Amiodarone: Infusion or Bolus ?

You’re dispatched for a 55 y/o male complaining of palpitations. You find him in a-fib at a rate of 150 but otherwise stable. You load the patient and get a line, but soon after, you note a change to VT with no major change in patient condition. Your partner draws up 150 mg of amio, but without cross-checking, pushes it IV. The patient goes unresponsive and experiences a brief PEA arrest that, luckily, is remedied with a few compressions and some epi. Oops 🫣

Based on a true story. 

Amio is an antiarrhythmic that affects sodium, potassium and calcium channels. It prolongs action potential and depolarization, and suppresses sinus node function and AV conduction. Whew 🥵

This drug is a source of confusion among students & new providers, as it has multiple different modes of administration. Let’s break it down. 

🙂STABLE PATIENTS:

•Amio suppresses cardiac function and is dissolved in a solvent that can also precipitate hypotension - give SLOWLY 🐢 

•Via: s l o w infusion. 150 mg bolus ✨over 10 minutes✨

•Not ideal to try to push 3 mLs over 10 mins (typical concentration: 50 mg/mL), so we mix it in something. 

•If you have a pump, mix it in a small bag (if not prepackaged) and run the bolus over 10.

•No pumps? Put it in a 100 mL bag and run it in over 10(ish) mins with a macroset. Other size bags are acceptable based on IV access and fluid tolerance. 

•Can be mixed in D5W or NS (yes, NS)

•It worked!? Maintenance drip💧 (after finishing bolus)

☠️DEAD PATIENTS:

•Since perfusion sucks and we’re mechanically controlling cardiac output (compressions), just push it. 

•300 mg for refractory vf/VT, then 150 mg if it’s still happening. 

•It worked!? Maintenance drip💧 

🥳IT WORKED:

•For patients who convert with an amio bolus, we can MAINTAIN the bolus’ effects and keep the bad juju away with a maintenance drip

•1 mg/min

•No pump? Put 100 mg (usually 2mL) in a 100 mL bag. That’s 1mg/mL. Spike with a 60 gtt set, run at one drop a second (aka 1 mL/min) and voilà. 

⚠️: Amio is not to be used with Torsades, as it prolongs QT further and can cause deterioration into vfib. 

🤓: If using lidocaine instead, same concept of bolus before maintenance drip applies.

Testicular Torsion

 Testicular torsion occurs when the spermatic cord twists, cutting off blood supply to the testis. 

 SYMPTOMS: 

Pain and swelling of the scrotal sac are usually the main symptoms of testicular torsion. 

Most people, in general, do not understand the difference between testicular torsion and infection, and when they have pain, they assume it is due to infection and they start themselves on analgesics and antibiotics. 

 CAUSES: 

Torsion could occur while people are asleep. Torsion tends to occur early in the morning when testosterone levels are at their peak, and the cremasteric reflex is strongest. Occasionally, a tumor or prior trauma may be present and risk factor includes a congenital malformation known as a “bell-clapper deformity” wherein the testis is attached to the epididymis vertically instead of longitudinally allowing it to move freely and thus potentially twist. Cold temperatures may also be a risk factor. 

 Torsion of the testes is a medical emergency, but many adolescent males are hesitant to say they are having pains on their testes or seek treatment right away. You should never ignore sharp testicular pain. It’s possible for some men to experience what is known as intermittent torsion.

 This causes a man to have a testicle twist and untwist. Due to the fact that the condition is likely to recur, it is important to seek treatment. Seek to consult with a urologist, even if the pain becomes sharp and then subsides

VAGINA APPRECIATION DAY

Despite centuries of stigmatization, the vagina is truly incredible. 💗

Among many other things, it’s the structural connection between the outside world and the female body’s most powerful reproductive organs. 💪

So it makes sense that the vaginal microbiome — defined as the complex ecosystem of microorganisms, including bacteria and fungi, that lives inside the vagina — has biologically evolved to help protect that reproductive system. 🔬

Every day, the vaginal microbiome performs the equivalent of modern health miracles. ⚡️

It can fight off yeast infections and bacterial vaginosis (BV), protect a pregnancy, and possibly even defend against cancer, as well as play a crucial role in your overall health.

🔑 This #VaginaAppreciationDay, we’re celebrating vaginas (and vulvas and the vaginal microbiome!) because it’s time we started to recognize them as superpowers and not liabilities, as sources of pride and not shame, and as beautiful, complex, powerful parts of our bodies.

Leave a 💗 if you agree!

———
#destigmatizevaginalhealth #NurseOtienoWrites

Dapivirine Vaginal Ring Prevents HIV

The first topical HIV prevention method to be submitted for regulatory approval, it is an intravaginal silicone ring, developed by the International Partnership for Microbicides (IPM) for HIV prevention.

Also read: Campus Mafisi

The ring delivers an antiretroviral drug called dapivirine. It’s released slowly over the course of one month directly to vaginal tissue to help protect against HIV at the site of potential infection. Little of the drug is absorbed elsewhere in the body resulting in low systemic uptake.

Also read :Crash Cart

This means that the drug is unlikely to be found in high concentrations in the bloodstream and other body tissues, which may reduce side effects as well the risk of development of HIV resistance. Data from Phase III studies of the ring show no evidence that the ring increased resistance to NNRTIs, the class of ARV drug to which dapivirine belongs and which is also used in some treatment regimens.

The Dapivirine Vaginal Ring reduces the risk of HIV-infection, and offers a discreet and long-acting alternative to daily oral PrEP.

Although access to daily oral PrEP is increasing around the world, a daily pill is not a suitable or desirable prevention method for everyone. Today, women account for more than half of all people living with HIV globally, and face persistently high HIV-infection rates. Experience introducing oral PrEP in many countries has revealed that women face unique challenges when it comes to adhering to a daily pill due to gender inequity, social norms and other structural barriers.

Efficacy data shows that the ring reduces HIV risk by 35 percent, with recent data from open label extension studies suggesting a greater reduction in HIV risk by about half. Modelling has shown that even a partially effective prevention option can have an important protective impact for women and their communities as part of a comprehensive HIV prevention strategy.

