Techytechy

Tech friends, here is another interesting news I found from Manila Bulletin dated August 22, 2010. It’s another interesting material about related to the status of the Nursing profession and Nursing career as a whole. Please read and air your comments if any.

Amid the decline in the global demand for Filipino nurses, more graduates of science-related courses are now pursuing a degree in medicine, the Board of Medicine said over the weekend.

Board of Medicine member Jose Cueto said the lessening of employment opportunities for nurses abroad seems to have contributed to the increase in National Medical Admission Test (NMAT) examinees.

The NMT is a requirement for undergraduates seeking a degree in medicine.

Six years ago when there was a high demand for nurses abroad, the Board of Medicine noted a sharp decline in medicine students.

”During the time when nursing was at the top on the list of (preferred courses by) students, there was a sharp decline on the number of students taking the National Medical Admission Test,” Cueto said.

However, the Philippine Overseas Employment Administration (POEA) noted a reduction in the demand of nurses abroad.

Based on recent statistics from the POEA , the number of professional nurses deployed to other countries only increased by 6.71% from 12,618 to 13, 465 in 2009; as compared to the rate in 2008 when migrant nurses rose by 40.13% from 9,004 to 12,618.

Earlier, reports by the POEA showed that the trend was due to the global economic recession which reduced the demands of Filipino nurse in some countries like the United States, Canada, Kuwait, Quatar and Taiwan, and the increasing number of competing nurses from other countries like Pakistan, India, and some African nations.

”Doctors used to take nursing course, now it’s the nursing graduates who are taking medicine. The reverse education has been reversed,” Cuteto said.

Nursing, together with other health-related courses like physical therapy and medical technology are considered as some of the best preparatory courses for medicine.

A 2009 report by the Professional Regulation Commission (PRC) showed that among the three courses, nursing is considered as most popular with 77,898 examinees, followed by medical technology (2,270), and then physical therapy (1,347).

Cueto said the decrease in the employment opportunities for nursing students contributed to the increase in the number of examinees in the medical board exam and the NMAT.

”Now the Center for Educational Measurement, Inc. which gives the NMAT, says there is now an increasing number of NMAT-takers,” Cueto said.

However, despite the increasing number in registered doctors, the board said it would still not be enough to address the lack of doctors in rural areas, since they would usually prefer to practice their profession abroad.

”Even if we increase the number of medical students, the problem is that many of them are still going abroad and for those who choose to stay in the country they usually only stay in the metropolitan areas,” Cueto said.

Aside from Cueto, the meeting last Friday was attended by PRC Chairman Nicolas Lapeña Jr. and three of the six members of the Board of Medicine, which includes its chairwoman Mildred Pareja, Miguel Noche Jr., Restituto De Ocampo.

Tech friends, we are very pleased to tell everyone that techytechy.com has already aged and is now one year old. Actually, the birthday of this tech site was last July 14, 2010. Thank you for all your support, comments and messages. We are looking forward to many more years to come and many more partnerships built only here in techytechy – you’re one stop website for your Nursing and nurse-related subjects, animes and online money making.

The Nursing Profession Under Seige

Tech and Nursing enthusiasts, here’s a very good article I found lately on the web from ANC correspondent Caroline Howard. Please read below and air your feedback regarding this issue. Truly, the Nursing profession has become so commercialized in the Philippines to the point that many groups even including the government so to speak, are ‘taking advantage’ of the homegrown registered nurses in the country.

–start of article–

The Nursing Profession Under Siege

By Caroline J. Howard, ANC

MANILA, Philippines – An estimated 187,000 Filipino nurses are unemployed. The Professional Regulation Commission (PRC) says these nurses are competing for some 70,000 nursing positions in private and public hospitals. But as if that were not enough, the Philippine Nurses Association (PNA) admits the problem of unemployment in the nursing profession may just have gotten bigger.

“Another 92,000 nursing students took the board exams last Saturday. By statistics, 50% or less would pass, so you could expect [at least] 35,000 to be added to the swelling number of unemployed,” says PNA President Dr. Tita Barcelo.

