Nurse-Patient Ratio: A Major Determinant of Care Neglected by Managers

Nurse-Patient Ratio: A Major Determinant of Care Neglected by Managers Of Healthcare Industry By Olufemi Iseyemi Folakemi

 

How Many Patients Per Nurses? Correct Nurse To Patient Ratio:

 

Nurse to patient ratio is probably one of the most talked about issues in nursing. And apparently, it’s also one of the most common reasons why nurses leave the profession. When an institution suffers from short staffing, bad things start to happen. Nurses become grumpier and the quality of care they deliver decreases.

 

Infections increase and patients stay longer in the hospital. These things don’t only affect nurses and patients; they can be bad for the health institution, too.

 

The Problem Worsens

There are tons of things that force nurses to hang their nursing caps and just quit work. Bullying, burnout, and poor working conditions are probably some of the reasons you are already familiar with.

 

These things easily make one out of five fresh nurses quit the profession within their first year of getting a license. One out of three, on the other hand, quit within the first two years of starting work.

 

With more nurses quitting work, most institutions require nurses to take longer shifts, reduce their off days and take on more patients than necessary. One good reason is that institutions don’t see hiring more nurses as cost-effective.

 

In reality, however, they actually end up spending more in addressing the poor outcomes of short staffing and poor nurse-patient ratio.

 

What Is The Correct Nurse-Patient Ratio?

The American Nurses Association advocates for a legislative model wherein nurses have the autonomy to create a staffing plan that will meet the demands of their units and patients. This approach allows for a staffing plan that’s flexible and can be adjusted based on the following:

 

Number of admissions

Minimum number of nurses

Staffing level advised by specialty nursing organizations

Number of discharges and transfers

The level of education, training and experience of the staff

The intensity of patient needs

Unit geography and availability of technology

Patient numbers

Availability of ancillary staff and other resources

In determining staffing ratios, it’s a good idea for institutions to sit down with their nurses as they are the people who are in direct charge of patient care. They have a realistic view of what goes on in each unit and what problems they encounter.

 

What Does The Law Require?

In California, there are clearly and legally defined minimum nurse to patient ratios that are supposed to be maintained at all times. For example, for Intensive/ Critical Care, one nurse should only care for two patients. The same ratio applies to Neonatal Intensive Care, Post Anesthesia Recovery and Labor and Delivery. A 1:1 ratio applies for the Operating Room and Trauma patients in the ER.

 

Apart from California, there are 14 other states in the country that legally address nurse staffing. Seven of these states legally require hospitals to have staffing committees that will take charge in creating staffing plans and policies. This includes OH, OR, CT, NV, WA and IL.

 

Just recently, Democratic State Senator Mike Skindell reintroduced a bill that mimics the California law on safe staffing. It mandates a 1:1 nurse to patient ratio in certain areas of the hospital as well as prevents nurses from being overloaded and overworked.

 

The bill prohibits mandatory overtime as well as the use of cameras to substitute for nurses. It also prohibits the layoff of supporting personnel and practical nurses.

Why Does Proper Nurse To Patient Ratio Matter?

Proper nurse to patient ratio doesn’t only help achieve clinical improvements but it also offers economic benefits.

Here’s what adequate staffing can provide:

Decreased patient care cost related to readmissions from poor outcomes

Reduced medication errors

Decreased length of patient stay

Increased patient satisfaction

Reduced patient mortality

Safe staffing has also been found out to increase chances of stroke survival. When there are enough trained nurses, patients have a better chance of getting over the aftermath of stroke.

In the study, the addition of one trained nurse per 10 beds can reduce patient death after a month by as much as 30%. After a year, chances of death goes down by 12%.

 

What Can You Do?

Short staffing can be hard to deal with, particularly if you’ll be dealing with the actual institution you are working for. There are, however, a few things you can do to advocate safe staffing while staying employed.

Use the SBAR method in communicating your ideas

The SBAR method simply refers to Situation, Background, Assessment, Response. It’s a technique you can use to discuss staffing issues with the management. You can start with your immediate superior since most institutions follow a chain of command. Assess the response you get and find out the next best person you can talk to in order to get a better response.

 

Join nursing organizations

There are a couple of nursing organizations and groups that advocate for nurses’ rights. If you happen to belong to a union, make sure that your group is respectfully and positively working with your employer to avoid any conflicts that can affect the nurses in your institution.

 

Update your skills

As short staffing continues to be a problem, you should be more consistent in updating your training and improving your skills. This way you’ll be able to provide the best care to your patients despite your poor working conditions. It will also put you in the best position possible to advocate for your rights as well as your patients’

 

A NURSE TO FOUR PATIENT IN A STANDARD HOSPITAL

A NURSE TO EIGHT PATIENT IN A MEDIUM OR SEMI STANDARD HOSPITAL

 

WHAT DO WE HAVE IN NIGERIA?

A NURSE TO THIRTY PATIENTS IN MOST PLACES

TWO NURSES TO THIRTY PATIENTS OR MORE IN TERTIARY HOSPITALS.

INCREASE NURSE PATIENT RATIO AND IMPROVE CARE AND REDUCE HOSPITALISATION.

NURSES ARE OVERWORKED

UNDERPAID, OVERSTRESSED, MISINTERPRETED AND UNDERMINED. LISTEN TO THE PLIGHT OF NURSES AND MAKE THE NECESSARY AMENDMENTS.

 

The Good Old Days of Nurse Training: Rose-tinted or Jaundiced View?

