Fabulous Nurse Magazine by Sonya Publishing Corporation

Issue 11

Issue 11 November 2011

Sleep yourself

to Skinny

Working While

HIV Positive

Public Speaking

For The Nurse

Tax-Exempt Status

in American Hospitals

Nurses

Healing

With Art

Visit San Franciscoâ&#x20AC;&#x2122;s

Golden Gate

Fabulous Nurse Magazine

Issue 11

Fabulous Nurse Magazine

Issue 11

Fabulous Nurse Magazine

Elsie Ekwa

Editor-in-Chief

riters W

The vision behind Fabulous Nurse Magazine, Ms. Ekwa saw the need for a lifestyle magazine that all at once serves as a celebration of nurses, a guide for better living, a resource for career development, and a guilt-free escape from the sometimes grueling shifts that nurses work. Ms. Ekwa’s distinguished career as a commercial model, college newspaper editor, and intensive care nurse informs and influences the creative and intellectual direction of Fabulous Nurse Magazine. This is evidenced by the magazine’s fresh approach to home life, dynamic content, inspiring stories about real nurses, and professionally relevant editorials. Ms. Ekwa is also the managing editor for the Pacific Writer’s Corner online magazine. She writes as Sonya Justice and speaks on health and wellness issues, the business of writing, and entrepreneurship.

Zee Nickerson Writer

Zee Nickerson has a B. S. in Psychology and has owned several successful Businesses. She is currently a writer, fashion consultant, and public speaker. Ms. Nickerson has taught English in Japan, Communist China and state side. As a thrifty world traveler, she can travel for as little as a $1.00 a mile. Along the way, she taught herself spoken and written French, German, and Japanese. She has traveled in all 49 states and would like to add Alaska to her collection. Her watercolor paintings are currently displayed at the Creator’s Gallery in Jacksonville, Oregon. Ms. Nickerson is pleased to announce she is just starting to twitter at HelloZee! A play on the French words for Let’s Go!

Olusegun Iselaiye Editor & Writer

Olusegun is seasoned freelance writer, researcher, and entrepreneur. He taught nursing students Human Anatomy in his home country of Nigeria before going into fulltime writing. Olusegun, whose mother happens to be a respiratory nurse, is also a huge fan of the nursing profession. His ambition is to offer a meaningful contribution to Africa and his home country. When some give his country a bad reputation, it is good to see that there are many who live by higher standards. It is thanks to Olusegun that Fabulous Nurse Magazine will be bringing you its rating system.

Margaret Smith Writer

Margaret Smith is a native Texan who loves God, family, country, and writing. She has a variety of interests, and has worked in diverse fields from retail to education. Although she is not a nurse, she has done volunteer work in hospitals, where she has always admired the dedication and skill of the nurses she has seen in action. She recently made the decision to become a full-time writer. Margaret enjoys the process of discovery and development in each new project. 6

Masthead/Contributor Publisher Sony Publishing Corporation

Editorial Elsie Ekwa

Art & Graphic Design To submit artwork / ad creative Email: ads@fabulousnurse.com

Advertising & Marketing For advertising opportunities Email: ads@fabulousnurse.com Contact our Sales Director, Tel: (503) 877 – 3617

Writers To submit articles for publication Email: editor@fabulousnurse.com

Reach Us By Post Fabulous Nurse Magazine 29030 SW Town Center Loop E Ste. 202 Wilsonville, OR 97070-9490 info@fabulousnurse.com www.fabulousnurse.com

Issue 11

Fabulous Nurse Magazine

Sara Caldwell Writer

Sara Caldwell is an award-winning writer and the author of three entertainment industry books published by Allworth Press. She has written projects for many healthcare organizations, including the American Hospital Association, the Joint Commission, and the American Optometric Association. Sara is a professor of Media Entertainment Arts at College of the Canyons in Santa Clarita, CA and a frequent workshop leader. She is represented by the ADA Management Group.

Mindy Carney Wirter

Mindy Carney has been a professional copywriter for over fifteen years, working primarily as a freelancer. While not a nurse, she grew up the daughter of a Radiologist and an RN. Mindy’s niece is an RN in a neurology ICU as she pursues her goal of becoming a nurse practitioner. Mindy is the single mom of two daughters, both adopted as infants in China. Mindy and her family have travelled back to China several times. Much of her writing has focused on adoption, parenting, and cultural balance. She holds both a B.A. and M.A. in Communication, having focused first on journalism and then on education. She believes in a lifelong journey of learning, and her favourite aspect of freelancing is delving into new topics and material.

Carol Sowell Writer

Carol Sowell has been a writer and editor for more than four decades. She has edited books for more than a dozen publishers on topics ranging from global economics to mystical sex. In addition, her articles have appeared in Today in PT, National Catholic Reporter, Modern Maturity, and other national publications. As national director of publications for the Muscular Dystrophy Association, she edited MDA’s prize-winning magazine, Quest, and wrote and edited educational materials about medical conditions, caregiving, health care services, and other aspects of living with a chronic disease. She lives in Tucson, Arizona.

Karen Kalis Writer

Karen Kalis has ten years of experience as a professional copywriter. She has worked in industries such as education, real estate, healthcare, technology, and with non-profit organizations. With an M.A. in Creative Writing, Karen’s clients include: Fabulous Nurse Magazine, RMS Technologies, Lincoln Electric, Multi-Care Management, and The EPIC Group. An entrepreneur at heart, Karen focuses on helping businesses communicate what they have to offer with precision.

Matthew Fowler Writer

Matthew Fowler, founder of A Sodality of Wordsmiths, is currently a professional writer for the US government, namely, the US Department of Labor, where he adjudicates claims and writes formal decisions regarding labor issues. He got his start in the career field of language arts as an active duty soldier, civil affairs division, writing press releases and the like. As an active duty soldier he traveled, literally, around the world in various capacities and including combat operations in Bosnia, the Philippines, and Afghanistan to deliver the Army story. His practical experience is bolstered by considerable education, a B.A in Communications and an M.P.A in Public Policy

Issue 11

Fabulous Nurse Magazine

ditorial E

We are the privileged. We are nurses

etter to the editor:

I love nursing. My mom is a great nurse. All her friends are nurses and I grew up surrounded by nurses. My mom and her friends made it seem so easy. They worked in the same hospital. They joined the same associations. They attended the same conferences. When someone at work got pregnant, they joined the efforts to give them a baby shower. Just last year, a co-worker got sick and for weeks my mom talked about the efforts the hospital staff was making to help raise money for cancer treatments. Some people donated their sick time. They always made it seem so easy. Even their bad days were explained away as part of the deal. They stood up for one another and supported each other. As a little girl, I dreamed of someday becoming part of a group like my mom and her friends. It was like a sorority where you have to

pass the NCLEX to become a member. I worked very hard in nursing school to become just like my mom and her friends. But reality is a (bleep). It did not take me long to realize that what I saw as a wonderful friendship and a great support system works only for the members in it. There are clicks in the sorority group. And you are (bleep) out of luck if you are not considered a member of the click. I assumed nurses would embrace me and share the secrets of their knowledge. Some did but they are hard to find.

I have been told by my preceptor and manager that I am a good nurse. So it has nothing to do with my skill level. A co-worker jokingly said some nurses are threatened by other nurses who are younger and pretty. Can nurses really be this petty? Something has to change. Maybe there are nurses who care. I donâ&#x20AC;&#x2122;t want to change professions but this makes life very hard. What should I do? I know this is not the typical letter you receive. I hope you will publish my letter anyway. Rachel G. RN, Cardiovascular Intern. I made the editorial decision to publish Rachelâ&#x20AC;&#x2122;s letter because it highlights a latent problem in nursing. Some nurses really do eat their young. And by young I mean, youthful and/or new to the workplace. Reading this letter made me realize that yes, we nurses are indeed privileged. We have the opportunity to make a difference each and every day. What we do changes lives. It can be hard, yes; which is precisely why we need to support one another. Instead of being punitive, we need to encourage a culture of collaboration and professionalism. Find joy and happiness in the fact that you are doing something kind and noble. Not everyone can do what we do. We stand a world apart from other professions. Nurses belong to an exclusive club whose mission includes proudly dispensing good cheer and a healthy dose of TLC; one patient at a time. We are the privileged. We are nurses. So the next time you see one of us struggling like Rachel, reach out and lend a helping hand or a shoulder to cry on. Let it be your goal to help other nurses succeed as you have. We should strive to keep the good nurses. Only then can we grow and advance as a profession. We are nurses, after all. And, nurses do rock!

Table of

Contents Issue 11

COVER ARTICLES

FEATURES

P.15

P.79

Anti-Aging Super Foods

P.55

Keep Government Out of the Bedroom

Tax-Exempt Status in American Hospitals

P.18

Public Speaking For The Nurse

P.22

Working While HIV Positive

P.64

Male Menopause

P.26

Nurses Healing With Art

P.28

Surviving an Estrogen Filled Workplace

P.68

Sleep yourself to Skinny

P.43

Foot Care Tips From Your Clogs

P.58

Visit San Francisco’s Golden Gate

P.74

Baby Monitor Gift Ideas

WORKING WHILE HIV+

any nurses’ jobs include answering questions from people who have just learned they’re HIV positive. Nurses are well-trained to impart information about treatments, protection of loved ones, prognosis, etc., of the AIDS-related virus. But when it’s the nurse who has HIV, there’s a whole new set of questions about how the diagnosis might affect his or her work.

Fabulous Nurse Magazine

Hope. Stop-in today for your daily dose. 24-Hour | Co-ed | Secure Access to over 1,500 clubs worldwide

Find the location near you online at: AnytimeFitness.com

Join today and receive: Complimentary Virtual Training Perfect for those who want to stay in-shape despite their long-shifts and odd-hours.

November 2011

Issue 11

Fabulous Foodie

P.81

Fabulous Recipes

P.83

3 Festive Thanksgiving Cocktails

P.85

Perricone Diet

Fabulous & Fit

EDITORIAL

P.88

Daily Mile Fitness Tracker

P.10

We are the privileged. We are nurses.

P.91

Pole Dancing Aerobics

Finance

THE NURSE’S STATION I Professional Development

P.94

Income Booster: Wedding Photographer

P.97

Dinning Out Frugally

P.32

The Fabulous Case Manager Nurse

FASHION WATCH

P.36

Accessorizing with Clogs

THE NURSE’S STATION II Facility Ratings

P.39

Scrubs Style: Then & Now

BEAUTY SECRETS

P.45

Rid Acne at Any Age

P.46

Nightshift Makeup. Perfected!

ATTITUDE RE-DEFINED

P.48

A Nurse’s Guide to Self Defense

WALK IN MY CLOGS

P.51

Leesa Domingo: Managing Care One Patient at a Time

TRAVEL

P.58

Visit San Francisco’s Golden Gate

BREAKROOM DISCUSSIONS Marriage & Dating

P.100 5 Star Hospital Rating: Mercy Hospital & Medical Center, Chicago Houston Medical Center, Georgia P.102

5 Star Staffing Agency Rating: Advance Nursing

P.105

5 Diamond Nursing School Rating: University of Alabama School of Nursing

P.109

Electronic Charts Rating EpicCare EMR

POETIC VOICE

P.110

The Nurse Educator’s Prayer

LAUGH OUT LOUD

P.112

Nursing Humor

P.112

General Humor

RESOURCES

P.70

Biggest Relationship Blunders

P.114

Book Review – Bedlam Among the Bedpan: Humor in Nursing

Home, Hobbies & Parenting

P.116

November Nursing Conferences

P.73

Know the Colors of Feng Shui

P.118

Job Opportunities – Perm & Travel

P.75

Fun Sticky Nature Collages

P.119

Nursing News – Press Releases 13

Fabulous Nurse Magazine

The

Nurseâ&#x20AC;&#x2122;s tation I S Professional

Development

Issue 11

Evolution Of Tax Exempt Status In

By Olusegun Iselaiye

Historical View Historically, organizations operating fully based on one of the grounds stated under section 501(c) (3) of the Internal Revenue Code (IRC) got exempt from federal income taxes. In 1601, according to an article titled, “Hospitals Face Loss of Federal Tax-exempt Status” authored by R. Naubert and team and published in Healthcare Financial Management in September 1988, the English Parliament passed a law which exempted charitable establishments in charge of the sick from federal taxes. So, traditionally, America’s tax law is not different from this model.

American Hospitals

Current Trend Nowadays, demand for quality in America’s health care delivery, especially in terms of patient care and employee satisfaction, has occasioned hospitals’ repeated modification of their business models—to enable them stay in competition while meeting their customers’ needs by combining new and nontraditional services to remain in competition. Consequently, more questions as to why hospitals must be exempted from federal taxes are being asked by stakeholders. These questions are hinged on the fact that the broad justification for exempting organizations from federal taxes, which is premised upon serving public interest, is gradually bubbling out of America’s health care providers’ business contents.

Meaning of “Charitable” Since the concept of tax exempt in IRC Section 501(c) (3) originated from English common law of charitable trusts, it means there is a body of legal interpretation of the terms. Treasury Regulations’ definition of “Charitable” for instance comprises of the following: Relief of the poor and distressed or of the un-

derprivileged, advancement of religion, advancement of education or science, erection or maintenance of public buildings, monuments, or works, lessening of the burdens of Government, promotion of social welfare by organizations designed to accomplish any of the above purposes, or (i) to lessen neighborhood tensions; (ii) to eliminate prejudice and discrimination; (iii) to defend human and civil rights secured by law; or (iv) to combat community deterioration and juvenile delinquency. IRC Section 501 has 28 exempt categories, the most popular being Section 501(c) (3). An organization can only qualify under this section if its articles limit its activities to the tax-exempt purposes. These tax exempt purposes include charitable, educational, literary, religious, scientific, testing for public safety, to foster national or international amateur sports competition, promote the arts or for the prevention of cruelty to children

or animals.

Criticism of Hospitals Prioritizing Profit Over Care The concerns expressed over the relevance, rightness and even underlying principle for granting hospital tax-exempt have generated serious controversies among stakeholders. To avoid being one-sided on this issue, a quick analysis of the tax-exempt benefits to hospitals is worth considering. Tom Wang and Jacob Wambsganns 1996 Healthcare Financial Management article titled, “Is your organization’s tax-exempt status at risk? —tax management for healthcare organizations” states that “Government and private tax experts estimate that healthcare organizations save $15 billion a year in Federal, state, and local taxes because of their taxexempt status.” This, of course, is a benefit of tax-exempt. 15

Fabulous Nurse Magazine

Regardless of the merit and fiscal benefit of tax exempt, debate has continued and critics believe in the merits of stripping hospitals of their tax-exempt status. That is why they often refer to the 1990s when federal figures revealed a negative effect of tax exempt with regards to the nonprofit hospitals. Proponents of tax-exempt also mention Community Benefit—but the term “community benefit” in itself is legally unclear to most health care providers. Today, the community benefit concept—introduced by the IRS in 1969—is perceived by some experts as a fundamental error in polity, which needs a quick and permanent fix. They claim no universally adoptable definition for “community benefit,” and there is no best way to determine its usefulness or find its real impact on the populace. The Congressional Budget Office (CBO) expresses this more frankly by stating that “although non-profit hospitals must provide community benefits in order to receive tax exemptions, there is little consensus on what constitutes a community benefit or how to measure such benefits.” There are still other arguments that counter the idea of community benefit apart from those mentioned above. However, it is observed that federal courts seem favorably disposed to the idea of using community benefit as a standard even though their use of the standard is clearly not dependable. To put this in proper light, one landmark case easily comes to mind. In

St. David Health Care vs. United States, it was held by the Fifth Circuit that “the community benefit standard was the appropriate benchmark for analysis.” However, this does not explain the fact that the judgment seems skewed in another direction as the hospital was judged not to have met the guidelines stipulated in the (Section) 501 (c) (3). Today, different states have taken a more subtle and pragmatic approach to deal with the issue. In Utah for example, the ruling is that “nonprofit hospital is not a charitable entity for state property tax exemption.” On the other hand, Vermont is toeing the lines of the IRS by stating that in “extended tax-exempt status to non-profit hospitals because it saw the social value of care for the sick as being great enough to justify tax exemption.”

Government’s Review of Community Benefit Recent studies investigated community benefit coverage by other hospitals and nonprofit. These investigations include two studies by Government Accountability Office (GAO) in 2005 and 2008 and a study by the Congressional Budget Office in 2006. The studies generally show that community benefit reporting is not uniform among hospitals, and that community benefit expenditure and uncompensated care are concentrated in a relatively minuscule number of hospitals irrespective of their status—nonprofit, forprofit or government.

Recent Passage of the PPACA The recent enactment of the Patient Protection and Affordable Care Act (PPACA): section 9007 provides for the modification of federal income tax exemption for hospitals (non-profit based). In order not to run afoul of the law, the Act stipulates that the hospitals exempted from taxes have to embrace certain activities. Introduction of the PPACA became necessary because it is believed that hospitals cannot justify the benefits of taxexempt status if the level of healthcare delivery does not match what hospitals benefit. In view of this and the ambiguity of concepts like community benefit and charity care, the legislation is very important.

Challenges of Enforcing Compliance With New Requirements PPACA stipulates that all changes were effective starting from the tax year that followed March 23, 2010. The only exception was with the implementation of the community health needs assessment, which was shifted to the taxable year following two years after the initial implementation date (March 23, 2010). In spite of the concise changes that have been introduced, compliance has been a major concern. For hospitals that have been used to the status quo, crossing over to a new legislative regimen has been sluggish and far slower than envisioned.

Conclusion Over a period of decades, the American healthcare system has undergone quite a number of modifications, some of which were positive or for the worse. Irrespective of the nature of a policy, it always has its own controversial side. A classic example of this is the concept of tax exempt as introduced by the IRS in the late 1960s. To be fair, it has worked for the system but in the face of modern challenges, evolution must proceed. With the introduction of the PPACA, it is hoped that some of the grey areas in tax-exempt law as it concerns the health care industry would be resolved. As it is a pointer to a better future, some of the old challenges remain while we keep contending with new ones.

Issue 11

Public Speaking Presentation Skills A Must For The Modern Nurse

Fabulous Nurse Magazine

By Karen Kalis

ou’d think that public speaking wouldn’t be a job requirement for nurses, but that isn’t true.

With

more and more nurses involved in research, teaching, and leadership positions, having exemplary public speaking and presentation skills is a virtual must in the nursing field today.

Public Speaking Is Necessary For Nurses While most people don’t love public speaking, nurses who avoid it can slow down their career. According to Vicky, an RN and author of “Tips for Effective Public Speaking” AllNurses (July 4, 2009), “Public speaking is such a powerful form of communication that almost every profession requires it. The reluctance to get up in front of an audience can be a major impediment to career advancement.” Indeed, public speaking – whether to another group of nurses, a community group, physicians or business people – can open doors, as well as, provide new career opportunities for you. The good news is that despite the fact that many people cite public speaking as their number one fear, it is a skill that can be mastered, according to Gillianne Meek in her article “Enhancing Nurses’ Presentation Skills,” (June, 2005). “Nurses frequently have to give presentations, whether as part of a job interview, as feedback from a course or 18

conference or simply as part of a professional development program. It can be daunting. However, giving effective presentations is a skill everyone can learn.”

How To Prepare If you are asked to do a presentation, here are some key considerations to keep in mind when preparing. First, ask good questions

Issue 11

of the people that are asking you to speak.

hours, public speaking may require a change

is critical and will help you develop your

How long do they want you to speak? What

of dress. What you wear will change how

professional image and reputation. Beverly

topic would they like you to cover? Where

you feel, so choose carefully, always select-

Malone, Ph.D., R.N., F.A.A.N., the National

will you be speaking? Is it a formal speech

ing the most professional appearance.

