Jenna Birch

While cancer can strike anyone — young or old, unhealthy and healthy — we do have some idea of what can affect risk. Genetics often play a role, for instance, as do lifestyle habits. But according to a new study from Johns Hopkins University researchers, much of cancer risk may actually be due to mere chance.

Cancer develops when stem cells of a given tissue make random mistakes, mutating unchecked after one chemical letter of DNA is incorrectly swapped for another — the equivalent of a cell “oops.” It happens without warning, like the body’s roll of the die. 

For the new study, published in the journal Science, researchers wanted to see how much of overall cancer risk was due to these unpreventable random mutations, independent of other factors like heredity and lifestyle. 

“There is this question that is fundamental in cancer research: How much of cancer is due to environmental factors, and how much is due to inherited factors?” Cristian Tomasetti, PhD, a biomathematician and assistant professor of oncology at the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, tells Yahoo Health. “To answer that question, however, the idea came that it would be important to determine first how much of cancer was simply due to ‘replicative chance.’"

To measure this, the researchers plotted the number of stem cell divisions in 31 types of tissues over the course of a lifetime against the lifetime risk of developing cancer in the given tissue. From this chart, the scientists were able to see the correlation between number of divisions and cancer risk — and from that correlation, researchers were able to determine the incidence of cancer in a given tissue due to replicative chance.

Ultimately, researchers found that roughly two-thirds of the cancer incidence was due to this replicative chance, or simply “bad luck.” (However, it’s worth noting researchers did not examine some cancers, such as breast and prostate cancers, because of lack of reliable stem-cell turnover information.)

But don’t assume you’re simply doomed to the hand fate deals you. After additional analysis, researchers found that of the 31 cancers examined, 22 could be explained by “bad luck” — but for the other nine, there was another factor aside from simple chance that likely contributed to the cancer.

This is presumably because environmental and hereditary factors play a role in development. “There are many cancers where primary prevention has huge positive effects, such as vaccines against infectious agents, quitting smoking or other altered lifestyles,” says Tomasetti. 

Incidentally, the cancers where risk could be lowered by primary preventive practices were ones you may expect — diseases like skin cancer, where limiting sun exposure can lower your risk, as well as lung cancer, where avoiding smoking is key. 

Source: www.yahoo.com

Gay men who've abstained from sex for one year would be able to donate blood in 2015, ending a lifetime ban for the gay community, under a proposed FDA policy change unveiled Tuesday.

The current lifetime ban by U.S. Food and Drug Administration states dates back to 1983 and forbids men who have had sex with men from becoming blood donors because the group is "at increased risk for HIV, hepatitis B and certain other infections that can be transmitted by transfusion," the FDA has ruled.

But the FDA is now seeking a change in that policy and would allow such blood donations based on an independent expert advisory panel's recommendation, the agency said.

The proposed change would align the one-year deferral period "with that of other men and women at increased risk for HIV infection," the FDA said.

The agency will be gathering public comments on the proposed change.

"We encourage all stakeholders to take this opportunity to provide any information the agency should consider, and look forward to receiving and reviewing these comments," FDA Commissioner Margaret A. Hamburg said in a statement.

The National Heart Lung and Blood Institute and the FDA would monitor a national blood surveillance system to see any effects of the proposed policy change and to ensure the continued safety of the blood supply, Hamburg said.

"A history of male-to-male sex is associated with an increased risk for exposure to and transmission of certain infectious diseases, including HIV, the virus that causes AIDS," the FDA said. Men who have had sex with other men represent approximately 2% of the U.S. population, yet are the population most severely affected by HIV, according to the FDA.

In 2010, male-to-male sex accounted for at least 61% of all new HIV infections in the United States, and "an estimated 77% of diagnosed HIV infections among males were attributed to male-to-male sexual contact," the FDA said.

Source: www.cnn.com

By Jen Christensen and Elizabeth Cohen

A young Liberian woman who saved three of her relatives by nursing them back to health after they contracted the Ebola virus is coming to the United States to finish her nursing degree.

The news comes as Time magazine announced Wednesday that its "Person of the Year" honors go to the Ebola fighters, the "unprecedented numbers" of doctors and nurses who responded when Ebola overtook an already-weak public health infrastructure this year in West Africa.

Fatu Kekula is not named in the article, but she definitely holds a place among those being honored.

The 22-year-old, who was in her final year of nursing school earlier this year, single-handedly took care of her father, mother, sister and cousin when they became ill with Ebola beginning in July.

And she did so with remarkable success. Three out of her four patients survived. That's a 25% death rate -- considerably better than the estimated Ebola death rate of 70%.

