Julita

Working in OR should not be understaffed like some specialty areas are. OR was my 1st job when I qualified and I chose that area because the nurse:patient ratio was very good and we always had some nurses on stand by. I loved working in OR and even now I would work there again. I liked that fact that I only concentrated on 1 patient each time no matter how crazy the OR list was. Most of my friends who worked in other areas where always understaffed and came home tired and very late too. Other areas to try are Interventional Radiology, Endoscopy. So go for it you will love working in OR and if not you can always try something else. But don't burn out!

Wow!! Sideshowstarlet you went through some horrific experience. You must have been a threat to this co-workers and she had to find ways to get you dismissed from work. Very concerning that nurses who are supposed to be caring people can treat a co-worker like that. You have nothing to worry about them finding out about your old job, the truth will always speak for itself. I hope you are happy in your new job. Happy nursing! ?

Thank you Ciann I am glad you enjoyed reading it. And I totally agree with you as you highlighted the challenges of computerized assessments. I felt the same way too when they introduced computerized care plans at my hospital many years ago.It can be a challenge.We just have to do the best we can.Happy nursing ☺️

Decoding Patient Health Through Comprehensive Assessment In the healthcare environment, a patient's story unfolds through a nuanced interplay of symptoms, history and aspirations. Patient assessment, an intricate art of merging science and empathy, offers a glimpse into the detailed tapestry of one's health. It's more than just diagnosing; it's deciphering the silent language of the body and soul. This article ventures into the delicate arena of patient assessment, revealing how understanding the human narrative is paramount in providing compassionate and patient-centered healthcare. This discussion will address the general principles of patient assessment. Other types of assessments will not be discussed here because they require an in-depth analysis. What is patient assessment? Patient assessment is the structured acquisition of information from the patient1,6 or other sources in order to identify the patient's needs and design an individualized care plan. It is the first stage of the Nursing Process3,6 it precedes everything else. This initial step in care planning is very crucial in the patient's journey whether in hospital, a private clinic or community setting. Assessment involves putting together the information gathered, documenting it clearly and analyzing the data in order to make sense of that information. Many aspects of care can be assessed but generally it depends on the clinical setting and the nature of the patient's visit. Assessment is a priority and not an option. When done well; assessment provides clear guidelines to healthcare professionals and sets the patient journey in the right direction. Who is eligible for assessment? Assessment can be done on; · New patients on admission to the clinic, hospital or service · Existing in-patients through on-going re-assessments of their treatments · Emergency patients where multiple assessments are done due to the urgency of their presenting clinical condition · Unconscious patients especially in ICU, Operating Theaters and Recovery rooms · Patients waiting to be discharged to check if they are fit to go home or be transferred to another care facility Usually, verbal consent is obtained right at the beginning except for those patients who may be unconscious. What do we assess? Assessment can include the following criteria6 but is not limited to these alone. · Physical appearance / disabilities · Emotional status · Psychological / mental status · Vital signs · Socio-cultural needs · Spiritual needs · Economic needs · Life-style behaviors · Nutritional needs Assessment is a key nursing skill that should be performed for all patients receiving care regardless of their clinical environment. What questions do we ask during an assessment? There are specific and general questions to ask patients so you can gather more information. The rule of thumb in gathering information from patients is to ask them enough open-ended questions so they can explain fully what their immediate needs are. As healthcare professionals, we need to pay attention to the responses that patients share during their assessment. Good communication skills6 and interpersonal skills are paramount during this process. When patients answer questions, we get more insight into what's happening and can formulate more questions based on their responses. Sometimes during assessment, we ask patients many questions repeatedly to yield more results. Generally, we ask them their; · name · age · home address · occupation · allergies · medications · medical history · family history · hereditary conditions · any implantable devices · any pregnancy ( if applicable ) · presenting symptoms · when the symptoms started · what has helped in the past? · what triggers the symptoms? Those are some of the questions that may be relevant for assessment. At the end of your assessment, all the findings gathered must be clearly and coherently documented as per organization guidelines. Why do we assess patients? There are varied reasons why we perform assessments. · to gather information about the patient · to get to know the patient · to identify clinical needs · to identify goals for care planning · to determine if we are the right people to help this patient · so we can offer our services to the patient · so we can start treatment · so we can make referrals appropriately We assess patients, looking to gain information that we may not have beforehand. We want to know why the patient has come to see a healthcare professional. The information collected is important to aid with the diagnosis of the patient's condition. When is patient assessment done? Patient assessment is done at the beginning of the patient's visit to a care facility, right from the moment you meet the patient. It is implemented immediately; · on admission · before commencing treatment · post-treatment · during the patient's stay in the hospital · at the beginning of every shift · when clinical needs change We