Origin of The Nurse’s Cap by Katie

As a pioneer of modern nursing, Florence Nightingale felt nurses should put forth a clean, professional image. The nurse’s cap is representative of this ideal. Not only did the cap keep the nurse’s hair tidy and out of the way, it was usually made of bleached white fabric and starched to maintain its shape while the nurse performed her duties.

Traditionally, a nurse was presented with her cap in a “capping” ceremony when she had completed her training. This indicated that she was capable of the job, and could be relied upon to maintain a professional appearance and demeanor during any medical crisis.

The nurse’s cap has become a symbol of prestige, representative of the honor and dignity found among all professional nurses.

The Medical Caduceus - Jewelry and Origins of the Symbol
By Janet Ashby

Caduceus jewelry is a popular gift for graduating nurses, physicians and veterinary students but do you know how this symbol came to be used by medical personnel? The Rod of Asclepius is a more appropriate symbol for medicine and medical organisations but the caduceus is also used, although, unlike the Rod, it has no medical significance. In fact, just the opposite as the symbol is associated with Hermes, god of the market place and travel, of the cunning of thieves and liars, who was a patron of commerce and generally associated with mischief as a deified trickster. He was also the conductor of souls to the underworld so the use of his symbol for medicine is particularly inappropriate.

The Rod of Asclepius
The more correct symbol is the Rod of Asclepius which is a walking stick or staff entwined by a serpent. Asclepius is the god of medicine in the Greek mythology and his daughters were Hygieia, Aceso, Aglea, Meditrina, Iaso, and Panacea who symbolise medicine, cleanliness, and healing. Panacea means literally ‘all healing’ and is a familiar word in modern English. Asclepius was the son of Apollo and Coronis and was raised by a centaur called Chiron after his mother was killed for unfaithfulness. Chiron taught Asclepius the art of medicine.
In Ancient Greece, around 300BC the cult of Asclepius was popular and his healing temples were called Asclepieia. Snakes were used in the healing rituals and non poisonous snakes freely crawled around the temples. The Oath of Hippocrates originally began with the words ‘I swear by Apollo the Physician and by Asclepius and by Hygieia and Panacea and by all the gods …”

The Caduceus
The caduceus is usually depicted as a herald’s staff with two entwined serpents and very often a pair of wings. Originally the staff was carried by Iris who was the messenger of Hera. Only in later myths was it borne by Hermes. It may be the basis for the astrological symbol for Mercury, who was the Roman equivalent of the Greek Hermes. It is often used as a symbol for medicine especially in the United States. Why is there confusion between the Rod of Asclepius, an appropriate symbol for medicine and the caduceus which is inappropriate, associated as it is with Hermes, patron of thieves and tricksters and conductor of the dead to the underworld?

The Use of the Caduceus by Medical Personnel
It appears that it was used mistakenly instead of the Rod of Asclepius in the nineteenth century. It was first used as a medicine symbol around 1856 in the US on the uniforms of army hospital workers and was worn by medical officers from about 1902. The Surgeon General noticed the error a few years later but did not change it. The name is thought to come from a Periodical of military medicine called La Caducée and it was used by the Navy Hospital Corps and the Army Medical Department after the first world war. Although the American Medical Association used the caduceus for a time it was replaced by more correct symbol for medicine, the Rod of Asclepius, in 1912.

Modern Use of the Caduceus in Jewelry
Nowadays caduceus jewelry is popular especially among nurses and it is available as a charm for bracelets or a pendant or necklace. A medical caduceus is a popular gift for graduating students whether nurses, physicians or veterinary personnel. One theory of why the caduceus, rather than the Rod of Asclepius, is more popular is because it simply looks better!

Article Source: http://EzineArticles.com/?expert=Janet_Ashby

**pulled from thetowntalk.com and written by Karina Donica

‘N’ is for nurse: Local nurses use profession to teach students the alphabet

Four-year old Katie Smith from Alexandria Country Day had a good experience at the nurse’s station Thursday.

She was having so much fun in fact that now she believes she would like to be a nurse when she grows up — after all, it was a nurse who saved her stuffed bunny’s life.

“She got bitten by a shark,” Katie said with a smile holding her bunny’s leg, where a nurse had just put a large Band-aid to help the stuffed bunny heal.

The nurse was part of a team of registered nurses from Rapides Regional Medical Center, who came to the school as part of a unique educational activity to help the children learn about the letter N.

Since the year began, Katie and some 55 other pre-kindergarteners from the school have been learning about the alphabet.

All last week was dedicated to the letter N, such as “N for nurse,” explained Stephanie Neal, a pre-k teacher at the school.

Neal said that pre-k level children retain information better by actively engaging in the learning process. Having nurses visiting them not only put a smile on the children’s face but it is the type of activity they will remember, she said.