Kekula stayed healthy, which is noteworthy considering that hundreds of health care workers have become infected with Ebola, and she didn't even have personal protection equipment -- those white space suits and goggles used in Ebola treatment units.

Instead, Kekula invented her own equipment. International aid workers heard about her "trash bag method" and taught it to other West Africans who can't get into hospitals and don't have protective gear of their own.

Every day, several times a day for about two weeks, Kekula put trash bags over her socks and tied them in a knot over her calves. Then she put on a pair of rubber boots and then another set of trash bags over the boots.

She wrapped her hair in a pair of stockings and over that a trash bag. Next she donned a raincoat and four pairs of gloves on each hand, followed by a mask.

It was an arduous and time-consuming process, but she was religious about it, never cutting corners.

UNICEF Spokeswoman Sarah Crowe said Kekula is amazing.

"Essentially this is a tale of how communities are doing things for themselves," Crowe said. "Our approach is to listen and work with communities and help them do the best they can with what they have."

She emphasized, of course, that it would be better for patients to be in real hospitals with doctors and nurses in protective gear -- it's just that those things aren't available to many West Africans.

No one knows that better than Kekula.

Her Ebola nightmare started July 27, when her father, Moses, had a spike in blood pressure. She took him to a hospital in their home city of Kakata.

A bed was free because a patient had just passed away. What no one realized at the time was that the patient had died of Ebola.

Moses, 52, developed a fever, vomiting and diarrhea. Then the hospital closed down because nurses started dying of Ebola.

Kekula took her father to Monrovia, the capital city, about a 90-minute drive via difficult roads. Three hospitals turned him away because they were full.

She took him back to another hospital in Kakata. They said he had typhoid fever and did little for him, so Kekula took him home, where he infected three other family members: Kekula's mother, Victoria, 57; Kekula's sister, Vivian, 28, and their 14-year-old cousin who was living with them, Alfred Winnie.

While operating her one-woman Ebola hospital for two weeks, Kekula consulted with their family doctor, who would talk to her on the phone, but wouldn't come to the house. She gave them medicines she obtained from the local clinic and fluids through intravenous lines that she started.

At times, her patients' blood pressure plummeted so low she feared they would die.

"I cried many times," she said. "I said 'God, you want to tell me I'm going to lose my entire family?' "

But her father, mother, and sister rallied and were well on their way to recovery when space became available at JFK Medical Center on August 17. Alfred never recovered, though, and passed away at the hospital the next day.

"I'm very, very proud," Kekula's father said. "She saved my life through the almighty God."

Her father immediately began working to find a scholarship for Kekula, so she could finish her final year of nursing school. But the Ebola epidemic shut down many of Liberia's schools, including hers.

After a story about Kekula ran on CNN in September, many people wanted to help her.

A non-profit group called iamprojects.org also got involved.

With some help, Kekula applied to Emory University in Atlanta, the campus with the hospital that has successfully cared for American Ebola patients. Emory accepted the young woman so that she could complete her nursing degree starting this winter semester.

In order to attend, iamprojects will have to raise $40,000 to pay for her reduced tuition rate, living expenses, books and her travel and visa so that she can travel between Africa and the United States.

Kekula's father has no doubt that his daughter will go on to save many more people during her lifetime.

"I'm sure she'll be a great giant of Liberia," he said.

Source: www.cnn.com

By John Gever

Not all children with severe brain injuries need to be monitored for subclinical seizures, researchers said here, which means that resources can be focused on those at the highest risk.

Victims of abuse, those younger than 2, and those with bleeding within the brain rather than only in the epidural compartment are the pediatric ICU patients most likely to show significant seizure activity that should be detected and treated, said Rajsekar Rajaraman, MD, of the University of California Los Angeles (UCLA).

A separate study by many of the same investigators also found that, in a broader range of pediatric brain injury cases, risk of seizures could be predicted with "fair-to-good" accuracy on the basis of clinical characteristics that would be recorded routinely at admission.

Both studies were reported at the American Epilepsy Society's annual meeting here.

A senior author on both studies, Nicholas Abend, MD, of Children's Hospital of Philadelphia, said at an AES press briefing that identifying and treating seizures is important in the pediatric ICU. When seizures are extremely frequent or long-lasting -- and these can easily go without detection in hospitalized children who are unconscious or lethargic -- they significantly increase the likelihood of poor short- and long-term outcomes.

Such seizures can only be detected via continuous EEG monitoring, Abend explained, which also requires interpretation from trained electroneurologists.