Training for a fee

Speaking on ANC’s “The Rundown” on Thursday night, Barcelo says, given the sheer volume of new registered nurses and a shortage of skilled nurses, the health industry is faced with the persistent problem of where to place them.

She adds the situation has encouraged the prevalence of unskilled workers having to pay their way for 3 to 6 months of hospital training to get work certification.

“Ideally, they should be employed for in-service training, but because there are no vacancies for the skilled nurses, then these nurses get to work in these hospitals as volunteers. There’s no vacancy for the beginners, but there are vacancies for the skilled nurses. But to get to be a skilled nurse, you have to go through training in the practice of profession.”

Barcelo says new nurses often agree to do volunteer work because they take a chance at becoming part of the hospital labor pool. In case there’s a vacancy, she says, hospitals often choose from those who’ve already volunteered.

Barcelo admits the situation is worse off today, unresolved despite efforts they made three years ago to hold a dialogue with hospital owners.

“It was not as bad as it is now. In the past, they volunteer without pay, but now, they pay, which is ridiculous, a perversion of the word volunteerism,” Barcelo laments.

She says nursing graduates pay anywhere from an average of P4,000 to P5,000 for 3 months of training to as high as P10,000 for 6 months. But if hospitals don’t pay these volunteers, the least they could do is not charge them for training.

Curbing the practice

Today, Barcelo says, there are on-going measures meant to discourage hospitals from taking in volunteers without pay.

“There’s a new executive order, in effect, discouraging hospitals to get volunteer nurses,” Barcelo notes. “Hospitals should not just call them volunteers; rather, they should be given certification of work which can be utilized by nurses.”

Barcelo says they are also exploring the possibility of pursuing a legislative solution, citing discussions with Senator Edgardo Angara, an author of the 2002 Nursing Law. He adds the law has a provision for a salary grade of P15,000 which has never been implemented.

‘Paradoxical surplus’

Dr. Gene Nisperos, vice chairman of the Health Alliance for Democracy (HEAD) calls the surplus “paradoxical.”

“These hospitals actually do need the nurses except they don’t want to spend the money and provide them tenured positions,” Nisperos says.

“We’re not talking about private hospitals, we’re talking about government hospitals where you have wards full of patients and nurses who extend their work because there are too many patients for them. In a sense, you have all these nurses who have no experience and yet they’re not being hired by government. The hospitals should be hiring them but aren’t and are instead making them pay.”

Nisperos says the government should find a way to hire these nurses, provide them options within the health system, and make nursing a viable career in the country, as well as make labor migration a matter of choice, not a necessity.

“The position taken by the previous government is that nurses are our primary export commodities. If that continues, the current paradoxical surplus of nurses will just worsen,” Nisperos says.

Call for real solutions

Amid such challenges facing the nursing profession, Nisperos hopes the Aquino government will find real and lasting solutions.

“We’re looking very closely at how the new president will follow through with his campaign platform. Certain issues need to be addressed, particularly how much importance health will have in this administration. We see that in his appointment of the new health secretary, his vision of public health, the need to improve health infrastructure, health human resource,” Nisperos says.

“Health has always been a deodorizer. Giving out PhilHealth cards, that should stop. If this government is intent on making a big change, health should be at the forefront of change, and it should be comprehensive, not piece meal, not stop-gap like in the past administration.”

He now calls on the new government to stand firm on its promises and truly make health a priority goal.

–end of article–

Nurses and tech friends, this is the third batch of the most important Nursing laboratory test that every nurse enthusiast should know by heart. It is not only the doctors and medical technologists that must know these tests but the nurses as well. For tech lovers, it also does not hurt to know something about this.

