Think Twice About Going To The Emergency Room For Back Pain

With low back pain being the number reason why millions of Americans miss work, you would think hospitals around the country would be more compassionate with people who suffer from chronic low back pain. Being a chronic pain sufferer myself who suffers from low back pain with a herniated disc, I know too well how ER doctors treat patients seeking help for some kind of relief. It seems as soon as you walk in and tell them the reason your here to see the doctor is for back pain, your immediately cast in a different light.

The ironic thing in today's modern times, hospitals and ER doctors have available, and can look up information on patients that have on record tests such as, MRI's, CT scans, or any other type of documentation to verify a diagnosis the patient is complaining of. With so many people falsely going to ER rooms complaining of back pain just to get medication, they should actually do a little research before they put you in that category of just seeking medication.

For instance, I waited 2 hours in the waiting room, after I got back to see the ER physician, I waited in the room for an additional hour just to hear the nurse tell me I need to go see my primary care physician about substance abuse. I was in shock. I could not believe they thought I was there seeking medications and not truly suffering from pain. When just recently I had two MRI's taken at this same hospital showing indeed I do suffer from herniated discs, and other back problems as well. To add insult to injury, I received a bill the following week charging me for the visit. I wonder what did they do for me. What did they charge me for? The only thing they did in all reality is turn me away. So why do they charge me for turning me away in my time of need.

Unless your in a horrible car wreck, or your wheeled in by ambulance on a stretcher, going to the ER room for pain is a waste of time and money. Not only is it a waste of time and money, your humiliated by the whole ordeal. People who suffer from chronic pain are simply not believed. For whatever the reason may be, ER doctors do not want to treat people in pain. Chronic pain sufferers in America are discriminated again tremendously. Everyone who suffers from pain should write their congressman or senators. Something has to be done. Seems doctors are taken the war on drugs against the innocent, against the people who truly suffer from chronic daily pain. There is something wrong with this picture. America has the best healthcare in the world, but yet you cant get treated for something as simple as low back pain. I just pray for the millions of Americans who are in the same situation they that somehow will find a compassionate doctor who truly understands pain. Seems most doctors today are more interested in what's best for them, and not the patient. Don't they still take an oath to help the sick and hurting? Sometimes I wonder
By Robert Gould

Scrapbook Ideas for Your Baby Album

A scrapbook album of your baby’s first year is one of the most special albums you’ll ever complete. There are so many magical memories, beginning with the pregnancy itself and continuing right through your baby’s first birthday. Below are a number of scrapbook page ideas to help you capture those precious moments.

Title Page

A great way to start the album is by matting a 5”x7” or 8”x10” of your baby’s hospital photo on the first page. Then add the baby's name and birthdate as the title and subtitle respectively. This makes a very simple yet very beautiful page.

Baby on the Way

How did you celebrate the news that your baby was on the way? Maybe it was a quiet dinner just for you and your husband or a gathering with family and friends. Either way, remember to include some pictures of the celebration. Capture peoples’ reactions to the annoucement in photos. In addition, you may even want to take a picture of the pregnancy test showing the positive results.

The Ultrasound

If you had multiple ultrasounds during your pregnancy, include pictures from different points in time so you can see how your baby was growing. You may also want to include one that shows the graph of the heartbeat. In addition to journaling about the ultrasound pictures, this is a great place to journal about any nicknames you may have had for your baby before it was born.

The Belly

Starting at three months, when the pregnancy “bulge” is just barely noticeable, have someone take a monthly side-view picture of you. Pose in front of the same background each time so that the pictures are consistent. Try to fit all of the photos on one page (or a two-page spread), so you can really appreciate the month-by-month progression.

The Nursery

Include photos of the nursery all ready and waiting for baby; take pictures from different angles to show everything in the room. Be sure to include pictures of anything that has special meaning such as a bassinet that has been in the family for multiple generations, a special blanket made by Grandma, etc. Also, if you have one, include a photo to show what the room was before it became a nursery.

Welcome Baby

Those first pictures taken of your baby after the birth are some of the most precious ones you’ll ever have. Rememer to include your baby being weighed, having his/her footprints done, being examined, getting a bath, etc. You can put memorabilia such as the footprint card, bassinet name tag and baby id bracelet on these pages. Include key information/statistics in your journaling – baby’s full name, date, day, time, weight, length, details about your labor, name of the doctor/midwife, etc.

Mom, Dad and Baby

It's wonderful to have a page with pictures of just the three of you – Mom, Dad and Baby – and then include siblings, grandparents, etc. on other pages. Journal about how you felt upon meeting your baby for the first time, whether your baby resembled anyone in the family, how your baby reacted to hearing your voice, etc.

The Rest of the Clan

Once you have a page or two of Mom, Dad and Baby photos, it’s time to include the siblings if your baby has any. Capture how excited they are to meet their new baby brother/sister and how proud they are to be big brothers/big sisters. This is also a great page to put any little cards, drawings, etc. that siblings may have made to welcome your new baby.

Visitors at the Hospital

Your new baby is sure to have many visitors at the hospital such as grandparents, aunts, uncles, cousins and more. Include a picture of each one holding the baby and write an interesting fact and/or anecdote about each person in your journaling. Also, you may want to include pictures of the doctor/midwife who delivered your baby, the labor nurse and/or the doula.

Going Home

Going home from the hospital is a big event! On this page you can include pictures of leaving the hospital, a photo of the outside of the hospital, and the birth announcement. Journal about who took you and the baby home, what the weather was like for your baby's first time ever outside, what he/she was wearing for a "going home" outfit, and what he/she did during the car ride home.

The New Family

It’s nice to have a couple of pages showing the new family settling in at home over those first few days. Be sure to include a picture of everyone (Mom, Dad, siblings) with the new baby, plus a picture of the whole family. Put some of the flowers and balloons received as gifts in the background of the pictures to add a special touch. This is a great place to journal about how the family dynamic changes when the new little one joins the clan.

Visitors at Home

In addition to having photos of the visitors that came to meet your baby at the hospital, you’ll also want to have pictures of the visitors at your home. Again, include a picture of each one holding the baby and write an interesting fact and/or anecdote about each person in your journaling.

Siblings

If your baby has siblings, you can make a separate page for each sibling with lots of photos of the big brother/big sister with the new baby. Depending on how old the sibling is, he/she may be able to help you create the album page by arranging photos, picking out embellishments and providing input for the journaling (e.g., what is the best thing about being a big brother/big sister).

Heritage

If your baby is lucky enough to meet his/her great-grandparents, have a page or two with pictures of them holding the baby. Ask the great-grandparents to share some of their most cherished childhood memories so you can include them in your journaling. When your baby is older, he/she can read their stories to get a glimpse of childhoods long ago.

For additional ideas, please read part two of this article entitled "Scrapbook Ideas for Your Baby Album – Part 2" at http://www.scrapbooktown.com/library-article4.html. If you need a baby album and supplies, visit Scrapbook Town’s online store at http://stores.scrapbooktown.com/storefront.bok.
by Lisa Fleming

Ouch That Hurts! A Nursing Mom’s Guide to Treating Plugged Ducts

A plugged duct is a mass of milk or cells that cause the flow of milk to become "stuck". It often happens to women who have an abundant milk supply.

You may feel a hard bump on your breast, or have swelling and tenderness. You may see a red area on your breast, or it may look streaky. It may also feel warm to the touch. Plugged ducts usually affect only one breast at a time but there are exceptions.

Plugged ducts can be caused by several things including: pressure on the duct from ill fitting clothing or a bra (especially too tight or underwire bras) or even baby carriers that put pressure on the breast. Nursing schedule changes that contribute to baby nursing (or Mom pumping) irregularly, stressful times like holidays and vacations can cause it too.

A clogged duct is uncomfortable but thankfully, there are several things you can do at home to treat it.

The most important treatment is to keep nursing. Some Moms are told that they have to wean their babies when they experience a plugged milk duct, but this is false. Weaning would mean more pain and the simple plug could lead to a more serious infection or abscess. Keep nursing your baby and offer the breast with the plugged duct first. Baby sucks with more vigor at the beginning of the nursing.

This may require some contortion, but try to "aim" the baby's chin towards the plugged duct. Her suction will be strongest in the area of the clogged duct, helping clear it out.

Get lots of rest! Plugged ducts are often a symptom of Mom doing too much too fast after having a baby.

More tips:

· Use a warm compress and gentle massage on the breast with the clogged duct.

· Get in the shower and aim the shower head on your sore breast. Get the water as hot as you can comfortably stand, then massage your breast. Start from high up on the chest and rub down, towards the nipple. You may see milk shoot out, or a stringy looking ribbon, or even a crystallized, dried milk clump if the duct clears out. As soon as possible after doing this, nurse your baby to empty the breast further.

· Loosen clothing and bra so there is less constriction on breasts while nursing. If you use underwire bras, switch to a soft cup style for awhile, or permanently if plugged ducts are an ongoing problem.

