Nurses Resignation Procedure In Kuwait

Do you want to be resign? Yeah, I just want to share my experience to do resign as a Nurses work in Kuwait Ministry of Health (MOH).This month I,m so tired because of my resignation procedure, but Alhamdullilah, even the long event procedure was passed. I,m a nurse who worked in Clinic of Deportation Center ( Ebaad Jail) under Ministry of Interior Kuwait. I have been worked 3 years already and have been resigned on early of November 2007.

This is my first experience as a nurse as long as 10 years. Work as a nurse in the jail so interesting and getting different experience than other Health Care provider such as the normal hospital, clinics and others even the work procedure is almost similar. I can not forget the experience so horrible and interesting.

The first time really i,m so scare when my matron posted me to be work in Central Prison Hospital. How I can imagine, working in the jail, ohh, I thought that Jail so life condition like in Wild World. The people are so cruel, impolite, no hospitality, not friendly, liar and so on. Yeah, Jail Living is almost same with community out site, some prisoner is having bad attitude, impolite, cruel and other even like that many prisoner is so respect to Nurses.

After several month later, working in the jail is enjoy, we can meet so many different people character made me recognize distinguish who is really prisoner with pure doing crime and people who as a victim only of unfair condition, even like that we are nurse who care to all prisoner without making different care. Yeah, this is brief of my experience as long as work in the Jail.

I continue about Nurses Resignation Procedure, just follow to steps of this procedure below:

1. Please write request resignation letter to your Matron at least 3 months previously.
2. Your matron maybe recommended to you to taking annual leave before resign or not, but as my experience I suppose you to taking leave before going to process your resign, because it will be help you to do resign early.
3. After your request was approved by Matron, then your request resignation letter sent already to ministry please follow up to Ministry of Health (MOH) after month in Resignation section and ask about your file, but before you are going to ministry please taking reference number file of your request resignation letter from your hospitals or clinics, ask to secretary of your nursing department. This reference number is very important to avoid difficulty problem in ministry, because if you bring the reference number the resignation officer will help you what to do to checking your file is ready in ministry in the right please.
4. After your file was collected in resignation section, then the resignation section officer encourage you to starting clearance letter to Ministry of Communication (in shuwaikh near the Gulf Bank, enter inside and ask to officer, but my experience they suppose me to go to building number 8 in the same area), ministry of electricity and water (South syura opposite with Civil ID building, first floor), Your Bank, Ministry of Interior in Farwaniyah (in crime section building, 8th floor) opposite Seer Center Farwaniyah, Housing ( Each Fawas of your building residency), then last is Hospital Clearance.

Above are 4 steps you have be completed, but what you have to do to complete your resignation process? I will guide you so you will getting clear information before you are going to process your resign, please follow me:

1. Please do clearance to Ministry of communication, you just need showing your Civil ID, the they will process around 1 minute finish.
2. Please go to Ministry of Electricity and Water, same procedure just need your civil ID, they will process few minute finish.
3. Go to your Bank, they need also Civil ID and your Bank Account Number, if you have credit card , better you have to close or pay off your credit card 2 months before you are submit your resignation letter, because credit card it will take time till 2 months for clearance otherwise you will get problem later.
4. Go to Ministry of Interior, just need Civil ID and coror letter (your resignation letter, this letter given by resignation section).
5. Housing, you have to come to your Fawas area which building you are stay and you must accompanied by your flat residence as a witnesses and bring also your key room to endorsed to your Fawas.
6. Hospital, you have request to your Head Nurse notice that you have not any inventory in your Hospital Workplace and forwarded to your Matron.

Sorry, I dont have time enough, because I have to prepare my travel property, I will continue when I reach in Idonesia, ok, see you then.

Why Nurses is pay less than other Professional, Even Health Partnership?

Nurse is profession who save to patient of live. In daily activity nurses are 24 hours companions patient in care well-being. Nurses is front line profession who have high risk of accident or even getting prefer transferable disease from patient through by many body material such as blood specimens, fluid specimens, injection accident, Musculosceletal disorder, HNP (back pain), stress and so on.

Nurses who work in emergency room and Intensive Care Unit Ward perform heavy emotional stress job and risk of injury even they did not think care to their safety because most of their activities to safe of patient live first. It is a describing Nurses in the daily activities. If we compare with other health partnership like doctor, pharmacist, radiologist, Laboratory technician Nurses are more stressful than others.

The problem is even nurses have so many activities with high risk but they did not get good rewarding. Nurses in many country always getting low pay scale salary than other professional. Nurses wages In many Asian country such as Indonesia, Thailand, Philippines, China are getting less salary even they can not cover the monthly expenditure and sometimes to cover they necessary they taking loan. This is a dilemma because Nurses is honor profession but they employer or even government did not care with Nurses welfare.

To increase nurses earning some nurses taking master even doctor, but the educational expenses is not questionable reward. Nurses currently is not only doctor second hand, with nurses skill and master education are same with doctor, even some nurses more skillful in several area like emergency room, Intensive Care Unit, all linked training that they taking so nurses can do to save of patient live without waiting doctor order.

EPISTAXIS

Have you ever been experienced with nose bleeding? We know most of people in the life cycle ever had experienced nose bleeding or in medical term is EPISTAXIS. Epistaxis is bleeding condition in your nose who make your nose running fresh blood if bleeding overload sometimes blood to become clot and stuff of your nose. This situation is uncomfortable and very interrupt to your daily activities.

Nose bleeding can occur spontaneously when the nasal membranes dry out, crust, and crack, as is common in dry climates, or during the winter months when the air is dry and warm from household heaters. Some people who suffering nose bleeding caused by taking any medications which prevent blood clotting such as for patient who have heart problem or hypertension is more vulnerable. Common Medicine cause bleeding in a perifer are Caumadin, Warfarin, Aspirin or any anti-inflamatory medications.