League for Nursing Chief Executive Officer said, “It’s nice that you’re brilliant but, if you

or a casual Q & A format? Will anyone else be speaking? Who will you be addressing? Having all of this information provides you with critical information as you prepare. Secondly, Vicky suggests that you, “Know your subject material thoroughly, including

Finding Your Niche While you may not enjoy public speaking now, you may learn to enjoy it. Public speaking was a skill that Karon White-Gib-

can’t pass it on, it’s for naught.” (“Future Academic Nurse Leaders Hone Presentation Skills, April 23, 2009, Robert Wood Johnson Foundation Speech).

son, an RN and host of her own television

As a nurse, you may never have considered

show, “Outspoken with Karon,” developed

public speaking a professional requirement,

along the way. “I was terrified of public

but as more and more nurses work outside of

speaking. Never took it in high school. I

the medical community, complete research

was asked to go to colleges and universities

that needs to be presented, and become nurse

A good deal of practice is the key to becom-

when [my book was published]. The bigger

educators, those public speaking skills be-

ing at ease when doing public speaking. Try

the crowd, the better I liked it. I was asked

come critical. With a little practice, no mat-

to vary your pitch, remember to speak loudly

a lot of questions that weren’t in the book.

ter how daunting speaking in front of a group

and look at the people you are speaking to.

What I learned is that you have to say what

may seem, you can master it.

Maintaining eye contact keeps your audi-

you have to say no matter what they ask you.

ence paying attention to you. You may even

You have to get a message across,” she said.

the purpose of the presentation. Know it so well that you generate enthusiasm. Preparation is one of the most important factors for oral communication success.”

pick up subtle body language as you speak.

That is sage advice. As a nurse you know

Another area where nurses may need coach-

that no matter the interruption or distraction,

ing on public speaking is on what to wear.

you must stick to your job. Public speaking

While scrubs may be appropriate for on-duty

is no different. Completing your message

Fabulous Nurse Magazine

UNIVERSITY OF CENTRAL FLORIDA UCF College of Nursing Offers Advanced Doctoral Degree Online ORLANDO, Aug. 29, 2011 -- A new doctoral degree

support the growth of practice-based doctoral degrees to

track at the University of Central Florida prepares nurses

address national concerns about quality of care and pa-

in a leadership role to succeed at the highest level of ad-

tient safety. UCF’s program will prepare nurses to use the

vanced practice by becoming “change leaders.”

latest technologies, trends and research to address chang-

The degree track, a post-master’s Executive Doctor of

ing regulations and anticipated nursing shortages over the

Nursing Practice (D.N.P.), is the most recent example of

next decade.

the College of Nursing’s efforts at creating cutting-edge

Designed for working professionals, the part-time, flex-

programs that give its graduates the ability to adapt and

ible degree consists of online courses and an intensive

lead during challenging times in healthcare. The track

three-day seminar at the start of each semester. The semi-

will prepare students to shape practice, and their proj-

nar brings together theory and practice to round out the

ects will make a difference in improving care for patients

comprehensive program.

where they work. “For busy nurse leaders, the program promotes out-of-

leadership and organizational analysis. In addition to

the-box thinking to shake up what they are already do-

opportunities for online collaboration with peers, the

ing, to support them in becoming change leaders,” said

seminar will allow students to meet their professors and

Associate Dean for Graduate Affairs and Professor Susan

develop deeper relationships with faculty members and

Chase. “They’re not just responding to new policies, but

their colleagues. Nationally recognized leaders in health-

informing the policy and putting into practice the evi-

care will share their best practices during the seminars

dence that is there.”

and in presentations open to interested nurses in the Or-

The federal Institute of Medicine and other groups are

lando area.

calling for more advanced educational programs as the

The first group of students, who will stay together for the

nation’s healthcare environment grows ever more com-

required nine semesters, starts coursework in January.

plex and demands of nurses a higher scientific knowledge and practice expertise. The American Association of Colleges of Nursing (AACN) and its member schools also

Curriculum focuses on areas such as decision making,

As nurse leaders and administrators plan for policy changes, the Executive D.N.P. will provide them with analytic

Issue 11

skills they can use to actively impact the environments in which

“We want them to think about the whole system of care, such as

they work, be it acute care, clinics, community health programs,

how to guarantee quality for outcomes, while letting people on

Magnet preparation, strategic planning or overall interdisciplin-

their teams be creative,” Associate Dean Chase said.

ary leadership. Through study and testing of evidence-based practice strategies, students will learn how to evaluate and apply existing research to improve practice innovations and outcomes. “It’s a new opportunity to prepare nurse executives from different backgrounds to change practice in ways which reflect their professional and personal interests,” said Diane Andrews, assistant professor and program coordinator. Led by UCF’s outstanding practicing faculty who have been on the front lines of change, students will put what they learn to work. The degree culminates with a project that is completed during residency, which allows nurse executives to examine how to improve patient care and safety.

Nurse executives who hold a M.S.N. in Nursing Leadership and Management are encouraged to apply. However, interested, registered nurse leaders with a non-nursing master’s degree also may apply. An online application with all supporting application materials is due Oct. 1. Eligibility will be considered with a portfolio review to determine course equivalency and verification of completed practice/laboratory hours. For candidates without a M.S.N., individual plans of study will be developed to include missing elements of the M.S.N. curriculum. Interested applicants may review additional program information and apply online at www.nursing.ucf.edu/academics/Executive_MSN-DNP.asp.

Contacts: Rebecca Basu, News & Information, 407-823-1637, rebecca.basu@ucf.edu Carolyn Petagno, College of Nursing, 407-823-1665, carolyn@ucf.edu UCF Stands For Opportunity: The University of Central Florida is a metropolitan research university that ranks as the 2nd largest in the nation with more than 56,000 students. UCF’s first classes were offered in 1968. The university offers impressive academic and research environments that power the region’s economic development. UCF’s culture of opportunity is driven by our diversity, Orlando environment, history of entrepreneurship and our youth, relevance and energy. For more information visit http://news.ucf.edu. 21

Fabulous Nurse Magazine

Working

While By Carol Sowell

Positive M

work often exposes them to bodily fluids, it might be wise to share the information with your supervisor. Be aware of discrimination against people living with HIV, even in a health care setting. A 2009 study of HIV-positive health care workers by the National AIDS Trust in Great

Can I still work as a nurse if I am HIV-positive?

nearly every other trade and profession.” Those who are taking HIV medications can

who disclosed their HIV status at work felt

There is no medical or legal reason why a

generally live and work for many years.

they were discriminated against as a result

nurse with HIV cannot continue to work.

With these drugs the viral load can be sup-

-- treated differently by supervisors, made

pressed to barely discernible levels, keeping

to feel isolated, and left out of social events.

On The Body, a website that calls itself “The Complete HIV/AIDS Resource,” David Wohl, associate professor of medicine at the

the immune system strong and significantly reducing the potential for transmission.

tors, pharmacists, GPs, and other healthcare workers, just as there are HIV-positive cleaners, teachers, bus drivers, police officers, and 22

NAT Assistant Director of Policy and Campaigns Eleanor Briggs said, “You might expect people in a healthcare setting to be the

University of North Carolina at Chapel Hill, says, “There are HIV-positive nurses, doc-

Britain showed that a fifth of respondents

Do I have to tell my supervisor that I’m HIV-positive? You are under no legal obligation to disclose your HIV status at work, but because nurses’

most informed. We found that wasn’t the case and people faced a range of negative responses.”

Issue 11

Fabulous Nurse Magazine

If your diagnosis makes you fatigued or fre-

These policies should be designed only as

notified about the exposure; receive expert

quently ill, you may want to ask for some

precautions to protect patients. If you feel

counselling regarding the implications of

changes in your duties. You’re covered by

they’re limiting your professionalism or dis-

the event; be offered effective post-exposure

the Americans with Disabilities Act, but

criminating, consult with an ADA adviser.

prophylaxis; and receive appropriate long-

asking for ADA protection may require disclosure. Under the ADA, an employer or potential employer can’t ask about your health status but can ask if you’re able to perform a list of duties that are normally part of the job. The ADA only applies to workplaces with 15 or more employees.

Will I be putting patients at risk? Universal precautions designed to prevent transmission of blood-borne diseases work both ways. Gloves, gowns, masks, and protective eyewear will protect both patient and nurse from exposure to HIV through contact with blood. The chances of a nurse’s blood contacting patients’ open tissues are miniscule. But some facilities don’t allow HIV-positive nurses to participate in procedures that expose tissue such as handling acute trauma patients, inserting chest drains or making tissue repairs.

An article by Nursing Times (Nurses with HIV: Fear and Loathing on the Frontline, September 2, 2009) shares that HIV-infected nurses should have no problem with general procedures, intensive care, fitting IUDs, vaginal delivery or resuscitation performed wearing masks. It’s important for patients to know your clinic or hospital takes precautions seriously. Seeing nurses masked and gloved reassures them that the health care facility is committed to their safety and well-being.

Should patients be informed that I’m HIV-positive? The American Nurses Association is opposed to mandatory HIV testing and disclosure of status of patients, nurses, and nursing students. The ANA also opposes removing HIV-infected nurses from their care activi-

tion paper “The Patient’s Right to Know the HIV Status of the Health Care Provider” goes on to say, “The exposed patient need not be notified of the source provider’s name nor of the exact circumstances of the exposure.” Patients’ responses to an HIV-positive nurse will vary. A facility may choose to establish a policy of disclosure to protect itself from liability claims filed by a patient who believes he should have been informed.

Is it dangerous for me to continue working? It may be more dangerous for an HIV-positive nurse to continue treating patients than for the patient, simply by being in contact with patients who may have open wounds or other conditions favoring transmission.

ties based solely on the presence of HIV in-

Monitor your immune system status regular-

fection; the nursing work force in some areas

ly. If your system is weakened, you could be

of the world has been decimated because of

susceptible to patients’ infectious conditions

HIV infection.

such as pneumocystis pneumonia, tuberculo-

Similarly, the American College of Occupational and Environmental Medicine doesn’t support notification of patients of a health care worker’s HIV status unless an exposure has taken place. If a patient is exposed to the blood of an HIV-positive nurse, the Massachusetts Nursing Association advises that the patient and his or her physician “should be promptly

term medical follow-up.” The MNA’s posi-

sis, candidiasis, cytomegalovirus, and toxoplasmosis.

How do I deal with co-workers’ and patients’ misconceptions about HIV? Most staff members will be understanding about your HIV status and simply wish you the best. But sometimes even well-informed health care workers have some wrong ideas.

The most likely concern will be that casual contact could expose a colleague or patient to HIV. Make it clear that HIV can be contracted only from infected blood, semen, vaginal fluid or mother’s milk. Be patient and explain calmly. If that doesn’t satisfy their concerns, ask a supervisor or HIV specialist to step in. There’s no evidence that anyone can get HIV from touch, tears, sweat, saliva, a toilet seat, doorknob, water fountain, handshake, hug, kiss, shared eating utensils, food, exercise equipment, pets or breathing the same air as someone who is HIV-positive. If colleagues believe that you have fullblown AIDS or are near death, assure them that you’re taking effective treatment. With the right medications, you can have HIV for decades without progressing to AIDS.

What can I do to stay healthy?

Issue 11

Most people with HIV take a combination of

What sources of support can I turn to?

drugs, each of which inhibits the virus in a

For ADA questions, call the information line

different way. There are several versions of

at 1-800-514-0301. HIV is classified as a dis-

each, so if one has disagreeable side effects

ability and you have the right to ask for rea-

that interfere with your work, you may be

sonable accommodations in the workplace.

able to try another.

Each state has an HIV resource service.

Healthy foods are important. Watch out for

Check with your state’s department of public

underdone meat, unpasteurized milk, raw

health.

eggs and raw seafood, any of which can carry illness. When you get flu and pneumonia vaccinations, make sure they don’t contain live viruses. Some dietary supplements may boost the im-

In addition, there are support groups and counsellors to help you cope with the diagnosis. Lean on these, and on your friends and colleagues, and know that your career will be part of your life for many years.

mune system or counteract the side effects of anti-HIV drugs. These include fish oil, whey protein, and coenzyme Q10. At the same time, St. John’s Wort and garlic supplements can reduce the effectiveness of your medications. Garlic in food appears to be safe.

Fabulous Nurse Magazine

Nurses Healing By Margaret Smith

With Art

ary had been undergoing treatment for breast cancer, and it was getting to her—the pain,

the tiredness, the anxiety, the fear. One day she showed up to a chemotherapy session and her nurse introduced her to Kate. Kate was organizing a group of chemo patients to participate in a new program of therapy involving art. Mary was skeptical; the idea of dragging herself out of her house for one more activity, a silly one, at that, didn’t appeal to her at all. Her nurse told her that art therapy had helped many of her patients and, when Mary’s husband chimed in with his two cents, she agreed to try it. After just one session working with a team

The power of creativity Vincent Van Gogh once commented, “The only time I feel alive is when I’m painting.” That comment sums up the power of art to restore, to regenerate, to soothe, and to heal. By integrating art therapy into patient treatment, health providers are able to affect patient well-being in measurable ways. Patients who participate in art therapy have a better quality of life and are more likely to cooperate with painful procedures. According to The International Encyclopedia of Rehabilitation, 10/12/11, the reduction in the levels of depression, fatigue, pain, anxiety, and stress may also have a beneficial effect on the patient’s immune system.

that included Kate, her nurse, and a group of other cancer patients, Mary had created a masterpiece! Everyone in her family said

How art therapy works

As more mental health care providers embrace this form of therapy, it has expanded to include other forms of art such as writing, dance, and music. In a typical art therapy setting, a therapeutic team is assigned, where the art therapist may be supported by physicians, psychologists, psychiatrists, nurses, and teachers. The team works to observe the patient and record their observations for discussion with the rest of the team. The technique is currently being employed to address an array of physical and mental conditions including anxiety, depression, and PTSD, as well as, various organic illnesses. Because the emotional catharsis provided by the experience helps to relax the patient/artist and relieve stress, problems like high blood pressure and irregular heart-

so! And now she was looking forward to the

There is abundant evidence of a strong con-

beats are relieved, and the immune system

next therapy session. Somehow, express-

nection between mental and physical health.

is supported.

ing herself through images and colors made

For patients who have trouble verbalizing

her feel better. She wasn’t as tired, the pain

their feelings, it is easier to represent them

didn’t bother her as much, and her general

through images, so art therapy has tradi-

well-being was greatly improved. Now the

tionally centered on visual media such as

big C didn’t seem as formidable.

drawing, painting, collage, and sculpture.

The sensory stimulation of creating art and the pleasure the patient/artists feel in accomplishing something, empower them to develop coping skills to deal with their issues con-

Issue 11

connection, as well as, a feeling that they

setting, activities, and interactions of the

have choices to make and control over what

therapy sessions.

they produce. Nurses who participate in these settings are gratified at the visible signs of progress among patients. Although many institutions are still resistant to art therapy as a treatment because of a lack of evidence-based studies, nurses who understand the benefits of treating the whole patient recognize art structively. During therapy sessions, patients

therapy as a helpful complement to standard

are encouraged to explore the inner feelings

clinical care.

they’re not able to talk about and represent them through images, movement or creative writing. Once they have created the piece, they are prompted to discover its meaning. According to information published by the National Center for Biotechnology Information 10/12/11, this type of therapeutic pro-

Re-humanizing medicine Patients who are given the opportunity to participate in art therapy programs generally respond to it in a positive way. Most patient/artists find that the experience is personally fulfilling, creating in them a feeling of confidence and self-worth. No longer do they feel like test subjects to be poked, prodded, and interrogated. Instead, they are given opportunities—opportunities to create

Despite the reluctance of some institutions

something meaningful, opportunities to gain

to embrace art therapy as a viable comple-

insight into their own thoughts and emo-

ment to clinical treatment, there are still

tions, opportunities to express themselves,

many facilities that value this type of thera-

opportunities to be heard, and opportunities

py for its potential to restore and transform.

to heal.

Besides hospitals and psychiatric facilities,

cess usually leads to increased self-awareness and insight. As the therapy continues, nurses and therapists can track the patient/ artist’s progress through the way that their evolving art pieces represent the changes in the patients’ internal states.

Healing for the mind, body, and soul Based on the psychological theories of Freud and Jung which involve the subconscious and unconscious, art therapy assumes that visual symbols and images are the most natural way to understand the human experience and enable communication. The therapy is appropriate for all types of patients who suffer from mental, physical or emotional illness—children, adolescents, the elderly or frail, war veterans, the chronically ill, and even the terminally ill. Whether the therapy includes working in a group with other patients, or individually with a nurse or therapist, any sense of isolation is neutralized. Patient/artists experience a social

art therapy is practiced in clinics, shelters, skilled nursing facilities, nursing homes, veterans’ hospitals, and community programs. Depending on the makeup of the therapeutic team, nurses serve in various capacities. Sometimes the nurse is actually an art therapist. Otherwise, it’s usually the nurse’s responsibility to gauge the abilities and limitations of the patient and design the 27

Fabulous Nurse Magazine

Updating Perceptions

doctor who delivered them male or female?”

Opening her eyes, the patient gazed suspi-

“Well, male, of course. I never saw a woman

A Nurse who Happens to be Male, Not a Male Nurse

ciously at Carl as he jotted down statistics

doctor ‘til I was much older.”

Carl is in his early 30s, a nurse at Washing-

in her chart. “You’re not my doctor,” she

“Exactly. And you were comfortable with

ton University’s teaching hospital. He has

murmured. Carl agreed with a grin, telling

your doctor, right? No qualms about him

her that he was her nurse for the evening

seeing you or delivering the babies?” As

and would make sure she was comfortable

she nodded, Carl assured her that he was a

through the night. “I don’t know,” she said,

medical professional and would treat her re-

shaking her head. “I’m not sure I want a

spectfully, because that’s the job of a nurse,

man being my nurse.”

male or female. She seemed to relax as he

Carl stopped at her bedside and patted her

spoke to her, and when he promised that if

hand. “Let me ask you something. Do you

she ever felt uncomfortable with him, she

have children?” When she nodded, he con-

could request a female be present in the

tinued, “and when they were born, was the

room, she squeezed his hand and told him

dealt with several patients like this, others who assume he is gay, and many who call him “Doctor,” no matter how many times he corrects them. He says that most of these patients are elderly, and he tries to remember that he and the many other males in his profession represent a significant shift away

Sur

viv

ing

that wouldn’t be necessary.

e g o r

le l i F

t Es lace p k r o W

Male

Nurse By Mindy Carney

Issue 11

Fabulous Nurse Magazine

Issue 11

from the traditional gender roles to which they are accustomed. He has a good friend, a female physician, who has seen many similar reactions from her older patients over the years. Stereotypes, especially ones based in what was once reality, can be hard to overcome. Carl is well-respected by his co-workers. He is a married father of two, a committed nurse who has earned that respect by understanding the culture into which he has come to work. His fellow nurses, both male and fe-

Professionalism, an Attractive Attribute Over the years, Carl has gathered a few pearls of wisdom for succeeding in a traditionally estrogen-laden profession. •

Don’t take responses based on your sex

personally. It’s not about you. •

Remember that, in essence, you are the

brother/son in a family of many sisters. If you treat your female co-workers and patients with the respect you would treat family members, you will significantly lower the

male, agree that Carl’s patience and sense of

risk of being mistaken for a sexist cretin.

humor have served him well in dealing with

•

being the minority. He also is adamant about

in, better) than they sometimes do your fe-

sharing credit for successes, which goes a

male counterparts, make sure the docs know

long way with his co-workers. He realized,

that you respect and value the input and ad-

early on, that doctors talk to him differently

vice of the females on your team.

than they do female nurses. He has cringed, at times, overhearing a tone or harsh critique that he knows full well would have been delivered quite differently to him.