1. Guthrie test – test for phenylalanine levels to diagnose PKU
2. Nitrazine test – test for acidity / alkalinity; red for acid and blue for alkaline
3. Fern test – microscopic exam to determine rupture of membrane (ROM), (+) if there’s NaCl fern-like crystal seen
4. Post-coital test – done within 1-2 days of presumed ovulation, a test for fertility; determine the number and motility of sperm
5. Beutler test – like Guthrie test but this is to screen for galactosemia
6. Scotch tape test – done before bowel movement early in the morning to detect pinworms
7. Patch test – introduce an allergen into the skin to detect allergies (refer to the picture)
8. Tensilon test – a test for myasthenia gravis to determine whether it is myasthenic / cholinergic crisis by administering Edrophonium (Tensilon); if symptoms intensify, it is cholinergic
9. Voice test – examiner stand 1-2 feet away and let the patient block 1 ear; the examiner whispers a statement and asks the patient to repeat it. Each ear is tested separately
10. Serum trough and peak level – to know the effectiveness of gentamicin by getting a sample 30 minutes before and 30 minutes after the 3^rd dose is given
11. Fluorescent treponemal antibody absorption test – specific for syphilis
12. (RAIU) radio active iodine uptake test – if increased then hyperthyroidism; if decreased then hypothyroidism
13. ANA (anti-nucleic antibody test), then Coomb’s test then Complement test – most definitive tests for SLE
14. Glucose tolerance test – NPO (nothing per orem or nothing taken per mouth) during pre-procedure, drink high CHO (carbohydrate) substance then take the patient’s glucose level an hour after. An increase means impaired glucose tolerance if negative DM (diabetes mellitus)
15. Non-stress test – an evaluation of fetal heart rate response to natural contractile activity
16. Ishihara color test -  numerous plates with colored dots and pattern; if unable to read pattern then suggestive of color blindness (Blue, Green, Red for adults while Red, Orange, Yellow for elderly)
17. Bjernum tangent plate – to test central vision, if lost central vision then suggestive of macular degeneration
18. AIMS(Abnormal Involuntary Movement Scale) – used to assess tardive dyskinesia
19. Tine (prick) test – usually the first test done to detect TB, done before PPD, there’s a disk with tuberculin antigen used to puncture the skin
20. Tissue culture test – to test for the virus present
21. Sensitivity test – tests for bacteria present for prescription of antibiotics
22. Trendelenburg test – raise legs to inspect for varicosities
23. Anti-nuclear antibody test – test also used in rheumatoid arthritis

Maximize tech to your advantage by learning all these important Nursing laboratory tests only here in this site. Enjoy!

Tech enthusiasts and nurse aspirants, this is the third batch of the most important Nursing signs that every nurse and Nursing student should know. With this list, you will become more acquainted with some Nursing terms that are frequently used in school and also in the hospital setting. Read on!

1. Obturator sign – pain upon internal rotation of right ankle while leg is flexed, indicative of appendicitis
2. “mask-like fascies” – facial expressions in Parkinson’s disease
3. Cogwheel rigidity, lead pipe rigidity – in Parkinson’s disease
4. Brushfield spots – pinpoint white dots at the iris; in Down syndrome (refer to the picture)
5. Itchy, burning sensation with or curd-like creamy cheese-like discharge – candidiasis
6. Greenish-yellow discharge – gonorrhea
7. Profuse, bubbly white discharge – trichomoniasis (with petechial spots)
8. Pinpoint vesicles on erythematous vulva – herpes simplex II
9. “blue-berry muffin lesions on newborn” – sign of Cytomegalovirus (CMV) infection in pregnant women
10. Erythema chronicum migrans (macular lesions with clear centers) – present in Lyme disease, a viral disease common to infect pregnant women
11. Yellow-gray, frothy, odorous discharge – trichomoniasis
12. Gray discharge with frothy odor – bacterial vaginosis
13. Gray-white discharge – Chlamydia
14. Painless ulcer (chancre) on vulva – syphilis
15. Cauliflower-like lesions – human papilloma virus (HPV)
16. “skip lesions” – Chron’s disease
17. Couvelaire uterus (board-like) – manifests in abruptio placenta
18. Trendelenburg sign – lurching toward affected side in hip dysplasia
19. Galeazzi’s sign – shortening of femur (hip dysplasia)
20. Ortolani’s sign – “clunk” sound of the femoral head striking the shallow acetabulum, indicative of hip subluxation

Keep posted for the fourth batch of the most important Nursing signs to remember only here in this tech site.

