Filipino Nurses

The Sef Gonzales Tragedy

2023-07-18T15:12:00.000-07:00

Sef Gonzales, born on 16 September 1980, is a Filipino Australian man who received a life imprisonment sentence for the murders of his father, Teodoro "Teddy" Gonzales (46), his mother, Mary Loiva Gonzales (43), and his sister, Clodine Gonzales (18), in Sydney, New South Wales, Australia, in July 2001. The notoriety surrounding the sale of the house where the crimes occurred prompted the New South Wales government to make it illegal not to disclose information about a property's history.

Sef Gonzales was born in 1980 in Baguio, Benguet, Philippines, to Teddy Gonzales, a lawyer, and his wife Loiva Claridades, who married in 1977. In 1983, Sef's sister Clodine was born. After the 1990 Luzon earthquake destroyed their family's home and business, they emigrated to Australia. Settling in Sydney, New South Wales, Teddy requalified as a lawyer, established a successful immigration law firm, and bought a plot of land in North Ryde.

Although the Gonzales family appeared close-knit, the parents were devout Catholics with high hopes and strict expectations for their children. They particularly wanted their son to excel academically and abandon his musical and singing ambitions, urging him to pursue a career in medicine or law. Sef attended Parramatta Marist High School before starting medical science studies at the University of New South Wales, but he withdrew after two years and enrolled in law at Macquarie University.

Struggling academically and facing the risk of expulsion, Sef Gonzales attempted to conceal his poor performance by falsifying his grades. When his sister revealed this to their parents, they threatened to withdraw certain privileges, including the use of his prized car, a green Ford Festiva. Additionally, Gonzales had disagreements with his mother over a disapproved girlfriend, leading to threats of disinheritance. Police later established these issues, along with Sef's desire to inherit the family's assets, as motives for the murders.

On 10 July 2001, around 4:00 p.m., Sef Gonzales left the family's law firm, where he worked part-time, and went home armed with a baseball bat and two kitchen knives. He entered Clodine's bedroom and attacked her while she was studying, strangling her, hitting her head with the bat multiple times, and then stabbing her with one of the knives. The cause of Clodine's death was a combination of neck compression, blunt force head injuries, and abdominal stab wounds. Gonzales then waited for Loiva to arrive home around 5:30 p.m. He attacked her in the living/dining room with one of the kitchen knives, causing multiple stab wounds and cuts to her face, neck, chest, and abdomen. Her windpipe was completely transected post-mortem.

At approximately 6:00 p.m., Gonzales' maternal aunt visited the house and observed her nephew's and sister's cars in the driveway. However, the house was dark and unusually quiet, even though the family kept six small dogs inside. She decided not to enter via the garage after noticing movement inside. Teddy arrived home at about 6:50 p.m., and upon entering the house, Gonzales attacked him with one of the kitchen knives, inflicting multiple stab wounds to his neck, chest, back, and abdomen. One of the stab wounds penetrated his right lung, another his heart, and another partially severed his spinal cord. Teddy's defensive wounds suggested a struggle.

After the murders, Gonzales disposed of the murder weapons, clothing, and the size 7 running shoes he was wearing. He then showered, changed clothes, and spray-painted offensive graffiti on a wall in the house, attempting to mislead investigators into believing it was a hate crime against Asians. Gonzales later visited a friend's house, and they went to the Sydney central business district, where they dined at Planet Hollywood and visited a video game arcade. After dropping off his friend, Gonzales returned home and called emergency services at 11:48 p.m., falsely claiming to have discovered the bodies. He also ran to his neighbors' house frantically and informed them that his parents had been shot.

Following the murders, Gonzales made television appearances, urging the killers to come forward and expressing his desire for justice, offering a reward of A$100,000. A few days later, he visited the family's accountant to inquire about his inheritance, estimated at A$1.5 million in Australia and ₱1.3 million in The Philippines. As a supposed victim of the crime, he was also eligible for a A$15,000 payout. Gonzales moved to an apartment in Chatswood and placed a deposit on a A$173,000 Lexus, stating he would use his inheritance to pay for it. At the trial, it was claimed that he traded in his parents' cars and pawned his mother's jewelry. He also told relatives that he had a brain tumor and requested A$190,000 from his godmother in the Philippines for alleged surgery, but she refused to give him any money. At the combined family funeral on 20 July, he delivered the eulogy and sang "One Sweet Day," which some attendees found strange.

