Thursday, November 11, 2010

We wear our Poppies

One of my favorite songs for Remembrance Day was written by a man, Terry Kelly, who wrote it after an experience in a drug store when over the intercom shoppers were asked to observe 2 minutes of silence in memory of our fallen soldiers - on the 11th month at the 11th hour on the 11th day - and the one man who didn't.  Here it is in French.
It is at this time Canadians pause to remember - where ever they happen to be - for 2 minutes....remembering those who have made the ultimate sacrifice for our country.





Then there is a band "The Trewes" who wrote this song when one of their friends from Nova Scotia died in 2006 in Afghanistan.

In Ontario, when a Canadian soldier dies for his country in Afghanistan they touch Canadian soil at Canadian Forces Base Trenton in Ontario. From there, a funeral procession leaves the base and heads to Toronto, taking our departed heroes to the Centre for Forensic Sciences.

 Along the 172km path of Highway 401 -  people spontaneously line the overpasses to show their support, waving Canadian flags and signs or standing at attention,  paying their respect to the fallen and their families.

This portion of Highway is now called the "Highway of Heroes".

All proceeds from this song goes to a fund that awards scholarships for the children of the fallen soldiers:

Wednesday, November 10, 2010

Remembrance Day Sale

Holiday Sales.

It is something every store chain has every holiday in the USA - at least -  if what I see on every American TV channel is any indication.

But try it in Canada....on a certain holiday.....and all that store gets is bad press.

As the story goes,  Eddie Bauer needed to dump some of it's merchandise in this "recession" market - so this past Friday, they geared up with their newly minted "Remembrance Day Sale".  Now,  I can see how a company that is based in the USA can make an error such as this - assuming that Canadians are similar to Americans - because after all, we do like a good sale just as much as our southern neighbors do!

An immediate outcry ensued - demanding that Remembrance Day should be a day of commemoration, with "admiration, respect and honour for our veteran" and is not meant to be treated as "just a holiday".  Veterans voiced their displeasure and Canadians quickly -  via Twitter and Facebook - took up the hue and cry to preserve this day as sacred and to denounce the intended Eddie Bauer Remembrance Day Sale as "disrespectful".

 As a result:

"Eddie Bauer president Neil Fisk issued a statement saying the Canadian sale was based on a similar promotion held in the USA.
The Remembrance day sale was meant to be the equivalent of the Veteran's Day promotions held in U.S. locations, he said.
We appreciate the sensitivity around this holiday and the feedback we have received.  We have tremendous respect for Veterans across Canada and the U.S. and will adjust our marketing accordingly," Fisk said. "***

 Going to their website, I see that they have withdrawn it's Canadian campaign, but I still see them advertising their "VETERANS DAY SALE".......



Which leads me to deduce -  according to what Mr. Fisk says - the company either only has respect for the Canadian Veterans....or they are really only responding to the pressure from their target shoppers - and there is no *actual* regard for any Veterans - whether they be Canadian or American.

I will let you decide......



$Cha-ching!$





***TheChronicleHerald.ca (Canadian Press)

Tuesday, November 9, 2010

Our Ten Dollar Bill, In Rememberance, Prelude to November 11


Our paper money is known to be quite colorful. 

One of the most common denominations of our paper currency, the $10 bill is a commemoration of those who have sacrificed their lives for our country.

On the far right you can see Robert Metcalfe - a British soldier during WW2 - pictured standing at attention at an Ottawa Cenotaph.

Amazingly he survived the German Blitzkrieg on the European mainland albeit wounded in the legs with shrapnel.  En route to the hospital, his ambulance was ambushed by a German tank.   He was evacuated via Dunkirk - and out of the 3 ships that sailed, his was the only one that survived a severe hit by the enemy. 

On his recovery, he was sent to fight with the allies in Italy and North Africa.  En route, his ship was chased by the Bismarck.  They made it to North Africa and he served under General Montgomery, fighting against the "Desert Fox" Rommel.  It was there that he met and married a Canadian Physiotherapist.

After the war, they moved to Chatham where he was involved in politics, then retired to Ottawa.