As a profession we are disadvantaged with a descriptive verb for what we do—namely nursing! Many people feel that nursing is common sense, a trait with which you are born, that the caring woman next door can do it expertly and that kindness, respect and compassion are the main criteria for becoming a nurse. In the 21st century, these traits are important but they do not make a competent and professional nurse. To meet present and future health and social care challenges, nurses must also be analytical, assertive, creative, competent, confident, computer literate, decisive, reflective, embracers of change and the critical doers and consumers of research. Most of these qualities were not inculcated in the old apprenticeship system of nurse training.

 

In the United Kingdom, there has recently been a plethora of newspaper articles and letters stating that recently qualified nurses are ‘too posh to wash’ and ‘not fit to practice’ (Magnet, 2003) and calling for a return to the ‘golden age of nurse training’ (Meerabeau, 2004). This call has also been supported by some nurse managers and policy makers who feel that the move to university-based education was a mistake. They too embellish their assertions by harping back to the past. This retrospective ‘rose-tinted’ view of how nurses were trained previously is often peppered with anecdotes highlighting qualities such as caring and obedience. This reflects the quasi-religious sisterhood of veils and vocation, the militaristic belts, buckles and epaulettes and the unquestioning devotion to duty. Perhaps they should remember Nightingale’s remark that obedience was “suitable praise for a horse”! (Nightingale, 1859).

 

The claim that nurse training in the past was better merits some analysis. According to Revans (1964), total attrition from UK nursing in the early 1960s was around 50% per year and this figure remained high over subsequent decades. Reform of UK nurse education in the mid-1980s (Project 2000), which moved nurse education into the universities, was an attempt to halt this decline by increasing the attraction of nursing as a career through improving its status. It was based too on the great success of degree courses for nurses in some universities (King’s College London, Edinburgh, Manchester, Ulster, Nottingham and others) established in the early- and mid-1970s. These courses ran in parallel with hospital-based pre-registration programmes from the early- to mid-1970s, but attracted well-motivated university students with good A-levels, who chose to read for a degree over 4 years in Nursing Studies in preference to other degree programmes. These graduates received a liberal education and high-quality clinical supervision from well-qualified and experienced staff, and produced excellent academic and clinical work. Research into the careers of graduates showed also that, contrary to their critics, these university programmes produced graduates who were retained longer in clinically based nursing than nurses from the hospital-based programmes (Montague and Herbert, 1982; Howard and Brooking, 1987). Project 2000 was thought to be a mechanism by which the standards of care delivered by the majority could be raised to that of this university elite. How far this has occurred is debatable, but our judgement is that without Project 2000 reforms, recruitment to nursing would be very much more difficult than today and standards of care would be lower overall.

 

It is conveniently forgotten that nurses in the ‘good old days’ were often regarded as handmaidens—subservient, dependent and unthinking, and patients were subjected to ritualistic and routine practices passed down without question from one generation of nurses to the next. Examples of evidence-based practice 20 years ago were salt and Savlon baths, soap and water back rubs, older patients sitting around walls in tilt chairs for most of the day, and reference to disease entities rather than persons.

Most nurses of our generation can recall being placed in charge of a ward on night duty while they were still students and witnessing large pressures sores that would be rare today—possibly made worse through the inappropriate use of EUSOL, a desloughing agent which also harmed granulation tissue. The philosophy of ‘batch processing’ was commonplace, where all patients were treated the same regardless of their individual needs; they all had their temperatures, pulses, respirations and blood pressures taken (and most tended to read 36.8°C, 80bpm, 20rpm, and 120/80mmHg, respectively!), were weighed, medicated and subject to backs rounds every 4 hours. Paradoxically, there was also less pressure on staff: patients often spent weeks in hospital and, as they recuperated, many assisted nurses to distribute meals, feed other patients and make beds.

 

How does this compare to today? Nursing has become ‘intensified’; health-care assistants carry out procedures, ONCE THE REMIT OF QUALIFIED NURSES, and nurses are extending their role into medical and even surgical practice (McKenna, 2004). The fact is that there is now less time to ‘nurse’ than there was previously. Patient throughput has increased and new treatments and technologies require confident and competent practitioners. Modern health care is complex and hospitals are little more than large intensive care units where, as soon as patients are over the acute stage of their illness, they are discharged to community care. This means that community nurses are undertaking home-based interventions, which were recently practised in the safety of a ‘hi-tech’ clinical setting. Contemporaneously, public expectations of health care are rising and their tolerance of error is diminishing.

 

Therefore, nursing is no longer the common sense carrying out of uncomplicated tasks under the direction of others, nor is it a vocation for which short-term technical training will suffice. It is a profession that requires highly knowledgeable individuals frequently making sophisticated decisions, often with inadequate information and resources. Newly registered nurses from the mid- to late 20th century would be unprepared and overwhelmed if faced with the complexities and pressures of a 21st century health-care setting. Calls for returning to the ‘sitting next to Nelly’ system of training are based upon selective reminiscences and a lack of acceptance that nursing and health care have changed, as have the people who require nursing care.

 

A report completed by the Judge Institute,(1999) in Cambridge, England, examined future trends and patterns in health and social care. It noted that over the next 15 years and beyond, there will be complex changes in demography, disease patterns, lifestyle, social and physical environment, targeting health and social need, public expectations and information technology. To meet and address these challenges expertly, we require intelligent and well educated, as well as highly motivated and caring nurses.