Once the blockage is gone, the hard lump will disappear and tenderness will go away. If the pain or swelling becomes worse or you have flu-like symptoms, you may have mastitis. The remedies mentioned above can heal mastitis, but if it doesn’t respond to home care in two days, call your Lactation Consultant or a La Leche League leader for recommendations.
by: Carrie Lauth

What Determines Nursing Salaries

In today’s economy with declining employment in many fields that require degrees, the profession of nursing is as solid as it ever was. People with prior degrees are looking to enter the nursing profession. The salary of a nurse varies greatly. There is really no base salary but a fluctuation across the board. The reasoning for this is a varied as the salaries in nursing.

The base pay of a nurse is determined by many different factors. The first of these factors are the years of experience that the nurse brings to the table. A GN or graduate degreed nurse will start out at the lowest salary of nurse pay. They will remain at this level until they pass their board exam or NCLEX. Upon passing their boards they will receive a small increase in pay anywhere from $2.50 per hour to $5.00 per hour. The most important factor in this scenario is to keep in mind that if the graduate nurse does not successfully pass the board exam the hospital can terminate their employment or extend to them a grace period in which they have the opportunity to pass the boards a second time. In the past years, it was not unusual for a graduate nurse to stay on as a hospital employee for years before finally passing or taking their boards.

This practice is no longer widely accepted. Also the graduate nurse is not allowed to pass any medications until they have their licensure. The question remains, what is the typical base salary for a graduate nurse. It is safe to say that the salary ranges in the low to mid forty thousand dollars per year. This discrepancy of several thousand dollars has much to do with the location of the hospital. For instance, in rural communities where much of the hospital funding comes from the government, the pay rate may be higher or lower than a privately funded institution.

The mitigating factor is how successful the grant writers are at tapping into government funds, and how much private endowment monies are bestowed to the hospital. Even with these two factors in place comes the process of dissemination of the funds. This is dependent on how the board of directors see fit to use the funds. These funds could be put to the construction of a new hospital wing, or to the purchase of new diagnostic equipment.

Whether or not the nurses are unionized is also another factor in entry level nurse pay. Unions can either work for or against nursing wages. Sometimes non-unionized hospitals pay more.

Shift premiums are also a factor. The top shift premium is paid for the midnight shift. Midnight shift premiums range anywhere from $2.50 per hour to $4.50 per hour. Since most shifts in hospitals are now twelve hour shifts, midnights start around 7:30 p.m. and end around 7:30 a.m.. These are attractive hours for many nurses since they get four days off during a week and are still considered full time at thirty six hours per week. Health benefits including dental and optical are included in the total package and begin anywhere from one week after hire up to ninety days.

The area of the hospital that the nurse will work in is also a factor in pay. For instance those nurses that are trained for specialty care areas such as intensive care units (I.C.U.), the operating room, recovery room, or in the cardiac care facility will get paid an extra premium upon completion of their training in the hospital.

Different areas of the United States have been known to differ in nurse pay scales according to the cost of living and population densities.

In the final analysis, the following factors are involved in determining the salary of an entry level nurse
by: Robyn Knapp

32 Services Provided By a Legal Nurse Consultant

Legal nurse consultants apply their knowledge and understanding of medical, nursing and health-related issues to make the attorney's job easier, more efficient and more effective.

Legal nurse consultants are medical insiders who know the inner workings of our complicated healthcare system firsthand. Their professional expertise as an RN and a legal nurse consultant qualifies them to provide the following services:

Assessing Medical Records and Analyzing the Case

* Identify, locate, review and interpret relevant medical records, hospital policies and procedures, other documents and tangible items.
* Organize, tab and paginate medical records for easy reference.
* Prepare chronologies of the medical events involved in a case.
* Summarize, translate and interpret medical records.
* Identify issues of tampering with the medical records.
* Screen medical malpractice cases for merit.
* Identify, locate, summarize and interpret applicable standards of care.
* Identify adherences to and deviations from these standards.
* Identify causation issues, assess damages/injuries and identify contributing factors.
* Identify and recommend potential defendants.
* Develop written reports for the attorney's use as study tools.

Supporting the Attorney's Case

* Search and summarize medical and nursing literature and integrate results of your search into case analysis.
* Analyze the validity of research studies relied on by all parties.
* Coordinate and attend independent medical examinations.
* Help in developing life care plans.
* Expand the attorney's medical library.

Serving as the Attorney's Liaison

* Interview plaintiff and defense clients, key witnesses and experts.
* Consult with healthcare providers.
* Meet with other consultants and service providers on the attorney's behalf.

Working with Experts and Other Witnesses

* Identify types of testifying experts needed for the case.
* Find and communicate with appropriate expert witnesses for deposition and trial.
* Analyze potential experts' reports and other work product.
* Help prepare witnesses and experts for deposition and trial.
* Serve as an expert witness and testify to the nursing standard of care.

Assisting with Discovery and Preparing for Court

* Prepare questions for deposition or trial examination (direct or cross).
* Prepare interrogatories and requests for production.
* Review and draft responses to various legal documents and correspondence for the attorney's signature.
* Analyze and summarize depositions and past testimony.
* Assist with exhibit preparation and other demonstrative evidence.
* Attend courtroom proceedings when relevant.
* Coordinate and assist with facilitating focus groups and mock trials.
* Assist in resolution of cases through alternative dispute resolution, such as arbitration and mediation.

Nursing Education – The Importance Of Critical Thinking

In the nursing profession, more now than ever, the ability to think critically is essential. The responsibilities of a Registered Nurse have increased over the years. In correlation with this increase in responsibility comes the additional increase in educational prerequisites and core requisites required to achieve a degree in Nursing. The ANA (American Nursing Association) Standards has set forth the framework necessary for critical thinking in the application of the “nursing process". The nursing process is the tool by which all nurses can equally become proficient at critical thinking. The nursing process contains the following criteria:

1. Assessment

2. Diagnosis

3. Planning

4. Implementation

5. Evaluation

It is in the application of each of these processes that the nurse may become proficient at critical thinking. It is important to look at the components that describe critical thinking in nursing, The table below lists components that define the critical thinking process. There is much more that goes into critical thinking than what is listed in the table. The table is a rough draft of the process.

CRITICAL THINKING COMPONENTS

Entails purposeful, informed, outcome focused thinking, that requires careful identification of specific problems and other physiological and psychological factors that affect the clients position on the health and wellness continuum.

The process is driven by the client, the client’s family and other health team members who are also collaborating in ensuring essential client care.

Specific educational knowledge base and level of experience in applying that knowledge in client care. (Nursing School to graduate nurse to experienced nurse) As the level of experience of the nurse increases so will the scientific knowledge base that the nurse applies.

Proficiency in the application of the institutions standards, policies and procedures.

Application of the humanistic standards of caring in conjunction with the nursing process, to holistically treat the clients response to an actual or perceived illness.

Constant evaluation and re-evaluation of the nursing process to determine the clients level of wellness

Nurses learn critical thinking via application with experience. Experience is the best teacher. But it is equally important to know that the process is being applied correctly. Many institutions will ensure that this pathway is followed by enlisting new nurses in a eight to ten week orientation program. During this time the new nurse will learn about the polices and procedures of that institution and what type of documentation is used for charting purposes. Also, the new nurse will have an experienced mentor who they will follow and who will evaluate their performance as well.

Documentation is an essential part of the critical thinking process for the nurse. Every institution places emphasis on documentation. It is said, “that if it is not documented, then it was not done". Since the nursing process is a scientific process. In scientific research, all things are documented. In this documentation, researches can look back to see if the results were due to interventions and whether or not the interventions were successful or have to be altered. The documentation process helps the nurse accomplish the same goals. Many times procedures are used that have unproven efficacy.

In it is this framework of critical thinking and documentation that such procedures can be either continued or eliminated, depending on the efficacy of the research. In other words, does the procedure actually improve, help or otherwise jeopardize the client’s health. An example of the critical thinking process and scientific reasoning is in the efficacy of taking a rectal temperature of new born infants. Currently, this procedure is still widely accepted. However the scientific approach is to ask the following, is the procedure safe, is it necessary, and can an axillary temp be used in place of the rectal temp? In answering these questions, the nurse can better evaluate whether the efficacy of taking a rectal temp on a infant should be continued.

This is just one example of how the critical thinking process is used within the nursing profession. The scientific approach using critical thinking helps the nurse develop evidence based practice. It is through “evidence based practice" that the Joint Commission on Accreditation of Health Care Organizations (JCAHO) rates the performance of hospitals. Further research is still continuing in delineating the intricacies of the nursing process and the integration of critical thinking. All health care professionals are encouraged to pursue this type of research in their practice to ensure the quality of client care and enhance the validity of their profession.

Learn more about nursing education at The NET Study Guide.
Ceated by Robyn Knapp

Registered

nurses

(RNs), regardless of specialty or work setting, perform basic duties that include treating patients, educating

patients

and the public about various

medical conditions

, and providing advice and emotional support to patients’ family members. RNs record patients’ medical histories and symptoms, help to perform diagnostic tests and analyze results, operate medical machinery, administer treatment and medications, and help with patient follow-up and rehabilitation.

RNs teach patients and their families how to manage their illness or injury, including post-treatment home care needs, diet and exercise programs, and self-administration of medication and physical therapy. Some RNs also are trained to provide grief counseling to family members of critically ill patients. RNs work to promote general health by educating the public on various warning signs and symptoms of disease and where to go for help. RNs also might run general health screening or immunization clinics, blood drives, and public seminars on various conditions.