The nurses gave the children nurse hats and coloring books.

“We’ll do a little first aid on the bears and teach the kids about what it is to be a nurse,” said Karen Hathorn, Rapides Regional education director, as the children sat in holding their teddy bears, dolls and other stuffed animals.

“Who are they?” a teacher asked the children during the introduction. “Nurses,” the children said in unison. “And what do nurses do?” she asked. “Take care of patients!” the children answered.

The team of nurses, from Rapides Regional’s education resources, took the opportunity to teach children about their job.

They sat on the floor with the children and gave them a small demonstration on some of their routine work tools including stethoscopes, thermometers, and plenty of Band-aids.

“Can I use it, too?” Connor Noland asked Vanessa Graves, one of the nurses, as she helped Jack Melton, another pupil, listen to her heart using the stethoscope.

Hathorn said many children are afraid of nurses because they quickly relate them to getting a shot at the doctor’s office. Some of them are more afraid of a nurse than of a doctor, she said.

“So we want to help them realize that nurses are there to help them feel a little better,” Hathorn said, who has been a nurse for 34 years. “It’s just a good community awareness activity.”

At the end of the activity, the children got some candy for being N-ice

Tylenol Arthritis Caplet voluntary recall expanded

Pulled from Yahoo health news

NEW YORK – Johnson & Johnson is expanding a voluntary recall of Tylenol Arthritis Caplets due to consumer reports of a moldy smell that can cause nausea and sickness.

According to a statement posted to the Food and Drug Administration Web site late Monday, the New Brunswick, N.J., company is now recalling all product lots of the Arthritis Pain Caplet 100 count bottles with the red EZ-Open Cap.

Johnson & Johnson had recalled five lots of the product last month after consumers complained of a musty, mildew-like odor that triggered nausea, stomach pain, vomiting and diarrhea.

The health care company said the odor results from trace amounts of a chemical called 2,4,6 tribromoanisole. That chemical is believed to result from the breakdown of another chemical used to treat wooden pallets that transport and store packaging materials.

To date, the side effects, which also include vomiting and diarrhea, have been “temporary and non-serious,” although the health effects of the compound have not been studied.

The recall only affects the specific lots cited. All other Tylenol Arthritis pain products remain available.

The company will reintroduce Tylenol Arthritis Pain Caplets 100 count by January after moving production to a new facility.

J&J’s McNeil consumer health care division sells a range of over-the-counter medicines, including cold reliever Sudafed and the antacid Mylanta. The unit posted $16 billion in sales in 2008, according to J&J’s annual report.

Consumers seeking a refund or replacement can call J&J at 1-888-222-6036.

Company shares rose 38 cents to $65.32 in morning trading Tuesday

What does teamwork mean to you?

To me, teamwork has always meant that everyone should be working together to achieve the same goal. In nursing there are not only other nurses that are part of the team but also ancillary staff, doctors, social workers, and dieticians.

The hospital that I am working at now has a big problem with teamwork. It is particularly a problem for the nurses and the nursing attendants. The nursing attendants do not take the initiative at all. They have to be asked to do things that should be just part of their routine. Examples of this are setting up rooms for admissions and assisting transport in getting the patient into the bed.

At this particular institute, the nursing attendants will set up the rooms if you ask them. On occasion they will set up the room if the unit secretary asks them. However, once they know a patient is coming they seem to disappear so they are not available to get the patient in the bed. Patients end up waiting in the hallway sometimes while the unit secretary is trying to locate the nurse (who is usually busy in another patient’s room).

Since I am a travel nurse at this location I speak up very frequently to the charge nurse or the manager (who is new). I have asked the unit secretary on numerous occasions why she didn’t call the nursing attendant to get the patient settled in bed. The response I usually get is that they don’t want to get into a fight with the nursing attendant. There is such a poor work ethic among the ancillary staff that it makes it very unbearable for the nurses.

I have seen on many occasions nurses asking nursing attendants to do a task and they either don’t respond, don’t get up, or give the nurse an attitude. The next thing I have witnessed after that is the nurse going to do the task herself. I try very hard not to do the task myself unless I have nothing else to do.

My feeling is that if you keep doing things for everyone they will never change and do what they are asked to do. I have spoken to the manager and supervisor on several occasions and they both have told me that the nurses need to write these incidents down and submit them to the manager or nothing will ever get done to change anything. When I have spoken to the nurses about it some of them say that they don’t want to do that because it will only make their lives worse at work. My response to that is how much worse can it get. This is absolutely the worst hospital I have ever worked at as far as a lack of teamwork.

