Inside the Operating Room: An Introduction 2 comments

Blood. There is blood everywhere. On the floor, pooling in basins, dripping from sponges and coating once glimmering stainless steel instruments. Smoke lazily floats up the room as the smell of burning flesh lingers in the air, cloying, at times suffocating. A monitor is beeping incessantly at one corner of the room, wires and cables extending from its body like a robotic creature happily entangling its prey. 

The room is filled with aliens. Or maybe not, but they sure look like extraterrestrial beings. Or maybe those specialists who cater to ones. All suited up, capped and masked, with rubberized hands. They talk with invisible mouths, their eyes being the only windows to their souls. Assuming each of them has one.

And in the middle, a body. Lying down, immobile and strapped up. A tube protruding from its mouth, and its intestine poking out from its torso. A plastic suction tube held by one of those rubber hands slurps out excess fluid as a variety of metal clamps stick out from the abdominal hole like some grotesque part of a Saw torture chamber.

Buzz. Smoke. Clamp. Tie. Suture.

Stitch, stitch, stitch.

The scene may seem like an empty mechanical show of technical procedures, but behind every needle bite is a disease and behind every disease is a person, and behind every person is a story. 

These are the stories that I would never have witnessed anywhere else. 

This familiar shiny hallway and these tiled rooms have witnessed much of people's weaknesses, but also humanity's unwavering strength, more than any other places in the world. To be a spectator a midst all the action, suspense, drama and comedy have undoubtedly shaped me more than I can explain and have made me view things in a different lense. Things may not appear brighter nor more colorful, but they do extract sense and importance in this world governed by misplaced priorities and the pursuit of temporary bliss.

Future related posts in this series will tell stories not my own, but of life's complexities that only presents itself in the most trying of times. No paper-pushing routine job, even the highest paid ones, could mirror this front-seat view on the unadulterated, barefaced truths of our existence. And this is why I wouldn't exchange this experience for the glitz of a more glamorous job.

So, who am I?

I am an OR Nurse. And I have stories to tell.

DOH Terminates Nurse Volunteer Programs: A Nurse Volunteer's Point of View 8 comments

In an intelligent and thought-provoking decision, Department of Health Secretary Enrique Ona issued a memorandum terminating all "Nurse Volunteer Programs", "Volunteer Training Program for Nurses" and all similar and related programs, in all DOH-retained hospitals.

64666926 DOH Termination of Nurse Volunteer Programs

While the memorandum brings appealing images to mind (the end of nurse exploitation, employment for licensed registered nurses, respect for the nursing profession etc.), the only effects of the ordinance that is evident right now is public hospitals being grotesquely understaffed, patients suffering from inadequate care from overworked and burnt out staff nurses and entry level nursing graduates experiencing What-The-Hell-Do-I-Do-Now? syndrome.

Two-Way Street

It's not all bullying, over fatigue and slavery that envelops a nurse volunteers life. Not every registered nurse gathers used bottles in a kariton to sell at junk shops just to have money for hospital training fees. These scenarios get featured in news programs and documentary reports because it is dramatic and controversial. Truth of the matter is, nurses volunteer because they choose to practice their profession rather than apply in call centers, have fake accents and answer calls from strangers. They do it to gain leverage in this highly competitive job market.  Because let's face it, no hospital in their right mind will hire a newly licensed nurse with zero post graduate experience.

Please do not underestimate us. We are not slaves, we know what we are doing and we are aware of the situation in these hospitals. We are not shackled to the nursing station with big metal chains, forced to administer medications under duress and monitor vital signs at gunpoint. We were not dragged into an institution to serve against our will but we do it because we want to and, so far, we see the favorable outcome of honing our crafts and sharpening our skills.

Add to that the priceless feeling of having a schedule to follow, a purpose to attend to, every day. One of the hardest things in life is to wake up at numerous mornings in a row and not be able to know what to do that day or the day after that. Plus, there is the relationship and unique bond that is formed with co-trainees, staff nurses and even patients that no bum, useless, non-"slavery" day could replace.

One thing I could completely agree with, though, is that we should not be paying thousands of pesos for these so-called trainings when we have already offered our brains, bodies and licenses for free. That long-standing custom, Secretary Ona, should be the one eternally abolished but NOT, yes you read it right, every training/volunteer program in the country.

A Dead End

So, with all due respect, DOH Secretary Ona, what do you propose we, unemployed registered nurses, do now? 

With Nurse Volunteerism / Nurse Trainings now prohibited in DOH mandated hospitals and NO ADDITIONAL BUDGET given for hiring needed nursing manpower, every one suffers. Staff nurses are reeling from the sudden influx of additional work load, patients are neglected from lack of care from the preposterous nurse-patient ratio and fresh graduates now have no opportunity to practice what they have learned in college, therefore lessening their chances of getting hired by hospitals due to inadequate experience.

Forgive me for this, but I think the memorandum is a hasty band-aid approach to a long and complicated problem of nurse shortages and exploitation in the country. It was a decision without due thought of the various elements that made the despicable nursing trade of our country what it is today. The problem is a hideous many-limbed menace and cutting of one arm will only make it bleed and stagger.

So, again, if I may ask, seriously, WHAT NOW?

SERIOUSLY, JUST NOW?: Nurse Volunteerism-For-A-Fee Finally Hits The Local News 23 comments

For most people, the explosion of feed hospital volunteerism by registered nurses all over the country is considered as news, but for thousands of professional nurses it is a lifestyle. An absurd reality where the one serving is also the one spending money for offering one's services.

It's like selling your cellphone but instead of receiving payment, you will also be the one paying the buyer in addition to giving him the gadget. Sounds absolutely insane, right?

It is. But that did not stop countless of Filipino nurses from giving in to the preposterous proposition of both government and private hospitals all around the metro for the sake of gathering experience in hopes that it will help them to finally land a paying job. Including me, my classmates in college and most probably one of your  friends, relatives or even your own child.

