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    L Jane Acree

Nurse Job Cruise Ship

oceanSerious as a heart attack! Don’t believe me? Google it. See? The demand is high for cruise ship nurses!

What types of medical personnel are typically assigned to a cruise ship? Larger ships may staff a Chief MD, surgeon, dentist, NP, Chief Nurse, one or more Ship RN, paramedic and others. Smaller ships will require a smaller medical staff.

What are the qualifications? The RN must have a valid nursing license, valid passport, and be able to travel for three to four months at a time at sea. They must speak fluent English and be teachable.

BLS is, of course, required. ACLS is strongly encouraged by some cruise lines, and required on others –  along with experience using it. ICU and/or ER experience, as well as routine nursing and first aid, is needed.

What about the work? If you think about a typical cruise liner as carrying a few thousand passengers, you can imagine how busy the nurses can be at times. There can be an unlimited array of chief complaints – some very serious.

You might have a day where your only patients’ complaints are minor – and then a day where you see a CVA, MI, and AA back to back. It can be stressful. Thankfully, the nurses rotate and do get days off.

Other duties as assigned? Yes, the cruise ship nurse cares not only for the passengers, but is also the occupational health nurse for the crew. The nurse may be expected to learn to run basic lab tests and shoot simple x-rays as well.

In addition, the ocean liner nurse is usually the one to order medical supplies, be in charge of lifeboat drills and exit drills, test water samples, dispose of hazmat, keep the clinic clean, and do lots and lots of paperwork.

What will you get for all your hard work? You get free uniforms and meals plus competitive salary and benefits. You can expect free private accommodations, and some ships allow the spouse to stay as well. The cruise lines generally provide free transportation to and from the ship. And they pay for your malpractice insurance.

So if cruise ship nursing sounds like your thing, but you lack critical care experience, quickly get transferred and trained in your hospital’s ICU or ER. You could also arrange to volunteer some time with your local ACLS ambulance unit for more experience. Do the above for two or three years, and then prepare your resume!

The information provided here came from various online cruise liner ads for qualified RN’s and from related blogs on the subject.

Cheers! and Bon Voyage!

Travel Nurses Needed STAT

Bethel and grounds 074How many travel nurses have you worked with or known? What would entice you venture out and try travel nursing yourself?

During one of my dad’s hospital stays, he had a travel nurse who talked to him about some of the advantages she enjoyed by traveling. Her story was intriguing.

She and her husband were both nurses in their late 20’s. They were unencumbered by too many possessions. They had no children yet. They were 100% free to earn money while traveling as much as they wanted to.

His parents lived in Wyoming, and they were able to work two 13-week stents there. Most of her family members lived in southern California, and they were able to extend their time there to almost a year.

She said she and her husband stuck pins in their USA map at home, after each work assignment there, and they planned to visit all 50 states before starting a family and settling down.

What a life! They always tried to work the same shifts so they could enjoy the region together on days off. And they loved it!

I knew a 30’something years old traveler in the Clear Lake area of Texas, and she loved our hospital so much that she said she kept extending her assignment as many times as her agency would allow.

She did not, however, plan to go to work directly for our hospital because her travel nurse benefit package was far superior to ours.

I have also met a couple of middle-aged nurses, who had become single, and decided they wanted their lives to be more interesting. And they accomplished this by travel nursing.

One even took in and fostered a few different cats from the humane society until they were adopted by families.

I say – why not?

What are some reasons to choose travel nursing?

Get paid to travel

See many different parts of the country

Experience people of different cultures in the various states

Enjoy the famous sights, foods, and people of each region

Excellent benefits packages

Enjoy typically higher pay than stationary workers

Free, fully furnished and supplied, housing – or housing stipend

Get paid while you spend time in regions near family and friends

Learn new ways of doing things

Improve your comfort level with meeting new people

Improve your self confidence at dealing with change

Enjoy how others envy you

Travel expenses to each new assignment are paid in full

Visit famous landmarks that you might not otherwise see

Plan your work assignment areas according to the type of weather you enjoy

Work in unpopular areas, for extra money, if you want to

I could go on and on about the advantages of travel nursing. But what advantages do you see in travel nursing that could benefit you?