RNs can specialize in one or more patient care specialties. The most common specialties can be divided into roughly four categories—by work setting or type of treatment; disease, ailment, or condition; organ or body system type; or population. RNs may combine specialties from more than one area—for example, pediatric oncology or cardiac emergency—depending on personal interest and employer needs.

RNs may specialize by work setting or by type of care provided. For example, ambulatory care nurses treat patients with a variety of illnesses and injuries on an outpatient basis, either in physicians’ offices or in clinics. Some ambulatory care nurses are involved in telehealth, providing care and advice through electronic communications media such as videoconferencing or the Internet. Critical care nurses work in critical or intensive care hospital units and provide care to patients with cardiovascular, respiratory, or pulmonary failure. Emergency, or trauma, nurses work in hospital emergency departments and treat patients with life-threatening conditions caused by accidents, heart attacks, and strokes. Some emergency nurses are flight nurses, who provide medical care to patients who must be flown by helicopter to the nearest medical facility. Holistic nurses provide care such as acupuncture, massage and aroma therapy, and biofeedback, which are meant to treat patients’ mental and spiritual health in addition to their physical health. Home health care nurses provide at-home care for patients who are recovering from surgery, accidents, and childbirth. Hospice and palliative care nurses provide care for, and help ease the pain of, terminally ill patients outside of hospitals. Infusion nurses administer medications, fluids, and blood to patients through injections into patients’ veins. Long- term care nurses provide medical services on a recurring basis to patients with chronic physical or mental disorders. Medical-surgical nurses provide basic medical care to a variety of patients in all health settings. Occupational health nurses provide treatment for job-related injuries and illnesses and help employers to detect workplace hazards and implement health and safety standards. Perianesthesia nurses provide preoperative and postoperative care to patients undergoing anesthesia during surgery. Perioperative nurses assist surgeons by selecting and handling instruments, controlling bleeding, and suturing incisions. Some of these nurses also can specialize in plastic and reconstructive surgery. Psychiatric nurses treat patients with personality and mood disorders. Radiologic nurses provide care to patients undergoing diagnostic radiation procedures such as ultrasounds and magnetic resonance imaging. Rehabilitation nurses care for patients with temporary and permanent disabilities. Transplant nurses care for both transplant recipients and living donors and monitor signs of organ rejection.

RNs specializing in a particular disease, ailment, or condition are employed in virtually all work settings, including physicians’ offices, outpatient treatment facilities, home health care agencies, and hospitals. For instance, addictions nurses treat patients seeking help with alcohol, drug, and tobacco addictions. Developmental disabilities nurses provide care for patients with physical, mental, or behavioral disabilities; care may include help with feeding, controlling bodily functions, and sitting or standing independently. Diabetes management nurses help diabetics to manage their disease by teaching them proper nutrition and showing them how to test blood sugar levels and administer insulin injections. Genetics nurses provide early detection screenings and treatment of patients with genetic disorders, including cystic fibrosis and Huntington’s disease. HIV/AIDS nurses care for patients diagnosed with HIV and AIDS. Oncology nurses care for patients with various types of cancer and may administer radiation and chemotherapies. Finally, wound, ostomy, and continence nurses treat patients with wounds caused by traumatic injury, ulcers, or arterial disease; provide postoperative care for patients with openings that allow for alternative methods of bodily waste elimination; and treat patients with urinary and fecal incontinence.

RNs specializing in treatment of a particular organ or body system usually are employed in specialty physicians’ offices or outpatient care facilities, although some are employed in hospital specialty or critical care units. For example, cardiac and vascular nurses treat patients with coronary heart disease and those who have had heart surgery, providing services such as postoperative rehabilitation. Dermatology nurses treat patients with disorders of the skin, such as skin cancer and psoriasis. Gastroenterology nurses treat patients with digestive and intestinal disorders, including ulcers, acid reflux disease, and abdominal bleeding. Some nurses in this field also specialize in endoscopic procedures, which look inside the gastrointestinal tract using a tube equipped with a light and a camera that can capture images of diseased tissue. Gynecology nurses provide care to women with disorders of the reproductive system, including endometriosis, cancer, and sexually transmitted diseases. Nephrology nurses care for patients with kidney disease caused by diabetes, hypertension, or substance abuse. Neuroscience nurses care for patients with dysfunctions of the nervous system, including brain and spinal cord injuries and seizures. Ophthalmic nurses provide care to patients with disorders of the eyes, including blindness and glaucoma, and to patients undergoing eye surgery. Orthopedic nurses care for patients with muscular and skeletal problems, including arthritis, bone fractures, and muscular dystrophy. Otorhinolaryngology nurses care for patients with ear, nose, and throat disorders, such as cleft palates, allergies, and sinus disorders. Respiratory nurses provide care to patients with respiratory disorders such as asthma, tuberculosis, and cystic fibrosis. Urology nurses care for patients with disorders of the kidneys, urinary tract, and male reproductive organs, including infections, kidney and bladder stones, and cancers.

Finally, RNs may specialize by providing preventive and acute care in all health care settings to various segments of the population, including newborns (neonatology), children and adolescents (pediatrics), adults, and the elderly (gerontology or geriatrics). RNs also may provide basic health care to patients outside of health care settings in such venues as including correctional facilities, schools, summer camps, and the military. Some RNs travel around the United States and abroad providing care to patients in areas with shortages of medical professionals.

Most RNs work as staff nurses, providing critical health care services along with physicians, surgeons, and other health care practitioners. However, some RNs choose to become advanced practice nurses, who often are considered primary health care practitioners and work independently or in collaboration with physicians. For example, clinical nurse specialists provide direct patient care and expert consultations in one of many of the nursing specialties listed above. Nurse anesthetists administer anesthesia, monitor patient’s vital signs during surgery, and provide post-anesthesia care. Nurse midwives provide primary care to women, including gynecological exams, family planning advice, prenatal care, assistance in labor and delivery, and neonatal care. Nurse practitioners provide basic preventive health care to patients, and increasingly serve as primary and specialty care providers in mainly medically underserved areas. The most common areas of specialty for nurse practitioners are family practice, adult practice, women’s health, pediatrics, acute care, and gerontology; however, there are many other specialties. In most States, advanced practice nurses can prescribe medications.

Some nurses have jobs that require little or no direct patient contact. Most of these positions still require an active RN license. Case managers ensure that all of the medical needs of patients with severe injuries and illnesses are met, including the type, location, and duration of treatment. Forensics nurses combine nursing with law enforcement by treating and investigating victims of sexual assault, child abuse, or accidental death. Infection control nurses identify, track, and control infectious outbreaks in health care facilities; develop methods of outbreak prevention and biological terrorism responses; and staff immunization clinics. Legal nurse consultants assist lawyers in medical cases by interviewing patients and witnesses, organizing medical records, determining damages and costs, locating evidence, and educating lawyers about medical issues. Nurse administrators supervise nursing staff, establish work schedules and budgets, and maintain medical supply inventories. Nurse educators teach student nurses and also provide continuing education for RNs. Nurse informaticists collect, store, and analyze nursing data in order to improve efficiency, reduce risk, and improve patient care. RNs also may work as health care consultants, public policy advisors, pharmaceutical and medical supply researchers and salespersons, and medical writers and editors.

Working Conditions	[About this section]	Back to Top

Most RNs work in well-lighted, comfortable health care facilities. Home health and public health nurses travel to patients’ homes, schools, community centers, and other sites. RNs may spend considerable time walking and standing. Patients in hospitals and nursing care facilities require 24-hour care; consequently, nurses in these institutions may work nights, weekends, and holidays. RNs also may be on call—available to work on short notice. Nurses who work in office settings are more likely to work regular business hours. About 23 percent of RNs worked part time in 2004, and 7 percent held more than one job.

Nursing has its hazards, especially in hospitals, nursing care facilities, and clinics, where nurses may care for individuals with infectious diseases. RNs must observe rigid, standardized guidelines to guard against disease and other dangers, such as those posed by radiation, accidental needle sticks, chemicals used to sterilize instruments, and anesthetics. In addition, they are vulnerable to back injury when moving patients, shocks from electrical equipment, and hazards posed by compressed gases. RNs who work with critically ill patients also may suffer emotional strain from observing patient suffering and from close personal contact with patients’ families.

Company doctor and nurse services

can have a significant impact on performance and productivity within your organisation, as well as being a highly appreciated employee benefit.

Reduces time away from work
Helps keep your staff at optimum health

Easily tailored to your staff's needs
Appreciated by your staff
Highly experienced practitioners
Nursing support

Instead of visiting their own GP, your employees will be able to see a doctor based on-site or nearby. This reduces the need to take time off and results in less disruption to the working day. These advantages can be easily illustrated:

Case 1: a key revenue generator takes time off to see her local doctor, 30 miles from the office, resulting in a whole morning of non-productivity. She has to wait two days for the appointment, whilst soldiering on under par.

Case 2: a project team member takes an afternoon off to see his home doctor - upsetting the team's performance or even halting its work entirely.

Compare these scenarios with the 15-minute appointment time needed to consult an on-site BUPA doctor and you can appreciate the potential benefits of the service to both the company and its employees.

