All about Dengue Hemorrhagic Fever.

Dengue Hemorrhagic Fever is a severe, potentially deadly infection spread by certain species of mosquitoes (Aedes aegypti).

CAUSES

Four different dengue viruses are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person catches a different type dengue virus after being infected by another one sometime before. Prior immunity to a different dengue virus type plays an important role in this severe disease.

SYMPTOMS

Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever, but after several days the patient becomes irritable, restless, and sweaty. These symptoms are followed by a shock-like state.

Bleeding may appear as tiny spots of blood on the skin (petechiae) and larger patches of blood under the skin ecchymosis). Minor injuries may cause bleeding.

Shock may cause death. If the patient survives, recovery begins after a one-day crisis period.

Early symptoms include:

• Decreased appetite
• Fever
• Headache
• Joint aches
• Malaise
• Muscle aches
• Vomiting

Acute phase symptoms include:

• Restlessness followed by ecchymosis, generalized rash, petechiae, and worsening of earlier symptoms
• Shock-like state (cold, clammy extremities and diaphoresis)

POSSIBLE COMPLICATIONS

• Encephalopathy
• Liver damage
• Residual brain damage
• Seizures
• Shock

SOURCE

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I am posting this because one patient of mine just died due to this illness. The virus that Aedes aegypti mosquitoes carry is really alarming. Pertaining to the aforementioned patient, I have provided utmost care and effort for the child to recuperate as soon as possible. All along, I thought everything will be positive as I left him. I had two days off and I didn't know what is already transpiring inside the hospital. I had no single idea if the patients I handled were still confined or already discharged.

Suddenly, a colleague of mine sent me a message telling that patient CN already passed away. It is so heartrending to know that the children you treated with quality nursing care are already gone in a snap. More so, this patient's relatives are very kindhearted and sympathetic that's why he's adored by many. I was totally taken aback with that news. I know, he's happy where he is now and I believe that he's watching over us from now on.

One piece of advice: Getting too emotionally attached to patients and their relatives will really give you a heartache eventually. Emphasis on the adverb too. There is nothing wrong with being attached to them, just be prepared enough when this kind of scenario comes into picture.

To all the parents out there, take good care of your children. Don't let a single mosquito bite take away their lives. As we all know, we only borrowed our precious lives from Him. Remember, as what the famous adage says, prevention is better than cure.

Drexel Heinz Magpantay Cruz, RN, RM

Pediatric Nurse

We Are Patient

The word patient originally meant "one who suffers". This is the reason why patients are called such; to serve as a reminder of how patience plays a huge part in our everyday role as care providers. When we attend to the sick and the incapacitated, we are integrally reminded that they need us to be patient with them without telling. When we are burnt-out from a 16-hour shift and we get more calls, we do not complain. Even when we deal with irate, demanding, or impossible patients, we learn to endure and just muster patience some more. This is because we are nurses and a lot is expected from us: skills, knowledge, and attitude. With the kind of service that we provide, patience thus becomes very much inherent in our profession.

But the act of forbearing should not only be used for the purpose of human interaction. Sometimes, in the process of becoming a nurse, we need to be patient within our selves too..

I am a nurse from the June 2006 batch. Since that time I took the infamous board exam everything seemed to become a test of patience for me. Like the rest I had no choice but to retake and create a new victory. I now celebrate a 2007 license. Getting my IVT card was another story. When I passed my NCLEX it was in the midst of retrogression in the United States. My attempts to sponsorship only lead me to accept that it was not the time to force it but a more sensible time to retreat. When my IELTS expired I had to retake in hopes of trying my chances in Australia. I got unnecessary delays in my application and unfortunately was left by co-applicants in doldrums. And just like most of the struggling nurses of today, it has been three years now that I continue to hop from one hospital to another in search of training and volunteering slots, mindless of the promise that maybe someday I would be absorbed because of my capabilities and not because I have the strongest of connections. Needless to say, this has been the common plight of my contemporaries. I am not yet a full-fledged nurse yet my patience has already gone through rough weathers.

