NursesNotes

Easier said than done

After the nice drive yesterday, seeing a couple of bald eagles and some hawks soaring overhead, it was back to the grindstone today. Mondays always leave me kind of blah. All my palliative beds are full, all four of my dedicated AIDs beds are full, my respite beds are full, my extended/continuing care unit has a waiting list. Of course the B likes this; it makes her look good to the head honchos in the hospital's upper echelons. If the beds are full, they are making money and all must be well. I have the philosophy that if my beds are EMPTY, we are doing a good job, maybe I just don't understand the BUSINESS of medicine!! Of course, if my beds were really empty I would not have a job!!! :(
BTW, it was cafeteria food for "HER" today, and the wind was blowing from the North Pole!!! must have been fight night USA all weekend or the little blue pill did not do it's job. :)

I have been thinking about my last couple of posts, and have decided that it is up to me to erase hated, where I can. I can only start in my own home, with my own family, so that's where I will start. We will not tolerate any sense of disrespect towards other people from now on, and if any of the bloggers sense me getting disrespectful, please let me know!! From here I can only hope it will spread out, like ripples in a pond and will gather momentum. If all the children's friends can join us, perhaps we stand a chance to erase intolerance and disrespect during their lifetime.
I prayed yesterday, in church, for the intolerant and the ignorant. May they one day see the beauty of the world around them and try to help one other person, rather than harm another.
Easier said than done, I know, but it's so worth a try.

Thanks, folks!!! mmmmuuuuuuhh!!

Thank you to all of nursenancy's readers who were as shocked and upset as I was about the comments to me left by an "outside user" on DianneMaries blog. I don't know when I have seen such garbage, written or spoken. It says a lot about society in general. What were these people's parents doing while they were growing up? Obviously not much of anything, except speading more of their vindictive hatred. Hate begets hate, and we have had an example of it here this weekend.
On the other hand, we had a great time today visiting some of our friends over in another town. We saw two American bald eagles while we were driving through a farming area. Neat!!

now I KNOW I'm going to be sick

This is to NurseNancy's regular ( nice, clean) readers. I apologize in advance for the vituperative , threatening slander on this blog. I am immediately going to let the system adminstrator know about this slagging, but just so we are all aware, these people likely do exist in our country. How scary is this? I'm sorry to say that I live on the same planet as this beast. I'm also sorry that s/he did not avail her/himself of the free public education available to everyone in the country. Obviously, there is no comprehension that people like DOCTOR Condoleeza Rice has more knowledge in her baby finger than this idiot has in his/her entire body, which is likely a skin headed one, wearing Doc Martins. All I can say is that this bloggers negative tooth to tattoo ratio is probably pretty high. Give everyone a break and try out for a Darwin award, doofus. At least please do not reproduce. Those of us who are law abiding, tax paying, WELL EDUCATED citizens shouldn't have to share air with you or any of your progeny.
These comments were addressed to me, NurseNancy, on DianneMarie's blog, where I left a comment. Can you believe the hatred? I will leave this on for a few days then delete.

I HAVE NOW DELETED THE HATRED.

So there you have it. NurseNancy received racial slurs and insults. I also see a threat to harm people in this blogger's diatribe. What an idiot. What can I say? I hope you never show up on my unit in my hospital, jerk, I might have to save your sorry excuse for a life. Because that is what I do. I don't randomly want to hurt or harm others. I want to help and heal them. That's why I went to university. ( yes, there are grades past the third, chump)

Ohhh, I think I'm going to be si.......whooop!

Some people are calling in sick to school or work with the "stomach FLu" Well, NurseNancy is here to tell you that this is not the "Flu", it is a different viral illness called Viral Gastroenteritis. All this info is from the www.cdc.gov web site.
Dear ol' Mozilla doesn't like links, pics etc. so you'll have to check it out yourself!!

So, just what is viral gastroenteritis?

Gastroenteritis means inflammation of the stomach and small and large intestines. Viral gastroenteritis is an infection caused by a variety of viruses that results in vomiting or diarrhea. It is often called the "stomach flu," although it is not caused by the influenza viruses.

What causes viral gastroenteritis?

Many different viruses can cause gastroenteritis, including rotaviruses, adenoviruses, caliciviruses, astroviruses, Norwalk virus, and a group of Noroviruses. Viral gastroenteritis is not caused by bacteria (such as Salmonella or Escherichia coli) or parasites (such as Giardia), or by medications or other medical conditions, although the symptoms may be similar. Your doctor can determine if the diarrhea is caused by a virus or by something else.

What are the symptoms of viral gastroenteritis?

The main symptoms of viral gastroenteritis are watery diarrhea and vomiting. The affected person may also have headache, fever, and abdominal cramps ("stomach ache"). In general, the symptoms begin 1 to 2 days following infection with a virus that causes gastroenteritis and may last for 1 to 10 days, depending on which virus causes the illness.

Is viral gastroenteritis a serious illness?

For most people, it is not. People who get viral gastroenteritis almost always recover completely without any long-term problems. Gastroenteritis is a serious illness, however, for persons who are unable to drink enough fluids to replace what they lose through vomiting or diarrhea. Infants, young children, and persons who are unable to care for themselves, such as the disabled or elderly, are at risk for dehydration from loss of fluids. Immune compromised persons are at risk for dehydration because they may get a more serious illness, with greater vomiting or diarrhea. They may need to be hospitalized for treatment to correct or prevent dehydration.

Is the illness contagious? How are these viruses spread?

Yes, viral gastroenteritis is contagious. The viruses that cause gastroenteritis are spread through close contact with infected persons (for example, by sharing food, water, or eating utensils). Individuals may also become infected by eating or drinking contaminated foods or beverages. ( NN note....Norovirus can be spread via the airborne route,too,via contaminated items. The virus lands on something, someone touches it and then sticks their fingers in their mouths, and voila!, puke, poop, puke, poop!!)
SO, WASH THOSE HANDS, AND USE THE ALCOHOL SANITIZERS,PPL!!!!!

How does food get contaminated by gastroenteritis viruses?

Food may be contaminated by food preparers or handlers who have viral gastroenteritis, especially if they do not wash their hands regularly after using the bathroom. ( How charming!):(
Shellfish may be contaminated by sewage, and persons who eat raw or undercooked shellfish harvested from contaminated waters may get diarrhea. Drinking water can also be contaminated by sewage and be a source of spread of these viruses.

