Archive for June, 2008
Patients with cancer who attended a clinic nurses instead of a consultant-led clinic to regulate radiation received more comments, more frequent consultations symptoms and good, according to a study in the June issue of the Journal of Clinical Nursing.
And because the clinical nurse specialist was able to carry out 83 per cent of consultations without reference to issues of the consultant, patients also avoids the need to see your doctor routinely.
Researchers at the University of Dundee and the City of Ninewells Hospital also found that patients - who were undergoing treatment for head and neck cancer - were more likely to be forwarded to members of the multidisciplinary team. This led to better manage common side effects of radiotherapy, such as oral and nutritional problems.
When researchers compared 23 patients who attended the clinical nurse specialist led with 20 who had attended consultant-led clinics in the previous six months, found that patients reported few significant differences in quality of life. His remarks also show that especially value the relationship he had built with the clinical nurse specialist.
Comments by family physicians who participated in the study was also good. They were positive about the timing and content of information they received from the nurse specialist clinic patients about their ongoing treatment.
“Our study showed that clinical nurse specialists can play a key role in the management of head and neck cancer patients with radiotherapy and this can take the pressure occupied consultants, without reducing the quality of care” says author Principal Dr. Mary Wells, a professor and fellow at Cancer Research Clinic at the University of Nursing.
“As a result of our investigation, most clinics radiotherapy review Ninewells Hospital are now carried out by a nurse clinical specialist. However, greater investment is necessary to develop specialist nursing functions in the event of initiatives like this are to be replicated elsewhere in the UK. ”
The main findings of the study include:
* Nurses were able to spend 16 minutes at each visit - four times as long as consultants - patients had shorter waiting to see them (two minutes versus nine).
* Overall quality of life scores were similar in both groups, but patients in the clinic run by consultancy group reported slightly higher operating emotional.
Base pain scores were higher in the nurse-led group, but increased markedly less than in the medical group.
* Patients in the nurse-led group had better social outcomes for eating, social contact, dry mouth, sticky saliva, teeth problems and weight loss.
* Patients in the medical group were more likely to have lost weight and less likely to have gained weight, despite receiving more nutritional supplements.
“Our study demonstrates that the clinical nurse specialists in radiotherapy can lead effectively in dealing with examinations for patients through a protocol based approach that patients and family physicians and appreciate the support, information and communication provided by Clinics run by nurses, “said Dr Wells.
“The results suggest that when nurses work as part of a multidisciplinary team that can handle most of these routine consultations without direct input from consultants, even in this complex and symptomatic group.”
The study has led to direct changes in how the head and neck cancer patients are managed at Ninewells Hospital and most of the clinical examination of radiotherapy are now carried out by a nurse clinical specialist with specific training and experience in care of radiotherapy.
“The clinical nurse specialist is now able to prescribe a wider range of medicines and is responsible for coordinating complex treatment regimens and support to patients with complex symptoms” said Dr Wells.
“I also believe that there is considerable potential to develop evaluation and care of patients with head and neck cancer before and after treatment and during radiotherapy.
“Clinical nurse specialists are ideally placed to provide information and advice on issues such as health education, smoking cessation and alcohol consumption, to help reduce the impact of the patient’s symptoms and improve their quality of life .
“They could also provide support, community liaison and management of symptoms immediately after treatment when patients are no longer on a daily contact with the hospital, but the side effects that continue to affect their daily lives.”
But researchers point out that the potential for developing nurse-led radiotherapy clinics throughout the UK is hampered by lack of investment in radiotherapy nursing.
“Nurses working in radiotherapy are relatively few and postholders often work in isolation and their contribution has not been sufficiently recognized” said Dr Wells.
“We hope that our study and development of services that has inspired, will stimulate a debate about the valuable role that nurses can play in supporting cancer patients undergoing radiotherapy.
“We also hope that will highlight the need for greater investment in this valuable expertise.”
