Rabu, 27 Februari 2008

Breastfeeding Problems - Mastits

Mastitis

Women deciding to breastfeed anticipate that it will be a wonderful bonding experience for her and her baby. Nursing mothers all know that breast is best but what does she do about a case of mastitis?

Recognizing the problem

There are many warning signs and indicate that you may be coming down with mastitis.

1) An area on the breast becomes sore and red. The site of the clogged duct develops a very pronounced red spot which is extremely painful to the touch and holding or carrying your baby on this side may become unbearable. You may also see or feel a lump.

2) You may experience pain during nursing sessions. This may begin as a tingling sensation in the nipple. If there is no pain while the baby is nursing on that side, it does not mean that you don't in fact have mastitis.

3) Development of flu-like symptoms. You may experience a fever along with chills and body aches. Exhaustion is another common side effect. Many women report not even being able to get out of bed.

What to do if you suspect mastitis

At the first signs of developing mastitis:

1) Get into bed and rest! Even if you can just sit quietly for a few hours without doing anything such as housework or taking care of other children or family members, you'll benefit.

2) Apply warm compresses to the site of the clogged duct. Take a hot shower or even lower your breast into a bowl or pot filled with warm water and soak for a few minutes, several times an hour.

3) Nurse, nurse, nurse! Try to nurse the baby on the side of the clogged duct as often and as long as possible to work out the clog. Massaging the breast while the baby suckles may also help.

4) Remedies such as echinachea and vitamin C can be taken. Antibiotics may be prescribed by a physician or midwife as well.

How to avoid mastitis

Mastitis starts out as a plugged duct and develops into an infection. In order to avoid your ducts becoming clogged in the first place, it is a good idea not to constrict your milk ducts with underwire bras or tight fitting clothing. Try not to sleep on your stomach as this may also lead to a plugged duct. Avoid supplementing with bottles because this may lead to an overproduction of breast milk. When a feeding is missed, breasts may become engorged and ducts can get plugged up. Breast compression or breast massage before latching is also a helpful tool to avoiding clogged ducts all together.
by Liz Picket

Selasa, 26 Februari 2008

Certified Legal Nurse Consultant’s Pain and Suffering Analysis Spurs Record Settlement

When an attorney takes on a medical-related lawsuit, the attorney is confronted with enormous volumes of medical records crammed with esoteric terminology, inexplicable shorthand and indecipherable handwriting. Yet his client's (plaintiff or defense) future depends on the attorney understanding those records and using them to support the case effectively. That's why being a Certified Legal Nurse Consultant is the healthiest thing that will ever happen to your attorney-client's practice.

On a sunny Virginia morning, meter maid Beverly Adams was severely burned over 50% of her body when her three-wheeled motorcycle turned over and caught fire. "She was making a slight turn on dry pavement," says her attorney, Rob Walker of Robert Walker and Associates, Richmond. "The vehicle was defectively designed with the driver sitting right on top of the gas tank." That arrangement almost proved lethal for Adams.

"Under Virginia law," continues Walker, "you can't sue an employer for an on-the-job injury that takes place in the course of employment. Instead, we took on the engineering firm and the foreign corporation that designed and distributed the vehicle."

According to Walker, his 42-year-old nonsmoking client sang in her church choir and was a 15-year veteran of the police force. Adams had a reputation for going by the book and writing more tickets than most of her peers. "She was the perfect plaintiff," he says.

The accident changed Adams' life completely and permanently. "In addition to her severe burns," says Walker, "she lost four fingers on one hand, lost her eyelids, ears, nose and most of her hair. She spent three months in the hospital, almost a year in rehab, and needed 32 reconstructive surgeries and other surgical procedures. For the rest of her life she'll have to use prosthetic devices and special creams for her damaged skin."

How does the attorney make sense of a year's worth of complicated medical records describing such devastating injuries? How does he even begin to grasp the pain and suffering Adams endured, much less make it real for a jury? Walker's answer is simple: He doesn't. He calls in an expert. His expert of choice was Sharon Scott, RN, CLNC.

The Certified Legal Nurse Consultant Is the Key to Understanding the Medical Issues

For the Adams case, Scott tapped both her 19 years of nursing experience and her extensive training as a Certified Legal Nurse Consultant. "I developed a detailed chronology of the case and explained all the medical procedures in lay terms," she says. "My services included indexing the records and explaining the difference between second and third degree burns. I also pulled out every recorded instance of Adam's pain and suffering and prepared a chart listing all the pain medications, sedatives, etc., she took."

Walker explains the value of Scott's Certified Legal Nurse Consultant services. "I had no idea what was being done to the plaintiff because much of it was in medical shorthand. Sharon indexed the records so we could find what we were looking for. Then on a daily basis she summarized Adams' condition, treatments, surgeries, medications and outcome." This detailed summary made it easier for Walker to answer defense interrogatories and to decide which witnesses to call.

"We were most concerned about Adams' pain and suffering," he continues. "We needed a handle on that. Sharon put all the procedures and surgeries into words we could understand. For example, debridement is just a medical term to me. Sharon explained that meant scrubbing off the dead skin. When you see how often they did that, you understand how much my client suffered."

Scott's next step was to make the actual amount of painkiller Adams received real for people. Walker explains, "Sharon tallied all the dosages for the first six weeks of treatment, then concluded by saying my client had received enough medicine to relieve the pain of 850 heart attacks or 1,700-3,400 hours of labor. That vivid picture of what Adams went through gave us an advantage over the defense attorney when we started talking about damages."

Although the case was pending in federal court, local rules required Walker and the defense to attempt a good-faith settlement. "Both sides chose mediation," he says, "and we settled in about a day. Sharon's summary made the damages so evident, we never had to discuss them. This made for a cleaner conference focused on the liability issues."

The result was a $14,000,000 settlement, at that time (2000) one of the largest out-of-court settlements ever reached for a personal injury case in Virginia. "One reason we got this settlement," Walker acknowledges, "was the understanding of the medical records Sharon gave us." An indirect result of this case was that the vehicle in which Adams nearly died has been redesigned to move the gas tank and its opening to the back.

Certified Legal Nurse Consultants Save Attorneys Time and Money

I have a small office," Walker says. "I can't read 4,000 pages of medical records. Having the services of someone like Sharon allows me to take on complex cases that I could not handle otherwise."

Scott's status as an independent Certified Legal Nurse Consultant in private practice is an advantage for Walker. "I trust her judgment and her opinions more than I would a nurse working in my own office. An independent consultant doesn't have an ax to grind with you. If you get a case of questionable merit, Sharon will tell you not to pursue it."

Another benefit of working with a Certified Legal Nurse Consultant is cost savings. "You can lose a lot of money on cases with complex medical issues if you're not on firm ground," says Walker. "My out-of-pocket expenses on the Adams case were around $240,000. Sharon can quickly and economically identify whether you have a case, and she can cut down on your staff time going through medical records. If you're in a small or medium-sized firm and you need help indexing records or understanding complex medical issues, a Certified Legal Nurse Consultant is indispensable.”

Online Accredited Degrees

Many of us have a dream of getting a degree, but it is difficult to achieve. This is due to the fact that we have jobs and find that there is a full schedule all week while community colleges and universities often make it impossible for us to attend. We also have family members to take care and must dedicate our time to. These are the very things that are making online degree ever so more attractive. And for sure the colleges and universities across the country will definitely recognize this demand and respond to it.

Luckily, there is an alternative for the person who desires to attend college classes is online degree. This online degree is a course which is designed by college and university. It officially meets the state's guidelines and is deemed to be every bit as credible as a brick-and-mortar earned degree.

The online courses offered in the form of online degrees are very great and convenient. To get the most benefit from this course, it is recommended that you do your homework and learn as much as you can to know more about the offered online courses. The more information you obtain, the more benefit you will receive from participating in those chosen programs. Please remember that there are so many online coursed out there available for you, what you have to do is choosing the right one that suits you the most. There are 4 degree levels available online; Associates, Bachelors, Masters and Doctorates.

There are tons of advantages of an online degree. No need to schedule classes. Have your own time with family and take care your kids. Have flexible time and leisure time. However, the only thing you really have to do is be on yourself to stay disciplined to get your work done.

It is absolutely vital that you make sure that the degree that you are pursuing and the classes that you are taking are indeed accredited. You may not want to end up wasting your time and money taking classes that you will not get credit for.