Where and when does viral gastroenteritis occur?

Viral gastroenteritis affects people in all parts of the world. Each virus has its own seasonal activity. For example, in the United States, rotavirus and astrovirus infections occur during the cooler months of the year (October to April), whereas adenovirus infections occur throughout the year. Viral gastroenteritis outbreaks can occur in institutional settings, such as schools, child care facilities, and nursing homes, and can occur in other group settings, such as banquet halls, cruise ships, dormitories, and campgrounds. ( really puts a fun spin on a lot of this stuff, right?)

Who gets viral gastroenteritis?

Anyone can get it. Viral gastroenteritis occurs in people of all ages and backgrounds. However, some viruses tend to cause diarrheal disease primarily among people in specific age groups. Rotavirus infection is the most common cause of diarrhea in infants and young children under 5 years old. Adenoviruses and astroviruses cause diarrhea mostly in young children, but older children and adults can also be affected. Norwalk and Noroviruses are more likely to cause diarrhea in older children and adults.

How is viral gastroenteritis diagnosed?

Generally, viral gastroenteritis is diagnosed by a physician on the basis of the symptoms and medical examination of the patient. Rotavirus infection can be diagnosed by laboratory testing of a stool specimen. Tests to detect other viruses that cause gastroenteritis are not in routine use. ( NN note...Norovirus is a small round virus and is very commonly identified as the source of an outbreak)

How is viral gastroenteritis treated?

The most important of treating viral gastroenteritis in children and adults is to prevent severe loss of fluids (dehydration). This treatment should begin at home. Your physician may give you specific instructions about what kinds of fluid to give. CDC recommends that families with infants and young children keep a supply of oral rehydration solution (ORS) at home at all times and use the solution when diarrhea first occurs in the child. ORS is available at pharmacies without a prescription. Follow the written directions on the ORS package, and use clean or boiled water. Medications, including antibiotics (which have no effect on viruses) and other treatments, should be avoided unless specifically recommended by a physician. (NN note: Always check with a physician before taking antibiotics for diarrhea, you could really do a number on yourself if you self diagnose and decide to take antibiotics with out a lab test- not something we can normally do in North America, but in some countries one can purchase all kinds of antibiotics, vaccines etc. over the counter!!))

Can viral gastroenteritis be prevented?

Yes. Persons can reduce their chance of getting infected by frequent handwashing,:) prompt disinfection of contaminated surfaces with household chlorine bleach-based cleaners, and prompt washing of soiled articles of clothing. If food or water is thought to be contaminated, it should be avoided.

Is there a vaccine for viral gastroenteritis?

There is no vaccine or medicine currently available that prevents viral gastroenteritis. A vaccine is being developed, however, that protects against severe diarrhea from rotavirus infection in infants and young children.


So Wash, Wash and Wash some more!!! Carry alcohol sanitizers with you. Purell is popular.
Nurse Nancy wants you all to stay healthy!!! :)

Is it a Cold or is it the Flu?

Is It a Cold or the Flu?

OK, by now some people are suffering from influenza. How do you know it is true influenza as opposed to a really, really bad cold? Well, NurseNancy is here to tell you....
and BTW, there is EXTRA vaccine available and it is not too late to get a flu shot!! See your health care provider. This was a nice chart that did not translate well onto my Mozilla browser, oh well all the info is there. Just ask Nurse Nancy if you need to know more!! And ,folks, puking is not a sign of the "flu". It is a separate illness called gastro enteritis and I will post about it and the common cause,Norovirus, sometime soon. Yay!! Vomiting!! Diarrhea!! hoohoo so much to look forward to!!


SYMPTOMS of COLDS vs: FLU
Fever cold-Rare flu-Characteristic, high
(102-104°F); lasts 3-4 days
Headache cold-Rare flu-Prominent
General Aches, Pains cold-Slight flu-Usual; often severe
Fatigue, Weakness cold-Quite mild flu-Can last up to 2-3 weeks
Extreme Exhaustion cold-Never flu-Early and prominent
Stuffy Nose cold-Common flu-Sometimes
Sneezing cold-Usual flu-Sometimes
Sore Throat cold-Common flu-Sometimes
Chest Discomfort,
cold-Cough Mild to moderate;
flu-hacking cough Common; can become severe

Complications
Sinus congestion or earache
Bronchitis, pneumonia; can be life-threatening

Prevention
cold-None flu-Annual vaccination; amantadine
or rimantadine (antiviral drugs)

Treatment
cold-Only temporary relief of symptoms
flu-Amantadine or rimantadine within 24-48 hours after onset of symptoms

SOURCE: The National Institute of Allergy and Infectious Diseases, April 2001.

A Healthy Bladder is a Happy Bladder!!

To keep your bladder healthy, follow a few simple rules:


Drink enough liquid: 3-4 pints - about 2 litres - per day, more in hot weather or if you have been exercising. If your problem is having to get up at night, cut down on how much you drink in the evening - but not overall.

Relax! Don’t strain to empty your bladder or bowel. Women should sit down on the toilet, not ‘hover’ above it.
( NurseNancy suggests toilet seat covers for public washrooms)

If your bladder is giving you problems, cut down on alcohol and beverages containing caffeine (tea, coffee and many fizzy drinks), which may make the difficulty worse. If you often suffer from cystitis (urine infections), try drinking cranberry juice, which has been proved to prevent these attacks.

Never go to the toilet ‘just in case’. Go only when you really need to. But try to keep bowel movements regular and avoid constipation.

Know when you should get help. If you leak, feel pain when you empty your bladder, or find blood in your urine, see your doctor or nurse. NurseNancy has "nurse's bladder" which is the bladder capacity of two camels, so she knows and understands about bladder issues!! :)

Validation but not necessarily vindication!!

NurseNancy actuallly feels better today. I managed to get some validation for what I do from some colleages and some of my patients and their families. Thank goodness for some reasonable people in the world!!
"Her" secretary was on "high alert" today, the wind was really blowing in icy and cold, even worse than yesterday. "She" even admited to being in a "vile" mood.... The only blessing in all this is that she is slated for promotion TO ANOTHER SECTION!!! IS THAT F'ING GREAT OR WHAT!!!!!!!!
What she did:
She sanctioned me for something I did but did it at the lunch table in the cafeteria in front of her secretary and the IT guy. I don't appreciate being scolded for something that she told me to do in the first place, and I even like it less when it happens in front of other employees. A pox on her and her house!!!
Today my colleagues were all very supportive ( except for the one who has her nose up the beech's butt, but I digress.....)

