Archive for November, 2007

Forensic Nursing and Professional Speaking, comment

November 30, 2007

You can take Professional Speaking. It is designed for professional individuals such as Forensic Nurses. The Professional Speaking class does offer several opportunities to practice your public speaking. See the link on the right named “Professional Speaking.”

Original Post:
WEDNESDAY, NOVEMBER 28, 2007
Forensic Nursing and Professional Speaking

I am a Forensic Nurse. Many times I have to testify in court. I get very nervous and have fear of public speaking each time. Many times my side looses in court or before a trial because in part due to my fear of public speaking. Once, a judge ordered a recess because I was so nervous that I nearly fainted. I like the fact that you include Testifying and Depositions in your program. Do you provide practice opportunities within your program?

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Pandemic influenza (H5N1)

November 29, 2007

If/when a pandemic takes place, clinical nurses will need to use advanced assessment skills to recognize those who have been infected as well as those at risk. The symptoms of H5N1 have been shown to mimic the pandemic flu of 1918. Early symptoms of H5N1 mimic that of regular seasonal flu. However, the disease process of the H5N1 appears to be more inflammatory in nature leading to a mortality rate >50% affecting those with healthy immune systems. There is no rapid method to test for H5N1 and no vaccine. A person with seasonal flu or a regular cold has upper respiratory symptoms and an increased WBC count. A person with H5N1 has upper respiratory symptoms and a low WBC count. Could these clinical markers be used as an effective screening tool to triage and disperse available treatments (anti-virals, ventilators, etc.) in the throws of a full blown pandemic? If/When H5N1 mutates to develop human-to-human transmission initiating the pandemic, could the virulence decrease?

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Forensic Nursing and Professional Speaking

November 28, 2007

I am a Forensic Nurse. Many times I have to testify in court. I get very nervous and have fear of public speaking each time. Many times my side looses in court or before a trial because in part due to my fear of public speaking. Once, a judge ordered a recess because I was so nervous that I nearly fainted. I like the fact that you include Testifying and Depositions in your program. Do you provide practice opportunities within your program?

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Assessment for Drug Abuse, Understanding the Impact of Culture and Gender, comment

November 27, 2007

Original Post:
Assessment for Drug Abuse, Understanding the Impact of Culture and Gender -Thursday August 23/2007

I am a Nurse Practitioner yearly I do Locums in Alaska (locum is like a traveling nurse who works a clinic while the normal practitioner is on vacation)
I realize the high prevalence of alcoholism in these Alaskan small tribes. Everyone drinks including some of the children. Drugs are also a problem and I am beginning to see Meth. Most of the drugs are brought in by fishermen (I work on the Aleutian Islands) I have medications and support products to help these people (not detox, but) with treating a life threatening problem like alcohol intoxication, dehydration, or pancreatitis and liver failure. To change the habits now in the culture of these people will not be possible. Alcohol is part of their life. The Native Hospital will help them detox but they almost always come back to the islands and become drunk again. Money is given to all natives monthly and alcohol is purchased. All of the islands I have been on have a bar that provides credit until the checks come in.
The tribe tries to help everyone to have some sort of a job if they want it. Even the worse drunk can get a menial job to make a few extra dollars. The tribe tries to help all of its members to keep some pride.
Since everyone is related in some way on some of these small islands it is important that any care given to people who have alcohol problems (even though everyone knows) needs to be kept a secret.

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Age Progression Training, comment

November 27, 2007

RESPONSE:
Click on the link to right of the main page of this blog. The title of the link is “Online Forensic Anthropology/Police Science Course at Canyon College.” You will see the class which police officers take to learn age progression imaging. The class is suitable for officers learning (for the first time) about police drawings on the computer. It is also suitable for those gaining experience after vendor instructions. And it is suitable for officers wanting advanced computer age progression techniques. Students eligible to take Forensic Anthropology include police officers, nurses, forensic nurses, anthropologists, physicians, and others. This online class allows each student to learn at his or her own pace.

Law enforcement agencies can establish an account for rapid composite drawing, police sketch, and facial reconstruction services. The final product, which is an police composite is sent to the agency via the Internet. Secure transmission is available. This frees the time of law enforcement officers and frees the resources of agencies.

For more information, you may also click on the link “Email Me With Topic Suggestions.” This is also found on the right side of the main blog page.

ORGINAL POST: MONDAY, NOVEMBER 26, 2007
Our police department needs help with making age progression pictures and photos on a computer. We recently purchased facial reconstruction software. The vendor gave us training. However, we need more time to learn to use the software. Our police officers cannot all learn at the same time.

The police department in the city next to ours wants to purchase the same software in January. The department wants to start training their officers in January 2008 to make police sketches and police drawings on the computer. They can use your help also because they handle a lot of cases of missing children.