Like oral PrEP, the Dapivirine Vaginal Ring does not protect against other STIs or unwanted pregnancy.

The ring does not reduce risk of chlamydia, gonorrhea, syphilis or herpes, or unwanted pregnancy. There are studies underway examining the safety of a combined dapivirine-levonorgestrel ring that would protect against both HIV infection and unwanted pregnancy, as well as different vaginal rings that combine antiretrovirals and other medications to prevent STIs.

For more information read Dapivirine

Top Nursing Jobs Away from the bedside

“Tired of the Bedside??"

(Save this post)

1️⃣ Flight Nurse: A RN trained to care for patients arriving at a medical facility via an emergency Aircraft 🚁. Trained to manage a number of conditions in-flight.

2️⃣ Forensic Nurse: Provides care to victims of violent crimes and collects evidence and DNA.

3️⃣ Aesthetic Nurse: This nurse administers non-invasive cosmetic procedures including dermal fillers, chemical peels and anti-wrinkle injections. 

4️⃣ Nurse Consultant: The Nurse uses their experience and expertise to provide medical information to those otherwise not know. A “legal” nurse consultant can provide this expertise on criminal cases. 

5️⃣ Nurse Educator: These Nurses teach the nurses. Nurse educators are strong communicators and are responsible for developing and teaching nursing curriculum.

Also read : Code Blue

6️⃣ Mental Health Nurse (NP): A mental health NP works with a team of psychiatric professionals to service patients suffering from mental health issues and disorders. This involves diagnosing and treating a variety of psychiatric conditions.

  Which position is for you?

The beauty of Nursing is being able to change the trajectory of your career when needed. Take an opportunity to see what field fits you best. Your career is in your hands!

 Also read : My Challenging Night Shift

Other off-bedside specialties:

-Travel NP- 

-Telehealth

-School Nurse

-Pharmaceutical sales

-Nursing Informatics

-Public Health Nurse

-Cruise Ship Nurse

-Research Nurse

-Nutritionalist Nurse

-Correctional Nurse

-etc

The Code Cart Or "Crash Cart."

This is the heart of every unit. It’s the last weapon in the arsenal( get to know the meaning of arsenal not the football club); the final measure standing between this life and the next. Its function and its contents are universally known by nurses across the continuum. 

Also read: Team Mafisi

.

You should certify it every 2 years to ensure that you are up to date with the latest evidence for optimal outcomes. You should run “mock codes” to train for the many scenarios that require precision and sound judgement. You should check it daily to ensure that it is properly functioning and equipped with the tools and medications designed for the single purpose of prolonging life and preventing death. Any missing item, oversight or misstep can mean the difference between success or failure. 

 Also read : Nurse Are Rude

No matter what is happening around us, when the Crash Cart is activated, nothing else in the nurse’s world matters in that moment. We form one team. We assume one role. We speak one language. And we unite together with one mission- to save a life. 

 .

When was the last time you familiarized yourself with the crash cart?

When was the last time your crash card was updated? 

YOUR PENIS CAN PREDICT THE FUTURE

Wait, I'm not saying that it can tell you the best future partner or which career path to tow but it is clinically recognized as a future predictor of heart disease.

Many Cardiovascular diseases leads to damage of the endothelial cells of the blood vessels leading to hyper-inflammation.

📷 credit: fb 

This rapidly prevents arteries and veins from pumping oxygenated blood around the body which leads to the heart being starved of oxygen causing "Myocardial infarction" (what is commonly called heart attack).

Other conditions like atherosclerosis or hypertension can also cause heart attack - but whatever the cause, there are often no warning signs.

No signs usually except sudden problems in your sexual life (performance and satisfaction). Unless you can manage to be doing ECG to predict any heart disease occurance

This is because your penile erection requires a healthy blood flow.

Therefore when you have any issue with blood circulation, your penis will not have enough blood to engorge to the required level and behold, you start reducing performance in the bedroom.

That is why you need to seek help immediately your sexual performance starts dropping........you might just save your life.

Dear Queens, help your significant other by calling their attention if you notice a repeated dip in their sexual performance.

DOES SIZE REALLY MATTER?

 This has been a subject of debate over the years and as usual in things concerning sexuality, there as been more emphasis on the male than the female therefore I beg to look at the female perspective. 

 Within the reproductive organs of a female stands the replica of the penis called the clitoris.

☝️

You can now order your clitorial designed pillow

 Also read: HIV and immune boosters

 Made from the same tissue of the penis, almost the same length of the average penis (about 5.1 inches sometimes up to 8 inches) and even more sensitive than the penis (I guess what a man can do, a woman can do better). 

 If the clitoris is of the same make as the penis and there are debates on how the size of the penis matter in sexual satiety, does the size of the clitoris matter in a woman's sexual satisfaction as pertaining ability to achieve orgasm? The size of the clitoris does not really matter, but the size of the clitoral hood does matter.

  The clitoral hood affects attainment of orgasm because it's affects the amount of sensation that can get to your clitoris. This is why many women easily reach orgasm why masturbating than when with a partner. 

Also read: Watch Out this ladies in campus

 Clitoral hood is the fold of skin that surrounds and protect the glans clitoris (it is the female equivalent of the male foreskin).

 The clitoral hood protects the sensitive glans clitoris from irritation and excessive sensation (maybe from underwear). 

 It retracts when the clitoris is aroused (just like the male foreskin) although level of retraction differs. The thicker your clitoral hood, the more pressure needed to reach orgasm. 

 Sometimes, the clitoral hood might adhere and not retract at all thereby blocking the clitoris from being stimulated which results in sexual frustration. 

Also read: Sexy Girl In Campus

 Dear Queens, your sexual satisfaction is not only the responsibility of your partner, it's pertinent to know and understand yourself so you can guide your partners right for mutual satisfaction.

  #sexualhealth #reproductivehealth

MY MOST CHALLENGING SHIFT

Nurses play one of the most vital   roles in delivery of care within the healthcare industry ,caring for people when they are at most vulnerable and offering support are some of  the fundamental tenants of  of nursing.