I remember being very depressed when I read somewhere that their breasts do not grow further after reaching the age sixteen years since the age of seventeen, I just filled a Cup. I figured that was it, but little did I know that my breasts would get significantly more while I was pregnant and lactating - all the way to a cup of C! Aside from the cosmetic advantages, it’s wonderful to realize that these same breasts that I had always wanted bigger could work well, thanks, and with success after six nursing babies, no longer fantasized about being a D cup. Now that my nursing days, I once again return to a Cup, but I no longer complain. I just hunting throughout the lingerie racks trying to find 38 A bras that fit me.
Over the past twenty-five years working with nursing mothers whose breasts came to an astonishing variety of shapes and sizes, I discovered that breastfeeding may present special problems for large-breasted women.
The production of breast milk is a function of the glandular tissue inside the breast and the baby’s appetite and capacity of breastfeeding. The fatty tissue is what gives the rounded form his chest and protects the internal structures of the injury. The amount of fatty tissue and breast size are not related to the ability to produce milk, so small breasted women are less able to adequately produce milk as the most widely gifted.
The mother with large breasts (DD or higher) may find that she has to experiment a bit to find positions and techniques to have a greater success of breastfeeding.
Here are some tips I found useful:
1) Find a nursing bra that really fits. Small-breasted women do not need as much support as infants older women, in order to find a bra is more a priority for the mother with breasts bigger. Breast size will increase during pregnancy, but by the last quarter, most prenatal growth has occurred and is a good time to buy nursing bras. It is impossible to predict exactly how much larger your breasts will receive when their milk is coming, but we can estimate that it will be a size or two larger in both size and cup banda. You can help achieve an extender back into use during the last stages of pregnancy or the early stages of engorgement, as this can be easily removed as size changes. His ribcage expands during the last months of pregnancy, and the extender can help make you feel more comfortable during this stage. Start with only a couple of bras, and invest in more than once the initial engorgement has declined and it reaches its long-term nursing size. Good nursing bras are expensive, and you do not want to stop investing in a drawer full of bras that no longer fit after the first few weeks of nursing. You should try to avoid under-wire bras, if possible (which can press against the breast tissue and cause problems connected with ducts and mastitis) and athletic tight bras. Bras that are too loose can also cause problems for large-breasted women. The best option to get a comfortable, supportive bra that is installed by a professional, but this is not always possible. Many stores do not carry maternity a variety of sizes, so there may be an end to their place. Plan to order early enough to allow time to return if the adjustment is not ‘just right. The best online resource I’ve found is birthandbaby.com for nursing bras. Go to the page and look under “breastfeeding.” Click “nursing bras” and you’ll see the resources of the family. They have an excellent selection of bras in a wide range of brands and sizes, along with detailed information on how to fit bras and order.
2) experiment with different positions. The traditional cradle hold is the most popular position, but football in general, celebrate works best for women with larger breasts. In this position, the baby is hidden under his arm and has better control over the baby’s head because in the locks, as well as greater freedom of movement of the arm. Be sure to use lots of pillows for the baby to their level, instead of having to lean on him. You also want to support your back with pillows as well. The increase in the knees, with feet also helps (Medela nursing stool is ideal for this). It is difficult to learn how to position your baby to read a book, so spend some time in La Leche League meetings if you have a chance. You’ll get the chance to see real live babies in action in a comfortable situation where only other mothers are present. Medela has an excellent video called “Breastfeeding Your Baby: A Mother’s Guide: Positioning” which shows a variety of nursing positions. It is available in many libraries LLL group, and in our area, Blockbuster Video offers for free as a public service. You may find it helpful to “practice” different positions before the baby arrives, using a baby doll or stuffed animal. While this is not the same as a real live Wiggly nursing baby, can give you an idea of how to use pillows to support and help you get an idea of positions that could be more convenient for you.