Based on the initial evidence, the NSW Police investigators initially assumed the murders were part of a robbery attempt. However, the absence of forced entry and the lack of missing valuables, including cash, along with the extended duration of the crimes, led them to suspect Gonzales' involvement. They noticed his emotional detachment and numerous inconsistencies in his story, such as his claims of performing CPR and the absence of evidence supporting the presence of intruders. Further evidence implicating Gonzales included paint matching on his clothes to the graffiti and a shoe box in his room matching the shoes used in the attack. This prompted authorities to search Gonzales' internet records, record his phone calls, and have an undercover officer befriend and surveil him.

In December 2001, the police discredited Gonzales' first alibi that he was in his car in the driveway on the night of the murders before driving to another suburb and meeting his friend. He then fabricated a second alibi, claiming he took a taxi and visited a brothel during the murders, but both the supposed taxi driver and a sex worker discredited this claim. Other false trails included a fabricated email implicating a business rival of Teddy in the murders and staging an attempted burglary in May. A breakthrough occurred when Gonzales' fingerprint was matched to a series of product poisoning letters found on his personal computer, alongside evidence of his research into poisons, the ordering of toxic-plant seeds, and recent unexplained poisoning-like illnesses in his family. As a result, detectives from Strike Force Tawas arrested Gonzales on 13 June 2002.

Gonzales faced three counts of murder and one count of threatening product contamination. He was denied bail and held on remand in Silverwater Correctional Centre. During this time, he was unable to access the family's estate for his defense and sought legal aid for the murder trial that took place in April and May 2004. Prosecuted by Mark Tedeschi, the trial revealed that Gonzales had planned the murders months in advance, initially researching the idea of poisoning his family, leading to an elaborate contamination hoax one week before the killings. The court heard about numerous lies he told to friends, family, and the police regarding his whereabouts during the murders, suggesting a pattern of pathological lying. The motivation behind the murders was his fear that his poor university performance would lead his parents to take away his car and revoke other privileges, wanting to be the sole beneficiary of their property.

On 20 May 2004, Gonzales was found guilty on all four charges and sentenced on 17 September 2004 to three concurrent life sentences without parole for the murders. Justice Bruce James characterized the murders as heinous and found no mitigating factors to lessen their severity. Gonzales sought an appeal in June 2007, granted approval by the Supreme Court due to potentially inadmissible statements taken from him by police on the night of the murders. However, the appeal was dismissed on 27 November 2007 as no miscarriage of justice was found, and his convictions remained.

In March 2021, Gonzales failed in his third attempt to initiate a special inquiry into his convictions for the murders, following unsuccessful applications in 2018 and 2019. The house in North Ryde, built by the Gonzales family in 2000 and put on the market shortly after the murders, remained unsold for three years due to its notoriety. When prospective buyers from Taiwan agreed to purchase the property, they were not informed of the events that occurred there by the realtors, LJ Hooker, learning about it from a newspaper later on. LJ Hooker initially refused to reverse the sale as they had no legal obligation to disclose the information but eventually refunded the buyers' $80,000 deposit due to negative publicity, resulting in a A$21,000 fine by the NSW Office of Fair Trading. Consequently, the NSW government made it illegal not to disclose information that could substantially affect a property's value. In November 2005, the house was eventually sold for A$720,000 (A$80,000 less than the previous price) to a buyer who was informed of its history.

How to Raise HDL Cholesterol Levels

2013-04-06T16:38:00.000-07:00

HDL cholesterol is often known as the good cholesterol. HDL levels less than 40mg/dl are likely to elevate the risks relating to coronary heart disease. Building good cholesterol levels enables you to eliminate the plaque. The proper amounts of HDL are any where from 40mg/dl to 60mg/dl. At the same time, HDL cholesterol levels greater than 60mg/dl helps reduce the possibilities of heart disease. Unhealthy cholesterol (LDL) raises the plaque which often brings about heart disease. There are some methods to help increase the good cholesterol ( HDL) levels by natural means.

Cholesterol is a waxy substance that is found in all of the cells of the human body. These particular cells pass by way of the bloodstream in all of the areas within the entire body. They're attached with proteins. Such proteins are known as lipoproteins.

Low density lipoproteins at proper amounts are actually helpful to your body. This circulates throughout the entire body and provides cholesterol to various tissues as well as organs. Any time there is too much LDL, it becomes lodged within the walls in the blood vessels underneath the lining. After a while, this will begin to reduce the size of the blood vessels that causes heart disease.

High density lipoproteins (HDL) are classified as the good cholesterol. It cleans away the plaque that settled on the walls within the blood vessels. It is then returned into the liver and also broken down.

It is important not simply to lower LDL but additionally to raise HDL. This could be explained that rise in HDL cholesterol levels is an necessary factor to lessen the possibility of heart disease.

It is also possible to raise the good cholesterol levels by natural means by a modification in diet and lifestyle. Shedding weight is an crucial factor in boosting HDL levels. Frequent aerobic fitness exercise which boosts the heart rate will likely aid to raise HDL cholesterol levels.