Now, with the explosion of this 'shocking' news, everybody's acting all concerned and affected  (politicians, the media, even our beloved PNA) when in fact, they've been turning a blind eye on the problem for YEARS now. Call me an idealist but I think that it's impossible for the media, hospital associations and even most government officials to not be aware of such injustice unless they've been living in a desolate cave without TV, radio, internet connection and cellphone signal for at least 4 years now.

And seriously, does it really have to take a physically abused and raped volunteer nurse to finally drill an opening in the thick dome of secrecy that this shameless exploitation is enveloped?

Just yesterday, a segment in GMA 7's Reporter's Notebook aired a heart-wrenching special segment about volunteer nurses paying fees just so they can practice in the hospital. So many colleagues can relate to the story that one of my friends even cried upon watching the episode.

Another video, this time from ABS-CBN regarding nurse's protest against such inhumane treatment from hospitals demanding money from would-be volunteers. (Click on the link to watch.)

http://www.abs-cbnnews.com/video/nation/01/13/11/group-protests-volunteerism-fee-scheme-nurses

Some cynics may say that none of these will happen if no one will allow such treatment. It's easy to not experience being overworked with negative salary: 

Just don't do it. Do not apply, do not pay, do not be fooled by these  well-oiled mammoth institutions looking for licensed slaves.

But then see, registered nurses took an oath. A pledge made just a few moments after passing the dreaded board exam knowing that they will be receiving their sought-after license. And for some, it is a promise they are willing to uphold no matter what. So many skilled and intelligent nurses are now in jobs not related with the path they have vowed to uphold but some are, to the point that they do it without salary or allowance, just so they can still practice the profession and help care for humanity.

It is not stupidity that brought these registered professionals to where they are now, uncompensated and begging for justice and respect. It is passion, it is the love for their profession that wakes them up every morning and takes them through the night shift. It is their concern for the sick that makes them do the unspeakable things nurses do just to get through the day because without monetary reimbursement, what else is there?

So Philippines, I am speaking to you. Start caring for your professionals, not only nurses but every under-appreciated, unrewarded job there is in the country, for when the day comes that there are already too few of them, gone from the exhaustion of being used and abused, you might by then realize your mistake way too late.

Nurse's Black-Out Campaign 2011 0 comments

Probably inspired by the recent nationwide fad of changing one's profile picture to a cartoon character to help the cause of anti child abuse and negligence, the Nurse's Black-Out Campaign aims to raise the public's awareness on the various depressing situations of Filipino nurses nationwide like paid volunteerism and unemployment. The total black-out of primary pictures on social networking sites such as Facebook and Twitter supports the online campaign in sharing the experiences and pleas of nurses all over the country.

 Title: The Nurses' Black-Out Campaign 2011

Main Objectives:

1. To utilize social media as a tool for nurses' rights awareness building;
2. To initiate social & mass mobilizations in relation to the protection of nurses' rights;
3. To garner online & non-online support from individuals, organizations and communities to end all forms of discrimination and abuse to nurses in the workplaces and communities.

Rationale:
In 2010, the Philippine Professional Regulation Commission, head agency for all the professionals in the country stated that there is already close to 200,000 unemployed and underemployed professional registered nurses in the country. And with the recently concluded December 2010 Nurse Licensure Examinations, the Philippines will be expecting more than 20,000 additional new nurses joining the unemployed sector. This rapidly growing concern of the nurses is now a crisis in the country. The Philippines is the top producer of export nurses and supplies the nursing shortage to many foreign countries but ironically lacks many skilled nurses itself.

The country's rural health units were lacking of many nurses to take care of the communities. One nurse is employed by the government to take care of 20-50,000 residents. In government hospitals, a nurse takes care of 20-50 patients in a ward. Still to some private hospitals, the nurse-patient ratio is imbalanced. Hospitals and healthcare facilities acknowledge their shortage of nurses but fails to hire more because of proclaimed budget constraints. Leaving dozens of nurses flooding in workplaces other than in the field of nursing.

Many expectant young nurses, wanting to gain hospital/clinical experience as a presumed key to international employment, offered their professional nursing services to the hospitals without getting paid. This practice led to the acceptance of hospitals to new nurses to practice in their hospitals tagging terms such as "Volunteer Nurses", "OJT Nurses" and "Nurse Trainees". However, with the overwhelming response from the new nurses, hospitals started charging training/OJT fees in exchange a certification stating that they are "trainees" of the said hospital.

Other abuses such as unfair working conditions, staffing, workplace bullying among others are being experienced by nurses who remained to be largely unreported. Other exploitation are also prevalent such as the exorbitant fees charged by Review Centers to nursing students are also rampantly unregulated.

Main Organizing Body: 
The main organizer of this online movement is the Alliance of Young Nurse Leaders and Advocates International Inc., a national registered organization of nurse leaders & advocates in the Philippines.

This project is coursed through the Alliance's network local chapters & through Ang KatipuNurse the Alliance's political arm in the following areas:
National Capital Region

1. Manila
2. Pasay
3. Makati
4. Valenzuela
5. Caloocan
6. Taguig
7. Mandaluyong
8. Las Piñas

Luzon

1. CAR Baguio-Benguet
2. Ilocos Sur
3. Pangasinan
4. Pampanga
5. Nueva Ecija
6. Nueva Vizcaya
7. Tarlac
8. Bulacan
9. Bataan
10. Camarines Sur
11. Rizal
12. Tuguegarao
13. Cavite

Visayas

1. Ilo-ilo
2. Aklan
3. Cebu
4. Negros Oriental

Mindanao

1. Davao
2. Davao Del Sur
3. Davao Del Norte
4. General Santos
5. Zamboanga

Implementing Partners: These are online communities, societies and organizations who are fully supporting the online campaign. Together, they raise awareness to their subordinates online and maintains communication with AYNLA to get materials necessary for the campaign.