Case study: Reducing the cost of lost time away from work to see the doctor, dentist or physiotherapist

From Undecided To Decided – A College Journey

Getting ready for college is much more than choosing the school, roommate and what hotspot is your favorite. There are many things to consider and one that is commonly overlooked, sometimes for years. Many students spend their younger and teenage years boasting what they want to be when they grow up, but when they get to college they can not make up their minds. For some, this is a panic because there are only so many basic classes that a student can take before it begins costing them. Even sometimes a few of the basics are specific or may not be required for a particular degree plan. There is nothing wrong with being undecided in the beginning, however as your college career advances, you need to make decisions about how you will spend the rest of your college life. Here are some of the basics about an undecided major and tips on choosing which degree plan to pursue.

Asking yourself a series of questions can assist in deciding on the exact path in college. There are many and even specialties in certain fields so really examining your knowledge as well as desires will assist in this important decision. You probably have narrowed the question down to maybe a specific field or may be struggling with more than one field. Could it be possible to combine the two, sometimes this makes for an excellent and highly demanded employee. Consider the following:

What is your passion – sometimes your passion may not be clear until you accidentally stumble upon something. This is present in stories such as the young lady that had always dreamed of being a teacher. As a child, she would line up her dolls and teach them the lessons she had learned that day at school. This was her plan and nothing could stand in her way, until a tragedy in the family. After her grandmother was diagnosed with cancer and she watched as she withered away, she had a notable thought. Watching how the medical profession, primarily the nurses made her grandmother comfortable and held her hand through the many long procedures changed her life forever. After very little thought or consideration the college application changed and today she is a successful nurse working in the Pediatrics field. Holding the hands of countless children while they too undergo some uncomfortable, but necessary medical treatments, is the happiest she has ever been.

Positive Attributes – Regardless of training some people are just better at some things than others. It is wise if you choose what you want to be when you grow up around something that you excel at. If you are a math whiz then you may want to consider business, accounting or some form of engineering. If it is people skills that you possess, how about a counselor, social worker or some other community helper. Generally, these individuals have exceptional listening skills, empathetic and have always been drawn to lend a helping hand. What about those that are excellent at getting the point across and are great at teaching. A teaching degree or some other form of educational career such as a diagnostician or administrator would be great. If running to the side of an injured or sick individual is your passion then pursuing a nursing degree is an exceptional idea. Nursing is not only about patching a boo-boo or holding a hand, it is about saving lives, educating patients and most of all making them feel better. Nurses are in high demand because of the nursing shortage in the United States, and God bless the nurses of this world!

Job Assessment or Placement – If your job placement assessment turned out like mine then you are in the wrong field. Keep in mind that just because your scored out at a particular field, does not mean that it is your life's career. Be careful with only using this test, because it is not 100% guaranteed. You must follow your heart and keep to something that you can feel good about doing. Because you are good at doing a particular job does not mean that it is something you want to wake up to for the next thirty years or so. Choosing a career field is a big decision and must be based on a variety of things, not just a test.

Your Parents & Their Accounting Degree- some career fields work better for some than others. You can not and should not base your career choice on what your parents have in mind for you unless it is something that you want to do. All too often college students fall into a trap of going to school for someone else and then hating their job for the rest of their lives. It is very important that you pursue the career field that interests you. A job should be a passion, something that you are ready to go and do, not dreading a forty-hour workweek that seems like hell.

Staying Undecided – It is perfectly acceptable to remain in an undecided plan until you have made your decision. There is not a huge rush to make a decision after you receive your acceptance letter. In fact many students enter one department and change two or three times before graduation. The important part of getting a college education is the fact that you are bettering your life regardless of the academic path you choose.
by Gene Grzywacz

Career Options For The Ambitious Nurse Entrepreneur

Nurses are taking control of their careers by exploring options other than the traditional roles of yester-year. Independent RN Contractors are storming the healthcare field. There was a time when nurses were hesitant about cutting the ties from the employer not true today. More and more nurses are now enjoying the many benefits of self-employment. Nurse Contractors are now a large part of the nursing industry thanks to the ambitious nurse entrepreneurs. Nurses have realized the many advantages of cutting the middleman out of nursing.

An Independent Nurse Contractor is one who practices outside the customary role of an employee of another; as an alternative they elect to work as an independent contractor. You will set the terms of your services limited only by need and your ability to negotiate. An Independent contractor can contract his or her nursing services directly with a healthcare facility or with a patient and continue bedside practice. A contractual agreement is drawn up between you and the institution. You will be able to negotiate your compensation, hours worked and length of time your services will be needed. The contract is similar to those used by nursing agencies and travel companies outlining the services to be provided, the responsibilities of both the healthcare facility and the nurse, and the length of time the services are to be provided. Nurses contract their nursing services out to a huge assortment of fields in the Healthcare Industry; Home Health, Nursing Homes, Hospitals, Rehab Centers and Doctors Offices just to name a few.

You may elect to practice as Sole Proprietors, Limited Liability Company or with others in a group using a variety of legal entities. These could include public corporations, partnerships, or other structures that professionals commonly use such as a common term “registrars” .It is actually something that nurses have been doing all along. Think about it, when you work for an agency you are doing the same thing except now you are eliminating the middle man and enjoying the all the benefits without them taking a large piece of the pie.

Any nurse can start a business, including two-year graduates and diploma nurses. No advance degrees are necessary unless your business includes diagnosing and treating medical problems. State nurse practice acts do no prohibit a nurse from starting up their own business as an Independent Nurse Contractor. Independent nurse contractor is one who contracts with a healthcare facility for nursing services. A contractual agreement is drawn up between you and the institution. You will be able to negotiate your compensation, hours worked and length of time your services will be needed. There is no prohibition in any Nurse Practice Act that prohibits your practicing as an independent contractor.

The advantages of business ownership are rewarding and challenging and far exceed the risks. No more Bosses, You are now your own chief. Dedication, ambition and long hours can increase your income, rather than increasing profits for someone else. Starting A Nursing Agency and working as an Independent Nurse Contractor is one that more and more nurses are turning to for career fulfillment. Nurses are finding that they can double or even triple their income; increase their choices as to how often when and where to work, gain professional autonomy and increase over all job satisfaction. So get rid of the “middle man” and enjoy all the benefits offered in this exciting Nursing Career Opportunity.

Visit http://www.independentrncontractor.com

Get everything needed to start up your business today

RN to MSN - Career Benefits and Education Options

A nurse in many cases holds a Master of Science in Nursing (MSN). The implications of an RN receiving an MSN go beyond patient care. Their education in leadership, research, and understanding the current political framework of the medical system allows an MSN to achieve greatness in the field of nursing.

Changing Course – RN to MSN

There are major differences between an RN and MSN. The education attained by an MSN opens the doors to learning the field of medicine that is similar to the work of a medical physician.

An MSN may choose one of many different nursing roles. They may be a Nurse Practitioner who diagnose and treat patients, Certified Registered Nurse Anesthetist who provide anesthetics to patients in collaboration with surgeons, dentists, or childbirth procedures. Next we have Certified Nurse Midwives who provides primary health care to women, prenatal care, labor and delivery care, care after birth, gynecological exams, and many other care taking procedures necessary for women’s health. Lastly, there is the Clinical Nurse Specialists who specialize in education, research, consulting, case management, and leadership.

National Implications of MSN

Managed care, Medicare, Medicaid, and hospital reimbursement issues are all realities of the current health care system. Many new nurses are unfamiliar with the national crisis occurring each day; a cloud of financial and political challenges that are within the medical system.

For an RN who seeks to make a difference in the current structure of our political system, they will be motivated to receive an MSN. An MSN degree offers the opportunity to deal with these issues head-on.

As medical costs continue to increase astronomically, the challenge is to cut costs wherever possible. Studies show that the U.S. could save up to $8.75 billion annually if MSN’s were used in place of physicians (Thomson Petersons). Advanced practicing nurses with MSN’s will be at the frontline to save money and treat patients, to diagnose and replace the role of the physician.

In addition, MSN nurses such as clinical nurse specialists, nurse practitioners, midwives, and anesthetists, are in high demand, for the medically underserved areas of both rural and urban settings to serve as lower-cost primary care providers (U.S. Department of Labor). In rural settings in particular, there may be fewer physicians available and the MSN will replace the duties of the absent physician unless the patient requires the use of hospital facilities or advanced medical care.

Education, Admission Requirements, and Salary

In order for an RN to achieve an MSN and become an advanced practice registered nurse, most programs require a masters program lasting approximately 2 years following the Bachelor of Science Nursing degree. Some programs require at least 1 to 2 years of clinical experience as an RN for admission. In 2004, there were 329 master’s programs for nurse practitioners, 218 for clinical nurse specialists, 92 for nurse anesthetists, and 45 for nurse midwives (U.S. Department of Labor). Many programs combine the BSN and MSN degree for the nurse to graduate with two degrees together.

The education includes both classroom learning and clinical requirements. Admissions usually require scores taken from the Graduate Record Exam (GRE) or the Miller Analogies Test (MAT). In addition, college transcripts, letters of recommendation, and essays, are usually required.