The anti-intellectual notion of the ‘overqualified nurse’ is not new and has been propagated in literature from the 19th, 20th, and 21st centuries (Bradshaw, 2001). Interestingly, Thompson and Watson (2005)  pointed out that physicians are seldom castigated for being over-educated or too well qualified. Who wants to be in a busy medical ward looked after by a caring nurse who cannot calculate the correct infusion rate or know the difference between micrograms and milligrams when distributing medication such as Digoxin?

 

People require and deserve to be cared for by intelligent, caring and skilled nurses who have been educated in an environment where the best knowledge, skills and understanding in their field is being produced, challenged, tested and then applied. In essence, this means nurses having a university qualification. Other than anecdote, there is no evidence that degree-qualified nurses are less caring. In contrast as outlined above, there is a plethora of research reports illustrating the benefits of graduate nurses (Howard and Brooking, 1987). More recently, in a cross-sectional study of 168 US hospitals, Aiken et al. (2003) found that a 10% increase in the proportion of graduate nurses was associated with a 5% decrease in the likelihood of death and failure to rescue within 30 days of admission.

 

All professions have a small number of individuals within their ranks who are incompetent and potentially dangerous; nursing is no exception. Such individuals did not first appear with the advent of university-based nursing programmes and calling for a return to imaginary halcyon days will not lead to their demise.

 

Citation : Hugh McKena, David Thompson, Roger Watson, Ian Norman

The good old days of nurse training: Rose-tinted or jaundiced view?

DOI: https://doi.org/10.1016/j.ijnurstu.2005.09.007

 

 

Home Remedies For Peptic Ulcer

1. Cabbage Juice
Cabbage is a popular natural ulcer remedy. Doctors reportedly used it decades before antibiotics were available to help heal stomach ulcers.
Its rich in vitamin C, an antioxidant shown to help prevent and treat H. pylori infections. These infections are the most common cause of stomach ulcers.
In fact, several animal studies show that cabbage juice is effective at treating and preventing a wide range of digestive ulcers, including those affecting the stomach.
In humans, early studies observed that daily consumption of fresh cabbage juice appeared to help heal stomach ulcers more effectively than the conventional treatment used at the time.
In one study, 13 participants suffering from stomach and upper digestive tract ulcers were given around one quart (946 ml) of fresh cabbage juice throughout the day.
On average, these participants ulcers healed after 710 days of treatment. This is 3.5 to 6 times faster than the average healing time reported in previous studies in those who followed a conventional treatment.
Cabbage juice contains compounds that may help prevent and heal stomach ulcers. Cabbage is also rich in vitamin C, which appears to have similar protective properties.
2. Honey
Honey is an antioxidant-rich food linked to a variety of health benefits. These include improved eye health and a reduced risk of heart disease, stroke and even certain types of cancer.
Honey also appears to prevent the formation and promote the healing of many wounds, including ulcers.
Moreover, scientists believe that honeys antibacterial properties can help fight H. pylori, one of the most common causes of stomach ulcers.
Several animal studies provide support for honeys ability to reduce the risk of developing ulcers, as well as healing time.
Regular consumption of honey may help prevent ulcers, especially those caused by H. pyloriinfections.
3. Garlic
Garlic is another food with antimicrobial and antibacterial properties.
Animal studies observe that garlic extracts may speed up recovery from ulcers and even reduce the likelihood of them developing in the first place.
Whats more, lab, animal and human studies all report that garlic extracts may help prevent H. pylori growth  one of the most common causes of ulcers.
In a recent study, eating two cloves of raw garlic per day for three days helped significantly reduce bacterial activity in the stomach lining of patients suffering from H. Pyloriinfection.
However, not all studies were able to reproduce these results and more are needed before strong conclusions can be made.
Garlic has antimicrobial and antibacterial properties that may help prevent ulcers and heal them quicker. However, more research is needed.
4. Turmeric
Turmeric is a South Asian spice used in many Indian dishes. Its easily recognizable by its rich yellow color.
Curcumin, turmerics active ingredient, has been attributed tomedicinal properties.
These range from improved blood vessel function to reduced inflammation and heart disease risk.
It appears to have immense therapeutic potential, especially in preventing damage caused by H. pylori infections. It may also help increase mucus secretion, effectively protecting the stomachs lining against irritants.
Limited studies have been done in humans. One study gave 25 participants 600 mg of turmeric five times per day.
Four weeks later, ulcers had healed in 48% of participants. After twelve weeks, 76% of participants were ulcer-free.
Curcumin, turmerics active compound, may protect the stomach lining and help ulcers heal. However, more research is needed, especially in humans.
5. Aloe Vera
Aloe vera is a plant widely used in the cosmetic, pharmaceutical and food industries. It is widely known for its antibacterial and skin-healing properties.
Interestingly, aloe vera may also be an effective remedy against stomach ulcers.
In one study, aloe vera consumption significantly reduced the amount of stomach acid produced in rats suffering from ulcers.
In another study in rats, aloe vera had ulcer-healing effects comparable to omeprazole, a common anti-ulcer medication.
However, few studies have been done in humans. In one, a concentrated aloe vera drink was used to successfully treat 12 patients with stomach ulcers.
Aloe vera intake is considered generally safe and the above studies show some promising results. However, more studies in humans are needed.
Aloe vera may be an easy, well-tolerated remedy against stomach ulcers. However, more research in humans is needed.