Night shift are horrible, but I prefer it to Day duty because I love to have my days to myself.

I was on my Second in a row and I was tired- the sort of tired where your eyes feel hot and sunken and blinking takes three to four seconds, and you never knew a reflex could be so tortuous.

Also read : Disunity In Nursing... The Way To Go

On that day , I took over ten patients, six were critical, I mean four of them on non rebreathable mask and two in NIV Helmet Ventilation but oxygen saturation was less than 60% on oxygen 15L/minutes and 45L/min respectively at that moment. I knew am in for a sleepless night.

I was monitoring vital signs every quarter hourly and also answering & calling Covering Nursing Office about state of patients and need for more oxygen cylinders, Oxygen buzzler and Alarm were the only Music tune I could here after every few hours. 

Funnily enough there was also a bird that was producing a similar tone to that if Oxygen Alarm, so I had to go and check the percentage of oxygen available in the cylinders. 😂😂

My attention was drawn to one of the patient at around 1am, On getting to the him, he was already gasping, SPO2 has dropped to less down 50%....then 30%. We immediately informed the Physician , all emergency medication including CPR despite not recommended in Covid set up prove abortive. I lost my patients 😭😭

Also read: Beautiful Brainy Girl

As if that was not enough, my attention was drawn to another patient that was panting for air. I couldn't save this other patient too
I lost 2 of my patients on that dreadful night😭I was so confused and helpless.
I didn't start writing report until around 7am when I am supposed to be handing over the shift. I was tired and exhausted. And I ended up closing that shift at 1Oam.
____________________________
That day I learnt that, no matter all we do to save a patient life. What will be will surely be and that God has the final say, He alone can give and take life...

Then I look at one of the bereaved son and this quote by Arthur Golden  flash my mind-

"Grief is a most peculiar thing; we're so helpless in the face of it. It's like a window that will simply open of its own accord. The room grow cold but we can do nothing but shiver. But it open a little less each time, and a little less; and one day we wonder what has become if it"

Also read: Bullying and harassment in nursing
_______________________________
What really helped me that night was  staying positive through out the shift and this helped a lot in achieving greater job satisfaction even though I end up losing patients , I know I have try my best.

#TheCovidNurse #TheNurse

HIV + And Immune Boosters

Boosting the immune system is not that easy. None of the so-called ‘immune boosters’ that you see advertised in our country have been proven to help people with HIV…the only thing they boost, is the bank accounts of the people who sell them.

Your immune system is highly complex. It consists of thousands of different cells and enzymes that interact in many complicated ways. Along with the brain, the immune system is possibly the most complicated system that exists. This is one of the reasons why it is extremely difficult to find a way to boost it. The best natural and God-given way to boost your immune system is to wash your hand evertime you eat anything, avoid eating spoilt food, having unprotected sex, avoid breathing droplets that someone has coughed out, and I dare say; avoid kissing anyhow. Germs can enter your body according to the kind microbes they are and through means I stated above. Once a germ is inside your body, your immune system goes to to war against it. You need cells known as phagocytes to attack these germs and destroy them using a number of bodily chemical weapons….and no amount of ‘immune boosters’ can do this job. It is your natural immune system and it alone that can figure out these germs and protect you against them by producing antibodies to fight them. One kind of cell involved in making all this work is a T lymphocyte (T-cell). Some of these T cells have a receptor called a CD4. CD4 cells in your body are produced naturally by your immune system…not the ‘immune boosters’.

When your CD4 is low…all you need is an ARV regimen coupled with protected sex, washing of your hands before eating, avoiding eating spoilt food and kissing…in that way you immune system can be assisted in naturally producing more CD4s to fight germs in your body and thus stay healthy…not the ‘immune boosters’…There is no scientific evidence that ‘immune boosters’ boost the immune system.

Determined To Give More.

I lost my mum about 15 yrs ago.

I was in form 1, in certain precious Mixed Day School, Nyambare Mixed Secondary School

I blamed God and asked why He took her.

I promised to build her a house and buy her a beautiful car when I got a job 🚗😍

She left before I could do these.

God took Majuma and saved her more years of headaches, agony and suffering.

When I was done crying, I took time to think and ruminate about everything she has been to us and done for us.

Majuma & Her son (Otieno)

Also read : Grace

She lived a life of IMPACT.

She wanted His son to be doctor (off course Nyar Pedha didn't know the difference between a doctor and A Nurse) and tried a few times to make sure Baba Majuma (am talking of the son of Majuma 😂😂 I named my daughter after my Beautiful Mum)

God got her to work and serve the community as a casual, preparing for people Shambas (Orak) to make sure ni nyithinde ochiemo To odhi eskul.

Also read: Bullying In Nursing

She served them all faithfully and didn't entertain nonsense. (Majuma ne kwinya). Her relationship with all people earned her respect.

She impacted lives for Jesus and preached the gospel of peace 

Immediately after her death there was alot of dramas that happened (This a long story for my next write up)

I had given up with life, I knew I won't go to school. The prayers she used to do helped us. Nafoyo loved God and staunch Injili Takatifu Church Member, I guess she could  now be a layleader when she was still alive.

Upon her death I discovered how much she truly impacted her generation.

Now I asked myself, Oduor Otieno how will you fit into these shoes?

Majuma junior

She left great footprints in the sand of time...unforgettable impact was made.

As a registered nurse, I am now more determined than ever, to touch lives and use my knowledge and influence to:

Majuma junior & Her mum

✈️Nurse patients back to health, educating them at the bedside and taking this education to the social media too.

I know many people are sick but will rather stay at home and scroll over posts on social media than surrender to the healthcare system.

✈️Get people reconciled back to God or help them find Him.

✈️Mentor and coach more nurses and show them how to live a more amazing and extraordinary life.

✈️Coach and educate more pregnant women ...giving without holding back.

Dear Professional,

Dear Honourable Nurse,

Dear business person(s),

Dear Social media user

It's not about the length of your life or the number of years you stayed around on surface earth.

It's about the level of impact you have made and how many lives you have positively transformed.

Make a firm decision today to give all your energy into working to make someone's live better.