3) Ensure that support for breast while nursing. The use of “C” will be held often effective. The C optimum involves the use of holding out his hand (the one on the same side that is nursing) to support her breast. Put the palm of his hand gently under the breast, the finger curved at the top and side, forming a “C”. Be sure to keep the thumb and significantly behind the areola, as if their fingers are on the way, your baby can not compress the breast milk effectively. This can cause pain, as well as preserving it for the subsequent acquisition of the milk they need to grow. Some mothers found that rolling a towel and place it under during breast feeding provides additional support. You may need additional support only as long as you’re getting the baby closed, or you may need the support of breast along the entire food. Once your baby is larger and has better muscle control, you may not need as much support as you do in the beginning.
4) It is important to look after the catch. You must ensure that your baby has a good portion of the areola (the dark area surrounding the nipple) into her mouth, and not just the nipple. The milk is stored behind the areola in the pockets (lactiferes breasts) and the baby has to compress these pockets in order to breastfeed effectively. Babies are small Rosebud mouth, and if your areola is large (some are the size of a dish), then you must ensure that opens wide (like a yawn) before you pull it for you latch. Most of the areola should be covered, but there is no need for him to have everyone in your mouth.
5) gently massage your breasts while you are breastfeeding. Large-breasted women have more tissue that can become engorge or uneven, and massage can help ensure that the milk ducts are being emptied adequately.
6) Set up a nursing station in areas where spending a lot of time (usually bedroom and living room). Get all the supplies you will need together so you do not have to spend once resolved: pillows, diapers, wipes, change of clothes, towel or a cloth diaper for leaks or spitting, nursing pads, changing bed linen cots, water bottle, remote control, a book to read, so comfortable reclining is a wonderful investment. You will spend many hours of nursing in it, and they deserve to be as comfortable as possible!
7) Try to find a way to nurse while you’re sleeping with her baby. Newborns nurse much during the night, and you will get much more if the rest can learn to nurse comfortably while lying down. Many mothers find most difficult to master this situation, but in my experience, large-breasted women find it easier than women with small breasts. The article on “Nursing After a cesarean” has information on nursing lying down, and so does the video Medela.
8 ) Nursing discreetly in public can be a challenge for all mothers, but especially for women with larger breasts. If the football hold works best for you, you can use your bag of diapers for the baby to rest (instead of a pillow). The article “Nursing Discreetly” has more tips on how to nurse in public without attracting the crowd. Personally, I have strong feelings about nursing mothers not feed their babies in bathrooms, and there are many other options if you feel the same way. You have to do what is comfortable for you personally, but it is possible to nurse when you are out and whether learn some basic tips to make it easier.
9) A good breast hygiene is important, because women with large breasts are more likely to have problems with skin irritation or infection due to the folds of skin below their breasts. Many skin problems, such as yeast and heat rash are aggravated by humidity, and the area under the breast is prone to these infections. Wash your sinuses daily with water (not soap) and dry them carefully, paying particular attention to the area below the breast. You can use your hair dryer on cool setting to make sure the area is completely dry, especially during warm weather.
10) Many people make the assumption that mothers with large breasts are more milk, have more problems of oversupply, and leaks over the average woman. This simply is not true. Some women produce more milk and some leak more than others, but is not related to the size of the breasts. If you experience a problem with too much milk, see the article on the “oversupply: too much milk” for some solutions.
11) If you choose to use a breast pump, should bear in mind that the breastshields and flanges (the funnel shaped pieces that fit over their nipple and areola) are designed for “average” size of the breast . Women with very large breasts or areolas may need a larger flange. Medela PersonalFit makes a flange kit comes with two flanges of different size for large breasts, and this makes it possible for women with all sizes and shapes of nipples to pump comfortably and efficiently.
Breastfeeding a baby can present special problems for the mother who is widely gifted, but with preparation and practice, there is no reason why you can not have a successful experience of breastfeeding, regardless of size or shape of their breasts .