•

When doctors treat you differently (as

an Indy 500 lap. You can walk away, you can tell your own PMS story (about yourself, not your wife) because everyone’s hormones fluctuate, you can sympathize, or you can make them laugh. Laughing is almost always the best option. •

If a patient truly is uncomfortable with

you as the nurse, switch. Flexibility goes a lot further than digging in to prove a point. If you can be your charming self, you can typically overcome objections, but sometimes, you just can’t. Refer back to the first suggestion – it’s not about you. Lastly, Carl has heard male students say they chose nursing to work with the ladies. Since he met his wife on a unit not long after beginning his career, he gets their point – but he also reminds them that what attracted her to him, early on, was his professionalism.

Never leave your sense of humor at

She told him that the way he focused on his

home. Ever. When you’ve just about had

job, rather than coming on to his co-workers,

it with the PMS chat, a smart-ass comment

made him the sexiest beast in the hospital.

will alienate you from your team faster than

He’s never forgotten that.

Fabulous Nurse Magazine

abulous F Nurse Case Managers By Karen Kalis

or nurses looking for a new career path within nursing, case management offers the challenge of not only administering treatment, but also coordinating care for patients who need long term care. As case managers, these fabulous nurses make sure that every part of the treatment plan is being covered to ensure that the patient is receiving the best care possible.

Issue 11

What Is Case Management? According to Johnson & Johnson Services, Inc. (2009), a nurse case manager “coordinate[s] care for patients receiving long-term therapy, providing for optimal timing in all aspects of treatment. For cancer patients, for example, they coordinate primary care visits, surgery, radiation, and chemotherapy.” Nurse Case Managers generally specialize in an area such as: geriatrics, cancer treatment, long-term rehabilitation or children. During their work, case managers assess patients and follow clinical pathways as well as determine patient eligibility for treatments. According to Kaplan, Inc. (2010), Nurse Case Managers interact with patients by “work[ing] directly with patients and/or their families, developing a professional relationship with them in order to perform assessments on the patient, as well as analysis of data. Once an assessment has been completed and all proper data has been collected, the case management nurse works in close collaboration with the patient’s physician and all members of the health care team in order to coordinate and manage all aspects of that patient’s care and services including arranging referrals as needed.” Nurse Case Managers play a critical role in complex medical situations, guaranteeing a continuity of care and a feeling of security for patients and

ers. To take the test, a nurse must have completed their RN degree and have been working for at least two years. In addition, candidates must have 2,000 hours in case management over a three year period and thirty hours of continuing education in case management over the same period. The level of on-site training as well as the level of continuing education required provides potential Nurse Case Managers with the breadth and depth of experience they need in order to be effective at their job.

The Future of Case Managers While many Nurse Case Managers choose to work in hospitals or long-term care facilities, other opportunities include careers with home health care companies, government facilities, rehabilitation organizations or as independent consultants. RN Case Managers can expect that the demand for their services will grow. According to QuinStreet, Inc. (2011), “Case management nurses will be in high demand because the growing elderly population will need more and more assistance in managing their various chronic conditions. More new RN jobs are expected to be created than any other occupation, mostly because of the need to replace aging registered nurses as they leave the profession. Factors such as the growing elderly population,

their families.

general growth of healthcare, rising median age of regis-

A Nurse Case Manager’s Education

technological advances will keep registered nurses, includ-

To become a Nurse Case Manager, additional education and credentialing is required. Generally, Nurse Case Managers are RN’s who are currently working actively in a hospital or long-term care facility. In order to become a Case Manager, nurses must complete a credentialing test. The American Nurses Credentialing Center, a subsidiary of the American Nurses Association, offers a credentialing test for RN’s who are interested in becoming case manag-

tered nurses, increased emphasis on preventative treatment, ing case management nurses, in high demand.” As a result of that, Kaplan, Inc. (2010), reports that the top tier of case managers can expect to make upwards of $75,000. Nurse Case Management offers a substantial challenge to RN’s who have a desire to not only serve patients and families, but who want to have a significant role in fulfilling and coordinating treatment plans. With a future of high demand and a generous salary, Nurse Case Managers enjoy opportunities that go beyond the typical job description of a nurse.

Fabulous Nurse Magazine

Issue 11

FASHION Watch

Fabulous Nurse Magazine

Clogs

Style!

With

eing professional does not have to be boring. Your personality shines when you are comfortable with your

looks. Sometimes all you need is the right footwear. Fabulous Nurse is featuring some stand-out clogs that will lighten your mood. Go ahead nurses; make your day with these fun scrubs accessories.

Personality, Professionalism.

Cape Clogs Pink Ribbons and Butterfly Clogs – “clogs for a cause.” There are options for breast cancer, autism, and ovarian cancer. You can be stylish, professional and still support a cause close to your heart. The price of goodwill? $80 USD

Issue 11

Croc Cayman These unisex “comfortable work shoes” come in a variety of colors – seafoam, lavender, fuscia, mango and red (featured). Priced at $19.99 - $24.99 USD, you can afford to splurge.

Dots Swedish Clogs Polka dots clog from Cape Clogs. How do you say, “beautiful” in Swedish? We think this is retro and modern all at once. “Vackra!” The price of this Swedish polka dot beauty? $90 USD

Birki’s Woodby Cows not your thing? Birki’s Woodby “suede lined, anatomically correct” clogs come in different colors and feature a variety of animals including lions, hippos, horses, dogs, and cats. Price $62 - $99 USD

Fabulous Nurse Magazine

Scrub Styles Then

Issue 11

By Margaret Smith

Now

ally have much more going for them. Nurses were proud to wear the uniform to represent everything they stood for, but they didn’t necessarily enjoy wearing them. For one thing, the uniform soiled easily; and laundering, starching, and ironing it was time consuming. Moreover, it wasn’t comfortable; while those white stockings may have offered some support to nurses who were always on their feet, they felt hot and restrictive. The uniforms usually felt too binding, and it was difficult to move quickly in them, as nurses often had to do. As far as style goes, well, what style? And when men started entering the field of nursing, what were

ack in the days of “nurses’ whites,” more children were afraid of nurses than they were of clowns. It was

hard not to be sympathetic when you heard a child recounting her traumatic experience: “She had white legs and clunky shoes, and she gave me a shot! And it really hurt!” Unfortunately, the grim-faced nurse dressed all in white became a stereotype that grew to be parodied in movies like High Anxiety, where Cloris Leachman portrayed the harsh Nurse Diesel as the incarnation of evil. Nurses don’t deserve that kind of image! Thankfully, today’s scrubs-wearing nurses are viewed in a much kinder light. While the all-white uniforms, stockings, shoes, and caps were a good way to identify who was a nurse and who wasn’t (sometimes a problem in hospitals today), they didn’t re-

they supposed to wear? Definitely not white stockings!

Enter the age of Scrubs In due course, floor nurses in hospitals began eyeing the uniforms that were being worn by O.R. nurses. These were the follow-up garments to the sterile gowns that had been adopted in the 1940s. Up until then, doctors had operated in street clothes, covered with butcher-style aprons. When the medical profession became aware of the dangers of contamination in surgical procedures, it was time for an OR dress code. Originally white, the sterile drapes and gowns caused eye strain in the members of the surgical team because of the way they reflected the bright light in the operating theater. The white was additionally troubling because it tended to provide a high contrast for blood stains that often occurred during surgical procedures. So “surgical greens” became the standard

wear for O.R. staff, and the label was eventually changed to “scrubs” because they were worn in situations where doctors and nurses had to “scrub in”. Gradually, scrubs became the garment of choice for nurses in all positions. Not only nurses, but also nurses’ aides, food service staff, and housekeeping staff began to wear scrubs on the job. The easy-care practicality and comfort enabled everyone to move through their duties efficiently. The prototype for today’s scrubs was adopted around the 1970s. They were generally made of cotton or other easy-care cotton blends for wash-and-wearability—no more starching and ironing. The standard style was a 39

Fabulous Nurse Magazine

short-sleeved v-neck top with a drawstring pant.

Nurses now have choices Now, scrubs have moved on from the stark colors of white or “surgical green” to all kinds of eye-pleasing colors and prints. Nurses in pediatric positions especially appreciate the novelty prints like Disney characters, Hello Kitty, superheroes and cute forest animals. Children are less likely to resist when a nurse wearing a Mickey Mouse tunic leads them into the examining room. And now there are actually style choices available in scrubs! While the v-neck is still available, it’s nice that women with cleavage and men with hairy chests can choose alternative neck styles, like crew neck, square neck, and scoop neck. There are also tops available in mock-wrap styles, tunic styles, and others. Pregnant nurses can even get comfortable and stylish-looking maternity scrubs. Many institutions give nurses free rein to choose their own colors and styles, and nurses appreciate the opportunity for some freedom to express themselves through their choices. Other organizations may choose a standard color and style for the entire staff, making the scrubs more of a uniform and a kind of trademark for the organization. There are even some administrations that assign specific colors to each department. With all their practicality, scrubs have even become a fashion statement. You’ll see people wearing scrubs in the grocery store, at the deli counter, even in class. Maybe they’re members of the medical profession—maybe not. Ironically, there are some hospitals that are reverting back to the all-white nurse’s uniform. Because so many members of the staff wear the scrubs, some patients are reporting nurses as unresponsive, even though common sense should tell them that nurses don’t empty wastebaskets. Whatever the case, it’s highly doubtful that nurses will ever return to wearing the severe-looking, uncomfortable, impractical “nurses’ whites” of the olden days. 40

Issue 11

Beauty

Secrets

Fabulous Nurse Magazine

Issue 11

Foot Care Tips Advice from your clogs D

ry cracked or calloused feet can make you feel uncomfortable and unattractive. And it’s not only a

problem during these upcoming long winter

Baking Soda Soak.

Upgrade Your Clogs.

Add some baking soda to a foot bath and let

Poor fitting shoes can cut off circulation to

soak for about half an hour to help soften

your heels and toes. If the skin doesn’t get

dry, hard feet. This also works great for the

blood, it doesn’t get enough water, nutrients,

rest of your skin and you can even add some

or water. Get your feet measured to make

to your bath salts.

sure you’re wearing the right size.

Milk.

If you’re using an inexpensive brand, you

Add a cup of milk to a warm foot bath.

may want to invest in some quality footwear.

Dairy is a great natural moisturizer and will help soften up hard dry skin on your feet.

Banana.

months, dry feet can creep up on you at any time of the year. While there are many cures for dry feet at your local drug store, not all of them are nat-

Mash bananas into a pulp and apply to your heels and other affected areas. Let sit for about ten minutes and rinse.

Vegetable Oil.

ural. That’s why we’ve put together some of the best natural dry cracked feet remedies for

They can help your feet, legs, back, and usually last a lot longer too. Poor hygiene can also be a cause of dry cracked feet. It can be easy to neglect your feet when you’re scrubbing, but taking the extra time to scrub can be well worth it. Be sure to moisturize after since soaps can be drying.

Vegetable Oils have been used as moisturiz-

While it may not seem like a huge issue, dry

ers for dry skin long before traditional mois-

cracked feet could actually be a sign of a

turizers were manufactured. After you’ve

Vinegar Soak.

poor diet. Make sure you’re getting enough

tried one of these other treatments, pat your

water and eating a well balanced diet with

Mix about a cup of white vinegar and a small

feet dry and rub in a generous amount of

plenty of fruits and vegetables.

you. Get ready to reveal new soft, beautiful, touchable feet!

amount of dish soap in a tub of warm water. Mix and let soak for about ten minutes.

oil, then put on thick socks to help keep the moisture in.

Fabulous Nurse Magazine

benzoyl peroxide which can work quite well

body’s systems and it eliminates the food

if you have particularly oily skin. However,

bacteria thrive on. If your diet is particularly

for adults and those prone to dry skin, it can

high in sugar and starchy carbohydrates (think

worsen the acne problem.

white bread and baked goods) then going on a

4. Wear makeup selectively.

sugar elimination diet will show dramatic improvements in your skin.

Issue 11

Cutting back on sugar helps balance your

Rid

Watch what you put on your face and when. Makeup can clog pores. If you wear makeup, choose noncomedogenic versions. Don’t wear

Acne at Any Age

cne plagues millions. And when you suffer from acne and breakouts it can have a negative effect on your confidence. The good news is to get rid of acne at any age. Here are simple solutions that really work.

1. Cut back on sugar.

2. Limit your chocolate intake.

There are both good and bad bacteria that live

There’s a reason chocolate is so often linked to

in our bodies. And some bacteria, the kind that

acne, because it’s high in sugar. It’s also high in

can cause acne, thrive on sugar. Additionally,

dairy and if you have a dairy sensitivity, which

sugar affects your hormone levels and blood

many people do, it can cause acne. Additional-

sugar levels both of which can cause a strain

ly, dairy is often full of hormones added to the

on your body. This strain makes it difficult for

cows to help them produce more milk. These

your body to fight any kind of infection, even

hormones can wreak havoc on your system.

a small pimple.

Common foods that can cause acne include sugary foods, dairy, alcoholic beverages, fried foods, meat treated with hormones, and common allergy causing foods like nuts.

3. Exfoliate and moisturize. Exfoliation of your skin keeps the pores from being clogged. Clogged pores are the precursor to a blemish. However, beware of harsh abrasives. Many facial scrubs are just too abrasive for sensitive skin. Instead, use prod-

makeup when you exercise or when you’re going to be outside in the sun for extended periods of time.

5. Avoid too much stress. Easier said than done, right? Stress has an effect on our hormones and can cause breakouts. If you’re going to be dealing with stress, say you have a big project coming up, up the vitamin B complex and get some sunshine or vitamin D. Vitamin B helps your body manage stress and it helps protect your skin. Vitamin D, which our body makes when we get about 20 minutes of sunlight each day, helps promote healthy skin.

6. Try not to touch your skin. This goes beyond not squeezing or picking at your acne. Our fingers are full of bacteria. If you’re prone to acne much of it may be from simply transferring the bacteria on your hands to your face.

ucts with alpha hydroxy acids, retinols and

Overall, take good care of yourself. Get plenty

salicylic acids to remove dead skin and debris

of sleep, exercise, fresh air and a good healthy

from your face gently and consistently.

diet. Good overall health helps your skin stay

A common protocol might be to use a cleanser with salicylic acid and a night cream with retinol or alpha hydroxy acids or AHAs. Some

healthy and acne free. It helps your body manage obstacles, like stress and hormones, without suffering a breakout.

skin care protocols for teens with acne contain 45

Night Shift Makeup, A Step–By–Step Fabulous Nurse Magazine

Guide

Perfected!

What you will need:

• Brush.

foundation. Do not exaggerate the coat. This

• Mascara. Dark colors like black or brown.

to carry the foundation to your neckline for a

First things first. Hide any skin imper-

fections like dark circles or pimples with is makeup you will wear to work. Remember

• Eyeliner. Dark colors like black, brown, blue or gray. • Eye shadow. Two to three colors from the same family tone.

polished finish. 2.

Apply shadow. Application of eye

shadow goes from dark (closest to your eyelid) and fades to light. For starters, apply the light shadow from the inside of your eyelid and across entire eyelid as base. Then apply

• Foundation. Same color as your skin to cover imperfections.

the darker eye shadow from the outside in, fading out in the middle of your eyelid. The final effect should be a seamless transition from one shade of color to the other.

• Choice of lip liner and

lipstick color.

with your choice of eyeliner color.

• Translucent powder (optional).

Outline your eyes - above and below

It’s time to curled lashes and apply

mascara. This will help you make your eyes more luminous and large. 5.

Next outline your lips with a lip liner.

Then apply lipstick or lip gloss. The two colors should be from the same family. Think nude or natural for nightshift. 6.

Very lightly dab your face with translu-

cent powder to create an understated effect. 7.

There you have it. In a few short steps,

you applied makeup for your nightshift! NOTE: Think “light” application for work and go darker and mysterious for a night out. 46

Issue 11

Attitude

Re-defined 47

Fabulous Nurse Magazine

A Nurseâ&#x20AC;&#x2122;s Guide

Self Defense

By Sara Caldwell

s rewarding as the job can be, nurs-

the ease in which one can enter most hos-

force. The Bureau of Labor Statistics reports

ing is not without potential danger.

pitals to burglarize or attack victims. Then

that 2 per 10,000 private sector full-time

Beyond the risk of infection or other

there are those late night shifts that involve

workers suffer injuries resulting from as-

dark walks to the parking lot or bus stop.

saults and violent acts. Overall, health ser-

health hazards, you may have to manage volatile patients or family members, especially if they are emotionally distressed.

In the Workplace

More sinister sorts may take advantage of

Nurses are an especially vulnerable work-

vice workers number 9.3 per 10,000 fulltime workers. For nursing and personal care facility workers, the statistics are 25 per

Issue 11

10,000. A November 12, 2010 Nursing Link article,

phone, and stay alert. The Nursing Link article also

Self-Defense for Nurses, cites the major reasons for

suggests not rummaging through your purse as you

this high number:

head to your car or wait at a bus stop. Get keys or

• Easy availability of weapons • Presence of drugs and valuables in the hospital • Long emergency rooms waits • Low levels of staffing • Insufficient security measures • Poorly lit parking lots The article suggests reporting any incident you feel could lead to violence, even if it hasn’t reached that

coins ready before you exit a building so that you can avoid looking like an easy target. Also, make eye contact with strangers you pass – this tends to rattle potential attackers as they don’t perceive you as meek and realize you would be able to identify them in a line-up. But sometimes – at work, outdoors, or at home – action must be taken immediately to prevent personal injury. Without a basic understanding of self-defense, it is all too easy to panic and lose control of the situation.

level. But if it gets out of control, they advise staying

Self-Defense Techniques

near the door as an escape route, not turning your

Most men are bigger and stronger than the victim

back on the threatening person, and calling for help

they seek as prey, so your best defense is to react

as soon as possible.

quickly and with an element of surprise. If you are

Violence usually stems from rage, without a logical means to control it. Marshall Rosenberg is founder of the Center for Nonviolent Communication, an international non-profit organization. He described the psychology well in his book, Nonviolent Communication; A Language of Life, when he said, “All violence is the result of people tricking themselves

attacked, the first thing you should try to do is get away. You may consider using pepper spray, alarms, or weapons for an element of surprise, but these tools can be snatched away. If you are completely vulnerable, the Nursing Link article advises making as much noise as you can, as the last thing an attacker wants is to draw attention.

into believing that their pain derives from other peo-

One of the most effective tools when under assault

ple and that consequently those people deserve to be

is knowledge of pressure points. The Selfdefense-

punished.”

4-women website describes these as “areas extreme-

If an individual or family member is suffering from a health trauma, it is easy to imagine why those closest to the bedside might be a target for anger or blame. This is why you should not try to argue. The primary goal should be to de-escalate the situation and alert security as quickly as possible.

ly susceptible to incapacitating pain or injury.” Pressure points occur where nerves are more vulnerable to pain, such as the groin, nose, shin, or windpipe. If you have a set of keys or a cell phone in your hand, take advantage of the weight and strength of it. The point is not to render your attacker unconscious but to hurt him enough to make an escape. One good

Outside the Workplace

strike may be enough to send him running.

The Selfdefense-4-women website offers practical

Most nurses will never face a serious assault. But

tips that can help protect you outside the workplace.

being self-aware of your surroundings, anticipating

The first is self-awareness. In other words, be aware

violent behavior, and understanding self-defense

of your surroundings, especially in vulnerable set-

techniques will go a long way toward protecting

tings such as dark parking lots. If you feel at risk,

yourself, so that you can continue to care for and

unplug your MP3 player or stop chatting on the

protect others.