 

Nurse On Duty: Do You Have Ulcer?

Me: Do you have Peptic ulcer?
Patient: Worker ni mi ni church sugbon mi o kin se Usher ( I am a church worker but not an usher)
Me: I meant do you have stomach ulcer?
Patient: No o,ulcer ke? Olorun ma je kin ro gun ulcer! Where do I even want to see ulcer? Emi ti mo je gbogbo ile tan ( I can eat a building).I don’t play with food o.In fact,I don’t fast.
This is what I hear every time I ask people if they have ulcer. They start to tell you about their foodie attitude at home and away, how they strive to get food first before they see a bride at a wedding  and how they eat more than Muslims pray a day. Asking If a person has ulcer seem to be the best way to know the jeunkoku dot com people.
It’s easier for a needle to go through the eye of a camel than to convince people that irregular intake of food is not the main cause of ulcer,it’s only a predisposing factor if it becomes prolonged.
Peptic Ulcer is the break in the lining of the stomach. They are sores that form in the stomach and the upper part of the intestine (duodenum).
Under normal conditions, a physiologic balance exists between gastric acid secretion and gastroduodenal mucosal defense. Mucosal injury and, thus, peptic ulcer occur when the balance between the aggressive factors and the defensive mechanisms is disrupted. Aggressive factors, such as nonsteroidal anti-inflammatory drugs (NSAIDs), H pylori infection, alcohol, bile salts, acid, and pepsin, can alter the mucosal defense by allowing back diffusion of hydrogen ions and subsequent epithelial cell injury.
Helicobacter pylori infection and nonsteroidal anti-inflammatory drug (NSAID) use account for most cases of PUD.  Helicobacter Pylori is the bacterium that cause peptic ulcer ,it causes infection and inflammation.When H pylori colonizes the gastric mucosa, inflammation usually results.
NSAID use is a common cause of Peptic ulcer. These drugs disrupt the mucosal permeability barrier, rendering the mucosa vulnerable to injury,especially the frequent use of Ibuprofen and Aspirin. Some people are so used to these two drugs that they carry about and place it lateral to their condom. They use when they have every kind of pain, whether mild or not. Some people would even offer it to T-pain if they see him in a live performance! When you use Aspirin frequently,it relieves your pain and block the production of mucous that should protect your stomach lining,hence, increasing  the acidity of the stomach.
I don dey talk too much?
Drinking too much alcohol can predispose you to having Peptic Ulcer because it increases the acidity of the stomach.  Smoking is another factor (You know smoking is  a risk factor to many diseases) and also stress.
The symptom of ulcer is a burning sharp pain in the stomach ,sometimes extends to the chest.This is because more acids are produced in the stomach and they are pouring on the sores already. The pain can be relieved if you eat ( for duodenal ulcer) and it may get worsened if you eat (for gastric ulcer).
Other symptoms include nausea, vomiting, loss of weight, dark stools, indigestion, chest pain, vomiting.
The prevention involves limiting the use of Ibuprofen and Aspirin,seeking for medical attention to cure infections in the stomach ,hand hygiene to avoid bacteria, stop mixing alcohol and medications and limit the intake of alcohol.
If you have ulcer already,avoid Yoruba pepper . Research has shown that yoruba pepper are more peppery than bearing a grudge (Laughs). Well,pepper acts on pain receptors and not on taste buds. This is why when you put it on your skin or eyes ,you feel the peppery thing. This is why we cannot really establish the effect of pepper on ulcer.
Most Peptic ulcers heal if you take your medications . The elimination of non-friendly organisms from the digestive tract can reduce your likelihood of developing ulcer.
Don’t assume you have Peptic ulcer already and start taking medications ,seek medical advice.
Until next edition, Stay healthy!
I’m your Nurse on duty, Kikelomo Sowore, RN.

 

How do you prevent pimples?

How do you prevent pimples?

By Rachel Nall, RN BSN CCRN

Reviewed by Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT

Acne is a common skin disorder that can result in several types of blemish. Some include pimples, whiteheads, and blackheads. There are many ways to prevent acne.

Dermatologists have identified four factors that contribute to the development of acne:

the skin producing too much oil, which clogs pores dead skin cells building up, which has the same effect the presence of a bacteria called Propionibacterium acnes (P. acnes) in the pores inflammation of the skin, which also leads to redness

A doctor or dermatologist can help to identify which factor or combination of factors is causing acne. However, many methods of treatment and prevention are similar, regardless of the cause. The following tips can help to protect against acne and reduce the number of breakouts.

Fifteen ways to prevent pimples

There are many things a person can do to prevent pimples and other forms of acne, including:

1. Wash the face twice daily

Washing the face twice a day and not popping pimples will help to improve skin appearance.

Acne is rarely the result of a dirty face, contrary to popular belief. However, it is important to remove excess dirt and oil from the skin by washing regularly.

Many people prefer to use a mild cleanser and warm water. Applying an oil-free moisturizer after washing can keep the skin from becoming too dry.

Over-washing the face may cause the skin to become dry, which can aggravate pimples.

2. Refrain from harsh scrubbing

Some people scrub the skin with rough cloth pads or washcloths. This can irritate the skin and cause inflammation, making acne breakouts worse.

Applying a gentle cleanser with clean hands or a soft brush intended for use on the face can help to prevent pimples.

3. Keep hair clean

If excess oil in the hair travels to the skin, it can worsen acne. Regularly washing the hair may stop acne from developing, especially close to the hairline.