Forever improve the landscape of a relatively new profession, these passionate and prolific Nurses set increasingly high standards for the welfare of sick, injured and disabled. Each nurse must strive for both the advancement of care and condition of the people who need it most.
Florence Nightingale (1820-1910) - This British pioneer in the field (which was also a mathematician) insisted on more sanitary conditions for physicians and nurses during the Crimean War, which cut the mortality rate for soldiers wounded by a staggering amount . Florence Nightingale is a true legend of nursing whose work has changed the medical field dramatically for the better. It was also a tireless advocate for the advancement of women nurses and doctors.
Mary Todd Lincoln - better known as Abraham Lincoln’s wife, Mary Todd Lincoln proved his critics wrong (as Southern, his loyalty to the unionist cause is suspected) to put an hour almost impossible frequenting hospitals, cleaning wounds and comfort and nurture the soldiers who suffer unbearable pain.
Walt Whitman (1819-1892) - Whitman is one of the most famous poets of americas of all time, Penning classics such as “Leaves of Grass.” But did you know that he served as a volunteer nurse in Washington, DC during the Civil War? He used the experience to write a collection of poems, Drumtaps.
Mary Mahoney Ezra (1845-1926) - The first African American registered nurse, Mahoney graduated from the New England Hospital for Women and Children Training School Nurses in 1879, and went on to have an illustrious and distinguished career as a nurse .
Mary Breckinridge (1881-1965) - In 1925, Mary Breckinridge introduced an innovative and modern rural health car system in the United States. Call Nursing Service de la Frontera (FNS) Breckinridge ‘model provided professional medical services to one another uncared for rural people in southeastern Kentucky. The FNS used a decentralized system of nurse-midwives, district nursing centers, and hospital facilities, among other achievements, make sure that no patient was more than 6 miles from a nurse-midwife in this 1000-square mile region .
Edith Cavell - An English nurse, Cavell is the head of a nursing school and the Red Cross Hospital during the German occupation of Belgium during World War I. After helping the escape of more than 200 allied soldiers from occupied territory, was subsequently arrested and executed, an event that increased public sentiment against German aggression.
Florence Guinness Blake (1907-1983) - A distinguished pediatric nurse, Florence Guinness Blake is perhaps best known for his devotion to advanced education in pediatric nursing. In particular, Blake pediatric nursing taught at several universities, and established the graduate program in advanced nursing care of children at the University of Chicago in 1946.
Hazel W. Johnson-Brown - A retired former head of the United States Army Nurse Corps, Johnson-Brown was the first African American woman to reach the rank of brigadier general in the U.S. Army. It was the 16 th chief of the Army Nurse Corps, an organization to which he devoted 26 years of his life. He also served as director of the Walter Reed Army Institute of Nursing.
Elizabeth Gracen Neill (1846-1926) - Journalist, social reformer and nurse, Grace Neill was driven by the desire to create change. His brilliant career established the first Nurses’ Registration Act in the world in 1901. His life was devoted to social reform in the welfare of the poor and the suffrage of women. Their work began on course to a more responsible society.
[Source: Encyclopedia of New Zealand]
Sophie Mannerheim (1863-1928) - Sophie was a nurse known as a pioneer in the modernization of the profession in Finland. She was trained in nursing at the Nightingale School in St. Thomas Hospital in London. He was later appointed as head surgical nurse Helsinki Hospital and later elected President of the Finnish Nurses’ association, a position he held for 24 years. Baroness Sophie Mannerheim was a founder of the Children’s Hospital in Helsinki, and the Mannerheim League for Child Welfare.
[Wikipedia]
Virginia Avenel Henderson (1897-1996) - A nurse, researcher, theorist and author: Virginia Henderson graduated from the Army Nursing School, Washington, DC in 1921. She is an expert in nursing theory and graduated from the Teachers College of Columbia University with a Master’s degree in nursing education. Henderson is famous for the definition of nursing as a responsibility to help people, whether sick or not, and help them gain better health and recover under any circumstances. The International Council of Nurses his honor with the first prize Christianne Reimann in June 1985.