I'm sure I'm not the only one who works for a difficult, prima donna boss, but man it gets tired quickly!! All I can think is that the husband ran out of his prescribed medication and she had to do "without" last weekend!!! :) Some things are just so worth getting in trouble for!! :):)

My boss is the beech of the year.

NurseNancy is upset today. The Beech Boss was in fine form today and made NurseNancy very depressed.
What she did was extremely demeaning to me, but I will blog about this later, when I no longer feel like killing someone.

For now though, I have a glass of Merlot awaiting me!! :)

Snow day

Well the official tally of inches is around 19, but in my neighborhood it has blown and drifted. :(
Some parts of the yard have about six foot drifts. My driveway is a mess, about 4 feet there. errgg. MrNurse is getting someone to come with a plow to plow it all out. We are both probably going to take a snow day and stay home with the kids.

Happy shoveling to everyone here in the New England/East coast region! It is pretty, though! :)

The Trip to the Doctor- the NittyGritty

So, now NurseNancy has shared information about WHY guys should check their "boys" REGULARLY, HOW to do the deed, What to LOOK FOR, and now for my last post in this series, what the doctor will probably do if you find any lumps. So here's the lowdown, the nittygritty of what your doctor will probably do, if you do find a lump.

If you exhibit any of the telltale signs from yesterday's post, then go directly to your doctor. If you're a student, then a trip to Student Health works just as well. Hey, these are your testicles we're talking about. And while it's true that most abnormalities found during a TSE turn out to be benign, do you really want to risk losing your balls-or your life-simply because the doctor's office gives you the jitters? NurseNancy doesn't think so.

* In most cases, a TSE-prompted visit to the doctor will include a physical exam very much like the TSE itself, except conducted by the physician.

* If the doctor shares your suspicions, then the next step is usually an ultrasound of the testicle-in-question. An ultrasound is a very hi-tech, very expensive machine that uses sound waves to look inside your scrotum and take snapshots. Doctors look at these images and try to determine whether or not the bump is a solid tumor or just a fluid-filled cyst.

* If the bump isn't a cyst and looks threatening, then the doctor may also order a blood test to check for "cancer markers" in your bloodstream. These markers are just proteins that are byproducts of a testicular malignancy; they won't hurt you, but they'll usually blow your cancer's cover.

* If all signs point to still point to cancer at this point, then the physician will usually recommend a radical inguinal orchiectomy. In other words, you will probably have to lose the afflicted testicle. But hang tough (if not a little to the left): If the cancer is localized, then the procedure shouldn't really change your life in any noticeable way. One testicle in your sac will make more than enough gametes to pass on your original family recipe of As, Cs, Ts and Gs. And though you might find sex a little awkward at first, rest assured, your prowess in the other sack shouldn't decline in the least. There are even saline prosthetics available to make you feel more like your old self. ;)

In the event that the cancer has already spread out beyond the scrotum, the treatment becomes more involved. The longer you ignore cancer, the more likely you are to have to face chemotherapy or radiation treatments to kill off the cancer cells.

So you're out of excuses. For more information, check out these resources:
American Cancer Society: 1-800-ACS-2345 (24 hour hotline)
National Cancer Institute:

1-800-4-CANCER (Cancer information service)

Remember, NurseNancy is here for you! :)
She wants all of you to stay healthy. She does not want to meet you at work!!

Testicular Self Exam: What hides beneath?

Ok, guys, here's NurseNancy's nittygritty information. What to look for when your 'manberries', your 'crown jewels', the 'boys' are in your hands.....The real idea behind the testicular self-examination is to establish a good degree of familiarity with your testes. It's important to know your scrotum well enough to notice any changes that seem suspicious. Here are a few dependable signs that suggest something shady is going down, down below:

* Hard lumps. Rock-hard lumps on the testicles can vary in size from a pea to a golf ball. These abnormal lumps will often feel as hard as bone and will almost always be present on only one testicle. It's very common for Joe Sixpack to mistake a harmless, congenital cyst for a malignancy; that's because it's impossible to tell the difference between the two during a TSE. It's best to let your doctor decide by using more sophisticated tests (See tomorrow's post).

* Tenderness or general discomfort. A tender testis is rarely a sign of cancer, but anytime your testicles hurt without being bumped, it's a good idea to have them checked out by a doctor. Cancer-related testicular pain is usually associated with some bleeding, but an overly sensitive testicle could also suggest an inguinal hernia or epididymitis, an infection of the sperm-storing tube attached to the testicle. Either problem is treatable by a physician.

* Hardness in the entire testicle. This is usually the result of a hydrocele, a cystic mass in the testicle. A leaky hernia, prior trauma or infection could cause one of these fluid-filled sacs to show up where you'd like it the least, but fear not: Hydroceles are easily treatable, too.

* Discharge from the penis. Though rarely an indication of cancer, a non-ejaculatory discharge from the penis during TSE could suggest a sexually transmitted disease (STD), in which case you should consult a physician-not to mention your lover.

Tomoow's Post: SEE YOUR DOCTOR IF NECESSARY- and remember NurseNancy cares about your health!!! :)

Testicular self exmination. or,How to squeeze the Charmin

Continued from last post.... NurseNancy has now told everyone why the "boys" need to be checked. Other famous Testicular cancer survivors include Lance Armstrong, along with the previously mentioned "celebs". But you don't need to be famous to get this disease.It can happen to any guy, and the younger ones are in a higher risk catagory -see last post for these stats. Girls, maybe plan to check your man out on the same day you check your breasts. Because we all know that men will never remember to do this on their own. We hope you do, cause we kinda like having you around!! ( ALL of you, too!!) :)

At this point, you and your testicles should be pretty excited about performing the TSE. Try to contain yourself (or all three of you) and read over the next section carefully. Men between the ages of 15-40 should perform monthly TSEs around the same time each month. If you've never performed a TSE before, it's certainly normal to feel some anxiety during your first time. Just try to relax and think about the favor you're doing for your testes. I'm sure they'd thank you if they could.