Walk inMy

Fabulous Nurse Magazine

Clogs

Issue 11

Managing Care One Patient at a Time

Leesa Domingo By Karen Kalis

Introduction

hile many people go into nursing with the idea that staying in acute care in their

home country will be their career path, life sometimes takes a turn in another direction. Leesa Domingo, a nurse originally from Canada – now a Case Manager living in Dallas, Texas, with her husband and four-yearold son Miguel – is a perfect example of how a career in nursing can come in many forms.

Nursing In Canada After graduating from nursing school in Canada, Leesa worked on an as-needed basis because there was shortage of regular

nursing jobs in Canada. Though her work in

from acute care, she said, “After working

Canada was fulfilling, she decided to come

in the hospital for 10 years, I wanted to le-

to the United States as a travel nurse fifteen

verage my experience and work for an in-

years ago. “I stayed at the same hospital for

surance company doing case management.”

four years, then I went to Saudi Arabia for

Her attraction to case management had to do

four months. I ended up back in Dallas after

with wanting to connect to her patients on a

that,” she said. When Leesa left Canada, she

long-term basis. “As a case manager, you

did face changes, “I left all that I knew to go

are coordinating services for people over

somewhere I knew nothing about,” she said.

the long-term. In an acute care setting, you

Once she became adjusted to life in the Unit-

treat them for twelve hours and then leave.

ed States, Leesa’s nursing career took a turn.

In case management, you learn about their

The Move To America

life outside of the hospital. It’s a great fit for me,” said Leesa. Currently, Leesa is work-

Leesa spent the first ten years of her career

ing with the Medicaid/Medicare population,

in bedside, acute-care nursing and has been

coordinating services to make sure her pa-

a case manager for the last five years. When

tients can stay at home and not go to a long-

asked why she shifted to case management

term nursing care facility if possible. 51

Fabulous Nurse Magazine

Leesa worked, nurses are unionized. She

perience and recommends the certification

said, “When you have a union that backs you

exam. “If you are looking into case man-

and there is a push to be degreed it makes the

agement there is a CCM exam-- it’s a great

profession seem a little bit different.”

designation to have. You cannot take it un-

What She Has Learned

Leesa mentioned that nursing in the United States is different from nursing in Canada. Though she was there fifteen years ago, in her opinion, nurses are treated differently. “I found that nursing was more of a profession [in Canada]. When I came here I found the transition was a little rough. The nursepatient ratio in Canada was lower [than in

ing outside the hospital setting. “When you

ing can be more than hospital-based work.

are transitioning out of the hospital, the sky

She said, “I think for me, being in the insur-

is the limit! You have options to move up the

ance industry, being there is a better situation

ladder or move laterally.”

Leesa Domingo has leveraged her experi-

I’m doing a type of nursing that I prefer.”

ence to find a type of nursing that appeals

With a four-year old son, working as a case

to her – case management outside of the

manager has allowed her to be the mom she

traditional hospital setting. Her enthusiasm

wants to be. “I’m very glad I’m a case man-

and passion for caring for patients has pro-

ager as opposed to acute care. I’d be locked

vided her with the perfect fit for her family

into 12 hour shifts. With case management

and life.

there is a lot of flexibility and I still have time for Miguel. Doing this type of work gives me a lot of flexibility. My husband is self-employed so we have the time to do what we need to do for him.” For nurses who are considering working

tients are handled is a bit different as well,”

outside of the hospital, Leesa said to be pre-

she said.

pared for a transition. “Be prepared to put

in the way medicine is handled and the expectations for nurses. She said, “In Canada, they are very selective about who gets what [treatments and testing].

It’s socialized

medicine.” The way nurses are treated is different, too. “I do know that when I was practicing in Canada they were mandating that people bridge to BSN and the interaction between doctor and nurse was a little more formal,” she said. In Ontario, where

With a vast amount of nursing experience,

You don’t have to end up in a hospital. Now

the US]. The basic philosophy of how pa-

The differences are not only in attitude, but

enthusiastic about the opportunities for nurs-

Over her career, Leesa has learned that nurs-

than acute care.

Nursing Differences in Canada & America

less you have experience.” Overall, Leesa is

your business hat on. Insurance is a business. You have to keep that in mind. You are trying to save somebody money. That is something you don’t think of in acute care. In the hospital, in terms of your wage, you are paid by experience. In the insurance world, you can negotiate your wage. Be prepared for that. Some places might want you to take a pay cut. Fight back and stand up and don’t settle.” Leesa believes that case management is a great fit for nurses who are looking for a more in-depth patient ex-

Issue 11

Fabulous Nurse Magazine

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Issue 11

Faye Wattleton’s By Margaret Smith

Mission:

Keep Government Out of the Bedroom

knitting needle, a spoke from a bicycle wheel, a wire hanger or a meat skewer. Innocuous tools in the right hands, but potentially deadly in the hands of a desperate woman attempting to end an unwanted pregnancy. In the days before Roe v. Wade,

these were just some of the instruments of choice in back alleys or other secret locations. Seedy practitioners preyed on minority women and women of poverty, who were especially unwilling to bring a child into a hostile world. Sometimes these women would even resort to self-induced abortions, frequently with dire consequences. Thousands would die; quickly, from hemorrhaging of a perforated uterus wall or slowly from overwhelming infection. In the world of illegal abortion, Death wears many faces. As women continued to suffer and die from complications of illegal abortions, battle lines were drawn. The issue of reproductive freedom became a festering boil on the nose of society, and Faye Wattleton became the lancet.

Family ties Faye Wattleton grew up as the only child of hard working, Christian parents, who laid a groundwork of love, support, devotion for family and God, optimism, and confidence in each other. This environment fostered

that it went against the word of God. And,

what she learned from her experience there.

at some point, Faye may have embraced that

A new awareness dawned on her as she

philosophy. But she would adopt an entirely

found herself caring for children who were

opposing viewpoint when she came face to

victims of disease, abuse, and neglect—chil-

face with the cold realities of restricted re-

dren who had come into the world unwanted.

productive rights.

This experience had a profound influence on her actions for the future. She decided to

a sense of self-assuredness in Faye as she

Faye had talked about becoming a nurse

grew up. Later, she acquired a knack for

from the age of four, when she started

adaptability, as she was obliged to live with

school, precociously skipping both kinder-

relatives or church friends while her parents

garten and first grade. After graduating from

travelled around the country, spreading the

high school at sixteen, she enrolled in Ohio

word of God.

State University where she earned her Bach-

In an interview with Ohio State University

elor of Science in nursing.

College of Nursing Magazine, Wattleton ac-

Faye’s father was a factory worker and her mother was a seamstress who along with Faye’s grandfather, were also forceful evangelical fundamentalist preachers. Faye frequently heard her mother denounce the practice of abortion from her pulpit, asserting

An unexpected education

continue her education by enrolling at Columbia University to earn her Master of Science in maternal and infant care, with certification as a nurse-midwife.

knowledged, “Choosing a career in nursing was perhaps my most important professional

Her education continued as she began her

decision. Had I not had direct experiences

nursing career at Children’s Hospital in Co-

with patients and gained an understanding of

lumbus, but she found herself unprepared for

what goes on in women’s lives, I would 55

Fabulous Nurse Magazine

not have had the determination and commitment to

to the public wherever possible through print and elec-

non-compromise on the gains that women have made

tronic media.

with respect to reproductive choice.” It was during her first year on clinical rotation at Columbia University in New York that she was able to see how pervasive the problems of illegal abortion were, as approximately 6500 women were admitted to Harlem Hospital with complications related to incomplete abortions. One direct experience involved the case of a pretty teenager who was admitted in terminal condition. A victim of poverty, she didn’t have the money to pay for an abortionist, so she and her mother had collaborated to create a concoction of bleach and a household disinfectant and inject it into her uterus. Her blood stream absorbed the lethal chemicals, which resulted in damage to her kidneys. As a result, her other vital organs completely shut down. She never had a chance. Following her eye-opening time at graduate school, Faye returned to Dayton, Ohio and worked for three years in public health nursing, teaching nurses about obstetrics. But she felt there was an urgent need to mobilize an advocacy campaign for women, and she became executive director of the local chapter of Planned Parenthood. Eight years later in 1978, she found herself holding the office of president of the national organization. She was the youngest person to hold the office, the first African American, and the first woman since the founder, Margaret Sanger, held the post.

times violent resistance. Faye received hate mail and death threats to the degree that she was compelled to hire bodyguards to accompany her when she went out in public. Clinics were fire-bombed, doctors attacked, and even federal and state legislators did their part to interfere by doling out arbitrary court decisions and rules in an attempt to encumber abortion services. While the debate over reproductive rights grew, Faye tried to persuade her opponents to see reason. As she commented in an interview for the magazine Savvy Woman, “We’re not saying abortion is right or wrong or preaching a moral cause, because that is a very personal decision. What we are saying is that government has no right telling women what to do with their lives.” She upheld the notion that reproductive decisions were between a woman and her own conscience, not a judge, not a politician, not a government. Under the leadership of Faye Wattleton, Planned Parenthood made great strides in educating the public about reproductive rights. It was an exhausting battle, and Faye was ready to resign from her position in 1992. But she wasn’t ready to give up her passionate advocacy for women’s rights and gender equality. After a

A force to reckon with

talk show on women’s issues didn’t pan out, she went

When Faye took over the reins of the national organi-

the Line. In 1995, she established a think tank for wom-

zation, Planned Parenthood clinics in 46 states were

en’s policies—the Centre for Gender Equality, later re-

providing about 3 million people per year with services

named the Centre for the Advancement of Women. She

that ran the gamut from infertility counselling to birth

led it from the day it was established until she retired

control to prenatal care. She felt that the time was right

in July 2010.

for the organization to also take on the role of advocacy for women’s rights and reproductive freedom. With her calm, eloquent style, she delivered the message as widely as possible, making herself visible and available

As expected, her campaign was met with fierce, some-

on lecture tours and wrote her autobiography, Life on

With her poise, intelligence, and beauty, she could have chosen from many paths for her life to take. Faye Wattleton chose to make a difference.

Issue 11

Travel 57

Fabulous Nurse Magazine

A Journey through

San Francisco’s

Golden Gate By Sara Caldwell

nce a tiny trading post settled by

converting the small outpost into a cosmo-

For traveling healthcare professionals con-

the Spanish in the late 1700s, San

politan and cultural metropolis atop a hilly

sidering a move to this quixotic City by the

Francisco became the tenth larg-

corner of the northern California coast. In

Bay, jobs are plentiful. However, it is im-

est city in America by 1870, fueled by the

the 1840s and ‘50s, Chinese laborers were

portant to consider the cost of living against

discovery of gold. The Gold Rush brought

recruited to build railroads, work mines, and

potential earnings to figure out if you can

an influx of people from all over the world,

tend fields, resulting in the world renowned

truly afford San Francisco’s vibrant lifestyle.

Chinatown. But much of the city came

And despite picture-perfect neighborhoods,

crashing down on April 18, 1906, when the

there are lesser known and dangerous ones,

‘Great Earthquake’ struck and a subsequent

as well as, other safety issues to think about.

fire burned for four days, killing thousands of people and destroying much of the city. Despite the devastation, San Francisco rose from the ashes to become one of the top tourist destinations in the world. It is well known for its chilly summer fog, steep rolling hills, Victorian architecture, old-world cable cars, and famous landmarks, including the Golden Gate Bridge, Alcatraz, and Fisherman’s Wharf. The city is also surrounded by the world famous Napa Valley wine region and Silicon Valley, helping elevate it into one of the most affluent regions in the nation. 58

Clinical Environment: Nursing is one of the few steadfast professions during this recession, with plenty of need to fill short and long-term nursing shortages. The largest hospitals in the San Francisco include St. Mary’s Medical Center, Saint Francis Memorial Hospital, and UCSF Medical Center. Other area hospitals are Laguna Honda Hospital, Chinese Hospital, St. Luke’s Hospital, Keiser Permanente, and San Francisco General Hospital. San Francisco is also home to outstand-

Fun Facts: San Francisco 1.

Issue 11

San Francisco was originally called Yearba Buena, a Spanish name meaning “good herb” or “good grass.” “Baghdad by the Bay” coined

by columnist Herb Caen, and “The City that Knows How” are among the common nicknames of the city 2.

Denim jeans were invented in San Francisco because Gold Rush miners needed tough, comfortable clothing to work in.

San Francisco cable cars are the only moving National Historic Landmark.

The Hagiwara family invented “Chinese” fortune cookies at Golden Gate Park’s Japanese Tea Garden. San Francisco is also known for

having the largest Chinese community in the world, outside of China. 5.

John C. Fremont named the San Francisco Bay’s entrance “Chrysopylae” (Golden Gate) because it resembled Istanbul’s Golden Horn.

The Golden Gate Bridge is continuously painted and repainted all the time, because by the time the paint crew gets from one end to the

other, it’s time to start over again. 7.

Harvey Milk, who was portrayed in the recent film ‘Milk’, became America’s first openly gay politician. Harvey Milk was assassinated

in 1978, by political rival Dan White. 8.

Al Capone spent five years in the notorious Alcatraz federal prison island located in the San Francisco Bay. It was closed in 1963.

Did you know that San Francisco is one of the richest cities in the world? San Francisco ranks 4th in the world, after New York, Moscow,

and London, in terms of the numbers of billionaires that call it home. Amazing since it has less than 10% of the population of the other three cities. 10. Caffe Trieste is the first coffee shop in San Francisco that was established in 1956. It is said that large portions of the famous The Godfather Trilogy script was written here by Francis Ford Coppola.

Fabulous Nurse Magazine

sistance in finding a job. Traveling nurses

for rentals is the Mission District, named for

can expect to find very competitive salaries,

a Mission built in 1776 and now known as

sign-on bonuses, full medical healthcare

Mission Dolores. Mexican immigrants were

coverage, and bonuses for referrals. Howev-

followed by Irish and Germans, and today

er, the cost of living needs to be considered.

the neighborhood is full of thrift shops, cafes, and used book stores that attract a mix of

Cost of Living and Compensation: The cost

students, artists, activists, and those seeking

of living is 84.90% higher in San Francisco

affordable housing.

than the U.S. average and you can easily pay $2,000 for a 1-bedroom apartment. Since

Social Environment: San Francisco encom-

most people can’t afford to live in San Fran-

passes 49-square miles of distinctly unique

cisco proper, they commute from the out-

neighborhoods. It’s a city made for walking,

lying areas. The average commute time to

not driving. Parking fees are astronomical,

work is 33 minutes, compared to a 28-min-

so bicycling or footing it is the best way to

ute national average.

get around. According to a 2011 Walk Score Survey, San Francisco is considered the sec-

ing educational facilities, with more than 35 colleges and universities. The National

The good news is that according to the Unit-

ond most walk-able city in the nation, and

ed States Department of Labor’s 2011 sta-

scores of parks, waterfront running and bik-

tistics, California ranks highest in the nation

ing paths, and pedestrian friendly walkways

for R.N. job openings and wages, and San

that will encourage anyone into this healthy

Francisco’s average salary is $92,000 annu-

alternative to driving.

Research Council (NRC) rates the University of California, UC Berkeley and Stanford University as the two top-ranked graduate schools in the country. These schools offer training for Registered Nurses, Nurse Practitioners or Legal Nurses, with programs in Critical Care Nursing, Forensic Nursing, Hospice Care, Nursing Informatics, Midwifery, and other specialized areas. Travel Requirements: Recent laws on nurseto-patient ratios have resulted in a large number of available skilled nursing jobs, with highly competitive salaries. There is also a great need for temporary medical professionals, so those seeking flexible schedules will find lots of opportunities in this city. Given the high demand for nurses, non-US

ally for full-time nurses; this is 22% higher

nurses are also encouraged to apply for jobs

than average RN salaries for job postings

In fact, out of the 91 defined neighborhoods,

in San Francisco. Most nurse travel agen-

nationwide. While such a salary may seem

30 are considered a ‘walker’s paradise.’ This

cies will help cover many of the costs. For

like a lot, caution should be taken to calcu-

ranking includes access to amenities such as

example, American Mobile Healthcare of-

late cost of living expenses, such as housing,

grocery stores, restaurants, schools, public

fers an 18-month immigration program for

groceries, transportation, and utilities. At

transit, and parks. Commerce and shopping

nurses who are ready to move to the U.S. for

the end of the day, earnings versus expenses

are centralized in the Financial District and

the long term. Nurses are generally covered

might equate to a similar standard of living

Union Square, though most neighborhoods

for travel and lodging to take the NCLEX-

with a lower salary in the Midwest.

boast their own flavor of businesses, restau-

RN exam. After passing the exam, nurses are sponsored for a U.S. visa and given as60

rants, and venues for locals and visitors, alike. One of the most affordable neighborhoods

Issue 11

Since the 1960s, San Francisco has been the

down when seated. As odd as it seems, it is

Conclusion: If you are an urban sort who

epicenter of liberal activism. In 2007, the

not unusual to see a nude couple stroll down

thrives on the eclectic energy of a big city,

city expanded its Medicaid and other indi-

a public street.

with colorful neighborhoods and beautiful

gent medical programs under the Healthy

skylines, San Francisco may be your calling.

San Francisco program, with subsidies to

Safety Issues: Like any big city, San Fran-

But while your income might go up, you may

eligible residents. The city’s population is

cisco has its share of safety issues, such as

need to exchange a large living space for a

diverse; 29% of residents originate from

a large homeless population and pockets of

modest one or live outside the city limits.

overseas, predominantly of Asian and Latin

rough neighborhoods that should be avoided,

Those who enjoy physical fitness will also

American descent. There is also a large gay

such as the ‘Tenderloin’ district just north

enjoy this walker’s paradise of paths, hills,

population; the rainbow flag, the symbol of

of the Civic Center; violent crime is not

accessible amenities, and a general proactive

LGBT (Lesbian, Gay, Bisexual, and Trans-

prevalent but common sense safety mea-

health culture. One thing you can count on in

gender) pride, originated in San Francisco.

sures should be taken when visiting or living

San Francisco - the Golden Gate city lives up

Public nudity is legal so long as the individu-

in the city.

to its name when it comes to golden opportu-

al is not sexually aroused and places a towel

nities for nurses. Travel San Francisco – Sources for Fact Checking http://en.wikipedia.org/wiki/History_of_San_Francisco http://www.onwardhealthcare.com/jobs/California/San-Francisco-CA/ http://www.ayatravelnursingjobs.com/travel-nursing-jobs/California/San-Francisco/ http://california.nursingjobs.us/city/san-francisco/ http://www.bestplaces.net/city/california/san_francisco http://www.nursezone.com/nursing-news-events/more-news/Where-do-RNs-Earn-Top-Dollar_29106.aspx http://career-resources.allhealthcarejobs.com/articles/content/entry/where_to_find_top_paying

Fabulous Nurse Magazine

Breakroom Discussions

Issue 11

Living

Well 63

Fabulous Nurse Magazine

Jed uses the imagery of the “sexual diamond,” using Angeles Arrien’s polarity of the “magnetic dimension” and the “dynamic dimension” of life. The post-menopausal “magnetic man” feels a “coming home,” being more rooted and inner-directed. The “dynamic woman becomes more assertive and

Male Menopause

adventurous. Here Jed echoes what Robert Bly says in his audio tape The Red, White and Black. Men, Bly tells us there, begin in the red and move into the white before moving into the black. Women begin in the white, moving into the red at mid-life and then into the black. At any rate, the two-part story of male menopause and sex that Jed describes involves loss, perhaps even impotence, and then climbing the “second mountain” to have a deeper, fuller, richer sex life. Part 1: Loss and impotence A while back, a man wrote me at MenWeb, saying: I’ve had a problem with impotence for about six years. Never had the money to go get it check out, my insurance will not pay for it. But here’s my story. I’m hoping maybe you can help me. Everytime my wife and I are having intercourse I always lose my rigidity(erection)when I’m in her. Why, I have no idea. Kind of makes me mad. I always say to myself and god what’s wrong with me? Am I a man or what? Is there anyone you can refer me to or maybe know some other men who have walked in my shoes that might be an inspiration to me... thanks...please help.. There it is: that scary word. Impotence. Jed points out that impotence can be a significant problem for men going through male menopause. Impotence is defined as the persistent inability to attain and maintain an erection

he story of mid-life, male menopause and sex that Jed tells in Male Menopause is a two-part story, paralleling the general theme of the book. There’s the rolling down the mountain (or, for females in menopause the falling off the cliff.) Then

there’s the climbing of the Second Mountain, going on to a deeper, richer and fuller life. Jed pointed out at his talk at Gaia Bookstore that his wife, like many other women, experienced Post-Menopausal Zest, while he experienced Post-Menopausal ???

adequate to permit satisfactory sexual per-

impotence was 52 percent.

diabetes, as well as with the medications that

formance. According to results from the

Although the study found that psychologi-

are often taken to deal with these problems.

