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NotReady4PrimeTime RN

so over it!

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  1. NotReady4PrimeTime

    8 Organ and Tissue Donation Myth Busters

    I've cared for a large number of both donors and recipients over the last 15 years. Never have I seen a donor document that includes the ethnicity of the donor, the location of the donor, the age or gender of the donor or anything else other than blood and tissue types and a tracking number. Obviously, it's not a consideration when it comes to matching donor with recipient. Conversely, the recipients' ethnicity IS known in those situations to all involved in their care. I cannot recall a single instance of an ethnic minority donor passing through our unit, but can think of a large number of ethnic minority recipients. When we have a potential donor from an ethnic minority on the unit there is usually some dialogue about them in the break room, with most participants agreeing the request will be refused. I once heard someone say, "We're not even going to involve the OPO because there's no point." And that bothers me a little. My son became a liver recipient 28 years ago; I know first-hand the value of organ donation and am grateful every day for that family's sacrifice. I hope knowing that their child's death meant several others could live provides them with some peace in their hearts.
  2. NotReady4PrimeTime

    Measles, Mumps, Rubella... Forgotten but NOT Gone

    The bots have been banned and all spam posts from today removed. Thanks for the vigilance!
  3. NotReady4PrimeTime

    Measles, Mumps, Rubella... Forgotten but NOT Gone

    How would you know? Should I hang a sign around his neck?
  4. NotReady4PrimeTime

    Measles, Mumps, Rubella... Forgotten but NOT Gone

    I worry every day about my son and his health. He is one of those people severely affected by a medical misadventure and we pay the price for it every day. He has also been given the gift of life through organ donation. He was too young to have received his second MMR - the booster - at the time he received his transplant and now is at VERY high risk for getting measles if exposed. My spouse and I, and indeed most of his caregivers, have immunity but I worry about the people he encounters at the movie theatre and the mall and in the park and anywhere else he may go. When we travel he will be wearing a procedure mask in the airport and aboard the plane... no matter the reaction we get, because I don't trust the rest of the world to protect him for me. He's had enough ICU inpatient days.
  5. NotReady4PrimeTime

    Measles, Mumps, Rubella... Forgotten but NOT Gone

    Nearly three times as many cases are dismissed than are compensated. The ones that are compensated, according to this source, are largely settled without admission of any solid, provable scientific connection between the injury and the vaccine, simply because it's cheaper to pay a settlement than to litigate for years. Comparing the number of doses administered (1,968,399,297) to the number compensated (1037) reveals that 0.000000545 % of all doses administered were compensated. Seems like a negligible number to me.
  6. NotReady4PrimeTime

    Measles, Mumps, Rubella... Forgotten but NOT Gone

    I just heard from a friend that there have been 303 cases of mumps in the Akron area so far this year. The last case of mumps I can remember was when my oldest daughter had them in around 1984.
  7. NotReady4PrimeTime

    Measles, Mumps, Rubella... Forgotten but NOT Gone

    The province is now formally calling our measles cases an outbreak. Vaccine will be made available for all children older than 6 months in order to protect them in the short term. They'll still need the usual 2 shot regimen. Here's another tool from Australia for decision-making: MMR Decision Aid - Comparing the risks - Measles - NCIRS - National Centre for Immunisation Research and Surveillance
  8. NotReady4PrimeTime

    Measles, Mumps, Rubella... Forgotten but NOT Gone

    "EDMONTON - A fifth case of measles has been identified in an infant in the Edmonton area.The infant, less than 12 months of age, is too young to be immunized against measles, Alberta Health Services said Thursday morning. The health agency says this case underscores the importance of immunization to protect vulnerable people. “Quite simply, vulnerable individuals — such as infants too young to be immunized, or immuno-compromised Albertans who can’t be immunized — are dependent on the immunity of those around them,” said Dr. Gerry Predy, AHS Senior Medical Officer of Health, in a written statement." The remainder of the article may be viewed here: Measles case confirmed in Edmonton-area infant too young to be immunized
  9. NotReady4PrimeTime