Performing the TSE

1. Draw a warm bath. This is the best way to relax both you and your scrotum. If you haven't cleaned the tub in… uh… ever, then you can also take a hot shower. Warm water is key for relaxing the scrotal structures. :)

2. Get familiar with your body. Let's be honest: Aside from your Spiderman Underoos, no one knows your testicles better than you do. Maybe one's a little larger or hangs a little lower; these are normal differences. So, while in the tub, continue to take notice of the weight, shape and coloration of each testicle and report any noticeable changes to your doc. While testicular cancer is not necessarily reflected in changes in scrotal skin, a change in color could be a warning sign for something else, so it's a good idea to mention any differences to your physician.

3. Mount up. Place your right leg on an elevated surface, like your sink or toilet, giving yourself clear and easy access to your scrotum. Hint: Make sure the surface is dry. Slipping would suck. Trust any man who says so.

4. Do the deed. If you're right-handed, then place your left hand under your right testicle, lightly supporting it. Next, using your right hand, gently roll that testicle between the thumb and index finger, feeling for anything unusual. It should feel smooth and firm, but not hard. There should not be any bumps or lumps. Repeat for the left testicle, elevating your left leg instead. (If you are left-handed, simply reverse hands.)

Keep in mind that the above steps are general guidelines for the TSE put forth by the National Cancer Institute and physicians, and they may be adapted on an individual basis. For instance, heavier guys may find it easier to do the procedure laying on their backs or sitting down "Indian style." You should feel free to change to procedure as you see fit, so long as you're able to thoroughly inspect the contours of each testicle with your hand.

Tomorrow's blog...... KNOW WHAT TO LOOK FOR :)

How to touch your testicles, just checking!!

Ok, NurseNancy is posting something for the guys, and their *ahem* boys. I am going to be posting information, over the next few days, about testicular cancer and how to perform a proper testicular self examination. Aren't you thrilled?
I got this info from the so ya wanna know site.

Are you ready, Boys? (* Shania Twain strut*) then let's GO!!!

There are very few physical sensations that match the thunderous pain and awesome power of a swift kick to the testes. Everything seems to go in slow motion as you double over in agony… and then the gut-wrenching throb sets in. If you've ever discovered a new pothole with your ten-speed, you know exactly what we're talking about: Pain with a capital "YEOUCH!"

Since the testes are among the most sensitive (and enjoyable) parts of a man's body, it should hardly be surprising that few men are inclined to do a little exploring "down under." Sadly, most men are not aware of the high incidence of testicular cancer and other troubles that originate in the scrotal sac - dangers that are much easier to cure if caught early on. To do so, all men should learn how to perform a proper Testicular Self-Examination (TSE) - it could save your scrotum. Just ask celebrity testicular cancer survivors like Tom Green, Scott Hamilton and Richard Belzer. Performing the exam is well worth your while… and not as traumatizing as you think.

The Testicular Self-Exam is a risk-free, pain-free way to check your testes for potential cancers and other problems. It's really the first line of defense against cancer because testicular cancer comes with virtually no obvious symptoms or pain. No fever. No deep, booming voice from your crotch. Not even your lover would notice (though a popular women's magazine just published a "How-to-check-his-balls-w ithout-him-knowing" column, so don't freak out if your girlfriend asks you for a mid-coital cough). A monthly testicular self-exam is the best - if not the only - way to find out if your boys are in good shape.

That said, the TSE should not be considered a substitute for a clinical examination conducted by an experienced physician: A doctor's diagnosis is almost always going to be better than yours. The TSE functions more like a warning light on your body's dashboard than some sort of at-home diagnostic tool for cancer. If the warning light goes off, then it's time to make a doctor's appointment; that's the only thing this test will tell you. (I knew you guys would like the car analogy.)

A word on testicular cancer

The main purpose of the TSE is to familiarize yourself with your body when it's healthy so you'll be able to recognize it immediately when something unusual is going on. Most testicular tumors (called seminomas) occur in the cells responsible for sperm production. As cancers go, these tumors grow pretty quickly; an untreated seminoma could double in size in under a month. So needless to say, you can't waste time being squeamish about squeezing the Charmin, because time is really of the essence.

Indeed, by the time they're discovered, nearly half of all testicular malignancies will have spread to other parts of the body, like the abdomen or lungs. And while cancer at that stage is still often curable, you can bet your left testicle you'd like to avoid all that by discovering abnormalities as early as possible. What the TSE will do for you is lower your chances of having to undergo the often painful and draining treatments associated with more advanced cancers (such as surgery, chemotherapy and radiation). Detecting a testicular cancer early on typically allows the physician to prescribe a less trying therapy.

All in all, the numbers about testicular cancer aren't nearly as scary as one might think. Take a look:

* Testicular cancer will kill about 300 men this year. :(

* Roughly 6,900 men will develop a testicular malignancy this year. That's only about 0.3% of the projected readership of Maxim in 2000.

* According to the National Cancer Institute, testicular cancer is most common among younger men. In fact, it is the most common form of cancer developed by men between the ages of 20 and 35. :(

* As said before, catch it early, and you're pretty much in the clear. Testicular cancer is one of the most curable breeds out there. And although nearly half of all cases have spread to other parts of the body by the time they're discovered, the cancer is still often treatable in its later stages. But the danger of spreading is why you have to catch it early on.


Risk Factors :(

The research on predisposing factors for testicular cancer is rather thin, but there are a few variables that might change your odds of developing a malignancy, such as age, ethnicity, and personal and family histories.

Being Young. Believe it or not, the older you are, the less likely it is that you'll develop a testicular malignancy. Call it a trade-off for having to worry about prostate or colon cancer, but men over 40 are pretty much off the hook.

Being White. Caucasians have a 4.5 times greater incidence of testicular cancer than African Americans. White men may not be able to jump, but they'd better learn how to perform a TSE. ( and , believe me, MrNurse does his, or gets it from me!!)

Being Born Unlucky. Guys who had developmental problems in their youth, such as an undescended testicle or an infection resulting in testicular atrophy, are also more likely to develop testicular cancer than your average Joe.

Being Related. If you're dad had testicular cancer, there is some evidence that you're more likely to develop a tumor, too. Here's where it gets weird: The papers say that you're at an increased risk for cancer in the opposite testicle. In other words, if pop had a malignancy in his right testicle, you'll want to keep tabs on your left one.

Being John Malkovich. Just kidding, John. But you might want to perform one anyway.