Current listing of online Implementing Partners:
1. Filipino NURSES online community (base members: 197,303)
2. I am a Student Nurse online community (base members: 4,547)
3. Ateneo de Davao College of Nursing online page (base members: 1,988)

Medium of Campaign: Online resource mobilization; social networking sites (e.g. Facebook, Twitter, Tmbler, Multiply etc.)

Online Slogan: "Over 200,000 nurses are unemployed, underemployed & abused in the Philippines. Many of us are overworked but extremely underpaid. Help us gather awareness & support by changing your profile picture to pitch black from January 01-11,2011. It is time we take care of our prime care professionals! Appreciate your Nurses, take care of them - like they take care of you. Join the campaign now! [www.aynla.org]"

Campaign Period: January 01 - 11, 2011 (Initial 11 days from the start of the year)

Core Agenda:

1. Nurses' right to security of decent employment

• Demand urgent action of the Philippine Government to the ballooning unemployment rate of Filipino nurses through (A) Senate and Congressional inquiries and investigations, and (B) Formation of a multi-sectoral/agency commission or task force to oversee the Nursing Crisis.
• Implement Republic Act 9173 or otherwise known as the Philippine Nurses Act of 2002 and the Magna Carta of Public Health Nurses especially the implementation of Salary Grade 15 (SG15) for entry-level nurses and other stipulated benefits such as hazard pay, night differential pay & allowances.
• Reject internationally signed treaties such as Japan-Philippines Economic Partnership Agreement (JPEPA) where the Filipino nurses are in the losing end because of inequalities; pass Reproductive Health Bill with emphasis on trained Nurses being in the frontline of RH education and service employed by the government deployed to clinics nationwide.
• Regulate exorbitant charges made by institutions such as Review Centers to students taking the Board Exam.

2. Nurses' right to equality & to be free from all forms of discrimination

• Eliminate all forms of discrimination in the workplace such as but not limited to (A) verbal, physical and sexual abuse, (B) name calling, branding and stigmatization, and (C) LGBT nurses rights.
• Practice equal staffing in hospitals and clinics abolishing coercive 16, 18 to 24-hour duty shift and adherence to desired nurse-patient ratio of 1:20 or lesser.
• Provide avenues for alternative earning opportunities for Filipino nurses such as initial seed funding for Nursing Clinics and or loaning for interested nurses venturing on cooperatives.

Phasing:

• Phase I - Nurses Black-Out Online Campaigning through major social networking sites such as Facebook, Twitter and Multiply. Total black-out in profile photos are solicited when participating in the campaign. The online campaign will last until January 11, 2011. A probable culminating awareness activity may be set on the last day of the campaign.   
• Phase II - Nurses Rights Day After the Black-Out Campaign, we will declare every 11th of the month as the Nurses' Rights Day where we can once again go on Black-out online and do some awareness drives in localities where nurses belong. Awareness drives may be in form of pictorials, forums, seminars etc. The Nurses Rights Day shall be commemorated every 11th day of the month until we reach it's first year. Then we will evaluate each progress of the campaign. Nurses Hour is an hour allocated per working shift dedicated to Filipino nurses.
• Phase III - Physical Mobilizations will be done after we have gathered sufficient online support. Mass mobilizations such as gatherings, legislative fora, consultation meetings, benefit shows etc. can be done. International mobilizations are also expected.

Source:  http://www.aynla.org/page/nurses-blackout-campaign-2011?xg_source=activity

Facebook Page: http://www.facebook.com/event.php?eid=161884150525212

Personally, I think it is a valiant effort to utilize the Internet in spreading the word to other people who are still blissfully unaware of the standings of nurses all over the country, especially those who have just graduated in the recent years. The lack of a stable job, the myriad of trainings and seminars to undergo, the endless volunteer work, hospital experience paid BY the volunteer himself (and not the other way around, the way it should be in normal circumstances) and the work hazards in the hospitals are just a few of the things that needs to be heard by the public and even by the politicians who can actually do something about it.

Unfortunately, blacking out one's profile picture is not as fun as thinking like a child and choosing a suitable cartoon character to upload. Also, having everyone have the same black void as a thumbnail is confusing in identifying who's who in comment pages. I think those are a few of the reasons why the campaign is not as popular as compared to the one against child violence. As a graduate of nursing school, I have at least 100 friends in Facebook who are registered nurses and are experiencing the things that this campaign is trying hard to fight against, however, I have only noticed less than 5 friends who have committed to the campaign.

Blacked-out or not, I still support the advocacy and the fight that we nurses are desperately trying to win, especially since we are without help from national certified nursing organizations who all seem content on doing nothing else but hold seminars and trainings and distribute membership cards to fresh graduates. I may have not changed my profile picture to a black tile but hopefully, by writing articles and blog posts about these very topics like the one listed below, I've done my part in trying to make a better world for the graduating Filipino nurses of the future.

The Anatomy of Nurse Volunteerism

Secret Lives of Nurses

And may I just say, the injustices has been festering for too long, it's time we try to break out of our submissive cage and hit back.

Top 10 Things I Learned from the OB Ward 9 comments

10. 60 patients in the ward versus 1 staff nurse and 1 trainee is considered a benign shift.

9. "Not seen during rounds." Trodat. is an accepted Nurse's Notes' charting.

8. Ampicillin, Ketorolac and Nalbuphine are best of friends. Sometimes, they also hang-out with buddies Gentamycin and Metronidazole.

7. Some patients never buy medicines. They just collect Rxs and irritate the medication nurse.

6. Medication x 100, IV insertion, carrying out orders, extraction, MgSO4, handling patients numerous enough to build an army etc. (Okay, halfway there. I felt compelled to put in something semi-serious for everyone else's sanity)

5. Patients panic once their IV bottles are empty or they see blood in their IV line like they're going to have a cardiac arrest because of it. Re-hook new one immediately or flush mentioned blood. Or else, relative will follow you around the ward and watch everything that you do.