If you were ever considering getting a degree to improve your chances of landing a job, or getting paid more, or even to perhaps change careers completely, now is the time to do it. The future is promised to no one and now with the advantages of online accredited degrees, there really is no excuse for not pursuing these wonderful opportunities. Most of these online accredited degrees are delivered by way of computer. Don't be intimidated by this if you are not computer savvy. A simple computer and Internet connection will be more than enough to get you through. So now you know. No excuses, get out there and get it done!

Do You Need A Maternity Nurse?

If you've determined there's enough money in your budget for a baby nurse (they don't come cheap), you'll need to consider several other factors before deciding whether or not to hire one. Here are some reasons why you might opt for the help:

• To get some hands-on training in baby care. If you haven't had experience or taken a parenting class and feel you'd rather not learn from the mistakes you make on the job and on your baby, a good baby nurse will be able to instruct in such basics as bathing, burping, changing nappies and even breastfeeding. If this is your reason for hiring a nurse, however, be sure that the person you hire is as interested in teaching as you are in learning. Some won't tolerate novice parents peeping over their shoulders; one with such a dictatorial take-charge attitude can leave you as inexperienced and unsure when she departs as you were when she arrived.

• To avoid getting up in the middle of the night for feedings. If you're formula feeding and would rather sleep through the night, at least in the early weeks of postpartum fatigue, a baby nurse, on duty twenty-four hours a day or hired just for nights, can take over or share this feeding responsibility with you and your spouse.

• To spend more time with an older child. Some parents hire a baby nurse so that they can be more available to their older children, and hopefully spare them the pangs of jealousy that are often provoked by new arrivals. Such a nurse might be hired to work just a few hours a day during the time you want to spend with your older child. If this is your major reason for hiring a nurse, however, keep in mind that her presence will probably serve only to postpone feelings of sibling jealousy.

• To give yourself a chance to recuperate after a Caesarean or difficult vaginal birth. Since you probably won't know if you're going to have a difficult time before hand, it's not a bad idea to do some scouting around for nurses in advance, just in case. If you have the name of a potential nurse or two, or at least have spoken to an agency, you can call shortly after you deliver and have a helper hired before you get home.

On the other hand, a baby nurse may not be the best solution to your postpartum needs if:

• You're breastfeeding. Since a nurse can't feed a nursing newborn, and feeding is one of the most time-consuming tasks in the care of a young baby, she may not prove to be all that helpful. For the nursing mother, household help - someone to cook,clean and do laundry — is probably a wiser investment, unless you can find a nurse who will do these chores and also offer breastfeeding tips.

• You're not comfortable with a stranger living in your home. If the idea of having a non-family member sharing your bathroom, your kitchen and your table twenty-four hours a day makes you uneasy, hire a part-time nurse rather than a live-in, or opt for one of the other sources of help.

• You'd rather do it yourself. If you want to be the one to give the first bath, catch sight of the first smile (even if they say it's only gas), soothe your baby through the first bout of crying (even if it's at 2 am), don't hire a nurse, hire household help to free you up for fun with baby.

• Dad would rather do it, too. If you and your spouse are planning to share baby care, a nurse may get in the way. There may also not be much left for her to do - except to collect her paycheque - especially if dad's around full-time while he's enjoying paternity leave. In that case, the money could probably be more sensibly spent on cleaning help.

If you decide that a baby nurse is right for you, the best way to go about finding one is to ask for recommendations from friends who've used one. Be sure to find out if the nurse in question has the qualifications and qualities you're looking for. Some cook, some don't. Some will do light housework and laundry, others won't. Some are gentle, motherly women who will nurture your innate mothering ability and leave you feeling more confident; others are bossy cold and patronizing and will leave you feeling totally inadequate. Many are qualified nurses: some have also been trained specifically in caring for mother as well as baby, in mother-child relations, and in teaching breastfeeding and child-care basics. A personal interview is extremely important, since it's the only way to know whether you are going to feel comfortable with a particular candidate. But excellent references ( do check them out) are a must. A nurse hired through an agency should be registered. It's also very important that a nurse - or anyone else you hire who may come in contact with the baby - has been screened for TB. She should also be trained in CPR and child safety, as well as be up-to-date on baby-care practices (putting baby to sleep face up; keeping toys, pillows and blankets out of the cot. and so on)

How to Become a Home Health Care Nurse

Home Health Care Nursing Information and Overview

Home health care is allowing the patient and their family to maintain dignity and independence. According to the National Association for Home Care, there are more than 7 million individuals in the United States in need of home health care nurse services because of acute illness, long term health problems, permanent disability or terminal illness.

Home Health Care Basics

Nurses practice in a number of venues: Hospital settings, nursing homes, assisted living centers, and home health care. Home health care nursing is a growing phenomenon as more patients and their families desire to receive care in their homes. The history of home health care stems from Public Health Nursing where public health nurses made home visits to promote health education and provide treatment as part of community outreach programs. Today academic programs train nurses in home care and agencies place home health care nurses with ailing individuals and their families depending on the nurse's experience and qualifications. In many cases there is a shared relationship between the agency and the academic institution.

Many changes have taken place in the area of home health care. These include Medicare and Medicaid, and Long Term Care insurance reimbursement and documentation. It is important for the nurse and nursing agency to be aware of the many factors involved for these rules and regulations resulting from these organizations. Population and demographic changes are taking place as well. Baby boomers approaching retirement and will present new challenges for the home health care industry. Technology and medical care in hospitals has lead to shorter inpatient stay and more at-home rehabilitation. Increases in medical outpatient procedures are also taking place with follow-up home care. This has resulted in the decrease of mortality rate from these technologies and medical care has lead to increases in morbidity and chronic illness that makes the need for home health care nursing a greater priority.

Home Health Care Nurse Job Description

Through an array of skills and experience, home health care nurses specialize in a wide range of treatments; emotional support, education of patients who are recovering from illnesses and injury for young children and adults, to women who have experienced recent childbirth, to the elderly who need palliative care for chronic illness.

A practicing nurse must have the skills to provide care in a unique setting such as someone's home. The nurse is working with the patient and the family and must understand the communication skills for such dynamics. Rapport is evident in all nursing positions, but working in a patient's own living space needs a different level of skill and understanding. There is autonomous decision making as the nurse is no longer working as a team with other nurses in a structured environment, but is now as a member of the "family" team. The host family has cultural values that are important and are different for every patient and must be treated with extreme sensitivity. Other skills include critical thinking, coordination, assessment, communication, and documentation.

Home health care nurses also specialize in the care of children with disabilities that requires additional skills such as patience and understanding of the needs of the family. Children are living with disabilities today that would have resulted in mortality just twenty years ago. Genetic disorders, congenital physical impairments, and injury are just a few. Many families are familiar with managing the needs of the child, but still need expert care that only a home health care nurse can provide. It is important that a home health care nurse is aware of the expertise of the family about the child's condition for proper care of the child. There are many complexities involved, but most important, a positive attitude and positive reinforcement is of utmost importance for the development of the child.

Medication coordination between the home health care nurse, doctor, and pharmacist, ensures proper management of the exact science behind giving the patient the correct dose, time of administration, and combinations. Home health care nurses should be familiar with pharmacology and taught in training about different medications used by patients in the clinical setting.

Many advanced practicing nurses are familiar with medication regiments. They have completed graduate level programs. Home health care agencies believe that a nurse should have at least one year of clinical experience before entering home health care. Advanced practicing nurses can expedite that training by helping new nurses understand the home health care market and teaching.

Employment and Salary

According to the United States Department of Labor, there were 2.4 million nurses in America, the largest healthcare occupation, yet many academic and hospital organizations believe there is a gross shortage in nursing staff. The shortage of nurses was 6% in 2000 and is expected to be 10% in 2010. The average salary for hospital nursing is $53,450 with 3 out of 5 nursing jobs are in the hospital. For home health care, the salary is $49,000. For nursing care facilities, they were the lowest at $48,200.

Training and continuing education

Most home health care nurses gain their education through accredited nursing schools throughout the country with an associate degree in nursing (ADN), a Bachelor of Science degree in nursing (BSN), or a master's degree in nursing (MSN). According to the United States Department of Labor, in 2004 there were 674 BSN nursing programs, 846 ADN programs. Also, in 2004, there were 417 master's degree programs, 93 doctoral programs, and 46 joint BSN-doctoral programs. The associate degree program takes 2 to 3 years to complete, while bachelors degrees take 4 years to complete. Nurses can also earn specialized professional certificates online in Geriatric Care or Life Care Planning.