Tomorrow.... How to Do the Deed!!!! :)

The Naked Blog

Wow, I never thought that such a tempest in a teapot could come of posting the comment that I didn't think posing naked on your blog was a good idea. Especially if you are a woman of a certain size and "type".
However, it seems that a lot of people do think it is a wonderful idea, so hey, if that's what you like to do, and it's what your adoring public wants, then go for it.
When I told MrNurse what the bruhaha was all about, his comment was "Well, that's just sick" !!

So there you go!! You heard it here first, folks.

Now, I have to go to work REALLY early because we have a staffing crisis. I am so pleased because I have only had about 4 hours of sleep. YAY! Sleep deprivation! When I get back home, I plan to SLEEP!!

No sex, please, we're adolescents!!

I just read this on Google news Alerts.

Adolescents who watch, or even hear, characters talking about sex on a show are twice as likely to have intercourse within a year's time, new research shows. WOW!! Someone got paid to conduct this research?? Well it doesn't take a rocket scientist to figure this one out!!

I find this kind of disturbing. I tried to raise our kids with a healthy respect for themselves and for their bodies. Actually, I leave brochures and pamphlets around about STDs, herpes etc. All with color pictures!! It worked during the older ones high school years, anyhow, because it scared the hell out of them!!.
Plus my kids know that I work a lot with HIV/AIDS patients. I keep telling them, it doesn't take much to catch a STD, so to think twice and if you do have sex, always use protection.

It's pretty sad when teenagers are probably having more sex than their parents, though!!

RANT!! Easy Come, Easy Go but still ( fairly) Clean!!

OK, NurseNancy is kinda steamed up now!!
How come some people arrive in the HOT BLOG, section out of nowhwere? And why do people get hits on their blog when they promote PORN? Does anyone else find that really disturbing, or is it just me? I'm not talking about the "for fun" nakey pics, I'm talking about someone who is promoting porn and has a disclaimer to that effect, to boot, as well as the language to back it up. How do I know this? Well, I confess, I looked, then backed out of there just as fast.

Also, if you are overweight and rather unattractive, pls. do not post naked pictures of yourself on your blog. It is really disturbing, and does not prove to anyone that you have a healthy self esteem. It just shows that you are not too bright.

Baby, it's cold outside!!

We have snow.....lot's of it too!! :(
At least it seems that way when it is blowing around.
Today: Windblown snow flurries and snow showers will affect much of the area. Cold. High around 25F. Winds NNW at 20 to 30 mph. Chance of snow 50%. Snowfall around one inch.

Tonight: Snow flurries this evening will give way to partly cloudy skies during the night. Low around 10F. Winds NNW at 10 to 20 mph.

Tomorrow: Mainly sunny. Cold. High 17F. Winds NNW at 10 to 20 mph.

Tomorrow night: Mostly clear skies. Cold. Low 7F. Winds NE at 5 to 10 mph.

Wednesday: Light snow. Highs in the upper 20s and lows in the low 20s.

Thursday: Snow showers. Highs in the upper 20s and lows in the low teens.

Friday: Abundant sunshine. Highs in the upper teens and lows in the mid single digits. :)

Tall Latte:HOLD the RUDENESS!!

This is a wonderful article. It's so true. We are living in a rude, rude society. I am tired of trying to teach my kids manners in the face of a rude majority. People: stand up and fight rudeness!! :) Take back our manners!! :)

Tall Latte, Hold The Rudeness - teaching manners to children in the face of adult rudeness - Brief Article
Susanna Monroney Luddy

WASHINGTON, D.C.--In the early morning, I enjoy walking my baby girl through the neighborhood, getting coffee, and watching her absorb the world around us. During a recent Starbucks stop, the woman in front of me felt she had been waiting too long and barked at the young man behind the counter. He apologized profusely, yet she continued to scold him to the point of embarrassment.

I stood there holding my one-year-old daughter,Jocelyn, wondering if she was noticing this woman's behavior. I thought about the previous day at MotoPhoto, where Jocelyn had witnessed another woman screaming at an employee. And last week at a gift shop, where she had watched the store manager berate a customer. Someone's order was wrong, and the store clerks were not only unwilling to help but downright insolent. I wondered how long before my little girl decides that rudeness is acceptable.

Right then at Starbucks, I decided to take a stand. I said to the rude woman, "They are busy and working very hard, and I think you were rude." She turned to me and my daughter and snarled, "Well, you may be able to sit around all day with your baby, but I have to get to work." Then she stormed off. As I left the store still in disbelief, she drove up to me and shouted, "Mind your own business!"

Clearly this woman thought my business was to go home and sit around all day. Au contraire. In addition to my new goal of promoting civility in this busy city, I'm a mother. I am responsible for shaping the character of a child into a young person who (I hope) will never imitate the rudeness she is hearing all around her.

Since she was born, it seems as if every time I've been dressed nicely and rushing out the door with her, Jocelyn has spit up or needed a diaper change. But I clean her up as fast as I can, hug her, and tell her I love her. My schedule is much less important than her feelings. I want her to learn that when we're frustrated or rushing, it's not a license to be unkind to others.

I often hear people order a clerk, "Give me a tall coffee? Is it so much trouble to say, "May I please have a tall coffee." When I hand my daughter her bottle, I tell her to say, "Thank you," in hopes she'll learn to repeat the phrase and understand its importance. Currently, she grabs it and sticks it in her mouth like she hasn't had a drink for a week, but we are working on it.

When I first gave her cookies, I'd break them in two and ask, "A piece for Mummy, please?" Now she won't eat anything without offering me some also. Tonight she tried to share her bottle with her doll. She will play with a toy herself for a moment and then hand it to me. She has learned to enjoy sharing.

Sometimes she cries because she is hungry or has a wet diaper. Other times, she is just testing me. I have spied on her in her crib: She will stand there and scream for a minute, then sit down quietly and wait for me to come running. When she doesn't hear me, she stands up and screams again. It would be easier to give in to her than to listen to her scream. But if she doesn't learn who is in charge now, when will she develop an understanding of authority or respect for others?

My friend Elaine has two toddlers, aged two and four. When her older daughter grabs a toy from her younger son, Elaine quietly dissolves the crisis. "Is that kind? I don't think taking something away from your brother is a kind thing to do," Elaine says. "I don't think you want to make him feel badly." More often than not, her daughter hands the toy back with an apology. Such empathy does not arise spontaneously in children. It is nurtured and developed with patience and creativity. And not by parents who sit around all day.