Another investigator in the studies, UCLA's Jason Lerner, MD, noted that children may appear to be napping peacefully while actually undergoing continuous seizures.

Although it would be desirable to perform intense monitoring on all pediatric cases involving head trauma, that is not feasible at most centers, Abend said. He said the field could benefit from risk-stratification models that would allow the care team to track only those patients at the highest risk for damaging subclinical seizures.

Such models, he added, could be tailored to meet the needs of individual centers on the basis of their patient mix, staffing, and other factors.

In a platform session at AES, Rajaraman described one approach to developing such a model. He and colleagues collected data on 135 consecutive pediatric patients (ranging in age from infant to late adolescent) with traumatic brain injury who were treated in ICUs at UCLA and at Children's Hospital of Colorado in Denver. These children had continuous EEG monitoring for detecting subclinical seizures.

They found that all such seizures occurred in children younger than 2 and in those with intradural bleeding, and that the vast majority also involved abusive head trauma. Rajaraman and colleagues then sought to validate these associations in a separate cohort of 44 pediatric ICU patients with head injuries treated at Children's Hospital of Philadelphia. The same patterns were seen.

Across both cohorts, 81% of those with subclinical seizures were determined to have been victims of abusive head trauma, whereas the prevalence of such trauma in all the patients was 25%. Abend said it was uncertain why abusive trauma should be such a strong predictor of these seizures, but speculated that "shaken baby syndrome" -- the most common form of abuse of infants and toddlers -- may produce fundamentally different injuries in the brain compared with falls and car accidents.

Also, such abuse is often chronic, such that the episode that brings a child to the hospital is only the latest in a series of abusive incidents.

The other study, led by Abend, was aimed at producing a predictive model yielding a risk index score that pediatric centers could use to identify critically ill children who could benefit the most from continuous EEG monitoring. It was based on clinical information to which the attending neurologist would have ready access: age, seizure etiology, presence of clinical seizures prior to beginning continuous EEG, initial EEG background category, and interictal discharge category.

Data to design the model were drawn from a database of 336 patients from 11 centers, and then tested against a separate validation dataset of 222 patients treated at Children's Hospital of Philadelphia.

Normalized scores in the model could range from 0 to 1.0, and Abend and colleagues examined the sensitivity and specificity of various cutoffs. When set at 0.10 in the validation cohort, sensitivity was 86% but sensitivity was only 58% -- the high sensitivity meant that 43% of patients would be identified as candidates for continuous monitoring. At the other end, a cutoff of 0.45 reversed the sensitivity and specificity percentages to 19% and 97%, respectively, such that only 5% of patients would be assigned to monitoring.

Abend said the beauty of this approach is that an individual center could choose its own optimal cutoff depending on the resources it has available to monitor multiple patients at one time. A well-equipped and staffed ICU could thus opt for high sensitivity whereas one with more limited resources could be more restrictive.

Source: www.medpagetoday.com

By Dennis Thompson

Already-strong public support for right-to-die legislation has grown even stronger in the days since the planned death of 29-year-old brain cancer patient Brittany Maynard, a new HealthDay/Harris Poll has found.

An overwhelming 74 percent of American adults now believe that terminally ill patients who are in great pain should have the right to end their lives, the poll found. Only 14 percent were opposed.

Broad majorities also favor physician-assisted suicide and physician-administered euthanasia.

Only three states -- Oregon, Washington and Vermont -- currently have right-to-die laws that allow physician-assisted suicide.

"Public opinion on these issues seems to be far ahead of political leadership and legislative actions," said Humphrey Taylor, chairman of The Harris Poll. "Only a few states have legalized physician-assisted suicide and none have legalized physician-administered euthanasia."

People responded to the poll in the weeks after Maynard took medication to end her life in early November.

Maynard moved from California to Oregon following her diagnosis with late-stage brain cancer so she could take advantage of the state's "Death With Dignity Act." Her story went viral online, with a video explaining her choice garnering nearly 11.5 million views on YouTube.

A "poster child for the movement," Maynard helped spark conversations that allowed people to put themselves in her shoes, said Frank Kavanaugh, a board member of the Final Exit Network, a right-to-die advocacy group.

"I think it is just a natural evolution over a period of time," Kavanaugh said of the HealthDay/Harris Poll results. "There was a time when people didn't talk about suicide. These days, each time conversations occur, people think it through for themselves, and more and more are saying, 'That's a reasonable thing to me.'"