Nurse enthusiasts and tech friends, this is the third batch of the most important Nursing terms that every nurse wannabee and would-be nurse should remember. With this list, you will come to be more familiar with Nursing terms that are commonly used at school and also at the work-place such as in the hospital and other clinical field. Go on and read on the list below:

1. genotype – actual gene composition
2. atresia – absence of a opening in a normal passageway like the esophagus
3. stenosis – narrowing of the passageway
4. diastasis – separation of the rectus muscle in pregnancy (in abdomen)
5. fecundation – other term for fertilization
6. sterility – inability to conceive
7. epispadias – opening of penis at the dorsal surface of penis
8. hypospadias – opening of the penis at the ventral surface (underside of penis)
9. hemorrhoids – varicosities of the rectal vein
10. Amelia / phocomelia – absence of one / more limbs upon birth maybe due to thalidomide
11. orthopnea – person needs to sit / stand to breath without difficulty
12. paroxysmal nocturnal dyspnea – waking at night due to shortness of breath
13. ankle clonus – continuous motion of the foot, in eclampsia
14. pseudocyesis – false pregnancy, no fetus but there’s enlarged abdomen
15. duola – without professional credentials, assists the women in labor; a coach
16. pudendum – refers to the male or female external genitalia
17. diagonal conjugate – antero-posterior diameter of the pelvic inlet
18. phimosis – constriction of foreskin that obstruct the urinary opening in males; an indication for circumcision
19. thrush – manifests as a white gray patch on the cheeks of the newborn with Candida infection
20. witch milk – newborn’s breast secrete this fluid

Look out for the next batch of the most important Nursing terms that every nurse and some tech friends should master.

Tech friends and Nursing aspirants, this is the second set of Nursing mnemonics that you should know by heart. This will help you in your studies and help you better remember some concepts that can be used both in theory and practice.

1. Fat Soluble Vitamins

A vit. A
D vit. D
E vit. E
K vit. K

2. Benefits of Breastfeeding

B best for baby
R reduce allergy
E economical
A antibodies, greater immunity
S stool inoffensive
T temperature ideal
F fresh / feeding milk never goes off
E easy once established
E emotionally bonding
D digested easily
I mmediately available, no mixing
N nutritionally adequate
G gastroenteritis greatly reduced

3. Technique for Feeding An Infant With Cleft Lip / Palate

E enlarge nipple
S stimulate sucking reflux
S swallow
R rest to allow child to finish swallowing

4. Vector Control Program

C community participation
H health education
L legislative support
E environmental management
M mosquito control

5. Dimensions of a Person

S spiritual
P physical
I intellectual/cognitive
E emotional
S social/affective

6. Components of Mental Health

S self-esteem
M maximization of one’s potential
S stress management
M mastery of environment
A autonomy and independence
R reality orientation
T tolerance to life’s uncertainties

7. Signs of Mental Health

H happiness
A appraisal of reality
C control over behavior
E effectiveness in work
H healthy self concept

8. Model for Assessment & Recommendation for Sexual Satisfaction

E engage patient in conversation
N normalize sexual interest
I inform patient & partner on sexual anatomy & physiology
G guide patient & partner by responding in same language
M maximize problem solving ability by peer-counseling
A assess / reassess sexual issues

9. Lethality Assessment for Suicide Risk

S sex
A age
D depression
P previous attempt
E ETOH (a.k.a. alcohol)
R rational thinking loss
S social support lacking
O organized plan
N no spouse
S sickness

10. Common Intracellular Electrolytes

C can (calcium)
M mary (magnesium)
P perform (potassium)
B blood (bicarbonate)
P pressure (phosphate)

Please keep posted and look forward for the next set of Nursing mnemonics only here in this tech site.

