Thursday, October 29, 2015

Why do Companies need Nurses?

Why do Companies need Nurses?

Why do Companies need Nurses?



by: Arlene Gentallan

It is our right to receive quality health care. Employees will always have health concerns and someone has to take care of it. That's where the role of company nurse comes to play.

A company nurse is tasked with an important responsibility to promote the health of each employee. Some of the tasks of company nurses are prevention measures like health education, flu vaccination and annual physical examination monitoring. It's also a nurse's vital role to alleviate a patient's current health concern ranging from independent nursing measures like providing warm compress to someone suffering from dysmenorrhea to dispensing the appropriate medication.

It's important to resolve employee's health issues. This will make sure that employees are at an optimum condition to perform work, thus increasing productivity in the workplace.

Especialy in a highly stressful environment such as the call center industry, people are prone to suffer from medical condition. Having a company nurse will significantly lessen hospital/clinic appointement/stay.

Healthcare is one of our indespensable needs. company nurse is tasked to meet that. It helps the employee. It helps the company. Having a company nurse is a win-win solution.


Wait there's more...

Do you know that hiring company nurses goes beyond the hopefully truthful fact that your company does indeed care about your wellbeing. It is mandated by the law! the "Labor Code of the Philippines" is this law. That means, hiring company nurses is not just aa simple act of kindness but it's also compulsory.

"The Department of Labor and Employment" is the department entrusted with the duty and obligation to exercise the power to protect employees. So, this department mandates through the "Occupational Safety and Health Standards" sets of standards that companies should comply to. One of these standards is to have a "Health and Safety Committee" which includes company nurses.





What are the Trainings I have to undergo to be a Company Nurse?

What are the Trainings I have to undergo to be a Company Nurse?

What are the Trainings I have to undergo to be a Company Nurse?



by: Arlene Gentallan

What are the Trainings I have to undergo to be a Company Nurse?

    There are four main trainings you are expected to have already completed or will have to complete to be a company nurse, these are:

    1. BOSH (Basic Occupational and Safety) training
    2. BLS (Basic Life Support) training
    3. ACLS (Advanced Cardiac Life Support) training
    4. IVT (Intravenous Therapy) training


Is it really necessary for me to undergo these trainings to be a company nurse? Why is it important to undergo these trainings?

    Undergoing these trainings may be costly. And I know that for those who had just taken up the Nursing Licensure exam that upon receiving your licence as a full pledge nurse, the first thing in your mind may be "Earning a Living." It's your opportunity to shine and earn your own money!

    You may decide to seek employment that's in line with your profession and not take a detour as a call center agent (so your four - five years of "pure" hardwork won't be wasted) but just to know that your previous trainings have already expired (or you haven't taken these trainings yet) so you have to renew or undergo the said trainings.

    Or are you the person who took the detour into another industry/profession and wanted to shift back to the nursing field, only to find out that all those trainings were already passed the expiration date. Why indeed do you have to spend your valuable saving in these trainings?

    Why? Because you are investing in yourself. It's part of your professional growth and development. Being up to date with your trainings is one way of proving that you are competent in carrying out your duty as a nurse.

    These trainings are costly but, I tell you, it pays to complete them. Never underestimate the knowledge and skill you'll gain from these trainings. These kinds of stuffs always come in handy. You'll need them. You might say that encountering a patient with a life threatening condition is a rare case, but always keep in mind that you have no way of knowing when you will encounter this senario. You may not always need it but you have no way of knowing when you'll need it.

    It pays to be prepared because you never know when a patient with a life threatening condition will suddenly come to you're clinic's footstep.

    Let me ask you, would you like to be in a situation you're not trained for, when the first thing you can do is panic?

    These trainings will prepare you for what's out there. So you know what to do.





What are the Duties and Responsibilities of Company Nurses?

What are the Duties and Responsibilities of Company Nurses?

What are the Duties and Responsibilities of Company Nurses?



by: Arlene Gentallan

PATIENT CARE

    A company nurse is the first line of response to relieve the immediate health concern of the people working in the company. Their health concern can vary from a mild ailment to a serious life-threatening condition.