MSN’s generally receive a higher salary than BSN’s and RN’s. The average salary for a RN/BSN is between $43,000 and $63,000. The average salary for a Nurse Practitioner, for instance, is approximately $66,000 and can go up to $90,000 if the nurse owns their own practice.

Conclusion

An RN who is becoming an MSN has much to ponder for the field they are about to enter. It is no longer about just becoming a practitioner. Many RN’s become outstanding clinicians; however the doors are open to make a difference in the current financial, political, and health care system. Their training is in leadership, research, clinical learning, and communication skills. This is a formula for success in the dynamic field of nursing.

Copyright 2006 Michael V. Gruber, MPH

Registered Nurse Jobs

It sometimes may seem like there are pages in the classified ads every Sunday for registered nurse jobs. In fact, registered nurses now constitute the largest healthcare occupation, as there are over 2.3 million jobs available. If you are looking to get into a growing field where you are in the drivers seat with employment and salary choices, it may be that becoming a registered nurse is a good option for you.

What is a registered nurse and why are there so many registered nurse jobs out there? A registered nurse is one that has a college degree (Associate’s or Bachelor’s degree) from an accredited institution and has passed his or her nursing boards. Required classes to get a degree so that you can qualify for registered nurse jobs include anatomy, physiology, chemistry, nutrition, and behavioral science classes like psychology. Most schools require clinical experience, and this experience will also help you when you are looking for registered nurse jobs.

Education and experience are key components to certain registered nurse jobs. If you are considering registered nurse jobs in administration, you may want to consider getting a Bachelor degree, as many organizations now require it. Sometimes if you are considering registered nurse jobs in more complex areas like surgery or neo-natal intensive care, organizations will want you to gain significant clinical experience. Also, other registered nurse jobs may even require you to have a masters’ degree, like being a nurse practitioner, certified nurse midwife, or certified nurse anesthetist.

Registered nurse jobs require a lot of patience and dedication, as a registered nurse will be promoting good health, prevent disease, and helping patients through times of illness. Registered nurse jobs also require you to be detail oriented and have decent writing skills. For instance, registered nurse jobs in psychology will require a nurse to document (in detail) behavior, response to medication, and follow doctor directions carefully so that a patient receives the appropriate care.

If you are qualified or looking to be qualified for registered nurse jobs, then you should be pleased that the job outlook for registered nurse jobs is very high. In fact, registered nurse jobs are expected to grow faster than the average growth for all other jobs through the year 2012. Registered nurse jobs in hospitals is expected to remain the same, though registered nurse jobs in nursing care facilities is expected to grow exponentially as the baby boomer generation ages.

Other areas in which registered nurse jobs are expected to increase is home healthcare and outpatient care centers. The growth for these registered nurse jobs may be due to technological advances and pressure from insurance companies to avoid in-patient hospitalization. Many advances in medicine have created registered nurse jobs in which RNs travel to patient homes to provide care or perform procedures in outpatient facilities.

The varying types of registered nurse jobs, and the great need for people to fill those jobs has offered the opportunity for RNs to have more variety in their careers. Many organizations now offer major bonuses and high salaries to lure RNs, as there are more jobs than nurses. Thus, finding registered nurse jobs can be a process of knowing what type of nurse you want to be and seeking out the opportunity to fill that need.
by: Charles Fuchs

Welcome to the Board of Registered Nursing

The California Board of Registered Nursing (BRN) regulates the practice of registered nursing and certified advanced practice nurses in order to protect the public. The Board exists to protect the health and safety of consumers and promote quality registered nursing care in California.
Information About
Picture of nurse

* Applying
o Frequently Asked Questions
o Licensure by Examination
o Licensure by Endorsement from Another State
o Repeat / Reapply for Licensure by Examination
o Advanced Practice Certification
o Reinstatement of a Lapsed RN License
o Continuing Education Provider Number
o Fingerprint Card / Live Scan Form Requests
* Renewing
o Frequently Asked Questions
o Renewal of RN License
o Renewal of Advanced Practice Certifications
o License Duplicate/Replacement Requests
o Verification of Licensure
o Change of Name and/or Address
* Careers in Nursing
o Careers in Nursing
o Become a Nurse Ambassador
o Steps to Become a Registered Nurse
o Financial Aid Information
o Get a Nursing License
o For Future Nurses
o Governor's Nurse Education Initiative



Upcoming Meetings

* Board Meeting
November 29-30, 2007 | More Information
* Diversion/Discipline Committee Meeting
January 17, 2008 | More Information
* Education/Licensing Committee Meeting
January 17, 2008 | More Information
* Nursing Practice Committee Meeting
January 17, 2008 | More Information

What's New

* Federal Bureau of Investigation's (FBI) Fingerprint Processing Fees Reduced - October 1, 2007 | More Information
* Forecasts of the Registered Nurse Workforce in California - September 20, 2007
* Exciting Job Opportunity, CA Department of Aging (CDA)! | More Information
* Survey of Registered Nurses in California 2006
* 2005-2006 Annual School Report with Prelicensure Interactive Database | More Information
* Regional Forecasts of the Registered Nurse Workforce in California
* More What's New

A Female Soldier's Last Battle

I arrived at Fort Bragg, North Carolina, in 1974, in my 19th year, into the heart of the 82nd Airborne Division at the John F. Kennedy Center. The old timers called Fort Bragg “Little Hell.” The 82nd Airborne was the first to engage the enemy on land to protect America’s freedom. Even in peacetime, there was always a natural tension of readiness and alertness among the troops and around the base itself.

Every other day or so a C-40 transport plane would arrive with a load of America’s kids, gaunt, aged, gray-haired beyond their years. Some shielded themselves with a barrier of hostility. They wouldn’t let you get close, didn’t want to know anyone, didn’t want anyone else to die in their arms. Some were hostile, some clearly mentally destroyed, forlorn and withdrawn, being led around like zombies. The first ones off the plane were in wheel chairs or on crutches, missing limbs, faced burned beyond recognition. All would be greeted by mobs of defiant protestors.

“Baby killers!” the mobs would chant, taunting and spitting at the returning soldiers. The protestors wore flags sewn to the seats of their jeans to demonstrate their disrespect for the American government and our country’s policies. The irony was their freedom to protest against the very kids who were risking their lives to defend democracy and the right to protest.

In the midst of the mob were grieving parents, claiming their sons in body bags. Many of the young returning survivors were hooked on heroin or cocaine, not at all coping with the devastating Vietnam experience they had endured. The rejection of their sacrifice by the American people only compounded the residual trauma of the killing fields. I saw the irony. Most of the returning vets were from lower and middle-class backgrounds. Most of the protestors were the privileged and the educated who didn’t have to go to war.

The talk on the base was all about John Travolta’s Saturday Night Fever. Another John by the name of Elton was making a splash with Kiki Dee in the duet Don’t Go Breaking My Heart. Sadly, for me, this was clearly be a place of broken hearts and broken dreams. From my point of view, the returning vets were damaged for life. I didn’t see how they would ever get on their feet. More than the loss of a leg, an arm or a fellow soldier, how would they ever heal their broken spirits?

In “Little Hell,” I was the first white soldier to be phased into an all-black unit. This phasing-in process was part of the military’s on-going plan to fully integrate the army. Official desegregation was passed into law in 1948, but that was the end of it. The reality was the races had difficulty working together, so ethnic groups congregated. All white and all black units still existed, and desegregation was still only on paper. When I was in basic training in Missouri, three white soldiers viciously assaulted a black soldier who they refused to allow in their unit. The drill sergeant supported it, and looked the other way. At this point in time, everybody looked the other way. But at the moment of my enlistment, through the encouragement of President Jimmy Carter, the Army official policy intended to make desegregation a reality. I was one of the first soldiers to be involved in the process.

Understandably, many among the African-American troops did not welcome my arrival. In particular, one of my roommates, Marty, had the habit of making “whitey” his punching bag. He continuously incited others to vent their racial anger as “black power” and do the same. I remember that into this tense situation, my other roommate, a good friend and fair-minded individual by the name of James Bailey, spoke words of wisdom.

“This is the army, and everyone has only one color…green. Give him a chance, Marty.” James was wiry and tough, with a don’t-mess-with-me quality honed in the streets. Marty was a good fighter, but he was softer from privilege in his life, a little more GQ, and he listened to James.

The music that defined my life at this moment came from Pvt. Billingsley, a heroin addict, who always seemed to be playing the Average White Band album, and particularly the single, Play that Funky Music, White Boy. It was either this or Herman Melville and the Bluenotes singing, “Oh, mercy, mercy me, things ain’t what they used to be.”

Billingsley used a three-word response in every situation to sum up the negativity of the environment. “This is bullll-shit, man, this is bullll-shit!” If I entered the barracks, if it was raining, if it was time for dinner, it was always the same response. Soon everyone would be repeating this mantra, and most would nod their heads and agree, “Uh-huh,” with vacant, drugged eyes. This was one of the more obvious signs of the depressed and oppressive atmosphere in “Little Hell.” The sergeants in my unit had just come from long tours of duty in Vietnam. They knew the military from experience. Shortly after my arrival, Second Lieutenant Mayer was put in charge of our unit. He was a thin, white Mormon from Brigham Young University who had only book experience from the ROTC, and had never tasted combat. Since he had to prove his authority over the combat soldiers, he made certain we took orders from him, by making our lives miserable. Tensions were high between the white lieutenant!

and the black sergeants. I was caught in the middle.

