Nurses/Midwives Beware of Facebook and Twitter {nursingcrib}

The Nursing and Midwifery Council of United Kingdom has issued a warning on health workers specifically nurses and midwives to be extra careful when using social networking sites like Facebook and Twitter.

The advisory was issued because the regulator is increasingly receiving enquiries about online conduct and improper use of Facebook in particular, which have already lead to a number of nurses and midwives being investigated and even struck off.

It comes after a community psychiatric nurse was struck off for “conducting an inappropriate relationship with a former patient”. He had contacted the woman on Facebook two weeks after meeting her in the course of his work, but then “blocked” contact with her after they had a sexual relationship.

In another story, a nursing student was expelled after she posted a photo on Facebook of herself with a human placenta.

According to Prof Dickon Weir-Hughes, chief executive of the NMC, “The Nursing and Midwifery Council is committed to public protection and ensuring nurses and midwives make the welfare of those in their care their first priority at all times.

“I would advise nurses and midwives to exercise caution when using social networking sites. They could risk their registration if they share sensitive information, make inappropriate comments, or befriend patients online.”

The NMC advice on social networking includes the following suggestions:

1. Never put confidential or sensitive information on social networking sites, especially if it identifies patients.


2. Whether or not you identify your work role online, be aware that all your activity online can reflect on your professional life.



3. Don’t accept friend requests from patients, or use social networks to build or pursue relationships with patients or clients, even if they are no longer in your care.


4. Do not post pictures that have patients in them.


5. Keep personal and professional social networking as separate as possible.


6. Consider everything you post as public, even in ‘private’ Facebook discussions.


7. Social networking sites should not be used for whistle-blowing or raising concerns – instead follow the NMC’s guidance on raising and escalating concerns.


8. Don’t discuss work online, and especially avoid talking about patients or colleagues.


9. Don’t simply accept the preset privacy and sharing settings on Facebook, think carefully about what you want to share with different kinds of friends.


10. Remember you can take action if you find you are the target of abuse; there are options available for blocking people from interacting with you.

The Nursing and Midwifery Council estimates that 355,000 of its 660,000 registered nurses and midwives use Facebook

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New Gonorrhea Strain: Antibiotic Resistant Posted: 12 Jul 2011 09:30 PM PDT A new strain of gonorrhea is discovered by scientist and they have found that this strain is resistant to all available antibiotics. The details of the discovery made byDr. Magnus Unemo, Dr. Makoto Ohnishi, and colleagues will be presented at the 19th conference of the International Society for Sexually Transmitted Disease Research (ISSTDR) which runs July 10-13 in Quebec City, Canada. The research team identified an unknown variant of the bacterium that causes gonorrhea, Neisseria gonorrhoeae. "This is both an alarming and a predictable discovery," noted Dr. Unemo of the Swedish Reference Laboratory for Pathogenic Neisseria. "Since antibiotics became the standard treatment for gonorrhea in the 1940s, this bacterium has shown a remarkable capacity to develop resistance mechanisms to all drugs introduced to control it." "While it is still too early to assess if this new strain has become widespread, the history of newly emergent resistance in the bacterium suggests that it may spread rapidly unless new drugs and effective treatment programs are developed," Dr. Unemo continued. Gonorrhea is one of the most common sexually transmitted diseases in the world. According to the Center for Disease Control and Prevention (CDC), the number of cases in the U.S. alone is estimated at 700,000 annually.

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“Most US Hospitals are Run by Non-Physician Managers” plus 1 more nursing article(s): NursingCrib.com Updates

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Most US Hospitals are Run by Non-Physician Managers Posted: 11 Jul 2011 12:05 AM PDT The conventional thought is that doctors should manage hospitals and business managers are suited for enterprise.  But according to the 2009 study in the Journal Academic Medicine, surprisingly out of 6,500 hospitals in the US, only 235 are led by physicians. In a recent research by Dr. Amanda Goodall, a senior researcher at the Institute for the Study of Labor in Bonn, Germany about hospital performance and ranking,  she found out that physicians leaders can result to improved hospital performance and patient care. The overall hospital quality scores were about 25 percent higher when doctors ran the hospital, compared with other hospitals. For cancer care, doctor-run hospitals posted scores 33 percent higher. The study doesn't offer any evidence as to why doctor-run hospitals appear to post better results, but Dr. Goodall said it may be because doctors truly understand "the core business of health." "Hence, they are more likely to better understand the conditions under which their fellow core workers — doctors and nurses — will function best,'' she wrote in an e-mail. "If a leader creates optimal working conditions for the core workers, then that is likely to create a more efficient organization."   Photo Credits: news.eastvillagers.org