Assess the patient for his/her chief complain. Gather data (history taking.) Ask for symptoms. Observe for sighns.

...so you can give proper intervention.


INDEPENDENT NURSING ACTION

    There are several independent actions you do to help ease the patient such as providing cold compress in case of fever and hot compress in case of dysmenorrhea.


DISPENSING MEDICATION

    There are several over-the-counter medication a company nurse can readily provide to alliviate the specific health concern of the person. These are usually non-drowse medications because it's a work setting. Common medications are:s

Paracetamol for fever/pain
Mefenamic acid for pain
Strepsil for sorethroat
Phenylpropanolamine / Phenylephrine for cold
Ambroxol for phegm
Butamirate for dry cough
Antacid for hyperacidity
Topical analgesic for muscle pain
Eye drop (artifical tear) for eye irritation
Metoclopromide for nause and vomiting
Betahistine Mesylate for dizziness
Captopril for hypertension
Metoprolol for hypertension
Loperamide for diarrhea
Band aid for bruises and wound


HEALTH TEACHING

    A nurse's role as an educator is crucial for the patient's wellbeing. Providing them information is the best way for them to take active part in maintaining/improving their health. Give them helpful advises and insight regarding ways to improve their current health condition. These advises can range from lifestyle such as diet and exercise up to referral regarding which health professional they can go to diagnose them.


REST A PATIENT

    Be mindful of the company's policy. Usually, an employee is alloted a certain timeframe (can be 5 minutes to a few hours) of rest period within their paid working hours provided they have valid medical concern. This is beneficial to the employee to allow them to recuperate a few minutes before they get back to work. Just make sure to properly assess the patient's condition to make sure the employee is not abusing this priviledge.


SEND A PATIENT TO HOSPITAL

    If it's a condition warranting emergency treatment, you will have to accompany the person to the hospital. Assess the situation properly so you can properly decide your best transport option. For example, in the case of a person who suffered from fall, you won't be able to move him/her on your own because their's a risk of aggravating his/her condition so you'll have to call an ambulance.


SEND A PATIENT HOME

    If the person is afflicted with communicable disease like sore eyes, measles, and chickenpox, there is a high risk of them passing the disease to their workmates. Now, we don't want that to happen so it's important for them to get well first before going back to work. Advise them to visit a hospital/clinic they prefer to be given proper treatment. Remind them to obtain a medical certificate as proof and come back when their doctor deems them fit to work.


WORK AS A TEAM WITH THE COMPANY PHYSICIAN

    We can do better as a team. Nurses and doctor, each have specific responsibility and capability as dictated by their profession but with a common goal to bring the person back to his/her optimal level of functioning.


MEDICAL CERTIFICATES VALIDATION

    Employees take leave / absenses because of various reasons, one of this is medical reason. The proof being is a medical certificate. You will be tasked to verify it. It's usually done by you calling the hospital/clinic in which they sought medical help. A company nurse may also need to validate the document with the company physician.


HOME VISITING

    In cases in which an employee fails to return to work due to medical reason, especially if it's beyond the timeframe given to them to rest, you may be tasked to visit them at home to see how they're doing.


DOCUMENTATION

    It's not just in the hospital setting where the quote "If it's not documented, it's not done." applies. You also have documenting responsibility as a company nurse. Stuffs such as these shown below needs to be documented:
    What was done.

       - What did you do during your shift? The usual things. The unusual thing.
    Patient care

       - What was the chief complain of the patient and what were the interventions (independent nursing actions, health teaching, medications, and resting period) given to correct it?
    Daily census

       - The number of females, males, and specific incident/health concern cattered to for the day.
    Medications dispensed

       - How much of each particular medication was given for the duration of your shift.
    Borrowed items

       - Clinic property that were borrowed should be recorded.
    Endorsement

       - The transfer of responsibility to the next nurse on duty. Is there a task you will need to delegate to the next shift?