For the next 60 plus years he volunteered - raising money for Veteran's causes, speaking for the Royal Canadian Legion to high school students, and acting as a volunteer guide in the War Museum bringing to life the sacrifices made by the Canadian troops.   He hosted trips (often at his own expense) by veterans and their families to the different cenotaphs, battlefields and cemeteries in Europe.

When he was 80 he wrote a book about his experiences.

Breast Feeding

I was over at the Man-Nurse Diaries reading some of his past blogposts. I ran across this one - "Dad's Prefer Breast Feeding" and had to chuckle - especially when I looked at his pie chart on why....

It reminded me of a story my mother told me once a while back (she would kill me if she knew I was repeating this, but, uh,  oh well - there isn't anyone I know reading this anyway, except for my girlfriend Jan- and she knows everything about my screwball family so it's gonna be no big news to her!)

 It is one of mom's own breastfeeding stories.

My mother breast fed all of her children - all five of us - in an era that encouraged bottlefeeding - the 1950s.  Or - should I say - actively discouraged breast feeding, so I am quite proud of mom for doing what she thought right when there was so much pressure around her to give it up or made to feel somehow that it was wrong.  It seems that milk production was not a problem for the women in her family.  She took to it really well.

So well, it seems, that at times she sometimes had too much milk - if there is such a problem. (which I don't believe!)  What to do when there was no baby around to feed and there is a little bit of excess and she isn't (for some unknown reason) wanting to pump and save?

So - fast forward to many years later when mom was in a group of women from her church who were discussing breast feeding.  The Pastor's wife had just had her baby and it seems that she had the very same "problem".

Of course she asked my mother, being the experienced and wise sage in the women's group,  what she did when the milk was overflowing and there was no baby to put to the breast.

Mom paused, slightly embarrassed.

"Oh, my husband took care of that" she replied sheepishly with a little smile.

 Way to go Mom.   Not the visual I really wanted.

Monday, November 8, 2010

White Coat, Black Art

I often listen to CBC (Canadian Broadcasting Corp) radio in the car as I am driving places..... and there is an MD that comes on regularily that gives interesting talks on various subjects.

Here is the plug.

I enjoy listening to his program when I get the chance.
For example - here is an interesting programme on "Healthy Design" from November 5th (repeated Nov 6 and 8th).   You can listen to the sound bite - which expands on the actual intro  by clicking on the audio beneath the article introduction.

It discusses errors made due to electronic devices to the design of hospitals that require RNs to take more steps than they should in the course of a shift to the changes made in psychiatric facilities.

He presents medical topics in a way that is clearly understood and interesting.

Check it out.

In Addition to.............

Emergency Blues made a very good point in this blog entry.

 I came to a similar conclusion - that your employer may throw you under the bus to save themselves -  with my blog entry in October - Murder in the Hospital.


Listen to this free advice from a Lawyer:






And now the police - agreeing with the lawyer, by the way:

Sunday, November 7, 2010

Passion for Nursing

I found Digital Catharsis via Emergency Blues.....
He is a Nurse working in the United Emirates.  His site is worth checking out.

He posted this Youtube Video, which I loved:




It got me thinking about what nurses do.....and what a difference we can make in the lives of others.  I suppose in the past I have taken for granted what people in the "world out there" experience, and although it is all "routine" to us - to those we come in contact with - it is more than routine....it can be  life-changing -  the height of joy and the depths of despair - depending on where you work and who you are taking care of.

The older I get, the more I appreciate my calling.

When I was younger, I have to admit that I did take it all for granted.

Being a Nurse.

There is nothing more reassuring to a patient than a Nurse that is passionate about his/her profession.

Friday, November 5, 2010

Obstetrical Emergencies BC

I was wandering around on the Internet and I stumbled across a Workshop Presentation by  Perinatal Services BC in May 2010.

 It's a great presentation by an RN and 3 MD specialists - one of which I knew as a Resident when I was working as an L&D RN at a particular Hospital.  She was fabulous and when she decided to go into Obstetrics as her specialty....we were all thrilled (Yay Jen!).  The hospital that has her practicing there is very lucky. 