4. The smell of disinfectant and lochia combined will haunt you on your way home.

3. There's nothing awkward about asking somebody you barely know (in front of other people): "Naka-utot na ba kayo?"

2. It is possible to fit 6 mothers and 6 babies in a single-sized bed.

...and the No.1 thing I learned from my 2-month stay at the OB Ward:

1. The location of Lying-In and how to get there. "Sir, sa Lying-In po yan, diretso sa dulong-dulo tapos kaliwa."

The Anatomy of Nurse Volunteerism 17 comments

So you just graduated from college, pinned that university nursing pin on your left collar, passed the board exam and pledged to God, BON and Nightingale that you will spend your life in purity and practice your profession faithfully. You undergo a myriad of trainings and seminars, First Aid, BLS, IVT, because it is considered mandatory nowadays and most hospitals will not allow you to 'work' for their institution without  expensive training certificates.

You pass your resume to several hospitals, use to your advantage every backer you and your parents know. After a couple of weeks of waiting, you get restless, bored and depressed from being an unproductive member of society. You are already considered a young adult. You're supposed to be doing something with your life.

You consider applying for call center jobs just to earn money, but your brand new PRC license, 4 years worth of nursing education and Nightingale's spirit floating in the air beside you like a Safeguard commercial stops you from letting go of your registered profession altogether. Mainly because there's nothing else left to do, you decide to file and volunteer for a hospital. You try to delude yourself that you are training, but inside, you know that  what you are doing is offering your services for free.

After months, even years for some, you find yourself again inside the busy bustling world of vital signs, charting, IVs and orders. It's amazing, fun and intoxicating. You meet new people, make friends with colleagues, learn new things and do procedures you were never allowed to do. You feel like you are now part of the health care system and not anymore just a nursing student trailing after her clinical instructor. You feel empowered, able and competent.

Add to that, you get to help people in one of the worst days of their lives. You feel like you're doing something right and selfless, probably for the first time in yours.

But then weeks, months, even years pass. Hospitals after hospitals will accept but never seem to hire. The initial bliss of having something to do and somewhere to go gradually dies down replaced by fatigue, burn out and this vague feeling of uncertainty. What am I doing here? How long will this go on? What's in it for me?

You start to question your purpose in life. Do you really want to be a nurse? If there's a better opportunity somewhere else, one that does not involve being an RN, would you take it? Should you take it?

With the current condition of nurses in the country these days, are you really waiting for a better tomorrow, when tides change and employment will be available once again, or wasting your time and energy being voluntarily used by these multi-million institutions, all of which can't seemingly afford to hire you even though it is fairly obvious that they need more skilled manpower? In fair trade, what company in their right mind will pay for nurses if hundreds of others are willing to work for them for free?

I once read an article referring to nurses as heroes of the current generation. Then someone commented on how self-righteous that was to call one's own profession as heroic. He then pointed out that it is called a job and not some superhuman feat of self-sacrifice. 

I think, it could only be called a JOB if you're getting paid for what you are doing, and not the other way around. Caring for the sick is probably not as noble as dying in Bagumbayan for your own country but it has a degree of altruism not seen in just about anyone.

I think the majority of the population is too selfish, too human to spend their days and years serving humanity with not much in return.

To be or not to be, that is the question.

If you took up Nursing just because your parents says so or you envision yourself in the middle of  glitz and glamour, strutting the streets of L.A. or London without much effort to get there, then this profession is not for you. If you can't handle carrying out orders for the majority of your professional life and if the weight of lives on your shoulders seems too much to bear, then don't do it.

But if you got into this profession in your own free will, without the lure of gold coins and fancy lifestyle, if the universe of health care and medicine just inspires and amazes you, then please, for all our sakes, continue what you are doing now and show the world there are still people like you who was born to serve and make  this country, and eventually the world, a better, more caring place.

The OB Nurse 0 comments

Volunteering in a tertiary government hospital in the OB-GYNE Ward will open one's eyes to the chaotic but endearing world of a woman's uterus and all the things connected with it. Oh, and babies, lots of babies. An OB nurse might not sound as hard core as, say, an ER or ICU nurse with their constant stab wounds, GSWs and Code Blues but it takes a special kind of health care practitioner to survive the OB floor. Believe me.

An OB nurse in a government hospital must always be on her toes. From the never-ending stream of mothers and their newborns coming in from the delivery room and operating room, it's easy to get lost in the chaos. (Really, in relation with the Dengue epidemic reaching record-breaking proportions, you would think pregnancy is communicable too.) She must have the strength and presence of mind to handle literally hundreds of patients, 2-4 patients per bed, who have just given birth to another human being a few hours ago or is gearing up for a major surgery later in the day. She must be willing to do hard work, lots of it, to get through the shift.

She must be understanding. Most of her patients are in pain, uncomfortable and with a crying, needy newborn in their arms. There are patients who request for painkillers right after you've already given it to them. There are those who complain of things, both real and imagined, and for a nurse who is currently catering to hundreds of bodies, it is sometimes exasperating to hear superficial concerns with no effect whatsoever to the patient's health and well-being. But empathize and look into those problems, she must.

An OB nurse must be tactful. It's not easy being around the smell of lochia and disinfectant combined all day long. The relentless crying of hundreds of babies just cannot be taken as music to the ears if heard on hours end and the sight of blood stains on gowns and bedsheets are not pretty to look at especially after one has reminded, even pleaded, for these mothers to please maintain proper hygiene while in the ward.

She must be non-judgmental. From mothers who already have ten children and counting but doesn't want to be ligated even though the family can barely pay for the hospital fees to 15-year-old teenage mothers who obviously have not planned having a baby this early in life, it's hard not to let personal prejudices come out and occupy one's thoughts. But still, she must treat each patient equally without discrimination nor malice.