ANNUAL PHYSICAL EXAMINATION (APE)

    Making sure that employees are fit to work and finding out any deviation in their health status is important to correct it. Make sure that employees comply to the annual physical examination. There's usually an APE team that will supervise the employees to complete this annual event.


FLU VACCINATION

    Prevention is better than cure. For a fee, discount or free, as per company policy, employees may be given flu shot to help prevent this commonly transmitted disease. Usually it's the company nurse who gives this prophylactic injection.
    Before:

       Always gather pertinent information from the person before injecting a flu vaccine. You have to ask them if they have an allergy to egg, is pregnant, is immunocompromised or have an preexisting disease. These are the conditions you have to watch out for. You can not give them a flu vaccine because of the risk.
    During:

       Inject intramuscularly (usually the deltoid muscle is used) at 90 degrees angle. Remember to aspirate the syringe before pushing the medication. If their's blood, withdraw the syringe. Keep in mind to never push the medication if their's blood aspirated. Apply pressure with cotton balls to prevent bleeding.
    After:

       After the intramuscular injection of flu vaccine, advise the person that it's normal for pain/heaviness to be felt on the site but will subside in a couple of minutes. Advise them that it's normal for them to develop headache, cold, and fever. This is due to their immune system reacting with the vaccine.


    Note: These are based from my experience as a company nurse. The purpose of this article is to serve as a helpful guide, not as standard. Please don't hesitate to check on your policy / guideline / regulation / standard / protocol.





Company Nurse Experience: What will you do in case of sore eyes?

Company Nurse Experience: What will you do in case of sore eyes?

Company Nurse Experience: What will you do in case of sore eyes?



by: Arlene Gentallan

What if someone comes to your clinic with a pink eye?

Definition: Conjunctivitis (aka. pink eye) is a communicable eye infection commonly spread through hand contact.


Assessment & History taking

    If an employee (aka. patient) comes to our company clinic with a slight red sclera, I do assessment and history taking first.

ASK for any unusual eye discomfort like:
- pain
- itchiness
- drainage
- blurring of vision
- photophobia (increased sensitivity to light)

There are times when the patient will just complain of having a reddened eye without other symptom like itchiness and pain. I have a patient before who went to our clinic because his coworkers keep commenting of how red his eyes were, but he doesn't really feel anything unusual with his eyes.


SINCE WHEN? Ask the patient how long he/she've been suffering from this condition.

If it's already more than one day without relief or if the patient reports that it's worsening, then it's probably not just a simple eye irritation.

But if it just happened today or just a couple of hours earlier, there may be a possibility that that he/she may have been exposed to a mild irritant. And if it's just slight redness of the eye and mild itchiness chances are, it will subside after a couple of hours of rest/application of eye drops(artificatial tears/lubricant.)


INSPECT the eye. Inspect the lower conjunctiva. You can use a penlight (or as what I've seen in informal clinical setting...a cellphone's flashlight) in order to visualize this area. The normal color of the conjunctiva should be pink or a light shade of red. So if the color is bloody red, that's not normal.

Inspect the periorbital area. Does it appear normal or is it edematous, puffy or inflammed?


USE YOUR JUDGEMENT.
Scenario # 1:

    Usually, when a patient complaining of slightly redenned eye and itchiness comes to our clinic mentioning that he/she just had the condition a couple of hours earlier, we just give them eye drop (two drops each eye) and advise them to return after an hour if the condition still persist.

There's an advantage to this: If in case the patient is just suffering from mild eye irritation, there's a chance that his/her condition will be alleviated by the eye drop.

There's also a disadvantage: If the client's condition is indeed sore eyes. Congratulations! Good job helping the patient spread the infection. So to aid this part, we instruct the patient to avoid touching his/her eyes and habitually wash his/her hands.


Scenario # 2:

    On the spot. If a patient comes to the clinic with a too obvious red sclera, red conjunctiva upon inspection, positive itchiness, drainage and pain, we send them home for good measure and advise them to follow up on their doctor. They still have to consult a doctor (if there's no doctor available in the clinic) and get a medical certificate (one for the consultation and one with the fit to work remark.)