Its fun to dream, eh?  Imagine this ad: “Urgent! Travel RN Needed in Honolulu (or your favorite city) STAT!” And who knows? Your dream might become reality!

Dreaming!

Cheers!

Safe Drinking Water After a Disaster

pics from phone 005Let’s pretend that a natural disaster befell your city. If you live in the Gulf Coast area, it would likely be a hurricane. Some other places might experience volcanoes, avalanches, tornadoes, floods, fires, earthquakes, tsunamis, or other catastrophes.

Whatever your region, most people will rush to the stores when they learn something is coming (or just after it hits.) Am I right? I know. I have done it. And I have found store shelves nearly bare.

But some prepare in advance. They pack a go-bag with their most important documents, medicines, photographs, clothes, food, and other essentials.

If you are a nurse, and most of the readers here are, then you probably prioritize your disaster preparing a little differently than others.

As plumbers and electricians scramble to save their favorite tools, you rush to make sure your first-aid kit is stocked with life-saving gear for any calamity that comes along.

You, as nurses, know that safe drinking water is often one of the biggest problems people face after a disaster. And you know how important safe water is for drinking and washing the inevitable injuries that always seem to accompany such situations.

So of course, you will, of course, have some type of water purification device in your kit – sufficient for your own family and probably extra for neighbors. After all, you are the nurse. Family, friends, and neighbors depend on you to help them with problems that are overwhelming to them – but are a piece of cake for you.

So go ahead and drink that nasty water. LifeStraw Personal Water Filter and LifeStraw Family 1.0 Water Purifier will make it safe. I know. It sounds unappetizing now. But when all heck breaks loose, you’ll be glad you are prepared – and so will all those that you save alive.

After all – that’s what you do. You’re a nurse.

Cheers!

Calling All Nurse Preppers

026Nurses, like all people, watch the news. And we don’t like to think about it, but local and national disasters are always possible. And we all know that economic collapse and utter chaos have been predicted for the near future.

Some believe societal breakdown is imminent. (Probable) presidential candidate, Ben Carson, states that this country might not even have a presidential election in 2016 because we may be under martial-law by then.

Whether we reach that level or not, hurricanes, earthquakes, fires, and floods are always possible. When Hurricane Rita came through the Houston area, most of us had not stocked up, and stores were shut down. So what will you do, as a nurse, to prepare?

If your family found itself in a position where supplies and utilities were cut off for an undetermined amount of time, and if medications and gasoline became unavailable – do you have a plan?

As flight attendants say: “put on your own oxygen mask before helping others.” In other words, prepare for yourself and your family first. Then consider banding together with your best friends/neighbors so they can add their strength.

Before the store shelves are empty and utilities are out, Maslow has already taught us how to prioritize our prepping as to – fresh air, potable water, food, shelter – in that order.

Your network of family and close neighbors will likely count on you to treat injuries and illnesses. So what will you want to prepare along the lines of basic first-aid supplies and a way to clean wounds?

People have learned a lot about how some essential oils and other elements can substitute for medications to bring down blood pressure or fever and to heal cuts and prevent infection, etc. So that could prove helpful.

You may be the only one around with any real training to treat the sick and injured. You may not have ever done certain procedures before, but you know the A&P and may have to do the unfamiliar.

People panic in a crisis and begin to loot and pillage those suspected of having food and supplies. So you might want to consider obtaining weapons and ammo in order to respond and save your family alive.

I know. “First, do no harm.” But, in desperate times, danger is a genuine possibility that needs to be thought through and discussed in advance. And if they are trying to harm you or your kids, you might have no choice.

There is a lot to learn about getting and staying prepared – especially for people in the healthcare field. And I have a new website coming soon which will address the various aspects of what prepping looks like for nurses and other humans – especially for small home or apartment dwellers.

I hope you will stop by there and take a look. As soon as it is “born”, its name will be http://www.apartmentpreppers.com .I’ll keep you posted here and on my facebook page: http://www.facebook.com/whatmotivatesanurse !