Also, refrain from getting products such as hair gel or spray on the face. These can also clog pores and lead to breakouts.

4. Refrain from popping or picking at pimples

It may be tempting to squeeze a pimple, but this usually results in inflammation and scarring.

To reduce the appearance of blemishes, use a topical treatment instead. They may take some time to work, but they can also prevent new pimples from forming.

5. Apply topical treatments

Over-the-counter treatments, such as creams or serums, can reduce breakouts, particularly when they tend to occur in certain areas.

The following problem areas are common:

the chinthe nosethe forehead

Treatments available for purchase online often contain salicylic acid orbenzoyl peroxide. These products are not as potent as prescription-strength treatments, but they can help to prevent mild acne and reduce breakouts.

6. Consider topical retinoids

Topical retinoids are products containing medicines derived from vitamin A, and dermatologists prescribe them to manage and prevent acne. These treatments can also get rid of excess dead skin cells and reduce inflammation.

Most topical retinoids are only available with by prescription, including tretinoin (Retin-A, Renova), and tazarotene (Tazorac).

However, one retinoid medication, adapalene (Differin), is available for purchase online or over the counter.

7. Talk to a dermatologist about antibiotics

Topical antibiotics can fight an overgrowth of P. acne bacteria in the skin. Examples of antibiotics that treat this inflammatory acne include erythromycin and clindamycin, which are available by prescription.

A person can identify inflammatory acne by its very red, irritated appearance. It can also be painful.

8. Talk to a doctor about hormone pills

Hormonal birth control pills are sometimes prescribed to prevent acne.

Birth control pills can help to prevent acne, by helping to regulate the hormones that may make acne worse.

However, these pills carry risks, so it is essential to review the benefits and side effects before making a decision.

Spironolactone, a medication often used to treat high blood pressure, may also help in cases of severe acne. However, spironolactone has many possible side effects, so it is best to speak to a doctor.

9. Cut back on foods linked to acne

Doctors are not certain of the connection between foods and acne. However, a growing body of research suggests that some foods may trigger acne in certain patients.

According to the American Academy of Dermatology, foods with a high glycemic index may increase the risk of developing acne or make acne worse.

These potentially problematic foods are sugary and high in carbohydrates. Some examples include:

Dairy products, especially skim milk, may also increase a person’s risk of developing acne. A person may want to cut back on a particular food group, to see if their skin improves.

10. Wear sunscreen when going outdoors

Too much sun has many damaging effects on the skin. Sunburn can also lead to an overproduction of oils that make acne worse.

Using oil-free sunscreen with a protection factor of at least 15 may help to prevent sunburns and exacerbated acne.

11. Consider light or laser therapies

A dermatologist or esthetician can provide these therapies, which aim to reduce the presence of P. acnebacteria on the skin.

12. Avoid skincare products that contain oil

Avoiding skincare products that contain oil may help prevent pimples.

Skincare products contain oil can clog the pores. These products are often intended for use on dry or mature skin that may not have as much natural oil.

Products that do not contain oil are usually labeled “non-comedogenic.”

It may be a good idea to avoid touching household grease and cooking oils, which can also clog pores.

13. Refrain from excess exfoliation

Exfoliation is the process of removing dead cells from the skin.

While some exfoliation can help to improve acne, too much can worsen breakouts. This happens when a person removes too much natural oil from the skin. The skin may compensate by producing more oil, which clogs pores and leads to more pimples.

If a person is exfoliating too much, the skin may become irritated or feel very tight after washing.

14. Reduce stress

Stress often causes inflammation, which can make breakouts worse.

Below are some means of reducing stress that may help to prevent acne:

meditatingexercisingdoing yogarelaxing before bed by reading or taking a bathspending time in natureengaging in hobbies

15. Keep facial care products clean

Makeup and facial sponges and brushes should be cleaned regularly with soap and water to prevent a buildup of bacteria, which could lead to breakouts.

Make sure that brushes dry completely before use.

Takeaway

Cleaning the skin regularly and gently, selecting skincare products carefully and avoiding contact with oil can help to reduce acne.

If none of these methods show improvement in 6 to 8 weeks, see a dermatologist for further recommendations.

 