Massachusetts Male Aging Study that stud-

cal factors play a role as men age, physical

Jed’s book goes into valuable detail about

ied a large sample of men between the ages

factors are more significant. It found that

the medical help, hormonal treatment and

of forty and seventy, the combined preva-

there was a high correlation between erectile

holistic approaches available. The book’s

lence of minimal, moderate, and complete

dysfunction and heart disease, hypertension,

worth the price just for this. But since the

Issue 11

physical, psychological, and sexual aspects are interconnected, most all these symptoms can be prevented and treated by concentrating on the whole man. This Jed does in later chapters. But there are other sexual changes that occur in a healthy, normal malea as they age, such as: •

Erections take longer to occur.

•

He often requires direct physical stimu-

lation to get an erection; a sexy sight or fantastic fantasy may not arouse him as it did before. •

The full erection doesn’t get quite as

firm as it used to. •

His urge to ejaculate is not as insistent

as before. Sometimes he doesn’t feel the need to have an orgasm at all. •

The force of ejaculation isn’t as strong

as it once was. The amount of his ejaculate is less, and he may have fewer sperm.

•

Reduce stress

and worry in your life. Stress is a major source of trouble for men at midlife. •

Embrace a sexuality appropriate to the

second half of life. In the second half of life, a man’s sexuality expands to include more emphasis on friendship, love, intimacy, and spirituality. Part 2: Sex and Love on the Second Mountain Jed makes an observation that gives one pause. It’s not true, he says, that “love” is an invention of Western Society and the in-

The desire for and frequency of masturbation

fluence of the Troubadours and the Courtly

may drop, but in some men may increase.

Love Tradition. It’s in every culture. Simi-

The testicles shrink some, and the scrotal sack droops. The sack doesn’t bunch up as much during arousal. Jed makes some general recommendations, both for impotence and for sealing with the sexual changes that happen to men at midlife, such as: •

Get regular health checkups. Regular

health care visits and screenings are important contributors to men’s health and longevity. •

larly, the idea of a “sex life” as something separate from a life involving sex, love and intimacy is a modern invention. Here he echoes the theme of Dagara African initiated shaman and Sorbonne doctorate Malidoma Somé in his best-selling tape We Have No

body of yourself and someone you love as

Word for Sex, also reviewed on MenWeb.

an intense physical expression and manifes-

Jed draws on the work of psychologist Paul Pearsall, author of Sexual Healing: Using

(Remember, for example, that the skin is our

the Power of an Intimate, Loving Relation-

most sensitive organ.)

ship to Heal Your Body and Soul who out-

Pearsall coins the term “sexual shaman.” He

lines a five-part approach to sexual healing: Check hormone levels as you get old-

er. Generally between forty and fifty-five a number of important hormones in a man’s body begin to decline.Lowered levels of

•

Self-Esteem - a connection with Self

•

Intimacy - a connection with someone

significant in your life

Dopamine, oxytocin, vasopressin, growth

•

hormone, melatonin, DHEA, pregnenolone,

one who shares your beliefs in a higher pur-

thyroid hormone, and testosterone may de-

pose and meaning

crease sex drive, increase depression and

•

weight gain, and contribute to a general decrease in health and well-being.

tation of all five levels of connection.

Coherency - a connection with some-

Mindfulness - a connection with the

current moment Sensuality - a connection with the physical

states: “To become a sexual shaman or healer requires learning two special skills practiced by all shamans: playful joy in living with others and sensual activity and movement throughout the life cycle.” Jed observes that shamanism as a spiritual tradition that links people to the natural world is as old as humankind. But “sexual shaman”? More common-sense living than “hocus-pocus,” as I read Jed’s advice. He offers his own seven-point program for healthy living and a healthy and satisfying post-menopausal 65

Fabulous Nurse Magazine

Elsewhere in the book, Jed reports on a study where, of the 10,000 impotency patients who took pausinstalia yohimbine (yohimbe), 80% reported good results. Embrace Self-Love and the Joys of Celibacy. Jed is not talking about entering the priesthood here. He points out that during his wife’s menopausal time of life there were periods where sex just “didn’t work.” He doesn’t deny that he experienced anger, frustration and sexual fantasies. But he does point out that he found some deep value in these periods as times to redirect his creative energies elsewhere, as well as finding more expansive expressions of intimacy ad love. Learn to Love the One You’re With. Find a partner and practice loving the one you’re Exercise for health. This is not just a mat-

with. It is the most difficult and rewarding

ter of keeping up your strength and endur-

activity on the face of the planet, in Jed’s

ance trough aerobic exercises like biking,

view.

and keeping the abs tight to prevent backaches, although “a lover with a stiff back is an oxymoron.” My wife, Bernetta, the yoga instructor, will be pleased to see Jed’s words of praise for daily yoga stretches as a way of keeping flexibility. Jed also points out that over half of the men over 40 have experienced impotence, but Walter Bortz M.D. reports that of the men over 75 in the Fiftysex life, that makes sense whether or not the idea of “sexual shaman” appeals to you. Eat food for life. Ancient diets of vegetarianism with a little meat added goes back to

Plus Fitness Association, 58% rated their sex lives as good or very good, 23% rated it fair, and only 19% rated it as poor. ‘Nuff said? Find the Healthy Herbs for High Level Sex.

Accept That You Have 24-Hour Access to the Best Healers in the World. What did he say? What does he mean? In 1978 Jed found a book by Mike Samuels, M.D. and Hal Bennett called the Well Body Book. The authors state that your body is a three million year old healer with all the knowledge, tools, materials and energy necessary to keep yourself healthy. These inner healers have been Jed’s main source of support every day since then. So where does this post-menopausal sex path lead you? In Jed’s view, to be the “sexual shamans” who will be the leaders we need

our Paleolithic ancestors and accounts for

Jed recommends:

longevity of life and lower rates of diabetes,

•

heart disease and cancer in Asian countries.

tance,

we all share.

Take vitamins to prevent disease. Here he

•

BIO. Jed Diamond is a psychotherapist with 30

quotes Dr. Andrew Weil, author of 8 Weeks

malizer,

years’ experience, and a prolific and noted author.

•

His book Inside Out: Becoming My Own Man

to Optimal Health(order on-line) in “Protecting Your Prostrate,” from his Self-Healing Newsletter Dr. Weil states he takes 10,000 IUs of mixed carotenoids, 800 IU of Vitamin E, 800 mcg. of selenium daily, and 2,000

Wild Yam for hormone building assisBlack Cohosh for a relaxant and norSaw Palmetto for a reproductive system

nutrient, •

Damiana as a prostate tonic, anti-de-

pressant and nutrient for sluggish sexual or-

to ensure the survival of ourselves, our children, our communities, and the fragile planet

was one of the first books of the “men’s movement,” before it was popularized by Robert Bly. He has also written Looking for Love in All the Wrong Places: Overcoming Romantic and Sexual

mg. of Vitamin C 2-3 times a day. He takes

gans, and

30 mg. of supplemental zinc and 80 mg. of

•

St. Johns Wart and Oat for nerve tonics

Healing Men, Healing the Planet. He also authors

coenzyme Q, which increases aerobic capac-

to help deal with depression and stressful life

Male Menopause (updated 2nd ed.)(Naperville IL,

ity and protects the heart muscle.

changes.

SourceBooks, 1998. ISBN 1570713979)

Addictions and The Warrior’s Journey Home:

Issue 11

Fabulous Nurse Magazine

Sleep Yourself to Skinny Better Sleep Helps You Burn Fat

ou might be surprised to learn that your sleep affects your weight. Studies have shown that people who get better sleep weigh less. Similar studies have shown that by taking measures to improve your sleep can help you lose weight.

Why Sleep Matters When you sleep, your body spends that time recovering from the day. Your organs,

you go to bed you might brush your teeth, wash your face and read a book for ten minutes before turning the lights out.

mode. It stores more fat. Not good for weight loss! Regardless of the reasons behind the sleep/

down time to regroup. If you’re not getting

weight loss correlation the facts are the

enough sleep or you’re not getting good

same. If you don’t get good sleep you’re

quality sleep, your body cannot recover. This

more prone to weight gain.

means your body spends the day struggling. found that people who sleep poorly eat more

same pattern of behavior. For example, when

enough sleep your body switches to survival

hormonal systems and your cells take your

Your metabolism is affected. Studies have

up at the same time every night. Follow the

How to Get Better Sleep

Aim for seven hours of sleep. Don’t use electronics in the bedroom. Electronics stimulate. You want to relax. Eliminate watching television, surfing or social networking on your mobile device before bed. Avoid stimulants in the afternoon. If you routinely drink a cup of coffee or tea in the

If you want to lose weight then, it makes

afternoon then consider switching to decaf.

sense to take measures to improve your

Or move your habit up an hour or two. Caf-

sleep. Here are some tried and true success

feine can stay in your system for several

strategies to consider:

hours and can affect sleep.

a study published on BBC News, researchers

Don’t eat or drink two to three hours be-

If you’re not sleeping well and cannot im-

suggest “the key might be that sleep depri-

fore bedtime. You’ll reduce your body’s

prove your sleep with these simple steps

vation alters the balance of hormones which

need to digest and you won’t have to get up

consider seeking a doctor’s help. Good sleep

control the rate at which we burn off calo-

to go to the bathroom in the middle of the

is important for overall mental and physi-

ries.”

night.

cal health. Once you’re able to sleep better

It may also be that when you don’t get

Create a sleep ritual. Go to bed and wake

you will also find you’re better able to lose

during the day. Some of this can be attributed to the fact that these people are turning to food for energy. However, it’s not really food they need, its better sleep. According to

weight and burn fat.

Issue 11

Marriage Dating

Fabulous Nurse Magazine

Biggest Relationship Blunders

How to Avoid Mistakes to Nurse a Great Relationship

By Sara Caldwell

“I know it is frustrating being with someone who doesn’t understand the stress and demand of the nursing field. When I started school, my boyfriend was really supportive. It progressed to him wanting me to go out every weekend and when I said I couldn’t he’d throw fits.” This posting on an All Nurses blog (August 14, 2010) probably rings familiar.

politics makes it all about you. If you don’t stop to listen to what your date has to say, chances are it will be the last one. Similarly, an article on eHow, The Worst Dating Mistakes (March 31, 2011), cau-

ith studies, long shifts, and

Blunder #2: Playing Games

tions against talking about your ex. Seri-

other obligations, many nurses

A Datingish article, 10 Biggest Dating Mis-

ously, there is nothing worse than listening

find little time for dating. And

when they do find that special someone, it’s amazing how quickly things can go wrong while juggling work and romance. It’s easy to blame problems on the other person, but sometimes it helps to reflect on your own actions. Are you doing the same things over and over and expecting different results? Blunder #1: Being Too Available A Glamour Magazine article, 8 Dating Mistakes Even Smart Women Make (April 15, 2010), warns against being too available as this sends a signal of desperation. Or worse, you’re always there as a standby if he doesn’t get the date he really wants. Your life should be fulfilling with or without a partner in the picture, and an active person is frankly much more attractive than someone who sits around waiting for the phone to ring.

grind, or your personal druthers on life and

takes (June 17, 2011), advises against game playing. Playing hard to get, ignoring texts or waiting for the third call to pick up the phone might make him enjoy the chase, but

to someone rant on about an ex-partner, whether the memories are good or bad. You may still have strong feelings for your ex, but if you can’t stop talking about him, it will

at the end of the day, don’t we appreciate

imply to your date that he’s only a rebound.

honesty the most? A blogger commenting on

Blunder #4: Settling for Mr. Wrong

the article has good advice on this matter:

How many friends or co-workers do you

“I personally try to set the tone by being

know who would rather be with a shmuck

honest early and often to let the person know

than alone? We all know from experience,

that I’m not playing games. Then I some-

you can’t change a person unless they want

times throw in, “And I hate women who play

to change themselves. Deep down, your gut

games, I don’t have patience for it.””

will tell you if it’s Mr. Wrong, given warning

Blunder #3: Telling Too Much, Too Soon The Datingish article also says sharing too much information too soon is a big no-no. On the first few dates, who wants to hear the detailed biopic of a virtual stranger? Sure, there’s getting to know, but forcing your date to listen about the minutia of your daily

signs. Does he drink too much? Is he constantly on the phone? Does he tell tall tales? Settling for the wrong guy, especially someone who treats you poorly is bound to fail. Glamour’s advice? Move on! Blunder #5: Mistaking Intense Attraction for Love at First Sight

Issue 11

The Datingish article also warns not to mis-

sional blunder. So how do you recover after

•

take attraction for love. It’s virtually impos-

making one? The dating service, eHarmony,

the blunder is habitual, such as always tell-

sible to fall in love simply by setting eyes on

offers some valuable tips in Recovering

ing too much, too soon, strategize. For ex-

someone. What is more common is an insane

from the Relationship Blunder (March 10,

ample, think of questions ahead of a time to

physical attraction, which can affect your ra-

2010), summarized here:

stimulate a two-way conversation and learn

tionality, especially after a few drinks. This

•

attraction can lead to jumping in the sack too soon, obsession and even stalking. Most often, it ends in heartbreak as rarely is the attraction mutual for long. Beyond the Blunders Nobody’s perfect or guilt free of the occa-

Take responsibility. No one likes to

Only you can change your actions. If

more about your date in the process.

admit they are wrong, but an apology goes a

•

long way to repairing a mistake.

ing “I’m sorry” all the time might be a sign

•

Accept the consequences. Blunders

have cause and effect. Acknowledging you caused someone else hurt or discomfort will

If you’re not at fault, speak up. Say-

he’s taking advantage of you. Determine if the blunder was really your fault or if there is a deeper issue involved.

make you think twice before committing the blunder again.

Fabulous Nurse Magazine

Home Parenting Hobbies

& 72

The Colors of Feng Shui

e all have our favorite colors. With the art of feng shui, the use of color takes on an importance

beyond whether we like it or not. Learn how color plays a role in your home’s tranquility.

Issue 11

Earth In feng shui theory, the earth represents stability in your life. It helps you to stay rooted and grounded in your relationships. The colors associated with the earth element are beige and a light shade of yellow. Light colors like these on walls will lighten up a space and make you feel as if anything is possible.

There are five elements that are essential to feng

Fire

shui: fire, wood, metal, earth and wind. Each el-

What’s the first thing that comes to mind when you think of this element? Maybe it’s the heat or a

ement is associated with a color or a group of

passionate feeling. Both words are used to describe the feng shui fire element. As you might imagine,

similar colors that represent its energy. You’ll

colors associated with the fire element are red, orange, bright yellow, pink and purple. If you think

be surprised to see where your favorite color

that pink doesn’t seem to fit, you haven’t seen the “hot” variation. All of these colors will make your

turns up.

heart race and feed your energetic attitude.

Wood In feng shui, the wood element is an ancient symbol of prosperity. Trees are made of wood and they contain lush green leaves and provide an abundance of oxygen for the people of the world. In keeping with these “life givers” the colors for this element are green and brown. So, it’s not a coincidence that money is green!

Metal If you’ve ever looked at metal you see how it has definite lines and shapes. In feng shui, metal brings clarity to your life. The colors gray and white represent these qualities.

Water Water is an element that represents abundance and a refreshing spirit. When you bathe in water it makes you feel clean. Using the colors of blue and black in your home promotes that purity. Don’t be afraid to add color in your home or workplace. How and where you use each color is governed by the feng shui energy map of your living area. You may have never thought that red could be an energizing force in your home but according to feng shui principles, it can. Color isn’t just for the walls but also the artwork, furniture, and accents. It inspires your dreams, opens your hearts, and brings new life into your home. 73

Baby Monitors

Fabulous Nurse Magazine

Holiday Gift Ideas

he holiday season is once again upon us. Thinking of getting someone a baby monitor? This chart will help you decide.

Cost Channels Audio/Video

Safety 1st Crystal Clear Baby Monitor

Philips Avent Basic Baby Monitor with DECT Technology

Sony 900 MHz BabyCall Nursery Monitor with Receivers

Summer Infant Best View Handheld Color Video Monitor with 2.5” Screen

Summer Baby Touch Color Video Monitor

Approx $20

Approx $120

Approx $70

Approx $200

Approx $280

Uses digital technology

Audio only

120 Audio only. Uses Zero Interference DECT technology

Audio

Audio and video 2.5” color screen with black and white night vision

Audio and video, with 3.5” color touch screen

Sensors & Alerts

Power on and low batter indicators

LED sound lights, out of range, low battery

Out of range indicator, low battery, light sensor lets you know if baby is making noise

LED sound lights

Battery low indicator

Range

49 MHz, 600 feet

1082 feet

900 MHz (distance not provided by the manufacturer)

350 feet

400 feet

Power Source

Electric and battery

Electric, 1440 minute rechargeable battery

Electric, rechargeable battery or standard batteries can be used.

600 minute rechargeable battery

2 AC Adapters and rechargeable batteries

Nightlight, parental unit locator, Intercom talk back

Voice activation mode, 2 water resistant receivers. Belt clip for handsfree carrying of receiver.

Belt clip and flip stand for receiver.

Additional Features

Receiver has belt clip for more portability

2-way talk back

NOTE: Comparison chart was created based on available information and features are subject to change. Consult manufacturer for safety information.

Create Fun, Sticky

Issue 11

Nature Collages W

ant a fun project for the whole family that is also

Supplies

educational? What about creating a nature collage

- Wide masking tape or duct tape

bracelet? Yep, even the boys will love this one.

- Construction paper

Here’s how to do it:

Step 1 Wrap your child’s wrist with tape, sticky side out, so they have a few inches of sticky tape to work with. You’ll want to make sure your child has plenty of wiggle room and that the tape isn’t too tight around their wrist. If it’s too tight they’ll spend the next few steps trying to get out of the tape and they’ll miss the fun. Additionally, if you’re using duct tape, you may want to touch it a few times with your fingertips to reduce the stickiness. Delicate items like petals and leaves can tear when you try to remove them from duct tape.

Step 2 Head outside for a nature walk. (Hint - if you have to drive to a nature area, don’t put the tape on their wrists until you get there. If you put the tape on too soon they’ll spend the car ride touching it and getting stuck to things and then the tape won’t be sticky enough for the activity).