Other medicines cause, nose bleeding caused by many problems as a following are:

1. Chronic Sinusitis
   
2. Epistaxis digitorum (nose picking)
   
3. Foreign Bodies
   
4. Intranasal Neoplasm or polyps
   
5. Irritants (cigarette smoke)
   
6. Rhinitis
   
7. Septal Deviation
   
8. Septal perforation
   
9. Trauma
   
10. Vascular Malformation or telangiectasia
    
11. Hemophilia
    
12. Hypertension
    
13. Lekukemia
    
14. Liver Disease (e.g, cirhrosis)
    
15. Medication (e.g, aspirin, anticoagulants)
    
16. Thrombocytopenia
    
17. Platelet dysfunction

What Will You Do If You Got Nose Bleeding?
If you got nose bleeding you have to conduct as a following:

1. Have the person with the nosebleed sit down and lean forward so the blood does not flow down the respiratory passage.
   
2. Press a tissue or cold compress against the nostrils below the bone to encourage clotting.
   
3. Have the person with the nosebleed keep his or her nostrils pinched together for 15 minutes without letting go.
   
4. Replace the tissue or compress with a new one if it becomes soaked with blood.
   
5. Leave a bowl next to the person so that he or she can spit out any blood that drips down their throat.
   
6. Remove the tissue or compress slowly. If bleeding persists, continue pinching the nose for another 5 minutes.
   
7. After bleeding stops, wash away any blood with warm water. Apply a small amount of petroleum jelly inside the nostrils to moisturize the area.
   
8. Make sure the person does not sniff or blow the nose for several hours afterward, as this could cause another nosebleed.
   
9. If the nosebleed originates in the back of the nose and does not respond to treatment, seek medical attention. This type of nosebleed, called a "posterior" nosebleed, is common in older people and potentially very serious.
   
10. Visit a doctor or an emergency room immediately if bleeding does not stop or if the patient is weak, pale or experiencing an elevated heart rate. Keep the patient leaning forward with the nose pinched on the way to the doctor's office or hospital.

Management Epistaxis

Pancreatitis

Most of people in the life time ever fell pain in stomach area even sometimes severe pain and need doctor to giving treatment for it. Some doctor may be wil give you treatment or medication related with your stomach problem. Stomach pain is not merely problem with stomach itself. Many dissease can cause pain in stomach area, some of them are Heart disease (miocardiac infarct), Appendicittis chronic, pancreatitis and some abdominal problem.

I have experience with my son, he has a long time before complaint pain in stomach area then doctor examined and suppose to do ultrasound, after coming result then doctor diagnosed that my son was getting gastritis. After taking gastric medication my son will be felling well, but after 3 month later my son complained again that he fell painfull in stomach area again following fever, nausea. His temperatue was increase till 38,8 o Celcius. I was getting worry about that.
Then my wife bring my son to see surgery doctor for examine anything worst with my son, because we are worry if my son develop appendicitis acute. Surgery doctor suppose to my wife to do ultrasound and the result is my son was diagnosted pancreatitis and doctor was gave some medication to my son till my son felling well.

yeah, this is the true condition is pain in stomach is not only error with the stomach itself, so you have to take care and more responsive about that. Pancreatitis is pancreas is infected so make pancreas getting infection. Symptom and sign that your pancreas is infected are a following below:

• swollen and tender abdomen
  
• nausea
  
• vomiting
  
• fever more than 38 o Celcius
  
• rapid pulse

Pancreatitis in Children

Actually Chronic pancreatitis is rare in children. Trauma to the pancreas and hereditary pancreatitis are two known causes of childhood pancreatitis. Children with cystic fibrosis, a progressive, disabling, and incurable lung disease, may also have pancreatitis. But more often the cause is not known.

Diagnosis

To make diagnosis may be difficult, but new techniques can help. Pancreatic function tests help a doctor decide whether the pancreas is still making enough digestive enzymes. Using ultrasonic imaging, endoscopic retrograde cholangiopancreatography (ERCP), and CAT scans, a doctor can see problems indicating chronic pancreatitis. Such problems include calcification of the pancreas, in which tissue hardens from deposits of insoluble calcium salts. In more advanced stages of the disease, when diabetes and malabsorption occur, a doctor can use a number of blood, urine, and stool tests to help diagnose chronic pancreatitis and to monitor its progression.

Treatment

Relieving pain is the first step in treating chronic pancreatitis and may be doctor will give pancreatic enzyme to help pancreas function. The next step is to plan a diet that is high in carbohydrates and low in fat.

Source:
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK.NIH)

What Is Parkinson Disease

Every body desire to keep their life time to be healthy forever without suffering any disability nor disease. To keep their body health a number of people doing healthy activities such as sport, playing foot ball, volley ball, physical exercise, going to gym, swim and others. In other hand they do to their life style forward healthy like taking healthy food, drink, and routine visit to doctor or any other health provider for check up or just health consulting.

Even though we 100% had protected to our self but sometimes we still got illness or disability from unpredictable caused. We can not prevent many disease nor injury even we have been maximized effort. Some degenerative disease still drop to our body even we do best of healthy life related to aging ages.

Many degenerative diseases like Diabetes Mellitus, Osteoporosis, Osteoarthritis , Alzheimer's , Parkinson. Most of degenerative disease cause of lack of function of body part such as nerve, bone, inner body part. One of degenerative disease is Parkinson. Parkinson's disease is degenerative syndroma in central nervous system which affecting to motor skill and speech functions.

The initially symptoms and sign are Trembling of hands, arms, legs, jaw and face, rigidity, and slowness in initiation movement, Poor balance and coordination. The early sign and symptom more clear prominent if people before have high mobility previously as a golf player, volly ball player, Gymnastic exercise which those dexterity of their activities are going to decrease so make affect to less of graping something, low of handling, dressing, or climbing stairs.

If you are feeling unwell and you have experienced symptoms and sign above I suppose you to visit to your doctor to check you Body Health for possibility suffering from PARKINSON DISEASE.