Virginity: What Most Females Don’t Know

Bleeding doesn’t determine if a girl is a virgin or not, so I decided to release this article to help educate our young men and women on this issue of girls bleeding during first sex…
THE MYTH ABOUT FEMALE VIRGINITY -why most women won’t bleed the first time they have sex. 
There’s a very common myth in South and Central Asia (Pakistan, India, Bangladesh, Afghanistan etc.) and Africa (Nigeria and many other nations ) that you can tell if a woman is a virgin, by whether or not she bleeds the first time she has sex.
There is zero truth in this. Not all women bleed the first time they have sex, as I’ll explain in this post. To understand why some women bleed and some don’t, it’s very important to understand what the hymen is. The hymen is a membrane that tends to cover part of the vaginal opening (it does not always block or cover the entire vagina, as some people mistakenly think). NOT ALL WOMEN HAVE A HYMEN. The hymen also differs from woman to woman – like all women have different heights and weights and features, all women also have different amounts and types of hymen. Some women have thick hymens, some have very thin hymens, and some women have NO hymens at all. Some women have larger hymens, some women naturally have a very little amount of hymen that covers only a small portion of their vaginal opening (and hence does not really get in the way, during first-time sex). In addition to this, the hymen wears away on its own as you grow up. For most women, the hymen wears away on its own with exercise, bicycling, horseback riding -it can wear off with pretty much any other physical activity, even dancing! – or from using tampons when menstruating.
Especially if the hymen is very small or thin, most of it tends to wear away on its own as a girl grows up. If a woman is born WITHOUT a hymen, she won’t bleed the first time she has sex. If a woman has a small or thin hymen, she might not bleed the first time she has sex. If a woman’s hymen has worn away on its own (which is very common as girls grow up), she won’t bleed the first time she has sex.
The result is that the overwhelming majority -at least 63% of women – will NOT bleed the first time they have sex, according to a study published by the British Medical Journal.
Women who do bleed include: Women with thick hymens (who constitute a small percentage of the population) – Younger girls. Because the hymen wears away on its own with time, a 16-year old has a higher chance of bleeding than a 25-year old. By the time a girl is of or above the legal age of consent – 18, 20, 24 years of age, for example – most of her hymen is likely to have worn away on its own, meaning it’s unlikely that she’ll bleed a lot, if at all. However, even a young girl can be physically active, have a thin or small hymen, or have no hymen at all, meaning she might not bleed during first-time sex.
Most often, women who bleed tend to be women who are dealt with roughly during sex. If the guy forces himself inside the girl, when she isn’t ready, relaxed or aroused enough, he is likely to cause injury or bleeding.
Because most people think it’s normal for women to bleed the first time they have sex, they don’t realize that this bleeding is a result of the woman having been hurt, and not of the hymen breaking Painful first-time sex is generally because the woman is not relaxed or aroused enough, and gets hurt as a result; it is rarely ever because of the hymen breaking. The bottom line is that there is no way to assess female virginity.
Bleeding does not have anything to do with virginity – it has to do with the kind of hymen a girl has, and hymens differ from girl to girl from birth. The result is that only a small percentage of women bleed the first time! (Only 37% bleed during first-time sex, according to the study published in the British Medical Journal.) Why is this so important to be aware of? Women all over the world get abused, injured and even killed due to the myth of ‘virgin bleeding.. Because most people (men AND women) think that bleeding is a sign of virginity, women who don’t bleed the first time have been divorced, suffered from suspicion leading to domestic violence and abuse, and even killed for honour.
Educating people that a girl does not necessarily have to bleed the first time she has sex – because not all girls have thick hymens, and some are born with no hymen at all – is important because it can literally save lives.
P.S: I understand that not everyone is able to share material like this, even if they want to. However, the only way we can educate people regarding this issue is if it goes into the news feeds of as many people as possible, if as many people as possible read it. So please consider sharing this FNA magazine. ,to educate people and to have impact on lives.
Written By: Charles Wealth

Surgeon plan Womb transplant after the first successful one was recorded in 2013

A surgeon is preparing to select three women to undergo Britain’s first womb transplant later in the year, following permission granted to British medics to carry out the procedures.

Report sais three women are among 50 infertile patients on a waiting list for the pioneering operation and they will be informed “within a few weeks”.

The operation, which has a price tag of £50,000 (about $66,700), has already been a success in Sweden and the United States.

The world’s first successful womb transplant was carried out on a Swedish woman in 2013.

If the British operation is successful, the first baby could arrive 2019 and then give hope to the 50,000 infertile women in the UK.

A team won approval from regulators three years ago to transplant wombs from dead donors but has been delayed by rules about collecting the organs.

Doctors now say they will also try to use live donors.

“We have got all our ducks in a row this time, we should be ready to go,” said Richard Smith of Imperial College London, who is leading the efforts.

About 15,000 women in Britain of childbearing age do not have a womb, according to press reports.

(Xinhua/NAN)

 

