Faints, Fits and Funny Turns

I did a little Google search and found a very informative article regarding faints, fits, and funny turns. The terminology used here is just worded differently than in other regions of the world.
Happy educational reading!!! Click on the title to read the article..

CDC guidelines aimed at resistant bacteria

U.S. health officials are preparing new hospital infection control guidelines to slow the growing spread of bacteria that has become resistant to antibiotics.

The Centers for Disease Control and Prevention will release the new hospital rules within three months, Michelle Pearson, chief of the National Center for Infectious Disease's prevention and evaluation branch, said in an interview at an infectious disease meeting this month in Washington, D.C. The new rules will intensify sterilization requirements for health workers, increase testing of patients who may harbor dangerous germs, and may call for hospitals to create special quarantine wards.

This is a subject that I have been following for the last few years. These infections are becoming more and more resistant to antibiotic therapies and patients must understand the reasoning behind the decrease in arbitrary antibiotic prescription. Stop asking for antibiotics when you have a cold and stop getting the kids something just because they have an ear infection. Very closely monitoring instead of slapping on broad spectrum antibiotics will reduce the amount of resistance. Quit taking other people's medications and make sure that you FINISH THE ENTIRE DOSE....
Click on the story title to read the rest of the story...

Why I don't want to be a MD

I don't mind people who disagree with me but I hate when they don't leave where they came from.
I'm not usually easily offended since I understand that there has always been conflict between nurses and doctors since time memorial. Paramedics have fought for years for the rights to practice their skills in the field. They were told to go to medical school if they wanted to practice medicine and "be doctors". Through years of experience, look at how many lives they have saved in the field. Nurses have fought for the rights to take care of their patients for years as well. Years ago, we weren't even allowed to take a temperature with a thermometer for goodness sake.
NPs are fighting for the rights to practice in their full capacities as well.What about the MD vs DO competition? DOs weren't considered "real doctors" either.
I just didn't appreciate the deliberate "quack" reference. I can laugh at a good joke regardless of who's supposed to be the butt of it, but it's more personal to those who are trying to reach the pinnacle of the profession.
For those who ask "if you want to act like a doctor, why don't you go to medical school?", I don't feel like doing four years of Chemistry plus Physics or Calculus. I've already done 5 years of classes with extensive A&P, pharm, etc. Why would I go back to school for another 8 years just to take the same classes again along with a class in bedside manners when I already know how to take care of my patients? I'm happy with the opportunity to diagnose, treat, and educate my patients as a NP until I finish my Doctorate of Nursing Practice. I will then be at the pinnacle of the nursing profession and proud to have gotten that far. I understand my limitations and will consult a doctor when I need to.
I am lucky enough to work with progressive doctors who aren't threatened by me and are eagerly awaiting my graduation...Until then, stayed tuned for the next installment of The Nurse Practitioner's Place!

One more reason for you to eat small doses of chocolate

Dec 21 (Reuters) - A few squares of dark chocolate every day might cut the risk of serious heart disease by helping to stave off the hardening of arteries, according to a study published on Tuesday.

Researchers from University Hospital in Zurich studied 20 male smokers, who are at greater risk of hardening arteries characteristic of coronary heart disease, to see the effects of dark and white chocolate on arterial blood flow.

The subjects, who were asked to abstain from eating foods rich in antioxidants for 24 hours, were given 40 grams (2 ounces) of chocolate to eat.

After two hours, ultrasound scans revealed that dark chocolate -- made up of 74 percent cocoa solids -- significantly improved the smoothness of arterial flow, whilst white chocolate, with four percent cocoa, had no effect, the study published in Heart magazine said.

The researchers, who said further studies were needed, suggested that the possible benefits arose from the antioxidants in dark chocolate.

"Only a small daily treat of dark chocolate may substantially increase the amount of antioxidant intake and beneficially affect vascular health," they said.


I love dark chocolate and here's another reason to eat it in small doses. I hope everyone had a wonderful holiday and has a happy new year!!!!

Grand Rounds are up!

Grand Rounds are up at Medpundit!
Click on the title to follow the link and enjoy!

Another slap towards nurse practitioners!

