Saturday, July 29, 2006

Three babies

Our clinical duty in a birthing home in Labangon ended this morning. We thought we were going to finish the week with only a single delivery! Fortunately, two patients arrived last night in labor. The first delivered her baby on the same night, while the other had a prolonged labor (she gave birth to her baby this morning). Both newborns are girls. So that's a total of only 3 for the whole week! According to Nang Lolly, the owner of the birthing home, who is also a midwife, it's busier there on most weeks. Last week they had 7 deliveries.

So we spent most of our free time studying... and eating. If we stayed there a week longer, manambok siguro mi, kay wala mi lain buhat kundi manglinkud og mangaon... Also, idle chit chat, that came down to such levels as...

Ate Janice: "Naa ra ba kunoy ungo dire maglakaw2x magabii. Ghost nga mag-scrub suit, bonnet og mask..."

Me: "Ghost nga conscious sa sterile technique."

Then we'd burst out laughing.

The week after next, we'll report to the district hospital in Danao. Hopefully, things will be busier there.

Friday, July 28, 2006

PDI Op Ed on the NLE scandal

Manila Standard Today's headline reads: Nurses can’t take oath. Some 17,000 board passers can't take their oaths because of the said leakage. Luoy kaayo sila. I'm sure majority sa ila walay parte sa cheating. That's the unfortunate part of this whole issue; it would be very difficult for the NBI to track down who really benefitted from the leakage, so the PRC's likely action would be to nullify the test results of all those 17,000. Tsk tsk tsk.

Today's Philippine Daily Inquirer editorial also talked about the NLE scandal:


THE leakage in the nursing board examination held last June 11 and 12 again brought to the fore what has gone wrong with many of our institutions: Core values, like honor and honesty, are dealt with like ordinary clothes, to be worn or discarded at one’s convenience. As Inquirer columnist Raul Pangalanan put it in his July 21 column, “It is nothing new for us to hear about another scandal, another leakage, in a government licensing examination.”

One can’t help being reminded of the string of other scandals tearing our society apart. And to be sure, there is outrage and serious concern. But the voices that shout in exasperation and protest are, more often than not, dismissed by an apathetic majority, not unlike the voice of the minority in Congress being drowned out not by reason but by the tyranny of numbers.

The reaction of the Professional Regulation Commission (PRC) to the reports about the leakage in the nursing board exam has been, to say the least, half-hearted, swinging from denial to disinterest. “After an initial investigation by the Board of Nursing, the board concluded there was no apparent leakage,” the government agency tasked to protect and uphold the integrity of the professions in the Philippines declared a week after the board exam. The examination system is “nearly foolproof” -- it has been “so streamlined that leakages are now things of the past,” the PRC asserted. Then it proceeded to release the results and to schedule the oath-taking of the “successful” examinees.

The haste with which the PRC made these twin moves did not escape criticism. And it only raised suspicion that the PRC was moving to outmaneuver its critics, by making their protests academic.

Thanks in large part to the persistence of a few concerned nurses, educators and examinees, the PRC did conduct an investigation into the leakage. And last July 20, it filed administrative charges against the two members of the Board of Nursing to whom the leakage of some question was reportedly traced. In the meantime, the PRC asked them to voluntarily go on leave. It could not place them under preventive suspension because both are presidential appointees, the PRC explained. And there has been no word from MalacaƱang until now.

Simply put, government action has so far failed to measure up to the urgency and significance of this case.

The quality of nursing education has long been on the decline, authorities admit. One clear proof is the passing rate in nursing board exam, which has fallen from 80 percent to 42 percent. Indeed, for many years now, the passing rate has not gone above 50 percent, according to Marilyn E. Lorenzo, director of the Institute of Health Policy and Development Studies. The result is that we are fast losing our reputation as a producer of “world-class nurses.” Chair Carlito Puno of the Commission on Higher Education has said, “I am the first to admit that the quality of tertiary education has gone down in general, including nursing.”

The decline in the quality of nursing education has been blamed on the rapid increase in the number of nursing schools (not to mention the “excessive political meddling” in the accreditation of such schools), lack of hospitals to provide students clinical experience, unqualified deans, lack of experienced teachers -- even grades for sale.