Fortunately, this was a time in my life when I was gathering much personal strength through the spiritual path of Zen Buddhism, a path of meditation that awakens the seeker to the timeless present moment. Zen Buddhism teaches the practitioner to value life, because it is transitory; we never know when death may come to call us. So we work diligently in the here and now, where we are, to achieve the enlightened state. The enlightened state is experienced when the practitioner brings all of his or her aliveness and concentration fully to the present moment. This is a way of finding the strength of God within right here, right now.

The requirements of sitting zen, known as zazen, are rather demanding. Zazen is the practice that Buddha used to attain spiritual enlightenment. In zazen, the meditator sits Japanese-style on the heels. However, in this rather difficult practice, the weight of the body is held approximately one-half inch off the heels by the strength of the legs. The chin is perfectly parallel to the floor, and every effort is made to hold a perfectly erect position. You sit absolutely still and keep the attention focused on the present moment, the breath, and nothing else. It is a powerful technique used by many martial artists, as it sharpens the mind and body very quickly. Our days were rather full so I would have to be up by four AM in order to get an hour of zazen under my belt. I wore a T-shirt and combat fatigue pants. It was quite cold, but in zazen you learn to ignore the needs of the body. What is a little cold compared to the goal of liberation and spiritual enlightenment?

Buddha was only a man, and he told himself after he sat under the Bodhi tree that he would not leave that spot for any reason until he achieved enlightenment. If Buddha could do it, there is hope for the rest of us. Buddha said, “I am a human being who is evolving spiritually. What I can accomplish, you can accomplish.”

One morning, Marty got up to use the restroom. Imagine his surprise to see me sitting so erect and motionless! He freaked out, and kept staring at me. And staring, And staring. I didn’t move a muscle. Marty was petrified. He was spooked, as if he was witnessing something demonic. He awakened Bailey to have a look. Bailey explained, “He’s meditating, man. It’s cool, it’s what you do in karate.”

Thank you, James Bailey. From that moment on, I was known as the meditating martial artist. I was continually giving classes to my fellow soldiers, showing them how to punch, block, and kick. It is amazing that in the West you can get away with being into God and spiritual subjects if you are a good fighter. The contortions one goes through for the Lord!

Bailey started to meditate with me every morning. Then another soldier from Hawaii, a black belt in Tae Kwon Do named Rick, joined us as well. Soon we had five meditating military monks in our zendo. (A zendo is the hall where the group practice of Zen takes place.) Before long, there were too many of us to use the barracks room. We relocated to a recreation hall and practiced around the pool tables. We needed a roshi, a Zen priest, and I was elected to serve in that capacity. I used the pool stick for the kyo-kyaku stick to keep the fires of meditation burning. The kyo-kyaku stick is also known as the stick of compassion. The monk uses it if your posture weakens or you start to fall asleep. He strikes you on either the right or left shoulder. After you are struck, you bow to the roshi in gratitude for keeping you on the path to enlightenment. The loud “crack” of the kyo-kyaku stick has been known to bring many a monk into spiritual enlightenment. Because the crack happens in!

the moment, it forces you to awaken into the moment. Buddha means “the awakened one.” To remind others of the transitory moment of life is an act of great compassion. It encourages the experience of the preciousness of life. Further, Zen teaches that we all have the power to turn hell into heaven. “Little Hell” needed a dose of Zen Buddhism.

Bailey invited our first female practitioner to join the group. This was Margaret, a single African-American mother of two young children. In attitude and physical shape, she reminded me of Whoopee Goldberg, except for her short military haircut. Nobody messed with Margaret. Her will power was too strong. Since the military was strict about weight, she had remarkably trimmed her body for 90 days on nothing but tuna and water. Margaret was a loner, who had clearly had a hard life. She’d known plenty of alcoholism and abuse from family members and her ex-husband, and although she was only twenty-four, she looked about fifty. In addition to her substantial military duties, she had the full responsibility of raising her two kids, four year-old Joe and five year-old Little Maggie. Yet she also was taking college classes. I first met her at night school, in Black History class. She needed the credit for the Nursing Degree she was working toward. I admired Margaret. “Little Hell” wa!

s hard enough for a man. Women weren’t respected. They could technically join the military, but they weren’t welcome.

All who attended the morning sesshins, as they were called, were dedicated and disciplined individuals without exception. I was a committed roshi, very serious about meditation and very strict about latecomers. I wanted everyone to achieve enlightenment so that we could live in a happier, and more peaceful world. No one wanted to be the recipient of Sergeant Schnell’s displeasure. That was the effect of the military, karate and Zen on me!

One day we knew something was wrong when Margaret didn’t show up. I discovered later that afternoon that she’d been diagnosed with leukemia. Her case was advanced, and she was in great pain and suffering. The doctors gave here only a short time to live. Margaret continued to attend sesshin for as long as she could. She said that the meditation helped her manage the pain and get through her day. Every morning she’d show up. She didn’t care about the diagnosis or what the doctors said. Her indomitable will kept her focused on her Zen meditation discipline. For all of us in sesshin, Margaret became the Buddha. Her strength during this crisis made our practices and difficulties seem lightweight by comparison. Margaret always asked for an extra dose of the compassion stick from me.

Her disease progressed until one morning Margaret didn’t appear. The temperature in the zendo that morning was particularly cold. Later that day, I learned from James Bailey that Margaret was in the hospital. I found her there, practicing her zazen in spite of heavy pain medication. She asked me if there was a way I could bring the sesshin to her hospital room. With her encouragement, nine of us gathered at the hospital early every morning to keep the sesshin going. The rest of the group continued without us at the recreation hall. Everyone wanted to participate with Margaret, but we couldn’t bring that many people into her room.

Our first obstacle was Nurse Leona, a Christian Fundamentalist. With a temper that matched the color of her red hair, Leona let us know that she didn’t want any disturbance on her floor. We explained that what we were doing was spiritual, that it was Margaret’s religion, and that we would be extremely quiet. She wanted no part of what she perceived to be Satan’s work and went to great lengths to have us expelled.

Leona complained to the hospital chaplain that a non-Christian element was invading the peace of the hospital. She called Second Lieutenant Mayer, and enrolled him to keep us distracted from our practice. He put me on all night guard duty with no relief, and he sent Bailey and I into the field for a week of survival training with no food. Margaret persevered while awaiting our return, and as a group we held our ground with clear, quiet, Zen authority. It was the first time I realized how few rights a hospital patient has. You can be dying and a fundamentalist nurse can deny you’re your religious preference and freedom. In order to see Margaret and help her with her Zen practice, I was required to fill out several forms declaring my religion to be Zen Buddhism, although I was, in truth, a Christian practicing Zen Buddhism. I had to do the same for Margaret and the rest of the group. I was also told that this admission would affect my ability to keep my Top Secret clearance. It!

was clearly a threat, designed to discourage me, but Margaret’s one-pointed determination that the group must continue as a whole was my inspiration. She was a clear model that especially in sickness that you need to keep your spiritual discipline.

An old, black Master Sergeant, a Green Beret, who joined our group every day went straight to the Head Chaplain of Fort Bragg. This Master Sergeant was one of the first people in my life who completely impressed me. He was all soldier, tall, erect, muscular, all spit and polish, an African-American king. No one crossed him, but not because he was mean. On the contrary, he was kind and fair, and he was known to be colorblind. He treated everyone equally. He was so decorated for heroism and carried himself with such regal dignity, his word on the base was essentially law. He worked around the clock to get the returning soldiers from Vietnam off drugs. The Master Sergeant had seen action in the Korean War and served multiple tours in Vietnam, where he saved countless lives and seen numerous buddies killed in action. Yet he maintained a powerful, positive spirit and strength I only wanted to emulate. In fact, he had been first exposed to Zen while touring in Vietnam. One of is ob!

vious big frustrations was dealing with the “textbook” officers like Second Lieutenant Mayer, who had no experience in combat but ranked over him because of a college degree.

The Chaplain was a textbook soldier like Lieutenant Mayer with a higher rank than the Master Sergeant, but I suppose the Master Sergeant made it clear that if Mr. Chaplain wanted to continue to receive the cleanest and finest transportation everyday he would have to play ball. I suspect he also made it clear that he was aware of some of the married Mr. Chaplain’s shenanigans with one of the young female soldiers. Apparently, he’d transferred her from his motor pool to be his personal secretary, and things were going on in his office behind closed doors. At that time, sexual harassment had not yet become an open issue in the military, but the Master Sergeant had a case to make, and the Chaplain knew it. No one messed with this Master Sergeant, not even the generals!

Much to Margaret’s relief, and the chagrin of Nurse Leona, we were granted clearance to report to the hospital at 8 AM to honor our spiritual practice of zazen. We were excused from all other duties from 8:00 to 10:00 AM.