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Medication Errors

November 26, 2007

Response To:
Forensic Nursing Chronicles: August 2007
Medication Errors

One of the hospitals that I work in is almost all computerized from charting to using a handheld for medication administration. Most physician orders are entered via the computer.
Last week when I was doing hemodialysis on a pt, I saw an order Gentamycin 80 mg IP x 1. To me it was very clear. 80 mg of gent was to be administered intraperitineal by the peritoneal dialysis nurse. (The pt was admitted for peritonitis, and was switching over to hemodialysis). I notified the PD nurse. Later on that day I received a call from the nurse taking care of the patient, informing me that she gave the medication IV, the way it was sent from the pharmacy. The only way the error was picked up was the PD nurse called the primary nurse to make sure that the gent was there when she arrived to instill it into the PD catheter.
Medication errors continue to occur. Just because it came that way from pharmacy didn’t mean that it was right. If the order is unclear to the nurse, the physician should be called to clarify the order, or perhaps the physician could write in the order “Attention PD nurse”. These are 2 simple ways to clarify the order. Everyone needs to work together to prevent medication errors from occurring. There have been countless medication errors that have cost lives.

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Age Progression Training

November 26, 2007

Our police department needs help with making age progression pictures and photos on a computer. We recently purchased facial reconstruction software. The vendor gave us training. However, we need more time to learn to use the software. Our police officers cannot all learn at the same time.

The police department in the city next to ours wants to purchase the same software in January. The department wants to start training their officers in January 2008 to make police sketches and police drawings on the computer. They can use your help also because they handle a lot of cases of missing children.

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Corporate Christmas gifts; education

November 22, 2007

Response:
Yes Christmas and Holiday gift certificates are available for the Forensic Nursing education program. Yes, each employee can use the Christmas and Holiday corporate gift certificate at a time that is convenient for her or him. Gift certificates are available for other programs and courses. Click on the “Email Me With Topic Suggestions” link for more information.
Happy Thanksgiving.

Original Post:
Tuesday, November 20, 2007
Corporate Christmas gifts; education
Do you have Forensic Nursing Christmas gift certificates that our staff can use at a time, which is convenient for them?

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Forensic Nurse Helps to Detect Child Abuse

November 21, 2007

Comment:
Child abuse is often under reported and a tragic event. More and more you hear on the news of a case of child abuse that is horrible, and these are just the ones that are caught and prosecuted. Fortunately not all cases of child abuse end up as tragic as this one where the child will be on a ventilator for the rest of his life with no hope of a normal life. Fortunately in this case, shaken baby syndrome was included in the physician’s differential diagnosis, and was treated as such from the beginning, and led to the conviction of the mother’s boyfriend. Violently shaking a baby just once can cause profound effects on the child for the rest of their life.

Original post:
Saturday, August 20, 2005

Forensic Nurse helps to Detect Child Abuse
Until you have witnessed a shaken baby syndrome case, either on a personal level or professional level, you cannot appreciate the devastating effects of these cases.

A 28-day-old baby was rushed to the ER with a sudden change in mental status. Mom’s boyfriend had been babysitting while mom was at work. When mom got home, her boyfriend claimed that the baby had been sleeping a lot and wasn’t acting right. Mom was unable to arouse the baby, this she brought the baby to the ER.

Upon presentation to the ER, the physician and the nurse rushed the baby to the trauma room. They realized the severity of the baby’s symptoms. The baby was lethargic and limp. His respirations were shallow, but present. The baby was intubated and stabilized medically, then prepared for transfer to NICU. The physician in charge included shaken baby syndrome in his differential. The mom and boyfriend were not allowed to be alone with the child pending further investigation.

Apparently, the mother’s boyfriend violently shook the baby when he wouldn’t quit crying. Shortly after the shaking incident, mom came home to discover that the baby wasn’t acting right.

Nearly five years later, this case went to court. The mother’s boyfriend was found guilty of first-degree murder status post shaken baby syndrome. The child lives in foster care. He will live on a ventilator for the rest of his life.

Shaking a child or a newborn can cause life-threatening injuries. The injuries are mostly internal. Head trauma is the most common. With an infant, shaking will cause the head to wobble around. The backwards and forwards movement of the brain within the casing of the cranium causes swelling, increased intracranial pressure and retinal hemorrhages. The first symptom that is seen is a change in level of consciousness. This symptom is worrisome to a parent and prompts treatment. Typically, there are not any marks on the body. If marks are discovered, usually fingerprints of the suspect will be seen on the arms or trunk. It is always best to consider child abuse and be cautious until proven otherwise. Time is of the essence for these cases.

As a forensic nurse, what would be the first symptom presenting that may alert you to Child Abuse in the form of Shaken Baby Syndrome?

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Corporate Christmas gifts; education

November 20, 2007

Do you have Forensic Nursing Christmas gift certificates that our staff can use at a time, which is convenient for them?

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