In addition, for those nurses who choose to pursue advancement into administrative positions or research, consulting, and teaching, a bachelor's degree is often essential. A bachelor's degree is also important for becoming a clinical nurse specialist, nurse anesthetists, nurse midwives, and nurse practitioners (U.S. Department of Labor, 2004).

All home health care nurses have supervised clinical experience during their training, but as stated earlier advanced practicing nurses hold master's degrees and unlike bachelor and associate degrees, they have a minimum of two years of post clinical experience. Course work includes anatomy, physiology, chemistry, microbiology, nutrition, psychology, and behavioral sciences and liberal arts. Many of these programs have training in nursing homes, public health departments, home health agencies, and ambulatory clinics. (U.S. Dep. of Labor, 2004).

Whether a nurse is training in a hospital, nursing facility, or home care, continuing education is necessary. Health care is changing rapidly and staying abreast with the latest developments enhances patient care and health procedures. Universities, continuing education programs, and internet sites, all offer continuing education. One such organization that provides continuing education is the American Nurses Association (ANA) or through the American Nurses Credentialing Center (ANCC).

Conclusion

There are many rewards to becoming a home health care nurse. Some rewards include the relationship with a patient and their family, autonomy, independence, and engaging in critical thinking. The 21st Century brings with it many opportunities and challenges. We must meet these challenges head on - there is an aging baby boomer population, a growing morbidity factor due to increased medical technology and patient care, and the growing shortage in nursing care.

Becoming a home health care nurse today is exciting and an opportunity to make a difference one life at a time. With clinical experience and proper education, a home health care nurse will lead the future of medical care.

Copyright 2006 Michael V. Gruber, MPH

Senin, 25 Februari 2008

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.

Doctor, Doctor, Give Me The News

You may have heard of the term, "Book Doctor" in your writing career. Maybe you've wondered what a Book Doctor does and if it's a good idea to utilize their services.

In essence, a Book Doctor is an individual who promises to assist you in making your manuscript ready for submission to an editor or publisher.

The sad truth is many Book Doctors simply provide minimal editing services and little else.

Many potential authors have sought the services of one of these 'professionals' in an effort to make their manuscripts as complete as possible. The belief most authors in this situation have is that the "Book Doctor", like a real doctor, will provide their manuscript with a thorough check-up and will diagnose problems with the manuscript and provide expert opinion on the best means of getting their manuscripts into the best possible shape for publishing.

It may be more advisable to simply have an editor take a look at your manuscript and fix glaring problems and offer suggestions. It is probable that there are some "Book Doctors" whose services are as good as advertised, but for the most part they simply will not do what you are expecting them to do. This scenario creates mistrust, costs valuable resources and causes a writer to become a bit more jaded if they are duped in this way.

If you have well respected writing friends it may be more advisable to approach one of them to assess their willingness to review your manuscript, offer advice and possible offer some editorial suggestions on the work.

The chances are pretty strong that you will get further by approaching a trusted writer friend than relying on a Book Doctor for your editorial requirements.

To be fair, you will find many qualified editors who can assist you in making your manuscript shine. Perhaps the greatest advise is this: if the services offered seem too good to be true - they probably are.

I am aware of several writer friends that I would turn to in a heartbeat if I wanted a complete review of my work, but this type of arrangement happens in the form of a writing community. When you become involved you begin to learn more about what works and who can help.

If you are a writer and haven't become a part of a writing community be sure to look for one in your region. You are also welcome to participate in the online community of FaithWriters.com.

Scott Lindsay

Kamis, 21 Februari 2008

What is IUD

by: Amanda Johnson
IUD is the short form of Intra Uterine Device. It is one of the most effective and safer birth control methods. It is a small and flexible T shaped device, normally made of plastic and having a thread that hangs down into the upper part of the vagina. It is placed inside a woman’s uterine cavity through her vagina to prevent pregnancy.

How does it work?

It prevents pregnancy by stopping sperms from contacting with an egg. There are two types of IUD. One is Copper IUD and another is Progesterone IUD. But copper-bearing IUDs are widely used. Copper IUD works effectively for about 10 years and after that it must be replaced. Likewise, hormonal IUDs (progestin-releasing IUDs) must be replaced every 5 years.

Effectiveness

If it is placed and maintained properly, its effectiveness rate is more than 99%. It is very rare that an accidental pregnancy occur while using an IUD. It is pertinent to mention here that only a trained doctor or nurse can insert and remove the IUD.

Care for IUD

Only thing you have to care is to check the string inside the vagina. At the time of your menstrual period, you can check the thread by inserting a clean finger into your vagina. If you do not feel the thread or IUD itself, it means the IUD is not in the right place. At this moment you must consult your doctor or the clinic where you have got the IUD fitted. It is recommended that you should have yearly check up by your doctor. However once the IUD is fitted you can exercise, swim and have sexual intercourse right away.

Advantages

• It starts working immediately.
• It is very effective birth control method.
• Once it is fitted, you need not to do any daily attention, like, taking pills etc.
• If you want your doctor can remove the IUD at any time.
• Your sexual life will not be affected any way. It is very private to you. Even your partner cannot feel it.
• It is not expensive.
• It is long lasting. Once it is fitted it can work for more than 5 years.
• No restriction of age. Women of the age of 20 years and more can use it.

Disadvantages

• IUD does not give you protection against AIDS or any sexually transmitted diseases (STDs).
• You cannot place the IUD by yourself. It requires a trained doctor or nurse.
• While inserting IUD uterus can be injured but it is very rare.
• After insertion of IUD you may feel backache or cramps for some time.
• It may tend to cause heavy menstrual bleeding.

Points to remember

• If you have more than one sexual partner, you have greater chance to be infected while using IUD. These infections can be more serious as IUD does not protect you from STDs.
• If you are pregnant, you should not use IUD.
• If you miss your menstrual period, you must consult your doctor.

Overall, if an IUD is inserted and maintained properly, it can certainly be a very effective method of birth control.

Find more information visit:
http://www.keepcondom.com/articles/birth-control/what-is-iud.htm

Congested? Get rid of it! (Beechams Night / Day Nurse)

Advantages: Decongestant, contains paracetamol, gets rid of cold symptoms

Disadvantages: night nurse can make you drowsy, can't take with other paracetamol containing rememdies

So I'm feeling rough again- it's the wrong time of the year for cold. If it weren't for this cold/flu remedy though I'd be feeling much. much worse! Its decongestants clear your nose and stop your chest from getting too clogged, preventing one of those awful hacking coughs that all too often accompany a cold. Gets rid of the all over body headachey feeling quickly, and night nurse will also get you off to sleep in less than 10 minutes, no matter how restless you're feeling. Highly recommend these!

It comes in capsule or liquid form,so that if your throat ain't up to swallowing down the capsules, assistance is still on hand. If you're already taking paracetemol though, its best not take the day nurse, although if you save one of your four-a-day doses you can still take the nightnurse before you go to sleep. Great if the difficulty you're having breating is preventing you from sleeping through the night. I usually have difficulty with the side effects associated with other decongestants, such as a wildly speeded up heart rate that prevents me from sleeping, but these I'm able to take during the night too.

So instead of spending the day forcing down hot lemon or blackcurrant remedies, start taking these capsules. As they are a short, sharp dose you don't have any disturbing aftertaste to put up with and they keep you going for just as long. I find that after a couple of doses my nose feels much clearer, an effect which lasts for as long as I'm taking them.

Summary:

What a relief! (Beechams Night / Day Nurse)

Advantages: Fast and effective

Disadvantages: Nasty taste

Have been suffering from a bad cold and cough, sore throat etc for a week. The pharmacist recommended this product and I have to say its the first time i have been able to breath properly for a week. Amazing! I must say there is one downside I bought the liquid form and couldn't believe how revolting it tasted it actually made me gag. I will have to be pretty strong to take it again later on, will just have to keep in mind that I felt so much better for it. Next time I will definitely be buying the capsules.

SNIVELS, SNOT AND A KNOCKOUT PUNCH...... (Beechams Night / Day Nurse)

Advantages: Helps/soothes the symptoms of flu and colds, aids restful sleep

Disadvantages: Side effects - see opinion

Whenever I start with anything remotely resembling the flu I head straight for a bottle of Nightnurse. Unfortunately in a fit of laziness it appeared that I hadn’t bought another bottle after the last one had run out so a quick journey to the chemist later I emerged with 10 Nightnurse Capsules for £3.15 (they didn’t have any bottles left).

