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A Nurse's Tale

pinoy careIt’s been quite a while since my last post, I apologize because of workload. I’ve also been tied up with the day-to-day operations of my everyday life. Still, it’s shameful that I’ve neglected this site for so long.

 

Christmas and New Year have never been better compared to last year, since I was surrounded by my loved ones especially my college friends. If there be any gift I received this Christmas, it would be the sense of fulfillment as a nurse and a teacher.

 

2008 is REAL; I can now feel the strike of the “quarter-age crisis”. I don’t want to spend another five years of my life in teaching, not that I hate my calling as an educator but the reality of becoming old. I don’t want to be looking at my students’ faces five years from now and reminiscing my college years. Right now, my greatest fear is to become old.

 

I spent my Christmas at Home for the Aged (Tahanan ni Maria, Carmona Cavite) where I am the Clinical Instructor for 50 nursing students (lived-in caregiver OJT course). It was an eight-day stay, 15-hour duty per day (from 5:30 am-10 pm) for a total of 120 hours.

 

I have always enjoyed being around the elderly, and this is probably the primary reason why I now love being a “nursing home” nurse. The opportunity to really “connect” and build relationships with your patients are not something which are always found in hospital setting where patient stays for only few days. There is a real challenge which comes along with taking care of someone for few months or years compared to few days. This challenge comes from trying to meet the client’s emotional needs as well as the physical needs to provide a comfortable “home like” environment for the client. The rewards received from meeting these challenges are significant, and are probably the major reason why many nurses in long-term care stay in the profession.

 

I know many years from now; I will be looking back at my own career. The things which I will remember will not only be how hard I worked or what technical skills I was able to perform effectively. The memories which will really stay with me will be those someone’s face lighting up when I entered the room; the reminiscences of days gone by, told to me by someone who actually lived them; the times when I laughed and cried with my patients or their families; the batch of cookies made for me by a patient’s daughter in gratitude for my care of her mother. But above all, it is the unconditional love you’ll learn from them. These are the things which make my job worthwhile, and the reason which I look forward to going to work each day and everyday. To those nurses who think of long-term care as an unrewarding, dead-end job, I strongly urge you to think again and maybe even to give it a try… You’ll be glad you did.

Mastering BP & RAAS

This is the coolest way to master Renin-Angiotensin-Aldosterone-System (RAAS)and BP. The humor makes a lot of sense.




Tags:

Oplan Vaccination anyone?

To: RN's, student nurses, nursing assistants, caregivers etc.

Re: Oplan Vaccination (anti-measles, Vit. A, deworming)

Meeting Place: Jollibee Bicutan; 7:30 am -sharp

Area: Upper Bicutan Health Center

Schedule: Starting Nov 5, 2007.

MWF 8-12 pm, TTH 8-5pm, Sat. 8-12, Sun 7-11

Happiness First

"The real troubles in your life are apt to be the things that never crossed your worried mind"

I want a brand new life. I want to resign from teaching. I want a more challenging career. I'm still on the process...

Well, if there is one thing I've learned during the 20 years I've spent on this planet that thing is, it's so silly not to live because of the fear of making mistakes...just because eventually you'll make those mistakes and all the years spent waiting for the perfect person you've dreamt about all your life long will make you feel like you've wasted the best part of your life. It may be because everybody makes mistakes, it may be because some asshole will come along and fool you with her pretty eyes and vile lies, it may be because that day you'll feel particularly alone and weak or it may be for a thousand of other reasons. Eventually, you'll fall somehow, and lying down there on the floor you'll cry but not for the mistake itself but for having wasted all your time for nothing, for having been so stupid to believe that if you would behave as a good boy then you'd get the deserved prize.....well, it doesn't work like this, definitely not. So that if someone will ever read this nonsense thing I am writing. You may want to take this advice from a perfect stranger. ......live your life today, keep the future clear in your mind and never forget what you really want out of this life and always live for the present, because if we keep bragging ourselves for that future happiness we always long to have,then we will spend our entire life just preparing ourselves to be happy but we will never actually be happy.

My PHONE was stolen

Just in case somebody will text you using my number (09065838841) please do not reply or entertain because my phone was stolen this afternoon. Be careful of scammer.


 

ZYGOTE- Pulis Pangkalusugan

Twenty years ago, Enemies were defeated by a brave warrior who fought to save Earth and the rest of the universe. Now that he has gone, the universe is once again threatened by the same force that tried to capture it before -- and a new breed of heroes is needed. Who will fill the shoes of the brave warrior of old? And what new villains are in store for the heroes-to-be?

Don’t miss the adventure that will take you to the far reaches of the universe. ZYGOTE, Pulis Pangkalusugan.

 

Reminiscing My College Life

So I'm six months away from the end of my college career, and I all I can think about is how much i miss my lifestyle. And I don't mean the parentally funded minimal responsibility way of life that I've grown so accustomed to.

As much as I love college, I hope it's not the best time of my life. It just seems a little sad to think that life peaks at age 22, and you spend the next sixty years missing the days where you and your friends would get drunk, hook up with randoms, and videoke all night.