Still there was quite a scene. Imagine a typical military doctor striding into the room with, “Hello, and how we doing today,” only to find nine soldiers sitting on the floor in perfect, silent zazen around the bed, in which sat his patient, totally still and erect. When doing a sesshin, we would not even veer from our practice to acknowledge the doctor or anyone who entered the space. The sesshin was our time to focus on our inner divinity. Often Margaret’s two young children, Joe and Little Maggie, would participate by sitting on the Master Sergeant’s lap. The kids behaved, because their mother had taught them the rules. After a few days, the doctor got into the spirit of it. He realized he was walking into a zendo temple. He came in quietly and performed his examination serenely. It was a total shift in the typical hospital protocol.

As Margaret grew weaker, she took advantage of the tilting mattress to keep her upright. Then she would just lie back with the bed tilted at the proper angle. In Japan when a person is dying, a screen is put in front of them that shows the Buddha traveling to heaven. The screen is used as a reminder about where we are to focus during this journey of life. Every minute of every day I wished for that screen for Margaret. I told her about the screen and its symbolism, but we both knew that it wasn’t likely we’d find a Buddha screen in the Bible Belt of North Carolina. She remarked that for her I was her screen, her reminder to look to heaven and follow the Buddha. For me, Margaret’s poise and her grace as she faced her death certainly made her the Buddha.

The doctors were amazed at how calm and accepting Margaret was about everything. They said she was taking about one-third the pain medication that similar patients would take. On some days, she took no pain medication at all. They didn’t understand how it was possible. Since Margaret had no family, the Master Sergeant was busy making arrangements with the social organizations to take care of Joe and Little Maggie.

We arrived on time one spring morning to find Margaret’s bed empty. Nurse Leona told us somewhat cruelly that we were no longer allowed in the hospital. We learned from the doctor that Margaret had died peacefully around 4:00 AM. He said she rang the bell for assistance and when they got there she had already died. Her bed was tilted up and she was sitting comfortably with a peaceful look on her face – a Zen Buddhist all the way! More than likely she made a conscious transition to the heavenly realms while sitting and doing her habitual practice.

Margaret had a military funeral, disguised as a weapons training procedure. Military funerals for ordinary soldiers are not customary, but all the arrangements had been quietly made by the Master Sergeant. The Chaplain was absent, so the Master Sergeant read from the Old Testament, the 23rd Psalm. I was given the privilege of folding the American flag that adorned Margaret’s simple casket and presenting it to her children. I walked toward them in the slow, dignified, carefully measured steps of the walking form of Zen meditation known as kinhin. A lump formed in my throat that I couldn’t control.

“Your mother was so strong, Joey,” I whispered as I knelt close to him. His big sad eyes looked directly into mine. “Keep this flag to always remind you of how strong you are and how strong your mother was.”

He asked, “Is my Mommy coming back?”

With tears streaming down my face, I said, “She’s with God now.”

As Joe took the flag in his little hands, he stood straighter and tears rolled down his young face as well. I rested my palm upon Little Maggie’s head. She reached up for me to hold her, which I did. Her little arms squeezed around me in the tightest grip I’d ever known. She buried her head in my shoulder and sobbed.

The shots from the rifles rang out in the clarity of that brisk spring morning, unexpectedly, like the crack of the kyo-kyaku stick. For me, and I’m sure for most of the zendo group, they symbolized Buddha’s teaching to awaken in this very moment to the preciousness of life.

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by: Donald Schnell

What You Need To Know About SEO: Basic Facts

Exposure could mean a lot for different firms, organizations or groups seeking a wider venue to make their views heard, accepted, and patronized. The main term used for this web-positioning method is the seo, or the Search Engine Optimization.

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What exactly is Search Engine Optimization?

The Internet age has spawned a phenomenon of new terms, new jobs, and new career paths. The growth of the Worldwide Web is creating a new realm, where new types of internet-savvy folks engage in careers that require the skills of an intrepid explorer, searching for new worlds to discover. Among these new tasks are those that require the faster, more strategic placement or positioning of company adverts, documents, products or issues, in order for these entities to have the most maximum level of exposure in the web.

Exposure could mean a lot for different firms, organizations or groups seeking a wider venue to make their views heard, accepted, and patronized. The main term used for this web-positioning method is the seo, or the Search Engine Optimization.

Search Engine Optimization is the terminology used to define, or describe the action of gaining a better position within a search engine or internet directory system based upon a selected key word or a group of key words. With well over 4 billion documents already on the internet, the prominent search engines are all flaunting that they can locate most of them and show you a link from within their systems, and each of the search engines or directory providers have different guidelines by which a listing within their system is accomplished.

* Achieving Maximum exposure

As web-updated consumers, we are constantly on the lookout for sites that address our specific interests, goals, or products at a specified time and day. Most of us do not always know the URL (Universal Resource Locator) for all the types of businesses that can fulfill that interest, so we use a search engine or directory service to find them for us.

For example, I plan to go out and take my girlfriend with me to a bar, but I haven’t got an idea of which place to go to that I haven’t already been to yet. The next most probable step for me would be to go to a search engine and type in something like: “bars and restaurants pasadena ca"; I put in the quotation marks to make the search more specific, to get me closer to what I am looking for. The phrase I wrote, "bars and restaurants pasadena ca" will be used represent my main key word phrase.

Once I write those key words, I am, hopefully, going to get back a list of the restaurants within the greater Pasadena area, and I indeed got well over 500 or so choices too. What makes it more helpful is that I could find those assorted choices in the local phonebook listings. However, if I wish to make my list of choices much shorter, I would type in, or enter a new search maybe like: "jazz bar pasadena ca”.

Once the search engine has done its job, then I probably will get a shorter list with these new, more precise characteristics. However, the list created will be made in an order that is determined by the search engine. The first one may or may not be starting with the letter A or a number like the one on the phone directory.

From the bar and restaurant viewpoint, if they could be in the top 10 or 20 and get a lot of “hits” or visits by web users, they will have a chance of being seen by the searcher. This is what Search Engine Optimization is all about: gaining a position as close to #1 as possible and then staying there on top, and to achieve maximum exposure.

* It’s all about location

For those who own businesses, then the primary name of the game is profits. Revenue of course, comes from people who spend their incomes with you. The more people spend their money with you, the richer and more successful you become.

In today’s business environment, it is all about LOCATION, and the next important word that comes is “ADVERTISE”.

The way the worldwide web works is the same as in the world of advertising or the directories: It’s about location in the search engines and directory systems, and advertising. If your listing is something less than the top 100, you stand an excellent chance of never being seen, or viewed. Most people are notoriously impatient, and they do not wish to wade through tons of listings. This simply means that you really need to be near, or on the top of the lists for the key words that you feel your prospective customers are, or will be using to find you.

* How Search Engine Optimizers Do This

Improving your position on the web could be done through a wide variety of methods. An easy way for this is to hire a professional Search Engine Optimization firm that can do the job for you. You could check their fees and price ranges on the web or the phone book. The process is definitely a labor-intensive one, and definitely doesn’t come cheap.

But anyway, you too can do it yourself. All you need to do is to get the rules for listing within each of the engines and directory systems where you wish to be listed, the register with them. If they allow you to point to secondary pages that also discuss specific topics, then be sure to do that by pointing to the pages within your site that cover that topic. You may also need to check on your position every month within each of the engines and directories to see how you are stacking up, and sometimes you may need to modify your site to improve your position, as well as your exposure.

by: Vanessa Doctor

The Doctor and His Cat

One day I saw a doctor playing a cat with a plastic fish. I went closer and told the doctor, "You have a nice cat, Doc."

The doctor answered, "Oh! Sel… I enjoyed playing my cat with this toy." He showed the plastic fish to me and said, “Yesterday morning, I fed this cat with a real fish. The cat immediately eat the fish alive. In the afternoon, I made this toy smell like a real fish and give it to the cat, but the cat didn’t responded. He only threw a weird look into this toy, and then after a while the cat played it."

I only smiled at him to show my agreement with him.

"Now I realized," the doctor continued, "that cats are really intelligent. We couldn't fool them. They knew if the food we fed them is real or not."

"Yes doc. Cats are really intelligent." I agreed. "They’re even smarter than you Doc. Cat’s didn’t study to learn what’s the real fish and what's not, isn’t it? And you studied several years just to earn the title and profession as a Doctor, but then you didn't noticed that the one you are kneeling and praying to is just an idol."

The doctor blushed and wanted to say something to me, but then I continued, "if I will bring you a piece of wood and told you to kneel down before it and pray, would you do that Doc? I think you would not do it instead you would say, 'am I fool to do it?' But if I will form that wood into Sto. Niño and bring it to you and tell you to kiss it, kneel before it and pray, I think you'll do it sincerely, isn't it?"

Then I got my Bible and said, "You know Doc, it was already written on the Scriptures…"

13 The carpenter measures with a line
and makes an outline with a marker;
he roughs it out with chisels
and marks it with compasses.
He shapes it in the form of man,
of man in all his glory,
that it may dwell in a shrine. (Isaiah 44:13, NIV)
19 No one stops to think,
no one has the knowledge or understanding to say,
"Half of it I used for fuel;
I even baked bread over its coals,
I roasted meat and I ate.
Shall I make a detestable thing from what is left?
Shall I bow down to a block of wood?” (Isaiah 44:19,NIV)

"You see Doc? You’re at the peak of your education but then you never realized that half of that Sto. Nino was used to cook food and to other purposes, and you bow and pray before it." I said.