Smoking

Smoking is definitely extremely damaging for health. When you stop smoking HDL levels in the body will rise.

Alcohol

Moderate intake of alcohol is beneficial for health. On the other hand, too much alcohol reduces the body's HDL cholesterol levels. A drink per day is healthy.

A number of food items help boost HDL cholesterol levels.

· Consuming one half an onion each day helps raise HDL cholesterol levels by TWENTY FIVE percent.

· Oats, grains, pears, citrus fruits, grape varieties, dried beans and lentils include soluble fibers. Soluble fibers aid in increasing HDL cholesterol levels.

· Canola oil as well as olive oil have high levels monounsaturated fats. These aid in increasing HDL cholesterol levels.

· Fish, sunflower oil, flaxseed oil and vegetables have omega 3 fatty acids that aid in increasing HDL cholesterol levels.

· Soy products such as tempeh and also tofu also aid in increasing HDL cholesterol levels.

· Olive oil and also canola oil include monounsaturated fats. These also aid in increasing HDL cholesterol levels.

All these are only many of the strategies where HDL cholesterol could be raised naturally.

Have your cholesterol checked regularly. When you know your cholesterol numbers, it is good to have the correct cholesterol risk chart to find out your risk level. It is never to early to make changes in your lifestyle. After all, this is the only body we have.

to all nurses

2010-10-14T02:22:00.001-07:00

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LIFE, DEATH AND RENEWAL

2010-09-25T08:09:00.000-07:00

A sense of foreboding gripped me as I entered the department. The aides were pushing a morgue stretcher away, leaving sharp intakes of breath and a muffled cry. Three nurses huddled around the triage desk, one nurse was visibly upset.

Outside the trauma room stood two burly policemen. The aftermath of a trauma resuscitation greeted me: the blood-splattered floor was strewn with discarded clothes, a used stylet, wadded gauze, and the blue overwraps from the instrument trays.

The night nurse looked shell-shocked. On Bed A, an unconscious male patient lay in a tangle of wires and tubes. The ventilator hummed and the monitors bleeped. Endotracheal tube to the ventilator, sinus rhythm on the monitor, an arterial line, two large-bore IV lines, a urinary catheter, right chest tube, right leg splint, dried blood on bandaged head, and his left hand cuffed to the side rails.

"Here's our 20 year-old trauma patient... this..." the night nurse bit her lip to stifle an expletive. "This person just murdered his girlfriend, her two children and her grandma. Shot them point-blank. He jumped four stories off the roof after he was chased by the police. All this because she tried to leave him after a night of beatings. That was the youngest child we just sent to the morgue. " Her voice broke and we both shuddered.

We stood at the bedside and shared each other's anger. The thought of the carnage this man left behind made me recoil in disgust. I felt a need to cry; bile rose up in my throat. Even in repose, this man's face looked so evil, almost satanic. Despite all the repulsion I felt, I had no choice; I had to take care of this patient. My training and my ethical responsibility will ensure that I give this patient the best of care, no matter what.

The night nurse struggled to finish the report. She was rambling, obviously wanting to simply put the ugliness behind her. I could only pat her back. "He's pending the CAT scan results. His pupils are fixed and dilated; he's unresponsive to any stimuli, no corneal reflexes, and he's posturing." This patient is as good as dead, I thought. The machines keep him alive.

As if on cue, the physician strode over. "He's got a huge subarachnoid bleed. No surgery for him. We're starting brain death protocol on him... and surprise! The cops just found his organ donor card."

Somehow, my anger simmered away. I clutched at one straw of sanity... in one rational moment, this man has willed his organs so that in his death, others could live. The organ donor card tells me that at one point in his life, this man cared enough. A little too late. Why couldn't he be as generous in life?

http://jo-cerrudo.blogspot.com/2010/08/ed-vignettes.html

Patient Privacy and technology

2010-09-17T12:02:00.000-07:00

The advent of technology has a lot of advantages. With Yahoo Messenger, Skype and other internet chat/ conferencing services, we can now talk to relatives and friends around the world at no cost at all, or very minimal if any (that's if you have to go to the internet shop and pay per hour). It allows us to rant or praise through blogs, reconnect with friends and make new ones through networking sites, and practice our writing, photo editing, singing, dancing instrument playing talents. Mobile phones are becoming cheaper and more high tech, you can now have a mobile phone, a camera, a videocam, an organizer and an mp3 player all rolled into one teeny tiny phone (and that's just the basics). Technology allows for better documentation of our daily affairs, reunions, vacations, projects, etc. Unfortunately, people have gotten overboard with these new found powers. They air their dirty laundry for everyone to see, mess with videos and pictures to destroy people. Some are premeditated acts, and some just fell victim to ignorance. Sad but true, even nurses have had issues with misuse of technology.