There are many instances wherein our patience will be put to test. Not only by the people we deal with, but also by adventitious challenges we face as nurses: the wait for our license to care, the wait for compensated employment, and perhaps ultimately, the wait for a greener pasture and a chance to a better life. Little did we know that when we entered this field we are bound to become the most patient people we could ever be. With the 'sufferings' attached in our profession, we only need to constantly remind ourselves that one cannot be a nurse without patience. We become our own reminder of this virtue.

After a year, I finally got my approval to bridge in Australia. I am still patiently waiting for my turn to serve.

A day in a life of an EMT: A bland week

I've been assigned in SLEX post where it rained long and hard. Still no patient. Apparently, I have been evaded by runs that are potentially learning experiences. I know, it's a cruel thought to hope someone gets careless behind the wheel but let's face it, you get better with experience, and what way to gather experience as an EMT other than being in a superhighway where people don't use seatbelts, don't inspect their breaks, and learned how to drive in Edsa. Well it's not that I want anyone to get hurt, all I want is if something happens.. I want to be there to do my job. Plus I'm really itching to use the hydraulic cutters; man, I'm not part of the extrication team but hell do I want to tear an expensive car into pieces (take that hell-borne capitalists!). Anyway, it was quite a dry shift. All I did was eat, sleep, and watch the hostage taking in Quirino Grandstand. Speaking of which, I felt quite disappointed regarding this issue. Actually, early in the afternoon I knew the hostages were toast. Considering the lack of training of our supposedly best of the best. A few years ago, something similar happened, I don't know if some of you remember; they shot through a child whom they assumed have already died to drop a hostage taker who was starting the cleave the child with his knife but as it turns out, the child died from the bullets the child took, whereas the wounds she got from the knife could have been manageable. Depressing.

Change topic: I was on standby at DLSZ yesterday. It was an overall crappy shift but somehow things came through, we had two patients so time flew a little faster. Both were for x-rays so together it took 2 hours of the 9 hour shift. So, they had an event, Linggo ng Wika. Kids there were really cute, they were wearing traditional Filipino garments the whole day skipping the uniforms. And then there was one this lady passed by and I was like "Wow, that teacher's super gorgeous!" She was wearing a white Filipiniana dress with the hair fixed and all the makeup.

Okay. So maybe I didn't really say those exactly words. Revised it a little. It's not just appropriate since this blog is just a grant and.. well, my other reason you'll know as I let on.

Where was I..? Right, I saw this lady who walked past the ambulance and my jaw dropped. Man she was beautiful. I was warming myself up to approach her and introduce myself until my partner who has been assigned in DLSZ longer than I was, whom I thought was napping (thank God he wasn't) told me that she isn't a teacher and that she's actually a fourth year high school student. I was like "Oh crap, that was close" I mean she looked exactly like a fully developed woman if you know what I mean, it's not like she's got statutory written all over her. Which reminds me, I'd like to share something I've learned from EMT school, which has proven to be true in pre-hospital and clinical practice.. and day-to-day situations such as this.


Never ASSUME; because it will make An ASS of U and ME.

COUNTING MY BLESSINGS

http://jo-cerrudo.blogspot.com/2010/08/counting-my-blessings.html

At Triage...

I worried about buying a new sofa and matching curtains for the living room,
a patient said he is homeless.

I fretted about not getting a pay raise and complained about the stress on the job,
the 55-year breadwinner with the chest pains was just laid off.

I whined about the high cost of L'Oreal and how my highlights do not last long,
my chemotherapy patient was depressed about her alopecia.

I grumbled about my being stressed out with demands of my time from family members,
the elderly gentleman just lost his wife and now is all alone.

I ranted and raved about the nation's state of affairs,
this bright-eyed refugee from a third-world country gushed about free speech.

I complained about being tired from shopping all day long,
this young, gaunt HIV patient whispered, "I'm dying.".

And now that I am being inconvenienced by a little snow and rain,
the horrific images of the tsunami, hurricanes and mudslides just make everything else trivial
and insensitive by comparison.