Neurotransmitters and How They Work Posted: 10 Jul 2011 08:18 PM PDT Definition Nerve cells arranged in networks communicate information with one another through neurotransmission which is the conduction of electrical messages from neuron to neuron. The electrochemical messages cross the synapses between neural cells by way of special chemical messengers called neurotransmitters. Neurotransmitters are chemicals found and produced in the brain to allow the transmission of impulses from one nerve cell to the next across synapses. They aid in the conduction of information throughout the body. These chemicals fit into specific receptor cells embedded in the membrane of the dendrite that either fuel up or excite action in the cells (excitatory) or stop or inhibit an action (inhibitory). Presence or absence of these neurotransmitters can directly or indirectly have an effect on neurons in a specific portion of the brain. Thus, the levels of these chemicals in the brain have an effect to a person's behavior. Mechanism of Nerve Impulse Nerve cell conduction or communication is an extremely rapid process which involves the following: The impulse moves through the nerve in a long and slender cellular part called the axon. As the impulse travels through the axon it travels the presynaptic membrane. It is in this area that neurotransmitters are released in the free space called the synaptic cleft. The receptors located in the postsynaptic membrane of another nearby neuron pick up the free flowing neurotransmitters. The molecule is adapted in the next nerve cell and the impulse continues to the next nerve cell until the message is relayed throughout the body. What happens after neurotransmitters sent the information? After they served their purpose of being released into the synapse and relaying the messages to the receptor cells, they are transported back from the synapse to the axon to be stored for later use which is a process called reuptake. If the neurotransmitters will not undergo reuptake, they will be metabolized and inactivated by enzymes, primarily monoamine oxidase. Major Neurotransmitters Acetylcholine This is the first neurotransmitter discovered which is found in the brain, spinal cord and particularly at the neuromuscular junction of the skeletal muscle of the peripheral nervous system. The mechanism of action of acetylcholine could either be excitatory or inhibitory. Acetylcholine is synthesized from dietary choline found in red meat and vegetables. Research and studies have linked the incidence of Alzheimer's disease with decreased acetylcholine secretion in the neurons. Physiologic Effects and Functions: Muscular stimulation – acetylcholine signals muscles to become active including the muscles of the gastrointestinal system. Controls the sleep and wakefulness cycle of a person. It has a part in scheduling the rapid eye movement (REM) sleep or dream.

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What is Phlebotomy Posted: 09 Jul 2011 11:03 PM PDT Definition Phlebotomy is a procedure that consists of venipuncture and withdrawal of blood. It is a safe outpatient method where blood is extracted from the vein through a cut or puncture. This procedure is performed by a nurse or technician called phlebotomist. Purpose Phlebotomy is performed for many reasons which include the following: To obtain sample for analysis and diagnosis. To treat polycythemia. Polycythemia is a condition where elevation or red blood cell volume is noted. Part of the treatment of this disorder is carrying out therapeutic phlebotomy. To decrease the total blood volume of patients with pulmonary edema. To remove blood from the body during blood donation. To analyze blood substances contained in blood before clearing a person for blood donation. Safety Guidelines Universal precautions are used with this procedure. Gloves should be worn when performing this procedure. Prior to blood collection it is important that the one performing the procedure is properly trained and identified as licensed phlebotomist. Supplies should be checked for their integrity. Needles should be immediately disposed in an approved sharps container. They never be recapped and should only be used once. Description of Procedure In this procedure, blood is extracted from a vein on the back of the hand or over the antecubital fossa. However, some tests require blood to be taken from an artery. In blood transfusion, donors are placed in a semirecumbent position and the skin over the antecubital fossa is carefully cleansed with an iodine preparation or antiseptic solution. A tourniquet or elastic band is applied around the arm to retain blood in the area and make the veins visible. After the phlebotomist selects an appropriate vein for blood extraction, venipucture is performed. – A needle is inserted into the vein and the tourniquet is released. The appropriate amount of blood to be withdrawn widely varies. Blood donation and therapeutic phlebotomy require larger amount of blood than blood analysis. Blood donors usually give about 450 to 500 ml of blood per session. For laboratory analysis, the volume of blood needed depends on the type of test performed. Approximately, one or more 5 to 10 ml tubes of blood are withdrawn. Withdrawal of 450 ml of blood takes less than 15 minutes. After the needle is removed, the donor is asked to hold the involved arm straight up and apply firm pressure on the site with sterile gauze for about 2 to 3 minutes or until the bleeding stops. The phlebotomy technician then places a bandage on the site. Instructions After the Procedure Within 1 to 2 minutes the donor is asked to remain in the position until they feel able to sit up. If weakness or faintness is experienced, the donor should rest for a longer time. Foods and fluids are given when the donor sits up and is asked to remain for another 15 minutes. Heavy lifting should be avoided for several hours. Smoking should be avoided for an hour. Alcoholic beverages should be avoided for 3 hours. For 2 days, fluid intake should be increased and balanced diet should be practiced for 2 weeks.

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Arterial Puncture Posted: 07 Jul 2011 10:48 PM PDT Definition One of the methods of collecting blood is arterial puncture. Obtaining arterial blood sample requires percutaneous puncture of the brachial, radial or femoral artery or the extraction of a sample from an arterial line. Once collected, the sample withdrawn can be used to analyze the patient's arterial blood gas (ABG) values. Determining if a patient is acidic or alkaline and assessing the oxygenation status of the patient is made possible by obtaining a blood sample through arterial puncture. The procedure is quite similar to venipuncture however, it should be done with no exposure to air to prevent the escape of gas from the arterial line and avoid intracellular fluid shift to extracellular. Indications Arterial punctures are usually performed for the following purposes: Arterial blood gas sampling or assessment of the patient's acid-base balance (ph) Ventilatory status assessment (PaCO2) or frequent need for blood sampling such as in cases of prolonged resuscitation Oxygenation status assessment (PaO2) Important Considerations In extracting blood samples from the arterial line, the nurse should keep the following factors in mind for successful outcomes. The arteries that are easier to palpate, stabilize and puncture are those that are superficial. It is also less painful for the patient if the punctured arteries are surrounded by insensitive body tissues such as muscle, tendon and fat. Potential complications of arterial puncture are vascular spasm, clotting of the vessel or bleeding that may result to possible hematoma and vascular compression. In cases where complication occurred, the artery should have a good collateral blood flow. It is the radial artery that meets these criteria and usually the brachial artery is the best second choice. Equipment 10 ml glass syringe or plastic leur-lock syringe 1 ml ampule of aqueous heparin 20 G needle – for drawing the heparin to the syringe 22 G needle Gloves Alcohol pad Two 2" x 2" gauze pads Rubber cap for syringe hub or rubber stopper for needle Ice-filled plastic bag Label Laboratory request form Adhesive bandage Optimal: 1% lidocaine solution

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