The first sensationalized case in the Philippines involving nurses was the canister videotape scandal where members of the medical team deliberately videotaped (using a cellphone) a procedure on patient who came to the ER with a very humiliating situation. That video found its way to the world wide web. It was very malicious and there's no way it could be argued that it was (the videotaping and the posting) an honest mistake. They thought it was funny, and even funnier if the patient suddenly finds his face plastered on the internet. These were people, who took an oath, to respect the dignity of any patient, regardless of color, race, political, religious or personal beliefs, etc. Shame!

Then this year, the technology bust came through again, this time in the form of the right-of-passage summer ritual among boys - circumcision. It's nothing new, every summer, there's medical missions offering free circumcisions to young boys. It's tradition. What was new was this year, pictures from these activities flooded the internet. Worse, it showed young boys, faces, penises, and all. No effort was done to protect their privacy. Worst of all, members of the medical team were seen smiling and posing over patient's agonized faces, or their private parts being cut (and that oh-so-annoying finger sign!) I doubt one will argue the "free" gave them the right to do whatever they please. It wasn't that at all. It was ignorance, and maybe complacency. After all, it was a good deed, a medical mission. Surely, anyone would be excited to share in someone's being hero for the day....right? Pictures started being shared and perused by friends, friends' friends, and so on and so forth. Pictures were re-tweeted, side shows became available on youtube. And then someone cried FOUL!

All of a sudden, Filipino nurses and doctors are being called pedophiles, exhibitionists etc. We've been branded! There's even a facebook page about it. You should see what's being said about us over there. It's unfair to be branded and generalized, it's true. But what's even unfair, is that the patients' rights to privacy and confidentiality were again violated, our oath to protect was disregarded. Seems to me like that oath isn't worth squat.

We can blame technology but I think that technology has helped us (in a twisted sense) realize that in every action that we do, we always need to look at it 360 degrees. Specially if it involves patient care. The patient always come first. Boohoo, You can't post pictures of the excitement, or need to take time blurring patients' faces. But remember, you took an oath. Better serve up.

what if??

2010-09-11T21:54:00.000-07:00

As a nurse, it's all part of our job to render health teachings to our clients. What to do, what to eat and drink. While doctors were the one whose explaining to them their medical status or medical condition. These were the routines were used to do inside the hospital.

But what if one day, you are the one whose hospitalized? You are the one whose lying on the hospital bed. You'll be the patient taken good care by others. Are you ready to listen? Are you ready to accept the findings? Are yo ready to face death?

Been asking this question inside my mind. Working inside a hospital, death is inevitable.

=====

dhee, r.n.

More Than Words

2010-09-06T07:43:00.001-07:00

Hello dear nurses,

I got a call recently from a client who was desperately seeking support for a nurse accused of misconduct and facing losing her right to practice as a nurse in Ireland.

When first hearing about the case, I asked a lot of questions and it seemed that communication difficulties were among the issues that patients had complained of about this nurse.

When I sat down to have a chat with this nurse to see how I could help her, it turned out that she was highly educated and communicated quite well.

One thing stood out about her communication and that was her pitch (how high and low her voice modulated). After reading a little about her mother tongue, it turned out that pitch was used quite differently in her mother tongue than in English. In English, people often raise to a high pitch when annoyed or nervous or anxious but in Hindi, this nurse's native tongue, pitch is used to emphasise content that is important.

It seemed that this nurse was simply transferring a habit from her mother tongue, without realising the effect on her patient.

The episode clearly highlights that communication is so much more than the words we use; it's all about how we use them. Knowing a language is more than having an extensive vocabulary; it's about how we use that vocabulary. The use of pitch (high/low voice range) in English is very different to other langauges and good to know that a raised pitch signals some kind of distress or anxiousness, something that patients are bound to react to as it signals something is not quite right with the speaker.

Have you had miscommunications that were due to something like this nurse's miscommunication - more than words?

Until next time,
Marie

My Colostomy Story

2010-09-04T09:41:00.000-07:00

A repost from my blog.

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

Today, I had to deal with the dilemma of me being an experienced neurosurgery nurse, working in a general surgery unit. I worked in an ER and neurosurgery environment for the last seven years, and I knew that I would be faced to deal with some unfamiliar cases in a new work place.

I had a patient with a colostomy. Well, it may sound so simple for some general surgery nurses out there, but it was a big deal for me. It’s not that it was my first time, because I have had several patients with a colostomy. But it was my first time in several years to actually perform colostomy care – to actually touch and clean the stoma.