The poll also found that:

• Support for a person's right to die has increased to 74 percent, up from 70 percent in 2011. Those opposed decreased to 14 percent from 17 percent during the same period.
• Physician-assisted suicide also received increased support, with 72 percent now in favor, compared with 67 percent in 2011. Opposition declined from 19 percent to 15 percent.
• Sixty-six percent of respondents said doctors should be allowed to comply with the wishes of dying patients in severe distress who ask to have their lives ended, up from 58 percent in 2011. Opposition decreased from 20 percent in 2011 to 15 percent now.

"The very large -- more than 4-to-1 and increasing -- majorities in favor of physician-assisted suicide, and the right of terminally ill patients to end their lives are consistent with other liberal social policy trends, such as support for same-sex marriage, gay rights and the decriminalization of marijuana, seen in the results of referendums and initiatives in the recent mid-term elections," Taylor said.

Support for the right-to-die movement cut across all generations and educational groups, both genders, and even political affiliation, the poll found.

Democrats tended to be more supportive of right-to-die legislation, but 56 percent of Republicans said they favor voluntary euthanasia and 63 percent favor physician-assisted suicide.

Kavanaugh was not surprised. "People think of this as a liberal issue. But I find that as I talk to [conservatives], you can appeal to them on the basis of 'get the government the hell out of my life,'" he said.

But the public is split over how such policies should be enacted, with 35 percent saying that the states should decide on their own while 33 percent believe the decision should be made by the federal government, the poll found.

"Most of the people I know in the field whose opinion I put stock in don't feel there's ever going to be federal movement on it," Kavanaugh said. "You're just going to have to suffer through a state-by-state process."

Kavanaugh does believe this overwhelming public support will result in steady adoption of right-to-die laws.

"I think this will become the ultimate human right of the 21st century, the right to die with dignity," he said. "There are good deaths and bad deaths, and it is possible to have a good death."

Despite increasing public support for assisted suicide, stiff opposition remains in some quarters.

"Assisted suicide sows confusion about the purpose of life and death. It suggests that a life can lose its purpose and that death has no meaning," Rev. Alexander Sample, archbishop of the Archdiocese of Portland in Oregon, said in a pastoral statement issued during Maynard's final days.

"Cutting life short is not the answer to death," he said. "Instead of hastening death, we encourage all to embrace the sometimes difficult but precious moments at the end of life, for it is often in these moments that we come to understand what is most important about life. Our final days help us to prepare for our eternal destiny."

Todd Cooper, a spokesman for the Portland archdiocese, said the debate over assisted suicide touches him on a very deep level because of his wife, Kathie.

About 10 years ago, she also was diagnosed with terminal brain cancer. She endured two brain surgeries, two years of chemotherapy and six weeks of radiation therapy, and remains alive to this day.

"If she'd given up the fight for life, she wouldn't be here," Cooper said. "That doesn't necessarily happen in every case, but it gives hope for those who struggle to the very end."

source: www.medicinenet.com

By DANIELA J. LAMAS, M.D.

One recent night I was asked to declare the death of a woman I had never met.

“Ms. L. passed,” the nurse said. “Could you pronounce her?”

The online medical record told me that she was 32 years old, one year younger than me. She had been in the hospital for months with leukemia that had progressed despite every possible chemotherapy regimen and a failed bone marrow transplant. And now someone needed to perform a death exam.

Declaring death is not technically hard but it is weird and sad and requires reams of paperwork. It is usually done by an intern, but my intern was busy so I said I would do it.

The first time I declared a patient dead was nearly six years earlier. I had been a doctor for a few months when I was summoned overnight with a page that told me that my patient’s heart had stopped. When I got to his room I was out of breath and his nurse smiled at me and told me that there really wasn’t urgency; he wasn’t going anywhere.

It was only when I walked into the room and saw my patient still and utterly silent, his tired family sitting around the bed, that I realized no one had ever told me precisely how to declare death. I wished I could come back later, but it didn’t seem right to leave him there, so I thumbed through my pocket-sized intern survival guide. The manual was alphabetized, and the discussion about declaring death came somewhere before a section on diabetes management.

The instructions were clear and began with the directive to express sympathy. I turned to the family to tell them how sorry I was. Listen for heart sounds and watch to see if the patient is breathing. I placed my stethoscope on the patient’s still chest and waited, watching for him to take a breath, and wondering what I would do if I heard something. But there was nothing. Feel for a pulse. I placed my hand on his neck and there was not even a quiver. And that was that. He was dead.

I looked at the clock and spoke the time out loud and said I was sorry again. And then I left the room.