routinely monitor patients' condition re-assessing3 the parameters that we assessed before and any new developments. After we implement the solutions to the problems identified, we assess the effectiveness of the treatment until favorable outcomes are achieved. Re-assessments are done frequently or less frequently depending on the clinical condition of the patient. Assessment is ongoing until the patient is discharged4. Where is assessment done? As nurses, we are always told to maintain confidentiality while doing patient assessments. Maintaining patient confidentiality is both "an ethical and legal responsibility for health professionals"5. In the past there were rooms dedicated specifically for assessing new patients. Patient assessment can be done; · in hospitals · in clinics · at home · in the doctor's office · in the hallways · in procedure rooms · by the patient's bedside area · over the phone · via video calls Different healthcare settings apply different rules in regards to the place of assessment. Many clinical areas do not have any dedicated areas or rooms for assessment. It is good practice to follow your organizational guidelines. Normally we draw the curtains around the patient's bedside area and begin asking them important questions about their life. It is very challenging when doing assessments at the bedside area because some patients do not hear very well. Sometimes, our voices will be raised in order to be heard making it very difficult to maintain confidentiality or privacy in that environment. Nevertheless, most healthcare staff will strive to maintain patient confidentiality given the circumstances of healthcare practice today. How is patient assessment done? Assessment must be done systematically and comprehensively4. All the crucial questions should be thoroughly captured during this stage. Primarily assessments were done face-to-face but now healthcare policies and guidelines have been modified in regards to patient assessment. Now we have virtual assessments, done through social media platforms. These can be very challenging due to a lack of physical interaction with the patients. Virtual assessments have become the norm, especially after the recent pandemic2. Many patients needed to see their physicians but because of lock-downs, the most convenient way was to have virtual appointments. However, it is important to note that patient assessment should not be; · rushed · interrupted · hurried · biased · forced or coerced · minimized · substituted / replaced by electronic equipment In the past, there was pre-assessments where patients would come and be assessed days or weeks prior to their procedure date. That too has since changed, and very few care facilities are still performing pre-assessment services. The change from pre-assessment could be a result of many challenges faced by healthcare facilities today. Today many patients come to the hospital and have their assessment done on the same day of the procedure. Usually they arrive 1 – 2hrs before their scheduled procedure time. The subjective / objective assessment process Assessment is done in partnership with the patient1, sometimes with the help of their loved ones, a carer or someone who really knows the patient's medical history. Assessment is not only verbal it can also be non-verbal. Subjective assessment; · it utilizes verbal responses · the patient describes how they feel · the answers given are unique to the patient · there is no right or wrong answer Objective assessment; · it is non-verbal utilizes electronic equipment · gives an objective judgment / result Through objective assessment we can obtain additional information; · from the patient's chart · investigational results, X-Rays, CT, MRI, blood tests · previous admission reports · by measuring the patient's vital signs e.g BP, pulse, respirations, temperature, oxygen saturation, blood glucose levels etc All these sources of information give us the background history of the patient, without talking to the patient; this is vital when dealing with unconscious patients. Tools used to assess patients Various tools are used in assessing patients depending on their clinical situation. Below are some of the common tools6 used. · Glasgow coma scale · Waterlow scale · AVPU · MEWS · CAGE / CIWA-AR · Pain charts · Stool charts · Fluid intake / output charts · Food charts · Neurological charts · Wound charts These tools are important for recording accurate information in order to deliver quality care. Barriers to assessment can be; · lack of understanding · short-term memory · lack of private rooms · language barriers · hearing problems · confused patients · environmental issues I.e. noise, heat, cold · cultural barriers · anxiety · healthcare professionals using jargon · patient not interested/compliant · lack of protected time · emergency situations The use of jargon by healthcare providers can be avoided by explaining things in simple terms. Simple phrases can help patients to comprehend what is being assessed and what is required of them. Through experience, we learn the art of rephrasing the questions in order to gain meaningful answers that we need from the patient. Conclusion We can all agree that a thorough, detailed and comprehensive assessment is critical in guiding healthcare professionals to choose the appropriate treatment therapies. Patient assessment is the responsibility of all care providers, collaborating to provide an unforgettable patient experience. Assessment is not just done once, rather it is a continual practice. Even though some aspects of patient care have changed throughout the decades, the essence of assessment still remains primarily for information gathering in order to plan care. References 1Assessing the patient's needs and planning effective care. 2Virtual care and COVID-19: A survey study of adoption, satisfaction and continuing education preferences of healthcare providers in Newfoundland and Labrador, Canada. 3Application of the nursing process in a complex healthcare environment. 4Clinical practice guidelines for comprehensive patient assessment in emergency care: A quality evaluation study. 5Health professionals' knowledge and attitude towards patient confidentiality and associated factors in a resource-limited setting: a cross-sectional study. 6Nursing Admission Assessment and Examination.