The packaging is green and blue and is easily identified by the shiny green cross on the front. Nightnurse claim to have been specially formulated as a night time products to provide relief from Headaches, shivers, aches, pain, tickly and dry coughs and actual throat pain. It’s a common belief that Nightnurse contains something that makes you drowsy, this isn’t in fact the case. Nightnurse simply relieves symptoms and naturally make you feel more at ease, making your body far more relaxed and more susceptible to drowsiness, therefore it is not a good idea to take Nightnurse during the day, if you operate machinery or have to drive within 10 hours.

The actual capsules are white and green in colour and are roughly the same size as a cod liver oil capsule. They have a coating on them which makes swallowing them very easy indeed. In my case I didn’t need to take them with water.

It is recommended that adults and children aged over 12 take 2 of the capsules just before retiring to bed. This product should not to administered to any child under the age of 12 due to the high doses of Paracetamol (which is an analgesic and kills pain and also helps to reduce body temperate), Promethazine which is an antihistamine (which dries up runny noses) and finally Dextromethorphan (which is a cough suppressant).

I popped two of these capsules into my mouth and swallowed and then headed off to bed. Unlike the liquid version, the capsules do not take an immediate effect, and I was lay in bed, still suffering for well over an hour. It did become evident after an hour that the chesty cough was not as nagging, my nose had stop running and I wasn’t sweating (which had happened the night before). Don’t get me wrong, all my symptoms hadn’t disappeared, I did still occasionally cough, but it was nowhere near as bad as earlier in the night. The relief I was getting though was obvious and I did become more drowsy.

The morning after taking the capsules I did feel rather groggy, but I put that down to me not being a morning person. I hadn’t woken at all through the night and I felt 70% better than I did the night before. My symptoms were there, but the effects they had been having on me had greatly reduced, I felt as though I could face the world.

5 or 6 hours into the day, the effects of the tablets did wear off and my symptoms returned to the same level as before. A good nights sleep thanks to the capsules had done me the world of good and my concentration wasn’t as affected.

Would I recommend the Nightnurse Capsules? Yes, wholeheartedly. If you are suffering from any form of cold or flu, take these, they will make you feel better. They are widely available, quite cheap (in comparison to other similar products) and get the job done. My only gripe is that they take longer than the liquid form of Nightnurse to actually start working, therefore, if you have a fairly bad cough, the liquid is for you, it sooths as you take it, something the Capsules don’t do.

RECOMMENDED

Now on for the boring bits:

As with all medicines, Nightnurse should be kept well out the reach of children. In the event of a possible overdose, you should go directly to the nearest A & E department, even if you feel well.

Nightnurse should not be taken by people who suffer from asthma, breathing problems, prostate or heart problems.

Nightnurse Capsules can be taken by pregnant women, but you should consult your doctor first.

Nightnurse only relieves symptoms, it does not cure you. If the symptoms do persist, go and see your doctor. That’s what he/she is there for,

If you are going to take these capsules, don’t consume any alcohol.

Nightnurse Capsules is a trademark of the giant multi-national that is:

GlaxoSmithKline
GlaxoSmithKline Consumer Healthcare
Brentford
TW8 9GS
United Kingdom

Thanks for taking the time to read and rate.


Steve :)

Get betta quick (Beechams Night / Day Nurse)

Fortunately, I haven't been unwell for a while, but I am a big fan of this product, and always ensure I have some at the back of my medication drawer. Night nurse is a fantastic medication to take if you are unfortunate enough to be hit by the lurgies.

WHAT IS IT FOR?

I personally only use it when I have a bad cold (also known as a flu-like illness, or man-flu to most women!) The box claims that it is useful for the relief of tickly cough, shivers, aches and pains, runny nose, sore throat pain and headache. It probably works for all of the above other than the cough as there isn't much evidence for medications helping with cough.

HOW DOES IT WORK?

It delivers a three-pronged attack against your symptoms, each delivered by one of the three 'active ingredients' (i.e. the ingredients in the pill which affect the body).

Paracetamol -

The old favourite, Paracetamol gets rid of all the aches and pains, high temperatures and that heavy feeling you get in your head when you have a bad cold. The dose in Night Nurse is the same as taking two of the usual Paracetamol tablets.

Promethazine -

This is essentially a sedating antihistamine. It is included to make you feel drowsy and therefore promote a good nights sleep. I feel that the worst problem with having a flu like illness is that it is often hard to get to sleep, and I am sure that lack of sleep makes the whole situation a heck of a lot worse!

Dextromethorphan -

This is a cough suppressant. This is supposed to raise the body's threshold before you cough. I am not 100% convinced this works, but I like the idea anyway. I think they have opted for this instead of codeine linctus (the usual old wives cough remedy), as codeine is addictive (and doesn't work either)

Night nurse also contains a host of inactive ingredients. These are constituents which hold the pill together, form the coating etc.. They are not actual medications. These are; lactose, dimethicone, colloidal anhydrous silica, gelatin and colours erythrosine (E127), patent blue V (E131), quinoline yellow (E104) and titanium dioxide (El71). No, doesn't mean much to me either!

HOW MUCH AND WHEN SHOULD I TAKE THEM?

This review is for the tablets, but you can also get the same medication in a suspension form. A pack has 10 tablets, and you should take 2 tablets at a time. I would only advise taking them at night to avoid daytime drowsiness.

WHERE CAN I BUY IT?

Night nurse is only available at chemists, and is sold as an 'over the counter' drug. This means you do not need a prescription, but you need to ask a pharmacist for it. They will ask some screening questions before handing it to you (namely - are you taking other products with Paracetamol in them?)

Night nurse isn't that cheap compared to Ibuprofen or Paracetamol. It costs about £3.30 at your average pharmacy.

WHAT ARE THE SIDE EFFECTS?

If you read the patient information leaflet you will be greeted with a host of side effects, and it will probably scare the life out of you. They have to include every possible side effect reported to cover themselves, and most have only been experienced by one or two people. So I would ignore most of them! The only likely side effect is that you may still feel a tad drowsy the next day, and they therefore advise caution with driving and using large machinary (and I guess small machines like chain-saws too!)

Some people complain of nightmares with it.

You also shouldn't take it with Paracetamol at the same time as it also contains Paracetamol, and therefore you would be overdosing! However, you can safely take Paracetamol four or more hours earlier, so long as you do not exceed 4 grams in 24 hours.

IN SUMMARY

I hope you do not need to use this stuff, but if you do get ill, its the best way to ensure a good night's sleep and quicker recovery! If you have problems getting to sleep because you feel ill, this will totally sort you out, and it also contains a decent dose of Paracetamol to get rid of the fevers and other flu symptoms.

During the day, I feel that simple Paracetamol is enough (and I'm not sure why you should be conned into parting with more cash on products like 'Day Nurse'.)

Obviously, it is always better to avoid medications, and homeopathy is always worth a go, but if all else fails, its better to take this than feel totally awful!

FOR MORE INFORMATION YOU COULD CONTACT:

GlaxoSmithKline Consumer Healthcare
Brentford, TW8 9GS, U.K.
Tel: 020 8047 5000

Get better soon!

Dan. (NB I have also posted this review on Ciao as dan_ep - it is my review!)

Summary: A sedating flu medication

Night Nurse gave me a hangover!! (Beechams Night / Day Nurse)

Ive found this blog whilst researching the side affects of taking night nurse because I took it last night and feel absolutely dreadful today! I have been suffering from a bad cold and sleepless nights due to coughing since Monday (now Thurs) I was really suffering yesterday and bought this (capsule form - took 2 as suggested) in the hope that I could get through the night without waking but I woke up anyway feeling really weird and light headed. I fell back asleep but its now 1pm and i feel like I drank 6 pints of stella last night. Im so thirsty!

Summary: Maybe only take 1 capsule if taking it at all...

How Will You Pay For Skilled Rehabilitation In The Nursing Home

One of the most frustrating events for individuals facing rehabilitation is thinking that their insurance is going to pay for everything and finding out that their insurance will not pay for the complete services required for a successful rehabilitation.

Nursing home skilled units want to be assured that the necessary steps will be taken to assure that they will be paid. Nursing homes are most familiar with Original Medicare, Medicare Advantage Plans, Medicare Managed Care Plans, Medicare Preferred Provider Organization Plans, Medicare Private Fee-for-Service Plans, Medicare Specialty Plans, federal employee health program, military health program and railroad retirement programs. If your patient has one of these, they will be highly considered once that payer source is verified.