December 2005 -- Mattel, the world's leading toy maker, has just released as part of its Furryville Collections (Series 2) a small doll called the "Nurse Quacktitioner." We are not making this up. The doll is a soft duck wearing a white lab coat and a white cap with a red heart on the front. Furryville dolls are evidently on sale at Target, Wal-Mart, and other major toy retailers and supermarkets, just in time for the holiday season. Selling a doll called "Nurse Quacktitioner" reflects little regard for nurses or public health. The name suggests that nurse practitioners (NPs) are "quacks," a term that has been understood at least since the 19th century to refer to untrained persons who pretend to be physicians and dispense medical treatment. It's hard to believe that it never occurred to Mattel that this doll would be taken as an attack on NPs, whose main professional stereotype has been that they are, uh, untrained persons who pretend to be physicians. In fact, Mattel--which is also responsible for Barbie--has apparently trademarked the name "Nurse Quacktitioner." This, along with the simple fact that the doll is a duck, confirms that the name was carefully considered, at least from a marketing standpoint. We urge everyone to find a lawful, environmentally conscious way to rid the world of the adorable little Nurse Quacktitioners as soon as possible.

You have got to be kidding!!!! Once again, another slap towards nurse practitioner's competencies..I'd like to trademark my foot stuffing a duck up their ass too! Click the link to read the rest of the story.....

Possible false positive HIV tests

A widely used rapid test for HIV called the OraQuick Advance HIV test has been associated with a high number of false-positive results that have led many to incorrectly believe they had the AIDS virus, say health officials in New York and San Francisco. The FDA has indicated that it will consider approving the test, which requires a mouth swab instead of a blood sample, for home use by the public, but the health officials say patients should be instructed to have positive results confirmed by another type of test.

I would hope that people are getting blood tests to confirm their diagnoses of HIV.. If you are at risk, please get tested. There are so many more treatments out there and there can be a better quality of life.. Be safe and continue to practice safe sex!!

Smoking lowers chance of recovery from cancer

NEW YORK (Reuters Health) - For people with cancer of the larynx or lower pharynx, continuing to smoke or drink alcohol make it less likely that they'll survive, while eating a diet rich in vegetables and vitamin C improves their survival, a new study shows.

Well..duh!!!! Of course continuing to smoke after getting throat cancer will lessen one's chance of recovery!! How much money was spent on this obvious study and where do I sign up for the next one!!

Click link to read the rest of the story...

New CPR Guidelines

There are new guidelines out for CPR according to the American Heart Association. I recently had a nursing student who was with me during a code who commented that the doctor was "doing it wrong according to what she had been taught in school". I explained that he was correct and that the number, depth, and speed of compressions is very important to perfusion and that one should always try to obtain up to date information from reputable sources.
I also explained that often what we are taught in school doesn't always get followed in the real world. The best way to ensure that she is giving adequate care to her patients is to become an informed provider...

Discussion of paraphilias by a nurse practitioner student

In one of the classes I took while waiting for the new nurse practitioner classes next semester, I had to summarize and comment on a chapter in my Human Sexuality book and this is what I came up with...
Paraphilias are an interesting bunch to read about. Well known fetishes include shoes and women's clothing. I don't find them particularly erotic but I can see how a man might.
S&M is a sport that I have lightly dabbled in, if love bites are considered. I don't bite hard but I enjoy nibbling. I don't like pain incorporated into any sex act toward me but I could probably give it (with a limit) to someone who is truly turned on by it.
I would never want to be tied down even with a trusted partner due to my past with my evil stepdad. He used to find it funny to hold us down until we panicked as children.
Autoerotic asphyxia is a scary thing to think about as a mother of three boys. This last year there were three "suicides" all by young teens. There was speculation by many that the boys were dabbling this type of paraphilia. I have had discussions regarding the danger of it and by my son's reactions, I don't think they have ever thought of it.
I hope it stays that way!
I never thought receiving enemas could be erotic. That's coming from a nurse who's given plenty of them. No one ever seemed to enjoy it at all.
As far as exhibitionism goes, I like to flash my husband (boobs mostly). It's our way of saying "I'm busy with homework but I'm still thinking of you". I would never flash anyone else unless I was single maybe at Mardi Gras or something. I have gotten flashed by patients and have found it's best to ignore the behavior and it usually goes away. I have noticed that they usually do it more to the younger nurses for shock value.
Zoophilia just is gross to me. I have no idea why having sex with an animal is supposedly appealing to people. That ranks right up there with necrophilia. That's just digusting! The idea of having sex with a dead person is just sacraligious, especially after having attended several deaths over the years as a nurse.
So, what's your favorite fetish???

More Clostridium Difficile information

Since I was listed on Netscape's CNN page regarding C-difficile infections, I thought I would look up C-difficile on the CDC website for you all to read. This infection is getting more and more dangerous and must be taken very seriously. I recommend that people wash their hands frequently when visiting others in the hospital and please don't bring small children to hospitals to visit!! To many times I have seen children crawling on the floors and playing with the biohazard cans.. It's scary out here!
clostridium difficile

What is Clostridium difficile (C. Difficile)?