Such weak school preparation, coupled with a strong determination to pass and find employment, makes cheating very tempting. The leakage of the examination questions is, therefore, in a sense a “manifestation of a deteriorating and highly commercialized nursing education,” as one nursing school official put it.
(Italics mine)

The leakage, of course, affects not only the examinees and practice of nursing in this country. The Philippine Overseas Employment Administration has warned that this puts in question the credibility of the government’s entire system of professional testing and licensing, and thus tarnish the image of all Filipino professionals, many of whom are practicing abroad.

The nursing exam leakage may appear less grievous than the charges of election fraud against President Gloria Macapagal-Arroyo and the P728-million fertilizer scam, but there is more at stake there than the government cares to acknowledge. Whether the leakage happened by design or by mere negligence, what is clear is that some people no longer deserve to sit in the Board of Nursing. This a matter of honor -- and not just for them, but for the entire nation.

The real casualty of this scandal is not only the 17,000 NLE takers whose eligibility to practice nursing is currently being questioned, but, to a larger extent, the reputation of all professional nurses in the country and overseas.

And I really agree, what's wrong with most of our institutions is that there is not anymore the core values of honor and honesty. In our school for example, and in most schools I bet this is also true, cheating has become a commonplace thing. Students cheat everytime the opportunity presents itself. Makatawa na lang ko usahay, kay it reminds me of that old song, "Honesty... is such a lonely word, everyone is so untrue..." I'm not excusing myself because I, too, have been a little less than honest a few times (or more!). But, I've always tried to avoid it na... honest! Pero seriously, it seems honest students today are hard to find, like endangered species. That's why it doesn't seem to shock us very much that the leakage happened, because everyday in school that's the reality, people cheat (especially those motivated by the drive to finish nursing in haste, so that they can start working abroad; these folks will do all that is necessary to pass nursing, nevermind "ethics" and all those silly inconviniences). Some teachers can even be bought! Our moral sensibilities are not really offended because... there's really nothing in us to offend.

And doesn't this whole issue closely mirror the situation with our country's political life? Look at Gloria, the whole issue of her being involved in the massive cheating in the previous elections hasn't yet been settled (she's not willing to clear her name through an impeachment proceeding; one wonders why, since someone falsely accused of a crime would normally readily seek every opportunity to prove her innocence). And what about the fertilizer scam? It seems she continues to be mum about it. And what about the fact about the rising number of killings of members of the Left and the Media happening under her administration which she has largely if not totally ignored? We go on about our daily lives as if everything's fine. All these dishonesty, this total lack of honor in our institutions, doesn't all these happen because we, the people, ourselves don't have these core values inside us, or don't hold them in high regard?

This will blow your mind away

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Thursday, July 27, 2006

Psalm 27: 4-5

One thing I ask of the Lord;
this I seek:
To dwell in the Lord's house
all the days of my life,
To gaze on the Lord's beauty,
to visit his temple.
For God will hide me in his shelter
in time of trouble,
Will conceal me in the cover of his tent;
and set me high upon a rock.

Tuesday, July 25, 2006

First labor and delivery

We were able to witness and handle our first labor and delivery yesterday. The experience was truly wonderful. The mother began her labor at around noon, and by three her baby was out. It was a boy, a healthy baby boy. He came out head first, and he even opened his eyes a couple times the moment his head came out. He looked so cute. We placed him in his mother's pelvic area. I did the suctioning (removing the excess fluids from the mouth and nose with the use of a bulb syringe) and the cutting of the umbilical cord (it would've been nicer if the father did it, but he was not with us inside the room at that time). He was coughing and crying sharply, and it was a good sign. The poor little fellow was just adjusting to his new environment. Then we placed him in this small tub and cleaned him up.

Welcome to the world, baby Nash.