Today i decided to have 1 minute of silent from 5.00am remembering and giving respect to Josephine Majuma.

It's Normal, I Do It Ones Year.

And yes!

The Nurse is Okay and better

Importance Of Starting Early Antenatal Clinic in Relation To Prevention of Mother To Child Transmission

……… I had just finished with the first patient of the day: A man and his wife who had just started on ARVs. I gave them a 2 week course and asked them to come after the two weeks.. The next patient was a beautiful bubbly 8 year old girl brought in by her uncle. She was all smiles and extended her hand to greet me .

 I went on to fill her prescription as I was chatting with her on how she takes her medication. I was actually impressed because she not only knew the number of pills to take but also the exact time to take the medication. Apart from the normal ARVs and Septrin  she was to be put on Isoniazid preventive therapy(Used to prevent TB) .. I remember packing her a bag full of drugs to last her 1 month. All this while she looked at me.. Quite keenly then out of nowhere she asked ‘daktari sasa nikimaliza hizi dawa zote si nitakuwa nimepona na sitarudi kuzikunywa tena?’. I froze for a second… Multiple questions crisscrossed my mind.. ‘she does not know her disease? How do I tell this sweet baby that she will take these drugs for as long as she lives?How do I look into those hope filled beautiful eyes and tell her the truth? Will she even understand? My eyes filled up with tears and before they could drop, I mumbled to my colleague’ Aloli kuja umalizie hapa siskii vizuri ‘… I ran out and cried my heart out in the washroom.. When I regained my composure and went back, Nyaramba (Not her real name) had already left. Her innocent face has since not left my mind..

Today, I want to talk to you… Yes, you who may be HIV positive or negative. You who refuses to go to the HIV tests to know your status. The pregnant lady who refuses to go for antenatal and ends up getting a baby who is HIV positive. I want to talk to the spouses, girlfriends or lovers who refuse to get tested.. Who spread the virus knowingly or unknowingly. Do you sometimes sit and think of the consequences of your actions? Do you know how hard it is to explain to a child that they inherited HIV from their parents?

Get Started Today. Let’s all prevent Mother To Child  Infections. The early The Better. 

DISUNITY IN NURSING…… THE WAY OUT….

Since the time Nursing as a profession came into existence, has there been any problems arising from it…..?

If there was, what led to it…. And has Anyone drafted any solution so Far?

If the answer is No, then Why is Nursing in Kenya different from Nursing in other countries?

A beautiful profession from its origin, why should it crumble in front of the people needing its help….?

A profession that embraces all Races from different regions, different ethnicities…. Different religions…..

Also read: Nurses & Their Mental Health

A profession with simple goal and target!!!…. Why should it babies die of Misunderstanding???……

As an Hindu, christian,muslim, budhist, atheist… And others, should our priority be about our religion,wants,desires, targets or about the calling of Nursing which is to save life…..?

“We laugh and hug in public and plot against each other when we retire to our ethno-religious enclaves,”

“Once in a while, this mistrust finds grotesque expression among our people as we witness bloodbaths premeditated by ethno-religious contempt for each other.”

Should this be the reason for coming to Nursing? This beautiful profession?

development is low in almost all parts and Tributaries of Nursing and there appears to be nothing to be proud of in almost all spheres aside cases of personal achievements of resilient colleagues.

Basic essential needs were lacking, while Issues that other professions had long taken care of were still hard for Nursing especially in Kenya ……

Also read: The Nurse

Nursing still ranks poor in many development indices while the menace of corruption is threatening to choke the profession to death due to the excessive Mismanagement and uncare attitude towards our available resources by some handlers of our affairs,

Clearly, our challenges of professionhood are linked to the inadequacies of some of our leaders at all levels. Yet, another compelling argument explaining our developmental backwardness is failure by Members to take ownership of their profession….

Also read : Nurses Investment

Because The director of Nursing service said it, I don’t care, I must follow it…… While doing this, other members have another say. No one wants to listen, and no one wants to take advice from each Parties.

Right from student days, Nurses have internal issues amongst themselves and when solutions are brought to the table, you will all notice that, it is not always to make peace but to claim seniority or claim the right of Being in the profession before the accused.

You met me in this profession and as such I am better off than you,

You can’t teach me what I know……

When did you finish from Nursing School.

Even if what the colleagues is saying is right……..

Looking through all this you will gladly agree with me that *One of the major problems bringing disunity amongst Nurses is Bad Leadership*

While other countries are afflicted by natural disasters, Kenya’s own disaster is leadership failure, noting that the metaphor might be exaggerated, yet it is certainly not too far from the truth.

We have burned out decades of self-rule moving in circles from one problem to the other, often caused by poor leadership challenges,

We have sold ourselves so cheaply to other professions just because of misunderstanding and self interest

We have sold our prides to professions that should accord us with respect, humility and prestige….

All because of Disunity, we have neglected our main Purpose for being a Nurse!

We became slaves to those who suppose to worship Us behind our backs

It is Saddening,Disheartning and Exasperating …. That Nursing is weeping and there is absolutely no one with an handkerchief to wipe its tears ….

It is more painful that those who have the will and power to take it Far, refuse to listen to Listen to Its plea of repair

This leadership inadequacy has contributed in compounding a number of our problems, from widening the parochial divisions among the Members to active participation in plundering our patrimony. 

Leadership was key to whatever social change and civilization desired, while advocating a top-bottom approach to solving different problems.

It is only when a soil is good that it roots becomes firm, Its leaves become healthy through photosynthesis and Its fruits Beautiful and consumable

It is the leader that charts and navigates the way for the flock to follow and it is the leader’s action, inaction and body language that dictate the tunes for the dance steps of any profession…..

if a leader eschews corruption, it will be difficult for those below him to indulge in such practice; and if the leader is deep neck in it, it becomes a free-for-all.”

Therefore a solution from this end is that all leaders chosen must be sensible and full of wisdom to act rightly and judiciously

The leaders of this profession at every level and sectors renaissance must therefore be strong, tough, and inclusive in his or her own capacity

Another answer to the problem is to invest heavily in social justice; political justice; and in the promotion of a regime of freedom as broadly as possible.