Becoming a Nurse of value

Value is an indicator of worth. Value defines quality. Value determines the quality of influence or impact. Value could be an upward surge or a downward spiral; it could be worthwhile or worthless; its quality could be excellent or mediocre; its influence or impact could be positive or negative. In our context, value connotes superior quality that distinguishes from all others. To become successful, you must become a person of value. In fact, until you become valuable you can never become successful. The more valuable you become, the more successful you become. This invariably implies, you do not seek to become successful rather you seek to become a person of value and you will automatically become successful. The level of contribution you make to life is dependent on the level and quality of value you create for others. Your influence increases when your value increases. Every human being has equal intrinsic value or self-worth; however, value can be appreciated or increased and value can also be depreciated or decreased. Value is increased through personal growth and development. Value could be decreased through self-depreciation and a stagnating or negative mindset. Value is a product of the level you have grown your mind through investment in self. The quality of investment in self is proportionate to the value you create for others. Therefore, value births influence and influence is the lead way to relevance. The start-up of a life of value is living a life of integrity. A person of value is not for sale because his or her life is built upon the rock solid foundation of integrity. And upon the rock solid foundation of integrity, towering heights of influence is built. The person of value does not compromise values that are based on eternal or timeless principles. Moral breakdown is the cause of societal breakdown. In fact, moral breakdown is the lead way to emotional breakdown; mental breakdown; relational breakdown and even financial breakdown. When morality is trampled underfoot, value erodes from life. When morality is elevated, value is enhanced. Integrity is not an outdated idea rather it is an upgraded version of living without regrets. What matters in life is the small things that adds up to make the big things. The root of integrity bears the fruit of respect, dignity and trust. Without integrity, value is lost. When there is a breakdown of integrity, there will be a breakdown of trust and when there is a breakdown of trust there will be a breakdown of harmony and when there is a breakdown of harmony, life loses its potency. Integrity is not flexible in nature; it is not situational; there is no middle ground-it’s either you have integrity or you are void of integrity. John Maxwell reveals, “Integrity commits itself to character over personal gain; to people over things; to service over power; to principle over convenience; to the long view over the immediate.” Crisis does not make character rather crisis reveals character. Everything you have done in the past and everything you’ve neglected to do unfold under moral pressure. Integrity is not a behavioral modification rather it is the modification of the thought processes. Integrity or character is not a product of upbringing or circumstances rather a life of integrity is a product of choice. Upbringing and circumstances undoubtedly influence your character. And except you are in your childhood, you are absolutely responsible for your choices through life including the character choice. The level of your value to the world is determined by the strength of character rather than the weight of your credentials. Credentials exploit rights and are short-lived; character expresses responsibility and it is timeless. The value of credentials starts and ends with self; it is self-focused. The value of character positively impacts the lives of others; its people centered. Credentials brags about past accomplishments or achievements. Character builds destinies thereby leaving a timeless legacy in people. Credentials stirs up envy or jealousy in people. Character attracts respect and trust from others. Credentials can open doors but character keeps the door perpetually open for you and consistently open greater doors and keeps them open. Character is the real deal. Public image is superficial unless it harmonizes with a strong moral character. D. L. Moody expresses, “If I take care of my character, my reputation will take care of itself.” How you treat people who cannot hurt you and whom you can gain nothing from is a test of the greatness of your character or lack of it. When you role-play based on the person you are with, you rule-out trust and a long term relationship with them. When you are not transparent with others, you trample relationships and business opportunities with others. Your commitment to live a life of integrity sets you up for victory in the moments of crisis or temptation. Integrity grows from the little things or minor things to the big things or major things. Integrity has no price-tag for its value is inestimable; it’s highly esteemed far above power, revenge, pride or money. Therefore, a person of value cannot be bought.

By Udeme Archibong

Nurse Be Nimble, Nurse Be Quick

The notion of pivoting in your nursing career isn’t a new one, and that readiness to pivot can emerge emerges from a nimbleness of mind and a willingness to read the tea leaves of your career. Are you nimble?

Nurse Be Nimble, Nurse Be Quick

Being nimble in terms of your career means that you’re willing to think beyond what’s right in front of you. It also means doing the work of preparing and paving the groundwork for something that you want — and if you don’t know what you want, you’re at least asking the right questions.

Many nurses appear to settle into an area of nursing, rest on their laurels, and think less of the future than perhaps they should. These nurses don’t necessarily think a great deal about what they may want in five or ten years; thus, when they’re suddenly feeling unhappy and itchy for change, there’s much more work to be done due to the years they’ve spent avoiding any forward movement or thought for the future.

In a post from 2015, I wrote:
Listen to the voices that you hear. Pay attention to the ever-evolving zeitgeist of your industry. Know what other people are thinking, and if you work in an evidence-based profession, follow the evidence when it pertains to you and your area of expertise.
The Consequences of Non-Action

In Buddhism, the concept of non-action is an important one. You know the old adage, “Don’t just sit there, do something”? Well, in certain circumstances, it’s sometimes better to turn that around, and say, “”Don’t just do something, sit there.” However, when it comes to your career and its ongoing trajectory, I prefer action, even if that action is listening, thinking, and asking salient questions.

Let’s say you’re a nurse like me who worked in home health for the first decade of your career. You’ve never worked in the hospital, and while you love home health, you’ve actually been feeling called to finally take the plunge and enter the world of acute care. This may be a tough row to hoe since you’ve been in outpatient nursing for your entire career, but there’s no saying it’s not possible.

During these past ten years when you’ve been focusing exclusively on home health, you haven’t done any networking, your resume is a mess, and you have few contacts beyond your small universe of home care colleagues. All along, you’ve never considered that any of the hospital staff whom you’ve met could be helpful to your career in any way, so you haven’t connected with anyone on LinkedIn, built relationships, or otherwise laid the groundwork for the future.

In your mind, you’d like to jump right into the ICU, but common sense says that without any hospital experience since nursing school, you’re going to have to pay some dues, prove your mettle, and begin with a position in med-surg, step-down, or a sub-acute floor. Sure, you’d love to land an ICU position, but you simply don’t have the nursing skills or the connections to get you there. Your road will be challenging, but it’s not impossible — it’ll just take time, and diligent action on your part.

Reading the Inner Landscape

Being nimble of mind means being open to possibility. It also means that, in terms of your career, you’re steeped in curiosity and expansiveness, rather than wearing blinders.

As a nurse who is nimble of mind and quick to grasp opportunity, you not only read your immediate surroundings and the healthcare landscape around you; you also read the landscape within your heart and mind.

If there’s an inkling in your head or heart that what you’re doing now won’t hold water for you in a few years, now is the time to take inspired action in a new direction. That inspired action can simply be chatting with a nurse or manager who you know and trust, reaching out to a career coach for inspiration or seeking informational interviews with professionals who are holders of information that may be helpful to you.

If you maintain awareness of how you’re feeling about your career and work life, you’re more likely to take preemptive action that will foment change, rather than being reactive when the going gets tough remain Awake and Aware.

We can all get sleepy and lazy at certain points in our lives. We feel comfortable, we settle into the status quo, and we conveniently forget or ignore the fact that we may want something more down the road.