Step #3 Start the hunt. Depending on the age of your children, you can structure the hunt any way you desire. You can ask kids to find things in a given category like “green” or you can let them run with it and find things they want to make their collage with on their own. The goal is to use the sticky part of the tape bracelet to collect their items. So, for

- Glue or spray adhesive example, if they find a rock or a frog it probably isn’t going to stick. However, a flower or a leaf will. Consider giving them a time limit so they know what to expect. For example, you could say, “We’re going to go on a twenty-minute hike and you can collect items during that time.” If they’re particularly young you may want to let them know not to fill their bracelet up in the first five minutes or they won’t have any room for things they find later.

Step #4 Head back inside. Have your child choose the color of construction paper they want and get ready with the spray adhesive.

Step #5 Tell your children to carefully remove their items from their tape. They can spend a few minutes deciding how they want to position the items on their collage. When they’re ready, you spray the paper with the spray adhesive and your child can position their items. The project can be completed or you can let your child continue with the project by coloring and labeling or decorating their collage further. A nature collage is a fun and inexpensive way to combine your child’s imagination with a good outdoor hike. It’s also an educational experience as your child learns about nature and the elements. 75

Fabulous Nurse Magazine

Issue 11

Fabulous

oodie F

Fabulous Nurse Magazine

Issue 11

Anti-Aging

Super Foods!

SDA scientists have developed a rating scale that measures the antioxidant content of various plant foods. The scale is called ORAC, meaning Oxygen Radical Absorbance Capacity. They discovered that a small group of “super foods” have up to twenty times the antioxidant power of other foods. It is recommended that one eat foods containing at least 3,000 ORAC units a day, which is not difficult, since 1/2 cup of blueberries contain 2,400 units. FOOD

ORAC Score

Prunes

5,770

Raisins

2,830

Blueberries

2,400

Blackberries

2,036

Kale

1,770

Strawberries

1,540

Spinach

1,260

Raspberries

1,220

You may not find the Fountain of Youth when you eat super foods, but you’ll get pretty darn close to it. Aging is a combination of time and environment. Environment doesn’t occur just outside the skin; it also refers to the environment you provide inside your body. A healthy internal environment will help you look and feel younger.

Avocado:

Garlic

This fruit, which is usually eaten as a vegetable, is a good source of healthy monounsaturated fat that may help to reduce level of a bad type of cholesterol in body. Avocado is a good source of vitamin E and can help to maintain healthy skin and prevent skin aging (vitamin E may also help alleviate menopausal hot flushes). It is rich in potassium which helps prevent fluid retention and high blood pressure.

Eating a clove of garlic a day (row or cooked) helps to protect the body against cancer and heart disease. The cardioprotective effects of garlic are well recorded. One 1994 study in Iowa, USA, of 41,837 women between the ages of 55 and 69 suggested that women who ate a clove of garlic at least once a week were 50 percent less likely to develop colon cancer. Another study at Tasgore Medical college in India suggested that garlic reduced cholesterol levels and assisted blood thinning more effectively than aspirin, thus helping to reduce the risk of heart disease.

Berries: All black and blue berries such as blackberries, blueberries, blackcurrants and black grapes contain phytochemicals known as flavonoids-powerful antioxidants which help to protect the body against damage caused by free radicals and aging.

Cruciferous vegetables: The family of Cruciferous vegetables includes cabbage, cauliflower, broccoli, kale, turnip, brussels sprouts, radish and watercress. Cruciferous vegetables assist the body in its fight against toxins and cancer. You should try to consume at least 115g/40z(of any one or a combination) of these vegetables on a daily basis. If possible, eat them raw or very lightly cooked so that the important enzymes remain intact.

Ginger: This spicy root can boost the digestive and circulatory systems, which can be useful for older people. Ginger may also help to alleviate rheumatic aches and pains. These are just a few of the benefits of eating super foods. It is a fact that the food you eat can influence your mental and physical health. If you could live healthier by eating better and smarter, wouldn’t you? Put Super Foods to work for you!

Fabulous Nurse Magazine

Issue 11

abulous F Recipes

Yields: 8 servings

Prep time: 20 mins

Ingredients:

Nectarine Arugula

alad S

•

4 cups fresh arugula or baby spinach

•

4 cups torn Bibb or Boston lettuce

•

3 medium nectarines, sliced

•

2 tablespoons pine nuts, toasted

•

2 tablespoons crumbled blue cheese

egar, sugar, mustard, salt and pepper until blended. Gradually whisk in oil until dressing

•

2 tablespoons raspberry vinegar

thickens. Drizzle over salad; toss to coat.

•

2 teaspoons sugar

NOTE: This recipe is healthy, quick,

•

1 teaspoon Dijon mustard

•

1/8 teaspoon salt

•

Dash pepper

•

3 tablespoons olive oil

Preparation:

In a large salad bowl, combine the first five ingredients. In a small bowl, whisk the vin-

and ADA friendly. Makes 8 servings.

Fabulous Nurse Magazine

Spicy African

Vegetable Stew

Ingredients:

Preparation:

1 onion (very large) chopped

Fry the onion garlic and stems of chard in a

•

1 Swiss chard bunch

pan. Add in the chopped greens and fry a lit-

•

1 can Garbanzo beans

tle bit longer to get cooking. Slice the yams

(known also as chick-peas)

in thick slices and add those to the pan along

•

1/2 cup Raisins

with garbanzo beans and tomatoes. Season

•

1/2 cup Rice, raw

to taste with salt and pepper. Allow this to

•

2 Yams

cook for 10 to 15 minutes. Make a well in

•

Several fresh tomatoes (or large can)

the center (you know, like you did with your

•

1 Garlic clove

mashed potatoes when you were a kid). Put

•

Salt and pepper, to taste

the rice in the well making sure the liquid in

•

Tabasco sauce, to taste

the pan covers it. Put the lid on and allow cooking for another 30 minutes. Serve with Tabasco sauce!

Chocolate Cake With Warm Lava Centers

Preparation: 1. Preheat oven to 450 degrees F (230 degrees C). Butter and flour four 4 ounce ramekins or custard cups.

Yields: 4 serving

2. In the top half of a double boiler set over simmering water, heat the butter and the chocolate until chocolate is almost completely melted.

Prep time:

3. Beat the eggs, egg yolks and sugar together until light colored and thick.

10 mins

4. Beat together the melted chocolate and butter. While beating, slowly pour the chocolate

Ingredients:

mixture into the egg mixture, then quickly beat in the flour and mix until just combined. 5. Divide the batter between the four molds and bake at 450 degrees F (230 degrees C) for

•

1/2 cup butter

•

4 (1 ounce) squares bittersweet chocolate

•

2 eggs

•

2 egg yolks

•

1/4 cup white sugar

with an orange slice.

•

2 teaspoons all-purpose flour

Makes 4 servings.

6 to 7 minutes. The centers of the cakes will still be quite soft. Invert cakes on serving plates and let sit for about 15 seconds, then unmold. NOTE: Serve immediately with Raspberries or fresh whipped cream, if desired. Garnish

Issue 11

3 Festive Thanksgiving Cocktails T

oast your reasons for giving thanks this year with 3 very festive holiday cocktail recipes. There is a non-alcoholic punch included for the so inclined.

Turkey Trot

Great Pumpkin Punch

Ingredients:

•

2 cups lemon lime soda

•

1 part rum

•

1 cup bourbon

•

2 part apple cider

•

2 cups cranberry juice

•

3 part ginger ale

•

1 oz pumpkin

•

Crushed Ice

Preparation:

Mix together with crushed ice in a glass. Garnish with mint leaves. NOTE: Best served in a Beer Mug.

Mix together. Serve in a hollowed out pumpkin with floating pumpkin chunks. NOTE: For an alcohol free alternative, skip the rum.

Wild Irish Buttery Squirrel Ingredients: •

1 oz vodka

•

½ oz amaretto

•

1 oz butterscotch schnapps

•

½ oz Irish cream

Preparation: Pour ingredients into a stainless steel shaker over ice. Shake until ice cold, and pour into a chilled ice-filled old-fashioned glass. Serve. NOTE: Best served in an Old-Fashioned Glass.

Fabulous Nurse Magazine

Perricone

Issue 11

Diet Plan

Diet

This diet is created by dermatologist Nicholas Perricone, MD. Diet Claim Eating foods that cause inflammation is what leads to wrinkles and other signs of early

eating inflammatory foods can cause mood

weight also in addition to fighting wrinkles,

swings and fatigue which no one wants.

disease and decreased immunity levels.

What can I eat?

Does the plan stress exercise of any kind?

aging. By using his line of lotions, creams,

Although the list of inflammatory foods you

supplements and eating certain foods, you

need to avoid is long there are still other

Dr. Perricone recommends thirty minutes of

can turn back the hands of time and stop the

foods full of antioxidants and healthy fats

exercise a day on his diet plan.

aging process.

you can enjoy. This food list includes foods

Diet Guidelines Changing what you eat can improve your metabolism and stop the disease process in your body. Boosting your immune system

like blueberries, salmon, eggs, yogurt, vegetables, olives, oatmeal (not instant), green

Eating a diet rich in fatty fish like salmon

tea, spices, legumes, fruits and avocados.

and blueberries helps neutralize free radicals

Drink at least eight glasses of water a day.

in the body that contribute to aging and dis-

In addition to the food, his supplements are

ease.

involves eating foods that wonâ&#x20AC;&#x2122;t initiate the

taken with breakfast and lunch.

inflammatory response in your body. Taking

What are the benefits?

supplements is a part of that plan.

Diet Pros:

Diet Cons: The diet is very strict. You are told what to

Eating carbohydrates that have low numbers

eat when with no exceptions. The main basis

The list of forbidden inflammatory foods is

on the glycemic index will stabilize your

of the Perricone diet plan is not weight loss

long. You will take around 25 supplement

blood sugar and prevent those mid-morning

but fighting the effects of aging. This plan

pills a day. The food plans are to be followed

and mid-afternoon cravings that cause you to

may also be quite pricey for some.

to the letter and food combinations are in-

overeat.

cluded to increase the metabolism.

How long do I follow this diet?

How much weight can I lose?

What does the diet plan cost? The Perricone diet can get pretty pricey.

The Perricone diet doesnâ&#x20AC;&#x2122;t stress weight loss

With the cost of supplements, his skin care

The basic Perricone diet is a 28 day plan

but stopping the ravages of time. By eating

products, salmon and fresh fruits and veg-

but you can follow this plan as long as you

the foods on his list, taking the supplements

etables you can spend well over $500 for a

like to keep your body healthy. Returning to

and using his line of products, you can lose

28 day program. 85

Fabulous Nurse Magazine

& Fit

Fabulous

Issue 11

Fabulous Nurse Magazine

Fitness racker T Daily Mile

aily Mile is a running tracker and social networking website

Once your workout is chosen, Daily Mile will show a drop down

combined. It helps runners, cyclists and other athletes con-

menu where you can add all the details for your exercise.

nect with one another and keep one another motivated.

Here’s a guide on how to use Daily Mile.

Step 1: Click Get Started to Setup Your Account

Follow the step by step process to create an account. You’ll have the

If you want to track more details, click “More Detail.” You can track

option of linking your Facebook and Twitter accounts to Daily Mile.

your heart rate, calories burned and a lot more.

You can also publish a picture so others can see what you look like. Because Daily Mile is such a social application, it’s generally a good idea to link either your Facebook or Twitter account so that you have a few friends already on the site when you get started. Here’s how to use Daily Mile once you’ve setup your account.

Step 2: Select Your Exercise and Provide Details Click the drop down menu under “Add Workout” to access the sports menu.

Click “Share” once you’re finished adding your workout entry.

Step 3: Choose and View Feeds Daily Mile has a feed very similar to Facebook’s. On the left hand side of the main page, you can choose to view feeds from just your friends, from people in your area or the most popular feeds on the site.

Issue 11

Daily Mile is a social site, not just a fitness tracking site. Comment on other

Step 5: Track Your Workout Progress Click on “Training” along the top to access your workout history.

people’s feeds and socialize with other sports enthusiasts.

Here you’ll see a detailed history of everything you’re tracking. By default, it’ll track your workout time, distance traveled, enjoyment of your workout and workout pace. You can add stats like calories and heart rate by customizing your shares.

Step 4: Commenting and Making Friends If you start commenting back and forth with someone, or meet someone in your area that share similar interests, you may want to become friends or workout buddies. To comment on a thread, just click

the

+Comment

button. You’ve now learned how to share a workout, comment on other peo-

To add someone as a friend, first click on their name to access their profile.

ple’s shares, make friends and track your fitness progress. You can also use Daily Mile on your iPhone or your Android phone. Although Daily Mile doesn’t have an app in the app store, you can use Daily Mile by going to DailyMile.com. They have a fully fea-

Then click “Add Friend” on the left to add them to your friends.

tured mobile version on their site. Daily Mile can be an incredibly powerful tool for staying motivated, making workout a social sport and just increasing overall enjoyment and consistency of your workouts.

Fabulous Nurse Magazine

Pole

Issue 11

Dancing

A Beat, a Passion, and Fitness

Aerobics By Margaret Smith

o you remember playing? That’s what you used to do back when you were a child. You didn’t need to exercise because you kept fit just by having fun! You’d run after your friends, scamper up and down the monkey bars, hang

upside down on the swing set, and wear yourself out without even trying. Maybe you were even one of those kids who could actually climb that rope in the gym instead of swinging from it.

playful side again. It’s aerobic Pole Dancing, and it makes exercising fun! Everyone says so! Admittedly, there are other programs that claim to allow participants to have fun; some of them do, like zumba, and some of them, like hot yoga—well, not really. But Pole Dancing is fun because it’s more like playing. The idea of pole dancing doesn’t appeal to everyone when they first hear about it. They associate it with exotic dancing and strip clubs, and, admittedly, that does seem to be where it got its start, before the mid-2000s. But proponents and promoters have worked hard to change perceptions of pole dancing. Don’t think of skimpily clad exotic dancers gyrating around a pole in a smoke-filled club. Instead, think of a legitimate, effective way to tone muscle, build flexibility, keep fit, and feel empowered. If some classes try to retain a little of the “sexy” element—well, that just adds to the fun!

A formula for fitness Pole dancing for fitness involves a combination of dance moves and gymnastics or acrobatics; the vertical pole provides both support and resistance, and it serves as a “dance partner”. Instead of the bumps and grinds of the strip club version, fitness pole dancing Now that you’re grown, you don’t have the

Pap smear or Prostate exam, but yes, it’s also

time to play, so you have to exercise to stay

just as necessary.

fit. And that’s no fun. Let’s face it, just the word “exercise” sends shivers up your spine and makes you start looking for excuses to avoid it. It’s about as enjoyable as a yearly

The good news is, there’s an exercise trend that’s getting grownups of all ages, mostly girls and women, to get in touch with their

incorporates spins, pole climbing, and body inversions. The routines are performed to music that is rhythmic and compelling, which helps to keep the dancers motivated and engaged. Working with a pole requires upper body and core strength, flexibility, and 91

Fabulous Nurse Magazine

endurance; but beginners can achieve these qualities through prac-

choice. For stability, the pole should be firmly attached to the ceiling,

tice. Depending on the class, the routine can be aerobic to affect the

which is sometimes difficult with portable poles.

cardio-vascular system, or anaerobic to tone muscle.

Starting with the basics Beginners usually begin a class in bare feet, sneakers, or socks, but the object is to work up to the point where the dancer can perform the routine in heels. Many experienced dancers wear six to nine inch platform heels and, yes, we’re still talking about fitness. In addition, pole dancing is non-exclusive. Women (and sometimes, men) from teenagers to middle-age enjoy the performance style of the dances, the engaging rhythms of the music, the sensation of working their whole body, and the feeling of greater strength and improved general well-being. And size doesn’t matter, either, since women who participate can be shaped like a pencil or a cinnamon roll (temporarily). The first ten minutes in a pole dancing class should focus on gentle stretches to warm up the muscles. Yoga moves like the Plank and the Downward Dog are often incorporated into the warm-up routine to get the upper body muscles engaged. Once the muscles are warmed up, it’s safe to rev up the music and dance! It’s important to pace yourself, though. Some people tend to get a little over-enthusiastic when they’re starting out, and end up with muscle strains and/or bruises.

There are several ways to participate in pole dancing for fitness. Gyms and dedicated dance studios offer group classes where participants have the benefit of personal guidance, and opportunities to make social connections. Classes for the public can focus on athletic type dancing, or the sensual dancing reminiscent of the clubs. Anyone can choose the style that suits them best. There are also pole dancing DVDs so that shy people or those with unpredictable schedules (nurses?) can work out in their own home. It’s even possible to buy your own pole! In the U.S., the typical dance pole is a floor-to-ceiling hollow pole with a diameter of about 2 inches. Most poles are made of stainless steel, chromed steel, or brass. There are also models made from acrylic glass, which can be equipped with LED lighting for special

Even though nurses have very busy lifestyles, it’s possible to find a

effects. Different poles offer different levels of slickness or friction;

way to enjoy the fun and benefits of pole dancing for fitness. If you

the type of maneuvers you wish to perform should determine the

can’t schedule a class, you can always get a DVD and a pole and set

type of pole you use. For faster dancing, the slick quality of pol-

up your own studio in your home. It’s a great way to make some time

ished steel is ideal. If you’re more interested in slower, more sensual

to play.

dancing, you’ll need more friction, which makes brass poles a good 92

Finance Issue 11

Fabulous Nurse Magazine

Ideas

To Boost Your Income

it won’t give you any real world practice. It still doesn’t take the place of getting out there and doing it.

Wedding Photographer

ow do you become a wedding photographer? There is actually quite a bit more

Option 2 - Learn from someone else This might be the better option. With this method, you would offer to help a current wedding photographer, either for free or for money. However, it’s not about the money you make. Rather, the experience you get is the most important aspect. No matter how much you read, nothing compares to seeing it done in the real world.

to this than meets the eye. It’s not as simple as buying a camera and filming.

Learning from an expert will show you ev-

There are a lot of nuances you have to learn. Here are three skills you need to

erything involved, from setting up your equipment, planning ahead, where to stand,

have to become a successful photographer:

1) Handle pressure Remember, just like nursing, this is also

3) Wedding-specific photography

etc. Make sure you pay close attention to everything they do. You also have to learn marketing. Just like

among the most pressure-packed jobs out

Just because you know other kinds of pho-

any business, you have to find jobs. Regard-

there. If you get the images wrong, there are

tography doesn’t mean you would make a

less of how good you are at photography,

no do overs. You are capturing one of the

good wedding photographer. There are tons

you have to locate people willing to hire you.

best moments of a person’s life. If you mess

of specific skills you need to photograph

up, you always have to live with that. For

weddings.

this reason, if you don’t like pressure situations it is best to find yourself another field.

2) People skills You have to be able to deal with the wedding party and learn about the kinds of pictures they want, and you also have to be able to sell them your services. If you can’t convince them you are the person for the job, you won’t get their business. All this requires the ability to interact with others. 94

For this reason, you might want to take a marketing course. Eventually you might get

So how do you learn photography for wed-

to the point where you build a business and

dings? There are two options:

hire employees to do the photography for

Option 1 - Teach yourself With this method, you would purchase instructional magazines and books, and then apply them. Also, you can study wedding magazines. This will give you an idea of the right lighting to use, where to stand, etc. However, it’s rather limited, because

you. This offers the most income potential and is where a hobby can become a six-figure business. The bottom line is, you can make a lot of money as a wedding photographer. If you don’t mind pressure and dealing with others, this could be a great occupation for you.