Lastly, an OB nurse must have patience. From nagging relatives to patients who won't buy nor take prescribed medicine, one will encounter all kinds of people in the area. There are mothers who don't know what to do with their first-born to those who don't care if their baby falls off the bed or die of breast milk aspiration, these are the situations a nurse must be prepared to take care of.

The medications and interventions might be the same for most patients on the floor, but it's the stories and personalities one meets in the ward that makes each day interesting. Handling unique circumstances with grace and dignity while maintaining that of the patients is not an easy task but it is what truly makes a great OB-GYNE nurse.

Nursing Shift Wars: 6-2 vs. 2-10 vs. 10-6 0 comments

Morning Shift (6AM - 2PM)

• Must wake up at 4 in the morning. Ugh.
• No traffic to work. Yay.
• Feeling of being in one with the rest of the country's working class hours. Yay.
• Morning Care. Ugh.
• Change of linens. Ugh.
• Twice the meds. (OD meds are most commonly given at 8AM) Ugh/Yay depending on nurse's preferences on duty toxicity.
• Doctor's rounds, carry out orders. Ugh/Yay, still depends on RN's preference. More experience for students/trainees, more work for staff.
• OPD hours. Too many people in clinics. Ugh.
• Less visitors before lunch. Yay.
• High frequency of student nurses in wards doing Vital Signs. YAY.
• Humid trip back home. Ugh.
• Plenty of remaining hours after shift to do whatever. YAY.

Afternoon Shift (2PM - 10PM)

• Get to wake up late in the day, no sleep deprivation issues. Double Yay.
• Humid trip to work plus traffic. Ugh.
• More visitors in the afternoon. Ugh.
• Discharge papers, instructions, nagging relatives all in one shift. Ugh.
• Late night commute plus high chance of hold-upper being in the same jeep/bus/FX as you are. SCARY.
• Change clothes, sleep 'till whatever hour the next day. Heaven.

Evening Shift (10PM - 6AM)

• Cool and breezy commute to work. Yay.
• Calm and serene ward. Patients are asleep. Yay.
• Very few to no visitors. Yay.
• Night life is hospital life. Ugh.
• Inevitable retelling of hospital ghost stories. Scary.
• Probable actual ghost encounter. Scarier.
• Shift can feel like forever if the area is not busy.
• Staying up while the majority of people you know is asleep. Ugh.
• Sleeping in while the majority of people you know is hard at work. Yay.

 

Okay, so I'm biased. I'm a night person, I hate waking up early in the morning. I like my sleep long and uninterrupted by annoying alarm clocks. So, my verdict: Afternoon Shift 2am-10pm.

Yes, evil wallet/cellphone-taking people lurk during the wee hours of the night but from experience, commuting at 10PM isn't as scary as it seem. Plenty of people are still out and sometimes it's even hard getting a ride. Granted, this shift only works for people who live near the hospital they are working at. The best thing about it is (for me at least) that I've proven that this is a great weight loss shift as long as you sleep right after getting home. Lost a couple of pounds with no food restrictions after a week in this shift. All I can say is Major Major YAY.

A Week in the Lying In 8 comments

So I decided I'm not going to keep my current life as a trainee nurse a secret but instead, ironically like all other things, I'm going to blog about it. Let's just say I'm training in a tertiary government hospital in Metro Manila (okay FINE, I'm talking about QMMC) and is assigned in the OB Ward which consist of 3 parts, OB Main Ward, OB Extension and Lying-In. We, the trainees, are called PNTPs and I am a part of the 12 trainees of our batch.

Our schedule in our first two weeks of stay is strictly 6am-2pm Monday to Friday but we were told that afterward we will have our own rotational schedules and 2 off days. We 12 were split into 3 groups and were assigned to one of the sub-wards.

Overcrowded maternity ward in a Metro Manila hospital. (Not actual picture, but close)

First stop was Lying-In. In this area, our patients mostly consist of post NSD women carrying newborns and looking for a comfortable place to sit on because there are 3 mothers and 3 babies in one bed in a normal, good and non-toxic day. 5-6 mothers (times 2 because of the babies) in busy seasons. It was surreal for me at first but we learned to adjust that on the 2nd day, it's normal for us to ask "Ilan po kayo sa kama?" when looking for a place for a newcomer.

Our tasks consist of taking the vital signs of both mother and child, trying to keep the ward clean and orderly despite the overcrowding and the choir of crying babies, logging in names in different lists and logbooks, charting (but we're not allowed yet because we're officially newbies), injecting contraceptives in the afternoon to willing mothers and answering questions of relatives regarding billing procedures, birth certificates and so on.

There are no IV medications to prepare, only oral drugs to instruct. Occasionally, a patient will arrive with an IV but it's always for discontinuation so we get to do that also. The climax of the day is always the intramuscular injection of the contraceptive DMPA every afternoon. This definitely makes up for the lack of needlework within the shift.

In general, I think this is a good warm up for our 2 month duty in the ward. I look forward to the time I will get to roam around the place with absolute familiarity with the comings and goings of the institution like the way those senior trainees do. Imagine, they got to learn so much in such a short span of time.

I will too.

Top 10 Must-Haves for Newly Registered Nurses 8 comments

10. Xerox copy of all important documents including Diploma, TOR, PRC License, Board Certificate, Board Rating, Certificates of Seminars/Trainings attended and resume.

9. White clinical uniform of your own choice. See: Uniform Designs for Nurses

8. ID pictures of all shapes, sizes and background colors. Whether it's 1x1, 2x2, passport size, 2x2 with green background, 1x1 with white background, corporate or casual attire, Matured Experienced Nurse or Enthusiastic Fresh Graduate look. You need them all.

7. Umbrella. The freak show that is our weather is certainly unpredictable. Whether you are avoiding the sun or trying hard not to get soaked, an umbrella is your best buddy while commuting. And let's face it, majority of nurses don't have their own cars. With non-existent salary, we can't afford one.