Medicare Part A is the primary source of insurance that will pay for a skilled nursing home stay. Medicare pays 100% of day 1 through day 20 and from day 21 up to day 100 Medicare will pay everything less $114.00 per day co-pay as long as the resident is making progress towards their rehabilitation goals.

If, Medicare is managed through a HMO (Health Management Organization) it usually pays 100% of the rehabilitation stay. The HMO determines the length of stay by the assessments provided to them by the nursing home rehabilitation staff and the level of independence required where the resident will reside after their rehabilitation stay. The HMO utilizes a Nurse Case Manager and a Medical Director who is a physician to make this determination.

Secondary insurances with Medicare Supplemental Coverage will usually pay the $114.00 per day co-pay from day 21 through day 30 up to day 100 depending upon the tier level of the insurance plan and some tiers will some times pay up to 120 days. It is important for you to know what your insurance will cover.

If you have the resources you can of course pay the Medicare $114.00 per day co-pay privately.

Most states offer a Medicaid Program for individuals who meet the financial eligibility and medical need criteria. Please contact your State’s Department of Human Services Income Support Division (local Medicaid office) to see if you or your loved one meets the criteria for assistance. Most individuals fear that they may loose their home or all of their income and assets if they apply for assistance. There are laws and regulations in each state that provides Medicaid to protect the home or homestead and to protect the spouse from poverty. There are also attorney’s that specialize in Elder Law that can help you protect your income and assets and plan for the transition to State Medicaid Assistance when you or your loved ones resources become exhausted.

Nursing homes generate income from providing rehabilitation services to keep financially afloat. They check to see that they will make a profit from providing the patient the services they need. That means that everything the patient needs in the way of treatments, therapy and medications must be covered by your insurance before they agree to accept a patient from a hospital.

The nursing home will also want to get an understanding of the patient’s cognitive status and psycho/social-well-being to see that they are appropriate for their facility unless they have a contract with the discharging hospital. Keep in mind that not all nursing homes are adapted to serve all types of patients. If you or loved one has some behavioral issues, related to dementia, Alzheimer’s disease or psychiatric problems they may not be accepted for admission. You may need to find a nursing home that specializes for those types of paient needs.

Understanding your insurance benefits and your needs will get you the services you require for a successful rehabilitation stay.

by: Tammy Gonzales

Jumat, 15 Februari 2008

Traveling Nurse - PT



Job Information
Post Date:TodayType:Full time
Start Date:2008-01-15 05:10:07 PMSalary:- n/a -
Location: AK - ANCHORAGE Job Reference:- n/a -
Facility: HRN Services Inc.

img

Job Details

Traveling Nurse - PT

HRN Services Inc. offers gateway to traveling assignments from coast to coast. Every assignment can feel like a working vacation offered with an extensive program of HRN benefits and private housing.

Adventures of discovery await you when bundled with your passion as a healthcare professional to provide safe, quality care to your patients with HRN verified competencies. Start now with your portfolio of experience and a willingness to follow assignment opportunities.

HRN Services Inc., earned the Joint Commission"s Gold Seal of Approval TM under the corporate model of survey review for the HealthCare Staffing Services Certification Program introduced in October 2004. HRN Services Inc. was established in 1991 to meet the growing need for healthcare resources to fill hospital vacancies and today enjoys the retention of our employees who know what a difference HRN makes.

Job Title: Traveling Nurse - PT
Company Name: HRN Services Inc.
Specialty: Rehabilitation
Job Location: ANCHORAGE, ALASKA

JOB DESCRIPTION: REHABILITATION
Facilitates the plan for the recovery of this patient population with supportive therapy services and the significant others who will manage care when the patient is discharged. Must be able to make appropriate assessments utilizing the nursing process to evaluate and update the plan of care.

Contact: Traveling Nurses
Email: travel4u@hrnservices.com
Phone: 888-476-9333
Fax: 888-223-5550


Contact Details / Apply for this Job

Rehabilitation - Occupational Therapist - OT



Job Information
Post Date:TodayType:Full time
Start Date:2008-01-15 05:10:07 PMSalary:- n/a -
Location: AK - Ketchikan Job Reference:- n/a -
Facility: Medical Staffing Network - Nationwide


Job Details









With top pay, excellent benefits and a variety of flexible assignment options, it’s no wonder thousands of top healthcare professionals nationwide choose Medical Staffing Network as their career partner each year.

Discover what they already know! Take a look at our latest opportunity:

Occupational Therapist / OT / Days

If you?re an experienced Occupational Therapist and you?d like a new professional challenge, The NEW Medical Staffing Network has exciting positions for you! We have excellent travel opportunities available in the OT setting. With MSN you?ll have a dedicated recruiter whose focus is to solely support you, to understand your needs and to be available whenever you need.

By ensuring ample employment opportunities, the best benefits, and a concerned staff available 24 hours a day, we strive to offer you a work environment that exceeds all your expectations. No matter where you want to work, or how hectic your schedule is, MSN will work with you every step of the way.

Why choose The NEW Medical Staffing Network?

  • The most competitive pay rates in the industry - Earn what you"re worth!

  • You decide your payday with our 100% Daily Pay option.

  • With our 401(k) Program you"re eligible after just 1 month of service and we match 50% of the first 7% that you contribute!

  • Highest bonuses in the industry Sign-on, Referral, Completion, Loyalty, and much more!

  • Never wait for your paycheck to clear or wait on long bank lines again with our MSN DirectPay card. Use it everywhere Visa? is accepted! Learn more about MSN DirectPay!

  • Experienced 24-hour support, every day of the year.

  • The best benefits in the industry including Health, Life, and Dental Plans.

  • Further your education from your own home with our Free Online Continuing Education!

Enjoy:
? Immediate access to recruiters
? Great locations/ prestigious facilities
? Exclusive partnerships


Traveling options available. If you are a traveler, enjoy these additional benefits:
? Free private housing or housing subsidy
? Paid utilities
? Travel expense reimbursement
? Flexible tax advantage plan


Job Type:Travel
Shift:All
Facility Type:All

Why choose Medical Staffing Network?

  • 24/7 Support from Caring Staffing Coordinators.
  • Dedication to Quality Healthcare Staffing – Joint Commission Certified.
  • Variety of Assignment Options, Including Local, Travel, Short- and Long-Term.
  • Benefits Healthcare Professionals Want Most, Like Health Insurance, Matching 401(k), Free Online CEUs and More.


For more information or to apply, call 800.MSN.TEAM (800.676.8326) or visit MSNHealth.com.

Note: All Medical Staffing Network job opportunities require that you have at least one year of experience and current approval to work in the United States.

Contact: Bob Admin
Email: extranetadmin@msnhealth.com
Phone: 6307912000
Fax: 6307912988





MEDICAL STAFFING NETWORK HAS EARNED THE JOINT COMMISSION’S GOLD SEAL OF APPROVAL.TM


www.MSNNurse.com



Rehabilitation - Physical Therapist - PT



Job Information
Post Date:TodayType:Full time
Start Date:2008-01-15 05:10:07 PMSalary:- n/a -
Location: AK - Ketchikan Job Reference:- n/a -
Facility: Medical Staffing Network - Nationwide

img

Job Details









With top pay, excellent benefits and a variety of flexible assignment options, it’s no wonder thousands of top healthcare professionals nationwide choose Medical Staffing Network as their career partner each year.

Discover what they already know! Take a look at our latest opportunity:

Physical Therapist / PT -days.

If you?re an experienced Physical Therapist and you?d like a new professional challenge, The NEW Medical Staffing Network has exciting positions for you! We have excellent Travel opportunities available in the PT setting. With MSN you?ll have a dedicated recruiter whose focus is to solely support you, to understand your needs and to be available whenever you need.

By ensuring ample employment opportunities, the best benefits, and a concerned staff available 24 hours a day, we strive to offer you a work environment that exceeds all your expectations. No matter where you want to work, or how hectic your schedule is, MSN will work with you every step of the way.

Why choose The NEW Medical Staffing Network?

  • The most competitive pay rates in the industry - Earn what you"re worth!

  • You decide your payday with our 100% Daily Pay option.

  • With our 401(k) Program you"re eligible after just 1 month of service and we match 50% of the first 7% that you contribute!

  • Highest bonuses in the industry Sign-on, Referral, Completion, Loyalty, and much more!

  • Never wait for your paycheck to clear or wait on long bank lines again with our MSN DirectPay card. Use it everywhere Visa? is accepted! Learn more about MSN DirectPay!

