A nurse is over twice as likely to suffer from occupational asthma, compared to the rest of the population, according to an article in The Lancet this week. The risk for cleaners is 71% higher. [click link for full article]

Pride2006, originally uploaded by richiesoft.

The NHS float at Europride 2006 in London was fantastic with this fella really getting into role!

I've been hearing since shortly after graduation, about the need for leadership in nursing.  It was just one of those concepts left on the back burner for a long time while I a) found a way to survive after ending a relationship and b) increased confidence in my nursing practice.  I've been at the same job for about 3 years now.  It's been long enough to understand and see the real need for leadership in nursing. 

I have made various attempts to implement change in my workplace.  One thing I learned from my excellent nursing teachers was to question the hegemony.  Question the way things are done.  Question why we do what we do throughout our shifts.  Is there a better way to do this?  Is it even necessary?  Is there a way to use our precious time resource more efficiently?  Good philosophy not just for nursing, but for life.  To that I'd add, ask better questions.

After a number of frustrating attempts to implement change, I wondered if I was going about it wrong.  Was I even in a position to implement change in my workplace?  Strangely, I had been waiting for our new nurse leader to arrive on the scene to make things better.  I would discover, once again, the Universe will give you direction if you open your eyes to see. 

Leadership in nursing has been more intensely on my mind for a number of months now.  Before the position of Nurse Leader had been filled, I wondered if I would be capable of filling the roll.  What would it take to be an effective nurse leader?  As I continued with my day to day practice, I just kept observing where and when I may be in a position of leadership.  Where and when could I be influential in my practice, to effectively lead other staff members towards a greater vision than present practice?  What would I have to change about myself to be capable of truly leading in an effective manner?  

Ask and it is given, it is said.  I was 'given' a situation at work where I ran into conflict with an LPN.  I believer her opinion was that I was not doing my job right.  I chose to remain neutral rather than become defensive.  I knew enough to at least do that.  Do no harm, right?  I'm not even going to write about she said/I said.  That's not the point.  We live in a benevolent Universe.  Along with this difficult-at-the-time situation, I was gifted with a solution as well.  The library called.  They had a book for me.   Lance Secretan's book, One - The Art and Practice of Conscious Leadership. 

I'll write more about what I'm learning, but suffice to say, I have already learned some very helpful principles to implement into my practice. 

Robert C. Keeley practices medicine in Roanoke. In September 2005 while on call for his practice at Carilion Roanoke Memorial Hospital, Keeley was in a car accident, subsequently charged and convicted of DUI. He also told the board that he provided medical directives to nurses on other occasions he drank alcohol and that he attended a substance abuse program in late 2005.

Keeley was REPRIMANDED by the board in April, almost two years later, and required to enter a program with the Health Practitioners' Intervention Program (HPIP)

Keeley is not alone:

Maybe she was having a bad day? Maybe she was thirsty?

Either way, Trisha Howell, a nurse at Town and Country Assisted Living in Lebanon, VA, was found with a 40 ounce beer between her legs in a residents room. At the time, Howell was responsible for 18 residents, 15 of which were mental health residents. She was fired and charged with neglect.

Howell was also charged with, in separate incidents, driving while intoxicated and child endangerment in 2006, forgery (1991) and concealment (2000). It looks like the most recent offenses in 2006 led to a year of supervised probation.

Howell's license was suspended in May by the Virginia Board of Nursing.

And last, but not least, Neva Tutwiler had her license suspended until the board meets again in September to discuss allegations of coming to work drunk in Winchester.

Let's turn to a brief from the The Huffington Post last year that points to a study about this topic:

"Workplace alcohol use and impairment directly affects an estimated 15 percent of the U.S. workforce, or 19.2 million workers, according to a recent study conducted at the University at Buffalo's Research Institute on Addictions (RIA) and reported in the current issue of the Journal of Studies on Alcohol.

Information about workplace alcohol use and impairment during the previous 12 months was obtained by telephone interviews from 2,805 employed adults residing in the 48 contiguous states and the District of Columbia. The sample of participants was designed to reflect the demographic composition of the adult civilian U.S. workforce from ages 18-65."