Also, in the audience, I recognized at least 3 of my former co-workers.  

Here is the presentation.

  It is at least 3 hours long, if you have the time - it is well worth a look.  Hopefully, if you are in the USA, you are able to view it.  It is a great presentation for student nurses as well as RNs.  I would use a little caution if you are a pregnant mom and have no medical background because some of the things discussed, you may not want to hear.

The first part by the RN was a bit of a snooze - but a good refresher nonetheless - the physiology of a Normal Delivery.   Following her are 2 Obstetricians and a Neonatologist giving very interesting presentations backed by numerous studies.

  Here are a few of the highlights in case you are interested : 


- You don't need to do an episiotomy to deliver a shoulder dystocia.  It is not a 'muscle' or 'tissue'  problem but a bone on bone problem.  You also don't need to do an episiotomy for an assisted delivery.  Studies have shown that increased peritoneal trauma occurs with routine episiotomies.  Be patient!!!  Allow the perineum to stretch on its own!

-  Mom pushing on all fours is desirable and is helpful in a dystocia and also with malpresentations.  Delivering on all fours is generally a good idea.

-  Second stage starts when a woman is fully dilated AND has the urge to push.  Take care when diagnosing prolonged 2nd stage -  2nd stage is diagnosed incorrectly if woman is pushing without the urge to push.

Physiologic pushing is best and we should modify how we encourage moms to push.  In other words, shorter pushes without breath-holding  - which the mother does instinctively -  until the very end.   We need to do away with those 2 hours of 10 second-breath-holding-counting-to-ten pushes with each contraction.  All it does is exhaust the laboring mom.

-  "Rotisserie" of mom is a good thing.  In other words....keep changing positions throughout labor.  Moving and mobilization is desirable and is proven to be beneficial to mom and the delivery of babe.  There is a drop in interventions in labor when a woman is allowed to mobilize.

-  Mom is the best incubator if you have to do a transfer to another hospital.

-  With careful case selection  and management, it is reasonable and safe to deliver breech.  Vaginal breech delivery is now an option for some Canadian women.

-  Low dose asa is being revisited as a treatment for prevention of preeclampsia.

-  It is beneficial to delay cord clamping.

-  IV oxytocin should not be given IV push post partum unless mother is on a cardiac monitor.

-  Treat a mother presenting with intrauterine demise (IUD) as a DIC unless proven otherwise.


Most of the information above doesn't surprise a lot of us L&D RNs....except that it is coming from Obstetricians.   In BC we are lucky to have a Perinatal program that seeks to optimize Neonatal, Maternal and Fetal health care throughout the Province.

Thursday, November 4, 2010

Travel Warnings: True Horror Stories

While we are on the subject of  Real Life Travel Horror Stories,  our Canadian Government has a couple of stories of Imprisonment on their website.   They don't sound real to me...but there is one story of a nurse "Lucie" who smuggled drugs.....     www.travel.gc.ca/truestories   not that anyone would do something as foolish as that.

But - you don't have to necessarily be doing something obviously illegal to be detained.  There are countries where you can be imprisoned for the most minor infractions of local customs.  The statistics below show numbers but they don't show any breakdown or explanation.

Doing time abroad: Foreigners filling prisons
So beware, for even a friendly kiss or texting explicit messages can get you into trouble.

And then, as if that isn't a cautionary tale as it is....there are other things that can go terribly wrong.

I have done a lot of travelling in my day,  but I will tell you one thing..... I do my homework before going anywhere. 

Wednesday, November 3, 2010

RISK - Nursing in a Foreign Land

She was a  Nurse Manager on a unit I worked on at one time, back when we called them  "Head Nurses".  Most of the nurses on the unit didn't really care for her....she was *old fashioned* - and not in a good way, or sensible way.   But - she did have her "posse" that she hung out with and were her "faithful few".