When Elaine's kids whine for something, she says, "Are you whining? Is that a nice way to ask for something?" If they ask again more politely, they are rewarded with their request. If they respond with a tantrum, she tenderly gives them one more chance to redeem themselves. If they do not, they go to their room. She loves them dearly and is teaching them the valuable lesson that there are consequences to their actions.

There are impolite and disorderly people in the world, and I don t want my child to become one. It is hard work to offset the examples set by the woman in Starbucks and the rude store manager. Raising my daughter to be a virtuous, civilized person requires constant attention, effort, and patience. There is very little "sitting around" involved.

Motherhood is full of struggles, and I am far from perfect. But it is the most rewarding vocation I can imagine. The job of raising children deserves the respect of everyone, no matter how long they have to wait for their coffee, or how late they are to their office.

Susanna Monroney Luddy, a realtor and freelance writer, raises Jocelyn in Washington, D.C.

COPYRIGHT 2001 American Enterprise Institute for Public Policy Research
COPYRIGHT 2001 Gale Group

The difference between you and your boss.....

Differences between you and your boss. At least the differences between me and my BEECH of a Boss.......!! sent via email from a sympathetic colleague..... :)

When you take a long time, you're slow. When your boss takes a long time, s/he's thorough.

When you don't do it, you're lazy. When your boss doesn't do it, s/he's too busy.

When you make a mistake, you're an idiot. When your boss makes a mistake, s/he's only human.

When doing something without being told, you're overstepping your authority. When your boss does the same thing, that's initiative.

When you take a stand, you're being bull-headed. When your boss does it, s/he's being firm.

When you overlooked a rule of ettiquette, you're being rude. When your boss skips a few rules, s/he's being original.

When you please your boss, you're arse-creeping. When your boss pleases his/her boss, s/he's being co-operative.

When you're out of the office, you're wandering around. When your boss is out of the office, s/he's on business.

When you're on a day off sick, you're always sick. When your boss is a day off sick, s/he must be very ill.

When you apply for leave, you must be going for an interview. When your boss applies for leave, it's because s/he's overworked.

Keep your BIRD healthy and stay healthy!!

Health Tip: Polly Want an Illness?

If you got a pet bird as a holiday gift, the Mayo Clinic wants you to be aware of an illness you can get from birds: parrot fever.

Psittacosis, as it´s formally known, is a bacterial disease that affects more than 100 species of wild and domestic birds, including parrots, macaws, cockatiels and parakeets. Though some birds with psittacosis don´t display any signs or symptoms, others lose feathers or change their eating habits.

In people, psittacosis symptoms include cough, chest pain, fever, chills, headache and muscle pain.

You can catch the infection through contact with bird feces or with the dust that accumulates in birdcages. Psittacosis also is transmitted by bird bites, holding your bird or touching your mouth to your bird´s beak.

The disease is treated with antibiotics. To prevent parrot fever, regularly rinse and refill your bird´s water and food dishes, and clean the cage daily.

How to Use Viagra

Here is an email I would love to send to my boss's husband.....Actually, guys, these tips work even if you don't need viagra!!
Here are some tips on how to get the most out of your Viagra purchase.

1. Make blood. Drink at least 1 gallon of water per day. This gives you blood volume, and it also helps you look and feel better. Viagra helps very much, but Viagra needs help too!
2. Get firm. An erection alone is not enough. Get in better shape. Just a few things such as cutting back on bread, reducing portion size, and going for regular walks will help. Getting very fit will help even more. Viagra in a fit body works better than Viagra in an unfit one.
3. Make love all day. Your partner will respond better and thus raise your own excitement level, if you make a point of doing random acts of kindness throughout the day. A love note left in the refrigerator, a rose given for no special reason, engaging in real conversation for even a few minutes, and doing one of your partner's regular chores are all ways to say "You are special." Most guys can make big headway by leaving the toilet seat down. You may find you will need Viagra not because of impotence, but because your partner wants you several times a day.
4. Make love to the whole person. This means showing you care--sort of like #3 above, but not just by acts of romance and thoughtfulness. You make love to the whole person by finding out what your lover really wants--and delivering.
5. Make love to your partner's whole body. There's a lot of skin on the human body--make use of it.
6. Don't rush into the bump and grind. Try kissing and caressing, warming your partner up to peak desire. Work at treating your partner as something other than a receptacle for your Viagra-charged tool.

These six tips can help you go from a Viagra-charged person who can do penetration to a dynamic lover who uses Viagra to help complete the job. There is much more to love-making and star-bursting satisfaction than Viagra can bring to the bedroom (or the kitchen table or wherever). use Viagra when you need to, but work on the other things, too.

Don't Ask!!!

Because Nurse Nancy cares about your health, here is another helpful hint!! Besides, nurses are constipation experts. Personal and Professional experience at work here folks!!!

Constipation
For minor symptoms:
# Increase dietary fiber and fluid intake
# Take a stool softener such as Colace or fiber product as Metamucil®
# DO NOT use laxatives, such as Ex-Lax, regularly
# Increase activity and exercise

See your health care clinician if:
# Condition persists for several days.
# You have a fever.
# You experience stomach cramping, bloating, rectal bleeding or nausea.

NurseNancy's tips to stay healthy

While we fret about the most complex and controversial aspects of our health care, don't forget to do these basic things that will definitely help your health. You don't need to go to medical school to be the most important member of your healthcare team - just follow these time-tested ways that really work.

Stop smoking
There is no question that if you smoke, stopping will be the very best thing you will ever do for your health. If you fail this time, keep on trying!

Get some exercise
Even a little is very helpful. You don't have to be an Olympic athlete to gain the benefits of exercise, which can occur at surprisingly low levels. Take a 15 minute walk . . . take the stairs . . . it will do a lot of good.

Eat sensibly.
If you can't be perfect, do as good as you can. Don't just give up on good eating habits because it seems too hard.

Learn to take your own blood pressure.
Write it down. Bring the list to your doctor. This is the best way to avoid too much or too little treatment for this controllable disease.

If you're overweight, trim a little off
At least don't gain weight. Weight loss is hard because it's a lifetime attitude that will accomplish the goal, but the benefits to your health and how well you feel are definitely worth it.

Work on balance
Be involved...without being overly stressed...and leave time for relaxation. This is a big challenge for all of us, but it's really important for people with medical conditions, particularly those involving the heart.