I had learned long ago to count my blessings.

BAYANIHAN

Filipinos are very warm and caring people. Part of our culture is the practice of "bayanihan". Bayanihan is a tagalog word that signifies the joint effort of a community to help a fellow man in need. Back in the days, when a family had to relocate their home, neighbors would literally help carry the house to a new location by lifting it with bamboo poles. Through the years, this practice has evolved into various ways of helping others.

I am one of many Filipino ICU nurses working in Laredo, Texas USA. Every day, we are exposed to critically-ill patients. We feel the pain that they and their families go through. We try our best to be there for them. It is an amazing feeling when we are able to help a patient recover from a life threatening disease. And it is heartbreaking when despite our best efforts, a patient dies. Unfortunately, this happens often in our line of work.

A few months ago we were moved when one of our fellow Filipino ICU nurses was diagnosed with cancer. What happened to her opened our eyes that it can happen to any of us at any given time. All of a sudden her life changed. From being a nurse, she became a patient. From being the caregiver, she became the one in need of caring.

She had to undergo surgery and now she is having her chemotherapy. Since she could no longer work, the expenses piled up.

To help her, we had a Filipino plate sale a couple of months ago. We cooked adobo, pancit and lumpia. This was a big hit in the hospital. Even our Hispanic co-workers bought and enjoyed the food.

The money we were able to raise was used to buy electronic gadgets for a raffle that would generate a bigger sum. The grand price was a 40 inches plasma TV. Other prices included digital cameras, bluray players, gps and mp3 players. We were surprised with the turn out. So many people from work helped to sell tickets. All in all we were able to raise $9500.

It felt good to know that bayanihan is still very much alive today. Not just in the Philippines, but in the hearts of Filipinos, wherever in the world they may be.

The noble heroes of modern time.

It can never be denied that we, nurses, are vital foundations of any healthcare institution. Without nurses, a hospital cannot function well. Without nurses, who will take care of ill persons 24/7? Without nurses, who will make the patients get better and stronger? No one else can do what nurses do.

There are times that people don't understand the sacrifices that nurses make in order to render quality nursing care to patients. As a matter of fact, the term "holiday" is not anymore included in a nurse's vocabulary. During Christmas season, nurses are taking good care of unwell strangers instead of spending the special occasion with their loved ones. During birthdays, a lot of nurses don't even recognize that it's their special day due to hectic daily routines. Apparently, nurses spend more time with unknown people than their family members. That kind of sacrifice is seemingly incomparable.

Nurses should also be credited for their good deeds. It is very heartrending to know that most nurses receive deprecating and belittling remarks from patients and physicians. We are not owned by someone. We have our own heart, mind, and ego. Hence, we do know how to think, how to react, and how to reason out. We were born to be exceptional nurses and not mere robots.

I admit, we get tired and stressed out everyday but we still manage to put a smile on our faces. A smile that never fades away, a smile that is fortified by the gratification we get from helping people survive life. For us, seeing our patients get well is more than enough. The mere appreciation of the people you've helped to recuperate is sufficient to relieve the tension and stress that we shoulder.

When I was a child, all I desired was to be a physician. It never crossed my mind that I will be a nurse. Now, being a nurse makes me so proud. Without exaggeration, I feel highly esteemed whenever people see the "RN" right after my surname. We, Filipino nurses, should always be proud of our profession. Regardless of the negative upshots concerning our noble profession, we should still be honored that we make an unequaled difference in the lives of people we do not personally know. Because as we all know, it is evident that the Nursing profession faces countless dilemmas nowadays. From the growing number of unemployed and underemployed Filipino nurses up to the noticeably abysmal quality of education that some Nursing schools offer. Hopefully, there will be well-defined solutions to these alarming conditions.

Let us not focus on what is negative, let us give ourselves proper acknowledgment on the great things that we offer to the world. Without the service of nurses, life and subsistence are hardly achievable.

Be proud of what you can do. Be proud that you save people's lives. Be proud because you're a hero. We, nurses, are the undoubted noble heroes of modern time.