Cheers!

See no Ebola, Hear no Ebola, Speak no Ebola

016“The Nurse Killer Disease” is Ebola’s nickname in Liberia. And its coming to a hospital near you. Will your hospital be ready?

According to National Nurses United conference call today, and reports all over the country, and abroad, hospitals are NOT prepared for Ebola – not at all.

Why is there no political support? Talking heads just keep talking.

Why do hospitals have no mandated training, no consistent guidelines or policies, no protocols, no adequate PPE or  hands-on training with practice?

Why are potentially adequate hospital isolation rooms not being reserved for Ebola cases – in favor of totally inappropriate rooms?

Why is a nurse being fired, for calling CDC to get advice on how to handle a potential Ebola case, in the name of a HIPPA violation?

How can hospitals get housekeeping to clean Ebola rooms adequately and dispose of used PPE and other waste from those rooms?

How many nurses will die and transfer EVD to others because of hospitals denying adequate training and appropriate PPE?

Per one of the expert speakers – whether or not EVD is classified as being transmitted by aerosol, the EV is now known to demonstrate an affinity to macrophages in the respiratory system where it replicates itself. Tiny particles become airborne as copious sprays of emesis and stool are broadcast. So whether or not the affected person develops respiratory symptoms, inhalation still could have been the mode of transmission.

Donning and removing PPE is, of course, the most vulnerable time. PPE needs to be impermeable. Rooms need to be negative pressure.

Caregivers need to wear respirators – not surgical masks. Preparadigm N-95 respirator is recommended underneath impermeable PPE that covers all. Massive supplies will be sorely needed.

Don’t let your hospital get away with saying that traditional contact isolation gear will protect you. Band together and insist.

If a member of the management team had to enter the room of an Ebola patient, you can bet your bottom-dollar that they would put on the best quality hazmat suit known to man.

Well-known, retired pediatric brain surgeon, Dr. Ben Carson, said: “I have no desire to induce panic, but we must realize that some viruses are known to undergo mutations, which make them even more virulent. If the Ebola virus becomes even more pathologic, the ensuing panic and destruction of human life could go far beyond what is currently being acknowledged…”

Fear, fear, fear, fear, fear. It can paralyze us, or it can push us to action.

Where will help come from? It may need to come from you. Here is your time to shine. Be passionate. Be heard. This is life or death – seriously.

More is being learned daily about Ebola. Know and practice at least the currently accepted CDC protocols found at www.cdc.gov .

The National Nurses United website has created a marvelous “toolkit” that is a must-see for all nurses: http://www.nationalnursesunited.org/pages/nnu-nurses-toolkit . It is a great place to start as you arm yourself with critical information.

If you see a breach of safety, call NNU at: 1-888-381-4585. They promise to keep your call as confidential as possible.

When given a chance to use more – or less – PPE, choose MORE. Cover it ALL up, baby!

L’Chaim! (To LIFE!)

What Kind of Ebola Isolation Breach Occurred in Dallas?

CNN reports a “breach in protocol”. Besides that, I wonder – is existing protocol is appropriate and sufficient?

Apparently, the first US Ebola victim, Duncan, had contact with at least 48 people before being put on isolation. And the nurse who contracted the virus was not among these 48.

At this time, reports say that no breach in protocol has been identified – but they also say that there was a breach. What???

In addition to that conflict, there is still another big question hanging in the air – Are the current protocols adequate for this type of virus? Oh, and are supplies sufficient?

Add to the mix – many of us have worked at hospitals that insisted staff answer their companion phone every time it rings – even if staff is in full isolation gear inside of an isolation room.

This pr028actice is infuriating – to say the least – not to mention that it is dangerous and unnecessary. And I can’t help but wonder if one of these types of practices is what led to the nurse catching the deadly Ebola Virus Disease.

Removing isolation garb is the most critical step in staying protected from the Ebola virus. And the nurse in Spain who caught Ebola said she may have touched her face when removing her mask.