Nurses must be free to make opinions and suggestions.

Both young and old Must be welcomed to the table to tender what they have

Also our leaders should celebrate shared experiences, connections and togetherness, which far outweigh the differences among the people, while resisting the influences of hate mongers who might be politicians or religious leaders.

This approach should include investment in law and order to ensure that there is zero tolerance for violence and hate speech.

Nursing have its own ethics.

But how many times have our leaders visited it and act on it?

On the other side, fairness and justice should not be only notional abstracts, it should be seen to be on display through every action of the state and our individual leaders…

The strengthening of schools and colleges of nursing with the university scheme as a way to building more bridges across nationalities and sustaining existing ones.

The demography in our universities and this colleges should also as much as possible reflect our ethno-cultural diversities,

 I am sad to note how our school, colleges and universities are becoming increasingly provincial in terms of students and teachers’ population, thereby ending up producing narrow-minded graduates.

It is therefore right to say that what the profession needs is honest and modern leadership that would be a rallying point for its members, one that can tame the consuming tides of corruption and evolve creative solutions to our myriad of problems.

It is my belief that firm and sincere leadership is the precursor for industrious and patriotic followership

Only by them can unity be pronounced and practiced…

This will enhance national development and bring an end to current mutual mistrust that is shaking the foundation of our profession

And to Note that

Before Unity would be achieved fully

These leaders have roles and steps to take

1. The orientation must change that Nurses are not slaves.

When has the leaders at council level visited schools, colleges, and universities to have a one on one talk with the Nursing students?

2. Leaders in Nursing should not be after making money for the organization but see to a high standard of duty discharge of its members and how they would progress

3. The Spirit of Sentiments should be flushed out of the profession

Or else Disunity will continue to thrive like a virus

4. There must be a salary structure that all health settings will hook up unto for all Nurses. Everyone should be entitled to a good and attractive salary

5. It’s should be mandated that all Nurses continue to upgrade, while full support is giving to them at all levels…..

Managing Nursing diversity in the context of justice and fairness is a pathway to progress. If we address these existential and leadership challenges, we are more than half-way into addressing all our problems……

Here I want to put a stop to the topic.

Hence, I hope a message is passed acrossed to us and I also hope that we are ready to bring a change to Nursing my calling and your Calling

Thank you for your time and be blessed

HEALTH BENEFITS OF PUMPKIN LEAVES

 [Telfaira occidentalis] - Susa, Malenge

Nutritional Content Of Pumpkin Leaves:

Potassium, Calcium, Folic acid, Iron, Vitamin E, Vitamin B6, Magnesium, Phosphorus, Thiamine, Niacin, Dietary fibres, Vitamin A, Vitamin C, Riboflavin, Copper, Manganese and Proteins

Also read : What's Pre-Labour

1. Premenstrual Syndrome 

Many women suffer from premenstrual syndrome (PMS), which is manifest in mood swings, depression and irritability. Manganese, found in pumpkin leaf can be useful to reduce these monthly situations. Women who suffer from severe PMS symptoms are advised to consume manganese supplements as well as manganese rich foods. Pumpkin leaf is a good source for manganese.

2. Cures any testicular damage and also increase the spermatogenesis. 

This helps in increasing fertility and is a good news for people suffering from infertility!

3. Improves Eye Health

Vitamin A present in pumpkin leaves helps in preventing degeneration of some of the parts of the eye, which otherwise would degrade with age. 

3. Lowers Cholesterol

As there is a huge amount of fibre in these leaves, it reduces the absorption of bile acid and cholesterol, from the small intestines, thereby resulting in low levels of cholesterol and healthy heart!

4. Anti-Ageing

Makes you looking younger for longer!: Pumpkin leaf’s copper content is a powerful antioxidant used by the body to defend cell membranes from free radicals. Free radicals attack many organ systems causing premature aging of the skin (wrinkles, age spots), susceptibility to numerous types of cancer, macular degeneration, and kidney malfunctions. Having sufficient copper in your daily diet can keep you younger for longer.

5. Diabetes

Pumpkin leaves are known to have the hypoglycaemic effect which helps in reducing sugar levels in the blood, thus keeping diabetes under control!

6. Skin Benefits

Being a rich source of Vitamin C, which helps in healing wounds and forming scar tissues. It also helps in keeping bones and skin healthy.

7. Fights Against Cancer

Studies show that there is a direct relation between the intake of fibre and risk of cancer. This is because the foods containing the high amount of fibre are also rich in vitamins and minerals, all of which are required for preventing cancer. So, it is recommended that have these leaves through soups daily.

8. Keeps Your Bones Strong

It is very rich in calcium and phosphorus, therefore, it is recommended for children and mothers specially. It helps to keep the bones strong and healthy. Also, it helps in keeping away the deficiency of calcium, helping in the proper growth of teeth and bones.

9. Boosts Immune System

Also read: She Beautiful Journalist

As it helps in increasing haemoglobin in blood and keeping your bones strong, they increase your immunity . This decreases the risk of getting affected by diseases, thereby keeping you healthy.

10. Protein Supplement

Keeping in mind the amount of protein it contains, it can be used for fulfilling your daily requirements of protein. This will keep you strong and healthy.

11. Helps In Digestion

As it has high fibre content, it helps you in improving your digestion and easy passage of faeces. As there is a large amount of fibre, the stools are large and soft, making the muscles contract and pass the faeces without any additional pressure. As your stomach is clean, your body will be detoxified as well.

So include pumpkin leaf in your regular diet to prevent constipation.

12. Prevents Infections

As it possesses anti-bacterial properties, consumption of these leaves on a regular basis will keep you away from bacterial infections that are very irritating to have.

13. Helps In Lactating

As it is a rich source of calcium, it is a popular choice for lactating mothers. It maintains the calcium levels to normal, helping in lactating properly.

14. Treats Anemia

These leaves are a rich source of iron, which helps in increasing oxygen content in blood and lungs, thereby increasing the haemoglobin in the blood. It is also rich in folate, which is very essential for the production of red blood cells. As red blood cells and haemoglobin increases, the disorder named anaemia vanishes.