Drexel Heinz Magpantay Cruz, RN, RM

Pediatric Nurse

A day in a life of an EMT: Prelude

Firstly, I'd like to introduce myself for future references. I'm Mikey, a Nurse/EMT. I work in Lifeline Ambulance Rescue formerly known as Lifeline Arrows.

Here in the Philippines, most people don't know what an EMT is. But they do know what a paramedic is, although the said term is often misused because people here don't know what it really is. EMT stands for Emergency Medical Technician. It's a profession by itself, providing pre-hospital emergency care to patients requiring immediate stabilization of their airway, breathing and circulation so they can reach the closest medical facility alive and as much as possible without any debilitation. The term paramedic is a skill level of an EMT; from an EMT-Basic, it goes up to EMT-Defibrillation, EMT-Intubation/Infusion, EMT-Advanced, and finally EMT-Paramedic. We don't have Paramedic schools here yet, we only have one EMT school which is in Cubao, despite that they only offer up to the second level.. and the only existing Pinoy paramedics in the whole country are only three; they are sort of retired, and two of which are my instructors. So the next time someone introduces himself a paramedic, ask for their license. The EMT will soon be a legally recognized profession here if ever our respectable senators and congressmen ever start to talk about passing bills (starting with this one specifically) on healthcare.

Anyway, this week I am taking up the second level. It's sort of hard, but I am hoping to get an outright passing mark. When I took the first level which was several months ago, I did quite well.. so the staff has expectations from me that I hope to live up to. It's basically a training module for a basic technician to be adept with the use of a manual defibrillator, a 12-Lead ECG and reading various arrhythmias, and what to do with it. Pretty much, it's like pre-hospital Advanced Cardiac Life Support without much of the bulk in medications. I wish to learn a lot from this class, and I hope I can use everything I learn in the field.

I pre-wite my posts since we had rotations here. If you are reading this, then my classes are already over and have already become a the living epitome of the third chain of survival.

Letting Go

(Excerpt from my published article)

http://jo-cerrudo.blogspot.com/

Redefining 'survival' in a profession that does so much business with death.

I remember when I was still untouched by death-when I was a child who believed in immortality and invincibility. It all changed when I became a nurse and came face to face with the harsh realities of death. Suddenly, the finality of it forced me to see us as the mortals we are. I dealt with my patients' dying by maintaining a "qué será será" attitude. It didn't mean losing my humanity; it didn't mean that I cared less for my patients. It just meant survival for me in a profession that sees a lot of suffering and death.

Until Mr. Contreras came to the ED to die.

It was a warm spring day, and on Bed 3 Mr. Contreras lay dying. Brain cancer with metastases-and the devastation of the disease was finally taking its toll on his 80-year-old body. He was unconscious, but a single tear clung to his right eyelashes.

The ED staff knew him as one of our "frequent fliers." He liked to be called "Abuelo"-Grandpa. He was always pleasant, even when he was in pain. His wife, Rosa, was a proud and feisty woman, and a bit protective of her husband. She used to complain to hospital administration that we were slow in giving him pain medication. "Why can't you give him more attention?" she grumbled.

Now, Rosa sat with hunched shoulders at the bedside. She looked tired and resigned. Her face reflected her fears; her eyes, unspoken misery.

The cardiac nurse told me that the family had signed the DNR papers. Marco, the couple's only child, stood vigil on the opposite side of the bed, gently caressing his father's wrinkled forehead. His face was in agony, but I sensed a quiet strength within him. He would need it now.

I tried to leave to give the family some privacy, but Rosa held on to me with her other hand. "We've said our good-byes. Now I'm letting him go. He wants to die in peace. We're all ready now." Rosa's voice quivered. I nodded because I knew that Marco had reconciled with his father four months ago after a long estrangement.

The intravenous line was removed. The patient wore a clean white shirt. The Foley catheter was discontinued. We all stared in silence at the flickering cardiac monitor, mesmerized by the even graceful strokes. Sinus bradycardia ... pulse 50 and thready. BP steadily going down ... now barely palpable at 70 systolic ... respirations shallow. Abuelo was at the threshold.

