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NormaSaline's Latest Activity

  1. NormaSaline

    Review of The First Cell

    Azra Raza has many excellent points to drive home in her book, The First Cell, particularly about the lack of relevance to patient care of animal models in current and ongoing cancer research, as well as the reductionist approach in general, in research. Her own work as the director of the Myelodysplastic Syndrome Center at Columbia University and as a doctor to many patients with MDS and AML, though, relies heavily on chasing DNA and mutations, which to my mind is a somewhat reductionist approach. What was lacking and therefore frustrating for me personally was any discussion or acknowledgement in the book about the role of diet or lifestyle in cancer prevention. She would allude to it here and there but to my mind never gave it its full due and in fact at some points dismissed it. She described the nature of carcinogenesis as “unsolvable.” Let me quickly point out that the crux of her book, repeated throughout, is that the solution to our current cancer misery is to detect cancer when it first appears. Prevention, of sorts, in other words. But the question to that answer is: and then what do we do? In terms of where it all starts, Dr Raza says: “One side argues that aneuploidy [chromosomal abnormality] comes first, and genetic mutations arise because of the chromosome breaks, while the other suggests a driver role for genetic mutations with aneuploidy as the downstream consequence." She states: Near the beginning of the book she does briefly mention lifestyle. So, it’s just impoverishment and obesity? So hold up. Let me understand. If you are from an “impoverished region,” and are obese, your cancer is lifestyle-related, but if not – your lifestyle will not be questioned, for, as a cancer doctor she knows that her (usually well-off patients) have had “pristine eating and exercise habits.” Not that I know what’s going on, but something is off there. And so begins and ends the main issue I had with this otherwise very excellent and highly recommended book. Here is a doctor all healthcare workers should both admire and envy - admire for her boldness, originality and creativity, and envy for the way she carves out a very personalized space for herself to have meaningful relationships with her memorable patients. She writes beautifully and her work is meaningful for all concerned, and has a lot of promise for the future. Definitely worth paying attention to and following. As a nurse, I learned some new things about blood cancers that will have applicability for my work, as well as appreciating her accounts of patient centered care in action.
  2. NormaSaline

    Forced from RN to MA question

    When I became a nurse, it was a rude awakening to learn that "techs" and MA s would often get to do what I perceived as the fun, hands-on stuff (in addition to the not so fun stuff), and I didn't know how to do what "even" they were doing. I was scared and jealous at the same time! I later moved to a place where RNs have to know how to do everyone's job, and it was a relief to learn what the assistants were doing there, get good at it,etc. It helped me in terms of delegation skills. They pay me the same - I love working as an assistant, when I do, which is not that often. All of which is to say, it's possible they want you as cross-trained as possible and maybe you can find a way to embrace it so you can get everything out of the job possible. Of course, it's possible there's more to the story than that.
  3. NormaSaline

    Wuhan Coronavirus - We Want to Hear from You

    Good that you're doing this!
  4. NormaSaline

    January is Blood Donor Month!

    Never received a penny for my blood here in the US. I donate several times per year. Many Children's Hospitals also take blood.
  5. NormaSaline

    The Drug Investigations - Three So Far

    Exactly. That's pretty much all I'm talking about. I'm not envisioning going to a patient's bedside and saying, "hey, do you know there's carcinogens in your medication?!" Instead, I'm asking, what is our role here? I interface with pharmacists, for example, and yet, I always forget to ask them about it. Should I bring it up to administration? I mean, shouldn't there be an overarching plan or message? But no one is talking about it at all. Hence, I brought it to this community, almost as a trial run. I have heard of metformin as a wonder drug in terms of life extension, as well, done lots of reading and personal research. Fascinating stuff.
  6. NormaSaline

    Prediabetes Now Common Among Teens and Young Adults

    Until we as nurses and doctors, as well as a society, accept that increased sugar consumption leads directly to metabolic conditions like diabetes, this "trend" will inevitably continue. It's amazing yet not shocking that ultra processed food containing sugar is left out of the risk factors. That's some lobby they have there. As a first step, what's needed is mass education.
  7. NormaSaline

    The Drug Investigations - Three So Far

    I suppose by "drug investigation," I meant, generally, a detailed analysis of the ingredients of those drugs. More specifically, Valisure has begun screening samples of losartan (and possibly other ARBs) from all batches of medications it dispenses for the cancer causing contaminants N-Nitrosodimethylamine (NDMA), N-Nitrosodiethylamine (NDEA), and N,N-Dimethylformamide (DMF), the chemical solvent that has been implicated in the production of these impurities. Lastly, there are ongoing investigations (finally) into generic medications that are manufactured overseas, particularly in India and China, and it’s been found that 80% of the manufacturing plants use fraudulent practices to certify that their drugs are safe.
  8. NormaSaline