I was busy with another patient when I heard somebody screaming. When I looked out of my patient’s room, I saw one of my co-nurses coming out from one of my patient’s room. She asked me if the patient in room x is my patient, so I told him yes and asked her what’s wrong. She said the patient was complaining because he was yelling for an hour already and nobody is coming for him.

Since I was finished with my current patient, I decided to check the complaining patient out. I went to his room and I was welcomed with some more yelling. I asked him if he was pressing the bell since that is the proper way of calling a nurse. He said he did but it seemed the bell was not working.

I investigated further, and found out that the bell cord was not attached to the plug. So that was the reason nobody was coming to him. I was successful in trying to pacify him. I asked him what he needed and found out that his colostomy leaked up to his back. He said he was trying to open his colostomy because he felt it was full of air. When he opened it, he got surprised with the contents and everything leaked out and went to his clothes and sheets.

My patient had a colorectal cancer and the surgeons tried to remove the cancerous part of his large intestines. A new opening was made on the left side of his abdomen where his stool can come out, and will be drained to a pouch called colostomy bag.

I checked what I needed to clean him, and after that I told him I need to get some things in the stockroom. When I got into the stockroom, I took some fresh linens, pads, cleaning wipes and saline. To my horror, I found that there were different sizes of colostomy bag. How would I know which one is for my patient? I decided to just bring one from each of the different sizes. I thought it would be safe since I do not have to come back if one size fails.

When I went back to my patient’s room, I checked his colostomy so I could choose which size of bag I would need. To my surprise, none among those I brought were the same as my patient’s. I needed the biggest size which seemed not available because I did not find that size before. I knew I took one sample from each of the sizes I saw.

I went back to the stockroom and searched for the largest size. I did not find any, so I asked one of my seniors. He helped me search until he finally said it was probably out of stock.

I decided to go to another ward and asked for that size. I knew that every minute counts for my patient who was irritable initially. I found the size from another surgical unit and hurriedly went back to my patient.

When I got into my patient’s room, I was greeted by a frown. I explained to him why it took me a bit long to come back, that I needed to get his size from another unit. He seemed dissatisfied with my explanations, so I just tried my best to talk to him nicely.

I detached the old pouch from where it was connected. I placed it in the bathroom since I wanted to save the wire that closes the pouch at the end. I cleansed his stoma with normal saline. After cleaning, I tried to attach the new pouch to the connector. It seemed I could not connect it. It was either I was doing it the wrong way, or I just do not know what I was doing.

While I was trying to attach it, I tried to converse to him to try divert his attention from what I was doing. I explained to him some facts about colostomy, and how to take care of it. I was posing to be a pro with what I was doing, when deep inside, I knew I could not connect the bag. It was hurting him when I pressed harder on the pouch lid.

I then decided to ask help from a co-nurse. God probably heard my heart beating fast, and gave me a colleague just passing by my patient’s door! I asked her to help me attach the colostomy bag. She told me how to do it and watched me do it. It was the same technique as what I was doing before. But she also felt it was difficult doing it that way so she suggested for me to just remove the part that was attached to the skin, and apply a new one. The adhesive part that was touching the skin and the bag should already be connected before sticking it to the skin.

I actually thought of that, but I knew it was the harder way of changing the bag. But now, it seemed there was no other way but to do it that way.

I was successful in applying a new bag on him. I went back to the bathroom and took the wire from the old bag. It was heavily stained with stool so I just tried to clean it. I closed his colostomy bag using that wire.

I wiped him a bit, and brought him to the bathroom after that. I changed his gown and placed new linens on his bed. His mood has changed, and was apologetic about his attitude a while ago. I told him it was pretty understandable for him to get mad in his situation. I left him clean and satisfied with what I have done for him.

In the evening, before I left the unit, I checked him out in his room. He was with his family, and I was introduced to them. I told him that my shift is over and that I was leaving. He asked who’s replacing me, but I was not sure who’s taking care of him next. I saw in his face that he still wanted me to stay for him.

Before I left, he said smilingly “See you on Sunday!”.

(picture credit: butler.org)

A day in a life of an EMT: Drink while driving

2010-09-04T09:13:00.000-07:00

Several weeks from now, it's going to be October. We all know what that means; it's going to be beer, beer, and more beer because of Oktoberfest. And as you've noticed, I'm overlooking September since I'm still assigned in Rockwell post for the whole month, which FYI-- is the most benign post you'll ever get assigned in. We hardly have multiple runs in a shift there. Sometimes we get lucky but most of the time we run once, and the rest is all eat and sleep.