6. Your own personalized stamp bearing your Full Name, R.N and Lic. No.  Personal choices are Shiny Stamps and Trodat Stamps available in leading National Bookstore nationwide (P.S. Am not getting paid to advertise ff. brands. Although I should.)

5. Dedication. If you are lucky enough to use the stamp that you have just requested to be custom made, it probably means you are offering your services for free. Nobody will survive a week working in a hospital minus the proper compensation without a fairly high amount of dedication coursing through their selfless humanitarian veins.

4. Lightweight, non-tormenting shoes. Yes, they look butt ugly. But 'lo and behold, you will worship their hidden powers of comfort. Especially when you're working in a busy ward where sitting without doing anything is considered a mortal sin and there is a shortage in monoblock chairs. Cheap imitations are not only acceptable but v. wise buys indeed.

3. Hospital backers. It's not what you know but who you know. It's the absolute truth. Learn it, love it, live it. If you can.

2. Tons of trainings and seminars if unpaid work experience is not your thing. Fret not, young Florence Nightingales. There might be a non-existent demand for nurses in the country but there are endless opportunities in the land of Trainings and Seminars! From First Aid to BLS, ACLS, BST, ECG, PALS, ETC, WTF... You name it, they have it.

and the No. 1 Must-Have for a Newly Registered Nurse is..

1. SALARY. Twenty years and counting of being dependent on allowance given by parents. Is this ever going to end? Unfortunately, if you are a nurse, only time will tell.

Uniform Designs for Nurses (Traditional Whites vs. Technicolor Scrubs) 6 comments

There is one thing that all newly licensed RNs go through. It's like a coming-of-age, right of passage ceremony / ritual every young and excited nurse experience. After 4 long years of wearing a university mandated uniform, the world has finally proclaimed that, this time, we are equipped enough to decide... what to wear.

To tell you the truth it's not as simple as it sounds. Okay, for male nurses, maybe. Their uniforms all look the same to me anyways, although some metrosexuals opt for the Chinese collar style even though most of them resemble a Chinese as much as Vice-President Binay does.

I've seen good designs and frighteningly bad ones from RN friends, college classmates and random-nurses-commuting-to-work. However, when I tried to search for pictures of such so that I could give a copy to my seamstress, Google either gave me nurses in scrubs or some slutty Halloween/Fetish costume with a probable porn star as the model.

Unlike other countries which have stopped tormenting their nurses with having to wear boring whites day in and day out and opted for more comfortable I-come-in-all-shapes-and-color scrubs, here in the Philippines, we're still stuck with white. And not just white as a color but also white in stiff must-be-ironed-with-iron-fists type of cloth. I think only the most advanced (and expensive) hospitals have their RNs in scrubs. But for the rest of the country, scrubs are only for OR and Nursery.

I don't think it's a bad thing, though. I think white uniforms look more professional although scrubs are definitely easier to move in. The appalling thing about scrubs in this country is that almost everyone wears it. From manicuristas to yayas who follow toddlers around to people in spas to people in derm clinics who prick pimples off other people... it's hard to count them off one by one. So maybe, for the meantime, unless I get hired in one of those high story buildings with the names St. Lukes / Medical City / Cardinal Santos in it, I'm voting for the traditional whites.

Speaking of which, I have compiled a small pile of white nursing uniforms for those who are still looking for a design that would best fit them. I'm not saying all of them are good (actually, most are Bleh with a capital B) but they are all I've manage to find. Click on the image for a larger version.

Not a lot to choose from, I know. Three of them looks exactly the same and I'm not sure if two of the above are even allowed in certain institutions. Okay, maybe I am now leaning towards scrubs now. Expensive hospitals, hire me already!

Secret Lives of Nurses 17 comments

Do you notice them? The ones in all white uniforms. The ones you call whenever there are problems in the IV line, with the medications, the hospital bed, rationed food, in house TV. Leaky faucet? Flickering lights? They are the ones you come running to.

Because they're there. They are always there. To answer every call, every need, even though most of it are still little things that are way beyond their duties.

Irritated at the laboratory because it's taking forever for the patient you are looking after to be scheduled for an ultrasound? It's okay, there are always nurses at the station for you to get mad at. Furious at your doctor for being out of reach and unavailable at the moment to take care of pressing concerns? All is well, here are the nurses to absorb your unspecified anger.

Do you notice them? Do you really notice them?

Do you notice that most of them are taking care of you for free? Yes, without compensation. Would you work for a company without a salary? Of course, not. But they would. They are, in fact, working for minimum wage or no wage at all.

Do you notice that they are professionals? In every sense and definition of the word, they are professionals. Like CPAs, teachers, engineers, architects, lawyers and doctors. (Yes, like doctors. The ones you can't even raise an eyebrow at because they look so darn respectable in those white coats.) They all have licenses and certificates to prove how far they've come and how much they've accomplished. Don't they deserve something for their time and effort?

Their services might be free now but be assured that their education wasn't. The books, uniforms, bags and other equipments were definitely not. Not to mention four years worth of daily food allowance and transportation expenses.

Did you also know that they have to undergo a myriad of trainings and seminars to get to where they are now? Apparently, their college diploma, PRC license, board certificate aren't enough to meet the standards.

Are you aware that in government hospitals, the nurse-patient ratio can get up to 1 nurse to 30 patients? In fact, in some institutions, it is considered a norm. Even waiters cannot serve 20 tables efficiently all at the same time. How much more can they?

So please don't blame them if their primary goal in life is to get out of the Philippines and support their families from thousands of miles away. It's not their fault that it's pretty much impossible to live on nothing. Entry level nurses can volunteer all they want but doing so doesn't put food on the table.

How's that? Feeling a little respect for them now? You should. Just imagine a world without them and maybe you'll somehow get a gist on how it's really like for nurses. Because it's obvious that not a lot of people are aware of the current state of our health care system. All everybody can see and concentrate on are the patients (and Reproductive Health like pregnancy is the new AIDS and H1N1 virus combined).  