    Measles, Mumps, Rubella... Forgotten but NOT Gone

    That's not quite as easy at it sounds. I've been working in PICU since 1997 and have been exposed to God-only-knows-what on a regular basis. I also am the parent of a transplant recipient. I've NEVER brought anything home to him. When he gets sick it's from exposure outside the home 9 times out of 10 - and the other 10% he gets from his dad. When I was getting ready to start nursing school I was told I had to be vaccinated for polio before classes started. Because I live with a transplant recipient I cannot have live viruses and I appealed to the school to be exempted on his behalf. Appeal denied. I was told to get the shot if I wanted to go to school, so I did... knowing I was already well-protected. I had quite the immune response... HUGE, hard, purple lump. But I wanted to be a nurse so badly that I sucked it up. At the same time as I was getting the polio shot, I mentioned to my doctor that I'd never had the mumps, at least I couldn't remember ever having them when my siblings got them. So she ordered a titre. Guess I either had a subclinical case or I was exposed enough to build a response because my titre was high. Tokmom's comment about how she had a mild case of chicken pox after being exposed at work but her son having a really severe case is actually very common with chicken pox. The first person in a family to have it will have a mild case - shorter and less intimate exposure - and all the rest will be worse. I came down with them first in my family, the summer I was 7. I thought I had them BAD but my mother has informed me that I was barely sick at all while my younger sister and brother had lesions in their mouths and on their eyelids and every other body part. I saw the same scenario play out with my own kids. Oldest daughter got them first, hardly noticed she was sick. My immune-suppressed son was second, even though he'd received varicella immune globulin and was admitted for a week's worth of acyclovir, which gave him a mild case too. Daughter #2 was third. The girls stayed with my neighbour so that I could be at the hospital. Not only did daughter #2 have chicken pox on her chicken pox, my neighbour's child did too - close and intimate exposure. (This was before the vaccine was available, obviously.) Oh, and my neighbour's husband hadn't had them as a child so he had the pleasure of having them as a grown-up. How do you repay someone for that kind of sacrifice?
  10. NotReady4PrimeTime

    Measles, Mumps, Rubella... Forgotten but NOT Gone

    The first part of my challenge was to examine your thoughts and feelings without the emotional responses that can sometimes cloud the issue. As a pre-nursing student you have yet to see a child born without a functioning immune system die from complications of chicken pox. You've yet to witness the continual episodes of coughing that lead to apnea and bradycardia in infants too young to be immunized who catch pertussis from an adult who didn't know they had it. Some of those children are brain-injured and others die. You may never hold a new mother while she cries after being told her baby's heart is so malformed from maternal rubella that it can't be fixed and he will die. You may never see a child on long-term cardiopulmonary bypass (ECMO) because he didn't get a flu shot. I've done all these things, some of them more than once. It changes you. I sincerely hope that you inform the parents of children yours interact with that they aren't immunized so they may make the choice to protect their own. I wonder if you realize that entry to nursing school and employment in health care require that you be immunized against a variety of bugs as a condition of admission/employment. Some facilities have mandatory flu shot programs. And in the case of a measles or chicken pox outbreak in your area, you may be required to remain home without pay for the duration unless you can prove your immunity. You might also consider immunization against hepatitis B, a blood-and-body-fluid-borne pathogen nurses are exposed to a lot without knowing it. Make your choices wisely.
  11. NotReady4PrimeTime