This is the second set of the most important Nursing grades or scales that every medical practitioner and aspiring nurse should know in his or her studies. With this, your Nursing life will become a lot clearer, not to mention, a lot easier. By simply knowing these scales or grades by heart, these will place you way ahead of your colleagues. These grading system are not only used at school but also during the actual work experience in the hospitals and other related areas. So nurses and friends, hope you enjoy reading the material below: 

• APGAR Score

a. heart rate

    0      absent

    1      <100bpm

    2      >100bpm

b. respiratory effort

     0     absent

     1     slow, weak cry

     2     good, strong cry

c. muscle tone

     0     flaccid

     1     some flexion

     2     well flexed extremities

d. reflex irritability

     0     no response

     1     grimace

     2     cough/sneeze/cry

e. color

     0     blue/pale

     1     acrocyanotic

     2     completely pink

­Thus, if:

   0-4 grave condition

   5-7 needs intensive care

   7and above NB doing well

• Urinalysis  (albumin test using acetic acid)

            negative      – no albumin

            trace             - mildly clear to liquid opaque

            + to ++        – frankly cloudy

            +++              – white like an egg white

• Urinalysis (sugar test using Benedict’s solution)

              Negative   - no change in color

              Trace          - blue green

              1+ to 2+     - yellow green

              3+ to 4+     – orange yellow

• Pain Rating Scale

            1-3       - mild

            4-7       - moderate

            8-10     - severe

• Breast Cancer Staging

            Stage 1             less than 2cm, confined in the breast

            Stage 2             up to 5cm, axillary spread

            Stage 3             greater than 5cm, chest spread

            Stage 4             distant metastasis

• Placental Grading by Ultrasound (UTZ)

             0     =    12-24 weeks

             1     =     30-32 weeks

             2     =     36 weeks

             3     =     38 weeks

• Ankle clonus in eclampsia

     Mild             = 2 movements

     Moderate   = 3-5 movements

     Severe        = over 6 movements

• Age of Gestation (AOG) with fundal height monitoring

        -   Fundal height at symphysis pubis =12th week gestation

        -   Midway between symphysis pubis & umbilicus = 16^th wk. gestation

        -   At the umbilicus = 20^th wk.

        -   At the xyphoid process = 36^th wk.

• Stress test (Oxytocin Challenge Test)

             (+) / (+) window / late deceleration / Abnormal

             (-) / (-) window / no deceleration / Normal

• Kick Counts

            (+) / Normal / 3 or more movements in 1 hour

            (-) / AbN°/2 or more movements in 1 hour

• Classification of perineal laceration

           1^st degree      laceration at the perineal skin

           2^nd degree     at the muscle of perineum

           3^rd degree      rectal sphincter

           4^th degree      lumen of the rectum

This is the second set of some of the most important tests that nurses , Nursing inclined individuals and tech enthusiasts must know. Listed below ar 20 itemized tests for you to either memorize and know by heart. Surely, this will come in handy in some parts of your healthy living.