Know Your Blood Cholesterol

In the life time no body want to get get sick. They need that their life is always keep a way from any sick, but sometimes human being unable to keep their body a way always health as many reason such illness caused by intern and extern factors. The extern factors like accident, injury or many infection diseases caused by environmental factors influences to their body healthy.

Internal factors such as psychologist, biologist imbalance, food style claimed play to lead many death disease one of them is Heart Disease. Heart Disease is still rank in the top position death disease in the world. Number of deaths for leading causes of death could be mentioned by categories as follow:

• Heart disease: 654,092
  
• Cancer: 550,270
  
• Stroke (cerebrovascular diseases): 150,147
  
• Chronic lower respiratory diseases: 123,884
  
• Accidents (unintentional injuries): 108,694
  
• Diabetes: 72,815
  
• Alzheimer's disease: 65,829
  
• Influenza/Pneumonia: 61,472
  
• Nephritis, nephrotic syndrome, and nephrosis: 42,762
  
• Septicemia: 33,464

Sources N C H S - FASTATS - Leading Causes of Death and Deaths: Preliminary Data for 2004, tables 7.

What Heart Disease Causes?
Major Risk Factors

• High Blood Pressure (Hypertension)
  
• High Blood Cholesterol
  
• Diabetes
  
• Obesity and Overweight
  
• Smoking
  
• Physical Inactivity
  
• Gender
  
• Heredity
  
• Age

Contributing Risk Factors

• Stress
  
• Sex hormones
  
• Birth control pills
  
• Alcohol

From all factors above Cholesterol was claimed as common leading causes Heart Attack. Cholesterol Level in your blood must be control so always Normal or near normal then to keep your Blood Cholesterol always normal you have to manage your food pattern and food style, below many food you to pay attention eat so make your life keep a way from Heart Disease you have to be follow and obey it.

Here the list of food consist of high cholesterol you have to be concern as folowing are:

Food	Serving Size	Cholesterol Level
Boiled Egg	1	225 mg
Cream Cheese	1OZ	27 mg
Cheddar Cheese	1OZ	19 mg
Butter	3.5OZ	250 mg
Lamb	3.5OZ	70 mg
Beefsteak	3.5OZ	70 mg
Chicken	3.5OZ	60 mg
Kidney, Beef	3.5OZ	375 mg
Liver, Beef	3.5OZ	300 mg
Ice Cream	3.5OZ	45 mg
Sponge Cake	3.5OZ	260 mg

In other hand you have to be understanding also about your Cholesterol Normal Level as a following mentioned below:

Total cholesterol

• Desirable: Less than 4.14 millimoles per litre (mmol/L) or Less than 160 milligrams per decilitre (mg/dL).
• Borderline high: 4.15–6.19 mmol/L or 160–240 mg/dL
• High:6.2 mmol/L or higher or 240 mg/dL or higher

HDL cholesterol

• High (desirable):More than 1.56 mmol/L or More than 60 mg/dL>
• Acceptable: 1.04–1.56 mmol/L or 40–60 mg/dL
• Low (undesirable):Less than 1.04 mmol/L or Less than 40 mg/dL

Total cholesterol-to-HDL ratio

• Desirable: 6:1 or less
• Undesirable: More than 6:1

LDL cholesterol

• Optimal: Less than 2.5 mmol/L (less than 2.0 mmol/L if you also have diabetes) or Less than 96 mg/dL
• Near optimal: 2.6–3.5 mmol/L or 100–135 mg/dL
• Borderline high: 3.6–4.0 mmol/L or 135–159 mg/dL
• High: 4.1–4.9 mmol/L or 160–189 mg/dL
• Very high: 5 mmol/L or higher or 190 mg/dL or higher

Triglycerides

• Normal: Less than 1.7 mmol/L
• Moderately high: 1.7 to 6.0 mmol/L
• Very high: 6.0 mmol/L

Sources condensed from www.bchealthguide.org

Nursing Online Degree

Do you still Diploma of nursing, LPN (Licensed Practical Nurse),LVN (Licensed Vocational Nurse) and curently you already have nursing job so you have plan to continuing to RN (Register Nurse) nor BSN (Bachelor In Nursing) or other nursing course without stopped your salary income. To day many nursing college and university online provide to you to help who any nurses want to go to nursing college such as RN nor BSN even Master of nursing without left your job.

They required to be register and enrolled you to their Nursing College without attended to classroom. Everything you wil do online. You may need only submitted and to be following nursing study online that they are perform through by internet. The following Universities list provide to you to lead your nursing career in the future. List of Online Universities as a following are:

1. niversity of Phoenix

They do nursing upgarade as well as you want with including:


• RN to B.S. in Nursing
  
• B.S. in Health Administration
  
• B.S. in Human Services/Management
  
• M.S. in Nursing

University of phoenix perform nursing undergraduate and graduate in 2 to 3 years, so it will be helpfull to you to achive you nursing future career.


2. Keiser College

Keiser College's online degree programs are offered one class at a time in a personal, student-centered environment.


• A.S. in Medical Assisting
  
• RN to BS in Nursing
  
• Associate in Health Services Administration
  
• B.A. in Health Services Administration


3. indiana state university

Indiana State University offers LPN/LVN'sprogram.

• LPN/LVN to BSN Nursing Degree.
  
• RN to BSN Nursing Degree


4. kaplan University

Kaplan University's online nursing programs let you to get your nursing study any time, any where to improve your nursing knowledge with profesional teacher. They done they program online nursing as a below:


• RN to B.S. in Nursing
  
• Forensic Nursing Certificate
  
• Case Management Certificate
  
• Life Care Planning Certificate
  
• Legal Nurse Consulting Certificate
  
• Geriatric Care Management Certificate


5. Grand Canyon University

Bring your nursig career with Grand Canyon University. They have so many nursing program online including are:


• RN to BS in Nursing
  
• BS in Business Admin.
  
• MBA in Health Systems Mgmt.
  