Take an aspirin a day
As long as your physician has not told you to avoid it. It is an easy and inexpensive way to prevent heart attacks and strokes, particularly for middle-aged males.

Find a doctor you like
Don't just take what comes along. Your healthcare depends most on you, but it's your job to find physicians who you can relate to, understand and trust.

Get and maintain health insurance
Let's be realistic - this is an increasingly important part of your healthcare. Always be careful to maintain it.

Be skeptical about information sources
There is a lot of incomplete, inaccurate, or simply wrong information available. This may be from relatives, acquaintances, charlatans, or the news media.

If you have a question, ask!
There are really no stupid questions. None of us were born knowing the answers. Ask, and you can put your mind at ease and do the right things for your health.

NurseNancy wants you to stay healthy this winter!! :)

Cover Your Cough!!

A serious shortage of flu vaccine would naturally affect the availability of flu shots locally, say experts at The William W. Backus Hospital.

According to the federal Centers for Disease Control and Prevention, the following are on a priority list to get flu shots:

* children 6 to 23 months old,
* adults 65 and older;
* children and adults with underlying medical conditions, such as diabetes or heart disease;
* women who are pregnant during the flu season;
* residents of nursing homes;
* children on aspirin therapy;
* healthcare workers who have direct patient contact;
* and relatives or caregivers of infants younger than 6 months.

Depending on availability, people in these risk groups would be the first to receive vaccinations. If you are a healthy young adult, you most likely will be asked to defer getting a flu shot.

In the meantime, everyone should practice good “respiratory etiquette,” said Faith Coleman, nurse epidemiologist at The William W. Backus Hospital.

“Cover your mouth and nose with tissue when you cough or sneeze,” Coleman said. “If you don’t have a tissue, cough or sneeze into your upper sleeve, not your hands. Put used tissues in a waste basket, not your pocket. And wash your hands with soap and water, or an alcohol-based hand cleaner.”

If you feel ill, don’t risk giving others the flu, Coleman advised. “Stay home from work or from school, and avoid public places if you have flu-like symptoms.”

The most common symptoms of the flu are:

* headache
* general aches and pains
* fever (102-104 degrees, lasting 3-4 days)
* exhaustion
* chest discomfort and cough
Stay healthy, everyone!!

Learn some manners!!!

Please teach your children some telephone manners!! I am so tired of calling someone and having the kid either scream "MMMMOOOOOOOOMMM PHONE" in my ear, or drop the phone on my ear or leave me hanging while they continue their conversation on the other line.
I am also mighty fed up with adults who carry on other conversations while engaged in a conversation with me. I just got off the phone with a ( so called) friend who does this all the time. It drives me nuts!! She will be talking to me and her kids are being so rude, they interrupt asking who she is speaking to, and then demand to use the telelphone!! Can you believe it! This woman allows her teenagers to decide when she is allowed to use the phone. I have heard her kids say "I need the phone", or else they will pick up and hang up the extension several times until I get fed up and say "I better let you go".
Call me old fashioned, but every one of my kids was taught how to answer a telephone as well as how to gently place the phone down while summoning someone to the call. They all say " Just a minute, please" and also ask "May I please speak to ------" when calling their friends, instead of the " Is XXXX there" that I hear when they call my children.
Come on ,America!! Let's wake up and teach some manners- to both the children and the adults!!

Stay Safe- Stay Warm

NurseNancy had a cold day, driving to my daughter's college and back, lots of outdoor time and a bit of rink time with my younger rink rats.BRRRR. Baby, it's cold outside!!

COLD WEATHER SAFETY TIPS

NORWICH — With the cold and snow that inevitably comes with winter in New England, The William W. Backus Hospital Trauma Department offers this timely advice to avoid hypothermia.
Safety tips

* Dress in layers so you can adjust to changing conditions.
* Avoid overexertion.
* Stay dry. If you feel too warm or start to sweat, remove extra layers of clothes.
* Do not drink alcoholic beverages because they cause your body to lose heat more rapidly. Instead, drink warm, sweet beverages such as hot chocolate or tea.
* Don’t ignore shivering. It’s your body trying to tell you your body is losing heat.
* Wind chill causes the air to feel colder than it the temperature indicates. A wind chill chart is available online at: http://www.nws.noaa.gov/om/wi...

About hypothermia

* When your body is exposed to cold, it begins to lose heat faster than it can be produced. The lowering of body temperature is called hypothermia.
* Body temperatures that become too low can affect the brain, making you unable to think clearly or move normally.
* Remember, it does not have to be bitter cold for you to suffer from exposure. Wind, wet skin from precipitation or sweat, and your level of physical activity can contribute to frostbite and hypothermia.
* Learn to recognize these warning signs for hypothermia:
o Shivering
o Confusion
o Memory loss
o Drowsiness
o Exhaustion
o Fumbling hands
o Slurred speech
o And in infants: Bright red skin and very low energy.
* If medical help is not immediately available:
o Get the person into a warm room or shelter.
o Remove any wet clothing.
o Warm the center of the body first — the chest, neck head and groin — with an electric blanket if available. Or use skin-to-skin contact under loose, dry layers of blankets, clothing, towels or sheets.
o Do not give alcoholic beverages. Warm beverages may help raise body temperature. Never give a beverage to an unconscious person.
o After body temperature has increased, keep the person dry and wrapped in a warm blanket, including the head and neck.
o Get medical attention as soon as possible.

These safety measures can save lives, but remember, they are not a substitute for proper medical care. Hypothermia is a medical emergency, and those with hypothermia should be evaluated by a medical professional.

TGIF!!!

Wow am I glad it's Friday!! The beyatch has been in full fightin' form all week!! And it's been a short week, to boot!! She has been the Ice Queen Supreme. Her husband (AKA Viagra Man) is "in the dog house" ( her quote) Regardless of where he is, we took the full frontal assault all week. Possibly because of his *ahem* "shortcomings".
Oh me, oh my, it will be Fight Night USA all weekend, I'm afraid.... My best friend at work and I keep asking ourselves "why does she stay with him?" I mean, she has been unfaithful on business trips, she complains about him, about his mother, about their kids, about ...you name it. Why put yourself through all that aggravation? Why not leave? She has confided some aspects of her life with me and my colleagues. We all say the same thing. Why bother, if that's how it is? Why be miserable? It really drives me crazy that she is so nasty to the staff because of her home life. She came aboard me this morning because of a report that wasn't on her desk this morning. It wasn't even something she had asked me to do.It was something that one of my staff was to have done. Wow, bitchy and losing her memory too!!
Other than her, I had a good day at work. I have some lovely patients in my extended complex care / continuing care unit. I spent a bit of time today with a nice lady who is 98 years old and as sharp as a tack. She told me some stories about our local area of 75 years ago. Wow, I can hardly remember to go to the dentist, let alone have a good memory of years ago!!
We are going to our daughter's college town tomorrow. My daughter likes to dance and is in a dance group at college. We are going down to see them rehearse. She is going to be performing a Latin salsa number. Ole!!
Our other kids are all involved in their skating activities and we will be on the fly for those as well. It will be a busy weekend and I will be ready for bed early every night!!
BTW- a half pound down again today!! Drinking lots of water and went to CURVES twice this week!!!

