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After Clinicals

Practicing Physical Assessment

 

 

 

Open Skills Lab

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NCLEX Review for your Smartphone?

Wow!   Seems like there are tons of NCLEX apps for your smartphone - many of them free.  Are they any good?  Depends.  Our ace investigative team scanned the mobile world and found over 200 apps that might be worth downloading.  The free ones are not as robust as the $ versions, but they are free, so check them out!  At the very least you can train the brain in your spare time.

We're not endosing any of these, but here's a list of NCLEX apps for Android and iPhone from appszoom.  They seem to do a pretty good job of scanning the universe of what's out there and how much it might cost you.  Let us know which apps you found helpful!

Elsevier's NCLEX Practice Question of the Week

Did you know Elsevier offers an NCLEX question of the Week on their Facebook page?   They also have a blog on Tumblr that has even more NCLEX questions - all free!  The Tumblr site is nice because you can go to Archive and scroll back several years for lots of sampe test questions.

Addict, Heal Thy Self

-by David Hechim, SN

I’m a proponent of patient participation in their own care plan. I’m a firm believer in the medical team helping a patient help themselves. But the latest medical device to be released by Richmond, Virginia based manufacturer, Kaleo Inc., seems to put this concept into the hands of someone who may not be able to use it at all. Evzio, a hand-held auto-injector that delivers a 0.4mg single dose of naloxone and will be available this summer, according to medical journal reports. Naloxone, commonly called Narcan,

Nursing New Grad – Now What…?

-by David Hechim, SN

What kind of nurses will we be? The first answer, of course is “a good one!” But, where? Maybe not so easy to answer. Especially with the changing dynamic in which health care is delivered. Seems that hospitals aren’t exactly the “place to be”, like they once were. Home health is on the rise. There seems to be a demand for Research Nurses. There are private practices, skilled nursing facilities, community health centers, schools, the list seems to go on and on. But the first question a lot of us will be asking ourselves after our final is, “Where would I really like to work?” The answer to that question is probably a lot closer than we might think. For myself, I look back on all of our clinical rotations. Do I want to be a Psych Nurse? Pediatric Nurse? Work in Labor and Delivery? Med/Surg as a floor nurse? Oncology infusion clinic? Wound Care? Dialysis? OR? ER? ICU? Which one of these felt right for me?

Nursing is a serious business...especially on Halloween!

Instructor Beth Smith prepares for an important lecture.

Fun Time at the Health Fair

Every Fall Semester Nursing Students participate in a College Health Fair where dozens of health-related exhibits are on display.  Once again, our team of amazing students made a serious impact performing glucose tests for diabetes, giving flu shots and demonstrating the art of washing hands!

I Want My Apps and I Want Them Now!

Need Nursing apps for your smartphone?

Relax.  Click here.

A LIttle Drop Will Do Ya?

What if routine bloodwork was near-instant and near painless? 

What if a pin-prick of blood,  say a microliter, could provide enough sample to allow hundreds, maybe even thousands of tests to be run? 

 

Photos courtesy of Theranos, Inc.

 

That future is actually be here and you can see it yourself at the local Walgreens Pharmacy in  Palo Alto, CA.  Starting today (Monday 23 September 2013) and soon nationwide.

A recent Wall Street Journal article profiles the genius and entrepreneur behind Theranos, a med-tech company you'll be hearing much about soon.  Meet 29-year old Elizabeth Holmes.  A  Stanford drop out at age 19 (sound familiar?) she cashed in her college fund and started up Theranos,  Her company has been quietly working on dramatically reducing the time and cost of common and not-so-common laboratory tests. 

Imagine, as nurses, you could eliminate the pain of large volume blood draws.  Lower risk of anemia.  No more dealing with collapsed veins.  No tears from a sick child.  No long waits on critical tests.  Welcome to the next wave of medical science.

Let the Clinicals Begin!

Congratulations, N211 Students!  You've completed your Pre-Clinical training and are on to your clinical rotations.  Welcome to the next level of your nursing education.