About IAS           Background:     IAS is a Full service, Allied agency. We have Elite group of nurses, who are
dedicated in serving their patients with dignity, professional ethics and multicultural diverse.
Our PTs, OTs, And SLP have been in their fields for more than 3 years and
Graduated from reputable Institutions.
Our Imaging Personal; RT, Ultrasound tech, Mammography Tech are well
trained on latest equipments. 

About Inland Allied Services, Inc. 

Inland Allied Services, Inc. is Inland empire's own agency. With the
growing population and its medical needs, IAS is teaming up with local
medical providers to well serve the community in every aspect of Medical
staffing needs. 

Our commitment: 

All nurses are screened according to State Department of Health
regulations and JCAHO 2 guidelines! We provide our clients with a
complete personnel file on every nurse including nurse competency
exams, proof of physical exam with PPDs, orientation to mandated topics
and license verifications, etc. All nurses pass a rigorous pharmacology
exam and a specialty exam (as applicable). We insist that our nurses attend
your Facility Orientation Program

This will be a test for the Blog, so we could see it online, and so could everyone else who have been linked to this site....

From the "Devilishly hard to explain." department, we have the story of the cat that has the (scary or comforting, depending on what kind of person you are) ability to determine when patients of the nursing home he does his rounds in are about to die:

PROVIDENCE, R.I. - Oscar the cat seems to have an uncanny knack for predicting when nursing home patients are going to die, by curling up next to them during their final hours. His accuracy, observed in 25 cases, has led the staff to call family members once he has chosen someone. It usually means they have less than four hours to live.

"He doesn't make too many mistakes. He seems to understand when patients are about to die," said Dr. David Dosa in an interview. He describes the phenomenon in a poignant essay in Thursday's issue of the New England Journal of Medicine.

"Many family members take some solace from it. They appreciate the companionship that the cat provides for their dying loved one," said Dosa, a geriatrician and assistant professor of medicine at Brown University.

The 2-year-old feline was adopted as a kitten and grew up in a third-floor dementia unit at the Steere House Nursing and Rehabilitation Center. The facility treats people with Alzheimer's, Parkinson's disease and other illnesses. - [Yahoo/AP]

I've always liked cats. Actually I love animals in general, but I've always admired the laid back, "I'll do as I darn well please, don't mess wit' me" attitude that many cats possess. Here in the US, I think many cats are often spoiled, and are pampered way too much, often to the point of unhealthiness.

Growing up as a young boy in a developing country, cats were generally much different animals. They played hard and worked even harder. I have personally witnessed one of our cats do battle with a rather unfortunate poisonous snake that dared intrude upon it's domain. Well it was actually our house, but by the way our cat acted, it might as well have been his.

Ancient Egyptians viewed cats as sacred creatures. The Japanese Maneki Neko (or Beckoning Cat) is considered a symbol of good luck. Cats have been considered creatures of great auspice in many cultures. Even in the US, cats, especially black ones, have become synonymous with the supernatural. But apart from their trademark familiar but aloof demeanor (especially for a domesticated animal), I have personally seen little evidence to warrant this special treatment.

This is one of the first documented cases of feline "clairvoyance" that I have ever come across. Or at least that I can remember. I'm actually kinda hoping they find out something about Oscar that will give us some new insight into what makes cats so special.

Oscar the cat predicts patients' deaths - [Yahoo/AP]

Ok so anyone else have a baby who gets milk streaming out of his nose when breastfeeding?  Yes, streaming.  Like it's going in his mouth and then straight out his nose.  And no, he's not laughing.  I do have a tendancy to have things come out of my nose.  Especially when I'm with Courtenay.  She's made many things go up my nose including carrot.  I hope there's not something wrong with Isaac's whole system there that's making this happen.

Breastfeeding is getting annoying.  Ike is having a pretty hard time during the day.  I think I might go see a lactation consultant to see if there's any tricks out there.  I know Silas pulled his head back and screamed bloody murder when I was nursing him too.  So frusterating!  Ike doesn't scream bloody murder but he still cries and cries.  Sometimes he cries when I just offer him my breast, like he's not looking forward to this next feeding.  He seems to get a gap somewhere so he sucks in some air causing him to cough and swallow air and then he's pissed because he has a burp in there which takes forever to get out of him.  His latch is best at night time.  It's perfect then and he likes to keep it latched for two hours sometimes.  I dunno, I guess I'm getting used to that part.