It's depressing how nobody remembers to take care of these people whose primary job is to take care of others.

So next time you or your relative is in the hospital, try to notice them, understand them. And maybe, hopefully, you'll appreciate them a little better.

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2010 PHILIPPINE BLOG AWARDS
Special Category – Post, Photo Post and Video Post and Podcast

FINALIST, Top Three Posts for 2010

PNA Trainings and Seminars for 2010 (July - December) 2 comments

PHILIPPINE NURSES ASSOCIATION, INC.
Committee on Continuing Education

INITIAL CPE OFFERINGS FOR 2010
July – December 2010

July 8-9 
BASIC EMERGENCY OBSTETRIC AND NEWBORN CARE (BEmONC)
8:00 am – 5:00 pm
Registration Fee:   1,650.00 php  members
1,850.00 php  nonmembers

July 9
DRUG PRINCIPLES AND COMPUTATIONS
8:00 am – 12:00 nn
Registration Fee:   400.00 php  members
500.00 php  nonmembers

July 16
ACUTE STROKE
8:00 am – 12:00 nn
Registration Fee:   400.00 php  members
500.00 php  nonmembers

July 19-22
ADVANCED CARDIAC LIFE SUPPORT(ACLS)
8:00 am – 5:00 pm
Registration Fee:   4,000 php

July 23
CARE OF PREMATURE INFANTS
8:00 am – 12:00 nn
Registration Fee:   400.00 php  members
500.00 php  nonmembers

July 30
METABOLIC SYNDROME
8:00 am – 12:00 nn
Registration Fee:   400.00 php  members
500.00 php  nonmembers

August 6
EASING THE ANGUISH OF ALZHEIMERS DISEASE
8:00 am – 12:00 nn
Registration Fee:   400.00 php  members
500.00 php  nonmembers

August 13
PATIENT SAFETY GOALS: WRONG SITE WRONG PATIENT SURGERY
8:00 am – 12:00 nn
Registration Fee:   400.00 php  members
500.00 php  nonmembers

August 16-19
ADVANCED CARDIAC LIFE SUPPORT (ACLS)
8:00 am – 5:00 pm
Registration Fee:  4,000 php

August 20
PREVENTING MEDICATION ERROR
8:00 am – 12:00 nn
Registration Fee:   400.00 php  members
500.00 php  nonmembers

August 27
UNDERSTANDING ASTHMA
8:00 am – 12:00 nn
Registration Fee:   400.00 php  members
500.00 php  nonmembers

September 3
HIV / AIDS
8:00 am – 12:00 nn
Registration Fee:  400.00 php  members
500.00 php  nonmembers

September 10
CORONARY ARTERY DISEASE
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers

September 17
END-OF-LIFE CARE: EASING THE TRANSITION
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers

September 20-23
ADVANCED CARDIAC LIFE SUPPORT(ACLS)
8:00 am – 5:00 pm
Registration Fee: 4,000 php

September 24
DIABETES MELLITUS, TYPE 2:WHATS THE BUZZ?
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers

October 1
BIOCHEMICAL TERRORISM
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers

October 8
HEPATITIS C: PREVENTION, ASSESSMENT & TREATMENT
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers

October 15
BLADDER MANAGEMENT AFTER SPINAL CORD INJURY
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers

October 18-21
ADVANCED CARDIAC LIFE SUPPORT (ACLS)
8:00 am – 5:00 pm
Registration Fee:  4,000 php

October 26-28
NURSES WEEK CELEBRATION
Venue: Manila Hotel

November 8-11
ADVANCED CARDIAC LIFE SUPPORT(ACLS)
8:00 am – 5:00 pm
Registration Fee:  4,000 php

November12
EMERGENCY CARDIAC CARE GUIDELINES
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers

November 19
CANCER CHEMOTHERAPY
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers

November 26
HEMODYNAMIC MONITORING: AN INTRODUCTION
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers

December 3
RESPIRATORY ASSESSMENT: ADULT AND PEDIATRIC
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers

December 6-9
ADVANCED CARDIAC LIFE SUPPORT(ACLS)
8:00 am – 5:00 pm
Registration Fee: 4,000 php

December 10
VENTRICULAR SEPTAL DEFECTS: EFFECTS, ASSESSMENT & TREATMENT
8:00 am – 12:00 nn
Registration Fee: 400.00 php  members
500.00 php  nonmembers




For further inquiries and confirmation, please contact
Mr. Nicole at tel. # 400-4430 / 521-0937 loc. 1006.

Venue: PNA Auditorium, Phil. Nurses Association,
1663 F.T Benitez St., Malate, Manila.

(First Come-First Served Basis, Limited Slots only)

NOTE: Scheduled seminars are subject for cancellation
without prior notice.

Source: PNA

IVT Training: More than just learning how to prick people correctly 10 comments

After almost exactly a year after taking my Nursing Board Exam, I enrolled at an IVT Training at a hospital near our home. Yes, the perpetual laggard is a laggard no more. Almost all of my friends (those who are not stuck in a call center) have already undergone the said seminar and I'd be lying if I said that I didn't feel left behind. Plus, being able to initiate an IV line to a person an interesting skill to have, not to mention lifesaving. Plus plus, most hospitals require the green IV Therapist card given by ANSAP.

So anyways, in a nutshell, I thought the 3 day seminar will going to consist of various techniques and procedures on how to choose and hit the vein correctly. Also, I expected that we will be given tips on how to manage common complications in an IV line, how to be an IV guru, so on and so forth. In short, I thought the sacred secrets of IV initiation and management, things that were never shared with us when we were in college because it is reserved only for the worthy registered ones, will be imparted upon us. Heck, no.

Because of my wrong expectations, that I was a bit bored with the training. For a day and a half, things we already know were reiterated in the lecture like functions of fluid in the body etc. etc. I found myself more interested in the lecturer's personal tales in the hospital and tips on how to get a job and NOT volunteer. 95% of the participants are registered bums. Ouch.