Issue 11

Fabulous Nurse Magazine

Issue 11

ating breakfast, lunch, or dinner out can be one of the largest discretionary spending items in

your budget. This luxury is normally one of the first things to get the axe when you’re pinching pennies. Here are a few ways you can still enjoy dining out, without forking over big bucks:

Restaurant email lists. Want a guaranteed free meal each year? Sign up for your favorite restaurant’s email list, and chances are they’ve got it set up to send you a coupon for a free meal on your birthday! Do this at a couple of restaurants, and you could be eating out free your entire birthday month. These lists also get you in on special deals, two-for-one offers, and other frequent buyer specials.

Entertainment books. Long a mainstay of non-profit fundraisers, the “entertainment books” are now available at drugstores and bookstores, usually at a deep discount (we picked ours up for 40% off this year!). The book is full of coupons for two-for-one offers at local restaurants and special deals for fine dining. Each book claims to include thousands of dollars’ worth of discounts, but even if you just use two or three, you’ll have earned back your investment. Check out sites like Entertainment.com to see what books are available near you.

Groupon. Want to see collective buying power in action? Check out Groupon.com. Available in over 60 major metropolitan locations nationwide, Groupon negotiates massive bargains for members by guaranteeing businesses a minimum number of takers. Free to join, Groupon offers a new deal each day. Recent offerings: $80 worth of take-out grub at a famous seafood restaurant for $40, and $30 worth of food at a Mexican bar and grill for $15. While not every offer is dining-related, a good number are.

Dining Out

Frugally Early bird.

Kids eat free.

Early bird dinners aren’t just the provenance

Tired of paying $7 for a grilled cheese sand-

of the senior set; anyone can take advantage

wich that your tyke will only lick the crust

of these early-hour dinner specials. Think

off? Then check out one of the thousands of

about it – you don’t want to wait until 8:00

“kids eat free” offers across the country. Ask

pm to feed your kids, so why not feed them

your favorite restaurants if they offer a kids’

at 4:00 pm at an early bird special. When

night special and sign up for their email list

you’re dining with a large group or with

so you get a heads-up about all their specials

young children, eating earlier can be not just

for kids. Also, check out sites like MyKid-

less expensive, but less stressful, too. Early

sEatFree.com for a searchable guide.

bird dinners can be significantly cheaper than dining at busy later hours (30-40 percent less), plus your wait-staff will be more attentive because they’re not worn out yet!

Once you find out your favorite restaurant has a “kids eat free” night, you’ll be happy to enjoy a night out with your family more often. It is always nice when you get the bill after a dinner out and can relax and smile! 97

Fabulous Nurse Magazine

The

Nurseâ&#x20AC;&#x2122;s tation II SFacility Ratings

Issue 11

Fabulous Nurse Magazine

The 5 Star Hospital Rating System

Fabulous Nurse Rating Summary Here is the summary of the Fabulous Nurse tenpoint rating system for MHMC, Chicago:

Rating Parameter

Points

Quality of Nursing Care

Nurse-Patient Ratio

Accessibility 10 Staff Quality & Welfare

Mortality Rate

Financial Base

Patient Volume

‘Green’ Factor

Academic Activity

Management Style

Total 81

Mercy Hospital & Medical Center, Chicago Profile Founded in 1852, Mercy Hospital & Medical Center (MHMC) is the first hospital in the state of Illinois and Chicago’s first chartered hospital. It is a non-profit Catholic hospital. Quality of Nursing Care: Information sourced from rating organizations, and patients’ testimonies indicates that MHMC’s overall nursing quality is above Illinois State and US national averages. Nurse-Patient Ratio: Information accessible on MHMC’s nursing staff to patient ratio suggests average range 1.2-1.6. Accessibility: Of all the 52 hospitals available within 25 miles of ZIP Code 60616, MHMC is the most easily accessible i.e., at 0.4 miles. Staff Quality &Welfare: MHMC’s staff benefits are designed to fit employees’ lifestyles. Benefits are grouped into four and they are as follows: 1. Health & Welfare Benefits—Choice of Medical plans, Choice of Dental plans, Flexible Spending Accounts (Medical & Dependent Care Expenses), Employee Assistance Program 100

2. Disability Benefits—Paid Sick Days, Hospital Paid Short-term Disability, and Hospital Paid Long-term Disability 3. Retirement Benefits—401(k) Retirement Savings Plan with Employer Matching Contribution, Survivor Benefits, Hospital Paid Basic Life Insurance, and Supplemental Life Insurance Options 4. Other Benefits—Paid Holidays, Paid Time Off (PTO), Bereavement Leave, Free Parking, Adoption Assistance, Tuition Reimbursement, Credit Union, Payroll Direct Deposit, and Employee Fitness Center. Mortality Rate: Reports reveal that MHMC’s in-patient mortality is better than US national average.

In-patient surgeries—1,962 Out-patient surgeries—4,107 ER Visits—49,356 ‘Green Factor’: MHMC’s green efforts include the recent decision to purchase 10 percent of its electricity in green form (from a wind farm in Pennsylvania) over the next 3 years. Other hospital wide green efforts are being made by MHMC. This effort will enable the hospital to avoid indirect greenhouse gas emissions of just over 5,500 metric tons of CO2, which is equivalent to taking 1000 automobiles off the road.

Financial Base & Related Information: Current estimates show this company has annual revenue of $100 to $500 million.

Academic Activity: Information on nursing academic programs offered at MHMC is not available in the materials used to prepare this rating.

Patient Volume: Mercy Hospital and Medical Center is a 290-bed facility with the following statistics in the latest year for which data are available:

Management Style: MHMC’s management’s style accommodates nurses’ participation in day to day decision-making in the organization.

Admissions—16,293

With a total of 81 points, Mercy Hospital & Medical Center, Chicago IL is rated 4 Stars.

Out-patient Visits—353,013

Issue 11

Fabulous Nurse Rating Summary Here is the summary of the Fabulous Nurse tenpoint rating system for HMC, Warner Robins:

Rating Parameter

Points

Quality of Nursing Care

Nurse-Patient Ratio

Accessibility

Staff Quality & Welfare

Mortality Rate

Financial Base

Patient Volume

‘Green’ Factor

Academic Activity

Management Style

Total

Profile

Houston Medical Center, Warner Robins , Georgia

Houston Medical Center (HMC) is a recipient of 2006 Georgia Hospital Association Community Leadership Award (an award usually given to organizations, groups or individuals who have made exemplary contributions to the health or well-being of Georgians through leadership on a major health policy or initiative). HMC is Perry and Houston County’s largest health care provider for 50 years.

array of core benefits such as health insurance, paid time off and retirement, Houston Healthcare also offers a wide range of family friendly benefits. Benefits offered include: Annual Leave, Medical Insurance, Vision insurance, Flexible Spending Accounts, Life insurance, Short and long term disability, Education Assistance, Financial Planning, Wellness Services, and Employee Assistance Program.

corded the following statistics:

Quality of Nursing Care: According patients’ testimonies and information obtained from rating agencies such FindTheBest, Medicare and so on, HMC’s nursing quality overall rating is below both state and national averages. Notwithstanding this rating, HMC has received total of six HealthGrades Quality Awards to date.

Mortality Rate: Reports reveal that HMC’s in-patient mortality is better than US national average.

Academic Activity: Full-fledged nursing academic program is not available at HMC. However, support is provided for new graduate to transition from student nurse to an independent RN. HMC’s Medical-Surgical RN Residency Program provides the new nurse with clinically significant classroom instruction as he/she works closely with a preceptor on a nursing unit.

Nurse-Patient Ratio: Information is not accessible on HMC’s nursing staff to patient ratio policy. Accessibility: Of all the hospitals available within 50 miles of Zip Code 31093, HMC is the closest i.e., at 2.1 miles. Staff Welfare: HMC offers an overall comprehensive benefit program. In addition to an

Financial Base & Related Information: In 2008 and 2009, HMC generated more than $414.9 and $482.9 million, respectively, in revenue for the local economy according to a recent report by the Georgia Hospital Association, the state’s largest hospital trade association. The report also reveals that HMC provided approximately $13.3 million in 2008 and $18.3 million in 2009 in uncompensated care while sustaining more than 3,459 full-time jobs throughout Houston County and the rest of the state. Patient Volume: HMC serves more than 200,000 patients yearly. In 2010, HMC re-

In-patient Admissions—15,803 Out-patient Visits—133,977 ER Visits—80,832 Births—2,100 ‘Green Factor’: To best of all materials accessed to compile this rating, no information is available on HMC’s “green effort.”

Management Style: Though management prides employees as their greatest asset, some employees’ testimonies suggest that current management style needs to accommodate more participation from nurses. With a total of 74 points, Houston Medical Center, Warner Robbins, Georgia is rated 4 Stars. 101

Fabulous Nurse Magazine

Fabulous Nurse Rating Summary Here is the summary of the Fabulous Nurse tenpoint rating system for Advance Nursing, Greenville, South Carolina:

The Star

Staffing Agency Rating

Rating Parameter

Points

Insurance Coverage Retirement Package Education Opportunity Incentive Programs Earnings Logistics Support

10 5 5 0 10 8

Total

Advance Nursing, Greenville, South Carolina

Profile A winner of Joint Commission’s Gold Seal of Approval—a symbol of quality that reflects an organization’s commitment to meeting certain performance standards, Advance Nursing is nurse-owned and nurse-operated company founded in about a decade and half ago by Christopher Brock, RN BSN. Today, Advance Nursing claims to be a leader in the healthcare staffing industry. Insurance Coverage: Though no available testimonies from any nurse that has worked or is working in the company, information sourced from Advance Nursing’s website says a comprehensive insurance benefits is available for travel nurses. Retirement Package: Advance Nursing has retirement plan for employees, but the nature of package is not stated on their website.

102

Education Opportunity /International Placements: Only in-house training is available for nurses at Advance Nursing. Both travel and permanent placements are also offered to nurses at Advance Nursing. Incentive Programs: Information regarding Advance Nursing’s incentive programs is not available as the time of this rating. Earnings: Advance Nursing has some unspecified bonuses for nurses in addition to their excellent pay.

Logistics Support: Per Diem, free housing and utilities are also offered at Advance Nursing. With a total 38 points, which gives 1.9 when divided by 20, American Traveler is a 2-Star travel nursing agency. *Facility was unavailable for comment and no information was provided to substantiate claims made on their website.

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104

University of Alabama, (UAB)

School of Nursing Birmingham, Alabama Profile The UAB School of Nursing is among the nation’s best according to the 2010-2011 U.S. News & World Report ranking of graduate schools. The UAB School of Nursing is ranked 21st in the country. Academic Standards: The UAB School of Nursing is one of nation’s best and the world’s leading schools. Programs within the nursing school ranked highly according to 2010-2011 U.S. News & World Report ranking of graduate schools—nurse practitioner (adult) program, 10th; nursing service administration program, 10th; nurse practitioner (family) program, 12th.

bama Board of Nursing (ABN). The school has program approval from the Pediatric Nursing Certification Board (PNCB) for: 1) Primary Care Nurse Practitioner and 2) Pediatric Acute Care Nurse Practitioner. Additionally, the school is in compliance with the National Certification Corporation for: 1)

Issue 11

Fabulous Nurse Rating Summary Here is the summary of the Fabulous Nurse tenpoint rating system for UAB School of Nursing, Alabama:

Rating Parameter

Points

Academic Standards Student Quality & Turnover Financial Aid Accreditation Peer Review Quality of Teaching Staff Academic Facilities Students’ Reviews Affordability Job Prospects for Students

9 10 10 10 10 10 10 9 9 9

Total

Student Quality and Turnover: The UAB School of Nursing has more than 12,000 alumni serving communities within and outside the US. The UAB School of Nursing has an international reputation, and that reputation is strengthened by the quality, skill, and compassion of its alumni. Financial Aid: UAB School of Nursing has different scholarship, traineeship, fellowship and loan programs in which many students participate including UAB Financial Aid; Scholarships in the UABSON; Additional Nursing Scholarships; Fellowship, Traineeship and Loan Programs; Scholarship Applications and Other Sources of Financial Aid. Accreditation: The UAB School of Nursing is CCNE-accredited. In 2010, the UAB School of Nursing got the 10-year accreditation (i.e., CCNE’s maximum accreditation limit) for its Baccalaureate and Master’s programs and 5-year (i.e., maximum accreditation limit) for its Joint Doctor of Nursing Practice (DNP) program. It means accreditation for the Baccalaureate and Master’s programs remains valid through June 2020 and Joint DNP program through October 2015. Since CCNE does not accredit PhD programs, the Southern Association of Colleges and Schools (SACS) has accredited UAB School of Nursing PhD program. All necessary approvals have also been given to the UAB School of Nursing by the Ala-

Neonatal Nurse Practitioners and 2) Women’s Health Care Nurse Practitioner Option.

All facilities to provide world-class standards are available.

Peer Review: Academic experts rate UAB School Nursing very high—indicating the school’s high standards.

Students’ Review and Affordability: Standard is high and fees are affordable.

Quality of Teaching Staff: A member of the Pan American Health Organization/World Health Organization (PAHO/WHO) Collaborating Centre for International Nursing, one of more than 40 worldwide. Teaching quality is very high. Academic Facilities: UAB School of Nursing is a recognized leader in the use of technology for teaching, learning, and research.

Job Prospects: The school conducts clinical education in a hospital with Magnet status, a hallmark of nursing excellence. Consistently, the school ranks in the top 5% of all schools of nursing in America. So, students who graduate from the school are well rounded and have higher chances of employment. Therefore, with total of 96 points,UAB School of Nursing is rated a 5 Diamonds. 105

Fabulous Nurse Magazine

UNIVERSITY OF CENTRAL FLORIDA UCF College of Nursing Offers Advanced Doctoral Degree Online ORLANDO, Aug. 29, 2011 -- A new doctoral degree

support the growth of practice-based doctoral degrees to

track at the University of Central Florida prepares nurses

address national concerns about quality of care and pa-

in a leadership role to succeed at the highest level of ad-

tient safety. UCF’s program will prepare nurses to use the

vanced practice by becoming “change leaders.”

latest technologies, trends and research to address chang-

The degree track, a post-master’s Executive Doctor of

ing regulations and anticipated nursing shortages over the

Nursing Practice (D.N.P.), is the most recent example of

next decade.

the College of Nursing’s efforts at creating cutting-edge

Designed for working professionals, the part-time, flex-

programs that give its graduates the ability to adapt and

ible degree consists of online courses and an intensive

lead during challenging times in healthcare. The track

three-day seminar at the start of each semester. The semi-

will prepare students to shape practice, and their proj-

nar brings together theory and practice to round out the

ects will make a difference in improving care for patients

comprehensive program.

where they work. “For busy nurse leaders, the program promotes out-of-

leadership and organizational analysis. In addition to

the-box thinking to shake up what they are already do-

opportunities for online collaboration with peers, the

ing, to support them in becoming change leaders,” said

seminar will allow students to meet their professors and

Associate Dean for Graduate Affairs and Professor Susan

develop deeper relationships with faculty members and

Chase. “They’re not just responding to new policies, but

their colleagues. Nationally recognized leaders in health-

informing the policy and putting into practice the evi-

care will share their best practices during the seminars

dence that is there.”

and in presentations open to interested nurses in the Or-

The federal Institute of Medicine and other groups are

lando area.

calling for more advanced educational programs as the

The first group of students, who will stay together for the

nation’s healthcare environment grows ever more com-

required nine semesters, starts coursework in January.

plex and demands of nurses a higher scientific knowledge and practice expertise. The American Association of Colleges of Nursing (AACN) and its member schools also

106

Curriculum focuses on areas such as decision making,

As nurse leaders and administrators plan for policy changes, the Executive D.N.P. will provide them with analytic

Issue 11

skills they can use to actively impact the environments in which

“We want them to think about the whole system of care, such as

they work, be it acute care, clinics, community health programs,

how to guarantee quality for outcomes, while letting people on

Magnet preparation, strategic planning or overall interdisciplin-

their teams be creative,” Associate Dean Chase said.

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EpicCare EMR

Issue 11

Fabulous Nurse Rating Summary Here is the summary of the Fabulous Nurse five-point rating for EpicCare EMR:

Rating Parameter

Points

Reliability

User Friendliness (ease of use)

Technical Support

Technological Capability

Cost Effectiveness

Total

Electronic Charts Rating Reliability

spending more

According to users’ testimonies, EpicCare is reliable because it:

time on the com-

• Provides secure, authenticated information access from any location • Ensures regulatory compliance, provides security of records and improves disaster recovery readiness • Supports users’ on-going commitment for improving patient care and staff efficiency • Provides a consolidated patient record database, creating the most accurate, consistent data

User Friendliness A nurse posted this on a nurses’ online forum: “Hi, Does anyone’s hospital use the EPIC system for charting? Our hospital is going to this system this month, and I am really interested in how other nurses feel about it. For me, it is very difficult to learn, and I feel like I will be

puter than with my

picCare EMR is recognized for its unique speed and user-friendly features. It is a “one patient, one record”

system that allows for improved health care.

patients. We keep hearing how much easier it will be,

Technology Capability

but right now, it doesn’t seem easy at all.

Epic maintains specialized technical teams

I am used to hard copies of charts, and the

that have experience working with the very

system we use now in the computer for chart-

largest EMR implementations. Epic helps

ing allows for a busy night where I may not

its clients plan a flexible, scalable hardware

look at a computer until the end of my shift.

foundation that fits clients’ budget, work-

And finding things in the EPIC system is very

flows and plans for future growth. Epic

complicated for me.

performs scalability and stress-testing in

Anyone out there that can ease my anxiety?”

conjunction with client organizations and

Of the 46 comments on the above post, more than 30 argue that Epic system is userfriendly. For the nurses that say they find Epic difficult to use, it appears most of their

with a variety of hardware vendors. Real data and real workflows are used to ensure meaningful benchmark results and accurate system sizing.

complaints are IT related.

Cost Effectiveness

Technical Support

The cost effectiveness of Epic is a little de-

Epic offers personal service and support.

batable. However, overall feedback from us-

From initial implementation and training

ers suggests that it is cost effective.

through ongoing support and optimization, Epic’s approach to customer care is culturerooted and process-focused.

With total of 47 points, Epic charting system is therefore rated 5 Diamonds. 109

Fabulous Nurse Magazine

Nurse Educatorâ&#x20AC;&#x2122;s Prayer By E. Laureate

I hope to pave the way for my nursing students to live fulfilled nursing careers, to confidently face each shifts struggles and strife and to improve the lives of each of patient they encounter. Not just the lesson in each textbook or how to start an IV, but how to choose the proper nursing career path that will lead to ethical patient care and a happy life, wherever they may go. To acknowledge the limitless boundaries of faith and know the right from wrong and gather or nurture all the newly blossomed daisies that may come their way. For if I teach nurses to represent competence and grace then I shall feel that my job as a nurse educator is done and I have accomplished my duty. So I ask for guidance, dear God in order that I may fulfill my role and do my part to instill character, confidence and happiness in the hearts of every nursing student I teach.

Amen.

110

Issue 11

Laugh Out

Loud 111

Fabulous Nurse Magazine

General Humor A lot of people are afraid of heights. Not me,

I knew I was an unwanted baby when I saw

I’m afraid of widths.

that my bath toys were a toaster and a radio. Steven Wright

Joan Rivers

I am not afraid of death, I just don’t want to

It is a scientific fact that your body will not

be there when it happens.

absorb cholesterol if you take it from another Woody Allen

person’s plate. Dave Barry

Nursing Humor Patients Say The Darnest Things A young male patient told me after he was extubated that he kept seeing little men rise up from the floor covering and try to attack him. He was genuinely shaken from this experience. Submitted by Deborah Richmond

While checking a vasectomy patient into OT, he was asked what procedure he was having..... “dunno... i think i am getting desexed....” yes vasectomy....kind of.... Submitted by Kerrie Curtis

You look like my angel!! Submitted by Elizabeth Georgeson

112

Issue 11

Resources

113

Fabulous Nurse Magazine

Bedlam Among the Bedpans:

Humor

s rewarding as nursing can be, stress can take its toll in many forms. Fatigue. Frustrating work conditions.