You must remain awake and aware to possibility, understanding that every colleague who you meet could be a source of brilliant information that will wake you up to something new. If you’re feeling complacent in your career, there’s no time like the present to do something about it and take a forward step.

As professionals, there’s always the micro and the macro. The micro is the minutiae of the day to day, the details of our lives and work. Meanwhile, the macro is the bigger picture, the bird’s eye view, and this is where we need to keep at least a little attention. It’s easy to get caught up in the web of details, but those details can blind you to the wider career horizon.

Being nimble and quick doesn’t necessarily mean turning on a dime or being blown in some new direction with every wind that comes your way. Being nimble and quick means that you’re listening, that you’re willing to change, and that you are quick to perceive that change may be in the air.

Is your workplace unstable? Are you becoming unhappy in your role? Do you feel limited or stuck? Is there something you’ve always wanted to do as a nurse? Is your current specialty area drying up and being supplanted by new technologies or skills?

I’m glad if these questions make you uncomfortable, because a little discomfort will galvanize you towards change, if change is what is called for.

Nurse be nimble, nurse be quick. Nurse, consider your future, and keep your eyes wide open.

———-

By
Keith Carlson, RN, BSN, NC-BC.

 

Who’s Driving The Bus of Your Nursing Career?

Plenty of people probably have opinions about what your nursing career should look like. However, the person behind the wheel of your nursing career should be you. Are you truly driving the bus of your nursing career?

Who’s driving the bus of your nursing career?

Who’s Driving the Bus?

Nurses, it’s crucial for us nursing professionals to internalize the fact that being behind the wheel of our careers is paramount.

So many nurses I speak with feel constricted not only by the opinions of others, but also by the voices inside of their heads that tell them they’re “less than” and unworthy. Whether these voices come from family, friends, colleagues, teachers, or the culture at large, your professional trajectory must be stamped with your imprimatur, your own self-generated sense of approval and self-worth.

Self-Limitation

Owning the notion of being “just a nurse” is only one of the many ways that nurses diminish themselves, demean their expertise and professionalism, and essentially put others in the driver’s seat of their careers. Self-limiting statements and beliefs may include:

“I’m just a nurse.”
“I can’t be an entrepreneur; nurses don’t own businesses.”
“Nursing is a calling, not a career.”
“Nursing is a calling, not a platform for business.”
“Being assertive and forward-thinking isn’t natural for me.”
“Nurses aren’t as smart as doctors.”

There are plenty more self-limiting beliefs that nurses internalize, but you get the idea; such statements and beliefs weaken your ambition, convincing you that you’re just stuck where you are with nowhere else to go.

Get Behind the Wheel

Getting behind the wheel of your nursing career looks different for everyone. For one nurse, it means putting her nose to the grindstone, and pushing forward consistently until she earns the PhD that’s been in her sights for a decade or more. For another nurse, it’s becoming a Legal Nurse Consultant and hanging a shingle as a nurse entrepreneur. For yet another nurse, it’s opening a concierge nursing practice for the wealthy elderly in San Diego.

Whether it’s entrepreneurship, scholarship, research, or clinical practice—each nurse has the power to decide for him- or herself on the most efficient and fulfilling path to get there.

Make A Plan

Getting behind the wheel and driving the bus of your nursing career means that you come up with goals and a plan. Those goals can’t be amorphous and ambiguous, like “earn more money” or “be happier”; they need to be “SMART”: specific, measurable, achievable, realistic, and time-bound.

If you want to launch a business as a nurse entrepreneur, SMART goals can be very valuable in that process. And if you want to travel from being an ADN to a PhD or DNP, some prudent planning is definitely in order, especially in terms of finances, work load, and the path to that desired goal.

That said, “achievable” and “realistic” can mean different things to different people. If Steve Jobs had limited Apple’s goals to the “realistic” column, we probably wouldn’t have the iPhone or the iPod—or the entire smart phone revolution. And if Florence Nightingale hadn’t reached beyond her “station” and convinced the field doctors in the Crimea to do things differently, medicine and the nursing profession would have been in the Dark Ages a whole lot longer, sacrificing many lives along the way. Jobs and Nightingale didn’t think about SMART goals; they had a vision and didn’t allow anything to stand in the way of its achievement.

Yes, realistic and achievable are generally good guidelines for steering the bus, but remember that we must also reach beyond our comfort zones at times; that can definitely mean playing your cards close to your chest when it comes to the naysayers who are just waiting to tear you down and disabuse you of your opinion that what you want is indeed possible.

Take Charge

Plenty of people will have opinions about anything you want to do with your nursing career. Some will urge you to keep your horrible job because of the health insurance and stability, and others will convince you that starting a business in the current economy is financially suicidal. This is usually a result of their fear of doing such a courageous thing themselves, and they’ll readily project their fear on you.

Stick with the voices of people you trust, not the people who are “shoulding” all over you. Those “shoulds” are what’s going to get in your way; kick those folks out of the driver’s seat. In fact, why not kick them off the bus entirely?

Trusted advisers will generally steer you in the right direction, but make sure you vet your advisers for limiting beliefs that will slow you down or take you off course; even the most trusted mentor can allow his or her own fears and projections to color their advice and support.

Nurses, take charge, empty the bus of the unhelpful voices, and seize the steering wheel now. This is your journey, my friends; make it your own and play it big.
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———-

Keith Carlson, RN, BSN, NC-BC,