I think this DIY invention is gorgeous, brilliant idea. It goes to show that nurses are very creative.

Bowel Habits When we hear the words "bowel habits," many of us immediately think it’s none of your business!! This kind of reaction usually happens when someone is asking about your bowel habits. Let’s face it; nobody really wants to talk about their bowel habits to anyone, even to a nurse. I remember many times when patients would shy away from discussing their bowel habits during admission. No one really wants to discuss in detail something they feel is their private concern. Having a bowel movement is a private activity of daily living, so private that we do it in the washroom all alone. In the healthcare service, almost everything that we talk about can be considered a private matter. That includes patients’ bowel habits. Discussions about bowel habits usually happen between patients and caregivers during admission to the hospital or when giving personal care to the patient. Most patients feel awkward when discussing their bowel habits with healthcare professionals. The clinical environment may not seem private enough for them to discuss freely without other patients hearing. What is Diarrhea? Diarrhea is also known by many terms like ‘dysentery’, ‘the trots’ and ‘the runs’. Diarrhea is when your bowels are very loose, watery and sometimes mixed with blood or smell very offensive. When someone has this type of bowel movement more than three times per day it is considered diarrhea. The consistency and frequency of the bowel movement are what classify it as diarrhea. Almost every adult has had diarrhea at some point in their life making it a very common ailment. Some symptoms are present when a person has diarrhea, but sometimes there are no other symptoms involved. Causes of Diarrhea In most cases, the causal factors for diarrhea are unknown, but sometimes diarrhea can be caused by the following: Viral infections: Viruses like cytomegalovirus or norovirus can cause diarrhea in adults. Anyone who comes directly in contact with someone who is infected with norovirus can get diarrhea. Bacterial infections: Bacteria like Salmonella, Shigella and E-Coli cause diarrhea, and these bacteria can be introduced into the body through contaminated food or water. Side effects of medications: Antacids, antibiotics and chemotherapy drugs can cause diarrhea as one of their side effects. Bowel preparation solutions also cause temporary diarrhea during the time of cleansing your bowel for colonoscopy. People on tube feeding can have diarrhea quite often. Fructose: This type of sugar is found in fruits, honey, fruit juices and as a sweetener in many soft drinks and people who have an intolerance to fructose may experience diarrhea each time they eat these foods. Lactose intolerance: People who cannot digest milk or any dairy products may experience diarrhea after eating dairy foods. Laxative abuse: People who suffer from chronic constipation usually take laxatives regularly and overuse of laxatives can result in diarrhea. Post constipation: When you take medication to relieve constipation like fleet enemas, the end result is diarrhea as the stools get loosened by the laxative. Diseases of the digestive system: People with Crohn's, ulcerative colitis, celiac disease usually have persistent diarrhea. Surgery: Some people develop chronic diarrhea post abdominal surgery involving the appendix, liver, pancreas, stomach and small intestine, especially where bowel resection and anastomoses are performed. Everyone has a part to play in preventing diarrhea by maintaining good hand washing techniques, especially: after using protective equipment after using the washroom before giving medication before preparing a meal after touching contaminated surfaces after touching an animal after caring for a sick person Using soap and water to thoroughly wash your hands is usually enough to remove any potential microorganisms. Symptoms of Diarrhea You may notice that the frequency of your bowels begins to increase and maybe the consistency has changed too. The color may be different from what you normally see in the toilet bowl and there may be blood in your stools. Diarrhea can occur in isolation or with a combination of symptoms like: Abdominal pain or cramps Nausea Frequent vomiting Fever of 102 degrees or greater Bloating Blood or mucus in stools Urgency to open your bowels Bowel incontinence If your diarrhea lasts longer than 3 days and you notice any of the symptoms mentioned above do not ignore them. Diarrhea can be acute, or it can be chronic in nature. Types of Diarrhea Acute diarrhea lasts less than 3 days and shorter than 2wks at the most has a sudden onset can result in severe abdominal cramps viruses like norovirus in adults and coronavirus Covid-19 can cause acute diarrhea Salmonella bacteria can cause acute traveler’s diarrhea typically seen among tourists in developing countries Chronic diarrhea means that it lasts longer than 4 wks it keeps recurring more frequently can be found in people who have gastrointestinal disorders like, irritable bowel syndrome, celiac disease, small intestinal bacterial overgrowth (SIBO), Crohn's and ulcerative colitis can