C. difficile is a spore-forming, gram-positive anaerobic bacillus that produces two exotoxins: toxin A and toxin B. It is a common cause of antibiotic-associated diarrhea (AAD). It accounts for 15-25% of all episodes of AAD.

What are C. difficile-associated diseases?

They are diseases that result from C. difficile infections including:

* pseudomembranous colitis (PMC)
* toxic megacolon
* perforations of the colon
* sepsis
* death (rarely)

What are the main clinical symptoms of C. difficile-associated disease?

Clinical symptoms include:

* watery diarrhea
* fever
* loss of appetite
* nausea
* abdominal pain/tendernes

Which patients are at increased risk for C. difficile-associated disease?

The risk for disease increases in patients with:

* antibiotic exposure
* gastrointestinal surgery/manipulation
* long length of stay in healthcare settings
* a serious underlying illness
* immunocompromising conditions
* advanced age

What is the difference between C. difficile colonization and C. difficile-associated disease?

C. difficile colonization

* patient exhibits NO clinical symptoms
* patient tests positive for C. difficile organism and/or its toxin
* more common than C. difficile-associated disease

C. difficile-associated disease

* patient exhibits clinical symptoms
* patient tests positive for the C. difficile organism and/or its toxin

Which laboratory tests are commonly used to diagnose C. difficile-associated disease?

* Stool culture for C. difficile: This is the most sensitive test available, but the one most often associated with false-positive results due to presence of non-toxigenic strains. Stool cultures for C. difficile also are labor intensive and require the appropriate culture environment to grow anaerobic microorganisms. Results are available within 48-96 hours of the test.
* Antigen detection for C. difficile: These are rapid tests (<1 hr) that detect the presence of C. difficile antigen by latex agglutination or immunochromatographicassays. They must be combined with toxin testing to verify diagnosis.
* Toxin testing for C. difficile*:
o Enzyme immunoassay detects toxin A, toxin B, or both A and B. It is a same-day assay but less sensitive than the tissue culture cytotoxicity assay.
o Tissue culture cytotoxicity assay detects toxin B only. This assay requires technical expertise to perform, is costly, and requires 24-48 hr for a final result. It does provide specific and sensitive results for C. difficile-associated disease.
* C. difficile toxin is very unstable. The toxin degrades at room temperature and may be undetectable within 2 hours after collection of a stool specimen. False-negative results occur when specimens are not promptly tested or kept refrigerated until testing can be done.

How is C. difficile transmitted?

C. difficile is shed in feces. Any surface, device, or material (e.g., commodes, bathing tubs, and electronic rectal thermometers) that becomes contaminated with feces may serve as a reservoir for the C. difficile spores. C. difficile spores are transferred to patients mainly via the hands of healthcare personnel who have touched a contaminated surface or item.

How is C. difficile-associated disease usually treated?

In 23% of patients, C. difficile-associated disease will resolve within 2-3 days of discontinuing the antibiotic to which the patient was previously exposed. The infection can usually be treated with an appropriate course (about 10 days) of antibiotics including metronidazole or vancomycin (administered orally). After treatment, repeat C. difficile testing is not recommended if the patients’ symptoms have resolved, as patients may remain colonized.

How can C. difficile-associated disease be prevented in hospitals and other healthcare settings?

* Use antibiotics judiciously
* Use Contact Precautions: for patients with known or suspected C. difficile-associated disease:
o Place these patients in private rooms.If private rooms are not available, these patients can be placed in rooms (cohorted) with other patients with C. difficile-associated disease.
o Perform Hand Hygiene using either an alcohol-based hand rub or soap and water.
+ If your institution experiences an outbreak, consider using only soap and water for hand hygiene when caring for patients with C. difficile-associated disease; alcohol-based hand rubs may not be as effective against spore-forming bacteria.
o Use gloves when entering patients’ rooms and during patient care.
o Use gowns if soiling of clothes is likely.
o Dedicate equipment whenever possible.
o CONTINUE THESE PRECAUTIONS UNTIL DIARRHEA CEASES
* Implement an environmental cleaning and disinfection strategy:
o Ensure adequate cleaning and disinfection of environmental surfaces and reusable devices, especially items likely to be contaminated with feces and surfaces that are touched frequently.
o Use an Environmental Protection Agency (EPA)-registered hypochlorite-based disinfectant for environmental surface disinfection after cleaning in accordance with label instructions; generic sources of hypochlorite (e.g., household chlorine bleach) also may be appropriately diluted and used. (Note: alcohol-based disinfectants are not effective against C. difficile and should not be used to disinfect environmental surfaces.)
o Follow the manufacturer’s instructions for disinfection of endoscopes and other devices
o Infection control practices in long term care and home health settings are similar to those practices taken in traditional health-care settings.

