If anyone is looking for ways to help with relief aid for the tsunami Google has set up a BLOG , as well as other resources. An idea that I read about is to get your employer to match fundraising funds and donate it to one of the relief agencies.

British papers now reporting 100,000 dead. :(

I worked Christmas day and it always makes me sad-to see those residents who get no visitors, no gifts, nothing. Its a time of year that almost everyone looks forward to. Family, friends, good food, happy kids…the music of the season, the Church services that many attend. Not for the average nursing home resident.

I work with kids and young adults, and trust me, it’s no different with them than it is with the elderly. Our census usually hovers around 14 (on a 15 bed unit), but Christmas day the census was 8. Not too bad. The few who stayed with us had no visitors, no phone calls, no gifts, nothing. These are kids-and some young adults aged 20-28…

The facility did buy presents for those who were to be with us on Chistmas day. SO at least they got something. The activity staff didn’t work, no religious services or people visited, no fancy meal. I was pretty disappointed.

How was Christmas day for those of you who worked?

Night Shift Linked to Late Pregnancy Loss
By Amy Norton
NEW YORK (Reuters Health) - Pregnant women who regularly work the night shift may have an increased risk of a miscarriage late in pregnancy or a stillbirth, a new study suggests.

The study of more than 40,000 Danish women who worked during pregnancy found that those who consistently worked the graveyard shift were 85 percent more likely than daytime workers to suffer a miscarriage relatively late in pregnancy or have a stillbirth.

Other job shifts — including rotating shifts that required some overnight work — were not related to late pregnancy loss, according to findings published in the Journal of Occupational and Environmental Medicine.

Overall, just over 1 percent of the pregnancies ended in miscarriage or stillbirth, and only 11 of the 420 women who worked a fixed night shift suffered a pregnancy loss.

Still, when the researchers weighed other factors such as the woman’s age, smoking habits and the physical demands of the job, overnight work was linked to an 85 percent higher risk of pregnancy loss compared with fixed daytime work.

“The results from our study are in favor of an effect (of) night work,” the study’s lead author, Jin Liang Zhu of the University of Aarhus, told Reuters Health.

The findings are in line with a number of studies suggesting that working the late shift, or rotating shifts that include night work, can take a toll on the body, including increasing the risk of digestive problems, heart disease and certain cancers. In a recent analysis of the same group of Danish women, Zhu’s team found that those who worked nights or rotating shifts had a slightly higher risk of having a low-birthweight baby.

It’s thought that nighttime work may promote health problems by throwing off the body’s circadian rhythms — daily physiological patterns, governed by the body’s internal “clock,” that not only help control the sleep/wake cycle, but also influence a range of body processes, including blood pressure changes and hormone production.

According to Zhu’s team, the link between pregnancy loss and steady overnight work may have to do with estrogen levels. Exposure to light at night suppresses the normal nighttime release of the sleep-related hormone melatonin, which in turn is believed to spur an increase in other hormones, including estrogen.

Some recent research has found a heightened risk of breast cancer among women who work mainly at night. Effects on estrogen levels have been proposed as one explanation for that finding.

As for why women on rotating shifts in this study did not have a higher risk of pregnancy loss, Zhu said it’s possible that a rotating schedule may fall short of any “threshold” at which night work begins to have an effect.

The researchers also found evidence that job stress could be a factor in night-shift workers’ higher risk of miscarriage and stillbirth. Job stress was not linked to pregnancy loss overall, but among workers on fixed night shifts, those who said their jobs had high demands but gave them little control over their work had a higher risk of pregnancy loss.

“We believe that job stress involved in working on a fixed night schedule may be larger than the job stress reported by all in general,” Zhu said.

However, the researchers say the finding on job strain “must be interpreted cautiously” because of the small number of women the sub-analysis involved.

SOURCE: Journal of Occupational and Environmental Medicine, November 2004.

By MARK SHERMAN

WASHINGTON (AP) - About 35,000 fewer nursing home residents are kept in restraints on a daily basis - down 23 percent from two years ago - according to a federal report released Wednesday that also found fewer patients in pain.

The Bush administration, the nursing home industry and patient advocates said the declines show the value of the administration’s 2-year-old program to tackle serious quality problems in many homes by requiring the nation’s 16,400 nursing homes to disclose data on care.