It will be my first October in Lifeline so I'm not familiar with the statistics of trauma but I'm guessing we'll be having Lifeline members driving piss-drunk that month. I could be wrong though; investing in healthcare is something a smart person would do. A smart person wouldn't do stupid things like gulping vino and then go behind the wheel.. but hey, we can't put alcoholics and juvenile delinquents out of the picture right? Haha. Let's face it: idiot drivers will give me much of the practice I need in intubation. I swear if I encounter an RTA with GCS 8, the moment the cot locks at the back of the ambulance I'll be over his head, prying his jaw open with a Macintosh. Medical practice. Nursing practice. Eh. There's a reason why they attached the word "practice". Of course I know what I'm doing; indications, advantages, disadvantages, complications.. I took ACLS. The success rate, however is an entirely different thing. I know what I'm doing, I'm just not that good at it yet. Burned!

So when October comes, think twice about driving drunk. Sure we' ll save your life; dial 16-911 and we'll be happy to extricate you from your Prius (with spinal immobilization of course). But the time you don't respond to sternal rubs and then your oxygen saturation takes a nosedive below 90% despite a well secured BVM before we reach the nearest ED, I assure you I'll be the first one to shove a tube down your throat. Drive safe people.

A Push to Future Nurses

2010-09-03T17:10:00.000-07:00

"I did my best and I know I have my chances." - an excerpt from a now RN friend.

This is one statement that stuck in my head years after the night our NLE result was released. I was fortunate to have passed the exam but was also heartbroken trying to comfort good friends who did not make it. It never occurred to me that the minute I become a boardpasser I am to apply all the nursing therapeutic communications I have learned in and out of the classroom. During this time it was hard to be full-throttle celebratory that I could only settle with being thankful.

The NLE, like any other board examinations, can be a life-altering event. Making it to the roster gives license to practice one's chosen profession. But while others take it as one huge step to reaching their dreams, to some it becomes a make or break deal. I have seen test-takers who were either disheartened or digressed by ill luck in this exam. Perhaps because we program ourselves to pass and never do we make any contingency plans that we put ourselves into instant defenselessness. Not making it the first time then becomes a more onerous test - a test to one's character. There are those who start to question their abilites, others turn either cynical or sour, and there are those who hastily decides to call it quits without attempt for a second try.

Bereavement is normal. We are humans afterall. But redemption will have to be a matter of choice. To those people who remain averse about retaking the exam will never know the difference; while those who prefer to rise to the occasion will have their chances of becoming certified one day. In this case, fortune may clearly have to favor the brave.

With the recent release of the new batch of registered nurses, I can't help but look back at that night when I had to share strength to colleagues who needed them. Years passed and I am proud to say that these friends of mine are not only licensed, but now fair in the industry, simply because they did not give up. What our future nurses should not fail to see is that NLE is a rite of passage; and it serves another purpose of bringing out the best or the worst in its test-takers, either of which for their own choosing. Life is larger post oath-taking to just miss out on it.

I often say that it's not about who's the smartest or who's the most studious in class who succeeds in this kind of endeavor. It has got to be the most determined that brings home the greatest reward. Because in a parallel universe where the smartest, the studious, and the determined all fail, the latter already has the determination, the spirit that will deliver.

Call a Code Blue!- A brief education on a medical emergency

2010-09-01T15:17:00.000-07:00

So who doesn’t love a good medical show? Nowadays the shows that are medical related are a dime a dozen. From House, to Grey’s Anatomy, to the never forgotten ER, these shows give us a peak in the lives of health professionals. What I want to talk about though is the infamous code blue. You guys know that moment in the show where you see the health staff yelling “code blue, code blue”. Then you see the patient on their bed pale, unresponsive, and they look like they literally have no life left in them.

In this article I will explain the basics of what is going on in the person especially their heart and what the medical staff is basically trying to do. This will be nothing to in depth just a basic education, because to be honest what is exciting to watch in TV is actually very scary experience in person especially if it is your own family member.

The heart which I like to call the “Real Muscle” of the body is responsible for ejecting blood to your major vital organs of your body. Without your heart outputting a sufficient amount of oxygenated blood, your organs suffer and basically don’t get their needed oxygen. I know all you guys have held your breath before and what you are basically doing? You are depriving the body of oxygen which your body needs and ultimately building up carbon dioxide which accumulates.

So which leads me to my next point, your heart rhythm is basically an electrical conductive system. Your heart has pacemakers to help set the rhythm and the rate at which it pumps. The main pacemaker of the heart is your SA node, but just in case that one fails there are backup mechanisms. With that said those backup mechanisms aren’t as efficient as the SA node. Your heart basically is full of fail safe pacemakers just in case anything goes wrong, but they may not pump at a proper rate or put your heart in a proper rhythm. When your heart is pumping in its proper rhythm it is called Normal Sinus Rhythm which pretty means Life is GOOD! You are getting proper cardiac output and your heart isn’t working too little or too hard, it is going just right.