San Francisco VA Hospital - one of the many hospitals CSM Nursing Students will experience.

New Warning from CDC

Superbugs - mutating strains of disease-causing pathogens - are increasingly killing people worldwide and the problem is getting worse.  Overuse and misuse of antibiotics are often cited as the most common reasons.

Click on the image for larger view

As healthcare professionals we are not only on the front lines of a global battle but in some ways we are also vectors.  CDC notes that annually, 250,000 hospitalized patients contract Clostridium difficile -  aka C. difficile, and that 14,000 of those patients die from the infection.   

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Looking at the range of growing threats, the numbers are staggering.   In the U.S.: at least 2,049,442 illnesses and 23,000 deaths.  The latest CDC report outlines the impact on patients and healthcare costs.

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You can download this 113-page report from the CDC (PDF) from this LINK.  Find out who

Look Out World! Here They Come!

Congratulations to our new graduates - College of San Mateo Nursing School Class of 2013.  We are so proud of you!  And wow!  Check out those super-clean hands!

Wash Your Hands or Lose Your Job?

Imagine this.  It's 23:00 and time to start your shift in PICU.  Your first assignment is to check on a post-op patient and do a cath change.  Video cameras follow you and transmit images to a company in India where you are being watched.  Actually, not you so much as your hands.  You did de-germ, right?  You were thorough, yes?  You do want to keep your job, correct?.  

You know why.  Dirty hands kill patients.  According to the New York Times, it's also about controlling costs.  Like $30 Billion USD annually in the US alone.  Hospitals everywhere are experimenting with all types of methods to improve hand hygiene. 

Want to know more?  Check out the CDC site on Hand Hygiene.

Need more inspiration?  Watch these videos!

Treating Stroke Victims with Stem Cells

Experimental stem cell therapy at the University of Glasgow's Institute of Neuroscience and Psychology (Scotland) on 5 ischemic stroke patients seems to work, although it's still very early in the clinical trials.

All 5 patients exhibited - and sustained - reductions in neurological impairment and spasticity.  While the results were minor, small changes did impact the quality of life.  The more exciting news is the university has been given the go ahead to proceed with the next phases of the trail, called PISCES (Pilot Investigation of Stem Cells in Stroke).  This is the world's first regulated clinical trial for disabled stroke victims.

 

Picture courtesy of  Sky News

You can read more about this incredible medical advance at these links:

• From Sky News
• From University of Glasgow 1
• From University of Glasgow 2

Gross!!!!

Bedbugs in Hospitals?  Yikes!

Pest control companies are doing a booming business treating hospitals, nursing homes and even ambulances for bedbug (cimex lectularius) infestations.

Yuk!  Photo courtesy of Orkin Pest Control

A recent story by Marketwatch.com reveals the dilemma facing care facilities and how difficult it is to prevent infestations.

Supposedly, bedbugs do not spread disease, but there are new questions, particularly in high vector environments like nursing facilities.

While new solutions are in development budget cuts and social dynamics make this a long term problem.

Got an itch?  Could it be....?

Earth Day Nursing

Earth Day is a great time to think about now the Nursing profession continues to evolve and adapt to new technologies, practices and, yes, sustainability practices that impact our Planet and patients. 

The National Institutes of Health (NIH) offers a comprehensive library of environmental health resources to help you explore a vast inventory of technical and informational journals.

Before clicking on this link be sure to have a fresh pot of coffee.You'll be here for a while.

Need a simpler explanation of Environmental Health Science to share with friends and patients?  Here's a fun and fast explanation (thankyou University of Michigan) that you can share with friends and patients.

WORLD TB DAY...XDR - Are You At Risk?

24 March heralds "World Tuberculosis Day", one of the worst human diseases. As Nurses, we are on the front lines to screen for TB.

TB is an airborne, infectious lung disease that is (usually) preventable and curable.  The good news is the global war against TB is making progress.  The bad news is it's mutating into new strains categorized as multi-drug resistant (MDR-TB) or extensively-drug resistent (XDR_TB) strains. 