The information is posted to help consumers make better choices and to prompt the homes to improve their performance. It is available on the government’s Web site, www.medicare.gov, or by calling 1-800-633-4227.

“When we made these measurements public, then people paid attention,” said John Rother, policy director for the 35-million member seniors’ group AARP.

All the information is based on data the nursing homes must routinely collect from residents as part of their participation in the federal Medicare program.

About 1.6 million people live in nursing homes daily. During a year, more than 3 million people have a nursing home stay, the report from the federal Centers for Medicare and Medicaid Services said.

In the middle of 2002, 9.7 percent of nursing home residents were restrained on any day. Two years later, the number was 7.5 percent.

Patients kept in restraints can become weak, lose their ability to go to the bathroom on their own and develop bed sores. Restraints should only be used when ordered by a doctor as part of a patient’s medical treatment, according to federal law.

Measurements of pain among long-term and short-term nursing home patients also improved, dropping 38 percent and 11 percent, respectively.

The report showed a slight increase, 2 percent, in the percentage of patients with pressure, or bed, sores. But among a select group of homes that focused on the problem, there was an 8 percent decline in the percentage of residents with painful sores that can lead to serious infection and can indicate neglect.

Dr. Mark McClellan, the Medicare and Medicaid administrator, cited examples of homes in which residents are not restrained and few have bed sores. The 150-bed Eliza Jennings Home in Cleveland, which does not restrain patients as a matter of policy, showed an 84 percent drop in sores , he said.

“It matters which nursing home you choose,” McClellan said.

The program started with 10 measures and has increased to 15. New entries include staffing levels and weight loss among long-term residents.

The government also is starting a trial program in seven states to conduct background checks on all prospective employees of long-term-care facilities who will have direct contact with patients. The states are: Alabama, Idaho, Michigan, Nevada, New Mexico, South Carolina and Wisconsin

Despite recent industry improvements, congressional investigators in 2003 found that many nursing homes have serious quality problems. The General Accounting Office, since renamed the Government Accountability Office, also said state inspectors are failing to catch a large number of the problems.

About 3,500 nursing homes were cited for harming patients or placing them at risk of serious injury, the GAO said. The investigation covered mid-2000 through 2002.

Examples of negligent care include improperly stored medical equipment and patients with untreated bed sores.

Patient advocates have praised the availability of the information but have warned that consumers should not choose a home without visiting it, talking to residents and getting information from state offices that monitor long-term care facilities.

Tiffani at Trinity Health Care Training asked me to link this site to her site. I am doing so, along with a brief overview of what Trinity offers.

THCT offers nurses, CNA’s and LTC administrators online CEU’s. For the purposes of this site, I am going to look at what is available for CNA’s:

Standard Precautions (sample here)
Infection Control
Fall Prevention
Preventing Elder Abuse
Communicable Diseases
Resident Rights
Fire Safety and Disaster Management
Preventing Skin Breakdown
Nutrition Basics
Managing a Seizure
Is This a Stroke?
Assisting with Arthritis
Diabetes: What is the big deal?
Normal Aging
Malnutrition and Dehydration
Alzheimer’s Series
Urinary Incontinence
Bowel Incontinence and Constipation
Depression
Allaying Anxiety
Measuring Vital Signs
End of Life Care
Addressing Psychosocial Needs
Heart Health and Disease
Keeping Clean Environment
What Is Mental Illness?
What Is an Eyewash Station?
Delirium, Dementia and Depression
An Overview of Alzheimer’s Disease
Why Do I Keep Hearing about Policies and Procedures?
How to Document Correctly

This all sounds really good to me, and I think the costs is reasonable: $25.00/month or $250.00/Year. I would print this up and bring it to work, show the DON and see what can be done. This is all done online so your employer would need a computer; there are other options so one would need to call THCT.

As a start for the BOOK, I am soliciting stories about nurses. In particular, stories about nurses who really make our job awful. These nurses demean and control every aspect of our work; they make huge demands on us and expect too much. They are the reason many hate to go to to work. Also, in fairness, send along stories about nurses who really impacted you in a positive way; the nurse who inspired you to do a good job or who encouraged you to be the best you could be. Email me with the stories or leave them in the comments section below.