Saturday, July 22, 2006

On the Middle East conflict

Letter from Noam Chomsky and others on the escalating conflict in the Middle East:

The latest chapter of the conflict between Israel and Palestine began when Israeli forces abducted two civilians, a doctor and his brother, from Gaza. An incident scarcely reported anywhere, except in the Turkish press. The following day the Palestinians took an Israeli soldier prisoner - and proposed a negotiated exchange against prisoners taken by the Israelis - there are approximately 10,000 in Israeli jails.

That this "kidnapping" was considered an outrage, whereas the illegal military occupation of the West Bank and the systematic appropriation of its natural resources - most particularly that of water - by the Israeli Defence (!) Forces is considered a regrettable but realistic fact of life, is typical of the double standards repeatedly employed by the West in face of what has befallen the Palestinians, on the land alloted to them by international agreements, during the last seventy years.

Today outrage follows outrage; makeshift missiles cross sophisticated ones. The latter usually find their target situated where the disinherited and crowded poor live, waiting for what was once called Justice. Both categories of missile rip bodies apart horribly - who but field commanders can forget this for a moment?

Each provocation and counter-provocation is contested and preached over. But the subsequent arguments, accusations and vows, all serve as a distraction in order to divert world attention from a long-term military, economic and geographic practice whose political aim is nothing less than the liquidation of the Palestinian nation.

This has to be said loud and clear for the practice, only half declared and often covert, is advancing fast these days, and, in our opinion, it must be unceasingly and eternally recognised for what it is and resisted.

Tariq Ali
John Berger
Noam Chomsky
Eduardo Galeano
Naomi Klein
Harold Pinter
Arundhati Roy
Jose Saramago
Giuliana Sgrena
Howard Zinn

Friday, July 21, 2006

On the Nursing Board scandal

Raul Pangalangan on the NLE scandal:

"That is why the scandal in the nursing board exams riles us so. Whoever leaked out those handwritten notes shortchanged all those honest students who took the exam on their own. Yet, unless the actual culprits and individual cheaters are found, the only proper course of action is to set aside the results of the tainted examination altogether. Its integrity has been breached, its results are not reliable. To compel the honest to retake an exam they have already passed -- that makes them the innocent victims of other peoples' greed and cunning. That is sad, but that is a legitimate price to exact. To allow the cheaters to be board-certified and to profit from their crime -- that leaves the public unprotected from the incompetent and rewards the dishonest with honors undeserved."

Thursday, July 20, 2006

Making it (and excelling) in nursing

Nigawas na, I think it was yesterday, ang results sa Nursing Licensure Examination last June. Congratulations to all the new RNs!!!

Sadly, no one from our school made it to the top 10 (in the previous NLE, 2 of our graduates managed to land in the 8th and 9th place). Surprisingly, 4 of those in the top 10 came from Southwestern University! Dili man nga wala tay bilib sa ato mga friends in SWU, but it's quite a surprise since it's been a while, I think, that they garnered top spots in the board exams. Congratulations to you all! :) As expected, some of the topnotchers came from Cebu Doctors' University, Velez College, and Cebu Normal University. I didn't see anyone from Ateneo de Davao, or Silliman... I think the Silliman graduates didn't take the board last June...

A friend asked me this afternoon if naga-aim ba pud ko nga maka-top inig board namo puhon... hahaha... as they say, char! Layo ra sa tinuod, pero kinsa ba dili ganahan ana di ba? Pero realistically, lisud naman gali ang makapasa, ang maka-top pa kaha? This guy we know who took the NLE, he graduated Cum Laude, but he didn't make it to the top. There are probably many factors to consider why some people make it to the top and why some don't. Of course, innate intelligence is one, then of course, hard work during those years you are studying, and then there's the time you spend preparing for the NLE. Some take it a couple of months after graduation. Some wait for many months and review intensively.

Well, I don't have innate intelligence, although I could work really, really, really hard. Then, I can review for 8 or 9 months... hehehe.

The girl who topped the board last year is now our clinical instructor, and a classmate of mine asked her about her "secret formula"... hehehe. She merely said that she has always been a "naning" since she was a student. She would always read, read, and read. It is said that she has read two volumes of a Medical-Surgical book (cover to cover, I guess). I don't know if that's a significant feat. She would opt to stay at home to study than to go out with friends to make suroy-suroy.