Two of the main deadly rhythms that are mostly seen in a code blue situation are Ventricular Fibrillation and Ventricular Tachycardia that is pulseless. These two heart rhythms are so erratic and so inefficient that your basically getting no cardiac output. The ventricles of the heart which are parts of the heart have the ability to be pacemakers but are horrible in doing so. So what you get is a patient with an abnormal heart rhythm with basically no cardiac output. Especially in Ventricular Fibrillation the heart is basically just quivering with no real actual efficient pump to eject the blood.

In the hospital when we notice this we call a “code blue”. Our basic goal here to either shock the heart back to a normal rhythm to help re-sustain some decent cardiac output. The quicker we are to react as health care professionals of course the better the outcome. Every second we don’t do something we are depriving the entire body of oxygenated blood. We use the defibrillator which will basically deliver an unsynchroized shock or electrical energy. What happens when the shock is delivered it trying to depolarize which basically means we are trying to reset the rhythm of the heart, in doing so we would hope the SA node would kick back in and reset the heart to a normal sinus rhythm.

I can go further in depth on this article but it would take me another page . I just wanted to give a basic brief summary. Once the heart rhythm is back there is many other things that can happen or must be done. For instance, trying to sustain a normal blood pressure or trying to raise the heart rate. I will save that for another day. In the meantime when your out in a public place and see the little box with the letters AED. That stands for Automated External Defibrilator and is used just in case someone needs it in a public setting.

Jed Jularbal, BSN, RN
The Methodist Hospital- Houston Texas

Email: jrjularb@gmail.com

All about Dengue Hemorrhagic Fever.

2010-08-31T06:47:00.000-07:00

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

CAUSES

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

SYMPTOMS

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

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

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

Early symptoms include:

Decreased appetite
Fever
Headache
Joint aches
Malaise
Muscle aches
Vomiting

Acute phase symptoms include:

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

POSSIBLE COMPLICATIONS

Encephalopathy
Liver damage
Residual brain damage
Seizures
Shock

SOURCE

-------

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

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

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

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

Drexel Heinz Magpantay Cruz, RN, RM

Pediatric Nurse

We Are Patient

2010-08-28T21:10:00.000-07:00

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

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

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

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

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

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

2010-08-28T10:28:00.000-07:00

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

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

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

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

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

COUNTING MY BLESSINGS

2010-08-27T23:07:00.000-07:00

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

At Triage...

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

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

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

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

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

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

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

I had learned long ago to count my blessings.

BAYANIHAN

2010-08-26T10:10:00.001-07:00

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

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

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

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

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

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

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

The noble heroes of modern time.

2010-08-22T09:58:00.000-07:00

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

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

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

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

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

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

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

Drexel Heinz Magpantay Cruz, RN, RM

Pediatric Nurse

A day in a life of an EMT: Prelude

2010-08-21T02:08:00.000-07:00

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

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

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

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

Letting Go

2010-08-18T07:25:00.000-07:00

(Excerpt from my published article)

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

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

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

Until Mr. Contreras came to the ED to die.

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

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

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

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

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

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

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

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

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

IS IT JUST BASIC EDUCATION?

2010-08-11T21:47:00.000-07:00

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

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

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

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

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

Looking for Bloggers!

2010-08-06T11:35:00.000-07:00

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

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

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

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

Thank you!

Admin

DEF Idioms

2010-07-23T04:14:00.000-07:00

Happy Friday nurses!

If you love idioms and want a way to learn more quickly, here are some ideas. On my last post I chose body parts with ABC. Here are 3 body parts with EF that are used in the following 6 idioms. It's a good way to learn new language quickly.

Eye
A blue-eyed boy is the favouite in any group or the pet of a group
To have an eye-opener is to have an enlightening experience
To have half and eye on something: to not give something your full attention

Face
To face the music is to face criticism/punishment as a result of one's own actions
To have a face as long as a fiddle is to look depressed
To stare one in the face is something that is obvious and clear to see

Try putting any of the above in a sentence that is meaningful to you to help you remember any one you like the look of. Always put a new word in a personal mental sentence to help you remember it. And, remember that if you don't use it, you lose it so start weaving some idioms into your language today.

Until next week,
Marie

ABC of Idioms with Body Parts

2010-07-06T04:50:00.000-07:00

Hello world-class nurses!

Kamusta mga pogi =)

This week I’d like to write about idioms. The English language has thousands of idioms. By an “idiom” we mean a number of words which, when taken together, have a different meaning from that of each separate word. If at the end of a long day, a person tells you that they’re “on their knees”, they are using “knees” idiomatically to mean that they’re extremely tired and feel like collapsing. If someone talks about their money worries and in the same breath tells you that they’re just about “managing to keep their head above water”, they mean that they’re struggling to keep out of debt.