1. Antibodies: Anti DNA antibody, Anti-Smith antibody, anti-nuclear antibody – positive is indicative for Systemic Lupus Erythematosus (SLE), also present in rheumatoid arthritis
2. Lupus E. cell preparation – SLE, Rheumatoid arthritis
3. Culture & sensitivity – to diagnose specific cases of pneumonia
4. Pulmonary angiography and ventilation – perfusion lung scan – test for pulmonary embolism
5. Myoglobin, CK-MB, Troponin – to test for Myocardial Infarction (MI)
6. Trendelenburg test (T-test) – for venous disorders like varicosities
7. Finger-nose test – test for cerebral function
8. Romberg’s test – walk along a line with eyes closed (test balance)
9. Guaiac test – assess presence of occult blood in feces and urine – a blue result means 3x positive
10. Coomb’s test – test for Rh compatibility like between mother and newborn to rule out erythroblastosis fetalis
11. Iliopsoas muscle test – done to test for appendicitis wherein patient’s legs are raised off the bed and a force is applied to the upper thigh while the patient opposes the force
12. Obturator muscle test – test for ruptured appendicitis, done with patient in supine position and his right leg is flexed at the hip and knees must be kept at 90° angle; afterwards internal rotate the right ankle
13. Antistreptolysin-O-titer (ASO titer) – used to diagnosed rheumatic fever
14. PPD tuberculin test (purified protein derivative) – for TB screening in pregnant women; it has a radiation source; otherwise known as Mantoux test
15. Glucose tolerance test – test for blood glucose level taken at regular intervals after giving standard dose of glucose
16. Kleihauer Betke test – detect whether blood is fetal or maternal in origin
17. Radioimmunoassay test (RIA) – Human Chorionic Gonadotrophin (Hcg) test for pregnancy; uses serum
18. Enzyme-linked Immunosorbent Assay test (ELISA) – Hcg test for pregnancy, uses urine or serum
19. Hepatojugular reflux – done to test for right sided heart failure wherein pressure is applied on ones abdomen for 30-60 seconds. A sustained increase in central venous pressure (CVP) or jugular distention is a positive result
20. Sweat test – test presence of sodium (Na) and chloride (Cl) to determine cystic fibrosis

Tech friends and nurses, please watch out for the third set of the most important Nursing tests in the upcoming posts only here in this tech site.

This is the second set of the most important Nursing normal values that nurses and Nursing enthusiasts should bear in mind. Not only them, all tech lovers will also enjoy learning some of these Nursing concepts as they read and memorize these very important values. Obviously, any value that will fall under or above the range of normal values below will be considered abnormal. Hence, after you get your laboratory results, try to assess the values for yourself and do a preliminary check. You’ll really be amazed to know that not only the nurses but all people (tech fanatics and non tech lovers) can make a beginner’s interpretation of the lab values. Go on and read through the entire entry of this set of Nursing normal values.

1. Normal liver span = 6-12 cm
2. Normal blinking = 20 times/min
3. Point of Maximum Impulse  = (PMI) 4^th to 5^th Intercostal Space (ICS) Left  Midclavicular Line (MCL)
4. Right arm BP = 10 mmHg higher than left arm BP
5. Hemoglobin Female = 12-14 gm%
6. Hemoglobin Male = 13-16 gm%
7. Hematocrit Female = 37-44 %
8. Hematocrit Male = 42-50 %
9. White Blood Cell Count = 4.5-11 thousand / mm³
10. Neutrophils = 55-70 % (segmenters), 0-10 % (bands)
11. Lymphocytes = 20-35 %
12. Basophils = 0-0.5
13. Eosinophils = 1-45
14. Monocytes = 1-6 %
15. Platelet = 150-400 thousand /  mm³
16. Reticulocyte count = 0.5-1.5 %
17. Red Blood Cells Female = 3.5-5.5 million /mm³
18. Red Blood Cells Male = 4.3-5.9 million  /mm³
19. Erythrocyte Sedimentation Rate Male = 0-14 mm / hr
20. Erythrocyte Sedimentation Rate Female = 0-20 mm / hr
21. Clotting time = 7-15 min
22. Bleeding time = 2-9 min
23. Partial Thromboplastin Time (PTT) = 20-35 sec
24. Prothrombin Time (PT) = 12-14 sec, (9.6-11.8 Male; 9.5-11.3 Female)
25. Fasting Blood Sugar (FBS) = 60-110mg/dl (70- 110 mg/dl)
26. Random Blood Sugar = 45-130 mg/dl (80-140 mg/dl)
27. Bowel sounds = 5-35 times/min
28. Urine output = 30 mL/hr (720 mL/day)
29. Plasma Osmolality = 275-295 mosm/kg H2O
30. Red Blood Cell lifespan = 120 days (90-120)

 Nurses and tech enthusiasts, please keep posted for the upcoming third set of Nursing normal values.