    Measles, Mumps, Rubella... Forgotten but NOT Gone

    One argument you could try is to point out that even though so many people have refused to vaccinate their kids the number of autism diagnoses continue to rise. Now does THAT make sense?? You might also point out that in the olden days when I was a kid and everybody was vaccinated, there were very few cases of autism. Can she explain that?
  12. To immunize or not to immunize... that is the question. When I was growing up, there really wasn't any controversy - when we were in certain grades, we were all lined up at school and the public health nurse either gave us a shot in the arm or a little pink drop of sugary liquid on a plastic spoon. I have a nice, circular scar on each of my upper arms just below my shoulders that signify my immunization against smallpox, the only disease to have been declared eradicated from the Earth. When my children were small they each were given their shots according to the vaccination schedule of the time. It's what we did. Then came Andrew Wakefield. The study published by Mr Wakefield purported to link immunizations with the development of autism and it set the world on its ear. The fact that this study has been debunked scientifically a number of times seems not to penetrate the consciousness of a growing group of parents who feel that herd immunity will protect their children. The principle of herd immunity is simple: if enough of a herd of any species is immune to a microbe the odds of an outbreak of that microbial disease are extremely low. And should an outbreak occur, it rapidly diminishes as the number of susceptible hosts drops. Well, guess what... the herd isn't immune any more. Outbreaks of vaccine-preventable diseases like measles, mumps, rubella, pertussis and varicella have been documented all over complacent North America. Combined with a falling immunization rate, high-speed intercontinental travel allows these diseases to gain a toehold and then they are free to run rampant through populations with low or NO herd immunity. Communicability begins before the infected host becomes symptomatic, so spread is difficult to contain once it begins. Measles had been declared eliminated in the Americas in 2002, with small sporadic outbreaks annually; there were 85 cases on the continent in 2005 and as many as 253 in 2010. But in 2011, the WHO American region reported the highest number of cases seen since the disease was reported eliminated. My city has just recorded its second measles case in as many weeks after years of zero cases and we've had two infants with congenital rubella admitted to our PICU in recent months. "So what's the big deal?" people say. Health care has changed since the 50s and 60s, and kids don't die of vaccine-preventable diseases any more. Right? Wrong. Children and adults DO die of these diseases, although the number is small and complication rates remain manageable. For now, at least. Even so, people still believe that it's all hype and not really anything to worry about. They forget about the children and adults who are unable to be immunized, not for lack of wanting it but because of other health issues. Children with cancer, blood dyscrasias, organ transplants and certain neurological disorders cannot be immunized against certain diseases. Adults who have been inadequately immunized as children for whatever reason are also at risk. And it's this population who are at risk for dying from chicken pox. Or measles. Or to become sterile from the mumps. Or to have a baby with severe anomalies from congenital rubella. It's not a joke. In the course of researching my family tree I have come across entire families wiped out by pertussis and measles, and others by typhus, cholera, or scarlet fever (infections that while not vaccine preventable, have been essentially eradicated by modern-day antibiotics and sanitation practices). I'm always deeply saddened when I find them, and I fear that if the current complacency and disdain for immunization continue we may find ourselves right back there. As pediatric nurses we have a unique opportunity to help make this better. We have many teachable moments in the course of our workday where we could reinforce the message that not only are vaccinations safe and effective, but also that parents aren't only protecting their own children, they're protecting those they encounter out in the world who aren't lucky enough to be able to protect themselves. We can remind them that no one knows what the future might bring and that someday they may find themselves with a child who can't be immunized. I remember a family that had 5 children. None of them were immunized because the mom was opposed. Their fourth child became critically ill and needed a heart transplant. The discussions with this mother were intense and, on some level vaguely threatening when it was pointed out that the child would surely die if one of the siblings brought home a vaccine-preventable disease after going through a transplant. She asked for some time to research things and in the end agreed to have all of her children immunized. My challenge to you is to examine your own thoughts and feelings about vaccinations from a scientific rather than an emotional perspective. Then I challenge you to formulate your responses to parents who are on the fence about having their children immunized so you have them ready when the opportunity arises. Our future is counting on you.
  13. NotReady4PrimeTime

    4th Nursing Caption Contest - Win $100

    "What did I say? I just called her an Angel of Mercy, not a Naughty Nurse!"
  14. NotReady4PrimeTime

    Coming Around Full Circle (or Why I Do What I Do)