Later I would face the inevitable pile of paperwork, which one hospital I worked at labeled the “Final Discharge Packet,” and another, in bold letters on a red binder, the “Death Binder.” That was followed by calls to admitting to report the death, minutes that felt like hours on hold with the medical examiner, death certificates returned to me because I had signed on the wrong dotted line. By the end of my intern year, one of the worst parts of having a patient die was those bureaucratic forms and phone calls.

Now, years later, I paused outside the room of Ms. L. before pulling back the curtain.

Until then, most of the patients I had been called to declare looked much as they did in life, only vacant. But this woman had been destroyed by illness. She was bald and yellow and bloated. She must have suffered. I took out my stethoscope as I had learned to do, rested it on her chest and listened to the silence that had taken the place of her heartbeat. I laid my fingers on her neck and there was no pulse. I looked up at the clock and said the time out loud.

As I turned to leave, I couldn’t help but note the wall of cards and photographs next to her hospital bed. She must have run a marathon to raise money for cancer research, for one photo captured her healthy and smiling, arms lifted victoriously as she crossed the finish line. Someone who loved her must have been there, waiting to take that photo.

“She must have been cool,” I said to her nurse. “I bet I would have liked her.”

“She was awesome.”

No one spoke. Two nurses gently pulled out the intravenous lines that had once run antibiotics and fluids into her veins and, one by one, removed the stickers on her chest that had recorded her heartbeat. One of the nurses paused and caught my eye.

“It’s so humid out,” she said. “How do you keep your hair from getting frizzy in this humidity?” I had showered just before my shift, I told her, and then I had come right to work so I hadn’t been outside much. When I caught a glimpse of myself in the mirror, my hair didn’t even look that good.

And then, because I didn’t know what else to say in front of this 32-year-old woman I would never meet, I offered only: “You know, I’ve always wanted to run a marathon.”

I left the room to begin the paperwork .

Source: nytimes.com

By Dan Munro

Released on Friday, the survey of 700 Registered Nurses at over 250 hospitals in 31 states included some sobering preliminary results in terms of hospital policies for patients who present with potentially infectious diseases like Ebola.

• 80% say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola
• 87% say their hospital has not provided education on Ebola with the ability for the nurses to interact and ask questions
• One-third say their hospital has insufficient supplies of eye protection (face shields or side shields with goggles) and fluid resistant/impermeable gowns
• Nearly 40% say their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use, less than 10 percent said they were aware their hospital does have such a plan in place
• More than 60% say their hospital fails to reduce the number of patients they must care for to accommodate caring for an “isolation” patient

National Nurses United (NNU) started the survey several weeks ago and released the preliminary results last Friday (here). The NNU has close to 185,000 members in every state and is the largest union of registered nurses in the U.S.

The release of the survey coincided with Friday’s swirling controversy on how the hospital in Dallas mishandled America’s first case of Ebola. The patient ‒ Thomas E. Duncan ‒ was treated and released with antibiotics even though the hospital staff knew of his recent travel from Liberia ‒ now the epicenter of this Ebola outbreak.

On October 2, the hospital tried to lay blame of the mishandled Ebola patient on their electronic health record (EHR) software with this statement.

Protocols were followed by both the physician and the nurses. However, we have identified a flaw in the way the physician and nursing portions of our electronic health records (EHR)interacted in this specific case. In our electronic health records, there are separate physician and nursing workflows. Texas Health Presbyterian Hospital Statement ‒ October 2 (here)

Within 24 hours, the hospital recanted the statement by saying no, in fact, “there was no flaw.”

The larger issue, of course, is just how ready are the more than 5,700 hospitals around the U.S. when it comes to diagnosing and then treating suspected cases of Ebola. Given the scale of the outbreak (a new case has now been reported in Spain ‒ Europe’s first), it’s very likely we’ll see more cases here in the U.S.

As an RN herself ‒ and Director of NNU’s Registered Nurse Response Network ‒ Bonnie Castillo was blunt.

What our surveys show is a reminder that we do not have a national health care system, but a fragmented collection of private healthcare companies each with their own way of responding. As we have been saying for many months, electronic health records systems can, and do, fail. That’s why we must continue to rely on the professional, clinical judgment and expertise of registered nurses and physicians to interact with patients, as well as uniform systems throughout the U.S. that is essential for responding to pandemics, or potential pandemics, like Ebola. Bonnie Castillo, RN ‒ Director of NNU’s Registered Nurse Response Network (press release)

As a part of their Health Alert Network (HAN), the CDC has been sounding the alarm since July ‒ and released guidelines for evaluating U.S. patients suspected of having Ebola through the HAN on August 1 (HAN #364). As a part of alert #364, the CDC was specific on recommending tests “for all persons with onset of fever within 21 days of having a high‒risk exposure.” Recent travel from Liberia in West Africa should have prompted more questioning around potential high-risk exposure ‒ which was, in fact, the case.