  • Experienced 24-hour support, every day of the year.

  • The best benefits in the industry including Health, Life, and Dental Plans.

  • Further your education from your own home with our Free Online Continuing Education!

Enjoy:
? Immediate access to recruiters
? Great locations/ prestigious facilities
? Exclusive partnerships


Traveling options available. If you are a traveler, enjoy these additional benefits:
? Free private housing or housing subsidy
? Paid utilities
? Travel expense reimbursement
? Flexible tax advantage plan


Job Type:Travel
Shift:All
Facility Type:All

Why choose Medical Staffing Network?

  • 24/7 Support from Caring Staffing Coordinators.
  • Dedication to Quality Healthcare Staffing – Joint Commission Certified.
  • Variety of Assignment Options, Including Local, Travel, Short- and Long-Term.
  • Benefits Healthcare Professionals Want Most, Like Health Insurance, Matching 401(k), Free Online CEUs and More.


For more information or to apply, call 800.MSN.TEAM (800.676.8326) or visit MSNHealth.com.

Note: All Medical Staffing Network job opportunities require that you have at least one year of experience and current approval to work in the United States.

Contact: Bob Admin
Email: extranetadmin@msnhealth.com
Phone: 6307912000
Fax: 6307912988





MEDICAL STAFFING NETWORK HAS EARNED THE JOINT COMMISSION’S GOLD SEAL OF APPROVAL.TM


www.MSNNurse.com



How to Become a Home Health Care Nurse

Home Health Care Nursing Information and Overview

Home health care is allowing the patient and their family to maintain dignity and independence. According to the National Association for Home Care, there are more than 7 million individuals in the United States in need of home health care nurse services because of acute illness, long term health problems, permanent disability or terminal illness.

Home Health Care Basics

Nurses practice in a number of venues: Hospital settings, nursing homes, assisted living centers, and home health care. Home health care nursing is a growing phenomenon as more patients and their families desire to receive care in their homes. The history of home health care stems from Public Health Nursing where public health nurses made home visits to promote health education and provide treatment as part of community outreach programs. Today academic programs train nurses in home care and agencies place home health care nurses with ailing individuals and their families depending on the nurse's experience and qualifications. In many cases there is a shared relationship between the agency and the academic institution.

Many changes have taken place in the area of home health care. These include Medicare and Medicaid, and Long Term Care insurance reimbursement and documentation. It is important for the nurse and nursing agency to be aware of the many factors involved for these rules and regulations resulting from these organizations. Population and demographic changes are taking place as well. Baby boomers approaching retirement and will present new challenges for the home health care industry. Technology and medical care in hospitals has lead to shorter inpatient stay and more at-home rehabilitation. Increases in medical outpatient procedures are also taking place with follow-up home care. This has resulted in the decrease of mortality rate from these technologies and medical care has lead to increases in morbidity and chronic illness that makes the need for home health care nursing a greater priority.

Home Health Care Nurse Job Description

Through an array of skills and experience, home health care nurses specialize in a wide range of treatments; emotional support, education of patients who are recovering from illnesses and injury for young children and adults, to women who have experienced recent childbirth, to the elderly who need palliative care for chronic illness.

A practicing nurse must have the skills to provide care in a unique setting such as someone's home. The nurse is working with the patient and the family and must understand the communication skills for such dynamics. Rapport is evident in all nursing positions, but working in a patient's own living space needs a different level of skill and understanding. There is autonomous decision making as the nurse is no longer working as a team with other nurses in a structured environment, but is now as a member of the "family" team. The host family has cultural values that are important and are different for every patient and must be treated with extreme sensitivity. Other skills include critical thinking, coordination, assessment, communication, and documentation.

Home health care nurses also specialize in the care of children with disabilities that requires additional skills such as patience and understanding of the needs of the family. Children are living with disabilities today that would have resulted in mortality just twenty years ago. Genetic disorders, congenital physical impairments, and injury are just a few. Many families are familiar with managing the needs of the child, but still need expert care that only a home health care nurse can provide. It is important that a home health care nurse is aware of the expertise of the family about the child's condition for proper care of the child. There are many complexities involved, but most important, a positive attitude and positive reinforcement is of utmost importance for the development of the child.

Medication coordination between the home health care nurse, doctor, and pharmacist, ensures proper management of the exact science behind giving the patient the correct dose, time of administration, and combinations. Home health care nurses should be familiar with pharmacology and taught in training about different medications used by patients in the clinical setting.

Many advanced practicing nurses are familiar with medication regiments. They have completed graduate level programs. Home health care agencies believe that a nurse should have at least one year of clinical experience before entering home health care. Advanced practicing nurses can expedite that training by helping new nurses understand the home health care market and teaching.

Employment and Salary

According to the United States Department of Labor, there were 2.4 million nurses in America, the largest healthcare occupation, yet many academic and hospital organizations believe there is a gross shortage in nursing staff. The shortage of nurses was 6% in 2000 and is expected to be 10% in 2010. The average salary for hospital nursing is $53,450 with 3 out of 5 nursing jobs are in the hospital. For home health care, the salary is $49,000. For nursing care facilities, they were the lowest at $48,200.

Training and continuing education

Most home health care nurses gain their education through accredited nursing schools throughout the country with an associate degree in nursing (ADN), a Bachelor of Science degree in nursing (BSN), or a master's degree in nursing (MSN). According to the United States Department of Labor, in 2004 there were 674 BSN nursing programs, 846 ADN programs. Also, in 2004, there were 417 master's degree programs, 93 doctoral programs, and 46 joint BSN-doctoral programs. The associate degree program takes 2 to 3 years to complete, while bachelors degrees take 4 years to complete. Nurses can also earn specialized professional certificates online in Geriatric Care or Life Care Planning.

In addition, for those nurses who choose to pursue advancement into administrative positions or research, consulting, and teaching, a bachelor's degree is often essential. A bachelor's degree is also important for becoming a clinical nurse specialist, nurse anesthetists, nurse midwives, and nurse practitioners (U.S. Department of Labor, 2004).

All home health care nurses have supervised clinical experience during their training, but as stated earlier advanced practicing nurses hold master's degrees and unlike bachelor and associate degrees, they have a minimum of two years of post clinical experience. Course work includes anatomy, physiology, chemistry, microbiology, nutrition, psychology, and behavioral sciences and liberal arts. Many of these programs have training in nursing homes, public health departments, home health agencies, and ambulatory clinics. (U.S. Dep. of Labor, 2004).

Whether a nurse is training in a hospital, nursing facility, or home care, continuing education is necessary. Health care is changing rapidly and staying abreast with the latest developments enhances patient care and health procedures. Universities, continuing education programs, and internet sites, all offer continuing education. One such organization that provides continuing education is the American Nurses Association (ANA) or through the American Nurses Credentialing Center (ANCC).

Conclusion

There are many rewards to becoming a home health care nurse. Some rewards include the relationship with a patient and their family, autonomy, independence, and engaging in critical thinking. The 21st Century brings with it many opportunities and challenges. We must meet these challenges head on - there is an aging baby boomer population, a growing morbidity factor due to increased medical technology and patient care, and the growing shortage in nursing care.

Becoming a home health care nurse today is exciting and an opportunity to make a difference one life at a time. With clinical experience and proper education, a home health care nurse will lead the future of medical care.

Copyright 2006 Michael V. Gruber, MPH

Choosing the Right Travel Nursing Placement Agency

by: Janet Fikany

Travel nursing is becoming one of our nation’s fastest growing professions, and it’s no surprise. If you love seeing new places and enjoy exciting new experiences that evoke the feeling of taking an extended vacation, then the career of a traveling nurse might be just what the doctor ordered! Travel nursing enables many people to stay on vacation for two to six months in free luxury accommodations while earning high hourly wages at the same time.

Yet despite all these advantages, many nurses describe to me that they’ve shied away from the traveling profession. Why? Because bad experiences with placement agencies have left them with nothing but a negative impression. They’ve been underpaid or lacked benefits, and I can’t tell you how many nurses have complained to me about inadequate housing or recruiters who were unkind, uncaring, and just plain unavailable. The sad result is that nurses end up jumping from one agency to the next, always in search of the perfect package that’s never there.

In this light, choosing the right staffing agency requires a nurse to consider everything that is offered. Some nurses emphasize pay as their top priority. Others require an excellent benefits package. Many travel RNs are location-specific and want to experience the lifestyle in the country’s hot spots. Career flexibility is often a pivotal factor, along with customer service. The bottom line is, your agency choice depends largely upon one of the four following criteria.