I think that many of the members of the ancillary staff think that when they see nurses charting they think we are not doing anything. They don’t realize that we have a lot of documentation to do in addition to the patient care that they see us doing. Several of the nursing attendants and unit secretaries are in nursing school and will therefore have a rude awakening if they encounter ancillary staff with the work ethics that they have here. Please remember that it takes more than one person to make any necessary changes.

Rainbow

I was so tired driving to work a couple days ago. I’d worked three straight evenings in a row, had one day off, and had worked a 12 hour shift the day before. I was driving in with the grim prospect of another 12 hours, and if the previous days were any clue, I would be busy. My feet hurt just thinking about it.

It was blustery in the morning, with gusts of wind, and clouds dancing quickly across the sky. Occasional bursts of rain completed the picture. I grumbled to myself as I began my drive, wishing for the umpteenth time that I’d had a reason to call in sick.

The construction at the end of my street made for a bumpy ride and my coffee spilled all over the cup holder, barely missing my new white pants. As I was negotiating a turn, and trying to keep the remnants of my coffee in the cup, my bag fell off the seat, spilling all over the floor. I had a tin of mints in the bag and they opened in the fall, scattering all over the floor. More grumbling and likely a few inappropriate words escaped me as I navigated my car.

When I finally got on the expressway the rain began in earnest and I had to drive slower than usual. With one eye on the clock and a careful foot on the gas pedal, I turned on the radio, hoping that a blast of music might improve my mood. It seemed that there were commercials on every station. I turned the radio off in frustration and reached for my coffee, only to discover that there was barely a sip left in it, and that one full of coffee grounds.

Sighing, I tried to let the road absorb my grumpiness.
The rain started to clear a mile or so later and all of the sudden, a blinding flash of light revealed a gorgeous sunrise to my left. I smiled, feeling some of the angst draining out of me.

The light didn’t last long, as another cloud raced across the sun, obliterating it momentarily. I slowed the car, bracing for another round of rain but instead it was just a light pattering of drops. The cloud moved from the sun again and I was gifted with a most beautiful rainbow, just in front of me. It seemed to arc over the road. I tried to figure out how the sun in the position it was in could possibly cast the rainbow where it did, but logic dictated that it couldn’t. I sighed, smiled, and gave up questioning. I took a deep breath and enjoyed the glorious colors in the sky and the sight of the world freshly washed and drying in the sun.

As I exited the expressway and turned towards the hospital, the rainbow faded from my view. I breathed a silent ‘thank you’ to the universe and entered the parking garage, finally ready to face my day.

Learning about Oneself.

This month I started my leadership classes. For the first session we did a very interesting activity called DISC. DISC is s ‘style analysis tool’ that helps you learn how you react to situations and your overall style of handling problems and challenges. At the end of it, you find out which type you are of the 4 available and you also see where you score on the other types. ( D=dominance, I=influence, S=Steadiness, C=Conscientiousness)

It shows you how you react naturally, (such as your reactions at home) as well as how you’ve learned to react (such as your workplace reactions). It gets pretty in-depth after that, about what role you would play in a group (for example, I am a natural supporter and an adapted coordinator). After that, we broke off into groups of each type and were told to draw a picture describing our type. It was a lot of fun and I learned a lot about myself.

I found out I am very high S and a very low D naturally, and that I am a high S and equally high C with a very low D adaptively. I encourage anyone who is interested to look into it further.

You can find more info here: http://en.wikipedia.org/wiki/DISC_assessment

Who should float first?

Does anyone have problems at their facilities with determining whose turn it is to float? Some hospitals use float books to keep track of who floated last and therefore whose turn it is when the time comes. There are hospitals, particularly those that are unionized, who have policies in place about floating. The other issue is where a person can float to.

I am working at a hospital that is unionized and therefore the policy with them is that anyone who has worked there over 17 years does not float anymore. As a traveler I find that I am one of the first people to be floated along with per diem nurses. What happens when a traveler and a per diem are both working and someone needs to be floated to another unit. How should it be determined?

Let me explain what I am referring to. Both nurses, the per diem and the travel nurse, were inexperienced with the A-line that the patient had. When the per diem was sent to the unit she got out of working there by saying that she was not comfortable taking care of an A-line due to lack of experience. She was send back to the unit she came from and then the travel nurse was sent in her place. The traveler was also inexperienced with the A-line. The nurse in charge decided that the nurse who would be working in the same area would take care of the A-line so that the travel nurse could stay with the assignment.

The traveler was okay with this but wondered why the other nurse had made a big deal about it and refused to stay. I did forget to mention that it was the travel nurse’s first day off of her very short orientation. I guess that is the role of the travel nurse….to fill in where needed.

Any thoughts on this matter?

RI tracking swine flu through electronic records.