15. Convulsion

It is very effective in preventing convulsions. 

How Are Pumpkin Leaves To Be Eaten?

Some people use it in soups, while some eat it raw as salads. Here are some simple recipes, so that you can make it tastier!

Recipe 1

Ingredients

1. Fresh pumpkin leaves

2. Olive oil

3. Salt

4. Garlic

Procedure

1. In a hot pan, put few drops of olive oil. Now, put pumpkin leaves and some salt in the pan and fry it for 5 minutes.

2. Keep moving the vegetables while frying. At the time of putting the cooked leaves into the dish, add some garlic to it for taste.

3. Serve hot to enjoy its taste!

Recipe 2

Ingredients

1. Fresh pumpkin leaves

2. Water-120 ml

3. Peanut powder- 1 cup

4. Chopped tomato-2 cups

5. Chopped onion-1 cup

6. Palm oil

Procedure

1. Clean the leaves and chop them. Put water, fresh leaves, tomato and onion in a saucepan and cover the pan till the leaves are wilted.

2. When it gets reduced to half, add peanut powder and 2 tablespoons of palm oil to the pan. Keep it on the simmer for 10 minutes.

#NurseOtieno #TheNurse

What's A Pre-Labour

If you are nearing the end of pregnancy. You may be wondering what signs indicate labor is nearing. Here are a few....⁠

⁠

So what is pre-labor?⁠

Also read : Braxton Hicks Contractions

⁠

Pre-labor or prodromal labor can start weeks before you actually go into labor. ⁠

⁠

Nurses get this question daily: "Hey I lost my mucous plus, does this mean I will go into labor soon?" Unfortunately it can come out weeks before labor sets in.⁠

⁠

Just remember that all of these signs may or may not make themselves known to you. It doesn't mean you won't go into labor soon. They may be happening without you knowing it. ⁠

⁠

Pre-labor signs:⁠

⁠

Fatigue: You may find yourself feeling like you did in the first trimester. This is your body gearing up for the big day. ⁠

⁠

Nesting: You might just get a sudden burst of energy and desire to get all the things done and organized. This is awesome but be careful not to over do it. ⁠

⁠

Mucousplug:  The mucous plus is a seal closing the cervix and protecting the womb.It looks like snot with strings red or brown blood. ⁠

⁠

Cervix: Your cervix may begin to dilate,⁠

⁠

Discharge: You may or may not notice a difference in your vaginal discharge, both color and consistency.⁠

⁠

Clumsiness: You may feel more clumsy than usual. This can be caused by the hormone relaxin that the body produces to relax your joints for labor.⁠

⁠

BackPain: Many women notice an increase in lower back pain as labor approaches. ⁠

⁠

Lightening: You will notice a big difference in your ability to breathe when the "baby drops". The baby will settle lower into the pelvis in preparation for labor. But with this comes intense pressure in the vagina. Sorry....⁠

⁠

BraxtonHicks: Sometimes, these increase and occur more often during pre labor. Consider these a bonus practice for the real deal.⁠

⁠

Poop: Yep, you might notice loose stools which is also a bonus as your body might just clear itself out before game day. (If not, don't worry!)⁠

⁠

What were some signs you are noticing or did notice before labor?

Also read: Grace

Put your comment on the comments section

DRAWINGS ON THE WALL

This is Siaya County Referral Hospital, a long laboratory wall from Outpatient to the Wards/Administration offices, this wall is also just next to Records office. If you've been to Siaya recently then you can know it.

I was much interested on the drawings.

Also read Nurse Are Rude

I couldn't resist taking a shot with my mobile 😂😂

Murals are very nice and important paintings that should be incorporated in various work environments.

Apart from use as decorations and aesthetic purposes, they speak to us.

Mural painting is one of the way of arts on the mind. They do quite a number of things we may not know.

They can:

Also read Sexually Transmitted Grades in Universities

1. Pass informations

2. Relief worries and anxieties

3. Relief pain

4. Integrate us with the environment.

These little things go a long way in treatments in healthcare settings.

The mind, perception, calmness, e.t.c are some of the things art also do in our lives.

Arts in Health practitioners know this well and have always utilized it for holistic care.

That's why I will encourage you today to always incorporate art, or anything at all apart from the routine that will make you refreshed in your schedule. E.g, music, expressive arts, dancing, painting, poetry, photography, e.t.c...

Places where we can have it:

✍️ Waiting bays

✍️ Maternity

✍️ Wards (Paediatric)

✍️ MCH

✍️ Washrooms

✍️ Halls 

✍️ CCC

✍️ E.t.c

ALLOW ME TO GO OFF TOPIC

Also read I'm Being Stalked

At times alot of work can affect your health 😪

Why am I saying this? 

I want you to priotize yourself today and stop acting like a super hero. 

Give your body the rest it deserves, take yourself out, have some me time, try new recipes, go hang out with friends, hike if you want to.

In summary, if you're off duty, take that time off you are not a Robot.

Plus work no dey ever finish🌝

Making money is important but, staying alive is importanter and, spending it in good health is importantest. 

 #health #healthcare #art #nursing

🤰BRAXTON HICKS CONTRACTIONS🤰

#BraxtonHicks #FalseLabor

Braxton Hicks contractions are sometimes called ‘false’ or ‘practice’ contractions.

🔹What are Braxton Hicks contractions?

Braxton Hicks contractions are a tightening in your abdomen that comes and goes. They are contractions of your uterus (womb) in preparation for giving birth. They tone the muscles in your uterus and may also help prepare the cervix for birth.

🔹What do they feel like?

Braxton Hicks contractions feel like muscles tightening across your belly, and if you put your hands on your belly when the contractions happen, you can probably feel your uterus becoming hard.

They occur from early in your pregnancy but you may not feel them until the second trimester. If this is your first pregnancy, you might start to feel them from about 16 weeks. In later pregnancies, you may feel Braxton Hicks contractions more often, or earlier. Some women won’t feel them at all.

Braxton Hicks contractions come and go irregularly, and usually last for about 30 seconds. While they can be uncomfortable, they usually aren’t painful.