The numbers held our attention. Heart rate 40 ... 34 ... 29 ... then asystole. The ED resident shook her head. A gasp escaped from Marco, and Rosa broke into sobs. I stood transfixed as a life ebbed away and the single tear rolled down Abuelo's cheek. His face stunned me. I expected to see suffering, but instead I marveled at a face that in death looked peaceful, almost ethereal. He died in peace, surrounded by love.

Rosa hugged and kissed her husband of 50 years. I tried to say something that I knew would comfort no one but me, but there was a lump in my throat. I just hugged her and we cried together for this wonderful man whose life had made such a difference. "Thank you for everything," Rosa finally said. Mother and son then walked away to begin a new life, and I said a silent prayer for the family.

I remember them to this day, several years later. I hope that their memories of togetherness sustained them through their grief. And I'm thankful that it was a quiet day in the ED, and that I had time to listen and to grieve. From them, I learned what strength there is in just letting go.

IS IT JUST BASIC EDUCATION?

IS IT JUST BASIC EDUCATION?
By: NOEL D. DE OCAMPO, MSN/ED, RN
http://thefilipinonurseforum.blogspot.com/
August 11, 2010

Now that the Philippine Senate is shifting focus, or at least paying a little bit of attention to our country’s education system, it is time for everyone to get involved and join the discussion. With the new administration, perhaps something positive will come out. It is true that the Philippines’ 10-year basic education system is much shorter than the international norm of 12 years. Maybe it is a good idea to adopt such education system. But is it the only system to blame?

It is common knowledge that passing rates in the Philippine Nursing Licensure Examination has been in the decline for the past five years. Many fly-by-night nursing schools, as well as questionable nursing review centers, are continuing to open and many nursing schools not showing improvement in their passing rates are continuing to operate. Shouldn’t there be some form of policy enforcement done by government regulators regarding this problem?

There are too many nurses, but not many places to practice. Many nursing graduates are resorting to the now norm of paying “unscrupulous hospitals” that are taking advantage of the system. It is now common for new graduates to pay hospitals in exchange for “clinical experience”. After these so-called clinical terms, many nurses are still faced with the dilemma of not getting jobs abroad because many of the prospective employers rarely consider “unpaid clinical experiences”. There are too many nurses, a plethora of deficient nursing education programs, and very few chances to get legitimate and paid employment; where will the predicaments end?

The global Filipino nursing workforce positively affects our country economically. If Filipino nurses show greater clinical competency around the world, more job opportunities for future nurses will come with it, resulting in more foreign money coming into the country. It is just fitting that the nursing profession in particular be included in the discussion about education in the Philippines. Many people has been calling for a review of our country’s nursing school systems for many years, or maybe a review of how regulations are enforced. It is time to stop the bureaucracy and time to change the system. Limit the quantity, and instead focus on improving the quality of nursing education with the hope of producing much more competent nurses. It’s time to do the clean-up. Check the system, and check it properly. Close the worst-performing nursing schools. Isn’t it time?

Looking for Bloggers!

I am looking for Bloggers/Photo Bloggers who are in the medical profession (Doctors, Nurses, Administrators, etc) who can write for this blog. The fact that you’re reading this is exactly how you will be exposed. I am writing this in the exact same place where you will be writing your articles. We are growing more and more everyday and what we offer is great exposure for you and your blog --- potential exposure to more than 127,000 members.


Don’t worry if you’re blogging about a specific subject. You’ll be in rotation with others, so one could be writing about nursing, the other could be life in the medical profession, etc. The most important thing is that you have a passion for something, and that you are blogging about it already.

The only requirement is that articles should be relevant to the lives of medical professionals as a whole. Also, you will need to be able to keep up with your rotation. You may need to write an article once every two weeks at the most!

If interested, please send us an email with "Medical Blogger" as the subject to recruiting@definitelyfilipino.com. It is very important that you include links to your articles. I will be in touch with you if I like what I see.

Thank you!

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