In English, words and phrases connected with parts of the body are extremely common in idioms. Here are a few idioms connected with body parts beginning with ABC. Should you enjoy them, let me know; there are lots more to follow.

Arm:

To keep someone at arm’s length: to avoid being friendly.

To give one’s right arm (usually with would): to be willing to make a sacrifice to get something.

Back:

To be on one’s back: to be ill in bed.

To have one’s back to the wall: to be struggling against great difficulty.

Blood:

Blood is thicker than water: one’s own relations come before all other people.

To get blood out of a stone: to achieve the impossible.

Bone:

To be all skin and bone: to be very thin

To make no bones about doing something: to have no hesitation in doing something (usually unpleasant).

Brain:

A scatter-brained person: a careless, forgetful person

To rack one’s brains: to think very hard; to solve a problem or remember something.

Cheek:

To have the cheek to do something: to be bold, rude enough to do something.

To turn the other cheek: to refuse to retaliate.

Chin:

To have a chin-wag: to chatter, talk with friends about unimportant matters.

To take something on the chin: to suffer severe difficulties with courage.

These idioms were shared from Everyday English for International Nurses. There are lots more to follow should you enjoy them. How many idioms do you know with body parts EARS, EYES and FACE?

Share the idioms you know with these body parts so that together you build your repertoire as a team of world-class English speaking nurses.

Warm hugs from Ireland.

Until Next Week,

Marie

Every Word Counts

2010-06-30T08:46:00.000-07:00

Dear Nurses,

I'm glad to be back to you after a stint in hospital and no blogging. I've just had my first ever visit to hospital and am more passionate now than ever about the power of your language as nurses to your patient's recovery.

I'd like to share a poem with you that Mother Teresa lived by when nursing her patients; it's called The Anyway Poem. As a nurse, every kind word of encouragement helps your patients to recovery so don't stop to worry about your grammar, don't fret over whether your words are as elaborate as your colleagues or as technical as the doctor's; be yourself and use kind empowering words, just because!

People are often unreasonable, illogical and self centered;
Forgive them anyway.

If you are kind, people may accuse you of selfish, ulterior motives;
Be kind anyway.

If you are successful, you will win some false friends and some true enemies;
Succeed anyway.

If you are honest and frank, people may cheat you;
Be honest and frank anyway.

What you spend years building, someone could destroy overnight;
Build anyway.

If you find serenity and happiness, they may be jealous;
Be happy anyway.

The good you do today, people will often forget tomorrow;
Do good anyway.

Give the world the best you have, and it may never be enough;
Give the world the best you've got anyway.

You see, in the final analysis, it is between you and your God;
It was never between you and them anyway.

[Reportedly inscribed on the wall of Mother Teresa's children's home in Calcutta, and attributed to her. However, an article in the New York Times has since reported (March 8, 2002) that the original version of this poem was written by Kent M. Keith.]

Until next week,
Marie

SEX EDUCATION IN THE PHILIPPINES

2010-06-22T18:29:00.000-07:00

SEX EDUCATION IN THE PHILIPPINES

By Noel D. De Ocampo, MSN/ED, RN
http://thefilipinonurseforum.blogspot.com/
June 22, 2010

The premise that the church has the moral obligation to promote God’s teachings is understandable as this is what most Filipinos believe in. But isn’t God promoting to protect the children from harm, too? By not teaching these children what their bodies will go through in their developmental stages is a clear indication that the church is refusing to evolve and would rather put these children’s health and well-being at risk.

Contrary to Filipino clergymen’s teachings, the more knowledgeable a person is about sexuality, the more responsible he or she becomes. Teaching sex and sexuality to children before their teenage years increases their awareness of many sexually transmitted diseases and the burdens of early parenthood. In the United States, sexuality education has been widely promoted as one of the most important educational responsibility since the 1960s. In recent years, this promotion increased significantly due to the proliferation of sexually transmitted diseases and significant increase in teen pregnancies (Daniluk & Towill, 2001).

Teaching sexuality does not necessarily mean teaching children to become promiscuous. Sexuality education and abstinence can be taught hand in hand. The time spent to teach sexuality may be the best time to teach abstinence and other health issues that most people are facing now. Most of these children will have sexual encounter eventually, and the best way to prepare them is to teach them what to expect and to teach them how to reduce risk-taking behaviors.

We are no longer in the Spanish era. Don’t let the church meddle with this very important educational initiative. Forget about flowers and bloom. Let the teachers talk about PENIS & VAGINA. There is nothing wrong with that.