Braxton Hicks contractions don’t cause labour and aren’t a sign that labour is beginning.

🔵How are they different from labour pain?

Braxton Hicks contractions:

✔️usually last for about 30 seconds

✔️can be uncomfortable, but usually aren’t painful

✔️come at irregular times

✔️usually occur no more than once or twice an hour (until late in the pregnancy), a few times a day

usually stop if you change position or activity.

Unlike labour pain, Braxton Hicks contractions don’t:

✖️get closer together

✖️last longer as time goes by

✖️get stronger or come more often when you walk

✖️get stronger over time

You can distinguish Braxton Hicks from ‘real labour’ as they disappear with a change of position or activity such as a warm bath or shower.

If the pain or discomfort of your contractions eases off, they’re probably Braxton Hicks contractions.

In late pregnancy, you may experience Braxton Hicks contractions more often — perhaps as much as every 10 to 20 minutes. This is a sign that you are preparing for labour — known as prelabour.

If you’re not sure whether what you’re experiencing is Braxton Hicks contractions or actual labour, contact your doctor or midwife. They will be able to tell by doing a vaginal examination — if there are no signs that your cervix is changing, it is not labour.

🟢Should I call my doctor or midwife?

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If you feel pain, pressure or discomfort in your pelvis, abdomen or lower back, you may be having the first signs of labour. You should contact your doctor or midwife immediately, if you’re less than 37 weeks pregnant, as this can be a sign of premature labour.

If you are full-term, you may choose to wait until a bit later in your labour, depending on what you have arranged with your doctor or midwife. If your waters break, or your contractions are strong and 5 minutes apart, it’s time to go to the hospital.

At any stage of pregnancy, you should contact your doctor or midwife immediately if you:

❗️have persistent pain in your abdomen

❗️have vaginal bleeding

❗️notice your baby’s movements have slowed or stopped

❗️feel very unwell

If you are in doubt, don’t hesitate to call your doctor or midwife for advice.

🟢How can I ease the discomfort?

Braxton Hicks contractions are normal and don’t need treatment. But if you feel uncomfortable, you can try:

☑️lying down

☑️taking a walk

☑️relaxing in a warm bath

☑️having a massage

It may help to practise your breathing exercises during your Braxton Hicks contractions.

#NurseOtieno #TheNurse

Grace

I have no doubt on what Grace  can do to your life

But am worried on how you think.

Your mind has to be continually renewed with the conciousness that you are a carrier of grace.

Grace is the basis of that partnership between the imperfect man and a perfect God. Your perfection is not needed here.

Grace is Devine acceptance-- When God accept you, accept yourself. If a king can accept a slave(Esther) without asking for her background how about you.

Grace is Devine assistance---- Making you look smart, strong and competent.

Grace is Devine providence--- Putting in place what you need even before you have need for them. So switch from weeping to seeking, because provisions are made available for you already.

Let me help you with a new response to negativity.

Your family is poor, and you have no uncle/aunty to sponsor this your business how do you intend to succeed ---------  Grace.

You are not beautiful, who told you he will marry you----- Grace.

You have failed several times, infact failure is all around you, I don't think you will succeed this
time ------Grace

You are not a perfect match for this job, am very sure you won't be employed -------- Grace

You are not smart in this field, you are a coward, you can't make it --------- Grace.

Whatever it is you have heard------- Grace

When you carry grace every body must like you, even those that don't like you didn't realize they like you and they will come back later to apologize to you. They will  tell you that they were blind earlier but now they can see how much they love you.

Well friends, I present to you Grace.

God bless the rest of your Day.

Follow Nurse Otieno

I’M BEING STALKED!

Be on the look out!

‘Hey, mambo?’ She said. Hey, how are you? I didn’t see her coming. She must have sneaked up on me. I had been busy typing a reply to a text message and all my attention had been drawn to it. I was just leaving work, at around half past seven. When I looked up, she had her hands outstretched for a handshake. 

Also read : Fresh Campus girls

‘Oh, poa.’ I responded reaching for her hand. Oh, fine. Her palm was soft but her fingers tiny inside mine, felt like I was squeezing life out of them and I let go. 

‘Umetoka mapema sana leo,’ she pressed on,’ungetoka saa tatu.’ You closed work early today, you should have left at 9pm. She seemed determined to extend the conversation to my dislike. 

‘Niko sawa.’ I scowled, trying to ignore her comment. I’m alright . She forced a plain laugh and then started walking away. 

‘Have a goodnight…Otieno!’ She said in a raised voice. With the momental pause before saying my name, I’m sure she was trying to recall it. She wanted to let me know that she knew my name. I wasn’t impressed by that, she was pushing too hard.

 

That was the first conversation we ever had. After that she developed a wont – passing in front of my shop several times a day. Whenever our eyes meet, she waves. When they don’t and there is no buyer, she comes to shake hands. Now, it’s not that I have never seen her, in fact her face for over a year now but she never did take notice of me or looked at me like she does now, we’ve always been strangers and just conducting our affairs like strangers do. She’s charcoal black – that’s the first thing I ever noticed, darker than I thought I was. And she’s one of the few ladies I would say, are proud to be really African, if you know what I mean. She is slightly above five feet tall, keeps her hair cut to almost an inch above her scalp, with the sides of the head trimmed shorter, mohwak kind of. Her face is… somehow… rectangular. Big white eyes, a small nose, and brief mouth – with thin lips curled upwards at the ends in a sneer. She has a long neck, which isn’t so bad. Her body is lean, and then she walks her bossom is pushed up as if she were carrying a bucket of water on her head from the river, on a steep slope, and she’s supporting it with both her hands. Bottom line is, she’s not my kind of girl, she doesn’t tickle my fancy

Also read : Campus Sponsers & Slay Queens

The other day, I confided in a friend of mine about her wierd and sudden friendliness. His answer was; she has a crush on you. I laughed out loud, really loud. That evening she came to my shop to buy some antihistimine tabs, she did the outstretching-hand thing again, and I took her hand reluctantly. I felt some fear grip my heart making it feel like a clenched fist in my chest. I let my hand slip away and then got her the drug. She was smiling and I was tempted to ask what she was smiling at but I couldn’t. She was about to begin a conversation when my phone began ringin, to my relief. She walked away. When I was done with the phone call, I noticed a piece of paper on the counter top, it hadn’t been there earlier, before she came. Out of curiosity, I picked it up and unfolded it -it was folded once,symmetrically. It was some kind of a note, surprisingly, with my name on it. 