• MBA and MS in Leadership (Dual Degree)


6. National American University Online

They do Quality accredited education is accessible 24 hours a day, 7 days a week, locally, nationally and globally through National American University's (NAU) distance learning program.


• Online RN-to-BSN
  
• B.A. Health Care Management
  


7. Florida Hospital College of Health Sciences

Florida Hospital College of Health Sciences - Earn your degree at homeand and the rewards at work.


• RN to BS in Nursing


8. Walden University

Lead your career RN to MSN degree and BSN to MSN degrees available online in Walden University. They have other program also are:


• Master's in Nursing (RN - MSN)
  
• Master's in Nursing (BSN - MSN)
  
• M.S. in Nursing/Education
  
• M.S. in Nursing (BSN - MSN)- Management and Leadership
  
• Master's in Nursing (RN - MSN)- Leadership and Management
  
• Master of Public Health - Community Health
  
• (M.B.A.) - Health Care Management


9. University of Cincinnati

The University of Cincinnati's on-campus programs, reputation, and support with the flexibility of online studies Nursing. Lead your Masters in Nursing Degree Online.


M.S. in Nursing/Nurse Midwifery

• M.S. in Nursing/Women's Health Nurse Practitioner
  
• B.S. in Clinical Laboratory Science
  
• B.S. in Health Information Management
  
• Masters in Education - Education Leadership


10. Loyola University New Orlean

The Loyola University New Orleans bringing Your MSN Degree Online From A Top Ranked University While You Work


• Masters in Nursing - Health Care Systems Management Degree


11. Norwich University School of Nursing Online

They Over 186 years of academic heritage and the highest form of accreditation a university can receive.

• Master of Science in Nursing

myonlinenursingdegree

First Aids Of Burn

Burn is something condition made people doing wrong when the accident occured. It make confuse to anywho geeting burn so you have to be understand how to do and how to help to the victim, why? because if you don't understand it will make worst to the victim even you will geeting serious problem also if burn stiil on.

Management for burn as immediate action are:

1. “Stop, Drop, and Roll” to smother flames.
   
2. Try to remove all burned clothing. If clothing adheres to the skin, cut or tear around burned area.
   
3. Try to remove all jewelry, belts, tight clothing, etc., from over the burned areas and from around the victim’s neck. This is very important; burned areas swell immediately.

State of burns
First-Degree Burns

First-degree burns involve the top layer of skin.
Signs:

• Red colour
  
• Very painful to touch
  
• Skin will show mild swelling

Treatment:

• Apply cool, wet compresses, or immerse in cool, fresh water. Continue until pain subsides.
  
• Cover the burn with a sterile, non-adhesive bandage or clean cloth.
  
• Do not use ointments or butter to burn; these may cause infection.
  
• Over-the-counter pain medications may be used to help relieve pain and reduce inflammation.
  
• The first degree burns usually heal without further treatment. However, if a first-degree burn covers a large area of the body, or the victim is an infant or elderly, seek emergency medical attention.

Second-Degree Burns
Second-degree burns involve the first two layers of skin.

Signs:

• Deep reddening of the skin
  
• Pain
  
• Come to blisters
  
• Glossy appearance from leaking fluid
  
• Possible loss of some skin

Treatment:

• Immerse in fresh, cool water, or apply cool compresses. Continue for 10 to 15 minutes.
  
• Dry with clean cloth and cover with sterile gauze.
  
• Do not break blisters.
  
• Do not apply ointments or butter to burns; these may cause infection
  
• Take steps to prevent shock: lay the victim flat, elevate the feet about 12 inches, and cover the victim with a coat or blanket. Do not place the victim in the shock position if a head, neck, back, or leg injury is suspected, or if it makes the victim uncomfortable.
  
• Further medical treatment is required. Do not attempt to treat serious burns unless you are a trained health professional.

Third-Degree Burns
A third-degree burn penetrates the entire thickness of the skin and permanently destroys tissue.

Signs:

• Loss of skin layers
  
• Often painless. (Pain may be caused by patches of first- and second-degree burns which often surround third-degree burns).
  
• Skin is dry and leathery
  
• Skin may appear charred or have patches which appear white, brown or black

Treatment:

• Cover burn lightly with sterile gauze or clean cloth. (Do not use material that can leave lint on the burn).
  
• Do not apply ointments or butter to burns; these may cause infection
  
• Take steps to prevent shock: lay the victim flat, elevate the feet about 12 inches.
  
• Elevate burned area higher than the victim’s head when possible. Keep person warm and comfortable, and watch for signs of shock.
  
• Do not place a pillow under the victim’s head if the person is lying down and there is an airway burn. This can close the airway.
  
• Immediate medical attention is required. Do not attempt to treat serious burns unless you are a trained health professional.

Sources and condenced

NCLEX Is For All Nurses In The World

Since a long time who Nurses want to go to USA for work as a Nurse must be certified NCLEX first without it you will be not accept to work in America and now not only USA, other country such as Australia, UK, North America, more country require NCLEX certificate and Middle east till now no NCLEX required. Why you have to taking NCLEX first? Why NCLEX is very important? What is NCLEX? NCLEX is National Council Licensure Examination. A student must pass the NCLEX in order to become a licensed registered nurse in the US. Most nursing students take the exam within 3 months after finishing nursing school. It,s require to be taken as a requirement that nurses are able to doing nursing good care in whole nursing department field. It is the same thing if you are a driver, before drive car you have to taking driving license so you will be able to drive car correctly and nicely. NCLEx is Nursing License that indicating who Nurses have NCLEX certificate is capable to doing whole health care.

NCLEX is all Nurses in the World

When I learn about NCLEX it is the best way Nurses must be taken NCLEX even though they don't want to go to USA or other country. NCLEX is the basic Nurses skill so every Nurses must familiar and full understanding with NCLEX. NCLEX study lead to the nursing skill and will be guide do the correct and fast action to the patient life. It is meant NCLEX is for all Nurses in whole world so it will be reflected to the standard nursing care in the world not only for USA nurses but for all Nurses in the world. I think in the future NCLEX standard must be applicate to Nurses in the whole world.