I think that's one significant characteristic of someone who has successfully become a knowledgeable and skilled nurse (of course, all nurses are knowledgeable and skilled, but others are exceptionally good in their profession) -- he or she always reads and reads. Reading man gud, I think, trains the mind to think critically. And, I think, in nursing, "all that is needed" (not to make it sound easy, of course!) is for you to master those concepts and principles about health and wellness, illness and disease. "All that is needed" is for us to be more familiar with those concepts, those "frameworks" that make up the multifacted discipline that is nursing, and we can more easily understand, appreciate, and remember the great body of knowledge that make up the science and art of nursing.

It remains to be seen if my theory is correct hehe.

Reporting in class

My main problem when it comes to reporting (orally) in front of our class is that I always have a "stage fright". You might think that I'm too old for stage frights, that with my age I should have developed the calmness that comes with maturity. But I have never outgrown that tendency. Well, I suppose most people never *do* outgrow their fear of the crowd no matter how far they advance in age.

But I noticed that the more you have mastered your material, the more confident you become in delivering it...

Another problem that I have is that I have difficulty delivering my material in simple terms. That's the *key* idea, I think, reporters should remember. It's about keeping it simple, explaining the material in the simplest, most concise and understandable terms possible, so that your classmates can easily absorb the lesson. I seldom think in simple terms, though, so that it is reflected in the way I report - it ends up a bit confusing, and I could see it clearly in me classmates' eyes. Sometimes I wonder if what I'm doing is clarifying the lesson or simply showing off my verbal skills.

I have many among my classmates whose reporting styles I admire. They do it in the most personal and down to earth manner, not the detached, nerdy kind of way (wherein the reporter's style is so impersonal and "cerebral" that he/she appears like a talking textbook). I think I should emulate these people. Magbinisaya ta kung mao na ang paagi nga mas masabtan nato ang lesson...

Nurse bloggers

I've noticed nga ubay-ubay na jud ang mga nursing students or nurses karon nga naga-blog. Sa ako lang nailhan daghan na... there must be countless others out there - nursing students or nurses already practicing their profession - blogging, writing about their experience... I should place a separate category of links for these bloggers in this blog one of these days...

I remember a week or so ago I searched Google for nurse bloggers and I found this very interesting blog. It's by a nursing student from UK. Too bad the blog is not being updated anymore, but he (or she) posted some links of other nurse bloggers. I haven't got the time to check them out, though.

I think more nurses and nursing students should write about their experience/s. There is much to be learned from our experiences in the hospitals and in our classrooms, and there's much that we are not sharing with others. The process of becoming a nurse is quite an interesting journey, filled with hardships, struggles, anxieties, dread, but also, of course, rewards, joy, and personal fulfillment. A lot of things happen to us and inside us as nursing students during those four years, and we don't usually tell others about it. We are silent, or confide only in our classmates or close friends. We undergo change, or better yet, a "metamorphosis", in the same manner caterpillars metamorphose into beautiful butterflies. That is something worthy to be told. From clueless freshmen we slowly become, in the next years, responsible, skilled, knowledgeable, and smart professionals. As bloggers we should write about the significant things that happen to us and within us as we go along this great journey... :)

Saturday, July 08, 2006

Going to Negros

The next couple of days promises to be dizzying. I'm leaving for Negros tonight to visit tita's wake. So after going to Sotto this afternoon to interview and assess my patient/s for next week's duty, I'm going straight home to get my things. Then I'll leave for the pier. The ship will depart late in the evening. Before day breaks I'll be in Dumaguete. Hopefully I can get to Sanke at around 8. I'll stay there for a couple of hours or more then I'll head back again for Dumaguete. Hopefully I can catch a fast craft trip there so I can reach Cebu for just an hour. If not I'll have to take the longer route - ride a pump boat from Sibulan to Liloan, then catch a vhire or a Ceres bus to take me back home in Minglanilla. I'll have an extra time to wash up and change to my uniform so I can report to Sotto before my shift starts at 10 in the evening. Mahuman amo shift 6 AM, so uli dayn ko to get some sleep, then wake up to read up on my patient's case and make a pathophysiology of the disease. Whew.