Low pay. Staffing shortages. Physician conflicts.

in Nursing

Book reviewed by Sara Caldwell

of Nursing Humor books, co-written with

nursing, and much more. The book is well

Colleen Kenefick. Her latest book contains

organized in easy-to-read short segments

Humor has long been held as the best anti-

fresh material not found in those earlier pub-

that are not dependent on a chronological

dote for the blues, and Amy Young’s fun-

lications. Interestingly, Young is not a nurse

order; one can turn to any page to digest a

filled book provides plenty of it. Bedlam

but a college librarian and her gift is the

stand-alone nugget of humor in a very short

Among the Bedpans: Humor in Nursing

painstaking research to find these endearing

amount of time. The material covers subjects

(2006) brings levity to the challenges that

gems. According to an October/December

like “You Know You’re a Nurse When…”

nurses face every day. It is a compilation of

2008 review on Lippincott’s Nursing Center

with sayings such as “You occasionally park

over 100 witty articles, anecdotes, and say-

website, selections originate from thirty-six

in the space with the ‘Physician Only’ sign

ings written or inspired by real nurses in the

journals, twelve websites, and six books of

and knock it over” or “You’ve spent more

field. Garnered from twenty years’ worth of

North American, British, and Australian de-

money on a stethoscope than a car payment.”

nursing journals, books, and internet blogs,

scent.

There are also funny cartoons and illustra-

these stories will touch the heart as well as the funny bone with a ‘been there’ under-

Bedlam Among the Bedpans focuses on

tions sprinkled throughout.

common nursing concerns: reasons for en-

For nurses who feel that their jobs some-

tering the profession, varying nurse and pa-

times rival War and Peace, Bedlam Among

Those familiar with author Amy Young will

tient perspectives, nurse/physician relation-

the Bedpans might be just what the doctor

recognize the wit from her previous Best

ships, the diversity and unpredictability of

ordered.

standing nurses can relate to.

114

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Fabulous Nurse Magazine

November

Nursing Conferences Around The World 3-5 November 2011 Salt Lake City, Utah Oncology Nursing Society Advanced Practice Nursing Conference. Oncology Nursing Society Advanced Practice Nursal experience and networking opportunity for nurse

9-11 November 2011 Albuquerque, New Mexico

practitioners, clinical nurse specialists, and other

University of New Mexico-School of Medicine

ing Conference. An innovative, advanced education-

healthcare professionals that promotes excellence in oncology nursing and cancer care. Web: www.ons.org

Neonatology Outreach Program, 20th Annual Amazing Newborn Conference. The topic for this conference is Late Preterm and will have current issues involving information from

8-9 November 2011 Berkeley, CA. USA. Aging and Society: An Interdisciplinary Conference The Aging and Society Conference seeks to analyze the facets of an aging society across the globe. In ad-

Neonatology, OB and Pediatrics sections. Registration for the will start by July 2011 and will have 300 Seats available. The speakers will be a mix of MD’s, NNP’s, PA’s and RN’s that currently practice in the NICU, Ped’s and Research fields. Web: http://www.neonatology-outreach.org/amazing_newborns/

dition to examining the economic outlook, the conference will focus on public health, policy, practices, will be held at the University of California, Berkeley,

10-11 November 2011 Karnataka, South India

CA, USA.

“Transcultural Nursing.”

and the sociological issues. The 2011 Conference

Contact name: Izabel Szary Website: http://agingandsociety.com/conference-2011/

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Web: http://www.manipal.edu Email: transcult.mcon@manipal.edu or office.con@manipal.edu Phone: 91(0)-820-2922443

Issue 11

17- 19 November 2011 Belek/Antalya, Turkey 5th International Nursing Management Conference, “Nurses Leading for Innovation in Challenging Times.” The goals for the conference are to share knowledge and experiences and creating opportunities for inter-

18-20 November 2011 Los Angeles, California

national collaboration for better quality health care.

2011 Infusion Nurses Society Fall National Acad-

Pre-Conference Workshops: “Leadership Camp” and

emy of Infusion Therapy and One-Day Program.

“Evidence Based New Practices For Nurses”: 16

The INS Fall National Academy of Infusion Therapy

November 2011 Abstract Submission Deadline: 3 June 2011. Web: http://www.inmc2011.org Contact: Assoc.Prof. Füsun Terzioğlu; Phone: +90- 312 -305-1580; Email: inmc@hacettepe.edu.tr

and One-Day Program, held on a weekend in November, is a three-day, advanced level conference for infusion nurses who have been in the specialty for a few years and those who strive for a more challenging educational experience. The Fall National Academy consists of a full-day program on Friday

17-19 November 2011 Singapore, Asia

with dedicated sessions that discuss some of the

1st NUS-NUH International Nursing Conference,

Sunday. The Industrial Exhibition is open on Friday

“Positioning Nursing for the Future: Advancing Nurses’ Role in Community and Home Care.” The international conference will provide a forum to examine the expanded and extended role of nurses

latest trends and hot topics in infusion therapy, and concurrent general sessions all day Saturday and and Saturday, with 2-3 hours of dedicated exhibit hours each day. Phone: (781) 440-9408; Email: ins@ins1.org

in community and home care through keynote speeches, symposia, workshops and poster presentations. The conference will involve world-renowned scholars, local and international clinical practitioners and researchers. Contact: Elaine Lee Email: nursing_conference@nuhs.edu.sg Phone: (65) 6516 3320 Web: http://medicine.nus.edu.sg/nursing/events/inc/welcome.shtml

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Job Opportunities Perm & Travel

ICU Director, San Antonio, TX • Accredited Chest Pain Center •,Newly Remodeled Facility • Large, Open ICU Unit • Established Magnet System with Great

Right now a HERO is needed. Right now YOU are needed. Thank you for supporting our nation’s hospitals in need!

CEO

HEALTHCARE seeker.com has a new Travel position that we thought you, or someone you know, might be interested in. We pay referral bonuses up to $3000 for each person so please feel free to forward this over to your friends.

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Director will be in charge of 20 bed ICU and 15 bed PCU with approx 80 FTEs. Position reports to the VP of Nursing.

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High paying travel nursing positions all over the country!

discuss.

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1- 877-447-3376 x709 srundlett@sagenths.com JOB CODE: EAE 118

JOB CODE: Elsie

Your Fastaff Benefits: • FREE Travel to U.S. Destinations and FREE Housing. • Paid Licensure for Qualified FASTAFF Jobs. • World Class Medical Facilities. • Medical and 401(k) Available. • Refer a friend and earn up to $3,000 per referral. Program rules apply.

includes weekly pay with direct deposit, GSA tax free per diem, a nationwide PPO Healthcare plan with full medical (with RX), dental, vision coverage, orthodontics, chiropractor, flexible spending accounts, life insurance, workers compensation and professional liability insurance. All depends on what you want and need.

RECRUITER: Mary Splihte Phone: 1-888-331-3431 x10 EMAIL: marys@healthcareseeker.com

Issue 11

Nightingale, a nationally recognized leader in travel healthcare professionals, has Immediate and Exclusive needs for ICU with excellent pay needed in

• ALASKA • CALIFORNIA • FLORIDA • GEORGIA • MASSACHUSETTS • MINNESOTA • NEVADA • NEW JERSEY • NEW MEXICO • OHIO • OREGON • TEXAS • VERMONT If you are available for consideration, please reply to this email and a recruiting specialist will contact you as soon as possible. Call us immediately: 800-591-7860 There has never been a better time to work as a traveling healthcare professional. Top medical facilities are always looking for qualified profes-

TEXAS Needs: ICU, CVICU, LDR, MS, Tele, Neuro ICU, ER, LDR, & OR RNs!

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sionals to fill numerous travel positions. Nightingale offers:

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• Top salaries and personalized compensation packages

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center. Supportive, positive, warm and caring staff. Opportunities for advancement as growth is expected to continue.

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• Referral and loyalty bonus programs Have a great day!

Permanent Openings RN’s for Tele-Step Down Unit...44 per hr... We are seeking RN’s to join our award winning staff our Telemetry / Step Down unit. We are located just north of Seattle, WA right on the shores of Puget Sound.

**Full Benefits **3 to 1 pts ratio for the unit **$27 to $44 per hour **Relocation pkg provided **Staff RN for Telemetry / Step Down unit **Seattle area **Permanent position

Why would someone want to work here?

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Located right on the water, can live on one of the many islands in the area, established and quaint downtown, nice area with lower cost of living than Seattle but Seattle is still within ½ hr.

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Nursing leadership is very focused on staff development, continuing Education and a commitment to being a cutting edge medical

Emerald is a Joint Commission Certified healthcare staffing firm eager to get you working this summer! Emerald is one of the founding members of the National Association of Travel Healthcare Organizations (www.natho.org)

Travel Team Favorite Healthcare Staffing, Inc. 800-755-1411 x824 FAX 888-262-4335

• Weekly pay with available direct deposit

Emerald currently provides travel nurses to hundreds of hospitals and currently is offering assignments in every major specialty (ICU, L&D, ER OR, TELE PACU, PICU, NICU, and PEDS).

Website: http://www.rennermedicalstaffing. com Why live in Washington? From the Columbia River Gorge to the top or Mt. Rainer, Washington has something to

Please feel free to contact Emerald at any time at 1-800-917-5055, or respond to this message via E-mail or you can also visit us on the web at www.emeraldhs.com Emerald Health Services 4640 Admiralty Way #201 Marina Del Rey, CA 90292 Office: (800) 917-5055 ext. 101 Fax: (310) 496-3281 Cell: (310) 913-1303 www.emeraldhs.com Emerald is a founding member of NATHO Emerald is one of the 10 largest Travel Nursing firms in the nation Emerald is one of the 20 largest Healthcare Staffing firms in the nation Emerald is a Joint Commission Certified Health Care Staffing Service Provider offer everyone. Just about any outdoor activity imaginable is easily accessible: fishing, hiking, camping, windsurfing, kayaking, cycling, snow-boarding-you name it, you can do it in the state of Washington. Not to mention the local festivals, wineries, fine dining, art, theatre and shopping. From river valleys and mountain tops to rain forests and glaciers, Washington is open for adventure. As home to some of the country’s leading businesses, Washington is rich not only in natural resources but also in innovation and opportunity REQUIREMENTS **Will consider candidates that have at least 1 year of experience in at least ONE of the following areas, ICU, Telemetry, or Step down / Progressive care as a Registered Nurse. 119

Fabulous Nurse Magazine

FOR IMMEDIATE RELEASE Contact:

Lindy Mueller Carhartt (313) 749-6588 lmueller@carhartt.com

Contact:

Tim Gilman Leader Enterprises PR for Carhartt (562) 719-2140 tgilman@leaderenterprises.com

CARHARTT TO LAUNCH NEW LINE OF MEDICAL APPAREL WITH CID RESOURCES, INC. INC . New Carhartt Medical Scrubs Available Fall 2011 DEARBORN, M Mich. ich. – (August 9, 2011) Carhartt, America’s premium work wear brand since 1889, today announced the selection of CID Resources, Inc, a leading manufacturer of medical scrubs for America’s healthcare professionals, as the new licensee for Carhartt-branded medical scrubs. “For more than 122 years, Carhartt has created enduring work wear that always values the hard-earned dollar of the worker,” said Rick Fecowicz, director of licensing at Carhartt. “CID Resources delivers the same quality and value in their medical apparel. This partnership is a natural fit for Carhartt to begin servicing the fast growing healthcare industry,” Fecowicz further adds. The initial offering will include two new medical scrub lines including Carhartt Premium and Carhartt Ripstop. The Carhartt Premium line will include two new top and bottom styles for women and one new top and bottom style for unisex made from 55 percent cotton/45 percent polyester brushed micro canvas and available in eight color options including industry standard colors. The Carhartt Ripstop line will include two new top styles and one new bottom style for men made from 55 percent cotton/45 percent polyester Ripstop fabric and available in four color options. Carhartt’s medical scrub offering will be available to the public through select Carhartt and uniform specialty retailers and on Carhartt.com for Fall 2011. All styles to feature Carhartt’s signature premium fabrics, triple-needle stitching to reinforce seaming, multiple pockets for storage and a comfortable fit designed for movement. --more --more-more-120

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“Carhartt is a well-respected work wear brand and we are thrilled to bring our expertise to build a Carhartt medical apparel line that incorporates the brand’s DNA throughout,” said Austin Park, director of branding at CID Resources. “This new premium scrub line will offer medical professionals the ultimate experience in Carhartt quality and style.” About CID Resources Inc. CID Resources Inc. is a leading manufacturer of medical uniforms based in Dallas, TX. The company focuses on passion, creativity and innovation and is committed to delivering functional and stylish uniforms for America’s healthcare workers. CID designs, manufactures and distributes uniforms under the WonderWink brand, which is available nationwide. CID’s licensed brand portfolio includes best-in-class American workwear brand Carhartt® and the “Queen of Cute” Mary Engelbreit. About Carhartt, Inc Established in 1889, Carhartt is a global premium work wear brand with a rich heritage of developing rugged apparel for workers on and off the job. Headquartered in Dearborn, Mich., with approximately 3,600 employees worldwide, Carhartt is privately owned and managed by the descendants of the company‘s founder, Hamilton Carhartt. For more information, visit www.carhartt.com. ###

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Medical Inflatable Exhibits invites you to give MEGA Thanks! NO PURCHASE NECESSARY. The Medical Inflatable Exhibits contest (“Contest”) starts on June 23, 2011 at 10:00 am CST via its Facebook page at www.facebook.com/MedicalInflatableExhibits and ends on Tuesday, September 6, 2011 at 2:00 pm CST (“Contest Period”). ELIGIBILITY: The Contest is open to legal residents in the fifty (50) United States and the District of Columbia who are at least eighteen (18) years old, and who have a Facebook user account and “like” Medical Inflatable Exhibits on Facebook. Employees of Medical Inflatable Exhibits (“Sponsor”) and their respective parents, subsidiaries, affiliates, promotion and advertising agencies and members of their immediate family (spouse, parent, sibling or child and their respective spouses, regardless of where they reside) and persons living in the same household of such employees, whether or not related, are not eligible to participate. The Contest is subject to all applicable federal, state and local laws and is void where prohibited by law. HOW TO PARTICIPATE: During the Contest Period, participant must select the “like” button on Sponsor’s Facebook page at www.facebook.com. MedicalInflatableExhibits and write and post a statement that recognizes a medical professional that has gone above and beyond to help a patient. The statement must express how the nurse helped or influenced the participant positively as a mentor or a role model. The nurse may be one who influenced the participant’s life, a fellow patients life or a nurse who has influenced the life of one of the participant’s children. Multiple separate entries per participating Facebook account are permitted. However, each entry must be completed in Facebook’s 420 character limit per entry. Entries that run over the 420 character limit into multiple posts will be disqualified. Sponsor is not responsible for lost, misdirected or incomplete entries. On September 9, 2011, five finalists will be selected from the Medical Inflatable Exhibits team of judges. Participants, colleagues, friends and family are invited to vote for their favorite nurse by liking their post. Voting closes September 23, 2011 and one winner is announced. PRIZE: On September 30, 2011, the one (1) winner (“Winner) whose entry received the most “likes” on Facebook will be awarded one (1) round-trip flight to Tuscon, AZ, one night at the Miraval Spa, and winner’s choice of a hour-long massage or private golf lesson for the medical professional nominated (“Prize”). Should winner be unable to provide nurse’ contact information -- including the hospital or doctor’s office where professional is employed -- the prize will be forfeited. In addition, should the contest receive less than 100 entries, the prize will be forfeited. Winner will be notified via a Facebook message or email no later than the Monday of each following week (September 26, 2011). (“Prize Notification”). The Prize will be shipped to the Winner upon receipt of the Winner’s confirmation of the Prize Notification. If the Prize Notification is returned as undeliverable, or if the potential Winner does not respond to Sponsor’s Prize Notification within three (3) days of the notification date, the Prize may be forfeited and, at Sponsor’s sole discretion, awarded to an alternate winner. No substitution, assignment or transfer of any portion of the Prize is permitted, except that Sponsor, in its sole discretion, reserves the right to provide cash or substitute prizes of approximately equal or lesser value.

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Judging will be conducted by Medical Inflatable Exhibit’s marketing team. Entries will be judged under the following writing criteria: organization, unity, coherence, clarity, grammar, punctuation and spelling. GENERAL: Neither Sponsor, its clients, nor their respective parent companies, affiliates, subsidiaries, divisions, advertising or promotion agencies shall be responsible for any problems or technical, hardware, or software malfunctions of any failed, incorrect, inaccurate, incomplete, garbled or delayed electronic communications whether caused by the sender or by any of the equipment or programming associated with or utilized in this Contest, computer online systems, servers, or providers, computer equipment, software, failure of any entry to be received by Sponsor due to technical problems, human error or traffic congestion, unavailable network connections on the Internet or at any website, or any combination thereof, including any injury or damage to participant’s or any other person’s computer relating to or resulting from participating in this Contest or downloading any materials in this Contest. Use of automated devices are not valid for entry. Sponsor has the right to cancel, terminate or modify this Contest if it cannot be completed as planned due to tampering, unauthorized intervention, technical failures, or other conditions beyond Sponsor’s control. By participating in this Contest, participants agree (i) to be bound by these rules; (ii) that any and all claims, judgments and awards shall be limited to actual out-of-pocket costs incurred, including costs associated with participating in this Contest but, in no event, attorneys’ fees; and participant hereby waives all rights to claim punitive, incidental, and consequential damages and any other damages, other than for actual out-of-pocket expenses, and any and all rights to have damages multiplied or otherwise increased, some jurisdictions do not allow the limitations or exclusion of liability for incidental or consequential damages, so the above may not apply to you; (iii) that Sponsor has the right to use participant’s first name, last name, and city and state, photograph, image, and likeness on Sponsor’s website and in any and all publicity and advertising for Sponsor without any further attribution, notification or compensation to participant except where prohibited by law; (iv) to be contacted by Sponsor by public announcement, telephone, mail or email regarding this Contest; and (v) to release and hold harmless Sponsor and its agents for any liability, damages, loss or injury resulting from participation in this Contest or the acceptance, possession, shipping and handling, loss, use or misuse of any prize provided in this Contest. Participants and prize recipients assume sole liability for injuries, including personal injuries and/ or damage to person or property, caused or claimed to be caused by participating in this Contest or the acceptance, possession, shipping and handling, loss, use or misuse of any prize provided. CAUTION: ANY ATTEMPT BY A PARTICIPANT TO DELIBERATELY DAMAGE ANY WEB SITE OR FACEBOOK PAGES OR UNDERMINE THE LEGITIMATE OPERATION OF THE CONTEST MAY BE A VIOLATION OF APPLICABLE CRIMINAL AND CIVIL LAW. SHOULD SUCH AN ATTEMPT BE MADE, SPONSOR RESERVES THE RIGHT TO SEEK DAMAGES FROM ANY SUCH PERSON TO THE FULLEST EXTENT PERMITTED BY LAW AND TO DISQUALIFY THE PARTICIPANT FROM THE CONTEST. WINNER’S LIST: The names of the Nominees will be posted on Facebook September 9, 2011 and on Sponsor’s website. The final Winner will be announced September 23, 2001. ODDS OF WINNING: The number of valid entries received will determine odds of winning. Sponsor: Medical Inflatable Exhibits, XXXX, Houston, TX 770XX. For questions, please email info@integratePR.com. 123

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