SALARY

No question about it, there are some agencies that offer more money than others. So the first thing to remember is that agencies may base salaries upon things like location availability, need-to-fill assignments, and cost of living.

Some agencies must offer noticeably higher rates if they expect to fill certain assignments where nurse-to-patient ratios are very low, or where a facility has extreme patient needs. If you’re a nurse who is attracted by very high dollars, be alert for a potentially desperate situation you might be entering, and the workload it could bring. You may make more money, but you’ll earn every dollar and more.

Location also factors into salary. The California bay area and many larger east coast cities definitely offer more lucrative pay rates. It’s also much more expensive to live in those places, so recognize the relationship that exists between salary dollars and cost of living. I’ve seen nurses return from Hawaii saying they had a great vacation and made a lot of friends—but their purses were lighter, not heavier from the experience. You might get less money in an exotic location and come back with more money from a not-so-exotic location. My point is, your criteria will determine your priorities.

BENEFITS

What some companies may lack in salary, they make up for with benefits. Many agencies offer benefits programs that revolve around monetary bonuses or discounted luxury housing; and I have even observed a trend with several newer companies that offer entirely free housing to all their nurses. Take note, however, that those agencies may not ante up the really high salaries. It’s a trade-off, so they compensate you with benefits to save you daily, monthly, and annual expenses. Every nurse should be aware of what benefits they need the most, and then ask their recruiters to assist in developing a package that is tailored to their individual needs.

CUSTOMER SERVICE

To many traveling nurses, customer service and aid are the most important attributes a placement agency possesses. If you called ten agencies and only talked with one live recruiter, it’s probably best to narrow it down to the agency where individual placement specialists were easily available. After all, if you’re ready to proceed with a new assignment you’ll want an agency that can make it happen fast and has recruiters available who already understand your criteria. In fact, your criteria may change from one assignment to another, so customer service is paramount. Determine what you want and then find out which agencies can make it happen.

FEATURED LOCATIONS AND HOT SPOTS

While for some nurses, salary, benefits, and career flexibility might be the number-one interest, many others just want the obvious—to travel and see the world. If you’re an adventurer who cares more about the travel experience than the money, then you’ll need an agency that can offer you the locations you want.

Not every agency can send you just anywhere. Figure out where you want to go, and then call around to discover who can send you there.

A travel nursing career is absolutely one of the best, most rewarding choices any nurse can make, but it’s important to select a company who will partner with you every step of the way. Before you jump in, do your homework and research all the best placement agencies. Finding the agency that fits your unique wants and needs will drastically increase your chances of success and happiness in your career.

Senin, 11 Februari 2008

Colorful Diamonds - Not For Individuals Looking for Champagne on a Beer Budget

Pink diamond engagement rings received a lot of attention recently when J-Lo received an exquisite 6 carat pink diamond in 2002 from Ben Affleck. Although the romance fizzled, the desire for pink diamonds did not.

Only a small number of pink diamonds are found each year, making them both extremely rare and highly sought after. Due to the supply/demand factor, they are often extremely costly and can easily run over $10,000 and typically much much more. Natural pink diamonds are light in color with just a hint of pink. Most of the world's pink diamonds are found in Australia.

An appealing alternative to pink diamonds are pink sapphires, which are less expensive ($500 and up), come in a wider variety of shapes and sizes, and have both light and deep shades of pink. Pink sapphires receive their color from small amounts of chromium. They are a hard gemstone and are therefore suitable for everyday wear. Pink tourmalines are another alternative to pink diamonds. For those who fall into the "want champagne on a beer budget category," you can always combine small pink diamonds with more affordable gemstones. Also, colorless diamonds can undergo treatment to develop a pink hue at a more affordable price.

One of the most famous canary yellow engagement rings was worn by Paris Hilton. The emerald cut ring weighed in at a hefty 24 carats. Regular couples today are also selecting canary yellow stones for their engagement rings. While diamonds with a slight yellowish hue are not considered desirable, those with a natural intense yellow color are actually becoming quite valuable. Only 1 in 1,000 diamonds are classified as canary yellow. The yellow color is believed to be due to the presence of nitrogen atoms when the diamond is formed. Diamonds can also undergo a process called irridiation or high pressure/high temperature treaments in order to give them a yellow hue.

Yellow diamonds are more expensive than their white counterparts, and the intensity of the color factors into this. If couples can't afford a natural yellow diamond as a center-stone, as with pink diamonds, there are always alternatives. Smaller yellow diamonds can be used as sidestones or natural yellow gemstones such as yellow sapphires or citrine can be used instead.

Diamond Jewelry Care

You just dropped several large bills to get your beloved (or maybe yourself!) a diamond or diamonds that take your breath away. That kind of investment deserves some careful attention, and that's the subject of discussion. To make your diamonds last a lifetime, there are several areas, some obvious, some not; that you need to keep in mind. While diamonds may be the hardest compound on earth, they still need some loving care.

There are cleaning, checking your settings, security and traveling.

CLEANING YOUR DIAMONDS Your diamonds can get pretty grotesque with day to day wear. Lotions, harsh soaps, food and even the oils from your skin can contribute to a less than lustrous diamond. Here are the four most popular ways to clean your diamonds at home. 1-Give them a mild detergent bath, gently using a small soft brush to wash away loose impediments. Be careful to do this in a small bowl away from the sink as the only thing worse than a filthy diamond is a lost one! 2-Soak them in solution of half ammonia and half cold water for about 30 minutes. Be sure to only use a soft bristled brush as it's possible to scratch your diamonds.

3-use one of the Quick Dip solutions sold in stores. Follow the directions and be sure not to handle the clean diamonds with your fingers, ruining all your hard work. Pick your diamond jewelry up by it's edges.

4-Ultrasonic cleaning. There's lot's of these small machines that will clean your diamond jewelry in a snap. Just be sure and follow directions, as each machine is different.

CHECKING YOUR DIAMOND SETTINGS At least once a year have your diamond jewelry settings checked by a reputable jeweler. Have them check for a secure placement, particularly if your diamond is set in soft metals such as 24k gold.

DIAMOND SECURITY Some thoughts on securing your diamonds. Keep your diamond jewelry in soft fabric covered jewelry boxes, preferably with individual compartments. One of the only things that can cut a diamond is another diamond, so keep them away from each other. don't wear it when doing hard heavy work. It's possible to chip your diamond with a hard glancing blow. Keep your treasures away from small, playful fingers. If you have a large amount, consider videotaping or digitally storing photos of your gems for insurance purposes. And be smart: don't wear your 15 carat diamond necklace to a Raider game and expect to make anything but a lot of new friends!

TRAVELING WITH DIAMONDS When traveling, store your diamonds in soft jewelry bags, individually, and use a specially designed jewelry travel case if you can get one. They are made for this purpose, and are handy indeed.

A piece of diamond jewelry means many things to many people. Diamonds are a symbol of great affection. Please honor those who gave this gift to you by giving your diamonds careful and regular care and attention and you'll be rewarded with a lifetime with a lifetime of sparkle!

Copyright 2005 Keith Thompson

Diamond Jewelry Online Buying Tips

When it comes to diamonds, there are numerous scams to avoid. Most scams are minor, but there are some major ones that come up from time to time concerning the buying and selling of diamonds. With all of the potential for scams concerning diamonds, buying diamonds online almost seems unthinkable! However, you actually can purchase diamonds online, without any problems – as long as you are careful.

First, think about your reasons for wanting to purchase the diamond online, as opposed to making a purchase from a local jewelry store. The most common reason is price. Due to low overhead costs, online jewelers and wholesalers are able to offer lower prices. However, you must be careful – sometimes a price that is too low is a sure indication of a scam.

One of the best things about purchasing online is the unlimited selection. When shopping offline, you are limited to the selection in the stores in your general area. Online, there are no limits. But again, you must use a great deal of care and consideration before handing your money over to someone that you cannot see and have never met!

Before shopping, learn as much as you can about diamonds – especially cut, color, clarity and carat weights. When you are knowledgeable about diamonds, it will be harder for a con artist to rip you off. Once you know more about diamonds, you will be ready to start shopping.

Take your time. Don’t purchase the first diamond that you see that interests you. Instead, look for similar diamonds for sale. Do some comparison shopping to find the lowest and best offer prices. Once you have found the lowest price, start doing your detail investigation. You know about diamonds, you’ve found a diamond that you love, and you’ve found the lowest price – but you are still quite a ways away from actually purchasing that diamond!