Most of us have never experienced the threat or impact of TB but in fact we are always at risk.  According the the World Health Organization (WHO), the global war against TB is working, but with mixed results.   Although the data from developing countries are unclear, WHO notes a 6-fold increase between 2006-2009 in these new strains.  Here in the U.S., WHO reported in 2011 over 100 cases of MDR-TB. The same report shows almost 700 HIV status patients with TB co-infection. 

In today's world of global migration and travel, you remain a vital part of the international effort to battle TB.  One of your particular challenges if treating a TB-positive patient will be patient education.  As TB becomes more drug resistant, so will the side effects, potential toxicities and treatment durations.  Read more about this global effort on the comprehensive WHO website. 

More news about MDR/XDR-TB:

• China - Independent Online, Capetown, South Africa, 7 June 2012
• CDC Report - February/March 2013
• South Africa - US News & World Report, 11 February 2013
• Worldwide Trend - Reuters, 30 August 2012
• India - Nature, 13 January 2012
• International Union Against TB
• European Union - Al Jazeera, 14 Sep 2011

Come to our OPEN HOUSE!

Mark your calendar for Tuesday, 26 March.  From 1500-1700 (that's 3 pm to 5 pm for you non-nursing folks) we are hosting an OPEN HOUSE to showcase our Nursing Program, Skills Lab and much more!

Meet students, staff and faculty.  Explore our 8 room / 14 bed "hospital".   Go "behind the scenes" of our advanced simulated patient lab and experience how simulation brings sophisticated reality to teaching and bridges theory with clinical training. 

If you're a past graduate and you haven't been up to the campus lately - you've got to see our new digs! 

Thinking about a career in nursing?  Check us out!

(Click on the pic for a larger view)

Other Nursing Blogs

Wonder what other nursing blogs have to say? 

Here's a small sample of the Nursing Blogosphere.  Some are no longer updated but are still interesting.

• Pixelrn - Life as a Nurse
• Health & Nursing Issues Australia - Nursing "down under"
• Head Nurse - "Brain on top, spine down the back."
• Becoming a nurse - "Diary of a midlife career change." (Dated but interesting.)
• Nurses Guide Blog - A collection of nursing issues
• Student Nurse - stories of a nursing student's life (not current but still lots to read)
• The Student Nurse - A man's perspective on his student nursing experience
• Just Call Me Nurse - A mom becomes a pediatric nurse
• The Nursing Blog - A Filipino perspective on the international world of nursing 
• My Strong Medicine - Adventures of a male nurse
• RN: Real Newbie - Tales of life as a new nurse
• Mental Health Nursing - The view from London
• NurseALI - Musing of a new nurse
• Confessions of a Student Nurse - Real nurse. Real stories.
• She's Off Again -  Life as a UK Mental Health Student Nurse
• The Nursing Site Blog - A bit corporate, but lots to read
• Nurses on Duty - Interesting perspectives - big focus on nutrition and diet
• Code Blog - Life as a nurse
• Underside of Nursing - Poetry meets nursing
• Ultimate Nurse - Stories of important nursing issues
• Reality RN - Cartoons, stories and much more
• Happy Hospitalist - Collection of odd and interesting hospital experiences
• Bob the Nurse - Bob likes to play with dolls. 
• At Your Cervix - L&D nurse tells all
• Nurse Power - Writings of nurse and author
• Student Nurse Lisa - The view from Sydney, Australia
• Tales of School Zoned Nurse - life as a school nurse
• The New Nightingales - an e-book of sorts that follows 2 British nursing students from the 1980s through today

Do you have a nursing blog or have one you'd like to share?  Email your favs to csmstudentrn at gmail dot com.

Injured by Hand Sanitizer?

(Portland, OR) Here's a sad but important news story from The Oregonian about a pediatric patient who was severely burned in her room and the culprit is hand sanitizer and static electricity.  While rare, it does suggest heightened awareness of the potential fire danger from hand sanitizer.

Eewww! What's that Smell?

It's not easy being a student nurse!  Students Alex Ruman, Santiago Tan and Cecilia Velasco are learning the "joys" of managing patient stomas.