She ruled it MANDATORY that all nurses on her unit were to wear caps! (I didn't even own one)  Also - It was mandatory to wear pantyhose with the uniform-even pant scrubs. Her reasoning? -  to "catch the pubic hairs" when you had to go into the OR - it was a "hygienic" thing she said (although I have no idea what she expected would happen when the alternate-gendered nurses and MDs(both sexes) didn't wear their pantyhose). **

Pink see-through scrub dresses were her choice of scrubs for the unit (crawling up on the bed or bending over was problematic, never mind that one's slip would always ride up and bunch up around the waist with these scrubs-revealing everything).

 She would look down her nose at you if you weren't "somebody" or "wealthy".... although she herself spent money she didn't have like it was water and barely had a pot to piss in due to her extravagant expenditures.

 
In her mind - this is what she thought
the scrubs looked like....
She was judgemental of anyone that didn't spend a fortune on what they wore (as she did),  or didn't socialize in a "particular" social circle(as she attempted to do). 

She would never be caught dead buying anything on sale or going to anything less than a name brand store,  or buying the best..... all while going into debt.  She looked at you in horror if you mentioned Walmart or Target or Dollar Store.


It could possibly be that this enormous debt she piled up with all her outrageous spending caused her to look outside of the country to get her finances in order.

From what I hear....it was a nightmare.

I am thinking she would have carried the same attitude with her as an expat in Saudi Arabia.   I am certain she would not have made very many friends with the way she treated people.   

Apparently she did have one friend there....because it was the friend and herself that got into a whole lot of trouble.

When I travel anywhere, I tend to find out what the laws are and then lay low -  following those laws to the letter.  I also avoid doing anything rashly stupid either.  When in Rome,  they say.....

If one is going to a land that actually punishes the smallest of infractions with cutting off the hand and/or public flogging and quite possibly putting you to death,  sensibility might tell one to refrain from going to that country in the first place.  Especially if one has Attitude and No Common Sense.

I am afraid common sense wasn't a strong suit with this chick.

As the story goes, this nurse and her friend got in trouble for taking photos that they shouldn't have been taking.***  Whatever it was they took photos of,  the "authorities" arrested them, confiscated their cameras and detained them.  


 One of the first things they do when you go to  Saudi to work - they will take away your passport and hold it for you.   So, sans passport and sans contact with the outside world, they were imprisoned. 

They were not allowed contact with anyone.  They did not have access to consulates or other friends or nurses.   They were kept separately in a prison stripped bare of any necessities save maybe a sink and a hole in the ground for a toilet, which to this nurse, was quite an inconvenience I am sure.

For several weeks they were kept in prison - probably one that was a step up from your regular Saudi prisoner but devoid of any niceties.   It was the not knowing what was going to happen to them that ate at them.  They must have been well aware of the possibile consequences.

When you travel to another country, there is only so much that our government can  and will do.  I just got my new passport sent to me from our government and some of the cautions they sent along (an information pamphlet included) are:

1. Your Citizenship offers no immunity
2.  Consular officials do not intervene in private legal matters, do not provide legal advice, do not post bail or pay fines or legal fees.  They do not investigate a crime or death, they do not ask local authorities to give preferential treatment to Canadians.
3.  They do not make travel arrangements, or pay for any expenses, and they do not coordinate and pay for search-and-rescue efforts to locate missing Canadians.
Peeking through the opening through which dinner is served at a Riyadh prison

Basically, they were at the mercy of the Saudi Government.

Luckily for them, due to the Saudi Government's good graces, within a couple months, she was sent home to her country - tail between legs - and unfortunately was given her old job back.  (Question.  Why do they always seem to do that?)

In her absence there was quite the shakeup and major changes made at the hospital back at home.  No longer was it mandatory to wear the white caps.  The pink scrub dresses were still around, but most nurses had switched over to the greens.   She had lost control of *her* crew.  

It didn't take long.....she was ousted quietly from her position....and put in charge of some innocuous area in the hospital where she could do little damage (why do they even bother?).


  I was never so glad as to leave that place for good. 

***************************************************************

**note her evidence based nursing decisions here.....(no need to ask - I am being sarcastic)
***As an aside here, though - I have a couple other nurse friends who have worked in Saudi,  and neither of them say they had any problems whatsoever....and they had taken many photos without incident.   Let's just say that someone ruffled a few feathers of someone with influence....