    I've had a couple of experiences that could be considered similar. I think I've already shared one of them, but I'll risk boring y'all by repeating it... 22 1/2 years ago, well before I became a nurse, my son spent 7 weeks in a PICU in another part of the country. He had a liver transplant that was complicated by multiple strokes, rejection and MODS. He was so unstable on several occasions that we were sure he was ready for his celestial discharge. I was one of those mothers we all love to hate, who arrived right after change-of-shift and stayed well past the arrival of night staff. I got to know several of the nurses who were routinely assigned to my son's care. I trusted them all, but there was one who was really the epitome of PICU nursing. I loved it when she was at the bedside. When my boy recovered and left the PICU, we returned to our home town several hundred miles away and that was that. Fast forward to 2007. I had by then been a PICU nurse myself for almost 10 years. I went to AACN's NTI in Atlanta, my first trip to NTI so I was beyond excited. Because of AACN's habit of clustering the peds topics into only a few time slots, I had to choose between a session that would have immediately benefited my practice and one that I really had a personal interest in. The speaker for the latter topic was listed in the timetable under one name and in the syllabus under a different first name. I told my companion that the speaker's name was familiar (my favourite nurse from all those years ago), but a very common one; the speaker was from a Texas city I'd never been to so I put it down to coincidence. Imagine my amazement when I saw the speaker, who looked very much like an older version of my PICU nurse-friend. When she began speaking, it even sounded like her... and then she said the magic words: "When I worked in Canada..." After her presentation, I approached her and asked her if she'd worked at the hospital where my son had been. She looked at me curiously, then said, "Ye-e-e-s-s... You look so familiar... OMG!!!!!!!!! You're Adam's mom!! What are you doing here??" I told her that I was there because of her, that I wanted to be her when I grew up and we both burst into tears. We're close friends now, having shared hotel rooms at 2 more NTIs. The other story arises from the same timeframe in my life. When Adam was in the hospital (for 1/2 of 1989) my little girls were cared for by a very loving neighbour who saw to it that they ate properly, took their vitamins, went to school in clean clothes and all those things Daddy kind of overlooked. She was a very motherly sort who had lived through her own nightmare when her twin girls were born 13 weeks prematurely. One baby died shortly after birth and the other, Ruby, had CP and sensorineural deafness. She was also raising her grandson but she had room in her heart for my babies too. Her husband, whose nickname was Irish, tried to help my DH cope with the changes that had comeinto our lives with all of Adam's problems but had only marginal success. Not more than a few weeks after Adam was finally discharged, she and her family moved away and we sort of lost touch. In 2002 we also moved to a city about 800 miles away. A couple of weeks after I got back from Atlanta, I was assigned to a premature infant with HLHS who'd had his Stage I Norwood and was critically ill. He had been on ECMO and had multi-organ injuries. In report I learned that his mom was deaf so would be communicating by TDD and email, but that by itself wasn't a big deal. I |spoke" to Mom, whose name was Ruby, through the TDD operator twice; the first half of my shift was busy so it wasn't until the last couple of hours that I had time to really look at the chart. When I saw that this baby's middle name was Irish, I started putting 2+2 together. He was indeed my dear old friend's grandson and I'd missed seeing her by a couple of days. I got permission from Ruby to call her mom and we got caught up over the phone. She was so grateful and relieved that there was someone familiar and trusted looking after her little grandson. (I only wish we could have given them a good outcome...) In 2009 I had several shifts looking after the daughter of an acquaintance of one of MY daughters. That was an interesting experience too... it was the baby's grandmother who recognized me and vice versa. I hadn't seen the baby's mom since she was about 12 years old so how was I to know? That family totally trusted me to give them the real story of what was happening... not an easy thing. But they were comforted by the fact that they KNEW me. I like to think I helped...
  15. NotReady4PrimeTime

    dealing with CNO

    Since this thread has veered into a discussion more related to IENs and their licensing issues, which the average Canadain nurse has no knowledge of or interest in, it's been moved to the International forum.