You can read more about the Student experience in the hot-off-the-presses January 2013 edition of the Nursing Student newsletter VITAL SIGNS.  This month features Hispanic-American perspectives in Nursing, discussion of our 8-week course cycles, pain management, life as a Student OR Nurse and a collection of great pictures and other news.

If you'd like a copy contact Alma in the Nursing Office.  (Sorry, we're not posting contact info on the blog at this time.)

Dead Men Do Tell Tales

Ok.  This is a bit off the nursing topic but if you have any interest in forensic medical science, this is a great story.

Recently, the bones of King Richard III (no...not the "Lionhearted") were discovered under a parking lot in the central England town of Leicester (pronounced "Lester").  In case you don't remember your 15th century history, this was a nasty sort of time for the Monarchy.  Richard III was quite the wicked one and his reign lasted only a couple years when he was "killed" in battle.  What makes this an interesting medical story is how his bones were validated and the amazing detective work required. 

Richard III was definitely killed.  Rather horribly it turns out. Also explains why he was buried in such an unusual manner.  Read the BBC story and more.

BTW - Leicester is about an hour drive north from London up the M1 in case you are thinking about visiting. If you are inclined you might want to pop in for a draft at the old Globe pub, just walking distance from the archeological discovery.   The Steak and Tiger pie is fantastic!  Oh, if you're there after dark and feel a mysterious presence...it's just a few old ghosties.  Seems the place was once a waystation for folks awaiting execution at the nearby Gallowtree Gate.

Yikes! Infectious Diseases!

 As a healthcare professional you are on the front lines of disease control.  Here in the San Francisco Bay Area we are increasingly seeing a rise in rare and obscure diseases as more people travel globally and immigrant populations settle here.

An obese 50 year old caucasian male with a history of Type II diabetes is assigned to you for basic patient education. In the course of conversation he describes what sounds like diabetic neuropathy and you begin to probe further for your report.  You ask about his travel experience and he reveals last year he spent a month in southern India at an Ashram that practices ayurvedic healing and therapies.  Upon performing a full body scan you notice some small unusual lesions on his feet.  Could it be leprosy (Hansen's Disease)? 

It's flu season and a parent brings in her 3rd grade child with symptoms of extreme stomach pain, diarrhea, and vomiting.   The mother is educated and affluent.  She reports several of her child's schoolmates are also sick with the same symptoms.  In fact, 2 other kids from the same school are in the ED now.  Her child attends a prestigious private school near the local university that also serves visiting scholars (with school-aged children) from developing countries.  Maybe it's norovirus.  Maybe it's influenza.  Or maybe it's shigellosis, a "rare" and easily communicable parasitic infection, particularly among children.


You are responsible for reporting infectious diseases to authorities.   If you're not up on what those are check out the CDC Summary of Notifiable Diseases.  Asking the right questions can be critical and possibly life-saving.  You might also want to read the Neglected Tropical Diseases report. 

The data are constantly evolving but fortunately you can stay on top of the latest by visiting the CDC Morbidity and Mortality Weekly Report (MMWR). 

Measles.  Mumps.  Zoster.  Yuk!  What about traditional vaccines?  The CDC has excellent resources on this topic, too. Check out these 2 resources:

1. Recommended Immunization Schedule for Persons Ages 0 to 18
2. Recommended Adult Immunization Schedule

When no one is looking!

Hey! No cheating!

It's bad enough these SIMs sneak around when the students are gone but they're setting a really bad example for the others. C'mon girls - at least play fair! (Click for a larger view.)

Ho! Ho! Ho!

Nursing instructor Ilene Simon (aka: Santa Gauze) attempts to herd her unruly reindeer.  Our elfin sources confirm NO egg nog was present at the time of this photo.

The "reindeer": Jamie Sleeper, Ramanpal Punia, Daisy Salmeron, Eva Torres, Angela Ballesteros, Dominc Brignetti, Joey Cortes, Clarrisa Aguinaldo, Allison Fuller