Skin Cancer

Do you have any spot dark in your skin? Please pay attention to evaluate and to look that the spot dark in your skin is massive growth , before anything happen to you because many people they don't know if the spot dark in their skin is early of skin cancer which called MELANOMA.

What is skin cancer?
Skin cancer is a malignant growth on the skin which can have many causes. Skin cancer generally develops in the epidermis, the outermost layer of skin, so a tumor is usually clearly visible. This makes most skin cancers detectable in the early stages.
Skin cancer is the most common form of cancer in the United States. The two most common types are basal cell cancer and squamous cell cancer. They usually form on the head, face, neck, hands and arms. Another type of skin cancer, MELANOMA, is more dangerous but less common.

What Is Melanoma?
Melanoma is a disease in which malignant (cancer) cells form in the skin cells called melanocytes (cells that color the skin). Melanocytes are found throughout the lower part of the epidermis. They make melanin, the pigment that gives skin its natural color. When skin is exposed to the sun, melanocytes make more pigment, causing the skin to tan, or darken.
Risk factors for melanoma include the following:

• Unusual moles.
  
• Exposure to natural sunlight.
  
• Exposure to artificial ultraviolet light (tanning booth).
  
• Family or personal history of melanoma.
  
• Being white and older than 20 years.
  
• Red or blond hair.
  
• White or light-colored skin and freckles.
  
• Blue eyes.

The following stages are used for melanoma:
Stage 0
In stage 0, melanoma is found only in the epidermis (outer layer of the skin). Stage 0 is also called melanoma in situ.

Stage I
Stage I is divided into stages IA and IB.

• Stage IA: In stage IA, the tumor is not more than 1 millimeter thick, with no ulceration. The tumor is in the epidermis and upper layer of the dermis.
  
• Stage IB: In stage IB, the tumor is either:
  o not more than 1 millimeter thick, with ulceration, and may have spread into the dermis or the tissues below the skin; or
  o 1 to 2 millimeters thick, with no ulceration.
  

Stage II
Stage II is divided into stages IIA, IIB, and IIC.

• Stage IIA: In stage IIA, the tumor is either:
  o 1 to 2 millimeters thick, with ulceration; or
  o 2 to 4 millimeters thick, with no ulceration.


• Stage IIB: In stage IIB, the tumor is either:
  o 2 to 4 millimeters thick, with ulceration; or
  o more than 4 millimeters thick, with no ulceration.


• Stage IIC: In stage IIC, the tumor is more than 4 millimeters thick, with ulceration.

Stage III
In stage III, the tumor may be any thickness, with or without ulceration, and:

• has spread to 1 or more lymph nodes; or
  
• has spread into the nearby lymph system but not into nearby lymph nodes; or
  
• has spread to lymph nodes that are matted (not moveable); or
  
• satellite tumors (additional tumor growths within 2 centimeters of the original tumor) are present and nearby lymph nodes are involved.

Stage IV
In stage IV, the tumor may be any thickness, with or without ulceration, may have spread to 1 or more nearby lymph nodes, and has spread to other places in the body.

How to reduce from Skin Cancer?
The following steps have been recommended by the American Academy of Dermatology and the Skin Cancer Foundation to help reduce the risk of sunburn and skin cancer.

• Minimize your exposure to the sun at midday and between the hours of 10:00AM and 3:00PM.
  
• Apply sunscreen with at least a SPF (Sun Protection Factor)-15 or higher, to all areas of the body which are exposed to the sun. Reapply sunscreen every two hours, even on cloudy days. Reapply after swimming or perspiring.
  
• Wear clothing that covers your body and shades your face. (Hats should provide shade for both the face and back of the neck.)
  
• Avoid exposure to UV radiation from sunlamps or tanning parlors. Protect your children. Keep them from excessive sun exposure when the sun is strongest (10:00AM and 3:00PM), and apply sunscreen liberally and frequently to children 6 months of age and older. Do not use sunscreen on children under 6 months of age. Parents with children under 6 months of age should severely limit their children's sun exposure.

Four types of standard treatment are used:

1. Surgery
   

Surgery to remove the tumor is the primary treatment of all stages of melanoma. The doctor may remove the tumor using the following operations:


• Local excision: Taking out the melanoma and some of the normal tissue around it.
  
• Wide local excision with or without removal of lymph nodes.
  
• Lymphadenectomy: A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer.
  
• Sentinel lymph node biopsy: The removal of the sentinel lymph node (the first lymph node the cancer is likely to spread to from the tumor) during surgery. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed for biopsy. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are not found, it may not be necessary to remove more lymph nodes.

Skin grafting (taking skin from another part of the body to replace the skin that is removed) may be done to cover the wound caused by surgery.

Even if the doctor removes all the melanoma that can be seen at the time of the operation, some patients may be offered chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy given after surgery, to increase the chances of a cure, is called adjuvant therapy.


2. Chemotherapy
   

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

In treating melanoma, anticancer drugs may be given as a hyperthermic isolated limb perfusion. This technique sends anticancer drugs directly to the arm or leg in which the cancer is located. The flow of blood to and from the limb is temporarily stopped with a tourniquet, and a warm solution containing anticancer drugs is put directly into the blood of the limb. This allows the patient to receive a high dose of drugs in the area where the cancer occurred.

The way the chemotherapy is given depends on the type and stage of the cancer being treated.


3. Radiation therapy
   

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.


4. Biologic therapy
   

Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

New types of treatment are being tested in clinical trials. These include the following:


5. Chemoimmunotherapy
   

Chemoimmunotherapy is the use of anticancer drugs combined with biologic therapy to boost the immune system to kill cancer cells.