2nd day was the demo day. I was further disappointed with it because (grouped into 12) we were the one tasked to perform the procedures and demo it to the whole class. I think it would be proper if the proctors did the demo themselves so that we could learn more from it rather than have us watch fellow participants who don't know half of what they are doing. Just my 2 cents. The preceptors did correct wrong techniques and after major tiptoeing and squeezing myself between other participants to get a better view I finally learned the proper steps on initiating an IV line and administering medication through Heparin-lock that I never got when I was in college.

3rd day was return demo day. It was hot (Air conditioning 'broken' for the third day. Boo.) and toxic but we all survived. My one-on-one I-prick-you-you-prick-me session was weird. The preceptor was exceedingly helpful that she was technically the one who managed to insert the catheter into the vein and not me. I still got a perfect score though but felt as if I was still inadequate to do the job right. I definitely need more practice. Any takers?

Completion duty to go and all I have to do is wait for my ANSAP card. Hopefully, my schedule will not interfere with my training schedule for another hospital. Feels awesome to be a nurse again.

Philippine General Hospital Training (APCN) 19 comments

 PGH's 27th Batch Advancement Program in Clinical Nursing (APCN)

(6 Months Training Program)

QUALIFICATIONS (any of the following):

1. A recent graduate of the BSN program; or
2. With clinical &/or hospital experience for the past five (5) years
(2005-2010)

• May 18, 2010 Screening
• May 25, 2010 Qualifying Exam (Php 100)

REQUIREMENTS:

1. Letter of intent addressed to Ma. Rita Villanueva Tamse - Deputy Director for Nursing
2. Dean's Form (Available at DNET Office)
3. Photocopy of Transcript of Records
4. Certified True Copy of Board Rating
5. Authenticated copy of PRC License
6. Photocopy of PNA Membership Card
7. Qualifying Exam (To be scheduled upon submission of requirements)

FEE: P 10,000

For more information, please visit:
http://www.pgh.gov.ph/divisions/nursing-services/training

Lung Center of the Philippines Basic Skills Training for RNs 4 comments

Lung Center of the Philippines

Tel: 924-6101 loc. 270 and 385

BASIC SKILLS TRAINING Requirements

• Resume with latest picture
• TOR including Diploma and RLE Records
• Board Rating Certificate
• PRC License
• Certificate of Passing
• 2 pcs 1x1 picture
• Chest Xray and PPD c/o Lung Center
• Long Brown Envelope
• BLS Certificate and ID
• Must have undergone IVT Training

Registration Fee:

• 6,000 for 3 months
• 1 month lecture and 2 months practicum.

Just wanted to share with you all struggling unemployed colleagues. A friend underwent this training and from what she said, the 6k was worth it. Problem is, they have limited slots that easily fill up upon opening. Better be prepared for loads of other people fighting for a spot on the program.

PNA Seminars and Trainings for 2010 0 comments

PHILIPPINE NURSES ASSOCIATION, INC.

Committee on Continuing Education

January - June 2010

January 15 - Basic Infection Control Course
8:00 am - 5:00 pm
Registration Fee: Php 600 Member
Php 650 Non-Member

January 21 - International Job Opportunities at the
Doorstep of UK
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

January 22 - Pregnancy and Post Partum Care
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

January 25-28 - Advanced Cardiac Life Support (ACLS)
8:00 am - 5:00 pm
Registration Fee: Php 4,000

January 29 - Preventing Medication Error
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

February 5-6 - Nursing Skills Fair
8:00 am - 5:00 pm
Registration Fee: Php 1,500 Member
Php 1,700 Non-Member

February 12 - Asthma Today: Definition, Diagnosis
and Causes
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

February 19 - Easing the Anguish of Alzheimers Disease
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

February 22-25 - Advanced Cardiac Life Support (ACLS)
8:00 am - 5:00 pm
Registration Fee: Php 4,000

February 26 - Think before you Talk: Effective
Communication in the Workplace
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

March 5 - Patient Safety Goals:
Focus on Prevention of
Wrong Site-Wrong Patient Surgery
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

March 12 - Patient Safety Goals: Focus on
Patient Identifiers
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

March 15-17 - End of Life Nursing Education Consortium
8:00 am - 5:00 pm

March 19 - Care of the Premature Infants
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

March 22-25 - Advanced Cardiac Life Support (ACLS)
8:00 am - 5:00 pm
Registration Fee: Php 4,000

March 26 - Acute Stroke
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

April 2 - Coronary Artery Disease
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

April 23 - Chronic Obstructive Pulmonary Disease
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

April 26-29 - Advanced Cardiac Life Support (ACLS)
8:00 am - 5:00 pm
Registration Fee: Php 4,000

April 30 - Metabolic Syndrome
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

May 7 - Drug Administration Principles
and Computation
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

May 14 - Aspiration: Preventing a
Deadly Complication
in Vulnerable Population
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

May 21 - Marfan Syndrome: Inherited Disorder
has far Reaching Effectss
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

May 24-27 - Advanced Cardiac Life Support (ACLS)
8:00 am - 5:00 pm
Registration Fee: Php 4,000

May 28 - Pain and Its Management
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

June 11 - Bloodborne Pathogens
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member

June 18 - Influenza Update
8:00 am - 12:00 nn
Registration Fee: Php 300 Member
Php 350 Non-Member


(PRE-REGISTRATION IS REQUIRED 1 WEEK
BEFORE THE OFFERING)

Venue: PNA Auditorium
Philippine Nurses Association, Inc.
1663 F.T. Benitez Street, Malate, Manila

For further inquiries and confirmation, please contact
Mr. Nicole at tel. nos. 4004430 / 5210937 loc. 1006

NOTE: Scheduled seminars are subject for cancellation
without prior notice.

SOURCE: http://www.pna-ph.org/