercept almost all of the harmful bacteria, viruses and other contaminants in the cabin. Still, that may not be enough to protect you from the germs of the sneezer sitting next to you.
What To Do:
* Bring your own lightweight microfiber travel blanket and pillow cover for long flights, because you can never be sure that supplies onboard are clean. (Airline cleaning schedules vary.)
* Wash, wash, wash your hands after touching potentially germy surfaces—door handles, toilet seats and handles, lavatory sink spigots, magazines or other people’s hands. Also, use clean hands when touching your mouth, eyes, nose or any food. “The most common way of contracting an infection onboard is by contact with an infected surface—not by breathing infected air,” says Jolanda Janczewski, an occupational health and safety consultant.
* If you can’t get to soap and water, use an antibacterial gel cleaner. Choose one that is at least 60% alcohol, recommends Dr. Christie Reed, a travel-health official at the CDC. Small, 2- to 3-ounce samplers that comply with stricter airport carry-on rules for liquids and gels are available at most convenience stores and drugstores.
* Use bottled water—not tap—for brushing your teeth.
Traveling at 35,000 feet can cause painful and potentially dangerous changes in ear pressure when the plane is ascending or descending. Passengers traveling with head congestion are particularly susceptible.
What To Do:
* Chew gum, suck on candy and keep swallowing. Says Dr. Reed, “Swallowing helps to equalize pressure. Sips of bottled water also help.”
* Consider depressurizing ear inserts (available in adult and children’s sizes at most drugstores), which also can help to equalize air pressure.
* Have a cold? Ask your doctor if decongestant medication would help. (Check security rules for packing nasal spray.) And don’t hold your nose and blow hard, which can do more harm than good by potentially damaging your eardrum.
Friday, February 29, 2008
Saturday, February 23, 2008
I am proud to announce that my school is the 2nd Best Nursing School in the Philippines as of the December 2007 PRC Nursing Board Exams. XU had a passing rate of 98% (still close to 100%) with 229 passers out of 233 examinees. I pity the 4 who failed because they not only carry the burden of failing but also the shame and the pressure of being the cause of XU's decreased passing mark... but we cannot blame them because the board exam is not easy. Imagine out of the 67,728 board takers, only 28,924 (or 43.42 percent) passed!
I am also proud that there are topnotchers from my school namely:
Top 6: Katrina Victoria Luceno Akut, Xavier University, 86.00 percent.
Top 8: Hernessa Torralba Hernandez, Xavier University, 85.60 percent.
There are also topnotchers from a sister school, Ateneo de Davao University! But I won't be amazed because it is Ateneo of course.
For more info and proof that I'm not making this whole up please visit this link: Inquirer
Or you can go to the official site of PRC: PRC Board Exam Results
Wednesday, February 20, 2008
I was searching the net for guidelines on proper hand washing when I stumbled upon a poem by a fellow nursing student, Ms. Danica Ansay, who studies at University of the East Ramon Magsaysay (UERM)., Here is a link to her poem: Proper Hand Washing!^_^
At first I was wondering why it sounds like a poem until I realized it is a poem. After reading the whole thing I was quite amazed how Ms. Ansay was able to incorporate the nursing procedure of handwashing into a delightful piece. The poem is very witty and funny. Why don't you read the poem for your self:
*Assuming that I did demonstrate the Hand Washing to you
Upon opening the door
You first stole me with your machong-machong body
Standing beside the sink located beside the door
Waiting for me, ay shit! Joke lang!
I mean waiting for the next student to demonstrate
the Proper Hand Washing
Suddenly after we sat,
I heard you call my name, Ms. Ansay!