Keep your skin away from Skin Cancer, do the right way, how to avoid skin cancer.
Sources:
www.maui.net
www.nlm.nih.gov
en.wikipedia.org
http://www.cancer.gov

Blood Tranfusion

What Is Blood Transfusion?
Blood Transfusion is a process of transferring blood or blood-based products from person to other person according to Blood grouping matching(A, B, AB, or O)and each type have 2 Rhesus (REE-sus) or "Rh" types should be matching too. The Rh types are positive and negative. All blood, even O negative blood, can have antibodies (AN-ti-bah-dees).

When you need Blood Transfusion?
Blood transfusions can be life-saving in some situations and will be given who anybody want to do surgery procedure or getting massive blood loss due to trauma, or can be used to replace blood lost during surgery. Blood transfusions may also be used to treat a severe anaemia or thrombocytopenia caused by a blood disease. People suffering from hemophilia or sickle-cell disease may require frequent blood transfusions.

Does Blood Transfusion safe?
If the blood transfusion given to other person precede by screened it will be save to the patients live, but if it's not screened it will be transfer many disease to the recipient through transfusion transmitted infections (TTIs) such as HIV, Hepatitis B, Hepatitis C and Syphilis from blood donated. Therefore donated blood should be tested for other infections such as Chagas Disease and Malaria. Blood is also tested to identify the blood group and for the presence of irregular red cell antibodies before transfusion. This is to make sure the patient who will receive compatible blood in order to avoid serious haemolytic transfusion reactions.

Transfusion Procedure

1. Ensure each pack is label with A,B,O and rhesus (D) group and the individual component number also record on the blood product document.
   
2. Check the patient identity on the blood product document againts the patient
   wrist bend.
   
3. Prior administration, record details, on the blood component infusion in the patient note, including date, time of issue, product pact number, ordering medical officer, given by, checked by, time started.
   
4. Infuse all blood component through giving set whit an integral filter to trap large aggregates. Microaggregate filter are not routinely require.
   
5. Never add any drug to a blood component infusion.
   
6. Do not use giving set which previously contained dextrose or gelatin.
   
7. Red cell concentrates may be diluted with 0.9% saline using a Y giving set to improve flow rates. Never add any other solution.

Complication of Blood Transfusion
Rapid infusion of blood products may lead to hypothermia. Blood product are normaly store 2-6 celcius deggre. Use blood warmers routinely for rapid transfusion. Never warm a blood product by putting a pack into hot water, on radiator, or any other heat source.
Occasionally complications caused by blood transfusions as a below:

• Fluid overload - this common side effect can be lessened by slowly introducing the donated blood.
  
• Allergic reaction - the most common complication. The recipient’s immune system treats the donated blood products as a threat. Symptoms include itching, dizziness, headache and difficulties in breathing.
  
• Haemolytic reaction - occurs if the recipient is given the wrong type of blood. The transfused red blood cells are killed off. Symptoms include a feeling of pressure in the chest, back pain and difficulties in breathing. Haemolytic reaction can sometimes be life threatening.
  
• Graft versus host disease - where the donated white blood cells destroy the recipient’s cells. The symptoms include low blood pressure and fever. It is also life threatening.

Transfusion Reaction
Monitor the patient especially closely the firsts 5-10 times of the infusion of the each unit of blood to detect early clinical evidence of acute reactions. Treat allergic reaction include itching, urticaria, bronchospasm, and fever.
If a transfusion reaction is suspected:

• Stop the transfusion.
  
• Keep the IV line open with 0,9% saline.
  
• Double check the blood unit label with the patient's wrist identity band and other identifiers.
  
• Send the unit of blood product and giving set to the blood bank.
  
• Take 40 mL of blood. Send it as follows:
  
5 mL anticoagulated and 5 mL clotted blood to blood bank.
10 mL for u&E.
10 mL for coagulation screening.
10 mL for blood culture.

• Contact the blood bank directly by phone for further advice and if further transfusion is required

New Drug for Advanced Kidney Cancer

The U.S. Food and Drug Administration (FDA) may,30,2007 approved Torisel (the generic name is temsirolimus) for the treatment of a certain type of advanced kidney cancer known as renal cell carcinoma. Torisel was approved based on a study that showed use of the drug prolonged survival of patients with renal cell carcinoma. The drug is an enzyme inhibitor, a protein that regulates cell production, cell growth and cell survival.

"We have made significant advances in the battle against kidney cancer,” said Steven Galson, M.D., M.P.H., director of the FDA’s Center for Drug Evaluation and Research. "Torisel is the third drug approved for this indication in the past 18 months, and one that shows an increased time in survival for some patients."
The approval of Torisel follows the December 2005 approval of Nexavar (sorafenib), which was based on a delay in progression of disease. In January 2006, Sutent (sunitinib) received accelerated approval based on durable response rate, or tumor size reduction, and was later demonstrated to delay tumor progression.

The safety and effectiveness of Torisel were shown in a clinical trial of 626 patients divided into three groups. One group received Torisel alone, another received a comparison drug called Interferon alfa, and a third received a combination of Torisel and interferon.

The group of patients who received Torisel alone showed a significant improvement in overall survival. The median overall survival was 10.9 months for patients on Torisel alone versus 7.3 months for those treated with the interferon alone. Progression-free survival (when the disease does not get worse) increased from 3.1 months on the interferon alone arm to 5.5 months on the Torisel alone arm. The combination of Torisel and interferon did not result in a significant increase in overall survival when compared with interferon alone.

The most common adverse reactions, occurring in at least 30 percent of Torisel-treated patients, were rash, fatigue, mouth sores, nausea, edema, and loss of appetite. The most common laboratory abnormalities were high blood sugar, elevated blood lipids and triglycerides, elevated liver and kidney blood tests, and low red cell, white cell, and platelet counts.

Renal cell carcinoma, diagnosed in about 51,000 people annually in the United States, accounts for about 85 percent of all U.S. adult kidney cancer.