[Wikipedia]
Many great people have historically done its duty to put nursing at the forefront of civilization, but nowadays there are also nurses who deserve our attention.
Jeanne Prentice (Active CNM, South Dakota) - The protection of the Mother’s right to choose a professional to oversee home births in South Dakota, Prentice is leading the initiative called “PUSH!” The aim is to enable nurses midwives for deliveries at home. Currently, women in many states can only have births at home unattended if they are able to find a doctor licensed to come to his house. That is not happening though. Therefore, Prentice is leading the charge to ensure that the home not only possible, however, safely and viable opstion. [Source: Black Hills Portal]
Joyce Slinsky (retired RN, New Jersey) - A registered nurse for 45 years, with 39 of those years in the ER (emergency room) from John F. Kennedy Medical Center in Edison, was presented with an official proclamation by the State Assembly and Senate in reverence to his career. On January 20, 2007 was honored as a retiree and member of great value in their community of Brick, New Jersey. [Source: Asbury Park Press]
You have the opportunity to make his mark in the field of nursing and health care. Embrace the race, get education, and become one more clear example in the treasure of tradition and nurses held. Take the first step toward making your dream of pursing a career in nursing a reality today.
For a long time, many in nursing leadership have maintained the view that that a new graduation is not a “real nurse” until you’ve spent a year working in a hospital in general medical / surgical floor. The usual justification is that experience that allows RNs to develop valuable organizational and technical skills assessment and helping new graduates get a firm grip on the RN role and learn leadership skills.
It is true that spending a year in medical / surgical floor can be time well spent, especially if you do not have a clear idea of the types of nursing jobs you’re interested in doing so or if you feel particular interest or doctor surgical nursing - an area of concentration in itself. However, due to the shortage of nurses, many new graduates are being hired directly in the areas of specialty. If this is combined with intense, extended orientation, especially with a mentoring component, we can work well. In fact, some types of specialized units like the formation of new graduates directly, in order to mentor in the field of culture and body of knowledge. For example, some organizations working in public health prefer to work with new graduates, in the belief that a nurse who has spent too much time in the hospital might find it more difficult to adapt to the sometimes harsh conditions that the health of the community nurses encounter in the field as well as the relative lack of continued mutual support and access to resources.
The best way to make this decision itself is talking with other nurses in their area of specialty desired. Listen not only the reasons why it or not spend a year in med / Surg, but also how they feel that their nursingcareer affected, either positively or negatively.
Nursing Schools
Okay, so now you have any idea what kind of programs you’d like to investigate nursing. Now what?
First, take a look at the most complete guide to nursing schools. There are books containing this information, but is no longer 1995, is probably using the Web to its initial investigation! And from the nursing school can be costly, you may need financial aid college. It may be possible to obtain private scholarships and / or government grants and loans to help finance her nursing degree. See www.FinancialAidFinder.com to learn the bowels of financial aid.
Two of the best sites in the nursing school and are www.allnursingschools.com www.discovernursing.com. The first contains information about - you guessed it-almost all nursing schools currently in operation in the U.S. and information about some schools outside the U.S. too. Its search function is very useful and allows you to reduce the degree options offered, geographic area, and accreditation. And they have a nice little feature that allows you to register to take the nursing school to send you information about its program. They have a lot of useful articles on the nursing school and nursing careers that are worth seeing.
Discovernursing.com is funded by Johnson and Johnson and encourages young people (and not so young) to enter nursing. You can search for a nursing program by geographic area (including the state or region), type of degree offered, enrollment size, private sector and public institution, and if options are offered online. Another interesting feature of discovernursing.com is seeking grants and inspiration “in the profiles of nursing, which are sprinkled throughout the site. In addition, if you’re trying to avoid being old and gray, even before the nursing school (or unwilling to be higher or gray as the case may be) before leaving his “nursing schools without a waiting list.”