OMG! I can’t believe I hear you call my stolen name
Walking towards the sink while stealing your sight
Preparing the materials upon preparing my heart
While starting the demonstration
I started to explain the meaning of Asepsis
As a freedom of my friendship with you
The purpose of Hand Washing is to prevent
the shyness I feel inside of me
And thus, I will now perform the Proper Hand Washing
First I will get a tissue to dry your tears and make you smile
Then I will open the faucet just enough to my satisfaction
Throwing the tissue away to the waste receptacle
Wetting my arms from elbow to fingers
Placing my hands lower than my elbow
I will get again another tissue to wipe my drool
while looking at you
Then throw again the tissue away from me
Rubbing the soap from palm to palm
Like kissing each other from cheeks to cheeks
Next is the interlace, then the dorsal part of my hand
Now the spider with my fingers rubbing my palm in circular motion
together with my eyes looking at your posture cephalocaudal
Then my fingers with five strokes each
while saying, ‘my-chu-va-chu-chu’
Lastly with circular motion rubbing my arms from wrist to elbow
Dreaming and wishing that you’re standing right next to me
holding my arms and together we will go to paradise
Now I start rinsing my arms from elbow to my fingers
Feeling the warmth of your hands embracing my coca-cola body
Picking the last tissue to dry my tears of loneliness
before saying goodbye
Throwing the tissue of my tears away from my sight
Getting the towel to pot dry my arms from hands to elbow
Wishing that you were the one who dries my tears
and makes me feel special
Preparing myself for the evaluation
A little spray of perfume and a touch of powder
I think is enough for him to notice me
Feeling nervous while standing in front of you
Listening to what you say and do
Rejoicing for what you’ve said
Giving thanks for passing meAnd specially for your time and cooperation.
Tuesday, February 12, 2008
It's about being who we are.
NO book can teach you how to cry with a patient.
NO class can teach you how to tell a family that their parents have died or are dying.
NO professor can teach you how to find dignity in giving someone a bed bath.
A nurse is not about the pills, the IV's and the charting.
It's about being able to LOVE people when they are at their WEAKEST moments and being able to forgive for ALL their wrong and make a difference in their lives today.
NO one can make you a nurse...
Tuesday, January 22, 2008
Reading in the Operating Room: Is It Acceptable, Just Because We Can?
by Terri G. Monk, MD, and Adolph H. Giesecke, MD
Like the stock market, which waxes and wanes in irregular, dysrhythmic undulations, the interest that residents and practitioners have in reading in the operating room (OR) follows a similar course. Recently, we have observed that reading in the OR has gradually crept back into our practice; it is in a waxing phase. We understand why anesthesiologists are tempted to read in the OR (“Watching surgery is like watching paint dry,” and “I have no time to read at home so I need to make up for lost time in the OR”). This subject became the focus of serious discussion in a panel on patient safety presented at the recent annual meeting of the Association of University Anesthesiologists in Sacramento, CA. We feel that reading in the OR seriously compromises patient safety and are opposed to it for the following 4 reasons:
First, reading diverts one’s attention from the patient. If, because one’s attention is diverted, 1 or 2 minutes of warning signals are missed, then the remaining time may not be adequate to evaluate the problem, make a diagnosis, and take corrective action. The consequence may be a severely injured patient. However, with improved monitoring techniques (pulse oximetry, capnography), it can be argued that this scenario is less likely.
Second, the patient is paying for our undivided attention, and most well-informed patients want to know if we plan to turn over a portion of their anesthesia care to a nurse or resident. If we are obliged to honestly answer that concern, then, should we also be obliged to inform the patient that we plan to read during a portion of the anesthetic? If patients knew, they would probably request a reduction in our fee for service or choose another anesthesiologist. On a personal level, we would not want the anesthesiologist caring for us or our family to read during surgery. Is it fair to provide less vigilance to our patients than we would expect during our own anesthetic?
Third, it is medico-legally dangerous. Any plaintiff’s attorney would love to have a case in which the circulating nurse would testify, “Dr. Giesecke was reading when the cardiac arrest occurred. Yep, he was reading the Wall Street Journal. You know he has a lot of valuable stocks that he must keep track of.” It is possible that if anesthesiologists informed their malpractice carriers that they routinely read during cases, the companies might raise premiums or cancel malpractice coverage.
Fourth, the practice of reading in the OR projects a negative public image. In this case, the nurses, technicians, aides, and surgeons represent the public. The officers of the ASA must occasionally serve as spokespersons for our profession at press conferences. Usually this follows a highly publicized disaster. It would be very difficult for them to defend the practice of reading in the OR. The public perception of our manner of practice is critical to the future integrity of the practice of anesthesiology. Let us strive to project an appropriate image. Reading in the OR should NOT be part of the image.
Despite our strong objections to reading in the OR, many of our colleagues feel differently. In 1995, Dr. Weinger wrote an article for the APSF Newsletter discussing the practice of reading in the OR and pointed out that there were no scientific data on the impact of reading on anesthesia provider vigilance.1 He concluded, “In the absence of controlled studies on the effect of reading in the operating room on vigilance and task performance, no definitive or generalizable recommendations can be made,” and the decision to read or not should be “a personal one based on recognition of one’s capabilities and limitations.”1 This commentary generated a flurry of letters to the editor from anesthesiologists supporting both sides of the issue. Advocates of reading said it was no different than “any conversation with another person in the operating room about topics unrelated to patient care” or “listening to music” during the procedure, while opponents called the practice “appalling” and “totally unacceptable.”