So, in Dallas, was it really a breach in protocol? If so, was the breach noticed – reported – addressed? Is the protocol insufficient?

And the million-dollar question: Have CDC and hospital management teams taken into account all of the other processes that currently interfere with a nurse protecting him/herself and others when working in an isolation room?

Taking your personal stethoscope into an isolation room is prohibited. The same rule should be applied to companion phones, personal cell phones, and all other items in pockets for which a nurse might be tempted to reach.

In addition, nurses in isolation rooms should be left undisturbed by overhead communications (often used in lieu of the companion phone.) Nurses should be permitted to focus on the duties at hand so as to finish and get out of the room quicker.

After all – would it really be that much trouble for the ward clerk or the charge nurse take the call and handle the issue while the nurse is detained in the isolation room trying to save a life?

Yes – a little frustration just popped out there. But you must admit – that is a genuine issue. And it contributes to problems in maintaining proper isolation – whether for Ebola, MRSA, VRE, C-Diff, or other conditions.

So what can the bedside nurse do? Be assertive. Decide to work by-the-book (the CDC book) to save your life and the lives of others. And do not let authorities bully you into breaching accepted protocols.

All you can do is the best you can do. Chances are – your assertiveness will inspire your coworkers to do a better job too.

Cheers!

Ebola – What You Always Wanted to Know

You know those public restrooms with blow-dryers for your hands? Aren’t they great? That is until you want to open the door to get out.

Do you use your shirt tail, toilet paper, or ???

Enter Ebola.

According to WashingtonPost.com Ebola virus can easily live on the door handle for hours and infect you with no problem. Oh – and don’t forget about the toilet flush handle and the sink handle.

And I don’t want to ever shake hands again. Maybe we can just bump elbows!

This virus is transmitted a lot easier than HIV. We are talking about blood, saliva, mucus, vomit, feces, semen, urine, breast milk, and even sweat and tears.

Except for the semen, nurses can come into contact with all of these bodily fluids on a daily basis. And – oh, lovely – the virus stays alive for several hours to several days on surfaces. But simple household bleach kills it.

And if an Ebola-infected person coughs or sneezes into your face, and their saliva gets into your eyes, nose, or mouth, you could become infected.

What are traditional ways to catch Ebola? Initially, it comes from contact with bodily fluids of bats, monkeys, and apes, as well as forest antelopes and porcupines. Once a person contracts the disease, it can be transmitted human to human.

According to CDC, CDC.gov an infected person can transmit the virus only after they become symptomatic. Symptoms include: fever, headache, diarrhea, vomiting, stomach pain, muscle pain, and unexplained bleeding or bruising.

Symptoms usually begin 8-10 days after exposure – but can begin as soon as 2 days.

How long does it take to recover? MD-health.com says that if you survive the first few weeks of illness, you are considered to be on the road to recovery.

After that, weeks of rehab are required to repair muscle damage and restore wellness. The virus remains alive in semen for up to 3 months after recovery, so males can still be a threat for that length of time. EVD can remain in breast milk for a prolonged period as well.

Fatality rate is 25-90% according to who.int .

NPR.org says that the most likely time to die from EVD is in the first 10 days. But if the person survives through the initial crisis, their body will begin to create antibodies against the virus.

Once the person has recovered from the infection, it is believed that they will have a life-long immunization against it. Treat EVD with rehydration and supportive care. There is no approved medication or vaccination as of yet.

Unapproved meds en.wikpedia.org says that ZMapp works a lot like immunoglobulin by producing passive immunity. However, the body itself naturally produces antibodies to EVD in response to the illness. So who knows whether it was the ZMapp that helped the two survivors who have been all over the news lately or if they would have done just as well with just supportive care?

Also, en.wikipedia.org/TKM says TKM-Ebola is the second drug used but is not getting as much attention due to possible side effects.

So, there you have it – On surfaces, use bleach. On your skin, use soap and water or alcohol-based hand cleanMoringa tree in the sunser. Don’t play with wild animals in West Africa. If you get infected anyway, seek medical attention immediately and say your prayers.

And that’s about all I have to say about that.

Cheers!

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