As it was, a relative called the CDC directly to question the original treatment of Mr. Duncan given all the circumstances.

“I feared other people might also get infected if he wasn’t taken care of, and so I called them [the CDC] to ask them why is it a patient that might be suspected of this disease was not getting appropriate care.” Josephus Weeks ‒ Nephew of Dallas Ebola patient to NBC News

The CDC has also activated their Emergency Operations Center (EOC).

The EOC brings together scientists from across CDC to analyze, validate, and efficiently exchange information during a public health emergency and connect with emergency response partners. When activated for a response, the EOC can accommodate up to 230 personnel per 8-hour shift to handle situations ranging from local interests to worldwide incidents.

The EOC coordinates the deployment of CDC staff and the procurement and management of all equipment and supplies that CDC responders may need during their deployment.

In addition, the EOC has the ability to rapidly transport life-supporting medications, samples and specimens, and personnel anywhere in the world around the clock within two hours of notification for domestic missions and six hours for international missions.

Source: Forbes

www.bestmedicalassistantprograms.org

There are a number of fantastic nursing blogs on the internet. Whether you’re an aspiring nurse, a working nurse, or a curious patient, you are sure to be entertained by these sites. We have narrowed down a list of the top 100 nursing blogs online to give you plenty of reading material for the future. Prepare yourself for hours of education and entertainment.

Top General Nursing Blogs

The Nursing Site Blog
The Nursing Site Blog is just one of those sites that you have to read as a nurse. We love it because it constantly has new articles to read, from helpful advice to healthcare news and more. The blog is run by public health nurse Kathy Quan, RN. Kathy has been in the nursing industry for more than 30 years now, and you can see evidence of her experience on her site. Kathy has a Bachelor of Science in Nursing, and most of her working life has been spent in hospice and home health care. She shares her stories and lessons learned on her blog, along with other information that any nurse would love to read. 

The National Nurse for Public Health
The National Nurse for Public Health is a blog run by The National Nursing Network Organization. This is an organization that is working hard to create a better working environment for professionals in the public health industry. The blog provides news updates for work that the organization is doing, as well as other news from the nursing sector. The commentary on here comes from doctors, nurses, and other important workers in healthcare. 

Scrubs Mag
Scrubs Mag is considered the “The Nurses Guide to Good Living.” The name may sound like a catalog for working attire, but the information within this site is far from that. Scrubs Mag offers a wide range of helpful articles for new, existing, and future nurses, including style secrets to keep you looking great on the job. There are a number of writers who work for Scrubs Mag, so you can see everything from career advice to personal stories on the site. You can even sign up for free giveaways to get cool outfits, accessories, and tools to use on the job. 

Confident Voices in Health Care
Confident Voices in Health Care is a blog run by Beth Boynton. Beth is a published author and nurse consultant who specializes in communication and collaboration in the healthcare industry. What we love about Beth’s blog is the fact that it offers advice for patients and professionals alike to ensure that everyone works together in harmony. Many of Beth’s posts are about her medical improv workshops, where she helps healthcare workers become better speakers and listeners through improvisational training. Confident Voices also features articles from many a number of credible guest bloggers who share their insights into nursing and healthcare. 

Nursetopia is a blog written for nurses by nurses. It is designed to honor these wonderful members of the healthcare world and showcase their influence on the modern world. The articles in the blog cover nursing news, career advice, business help, personal stories, art, freebies, and more. You always get a chance to see something different when you come here. Nursetopia is one of the most active blogs on our site, and it is one you will see in countless blogrolls from other bloggers on here. We’re subscribed to it for a reason. 

Nurse Together
Nurse Together is a fun and informative blog run by a team of nurses. The bloggers here range from nurse educators to RNs and beyond. While we may love the site for its blog-like articles, Nurse Together also offers a job board, nursing school guide, discussion panel, and much more. The Nurse Together Facebook page has more than 21,000 fans, showing just how much people love visiting this site. There are new blog posts on here every day, so you can always look forward to something new to read. 

Lippincott’s Nursing Center
Lippincott’s Nursing Center is a site dedicated to helping nurses be the best workers they can be. The site is home to more than 50 nursing journals online, including the American Journal of Nursing, Nursing2014, Nursing Management and The Nurse Practitioner: The American Journal of Primary Health Care. In addition to these peer reviewed journals, Lippincott’s Nursing Center features more than 1,300 continuing education activities for nurses, making it easy to maintain a career as a nurse here. The authors on the site are mostly advanced practice nurses and registered nurses who share their career expertise with the world. 