In this respect, ask about the seller’s credentials and qualifications, such as professional jewelry associations that they belong to. View and print the seller’s return, refund, and upgrade policies. Also inquire about additional services, such as settings and mountings, sizing, and free shipping. Do a search for customer reviews on this particular company around the Internet. Also check with the BBB Online to see if there have been any complaints.

Ask for a diamond grading report from an independent laboratory such as GIA, HRD, EGL or AGS. You should see this before making a purchase. Finally, use a reputable escrow service for high dollar diamonds – preferably one that will have the diamond appraised while it is in their possession. The seller sends the diamond to the escrow service, and you send the money to pay for the diamond to the escrow service. The escrow service has the diamond appraised, sends the diamond to you, and sends the money to the seller. This is the surest way to protect yourself…again, make sure that you use a reputable escrow service!

Do You Have Enough Jewelry Insurance?

Jewelry insurance comes in many forms and varieties and only an insurance agent can provide accurate and specific advice. However, it helps to know enough about jewelry insurance to ask your agent the right questions and to be aware of how the process works. The time to ask your insurance agent the questions is before you insure an item, not when you need to file a claim. Read the fine print in your insurance contract to be sure it provides the coverage you expect.

Understanding jewelry insurance begins with recognizing the difference between scheduled and unscheduled property.

Unscheduled property (jewelry not specifically listed) is typically included in basic homeowner or renter’s policies under blanket coverage. There is a usually a deductible (typically $500) and a maximum amount of coverage (typically $1500) although these amounts can vary with the specific policy. This type of coverage does not require an appraisal but sales receipts, written descriptions or photos are beneficial in proving the items existed and estimating their replacement value.

Scheduled property (jewelry specifically listed) is included in a floater, rider or endorsement to homeowner or renter’s policies. Jewelry insurance is also available with a separate policy, from a company specializing in jewelry insurance. For scheduled property, the insurance appraisal is vital because it describes the jewelry item and provides the “insured value” that is used in determining the premium you will pay to insure the item each year. Most scheduled property policies do not have an automatic appreciation adjustment as is common for the house and other unscheduled property. Therefore, even if it might cost 50% more to replace an item in five years, the “insured value” is still only that stated in the appraisal.

If you file an insurance claim, the settlement process and amount paid will depend on the policy and in particular, if the policy allows replacement or agreed value settlement. For agreed value policies, the settlement amount is stated in the policy whereas replacement value allows the insurance company to replace your jewelry or make a cash settlement based on the insurance company’s cost to replace your item. The insurance company’s liability ceiling is set at the “insured value” on the appraisal.

Do you have enough jewelry insurance? The answer depends on what kind of policy you have, the “insured value” is on the appraisal, the settlement procedure is for your particular policy, and the accuracy of the information on your appraisal. If you have a jewelry item valued at more than the $1500, you should definitely consider scheduled as opposed to unscheduled coverage.

The critical issue for scheduled property coverage is the how accurate is the information on the appraisal.

1) If the information on the appraisal is vague and general, the insurance company can replace the item with an item that satisfies the description but perhaps is not the quality and true value of the lost item. Be sure your jewelry appraisal has a detailed and accurate description of the jewelry item.

2) If the appraisal value is artificially high, the insurance company can replace the item at their cost even though the client paid premiums for years on a value twice as much. This is often the case for purchases from a jewelry store with prices double other retailers and the store provides an insurance appraisal even higher than the purchase price. You do not need an appraised value more than 150% of the price you would pay at low priced online retailer.

3) If the appraisal value is too low, the insurance company can make cash settlement that might not cover the current replacement cost of the item. This could be the case for items purchased three or four years ago from a low price online retailer and the appraised value was at or below the purchase price. With diamond prices increasing about 10% a year recently, it does not take long for appraisal values to be out of date if too close to online retail purchase prices. Be sure to have your jewelry insurance appraisal updated every four or five years so you do not end up underinsured.

Weddings Rings Shapes and Insurance

What you need to know for wedding rings.

Diamonds: A Guide to Diamond Shapes

EMERALD - This rectangular shaped stone is a very elegant and sophisticated look for a bride.

HEART - A truly romantic statement on any bride’s finger this stone’s shape resembles a heart.

MARQUISE - Beautiful as a solitaire, this diamond too is elongated diamond but has pointed ends.

OVAL - This perfectly symmetrical elongated shaped diamond adds length to fingers and is very popular among three stone rings.

PEAR - This shape is derived from combining both the marquise and the oval shaped diamonds. One end is beautifully rounded while the other leads to a point.

PRINCESS - This is a perfectly square shaped stone which has become increasingly more popular among brides today.

ROUND - A circular shaped diamond which has always been a popular and traditional choice for many brides.

TRILLIANT - Shaped like a triangle, the trilliant may have rounded corners or pointed ones and provides a perfect accent to a princess or round shaped diamond.

Appraisals and Insurance

Once the question has been popped, the marriage proposal accepted and the stunning diamond ring is on the finger, now is the time to think about taking care of the engagement ring.

Diamond rings are an investment. It shows the love and commitment to the relationship. It is an investment that will be a reminder years later, of how much time, energy and love was poured into the marriage. Like a relationship, a diamond ring needs care too. According to Colin Nash of Nash Jewellers in London, Ontario, the first step is to get the diamond ring checked and cleaned every three to six months. In doing so, this is a small part of the insurance that the ring is in tip-top shape. The claws are holding the stone properly, which will prevent the loss of the diamond. The mounting secure and the band is not thinning, which could cause breakage and at worst, loss of the ring itself. If weight loss has occurred and the ring is loose, make sure to have the ring sized, this is one way to guarantee against the loss of a valuable piece of jewellery, not only in monetary value but sentiment too.

The second step according to Colin Nash is to get the ring insured. Again, the investment of months of hard saving for the ring, the purchase and the memories would all be lost if the ring were to go missing or worse, stolen. Break-ins in Canada do happen and the targets besides small appliances and technological items are - jewellery! Jewellery is small and easy to hide on the burglar’s body and in pockets of clothing.

When the decision has been made to insure the ring, the next step is to have the ring appraised. Get in touch with a Jeweler, who has a Certified Gemologist Appraiser on staff. There are only 14 Certified Gemologist Appraisers in Canada. A Certified Gemologist Appraiser will give an accurate description of the diamond’s quality. They will look for stone damage, chips or marks or if claw damage has occurred and will disclose all information to the customer. The piece of jewellery is job-tagged with contact information and cleaned. Once the cleaning is done, they will record the 4 C’s, which are colour, clarity, cut and carat-weight. Measurements are taken and the gold is tested, to record what kind of gold it is, along with the price per carat of the diamond at the time because diamond markets do fluctuate. The Appraiser compiles all this information into a report for the customer. Nash Jewellers also takes a digital photo of the ring up to 10X for a clear and concise image, which they keep on file in their computer system along with a copy for the customer’s file. This is all done in order to give the insurance company a proper and modern retail replacement value, whether it was lost, stolen or damaged. It also is proof of what the actual piece looks like for insurance and police purposes.

The cost of an appraisal varies from company to company. It could start from $50.00 for the first piece and $40.00 for any additional pieces brought in at the time or could cost more or less.

Most Canadians purchase higher quality diamonds and spends approximately $2500.00 to $3500.00 on an engagement ring, which is a ring with a ½ (0.50) carat diamond to a 1.0-carat depending on wage and financial situation. Insure a ring that is over a thousand dollars. If the ring is less in value, make sure it is listed in the home insurance under Special Items or Personal. Even better, take a digital photo with a optical zoom of the ring and keep this photo and any other information (receipt of purchase) about the engagement ring in a safety deposit box at the bank.

If an appraisal file has been done, call an insurance agent and make sure to insure it for the full amount paid at the time of purchase or the amount appraised. Once insurance on the ring has been put into place, keep all these important papers in a safety deposit box. Any unworn and expensive jewellery would be best kept in the safety deposit box too. Safety deposit boxes are not expensive to keep. They are tax deductible and an investment towards piece of mind, same as the insurance on the ring itself.

The engagement ring is an investment towards a future life together, take care of that investment by following a few simple, precautionary steps towards guaranteeing that the ring will last for years to come and will be passed down to offspring and future generations.

For more information on planning your wedding visit my website http://www.getmarriedcanada.com