In an attempt to resolve the controversy, the APSF awarded a patient-safety grant to Dr. Weinger in 1997 for his project entitled “Scientific Evaluation of Anesthesiologist Performance: Further Validation and Study of the Effects of Sleep Deprivation and of Intraoperative Reading.” In a recent abstract, Weinger reported that anesthesia providers read in 35% of cases, but found no evidence that vigilance was different between reading and non-reading periods.2 He concluded that intraoperative reading by anesthesiologists “may have limited effects on vigilance and therefore may not a priori put patients’ safety at risk.”
While there appears to be no conclusive evidence that reading in the OR affects vigilance on the part of the anesthesiologist, we still object to this practice. Former President Bill Clinton was highly criticized for his affair with an intern, despite a lack of evidence indicating that this indiscretion affected his performance as president or adversely affected the country. When asked in a recent CBS television interview why he had an affair with Monica Lewinsky, Mr. Clinton responded, “For the worst possible reason: just because I could. I think that’s just the most morally indefensible reason that anybody could have for doing anything.” As anesthesiologists, we know that we can read in the OR and recognize that there is no scientific evidence that reading in the OR adversely affects a patient’s outcome. Would we, however, want to defend this practice in a television interview?
Dr. Monk is a Professor in the Department of Anesthesiology at Duke University Medical Center, Durham, NC, and Dr. Giesecke is a Professor of Anesthesiology and Pain Management and Former Jenkins Professor and Chairman at the University of Texas Southwestern Medical Center, Dallas TX.
1.Weinger MB. In my opinion: lack of outcome data makes reading a personal decision, states OR investigator. APSF Newsletter 1995;10:3-5.
2.Weinger MB. Assessing the impact of reading on anesthesia provider’s vigilance, clinical workload, and task distribution. Available on the web at: http://www.anestech.org/Publications/Annual_2003/sta117.html. Accessed on August 9, 2004.
Monday, May 7, 2007
New generation of nurses 'too posh to wash'
Last Updated: 2004-05-10 14:55:17 -0400 (Reuters Health)
By Tristan Jones
HARROGATE, England (Reuters) - A new generation of nurses who are "too posh to wash" are threatening traditional nursing practices by refusing to perform basic tasks, the leader of Britain's nurses' union, Beverly Malone, said Monday.
The changing status of women in society has made some nurses think they are above core activities like washing people's feet or backsides, Malone told a news conference at the Royal College of Nursing's (RCN) annual conference in Harrogate.
"Nursing in years gone by was associated with women's work and menial tasks, and women would only do certain levels of work relating to home care and babies' bottoms," she said.
"Women have moved up in the world and their status has changed. Now there is this assumption that if you become more professional then somehow you become too posh to wash."
The conference will discuss whether nurses should focus on treatment and technical nursing, leaving their caring role to less qualified health care assistants - a suggestion expected to be roundly defeated.
Nurses have taken on more specialized roles over recent years, including prescribing drugs and running chronic disease clinics. The conference voted Monday that nurses' managers should themselves be qualified nurses.
The RCN estimates that some 20 percent of junior doctors' work could be shifted to nurses and over 12 percent of nursing work given to health care assistants.
Jeremy Bore, a general nurse from Exeter in southern England, said he called for the debate because a significant minority of new nurses don't want to provide basic holistic care.
"I had a 10 minute debate with a student nurse who said, 'I do not wash people's bottoms, there are other people to do that,"' he said.
"Not doctors, not even priests become as intimate with patients as nurses. Nurses have got to come to grips with the deep philosophical concept that carrying someone else's shit is a privilege."
"Nurses have got to be clear that we are still the ones ultimately responsible and that we are always available to do things for our patients. If I become too posh to wash I should no longer be in the profession."
Janet Clay, a nursing sister in accident and emergency unit in Newport, South Wales, said graduate nurses were the most likely to consider themselves above basic treatment.
"There is a lot of attitude that: 'it is beneath me to do the bed pans'. But that is what basic nursing care is about," Clay said.
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