Torisel is manufactured by Philadelphia-based Wyeth Pharmaceuticals, Inc
Important Safety from used Torisel
Source

Cardiopulmonary Resuscitation (CPR)

What Is CPR (Cardiopulmonary Resuscitation)

CPR is combination of rescue breathing(to get oxygen to the lungs) and chest compressions (to keep blood circulating) delivered to victims to save of patient life when a person experiences cardiac arrest, whether due to heart failure in adults and the elderly or an injury such as near drowning,suffocation, poisoning, smoke inhalation, electrocution or severe trauma in the child and newborn.

Cardiac arrest is often caused by an abnormal heart rhythm called ventricular fibrillation (VF). When VF develops, the heart quivers and doesn't pump blood. The victim in VF cardiac arrest needs CPR and delivery of a shock to the heart, called defibrillation. Defibrillation eliminates the abnormal VF heart rhythm and allows the normal rhythm to resume. Defibrillation is not effective for all forms of cardiac arrest but it is effective to treat VF, the most common cause of sudden cardiac arrest.

CPR may not save to the victim even when performed properly, but if started 4 minutes of cardiac arrest and defibrillation is provided whitin 10 minutes, a person have 40% chance of survival. Here the CPR time line described you have to do CPR , if you are doing CPR starting 0-4 minutes you can save from brain damage, 4-6 minutes brain damage possible happen, 6-10 minutes brain damage probable and over 10 minutes probable brain death, so choose the right time when you are perform CPR.

To make learning CPR is easier , you have to remember the sequence letters A-B-C as explained the following:

1. A : Airway
2. B : Breathing
3. C : Circulation

When CPR to be Perform?

CPR is most successful when administered as quickly as possible, but you must first determine if it's necessary. It should only be performed when a person isn't breathing or circulating blood adequately.

How to perform CPR?

You should not try CPR unless you have had training - if it is done incorrectly, it could harm someone and will killing victim try to looking some help or you can calling victim, you have to be skill full, and to keep your skill up, you should repeat the training every two years. You can call 9-1-1 in USA, UK 9-9-9 or you can call any Emergency Care in your own country, or you can contact local Ambulance number if you have it.

If yo can do CPR, Remember the ABCs
Airway, Breathing and Circulation — to remember the steps explained below.

AIRWAY: Clear the airway

1. Put the person on his or her back on a firm surface.
   
2. Kneel next to the person's neck and shoulders.
   
3. Open the person's airway using the head tilt-chin lift. Put your palm on the person's forehead and gently push down. Then with the other hand, gently lift the chin forward to open the airway.
   
4. Check for normal breathing, taking no more than 10 seconds: Look for chest motion, listen for breath sounds, and feel for the person's breath on your cheek and ear. Do not consider gasping to be normal breathing. If the person isn't breathing normally or you aren't sure, begin mouth-to-mouth breathing.

BREATHING: Breathe for the person

Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened.

1. With the airway open (using the head tilt-chin lift), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.
   
2. Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head tilt-chin lift and then give the second breath.
   
3. Begin chest compressions — go to "CIRCULATION" below.

CIRCULATION: Restore blood circulation

1. Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
   
2. Use your upper body weight (not just your arms) as you push straight down on (compress) the chest 1 1/2 to 2 inches. Push hard and push fast — give two compressions per second, or about 100 compressions per minute.
   
3. After 30 compressions, tilt the head back and lift the chin up to open the airway. Prepare to give two rescue breaths. Pinch the nose shut and breathe into the mouth for one second. If the chest rises, give a second rescue breath. If the chest doesn’t rise, repeat the head tilt-chin lift and then give the second rescue breath. That's one cycle. If someone else is available, ask that person to give two breaths after you do 30 compressions.
   
4. If the person has not begun moving after five cycles (about two minutes) and an automated external defibrillator (AED) is available, open the kit and follow the prompts. If you're not trained to use an AED, a 911 operator may be able to guide you in its use. Trained staff at many public places are also able to provide and use an AED. Use pediatric pads, if available, for children ages 1 to 8. If pediatric pads aren't available, use adult pads. Do not use an AED for infants younger than age 1. If an AED isn't available, go to Number 5 below.
   
5. Continue CPR until there are signs of movement or until emergency medical personnel take over.

sources
1.www.mayoclinic.com
2.www.learncpr.org
3.www.americanheart.org

Back Pain In Nurses

Nurses is one profession who have susceptible getting low back pain under their daily activity if they don't take care . The daily activity such as , bed making, turning bed-ridden patients, transferring among stretchers, beds and chairs, move patients from bed to wheelchair, indeed if the patient was unconscious, emergency cases, nurses ignore doing safety to their self for example nurses who work in emergency department and ICU who all patients are high dependent attention and fast action from nurses, so some time they didn't care to their safety first because they want to safe to the patients of life.Nurses must have knowledge to understand about safety procedure how to doing manual handling in the hospital area or safety officer department must be control to nurses activity with safety procedures, without knowledge and safety control injuries and back pain cases come out lead.
Dr.Edgar Viera, a doctoral student in the University of Alberta Faculty of Rehabilitation Medicine said,"Nurses suffer from work-related low back pain more often than workers in other professions. It is point out number of nurses suffering back pain is still high, why? Do you still lets your safety away? did you think that safety is number two, doing something with safety first to save your life comfortin the future.
Related to the study of back pain factors above here some way to reduce nurses back pain when they are doing activities in Hospital as following:

1. Using lifting assistance devices

A variety of devices is available to help lift and move patients from bed to seat, such as:



• Gait belt: This is a special belt that fit snugly around the patients waist and has hand starsp for the nurse or caregiver to grasp while assisting during transfers or walking.
• Walkers: Lightweight metal frame devices with rails that can be gripped by the patient to help to support their body weight during transfer and rising from sitting.
• Rails: Wooden or metal rails are fixed to walls or equipment , such as beds, to allow the patient to help to support their body weight during transfer.
• 'Hoyer' Lifts: A hydraulic lift that consists of a metal frame and a heavy canvas swing. It is capable of lifting and suspending a patient for transfer.
• Sliding boards: A smooth board with tapered ends made of either wood or plastic that is used to help someone get from one sitting surface to another.
• Draw/lift sheets: A regular flat sheet placed under a patient in the bed can be used to move them. If the sheet is strong enough it can also be used to lift and transfer the patient.
2. Using appropriate equipment: There is a choice of powered equipment available to reduce patient handling activities, such as powered beds to change a patient's posture, height adjustable chairs, and powered wheelchairs.
3. Use appropriate beds: The height of the bed determines how much bending and reaching a nurse has to do. Nurse are different heights, so a simple to operate, height-adjustable bed is important to allow bed height to be appropriately adjusted to the nurse.
4. Use back belt: use back belt when lift a patient with heavy weight to prevent your back bone from injury or dislocation
5. Implement regular maintenance procedures: Equipment must be keep in good working order so anytime will be ready to be use.