result in weight loss, malnutrition, dehydration, reduced sleep and lack of appetite Many people with chronic diarrhea also have other underlying issues like bowel cancer, bowel obstruction, radiation to the abdomen and HIV which may contribute to the cause of diarrhea. Why do you have diarrhea? First of all, you need to be familiar with your own bowel habits. What is normal for one person, may not be normal for someone else. Our bowels are not like one size fits all. Some people have frequent bowel movements several times every day. Other people’s bowel movements are so infrequent, taking 2 or 3 days without opening their bowels. There are no specific criteria for normal bowels because everyone’s normal is different. Therefore, when things deviate from your normal pattern then you know something needs to be addressed. Sometimes causes of diarrhea are unclear, and it may resolve without intervention but sometimes having diarrhea might mean that: your intestines are not absorbing nutrients well something is changing in your bowels you might be getting severe side effects from medications you may be having an allergic reaction to certain foods Most caregivers want to know about patient’s bowel habits because they want to offer help. Always consult with your doctor or specialist and report any changes related to your bowel habits. Your doctor will need to thoroughly investigate the cause of your diarrhea if symptoms worsen. Treatment for Diarrhea The hospital’s infection control policy must be implemented in a timely manner to curb the spread of infection. If the diarrhea is caused by infectious microorganisms, healthcare staff may need to isolate the patient who is having diarrhea from other patients into a private room. Where such private rooms are not available the patient may have to be moved to another facility within the hospital where precaution measures can be adequately implemented. It’s very important to wear protective equipment like gowns, gloves and masks where necessary when dealing with a patient with diarrhea. Protective equipment should be removed before leaving the patient’s room to avoid cross infection. It is crucial to identify the causes of diarrhea in order to treat it effectively. If the diarrhea symptoms are mild, then you may not need to take any medications for it. Diarrhea that is caused by certain foods like prunes or papaya may resolve on its own once you stop eating those foods. Whether you are at home or in hospital, symptom control is paramount in dealing with diarrhea. Diarrhea can be treated with anti-diarrheal drugs like: Loperamide which can be taken as liquid or tablets Octreotide can be given to patients whose diarrhea is caused by certain tumors Caution is given to patients with diarrhea not to take medications without professional advice. Certain foods can also help alleviate the symptoms of diarrhea like a ginger drink for stomach pain Ensure that you replace any lost fluids by drinking plenty of fluids if there is no nausea associated with your diarrhea Most healthcare professionals recommend drinking at least up to 8 ounces of fluid per day to avoid dehydration A salt and sugar solution is preferable because it helps the intestines to absorb the fluids It may be necessary to limit the movement of people in and out of the patient’s room until the diarrhea is effectively controlled. Good hand washing techniques must be practiced by all healthcare workers and visitors who come in contact with the patient with diarrhea. Conclusion All healthcare professionals play an important role in caring for a patient with diarrhea. Diarrhea is a common ailment that requires timely intervention. A good knowledge of how to treat a patient with diarrhea is life-changing. Managing diarrhea can be achieved by implementing simple changes in the patient’s diet. As healthcare providers, we should apply effective solutions to solve the patient’s problems and encourage patients to communicate their bowel habits openly. References CDC: Norovirus Diarrheal Diseases: Acute and Chronic: American College of Gastroenterology Diarrhea. Canadian Cancer Society. Last reviewed April 2021. Diarrhea as a symptom of the Coronavirus (Covid-19) Canadian Digestive Health Foundation. Updated Dec 2021. Diarrhea: Mayo Clinic Diarrhea: Medline Plus Guide To Infection Control In The Hospital. International Society for Infectious Diseases. Symptoms and Causes of Diarrhea: NIH - National Institute of Diabetes and Digestive and Kidney Diseases Diarrhea: WebMD