I'm in between Kurt and Roadie, yumm!!!

I have lost one pound, so I am allowed to blog!! I am celebrating by having my favorite drink, a Cosmo. Here is how to make one!!

Cosmopolitan

* 1 1/2 parts vodka
* 1 part Cointreau
* 1 part cranberry juice
* dash of lime juice
*
1 lime rind

Shake all the ingredients with cracked ice. pour into a cocktail glass. Enjoy!!

I am enjoying drinking my cosmo while I relax in between Roadie and Kurt!!

I'm a sandwich

I have returned to my sandwich position between Kurt and Roadie, only this time our positions have been reversed!! Woo Hoot! :)

Not a Sandwich

My time in a Kurt/Roadie sandwich was, alas, short-lived, and it was so nice and cozy, too!! Thanks, Guys!!
now I'm back in mnash and notablog sandwichland. Will be dropping fast, I suspect as I will need to study more than blog. Plus lose weight in order to reward myself with blog time. since I am currently at work, I need to ensure I can clear the history before the IT guy sees where I have been..... However, we are allowed internet use on our own time, since so many of us are taking courses on-line.

thanks, newbie, but no thanks

A "Newbie" has visited and left anonymous no comment comments. "Newbie" even asked to be my "friend" awwww, isn't that special? :)
However, I prefer to get my standing the old fashioned way.
I'll pimp myself out to blog readers, thanks.
So, whoever you are, your intentions may be well meaning, but it clogs up my comments section and is rather annoying.
thanks, but not today.
However, it does feel good to have Kurt on top and Roadie on the bottom, in a virtual kind of way!!!! Hey, guys, you just made a NurseNancy sandwich!!!

Last day Blog

Well, I am going to keep a New Year's resolution that I am not going to spend much time on Blogging. I am going to start some courses next week working towards a Master's degree in Health Administration. I also need to get two kids organized to get back to college today. One is going to the airport, one gets driven back to her college, about an hour away. We also did not get a darn thing organized for the Christmas stuff. MrNurse will need to help with that after work today. I would get the younger kids to help me take the tree down, but want to keep the glass in the windows for the time being!! I can just see all nine feet or so of the tree going through the glass in the living room doors or the front window!!
The younger kids are involved in a variety of winter sport activities, skating, hocky, dance etc. This keeps us very busy especially on the weekends.
I am going to take a page out of mnash's blog and try to use the weight loss incentive to = blogging time allowed. It may encourage me to try and get my weight under control again. So if I blog, I will have lost weight!! Weight Watchers, here I come!! ( not literally, I went before and have all the stuff to follow, plus it's a time thing, again) I am going to get back to CURVES gym and do a work out at least three days a week. I am going to try and not let my boss "get" to me. She is a hopeless beech, who doesn't care about her own family, she cares less for the patients and the staff are way down there with pond scum. Patients are a bottom line to her, and I hope that my way of caring and loving what I do will help mitigate her uncaring attitude.
As always, send your NurseNancy questions to me, and remember.....WASH YOUR HANDS!!!! go to the CDC website to see how to do it right!!

New Year Sunday

I am not going to be blogging as much in 2005. I find the actual posting time is not too long, but the reading and response time is eating into time I need to use elsewhere. It's been fun, I've been able to vent a bit about my boss. She is a two faced beach who doesn't care about her own son, let alone anyone else. Her whole reason to exist depends on where she will get her next nookie. This is common workplace knowledge. She will flirt with doctors, therapists, sales reps. etc. However, her preference is for the more financially successful males. Those who have CEO or VP after their names. Her own husband isn't a bad dude. I've met him once or twice. He appears a bit beleagured. No wonder, being married to that emasculating beech. ( think Margaret, "HotLips", Hooligan from MASH!!) I know for a fact that she was probably unfaithful on a business trip. She also likes to go on a lot of trips that the CEO of another health care facility goes on. Oh, the speculation!! There is no place on earth more rife with gossip, innuendo and other litiginous talk than a hospital!! It's a veritable "Peyton Place!!"
I have also enjoyed the blogging of others. Reading about some of your lives is fun!! In a vicarious sort of way!!
I am going to be embarking on another college degree. I want to work towards a Masters in Health Administration. I don't think that this will take me away from the patient care areas that I love, but will enhance my knowledge about running the facility. My husband is facing a possible transfer as well. We are hoping that it won't be for another two years, so as to enable our remaining kids to finish up at their current schools. My education can be done electronically, so it doesn't really matter where I live. However, I have worked at my current facility for quite a long time, so would hate to leave and have to start over somewhere else. This is another reason to increase my education, so that I can obtain employment without giving up some of the perks I have worked towards; i.e. hours of work, vacation time, parking places. You know, the important things!!
All in all, I also need to spend some time going back to CURVES, I've been pretty slack lately and my body is getting rounder!! Time to get ON that treadmill again!!
I am off to church this morning with just the two youngest kids. The rest have colds or are nursing hangovers, (but we will say they are sick!)
We are going to a friend's place for lunch,after service, so should be a nice day, even though it's as cold as can be out there!
Hope you all have a wonderful, blessed Sunday!

Don't spill coffee in the keyboard!!

SPILLING A FULL CUP OF COFFEE ALL OVER THE KEYBOARD (BECAUSE THE CAT DECIDED TO JUMP UP ON YOUR LAP) TAKES A VERY LONG TIME TO CLEAN UP. PLUS, IT WILL RUIN THE MOUSE PAD. And can make the cap lock key stick, until you turn the keyboard upside down.

OH, AND HAPPY NEW YEAR!!