Other safety support is important also included:

1. Ergonomic design of workplaces: Use architectural and design features, such as rails or ramps, to minimize awkward movements.
2. Providing better ergonomic training: Train nurses and health aides in good work posture and ways of minimizing twisting, bending and/or lifting items from the floor. Also train them in safe lifting practices, and in the correct use of appropriate equipment. Provide ways os refreshing and reinforcing the training.
3. Provide adequate staffing: Injury risk can be reduced by increasing the number of people available to assist with lifting patients.
4. Systematic record-keeping: Implement processes that facilitate more detailed statistic on manual handling activities and outcome so that this can help to identify injury trends before more serious incidents occur.

Safe your life to be comfort in the future from getting back pain or low back pain, or injury!!!

Nurse Jobs Opportunities In Qatar Petroleum

Dear all nurses in whole world
This is good info to nurses who looking for a new job , or even you have had been already good job, so you can compare or want to move to other area with the good chance, why because as my experience Qatar Petroleum offering best reward to nurses who have qualification as well as they needed.
Qatar Petroleum is one of biggest company that produce oil and gases offering many jobs opportunities, one of them is nurse jobs. Are you nurses who have experiences more than 5 years or more, you like challenging jobs in oil and gas area who will place you in offshore or onshore, if you are nurses who have qualified of ACLS , ATLS, emergency background and ambulance skill so what are you waiting for, let,s join with Qatar Petroleum to increase your benefits.
Qatar Petroleum offering many benefits to you as a following:

• Salary attractive more than $1500 per month
• Biannual leave in year
• Full accommodation
• Full health insurance
• Allowed to your spouse settle with you
  
• Free education for your children
• Free air plane ticket till your destination place when you are vacation
• Many others benefits
  

Why you still conscious , wary, let's open your eyes, you want to get more information, visit to Qatar Petroleum web site or you can apply HERE will be bring you to application form, prepare requirements that they need and keep on your computer document, as a below:

• C.V.
• Certificate of your Nursing Study ( Diploma or BSN)
• ACLS certificate
• ATLS certificate
• Experience background
• Other certificate if you have it

Try to get chance and quick online apply.
For Indonesian Applicants, please contact toPT. Guna MandiriThank for your attention
Nurses Web Blog Team

How is Viagra Helpful To YOU ?

What is Viagra?
Viagra(Sildenafil citrate), sold under the names Viagra, Revatio and generally under various other names, is a drug used to treat male of erectile dysfunction (impotence)developed by the pharmaceutical company Pfizer. The other medicines which can support for sexual activity are Vardenavil(Levitra) and Tadalafil (Cialis).

How are Viagra, Levitra and Tadalafil work?
Viagra,Levitra and Tadalafil are prevent the breakdown of nitric oxide , chemical messenger that promotes relaxation and opening of the blood vessel supply erectile in the penis. Under the influence of nitric oxide, these vessel expand an stay dilated. Increased blood flow makes erectile tissue swell and compress the veins that carry blood out of the penis, resulting in a full erection.
This medicines till now still helpful and many men looking for it used for increase them sexual activity. Many men who have no sexual disorder also using for to take longer them sexual activity, so it is useful for man who have no sexual problem?

What is Viagra recommended for?
Viagra is a recommended only for who everyone have sexual activity problem, especially erectile dysfunction, so for man who have no sign and symptom of sexual activity erectile dysfunction will not take effect for it, even take effect the effect will not significant but sometimes makes forth serious problem, so don,t used Viagra without doctor recommended or prescribed. In testing researches found that men with Diabetes or who had undergone radical prostate surgery were less likely to benefit. The drug also should not be taken with nitroglycerin and patches.
Dr. Harin Padma - Nathan of University of Southern California s or said," This drug does not change libido or desire and it,s not going to have any impact on normal men, so this drug is only effective in men with sexual dysfunction and should be prescribed as an"aphrodisiac" in healthy men.

Dosage
As with all prescription drug, proper dosages is at the discretion of a licensed medical doctor. The tho of sildenafil is 25 mg to 100 mgtaken once per day between 30 minute and an hour prior to sexual activity. The best way is consulting with your doctor first to avoid problem or worse side effect.

Contraindication:
Contraindication include are:

• When taking nitric oxide donors, organic nitrites and nitrates, such as glyceryl trinitrate (nitroglycerin), sodium nitroprusside , amyl nitrite (poppers).
• In men for whom sexual intercouse is inadvisable due to cardiavascular risk factors.
• Severe hepatic impairment (decresed liver function).
• Severe inpairment in renal function.
• Hepertension (High blood pressure) and Hypotension (Low blood pressure).
• Recen stroke or heart attack.
• Hereditary degenerative retinal disorders (including genetic disorders of retinal phosphodiesterasess).

Side effects
Among sildenafil's serious adverse effects are : priapism, severe hypotension myocardial infarction, ventricular arrhythmias,sudden death, stroke, and increased intraocular pressure.
Common side effects include sneezing, headache, flushing, dypspepsia, prolonged erection, palpitation, and photophobia. Visual chnages including blurring of vision and a curious bluish tinge have also been reported.

If you want to share your experience or just want to compare any side effects for it, JUST VISIT HERE
Referencies:
Wikipedia
Medicines info
Yahoo.health