What is Inflammatory Bowel Disease? Inflammatory bowel disease (IBD) is a chronic condition that results in swelling of the lining of the gastrointestinal (GI) tract. This condition should not be confused with irritable bowel syndrome (IBS) which is a collection of symptoms and does not cause any inflammation to the lining of the bowel. This definitely shows us that these two chronic conditions are different because one causes inflammation and the other doesn't. IBD is characterized by two common diseases namely Crohn's Disease (CD) and Ulcerative Colitis (UC). These two are considered chronic conditions because they are marked by periods of relapse and require long-term solutions to treat them. There are some clear differences between UC and CD but those will not be covered in this report. Causes of IBD There are many theories of how IBD develops including speculations about: Autoimmune changes Cigarette smoking Environmental factors Psychological stressors Genetics But today the actual causes of IBD are still unknown. The nature of these diseases is described as idiopathic which means that their origin is very spontaneous, with no clear indicators as to why some people develop these diseases. Some scholars believe that smokers are at a decreased risk of developing UC but are more at higher risk of developing CD. How is IBD Diagnosed? There are several ways to diagnose CD and UC in patients. Clinical investigations include: Laboratory tests Radiological tests Diagnostic endoscopic procedures (colonoscopy, flexible sigmoidoscopy, gastroscopy) Magnetic Resonance Imaging (MRI) Computed Tomography (CT) Surveillance methods are used to identify those patients at higher risk of developing complications from IBD. But they are not without their limitations and most patients try to avoid these screening procedures as much as they can. Common Symptoms of UC and CD Sometimes symptoms for patients with CD may develop very gradually but with harmful effects. Most patients with IBD present with various symptoms namely: Frequent diarrhea Severe abdominal pain Rectal bleeding / bloody stools Constipation Cramping Urgency to empty your bowels Feeling like incomplete emptying of your bowels Extreme fatigue Excessive weight loss Bloating Severe IBD symptoms that are not adequately managed can even cause anemia and further damage to the GI tract. It is interesting to note that IBD symptoms are not just limited to the intestines. When symptoms are experienced elsewhere outside the GI tract they are often referred to as extraintestinal complications of IBD. Other body parts that can be affected are: Joints Skin Eyes Bones Liver Kidneys Reproductive system Further monitoring of these organs is required with scheduled regular health check-ups. How Women are Affected by IBD? IBD affects people between the ages of 15 and 35 but it is not rare for the disease to occur at any age even those between the ages 50 – 701. The prevalence of IBD is very diverse and affects all people in many regions globally. More numbers of people with IBD are now found in Black & Latin Americans within North America. It is widely accepted that IBD affects women differently than men. This could be attributed to some biological triggers that women with IBD experience. Common triggers can be pregnancy, menstruation, endometriosis and any hormonal imbalances. These causal factors can make IBD symptoms worse although many of the IBD symptoms are not necessarily caused by these triggers alone. How Best to Treat IBD Symptoms in Pregnant Women? Several treatment therapies can be implemented but it is important to note that there is currently no cure for IBD. Treatment therapies are mainly used to induce and maintain remission. During periods of remission, there are hardly any serious symptoms or flare-ups and this period can last for months or years depending on individual circumstances. To achieve this state of remission, physicians have to choose treatment methods that produce long-term results. Some of the medications used in IBD have low risks and can be used during pregnancy but a lot are not yet well researched and should be given with caution. Some medications are well tolerated by pregnant women if they fall pregnant during remission. Most women are encouraged to have their symptoms in remission before deciding to get pregnant thereby giving them an added advantage of a healthy pregnancy. Many researchers believe that a considerable number of women with IBD get worse during pregnancy. Statistics reports reveal 45% of patients who get pregnant during active UC get worse while 23% of them with active symptoms will continue to be active or remain stable and the rest will experience remission2. During pregnancy women with IBD are usually monitored by a gastroenterologist and an obstetrician. This fosters a collective decision-making approach to achieve better outcomes for the mother and baby. Most women of childbearing age with IBD have been concerned about the use of any medications during pregnancy. Pre-conception counseling with a responsible healthcare provider will address a lot of misconceptions about the available treatments. Below is a summary of four (4) treatment options relatively used: 1- Amino-salicylates A step-up approach to treating IBD is used starting with oral medications in the early stages of the disease. Aminosalicylates are medications that contain 5-aminosalicylic acids also known as (5-ASA compounds). Examples are, asacol, sulfasalazine, mesalazine, etc. These groups of drugs work well within the large bowel but are less effective if there is a flare-up in the small intestine. That is why they are best given orally as slow-release pills or rectally as suppositories or enemas. Fortunately, these drugs are considered safe to use during pregnancy. 