What can I use to clean and disinfect surfaces and devices to help control C. difficile?

Surfaces should be kept clean, and body substance spills should be managed promptly as outlined in CDC’s “Guidelines for Environmental Infection Control in Health-Care Facilities.” Hospital cleaning products can be used for routine cleaning. Hypochlorite-based disinfectants have been used with some success for environmental surface disinfection in those patient-care areas where surveillance and epidemiology indicate ongoing transmission of C. difficile. Consult the aforementioned guidelines for use conditions for generic sources of hypochlorite-based products (e.g., household chlorine bleach) for disinfection of environmental surfaces.

Note: EPA-registered hospital disinfectants are recommended for general use whenever possible in patient-care areas. At present there are no EPA-registered products with specific claims for inactivating C. difficile spores, but there are a number of registered products that contain hypochlorite. If an EPA-registered proprietary hypochlorite product is used, consult the label instructions for proper and safe use conditions.

Where can I get more information?

The Centers for Disease Control and Prevention also has General Information about C. Difficile and more information about Gastrointestinal Infections in Heathcare Settings.

Last modified: July 22, 2005
Content source: Division of Healthcare Quality Promotion (DHQP)

Clostridium difficile is mutating

I've written a few things over the years about Clostridium difficile and I keep finding more and more articles on the subject. My son is sick with the flu and my husband didn't understand why I didn't immeadiately ask for an antibiotic. Unless he gets a secondary infection, I'm not getting him one. There is no cure for the flu and colds. I now have the flu also two days before my job interview... Just great!!! Bring on the fluids and decongestants!!
Click on the title to read the full article...
clostridium difficile

A little funny someone sent me

I OWE MY MOTHER

1. My mother taught me TO APPRECIATE A JOB WELL DONE.
"If you're going to kill each other, do it outside. I just finished cleaning."

2. My mother taught me RELIGION.
"You better pray that will come out of the carpet."

3. My mother taught me about TIME TRAVEL.
"If you don't straighten up, I'm going to knock you into the middle of next week!"

4. My mother taught me LOGIC.
" Because I said so, that's why."

5. My mother taught me MORE LOGIC.
"If you fall out of that swing and break your neck, you're not going to the store with me."

6. My mother taught me FORESIGHT.
"Make sure you wear clean underwear, in case you're in an accident."

7. My mother taught me IRONY.
"Keep crying, and I'll give you something to cry about."

8. My mother taught me about the science of OSMOSIS.
"Shut your mouth and eat your supper."

9. My mother taught me about CONTORTIONISM.
"Will you look at that dirt on the back of your neck!"

10. My mother taught me about STAMINA.
"You'll sit there until all that spinach is gone."

11. My mother taught me about WEATHER.
"This room of yours looks as if a tornado went through it."

12. My mother taught me about HYPOCRISY.
"If I told you once, I've told you a million times. Don't exaggerate!"

13. My mother taught me the CIRCLE OF LIFE.
"I brought you into this world, and I can take you out."

14. My mother taught me about BEHAVIOR MODIFICATION.
"Stop acting like your father!"

15. My mother taught me about ENVY.
"There are millions of less fortunate children in this world who don't have wonderful parents like you do."

16. My mother taught me about ANTICIPATION.
"Just wait until we get home."

17. My mother taught me about RECEIVING.
"You are going to get it when you get home!"

18. My mother taught me MEDICAL SCIENCE.
"If you don't stop crossing your eyes, they are going to get stuck that way."

19. My mother taught me ESP.
"Put your sweater on; don't you think I know when you are cold?"

20. My mother taught me HUMOR.
"When that lawn mower cuts off your toes, don't come running to me."

21. My mother taught me HOW TO BECOME AN ADULT.
"If you don't eat your vegetables, you'll never grow up."

22. My mother taught me GENETICS.
"You're just like your father."

23. My mother taught me about my ROOTS.
"Shut that door behind you. Do you think you were born in a barn?"

24. My mother taught me WISDOM.
"When you get to be my age, you'll understand."

25. And my favorite: My mother taught me about JUSTICE.
"One day you'll have kids, and I hope they turn out just like you

Florida Nurse Practitioner Salaries for Various Places in Florida

I did a median search on the web and found a list of average Florida Nurse Practitioner salaries. The key is negotiating with your prospective employer and networking with others to find out what they are really making. I was told that where I am that the starting range was 60,000 for a new grad but I have acute hospital experience and that would put me higher. We'll see when the time comes in a year and a half!


Florida Nurse Practitioner Job Salary. Salaries for Orlando, West Palm Beach, Miami, Fort Lauderdale: ""