Nursing week, PEP day, Herbal Products, and a new staff member.

Most of you have probably seen this joke before, but it's funny the second time around too!

You know you are a Nurse when...

1) the front of your scrubs reads “Nurses…here to save your butt, not kiss it!”
2) you occasionally park in the space with the “physicians only” sign… and knock it over.
3) you believe some patients are alive only because it’s illegal to kill them.
4) you recognize that you can’t cure stupid.
5) you own at least three pens with the names of prescription medications on them.
6) you believe there’s a special place for the inventor of the call light.
7) you believe that saying “it can’t get any worse” causes it to get worse just to show you it can.
8 ) you wash your hands BEFORE you go to the bathroom.
9) you believe that any job where you can drive to work in your pajamas is a cool one.
10) you consider a tongue depressor an eating utensil.
11) eating microwave popcorn out of a clean bedpan is perfectly natural.
12) you have been exposed to so many x-rays that you consider it a form of birth control.
13) you have heard a patient with a nose ring, a brow ring, and twelve earrings say “I’m afraid of shots.”
14) you have placed a bet on someone’s blood alcohol level.
15) you have told a confused patient that your name is that of a coworker and to call if they need help.
16) your bladder can expand to the size of a Winnebago’s water tank.
17) you have seen more penises than any prostitute could dream of.
1 you believe that not all patients are annoying…some are unconscious.
19) your family and friends refuse to watch medical sitcoms with you because you spend the whole time correcting everyone and pointing out upside down x-rays.
20) you don’t get excited about blood, unless it’s your own.
21) you have sworn to have “do not resuscitate” tattooed on your chest. Soon.
22) discussing dismemberment over a gourmet meal is perfectly normal to you.
23) your idea of fine dining is anywhere you can sit down to eat.
24) your idea of a good time is a cardiac arrest at shift change.
25) you believe in the aerial spraying of Prozac.
26) you believe that “shallow gene pool” should be a recognized diagnosis.
27) you believe that the government should require permits to reproduce.
2 you believe that unspeakable evils will befall anyone who utters the phrase, “Wow, it’s really quiet, isn’t it?
29) you have wanted to write a book entitled, “Suicide: getting it right the first time.”
30) you have ever had a patient look you straight in the eye and say “I have no idea how that got stuck in there.”
31) you have had to leave a patient’s room before you begin to laugh uncontrollably.

HAVE A GREAT WEEK!

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It has been a while since I've posted anything, but I have lots of updates and new information to share from the ASPAN Conference. It will take me a while, but I will pass on as much info as I can. I did leave a copy of the AANA Journal (American Association of Nurse
Anesthesia) in the Block Binder along with some pamphlets about Nurse Anesthesia for anyone who might be interested in this role.

Thanks to all who came to the PEP retreat, feedback was very good, and I thought I would share the evaluations with you.

PEP DAY EVALUATIONS MAY 2TH, 2008
Evaluations collected – 58
1. Was this retreat what you expected?
Yes:48 No: 10
2. Did you enjoy it?
Yes:57 No:1
3. Were the presentations relevant to your practice?
Yes:58 No: 0
4. Did you realize anything today that might make you deal with the challenges you face each day a little easier?
Yes: 52 No:6

What did you like best? (In order of popularity)
All Aboard the Change Train-Rosita Hall
Out of Africa-Peter Chu
EVAR-Andrew Dueck
RNFA-Grace Groetzsch
A Complaint Free World-Ramona Hackett
What didn’t you like?
· IP&C – they were very rude & accusatory
Not the right venue to do this
Too much equipment thrown in the garbage
Other Comments
· Good Job – thank you
· Fun upbeat day
· Well organized
· Very Exciting day – enjoyed
· I enjoyed the whole day – by far the best
· Excellent motivational speaker
· To all educators – an excellent job
· Everything was great – no more complaining
· Vegetarians need protein – not just cheese
· Lunch need more meat or chicken no vegetables
· More social seating for lunch and coffee
What ideas do you have for next year?
· NP role
· Have a paid speaker again
· More presentations by the nurses
· Praise and recognition of staff
· Blood conservation
· Retirement
· Nurses in business
· Benchmarking
· Patient outcomes and patient flow issues

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At the ASPAN conference, I picked up an interesting pamphlet about Herbal Products and Anesthesia.

Herbal products are also known as dietary supplements, alternative therapies, complementary medicine, and homeopathic health care. There are few instructions on proper use and dosage requirements, and little information about possible side effects, toxicity and possible drug interactions. While many herbal products offer noticeable health benefits when used correctly, taking these products right up until the day of surgery may have an impact on the success of the anesthetic and/or procedure.

Herbal products should be stopped at least two weeks prior to the scheduled procedure to prevent side effects. Surgeon, anesthesiologist and nurses need to be aware of any herbal products that are being taken including over-the-counter drugs, dietary supplements, minerals, and teas.

The following are some popular herbal products and possible side effects when interacting with anesthetics:

Ephedra-used for the treatment of asthma, hay fever, and the common cold. It is primarily used as a nasal decongestant, but has also been found in diet aids to promote weight loss. the side effects are BP changes, exaggerated response to high BP meds, risk of heart attack and stroke.

Feverfew-used to treat fever, migraines, arthritis, and digestive problems. The major risk is prolonged bleeding, but also insomnia and anxiety.

Garlic- claimed to help prevent heart disease including atherosclerosis, high cholesterol, high BP, and cancer. Side effects include blood pressure changes and a risk of prolonged bleeding.

Ginger- may decrease joint pain from arthritis, and may have blood thinning and cholesterol lowering properties that may make it useful for treating heart disease. Commonly used to aid nausea, some cultures use it to treat the common cold, flu and diarrhea. Ginger is contraindicated in people suffering from gallstones as the herb promotes the release of bile from the gallbladder. Also contraindicated in people who are taking warfarin. Interactions with anesthetics include sedative effects, risk of bleeding.

Ginseng-is promoted as an adaptogen (a product that increases the body's resistance to stress,) a nourishing energy drink, an aphrodisiac, and in the management of Type II Diabetes. Side effects include insomnia and irritability, and risk of cardiac effects and blood pressure changes.

Kava-is marketed against stress, insomnia and anxiety. Mixed with anesthetics there is a risk of additive effect to medications, increased sedative effects.

St. John's Wort-used as an antidepressant, may help to decrease alcohol intake, and commonly used as an herbal tea. there are many adverse interactions with other medications, some which may prolong the effects of anesthesia. May also cause blood pressure changes.

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Last, but not least I'd like to make an announcement about another new staff member in PACU. Lindsay Richmond comes to us via CrCu. Previous to that she moved to Toronto from London, Ontario where she also worked in ICU. Welcome Lindsay!