2- Corticosteroids Steroid therapy with drugs like prednisone, methyl-prednisone or dexamethasone can be tolerated during pregnancy. Caution must be exercised with large dosages as these drugs are not recommended for maintenance in pregnant women. Unwanted side effects from steroid therapy in pregnancy include –pre-term gestational diabetes and hypertension. Pregnant women on such treatments must be regularly monitored to be able to detect the unpleasant side effects. 3- Immunomodulators These drugs change the body's immune system to limit the flare-up periods in IBD patients. Examples are azathioprine and mercaptopurine. There are varied opinions and clinical findings regarding the use of immunomodulators among pregnant women with IBD. Some reports discourage the use of immunomodulators for IBD in pregnancy linking these drugs to birth defects, unwanted problems in the bone marrow and inflammation in the liver and pancreas3. In contrast, other studies have discovered no substantial differences in pregnancy complications in patients with IBD. Currently, most clinicians agree that thiopurines are safe to use during pregnancy as long as they safely monitor the metabolite that can be passed on to the fetus4. Unfortunately, there is insufficient information about the safety of these drugs in pregnant women with active IBD. 4- Biologics Biologics are drugs made from living organisms using biotechnology. They are very powerful drugs whose primary treatment was not necessarily for IBD but have proved beneficial in the treatment of IBD symptoms. Examples are infliximab, adalimumab and certolizumab and these do not have any traces in the breast milk however they must be avoided late in pregnancy. If biologics are used late in pregnancy they may cause low birth weight, stillbirths, and congenital malformations5. However, a meta-analysis review discovered no significant differences between pregnant and non-pregnant women with IBD who were treated with biologics6. These authors allude to the safety of biologics during all trimesters but nevertheless, they also propose that supplementary studies are needed. Although a lot of medications are not well researched in this population group the goal here is not to exclude the women from therapies that could be beneficial to them. The majority of treatments implemented today help to alleviate symptoms of IBD and most patients may experience remission for months or years. Medications used in IBD require careful monitoring of the patient, in regards to reducing/increasing the dosage. The main goal is to maintain a balance between the risks and benefits of the treatment both to the mother and the baby. Conclusion IBD patients need to be reassured and supported during their treatment by using a multi-disciplinary approach. Healthcare professionals can support their patients by encouraging them to discuss any symptom changes openly. Supportive care may include helping patients to choose their diet carefully, how to minimize stress levels and how to comply with treatments. The lack of clear and concise information makes the management of pregnant women with IBD somewhat challenging to healthcare professionals. Clear communication methods are paramount in achieving measurable goals. The fight to get the cure for pregnant women with IBD is ongoing and it certainly is one that is worth fighting for. There are very few studies that address this issue extensively and definitely further studies are needed to inform practice. Every pregnant woman with IBD deserves a chance to live a healthy and symptom-free life. Let us continue supporting pregnant IBD patients by delivering care that will make their healthcare experience positive. References and Resources 1Overview of Inflammatory Bowel Disease 2Pregnancy and Inflammatory Bowel Disease 3,5Crohns & Colitis Foundation: Understanding IBD Medications and Side Effects 4Inflammatory bowel disease and pregnancy: fertility, complications and treatment 6Biologics for Inflammatory Bowel Disease and Their Safety in Pregnancy: A Systematic Review and Meta-Analysis What is inflammatory bowel disease (IBD)? Crohn's Disease in Females Inflammatory bowel disease Update on the Management of Inflammatory Bowel Disease in Pregnancy and Breastfeeding Fast Facts: What You Need To Know About Inflammatory Bowel Disease Top 10 Biologic Drugs in the United States: These Drugs Are Changing the Way Illness Are Treated The impact of inflammatory bowel disease on women's lives Smoking and Inflammatory Bowel Disease: A Comparison of China, India, and the USA

The hospital officials should always stand by their employees when unfortunate mistakes like this happen to a member of staff. Nurses do not work in a vacuum, we follow policies and procedures and sometimes we may not agree with the way procedures are implemented. We have all seen it before how a series of mistakes can happen in a single shift and many times when there is shortage of staff. I am positive to think that no nurse goes to work planning to kill a patient, we save lives, we care but unfortunately sometimes we make mistakes like all human beings do. If we were in her shoes how would we like to be treated? She has apologized, we can all learn from this but we cannot point a finger. I wish her all the best in her new life and career.