I'm glad I'm a person who formula is just not an option.  I like all natural things.  It's how I eat and live so my mind is just very made up about that.  The only cleaning things in my house that aren't all natural is my shampoo, but I'm a hairdresser so I'm picky.  I've been through a troubling nursing time before so I know I can get through it again.  I'm just frustrated.  Another thing I'm frustrated with is my sweet little Silas only sleeping an hour and a bit and is now screaming in his bed room.  I guess it's now time for me to go.  Will the teething ever end?

 

I have found in my own little quest for knowledge, a wealth of information at my fingertips on medically managing manic depression. I kept hitting a wall when it came to alternatives in treatment. 

When it came to tapering off medications that my ol' body had became accustomed to, I was hard pressed to locate much information that was helpful.  The meds I took usually made me feel great initially, then, there was the upward spiral.  An upward spiral which made me feel as though I was coming out of my skin. I came off several different medications, all with their own mind bending symptoms of withdrawl.  I did it on my own, because that was my preference.

To be quite frank, or quite Katie, I was sicker than I ever have been in my entire life when I went cold turkey off xanax.  I had no choice on quitting.  The choice was made for me.  A forced change in doctors and my benzo prescription was reduced by half.  Darn near, every month I went through some kind of withdrawl.  For an entire year, I would run out of my RX a few days prior to my refill.   I would taper to ease the withdrawl.  I did not abuse the stuff, just had real trouble going from 2-4 mg a day for 10 years to half that in one day.  My body had developed a dependency.  Dependency is just a nice word for addiction.

I got tired of the experience.  The last time I ran out I was sick.  Head in the toilette, kind of sick.  Alone and with the worst migraine in my life.  For two days I slept sitting up because my head pounded so hard I could not tolerate laying down with my head on my pillow.

I developed a pinched nerve in my neck from my sleeping position.

Friends brought 7 up.  One friend even brought  two Vicodin from a tooth extraction he had the week before.  It all went in the toilette, after I ingested it of course.  The Vicodin made me soooo nauseated that to this day I will never ingest the stuff again.

On day three I drove myself to the ER of the hospital where I had been employed.  They were kind.  Placed me in a private room.  I paced the floor quietly in that damn backless gown, and tried to remain calm, my head hurt so very much.  I asked for a shot of Toradol IM.  I refused narcotics knowing that these would just increase my nausea.  The doctor was kind, and insisted on starting and IV and infusing a liter of normal saline, secondary to my prolonged vomiting and dark, sunken eyes.

Within an hour of treatment I felt OK.  I walked outside and noticed how beautiful a day it was; sunny and gorgeous.

Perhaps, there are other Katies or franks out there that can benefit from a little support.

love,

katie

Three years after the 2004 launch of the ETXexpress specification, which has become the PICMG COM Express (COM.0) standard, Kontron defines a new footprint variant of the Computer-On-Modules (COMs) standard: nanoETXexpress. The nanoETXexpress specification is targeted to deliver extremely power-saving COMs with mid to high performance x86 technology on a footprint that is a mere 55mm x 84mm. This is 39 percent of the original COM Express module Basic form factor 125 x 95mm footprint and 51 percent of microETXexpress (95mm x 95mm). This new COM form factor follows the PICMG COM Express standard and will be 100 percent compliant with the COM.0 Type 1 connector. The locations of the identically mapped pin-outs will also be 100 percent COM.0 compliant. The goal of nanoETXexpress specification is to build PCIe-based COMs on the smallest possible form factor. Many new applications that will benefit from the nano-size include hand-held units for medical, mobile data solutions and other emerging applications that have not been possible as of yet due to size restrictions. "The nanoETXexpress specification will provide the ideal footprint for future applications, bearing in mind that forthcoming processor and System-on-Chip (SoC) technology will be delivered in 45nm technology and beyond," stated Dirk Finstel, CTO Embedded Modules Division, Kontron. The specification, documentation for nanoETXexpress will be available under a non-disclosure agreement in Q4 2007. Kontron plans to launch its first nanoETXexpress based COM in Q2 2008.