I miss the hospital stress

I miss the hospital alarm.

 I miss my group mates.

 

 

I miss my batch mates especially those who didn't make it. 



I miss semestral breaks. I spent my last one in Tanay. I miss the hallowed halls of the Nursing Lounge, the Riverside of San Jose.

I miss that clean NAL floor-waxed shine, which happens only during school nursing rotations, when your dean forces you to do it while wearing your white uniforms.

I miss those guilty weekends when I kept on editing photos and videos while my classmates are busy with the review.

Now, I'm a teacher I just can't do it again with my students.

 

Class Picture


Welcome to Nursing! The most exasperating career ever invented. It is also the most fulfilling. I can guarantee you intangible rewards that can rarely be matched by any other profession. I can also guarantee that as a nurse:You will never be bored.You will always be frustrated.You will be surrounded by challenges - so much to do and so little time.You will carry immense responsibility with very little authority.You will step into people's lives, and you will make a difference.Some will bless you. Some will curse you.You will see people at their worst - and at their best. You will never cease to be amazed at people's capacity for love, courage and endurance.You will see how life begins and ends.You will experiene resounding triumphs and devastating failures.You will cry a lot. You will laugh a lot.You will know what it is to be human and to be humane.




 



Liver Cirrhosis

Assessment:
 
  1. Anorexia, weakness, weightloss,. The liver is unable to metabolize nutrients and store fat-soluble vitamins.
  2. Fever- because of response to tissue injury.
  3. Jaundice, pruritus, tea colored urine due to increased serum belirubin
  4. Bleeding tendencies, the liver is unable to store Vitamin K, thereby unable to synthesize clotting factors.
  5. Decreased resistance to infection. The kupffer cells are damaged, thereby unable to perform phagocytosis.
  6. Portal HPN
  1. Hepatomegaly
  2. Splenomegaly
  3. Caput medusae (dilated veins over the abdomen)
  4. Spider angioma (telangiectasia/ dilated capillaries over the face and anterior trunk)
  1. Palmar Erythema due to elevated estrogen level in males
  2. In portal hypertension, plasma shift into interstitial spaces within the liver. The collection of fluids shifts out of the Glissom’s capsule and accumulate in the peritoneal cavity. The liver is unable to metabolize protein, thereby hypoalbuminemia occurs. The liver is unable to excrete adrenal cortex hormone, one of which is aldosterone. Hyperaldosteronism leads to retension of sodium and water.
 
Pathophysiology
 
Etiology:
Alcohol Abuse
Malnutrition
Infection
Drugs
Biliary Obstruction
Destruction of HEPATOCYTES
Fibrosis/ Scarring
Obstruction of blood flow
Increased pressure in the venous and sinusoidal channels
Fatty infiltration Fibrosis/ Scarring
 
Portal HPN
 
 
 
 
 
Collaborative Management:
1.Rest – to reduce metabolic demand of the liver
2.Diet:
 
a.             Early Stage: high calorie, high carbohydrates, high protein, low fat
b.            Late Stage: high calorie, high carbohydrates, low protein, low fat
 
3.Skin care
4.Avoid trauma or injury
5.Prevent infection
 
Pancreatitis
 
Inflammation of the pancreas
  1. Acute
  2. Chronic
 
Assessment:
1.Pain- Left Upper Quadrant, may start at the epigastrium, radiate to the back, flanks and substernal area.
2. Anorexia
3. Fever
4. Nausea and vomiting
5. Severe dehydration
6. Weight loss
7. Steatorrhea – due to excretion of undigested fats
8. Hypocalemia
9. Hyperglycemia
10. Jaundice
 
Pathophysiology:
Etiology:
Alcohol Abuse
Drugs (antihypertensives, diuretics, antimicrobials, immunosuppressives, oral contraceptives)
Autoimmune
Biliary Obstruction
Intestinal diseases
Unknown
 
Damage to pancreatic cells
 
Inflammation
 
 
Edema of the Pancreas and Pancreatic Duct
 
Obstruction to the flow of pancreatic Enzyme
 
 
Activation of Pancreatic Enzymes inside the Pancreas
 
Autodigestion of the Pancreas
 
Fatty Necrosis, Ulceration, Hemorrhage, Infection
 
Collaborative Management
    1. Relieve Pain – Administer Meperidine HCL as ordered. Avoid Morphine SO4 because it causes spasm of the pancreas.
    2. Diet: NPO during acute phase; then bland, low fat diet
    3. TPN. To provide nutritional supplement
    4. 4. IVF therapy. To manage fluid deficit
    5. Antibiotics. To control infection
    6. Calcium supplement to manage hypocalcemia
    7. Vit D. to promote absorption of calcium
    8. Insulin, to manage hyperglycemia
    9. Eliminate Alcohol
 

just passed the boards

ALEX B. OLIVAR JR., RN

www.prc.gov.ph
www.inquirer.net
www.mb.com.ph
www.pinoybsn.blogspot.com

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