Oh what an accurate account of what has been happening all along in the healthcare organization. Nursing shortage has become the norm in many countries. I totally relate to this. Thank you for highlighting this.

Thank you Maggie for this timely information. No excuse to step out in the sun this Summer without putting applying the knowledge you have just shared.All the best with your writing.

So informative article. Thank you for sharing.

Hi Brenda Thank you for sharing such great insights about Colon Cancer awareness, it is something I am very passionate about. I totally agree with you we have to take good care of ourselves and eat healthy. I am pleased to know about the community events happening in your area to raise awareness, what a great idea! ?You have given me an idea for my community too.

A colonoscopy is a test that is done by a specialist doctor called a gastroenterologist. The doctor will use a colonoscope (a scope) which is a long flexible tube with a camera at the tip end to visualize the entire colon. The main goal for having a colonoscopy is to reduce the number of people who develop colorectal cancer and those who die from it. A colonoscopy is usually done as a day case procedure at a hospital or a private clinic. It is one of many surveillance tools used to investigate colorectal cancer. In fact, it is the best screening tool by which all other tests are compared against. A colonoscopy is considered as the gold standard and a life saver in detecting and treating early colon cancer. According to the Canadian Cancer Statistics 2021 Report, colorectal cancer accounts for 12% of all cancer deaths. In actual figures that means an estimated 9,600 Canadians "will die from colorectal cancer". Similarly in the United States as stated by Cancer.Net Statistics 2022 approximately 151,030 cases will be diagnosed this year with colorectal cancer. These statistics and many other factors make it necessary for people to have a colonoscopy procedure. Why is a Colonoscopy Performed? There are many reasons why a patient will have a colonoscopy done and some of the reasons are: To screen for colorectal cancers and dysplasia To explore causes of symptoms like unexplained abdominal pain, loss of weight, anemia, uncontrolled vomiting, diarrhea To check for blockages or narrowing of the colon To assess for inflammatory bowel diseases I.e. Crohn's and ulcerative colitis To investigate any infections within the colon To obtain biopsies during a colonoscopy procedure that can be analyzed in the lab To follow up on previous findings like polyps or tumor removed To rule out or confirm unusual results from other screening tests I.e. CT or X-Rays To check for blood in the stool or excessive rectal bleeding Post-surgical treatment like major colon resection To treat certain conditions, therapeutic treatments can be applied directly to the area to close a bleeding blood vessel with heat, clips or inject specialized medication, remove polyps or tumor Is a Colonoscopy for Everyone? Certainly not, the physician decides who gets to have a colonoscopy based on the following criteria. Patients who are at risk of colorectal cancer due to family history Patients who have drastic bowel changes or various types of bowel conditions Anyone at the age of 55 in Canada should have a coloscopy done to screen for cancer even if they have no symptoms. In the U.S. the screening age is 45 – 75 years or 40years if at higher risk for developing colorectal cancer, especially those of African American heritage How Do You Prepare for a Colonoscopy? There are certain measures that should be followed before the patient has a colonoscopy procedure. The patient is advised to stop eating solid foods that contain seeds at least a week before the procedure The patient can consult with their physician when to stop taking any medications like blood thinners – usually 3 to 5 days depending on the type of blood thinner The patient must begin fasting after breakfast the day before the procedure Usually recommended to have early breakfast the day before the procedure The day before the procedure the patient should start taking the bowel preparation (bowel prep) solution after breakfast to cleanse the colon Once they commence the bowel prep drink the patient should not eat any solids anymore until after the procedure The patient should drink plenty of clear fluids on the day they take the prep to stay hydrated but avoid any colored fluids. No fluid intake at least 4hrs prior to the procedure Patients are encouraged to stay at home after starting the bowel prep because they would need to use the washroom quite frequently If the patient is in-patient the nurse will remind the patient when to start taking their bowel prep and an NPO sign will be put above the patient's bedspace Good bowel preparation is paramount to the success of the colonoscopy procedure because the physician will be able to see clearly inside the colon. A few hours before the colonoscopy procedure begins the nurse will ensure that the patient has a functional intravenous ( IV ) access. The IV access will be used to give the sedative medications during the procedure. Communicating with the Patient It