I'll actually be bringing along with me my Medical-Surgical book, NANDA, and Pathophysiology book so I can write the written requirements for the duty on the ship!

I miss Negros and I miss travelling by sea. I miss riding the Ceres bus... I miss Dumaguete. I'm happy I can visit it again, even though mulabay lang ko. Enough na nga makakita ko balik sa Negros. I miss the time my pangga and I spent there two years ago.

Friday, July 07, 2006

Goodbye, tita

Tita Epil died today. She had cancer. She was fighting the disease for about 8 years. Siguro time na jud niya.

She has suffered for many years. She even had her right arm amputated because of severe edema. We can't imagine the agony and the suffering she went through all these years. It has exacted such a huge toll on her and her family -- the expenses they incurred with the innumerable admission to hospitals, the expensive medicines, laboratory tests, and consultations with different doctors. (It cost them a fortune!) She was brave. She faced the terrible disease with such calmness and resilience, and there was no trace of self-pity in her.

At least she can now rest in peace. We mourn her passing but actually things are better for her now. Infinitely better, because she is now with our Lord, and free from the suffering of her terrible physical condition. We miss her because she is no longer physically present with us.

She died in Dumaguete. Her wake will be in her family's home in Sanke, Negros Oriental.

My first port-mortem care

I experienced my first post-mortem care last week in Sotto (VSMMC). The patient was an 83 year old man. I didn't know what his case was, he was not under our group's care. I noticed days earlier that his condition was already dire, because he was having difficulty breathing. He was using an oxygen setup and a few times he "slipped away". But the doctors/interns were able to bring him back. That particular day, however, he was already unresponsive. He wouldn't respond to the CPR, nor to the emergy drugs. Her daughter was barely able to control her crying when it dawned on them that he was already dead.

Our clinical instructor got three of us guys to do the post-mortem. We put on our gloves. Lolo was so heavy (He looked as if he was only asleep). Our CI told us to tie his wrists together as well as his legs. I asked myself if it's okay to do that, because it seemed a harsh thing to do. I was also sensitive to lolo's family members who were there observing us. Anyway, we went ahead and did it. I held his wrists and blood flowed out from his punctured skin where the IV used to be attached. I was too cautious, I couldn't do what I'm supposed to do right. Fortunately, my two classmates were very efficient and calm. Me, I was sweating profusely. Sweat ran down my forehead like a river. I looked ridiculous, which prompted my CI to ask if she could take down my glasses so I can wipe off my sweat... tsk tsk tsk. Then we wrapped him in a white blanket, then secured it with a string around his shoulder and legs. Then we attached the identification cards.

Death is a common occurence in Ward IX. People die there literally everyday. The staff nurses there are used to it. Nindut unta if naay role ang mga nurses to console the departed's love ones. Lain man gud if namatyan ka and then makita nimo nga ang hospital personnel are just there watching you at a distance, seemingly indiffirent to your loss.

Sunday, July 02, 2006

"Make me a channel of your peace..."

This song based on St. Francis' prayer is so beautiful. I realized this at mass tonight.

It has particular relevance for me because I'm currently experiencing an internal turmoil. I won't elaborate what it's all about. Suffice it to say it's school-related. It partly has something to do about the fact that we're having an exam tomorrow and I haven't studied yet (and I promised myself I was going to devote my Sunday to reading my textbook, and I didn't), and partly because I'm having difficulty trying to understand my new classmates.

Make Me A Channel Of Your Peace

Make me a channel of your peace,
Where there is hatred, let me bring Your love,
Where there is injury, Your pardon Lord,
And where there's doubt, true faith in You

Make me a channel of your peace,
Where there's despair in life let me bring hope,
Where there is darkness - only light,
And where there's sadness, ever joy

Oh Master, grant that I may never seek,
So much to be consoled as to console,
To be understood, as to understand,
To be loved, as to love with all my soul

Make me a channel of your peace,
It is in pardoning that we are pardoned,
In giving to all men that we recieve,
And in dying that we're born to eternal life
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