Scenario # 3:

    Obcourse, why will anybody let sore eyes stand between them and work if work is the priority. Some patient usually don't come back to the clinic even after one hour, even if their eye problem isn't resolved by eye drop (aritificial tear).

Yep, I've encountered just that. I have a patient before who came back to the clinic after three days from the day I gave her eye drops (...imagine, 1 hour versus 3 days.) It's only her right eye that's sore. The sclera is slightly red while the conjunctiva is bloody red. At this point, I've sent her to the nearby hospital to be checked by a doctor (because at that time as well as the time before, there's no doctor available in our clinic.) She was diagnosed there to be having conjunctivitis and was given prescription for a tobramycin eye drop and to follow up with an opthalmologist.

Remembering this, it's really important to be able to identify if the patient's condition is indeed sore eyes (pink eye/conjunctivitis) during the initial contact because there may not be a second one :(


Scenario # 4:

    I had a patient who requested for eye drop because of his painful reddened left eye. But upon inspection, I've noticed that his left periorbital area is swollen. He reported there's blurring of vision. He has diabetes and and a recent cataract surgery.

Apparently, his condition is serious so a simple eye drop won't help. He needs medical attention :( So, I accompanied him to the hospital where the doctor advised him to be confined.


    Note: These are based from my experience as a company nurse. The purpose of this article is to serve as a helpful guide, not as standard. Please don't hesitate to check on your policy / guideline / regulation / standard / protocol.





Company Nurse Experience: What are the commonly encountered incidence / cases in a company setting?

Company Nurse Experience: What are the commonly encountered incidence / cases in a company setting?

Company Nurse Experience:
What are the commonly encountered incidence / cases in a company setting?



by: Arlene Gentallan

These are the diseases / cases I usually encounter on my duty as a company nurse:

   

    • Allergy (skin rashes and urticaria)

    • Allergic rhinitis

    • Asthma

    • Cold / flu

    • Conjunctivitis / pink eye

    • Cough (dry/ productive)

    • Diarrhea

    • Dizziness

    • Dysmenorrhea

    • Fever / chills

    • Insect Bite

    • Headache

    • Horseness / loss of voice

    • Hyperacidity

    • Hypertension

    • Pain:
       - Muscle pain
       - Abdominal pain
       - Stomach pain
       - Toothache
       - Back pain
       - Ear pain

    • Migraine

    • Mouthsore

    • Nausea and vomiting

    • Sprain

    • Strain

    • Stiffneck

    • Sorethroat

    • Tonsillitis

    • Vertigo

    • Wound / bruise



What are the least encountered but potentially serious incidence?

    • Anaphylaxis

    • Appendicitis

    • Epistaxis

    • Gallstone

    • Myocardial infarction (MI) / Heart atttack

    • Stroke / Cerebrovascular Accident (CVA)

    • Urinary Tract Infection (UTI)



Communicable diseases:

    • Conjunctivitis

    • Chickenpox

    • Measles

    • Mumps

    Note: These are based from my experience as a company nurse. Reported cases may vary on your institution.





Company Nurse Diary: What are the commonly available devices / tools?

Company Nurse Diary: What are the commonly available devices / tools?

Company Nurse Diary: What are the commonly available devices / tools?



by: Arlene Gentallan

Here are the common devices and tools you will usually encounter in a company setting to help you with your role as a company nurse:

    • Medicines
    • Eye drops
    • Topical gel/patch
    • Band aid

    • Betadine
    • Hydrogen peroxide
    • Alcohol
    • Cotton balls
    • Gauge
    • Micropore
    • Bandage scisor
    • Normal saline solution (NSS) vial/ bottle
    • Syringe

    • Thermometer
    • BP apparatus
    • Stethoscope

    • Oxygen supply
    • Nebulization kit

    • Pen light
    • Face mask

    • Hot compress
    • Warm compress

    • Weighing scale
    • Bed
    • Pillow
    • Computer
    • Telephone
   
    Note: These are based from my experience as a company nurse. So tools and devices available to you may vary depending on your company etc.