is beneficial to the patient to have the procedure explained to them by the healthcare professional looking after them. The nurse has the opportunity to address any concerns that the patient may have prior to having the procedure. Many patients may feel very anxious on the day of the procedure. Therefore, the healthcare professionals must create an environment where patients are free to ask questions and reassure them. However, due to anxiety, it is always good to not overwhelm the patient with lengthy details about the procedure. Only give them information that is necessary to prepare for the procedure. It is vitally important to let the patient know that colonoscopy is a short and safe procedure however, possible complications can occur. It is ethical practice to mention to the patient some of the complications of having a colonoscopy procedure. This allows the patient to make an informed decision about their care. The following examples are some of the possible complications that your patient may want to know. Possible Complications of a Colonoscopy The following symptoms may occur immediately post-procedure or days after the procedure. Some patients may experience only one of the symptoms or a combination of symptoms or almost all of the symptoms. If a patient has any of these complications while at home, they need to see their doctor or visit the emergency department immediately. Bowel perforation especially if large polyps were removed Adverse reaction to sedative drugs Excessive rectal bleeding after removing polyps Severe abdominal cramps or pain Vomiting Fever Difficulty pooping or passing gas Dizziness Infection How Do They Perform this Colonoscopy Procedure? As we mentioned at the beginning it takes special equipment to be able to do the colonoscopy procedure. When the patient is taken into the procedure room, they will get connected to a monitoring machine and their vital signs will be checked regularly. The doctor and the nurse will explain what will happen while the patient is in the procedure room and ensure that the patient understands. Medications for Colonoscopy Sedation will be given to the patient intravenously and in most cases that will either be light or moderate sedation. Common drugs given for this type of sedation are benzodiazepines (midazolam) and opioids (fentanyl). But there are other times when deep sedation or general anesthesia may be required especially if the case is very complex. For these two types of sedation, an anesthesiologist will be involved to administer the drugs. Some patients choose to have a colonoscopy without sedation but these make up a very small percentage. After giving the sedation the scope will be advanced into the rectum. Some air will be pushed into the colon as the scope glides inside the colon. This air helps to open up the folds within the colon and enables the doctor to see clearly. With light or moderate sedation, the patient may feel drowsy or sleep during the procedure as long as they experience no pain. At other times the patient may even get to watch the procedure. The whole procedure usually takes about 30mins and then the patient will be taken to the recovery area. Recovering after a Colonoscopy In the recovery area, the patient's vital signs will be monitored until they are ready to be discharged. Sometimes after 30mins, the patient will be able to go home but it varies from patient to patient. Post-procedure the patient will be encouraged to pass the gas if they experience any bloating. After the colonoscopy, the physician will briefly explain the findings to the patient before they are discharged. The patient should have a responsible adult to look after them at home at least for 24 hours after the procedure. The reason is that after receiving sedation during the procedure the patient may be cognitively impaired and not be able to do or remember certain things. Finally, when all the discharge criteria are met the nurse will give verbal and written discharge instructions to the patient. The discharge instructions should address issues about: When to resume a normal diet When to take their blood thinner if that applies to them What activities they can & cannot do I.e. no driving, no alcohol for 24hrs Any follow–up arrangements What complications to look for Contact information in case of emergency This is some of the information that patients would like to know when having a colonoscopy procedure. References American Society of Anesthesiologists. Colonoscopy American Society for Gastrointestinal Endoscopy. Understanding Colonoscopy Canadian Cancer Society: Colorectal Cancer Statistics Report 2021 Cancer.Net, Colorectal Cancer: Statistics,  Approved by the Cancer.Net Editorial Board, 02/2022 Centers For Disease Control And Prevention. Colorectal Cancer Screening Tests. Cleveland Clinic. Colonoscopy Martin L.J. MD, Medically reviewed on March 01, 2020. WebMD, Colonoscopy Risks Medical News Today. What to know about sedatives National Institute of Diabetes and Digestive and Kidney Disease. Colonoscopy Pichardo G. MD, Medically reviewed on February 14, 2021.WebMD, How to Prepare for a Colonoscopy SGNA. Patient Care Safety – Recovery & Discharge ( n.d.)