    The Drug Investigations - Three So Far

    Well, ok then! I thought everyone had heard about these, but I guess not. Valisure expands capabilities to test medications for cancer causing contaminants implicated in recent recalls -- https://www.valisure.com/blog/valisure-news/valisure-expands-capabilities-to-test-medications-for-cancer-causing-contaminants-implicated-in-recent-recalls/ Valisure Detects NDMA in Ranitidine -- https://www.valisure.com/blog/uncategorized/detection-of-ndma-in-raniditine/ FDA Investigating Metformin for Possible Carcinogen https://www.medscape.com/viewarticle/922248
  9. NormaSaline

    The Drug Investigations - Three So Far

    I am curious what everyone thinks about the three drugs in question now (losartan, ranitidine, and metformin), and nurses' role in questioning the continued use of them.
  10. NormaSaline

    Why do RNs choose to work in nursing homes?

    What an excellent reply! So many things I agreed with: "our elderly are the most vulnerable in society and deserve the best." Bingo. Take care of the most vulnerable. It's a sign of a society's/community's humanity. As far as being "just" a CNA, let me share something. My father had a caregiver, and I'm here to say they are worth their weight in gold. She was not a registered/certified anything, but she was a genius in the field of care. Unparalleled intuition; presence (a woefully underappreciated quality); and common sense. Give me a good CNA/caregiver any day over a good cardiologist - for the elderly. Cardiologist calls me up and says, "listen, if your dad doesn't do x and y then z." Ok, thank you. How nice to actually talk to a cardiologist! Check with the caregiver, "Listen, your dad should do [fill in the blank]." I almost always went with the caregiver. They formed a relationship. This was so important to my dad, to our family and to her, the caregiver. She was there for him, knew what he needed and when, and if she couldn't handle him, no one could, and we'd all wait him out. She always wanted to take him home with her, and we never understood that, but now I work with dementia patients from time to time, and I finally get it.
  11. NormaSaline

    Sterile water for injection

    Great question this turned out to be!
  12. NormaSaline

    CNAs starting IVs

    All aspects of IV therapy, including insertion, I believe is a special skill that we as nurses should be as practiced at as possible. At the same time, I know that all kinds of different personnel in the hospital setting are allowed to start IVs. As long as they are competent and trained, I have 0 problem with that. What I really agree with the OP about is that it seems to have become a degraded skill, at times almost an afterthought. For example, I recently went in for a procedure, the young nurse was using horrible technique, but I did not want to be "that patient" and complain about every little thing she did or didn't do. In the end I did make one or two comments. The second site she tried was dangerously close to the wrist area, but not in the crease, so I didn't fuss. I came out of the procedure with the IV on the opposite hand. No explanation. Nothing. That's what I'm talking about. I have no doubt that clinics and hospitals with dedicated IV teams have excellent success rates, with reduced complications such as infiltration and infections. Not to mention patient satisfaction.
  13. NormaSaline

    Phlebotomy question

    Question on blood draws. A few years ago, I worked in a clinic setting, and would draw blood a few times a week. Mostly CBCs and chemistry. For the chem we would use a "tiger topped" red and gray serum separator tube (SST). For the CBC, the lavender. My question is on the chemistry tube. I know that in hospitals, plasma separator tubes are used (not the SSTs), which are the "mint" green-topped tubes, for speed, but also, I'm now reading, because heparinized plasma is preferred over serum for potassium. Who knew?? Why don't clinics likewise use the mint topped PSTs? Is it a question of economy because a whole range of tests can come from that one SST? Am I missing something? Thoughts? Thanks!
  14. NormaSaline

    When Police and Nurses Disagree Over Blood Draw Consent - Know What to Do

    Excellent clarification. Thanks.
  15. NormaSaline

    When Police and Nurses Disagree Over Blood Draw Consent - Know What to Do

    I might have been assuming that based on this from the original post -- --I thought the doctor's order carried the same weight as a warrant.
  16. NormaSaline

    When Police and Nurses Disagree Over Blood Draw Consent - Know What to Do

    Interesting that a doctor's order can override consent. Why isn't this more of a topic for docs then?

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