Off the Charts
Off the Charts is a product of the American Journal of Nursing. It mostly provides news updates and research study reports for the nursing community. With this in mind, you can also find a number of helpful career advice articles on this site. Some popular categories for posts on here include patient engagement, healthcare, medical prices, nursing research, nursing perspective, and more. Off the Charts is authored by a number of nursing professionals, most of whom have a graduate level education. The blog commonly highlights influential nurses from the past to inspire nurses of the future. 

Not Nurse Ratched
Not Nurse Ratched is a wonderful nursing blog that has been around since 2007. The blog is run by a writer, nurse, and medical editor who enjoys “investigating ways to save time.” The articles on here fit into categories like applications, gadgets, technology, personal, medical, humor, and more. Most of the articles are written with a great sense of humor, which is sometimes hard to find in healthcare blogs. 

Nursing Stories
Nursing Stories is a heartfelt blog about one woman’s experiences in nursing. Marianna Crane, the blogger, has been in nursing for over 40 years, and she now uses her blog to share her stories from the past and present. She has been a certified adult nurse practitioner since 1981, and she has a passion for writing that is evident in her blog posts. Marianna says, “My goal for this blog is to encourage nurses to boast.” You can get inspired to be a better nurse thanks to this woman and the great stories she shares on her blog. 

The Nursing Show
The Nursing Show is more than just a blog. It is a compilation of entertaining videos about nursing. Each episode teaches a new lesson about this ever-changing career, from getting through college to dealing with tough patients. The episodes are included in short, easy-to-read articles that summarize what the videos are about. There are already more than 300 episodes of The Nursing Show for you to watch, so you don’t have to worry about getting bored on this site. 

Advances in Nurse Science Blog
The Advances in Nurse Science Blog is tied to a nursing publication that comes out four times a year (appropriately titled Advances in Nursing Science). The blog allows readers to discuss big issues that are mentioned in ANS so that they can understand and expand upon these ideas. The ANS journal was founded back in 1978 by Peggy L. Chinn, RN, PhD, FAAN. It has been in publication ever since, but the blog was a much more recent addition to the ANS world. 

Reality RN
Reality RN is a pretty interesting blog because it is run entirely by new nurses. You may not think these men and women have a lot to share about their experiences, but they convey what “reality” is like for people who are new to this profession. If you are a nursing student worried about what you might be getting yourself into, this blog should be able to answer all of your questions. Best of all, there is a great list of “must read” blogs on the home page that link to even more top nursing blogs online. 

AllTop – Nursing
This site doesn’t exactly fit the “norm,” but we thought it was important to put it on our list. Essentially AllTop is just a directory for other websites, but it shows you the most recent posts from many nursing blogs online. It’s a one-stop-shop for nursing tips and news online, and it features the work of several other sites on our top 100 nursing blogs list. If you want to stay updated on other topics from around the web, AllTop has plenty of other categories for you to explore.

Diversity Nursing
Diversity Nursing offers a number of helpful articles and services for nursing professionals. The blog on the site features news information and career tips for nurses, but the site as a whole has a job board, college guide, and much more. There is even a forum on the site where nurses, patients, and nursing students can discuss important issues in healthcare. Diversity Nursing started off as a basic job board back in 2007, but it has grown to be so much more since then. You can even use this site to post a resume so you might get a better job in the future. Here is a look at some memorable posts from the Diversity Nursing blog:

• Disabilities in Children Increase, Physical Problems Decline
• New Device Will Help Monitor Parkinson’s Patients
• 7 Surprising Facts from a School Nurse

Nursing Ideas
Nursing Ideas is a blog that covers a variety of variety of nursing related topics. The blog was started back in 2008 as an online resource for nursing students. Rob Fraser, the blog’s founder, began writing articles for the blog while he was an undergraduate nursing student at Ryerson University. In 2013, Rob refocused the blog to be more about professional interviews so that his readers could see what life is really like as a nurse in today’s world. 

Soliant Health is a healthcare staffing company that offers some great advice for nursing professionals around the country. You don’t have to be a member of the Soliant Health network to benefit from the articles on their blog. Even if you already have a job as a nurse, you could learn from some of the news articles and tips on the blog. If you are in fact looking for a job, you can look through the job board on Soliant Health to see what opportunities may be available for you. 