***pulled from The Boston Globe and written by Eric Tucker

PROVIDENCE, R.I.—State health officials are tracking the spread of swine flu through electronic prescription records, developing what they believe is a model that could help doctors more easily identify and respond to an outbreak of the illness.

Rhode Island is believed to be the first state to use electronic pharmacy prescription data to track swine flu among its entire population, said Rob Cronin, a spokesman for Surescripts, which operates the country’s largest electronic prescriptions network. The company says it believes the state is also the first to have all of its pharmacies set up to receive electronic prescriptions from doctors.

Surescripts is using information supplied by pharmacies to document how much Tamiflu and other antivirals are being dispensed to patients. The company is giving the data — categorized by zip codes of the pharmacies where the medicine is dispensed and the age group of the patient receiving it — to epidemiologists at the state health department.

“This is a harbinger of capacities and abilities to come,” said Laura Adams, president and chief executive of the Rhode Island Quality Institute, which works to improve health care in the state. “This is very important for us in terms of being able to stop something sooner rather than later.”

The tracking initiative is being formally announced Monday by Gov. Don Carcieri.

The data is intended to show which communities are experiencing outbreaks or are hardest hit. But it can also reveal cases in which the medicine may be inappropriately or overzealously prescribed if, for instance, large numbers of prescriptions are dispensed in places where no uptick in cases has been reported.

President Barack Obama has declared the swine flu outbreak a national emergency. Health authorities say more than 1,000 people in the United States have died from the strain known as H1N1, and 46 states have widespread flu activity.

Rhode Island health director David Gifford has reviewed electronic prescription data from recent months, and the company says it now plans to give the state weekly data.

“It’s a new tool in the tool bag,” Gifford said. “This isn’t a larger hammer or a larger saw. This is like, ‘I had a hammer and saw and now I have a screwdriver.’”

There have been some other efforts beyond pharmacy prescriptions to track swine flu. Health agencies in places including New York City have used high-tech tools called syndromic surveillance systems — seen as especially useful after the Sept. 11 terrorist attacks to monitor for bioterrorism — to collect data from hospital emergency rooms.

New York City health authorities have also in recent years tracked over-the-counter pharmacy sales to detect outbreaks of flulike or gastrointestinal illnesses.

And after Hurricane Katrina in 2005, doctors were able to tap into a specially created Web site to access prescription histories for displaced Gulf Coast residents on whom they had no medical information.

But Cronin said he knew of no other statewide effort to track swine flu through electronic pharmacy prescriptions. The fact that all of Rhode Island’s pharmacies are connected to an electronic prescribing network made it a natural place for Surescripts to roll out the initiative, which could be expanded to other states if successful here.

“If you have 100 percent of pharmacies, this system is going to be much, much more valuable to you than if you have 60 (percent),” Cronin said.

Surescripts currently receives swine flu data from about 80 percent of Rhode Island’s pharmacy locations but expects to boost that to 100 percent as soon as possible, Cronin said.

Andrew Pekosz, an associate professor of microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, said it makes sense to give states another vehicle for monitoring the illness, but cautioned that there could be inherent gaps in the data.

Assuming, for instance, that doctors are following federal guidelines and being conservative in their distribution of Tamiflu, the data could potentially underreport the actual number of people sick with flu, Pekosz said. Also, the numbers alone may not reflect how long the person took the medication or whether the patient it was prescribed for is ill or merely lives in a house with someone who has flu.

“You’ll know that a physician felt strong enough that that person had influenza to give them a prescription,” Pekosz said. “One doesn’t know if that person then followed through in taking it appropriately and those kinds of things.”

One of those Days

Yesterday we had one of those weird days, where things just seem somewhat off. Maybe I should have checked the moon phase before going in…

It seemed like we were seeing many people we’d seen before, and for the same things they’d been seen for already. Ok, so it’s an emergency room, and we do have people who tend to use us as their PCP. Sometimes, though, it seems like treading water, or like there is a looped-repeat of the discharge instructions:

“Please follow up with your PCP.”

“Please be sure to follow the correct diet to control your diabetes/pancreatitis/GERD/gallstones.”

“Please follow up on that blood pressure.”

“Please remember to keep your follow up appointment at (name your specialty).”

Sometimes I am like a broken record, repeating the same phrases over and over.

I’m all about educating patients and I love being able to talk with someone and really teach them about their body and illness/disease process. It’s a huge part of nursing and a part I really like. It gets frustrating when I am telling the same people, the same things. And I have said to more than one person that they NEED to start following through because the next time they might come in to the acute ED instead of the urgent ED, and then it might be too late.

When I look into the waiting room and I know the first names of several of the patients out there…and they know mine….I know it’s going to be one of those days.