Hello Otieno, 

Please I am sorry but it’s really very bad to keep quiet with something that pains. You know what? I am almost even having a wound in my heart because of you. Yesterday was not my first time to see. Since the day I came, I saw you but there was no way of talking to you. 

I am Sharon. Originally I’m a Ugandan. 

Please help me, call 0713530 ***, or I just come back for my reply. 

Note: I don’t have someone to love me or a fiance nor a child.

 

I read the note twice, the more I read it the more comical it sounded. It was so full of errors but I got the message. Then something made me freeze…originally I’m Ugandan.

 Now, there’s this belief that the land of matoke has the most potent love potions. What if she had applied some of it on the note? Then I will be under her spell, following her everywhere like her shadow. If she says I bark like a dog, I would do it without second thoughts. If she says walk on fours like the dog, then I would be on it, I’ll be her puppet. That’s horrible. Just that mere thought got me shaking. I had to do something, real fast. The Bible. Yes, I had to undo it using the Holy Book. Neutralize the power of that potion, should there be any. I reached for the Bible that had been gathering dust inside a box of books. I held it on my palms, not knowing what I should do. The first impulse was to place the note inside the Bible, that’s where it had to be.

I had to keep her away from me. I wasn’t going to let her come back for her reply. What if she decided to chew some of those potions! I decided to give her some feedback through the number she had provided in the note.

 In the text message, I told her that I am happily married, with a kid. 

Her reply was: pliz not for sex. Who even talked of sex? I decided I’m not having a conversation on that. She calls when I don’t reply, then Truecaller app installed on my phone gives me one of the most genius suggestion, Block Spam Calls. I go for it, sit back and try to relax.

Do you want me to continue with the story ?

Do you think this a true story or Fictional ?

Self Driven Health Records & Information Officer

If you are to check some people's profile consistently here,you might just keep falling in love every minute😁😅 

The love might give you sleepless night just as it did to me because I wanted to know more about this particular person by checking through her profile😍😅

Now let me tell you about her, I am sure you will fall in love with what she does too😁😁

So I came in contact with this young lady, a multipotentialite who captured my heart 😊

Sharon Gwada - Health Records and Information Officer

She is a hard-working, methodical and driven individual with good experience in the Data Entry field and with the ability to input and manage data accurately, with great speed and in high volumes. She is able to demonstrate effective communication and organisational skills; work on her own initiative, both independently and within a team. Se has excellent ability to organise and prioritise her workload to achieve set goals and deadlines in the most efficient manner.

 Her Skills 

✍️ Excellent data entry skills (for both accuracy and speed)

✍️ Professional typing skills 

✍️ Attention to detail without compromising the tasks’ speed and performance

✍️ Excellent IT skills and hands-on knowledge of spreadsheets and databases

✍️ Perseverant and patient when dealing with repetitive tasks

Her Key Correspondences.

✍️ Processing patient admission and discharge documents.

✍️ Review records for completeness, accuracy, and compliance with regulations.

✍️ Collection and filing, including electronically, of reports of other departments on a daily, weekly, and monthly basis.

✍️ Extract and analyse hospital and maternity data and statistics.

✍️ Release information to persons and agencies according to regulations

✍️ Preparation of quarterly/monthly meeting minutes.

✍️ Extracting from the Electronic Health Record hospital monthly reports.

✍️ Maintaining hospital surveillance reports.

✍️ Maintain confidentiality and privacy of all medical records

✍️ To provide exemplary customer service to internal and external customers

✍️ To handle comprehensively all enquiries and direct accordingly from within and externally in a timely way

✍️ Give support services to all staff to ensure good customer service to our customers

✍️ Ensure efficient and smooth operations of the front office

✍️ Give feedback to the administrator on how to improve customer care

Should I continue listing her work ?

I know you must be wondering,all these in one person? Oh yes😁

But I am sure you must be more eager to know who I am talking about

Alright,let me break the suspense 😊

I present to you the Beautiful Sharon Gwada,a phenomenal lady who is very good at what she does.

I won't talk much about her, I guess that's enough

✍️ _*NurseIf you are to _check some people's profile consistently_ here,you _might just keep falling in love every minute_😁😅 

The love might give you sleepless night just as it did to me because I wanted to know more about this particular person by checking through her profile😍😅

Now let me tell you about her, I am sure you will fall in love too😁😁

So I came in contact with this young lady, a *multipotentialite* who captured my heart 😊

*Her Key Correspondences.*

✍️ Processing patient admission and discharge documents.

✍️ Review records for completeness, accuracy, and compliance with regulations.

✍️ Collection and filing, including electronically, of reports of other departments on a daily, weekly, and monthly basis.

✍️ Extract and analyse hospital and maternity data and statistics.

✍️ Release information to persons and agencies according to regulations

✍️ Preparation of quarterly/monthly meeting minutes.

✍️ Extracting from the Electronic Health Record hospital monthly reports.

✍️ Maintaining hospital surveillance reports.

✍️ Maintain confidentiality and privacy of all medical records

✍️ To provide exemplary customer service to internal and external customers

✍️ To handle comprehensively all enquiries and direct accordingly from within and externally in a timely way

✍️ Give support services to all staff to ensure good customer service to our customers

✍️ Ensure efficient and smooth operations of the front office

✍️ Give feedback to the administrator on how to improve customer care

Should I continue listing her work ?

I know you must be wondering,all these in one person? Oh yes😁

But I am sure you must be more eager to know who I am talking about

Alright,let me break the suspense 😊

I present to you the Beautiful Sharon Gwada,a phenomenal lady who is very good at what she does.

You were to know more about her just click Health Records and Information Officer then ask about her details. Strictly professional.