"Christ’s told us that worshipping God should be done in Spirit and in Truth,

24God is spirit, and his worshipers must worship in spirit and in truth" (John 4:24, NIV)

not through the images.

I wish you’ve learn a lesson from your cat, Doc."

Easy Home Cooking

Balance diet of food is the key for keep healthy, strength and active therefore to develop of mind intelligent. As we all knew, pyramid chart of food is very important to us to having a complete and balance dietary. We are what we eat..

Preparing a dish either breakfast, lunch or dinner can turn tiredness and headache especially for a mom that having a career and very limited time to prepare the food. This make mom did a short way by serving the canned food, or a ready-made food. This scenario turned the family having a very high cholesterol and healthiness food for their families.

With the right preparation of cooking, this situation can be able avoid. How do you feel when your family or customer appreciated on what you had doing. Like your kids says “its not enough”, or “give me more”..? You will get the feel of cooking satisfaction..!

Preparing the healthy food doesn’t meant you have to provide the expensive materials. There are several items like fruits, vegetables, and other raw materials, that can easily and cheap you can find at the local market.

In this blog, I will teach you, not only to prepare a dish by giving you a recipe, but I will teach you how to prepare it in the right and easy way as easy-home-cooking.com.Also I will give the origin of the dish and not only of the cooking, but everything of the cooking involvement including beverages, spices, herbs, nutrition, even organized the kitchen cooker..!!

This blog is not only for housewives to cook for the family. It is strongly recommended and extremely suitable for the student to get additional reference sources for the culinary course. Even to the Master Chef…!!

Even the dishes brings to you in the origin recipe, I will give you create it in the modern way. The recipe will content from the French to Chinese, Indian, Mongolians, Russian, nor Italian, even from the exotic of aborigine.

Have you heard the words of “the art of cooking”? What does it mean? It means that one knows a great deal about the practical aspects of cookery and cooking techniques.It presupposes a full and precise knowledge of food; a well developed sense of taste and smell; a sensitivity for colour, texture, and shape or form; and ability to coordinate all the major elements into complete harmony.

According to John Ruskin, a nineteenth century English writer and art critic, the art of cooking includes a grandmother’s thrift, a knowledge of modern chemistry, a frenchman’s sense of artistry,and an Arab’s hospitality. In summary, the art of cooking means providing high quality food and service to the complete satisfaction of guest.

Sounds complicated..? Yes…Never mind..Till next topic, let me turn it easy as easy-home-cooking..!!!

From the back desk

Dr.Chef

Nursing Education - Passing National Boards

The following information is from the Oklahoma Board of Nursing Task Force, that investigated the pass and fail rate of nursing students that have taken the NCLEX. The scores for the state of Oklahoma were lower than most of the states in the Union, prompting the formation of a task force and investigation of possible reasons for the low scores. What all perspective nursing students can gain from this report is how crucial it is to sit for the boards as soon as possible after graduation and to take advantage of all the help available in preparing for the NCLEX. The nurses efforts in putting this wealth of knowledge together has been a monumental task and all nursing schools across the country are grateful for the information that they have been able to provide after many long hours of research.

*Summary of Information from Pass Rate Reports *

In reports submitted by nursing education programs with NCLEX pass rates ten percentage points or more below the national average, the following commonalities were noted:

* Some programs do not regularly use accessible sources of data to evaluate the correlation between admission scores, grade point average, NCLEX predictor examination scores, and NCLEX pass rate. This impacts the ability of the program to make informed decisions about changes likely to result in an improvement of their NCLEX pass rate.

* Many programs have only recently begun the use of NCLEX predictor examinations as a requirement of the program. Data on the efficacy of these examinations and on appropriate follow-up plans is limited.

* Grade inflation is a factor leading to a low NCLEX pass rate in some nursing education programs, particularly in programs that allow significant point credit in theory courses for attendance, participation, and completion of assignments.

* Some programs do not identify minimum academic requirements for admission to the program. Instead, a point system may be used to select those who are deemed to be better qualified. While the use of point systems in admission decisions may be appropriate, point systems fail when applicant numbers drop. In cases in which there is a small applicant pool, identifying minimum academic requirements (such as minimum

scores on standardized pre-entrance examinations) may be necessary to ensure that students admitted have a reasonable chance of success in the program and on the NCLEX examination.

* Student characteristics identified by programs as leading to NCLEX failure include a high number of work hours, family commitments, English as a second language, and low admission points.

* In some cases, problems within the program, such as resignation of the program director, faculty turnover, inexperienced faculty, lack of knowledge regarding the NCLEX examination and/or test development, and increased use of adjunct faculty were noted as having an impact on the NCLEX pass rate.

Nursing education programs tend to take similar actions to address NCLEX pass rate concerns. Actions commonly taken by programs include:

o Initiating the use of an NCLEX predictor examination as a requirement in the program

o Requiring students to complete NCLEX review, tutoring, or other actions if the predictor examination score is low

o Increasing the minimum passing grade

o Providing faculty education in the areas of the NCLEX examination and test development skills

o Changing or increasing admission requirements

*Results of Survey of Nursing Education Programs *

In December 2002, a survey was sent to all state nursing education programs to identify the directors’ perceptions of factors impacting the NCLEX pass rate and the actions taken by programs to address pass rate. Based on the data obtained from 50 respondents (an 86.2% return rate), the task force noted the following:

The majority of programs have minimum academic requirements for admission

Why bow legs and knock knee lead to arthritis?

Basics

Bow legs (genu varum) is condition when legs have deformity outward of natural legs position.

Knock knee (genu valgum) is condition when legs have deformity inward of natural legs position.

Arthritis means a disorder of the knee joint, generally implying early joint surface damage.

Leg axis is conventional axis that shows how the body weight distributes among leg joints.

Articular cartilage is a type of dense connective tissue. It can supply smooth surfaces for the movement of articulating bones.

First of all bow legs (genu varum) and knock knee (genu valgum) are deformities that are not only cosmetic defects. They also lead to knee-joint move abnormality that after a number of years result to arthritis.

We find out that normal body weight distribution is when the leg axis go straight through femoral head, center of the knee-joint and center of articulation of foot. In this case the body weight distribute naturally and articular cartilage of knee-joint have equal weight distribution at full surface. There is natural position of knee-joint that allows to save the articular cartilage in health during years.

What is happen when a person have bow legs or knock-knee? As you could imagine that legs axises go still straight through femoral head and center of articulation of foot but do not go through center of the knee-joint. So body weight distribution change and regarding the knee-joint one part of the knee have more loading than another. If bow legs there is more loading of inner part of knee-joint and if knock knee there is more loading of outer part of knee-joint. So articular cartilage of knee-joint have different weight distribution at surface that leads to its attrition in the part where the loading is maximum. In time the articular cartilage attrition leads to arthritis and a person feels pain in knee-joints. Appearance of arthritis usually happen after years in elderly age but sometimes it is happen in middle age. It depends on individual health of each person.

The only way to protect yourself from appearance of knee-joint arthritis is the surgery for bow legs and knock-knee correction. With the surgery the leg axis become natural position so articular cartilage of knee-joint get equal weight distribution at full surface and keeps its health in years. Also there is a cosmetic effect that lets a person feels himself or herself more comfortable around other people.

The Nurse Is In

Do you have compassion for the sick and those that need your attention? Do you have the patience for long hours, devoting your attention and care for hospital patients? Perhaps, over and beyond these aspects, you just want to be able to try out the lucrative and rewarding career of nurses. Whatever your reasons and motivations, a vocational nursing school will be able to help you in your endeavor.

As you may know, there is a shortage of nurses in the United States and they are even looking to hiring nurses from other countries just to be able to fill the demand. Take advantage of the signing bonuses and other incentives that are being offered by hospitals for qualified people to accept nursing jobs at their hospitals.

To aid you on your quest, check out All Nursing Schools (http://www.allnursingschools.com) This site is a veritable treasure trove of anything and everything about vocational nursing schools. As its name connotes, they offer a listing of hundreds of vocational nursing schools in the United States.

Furthermore, this site is recommended because its search interface is easy and very useful. The search interface allows you to further narrow your search down to 25, 50 or 100 mile distances from your area. Aside from this, you can check or tick an option for whether you prefer online vocational nursing schools to even further narrow your search and widen the probability of finding the perfect vocational nursing school for you and your needs.

As mentioned earlier, aside from the fantastic search function on the site, All Nursing Schools is a wonderful resource on anything and everything about nursing. On your first visit, I suggest you check out first their Frequently Asked Questions page to help you getting a clearer understanding and picture of the nursing sector and how to go about finding the right nursing school for you if you continue to choose to take this path.

Also, don't forget to check out this site's featured schools as well as the different diplomas and degrees you may want to learn more about to further yourself in your nursing career. Whatever the case and need, the All Nursing Schools site will certainly be a great help to you on your journey to and through a nursing career.

First, it will help you find the perfect vocational nursing school to jumpstart your career, and then further down the road, you can still use the site to keep abreast and up to date on new trends as well as guides on different diplomas and certificates that keep you one step closer to the ultimate in your chosen path of nursing.
by: Low Jeremy