Just got hired for my first job

I'll start this monday for my first job as a school nurse. The board exam result is still pending (release is on July 15). I was amazed they provided me this opportunity given the fact that I'm not yet a registered Nurse. Honestly, I don't care about the salary, all I'm after is the job experience. I made a promise to myself and my classmates that never should I include call center on my job list, over my dead body! No offense to call center agents. But, today, everyone is just studying to become a call center agent without realizing that the amount of hardwork you put on it only tantamounts the (large?) sum of money you are actually earning minus the abnormal sleep patterns.

Ten years from now, I'm seeing myself as a Community Nurse. Smiling on less fortunate children while giving them vaccines ( then posing for pictures afterwards, lol). Why would I work abroad if my fellow Filipinos are sick?(sounds self-righteous?). I don't want to work in a hospital setting. I mean, hospitals are just second on my list . You know, If the goal of nursing is preventive rather than curative, why would anyone spend more time alleviating illnesses rather than preventing it from occurring and promoting health in statistically probable areas. I'm sorry but for me and Dean Lopez, we believe that 90% of the patients are not in the hospital. They are in the community. They are our mother, father, brother sister brush your teeth. Seriously, If nursing in a 'real sense' actually abiding on it's principle about quality care then we would have reached our goals on decreasing morbidity and mortality rates. The problem is, the more expanded the nursing roles today, the complicated it gets. In order to achieve this, I need to pass the board exam in the soonest time possible so that I could reformat the Philippine health care system.

New Guidelines in BP Monitoring

(note: may only be applicable in Philippine settings )

Measuring and monitoring blood pressure are common knowledge to all nurses including those graduates from proprietary nursing schools and yet, is often performed incorrectly. To standardized the procedure,(especially in community settings where there is no Digital equipments available) the Philippine Society of Hypertension provided guidelines and was translated by the UP College of Nursing for Nurses. (It is published in the new Public Health Nursing book endorsed by DOH).

Common Errors:
1. Some obese people are incorrectly diagnosed with hypertension when in fact their blood pressure is actually normal. This false diagnosis is usually based on improper use of blood pressure equipment, namely using the wrong sized blood pressure cuffs.
2. Improper application of BP cuff (Ideally around the upper arm 2-3 cm above the brachial artery). Apply cuff snugly with no creases.

3. Arm is not within the level of the heart

4. Not rested at least 5 min prior to procedure.

5. The client has smoked or ingested caffeine 30 min prior to procedure.

6. Nurse has not applied his stethoscope.

120/80 is the usual format in recording BP, but do you know that in the new guideline they include the Korotkoff Phase IV sound? So, in recording, you have to document it as 120-80-76 format.

During procedure, while deflating, we listen for pulse sounds (Korotkoff sounds) through stethoscope. We know that the appearance of the first clear tapping sound is the systolic BP (Korotkoff Phase I) and we record it as the numerator. Note the diastolic BP (denominator), which is the disappearance of sounds (Korotkoff V) unless sounds are still heard near 0 mmHg. In which case softening/ muffling of sounds is noted (Korortkoff Phase IV).
Document Phases I, IV, V by following the format for recording BP:
systolic/ muffling/ disappearance (e.g. 120-80-76)

Every NURSING procedure has a corresponding rationale. I believe that this is created to lessen errors in BP monitoring. Because errors in measurement may mean wrong decisions in blood pressure management, thus compromising care.

It is VITALLY important that clients become more aware and assertive about correct procedure in BP measurement.Of course, it is also important to note that not all diagnoses of BP problems are all inaccurate that one should ignore their blood pressure readings or disregard any diagnosis of hypertension. Not at all! It is that diagnosis of blood pressure problems should be done on the basis of accurate data.

Best Mom and Nurse in Town

Her name is Beverly and she's the Best Mom and Nurse in town. I salute her for being strong despite all the struggles she had gone through when we were still kids. I remember when I was still young, I didn't want to go to school until highschool. I always wanted to go with her in the hospital where she worked, and she didn't force me to go to school. She knew deep inside that I will eventually have the confidence to face the academic world. This motivates me to become a Nurse just like her, even though she didn't force me to become one.

Right now, she has stopped practicing in the clinicals and decided to work as a clinical instructor in a nursing school. I always try to help her with teaching, but sometimes I'm too busy studying for the boards or blogging, perhaps.

Happy Mothers Day, Bevs.
This one's for you; the best mom in town!

The Price You Pay For Being A Professional

The service at the Professional Regulatory Commission (like most government agencies here in the Philippines) was horrible. I dreaded and almost fainted because of the scourging heat of the sun. PRC just doesn’t have enough staff to meet the increase of applicants. The queue was extremely long and if you are not entertained on that very day you will have to fall back on the same extremely long line on the next day. Not to mention the ordeal you had to go through of lining up early in the morning (like 3am) and waiting for almost entire day just to go through the application process.

The PRC predicted that 80,000 nursing applicants will take the licensure exam, compared to 43, 000 last year, they extended the registration until May 15 2007 not to mention the date of extension they gave to the June 2006 examiners who wanted retake.

The reason for the increase in the number of applicants filing for the boards this June is because most of the June 2006 passers wanted retake. Even though their retake is non-licensure in nature and will not affect the validity of licenses previously issued by the PRC, they are doing it so that they could take the CGFNS and apply for work abroad.

If ever should I fail the boards, I will not take PRC examinations ever again just because of this harrowing bureaucratic experience. Applicants surely deserve something better.

I'm out! I left the Bomb!