Nursing Daily
Nursing Daily is a fairly new blog, especially compared to other sites on our list. Nevertheless, it has already developed a great reputation in the nursing community, and we’re hoping it sticks around for years to come. Nursing Daily is dedicated to providing “nursing tips, advice, and humor” for anyone who wants to read it. Many of the posts on here are quick, simple images that will make you chuckle a little about life as a nurse. 

The Nurse Path
The Nurse Path is a beautiful, entertaining, and inspiring blog that is dedicated entirely to nurses. The blog features a number of categories, including: nurse mind, nursing skills, health and fitness, technology, funnybone, and more. The motto for this site is “helping nurses find the way,” and every article here is evidently doing just that. You’ll find at least one new post a week on this blog to read and learn from, so this is definitely worth putting in your RSS reader. 

Living Sublime Wellness
Living Sublime Wellness is a blog dedicated to transforming the nursing community for the better. The blog is authored by Elizabeth Scala, an RN with an MSN/MBA and years of working experience as a nurse. Elizabeth is a public speaker who visits nursing associations, hospitals, and other healthcare organizations to teach people what they can do to make their working environments better for nurses. Living Sublime Wellness features a lot of great resources for current and future nurses, making it a great site to visit no matter where you are in your career. 

RTConnections Nurse Blog
The RTConnections Nurse Blog is designed to connect all members of the nursing world so they can educate and inspire one another to do better in their careers. This blog is particularly beneficial for new nurses because they can read stories from experienced professionals that they may aspire to become. One of the big focuses on this blog is nurse bullying, which has become a hot topic of discussion over the last few years. You can learn ways to avoid and prevent bullying in the work place by reading some of the posts on RTConnections. 

Dear Nurses
Dear Nurses is essentially a portal for several sites under the “Dear Nurses” umbrella. These sites are all focused on educating nurses through captivating illustrations. Dear Nurses combines simple graphics with helpful information to show nurses how to improve their skills and services. It also contains multi-part educational series that expand upon other posts they have on their sites. Dear Nurses has been online since 2006, and it has grown significantly in that time. 

Your Career Nursing
Your Career Nursing is centered around the idea of helping nurses improve their careers. The articles here teach nurses of all stages about the skills and processes they need to succeed in this profession. There are several categories of posts to choose from here, including education, entrepreneurship, lifestyle, networking, nursing success stories, online learning, unique nursing jobs, and more. No matter who you are, you can find something to like here.

Source:www.bestmedicalassistantprograms.org

Youtube

Fastaff

Making the transition to working nights may feel a bit intimidating, but many night nurses, myself included, have grown to love the position! It tends to be quieter and less chaotic because the patients are generally asleep, and there's a special camaraderie that develops between a team of night nurses. Put these tips into practice to survive, and even thrive, in your night shifts.

Stack several night shifts in a row: Rather than spacing out your night shifts during the week and having to switch between being up during the day and up during the night, try to put all your night shifts for the week in a row. That way, you can really get yourself onto a schedule of being awake during the nights you work and sleeping during the days in between.

Nap before work: As you transition from being awake during the day to being awake as you work at night, take a nap in the afternoon to help you go into your first night shift as rested as possible. Alternately, if your schedule allows, stay up later than usual the night before your first night shift and sleep in as late as you can the next morning.

Fuel up with healthy foods: While sugars may seem like they provide energy, they also come with a crash. Before heading into work, eat a filling meal with a healthy balance of carbohydrates, protein, and fiber. Then bring healthy snacks for the night that include protein and fiber to keep you going strong. Some options include yogurt, mixed nuts, hard boiled eggs, cheese cubes, or carrots with hummus dip

Plan caffeine carefully: It can be tempting to drink a cup of coffee anytime you feel sleepy, but you may develop an unhealthy dependence or be unable to fall asleep when you get home after your shift. Therefore, try to limit yourself to just one or two cups of coffee per shift, and drink your last one at least six hours before you plan to go to sleep.

Create a restful sleeping environment at home: The key to surviving night shifts in the long term is getting lots of restful sleep after each shift. Set up room darkening curtains and a white noise machine to help you block out signs of the day. When you get home, don't force yourself to go to bed right away. Instead, develop a routine that includes some time to bathe, read, and relax as your body winds down after work. Try to avoid bright screens, which block your body from releasing melatonin, the hormone that makes you feel sleepy.

With some attention to detail, you will probably find yourself really enjoying working at night. Many of the night nurses I know started out stuck on the shifts, but grew to prefer them. Plus, the pay differential doesn't hurt at all!

Source: http://www.fastaff.com