Vitamin E is an antioxidant and it is the name of a group of eight fat soluble vitamins,  known as tocepierols and tocotrienols. It is not only used when Vitamin E deficiency is noticed,  vitamin E is  rare and usually caused by an underlying problems with digesting fat.

Vitamin E dissolves in fat and it is food in many foods including vegetable oils,  cereals, meats,  eggs and wheat germ.

Dosage
Vitamin E is available in oral capsules,  oral solution,  compound powder,  oral liquid,  oral and topical oil.




The dosage varies with age,  severity of condition.
It is available in 1000IU and 1500U1for adults and smaller doses for children.

Uses
- Vitamin E is used to treat and prevent diseases of the heart,  blood vessels lncuding hardening of the arteries, heart attack,  chest pain,  high blood pressure.
- It is also used to prevent diabetes and its complications
- It helps in preventive lung and oral cancer in smokers
- Prevention of complications in late pregnancy due to high blood pressure, premenstrual syndrome, menopausal syndrome.
- Topical vitamin applied to the skin can keep it from aging

Contraindication
- Vitamin E cannot be used if a patient has vitamin k deficiency
- Bleeding disorders
- Diabetes
- Head and neck cancer
- Liver disease

Side effects
If vitamin e is taken in high doses, the higher the dose the greater the risk of side effects.  Research says taking 300-800IU of vitamin e can increase a patient's it's of having hemorrhagic stroke.

Below are the side effects of vitamin e
  - Nausea
  - Diarrhea
  - Rash
  - Dermatitis
  - Intestinal cramps

Interactions
- Vitamin e should not be used with iron replacement drugs like ferrous sulfate, ferrous gluconate and warfarin
- Alcohol may cause dizziness,  nausea, and it should not be taken with vitamin e

Nurse's Responsibility 
  - Know the 7Rs of drug administration
  - When you notice any drug reaction,  inform the physician and drugs should be discontinued
  - Patient with heart disorder should be monitored closely,  to avoid stroke.
  - When you notice bleeding, it could be a drug reaction, it should be discontinued
  -  For out patient patients, explain chances of having drug reaction and dosage correctly to patient.

Happy new week!

 Hydrocortisone is a corticosteroid with glucocorticoid and to a lesser extent mineralocorticoid activity. It is used as an immunosuppressive drug, and for conditions adrenogenital syndrome, adrenocortical insufficiency and high blood calcium.
Topics hydrocortisone is used to treat itching,  redness.

Nursing is beautiful, but it is so dangerous if it is done without adequate knowledge and carefulness. Student nurses most times see the perfect side of nursing,  all they know is nursing is noble,  then life takes a new turn the day a road traffic accident patient’s blood splash on the face and they have to pray the laboratory investigation results comes out negative.

One of the things I have chosen to be my mantra as a nurse is, “every patient is a suspect”, therefore I guide my care diligently with my suspicion. It is true that every occupation has its hazard,  ranging from emotional rollercoaster, to exposure to pollutant and chemical and various types of injuries.  The good news is as nurses we are enlightened about these hazards: we teach them and talk about them, yet a large number of nurses are victims of various kinds of workplace hazards.

1. Back Injury
This is common,  and it is relatable to every nurse. Research says about 40,000 nurses report back related injuries annually, and this is due to lifting patients in bed,  helping patients out of bed,  transferring patients from the bed to chairs, and movement devices. Nurses are known for their perseverance on the issue of short staffing and underpayment, which is one of the cause of back injuries.

All back related injuries can be related to short staffing. Example is a nurse who weighs 65kg is been designated to a female surgical ward of 15 patients. In a shift that will last for 8 – 12hours, the nurse will need to help half of her patients out of their bed, help them on a bed pan or have their bed bath.

How to prevent back injuries 
As much as the issue on underemployment is yet to be attended to by the government and labor congress, nurses can do themselves the favor of learning how to prevent back injuries.
It can be prevented in two ways
• Reducing the rate at which you carry heavy objects
• Learning to delegate work to nursing assistants or ward care

2. Stress
Stress has become a way of life for a large number of nurses, and they all have learnt to accept it as such. Stress can be managed to help you stay healthy and agile at work

Management
• Have a schedule of your time, don’t spend your day offs visiting friends who live miles away
• Eat healthy
• Exercise regularly
• Sleep well
• Avoid unhealthy foods,  such as caffeinated drinks
• Don’t procrastinate
• Know that you can’t have it all, you need to reward yourself after a busy shift. It not creativity.

3. Infectious Disease
December 1st  was the world AIDS  day and it was tagged,  “know your status”, health practitioners are at the verge of contacting several kinds of infectious diseases, either by body contact, inhalation or other means. Research says that 600000 to 800000 needle-stick injuries occur each year in all healthcare system.

Prevention
• Learn to keep an eye of aggressive patient to avoid inhalation or bodily contact with vomit or blood
• Never uncap a needle when it is not yet needed
• Don’t attend to a patient with your gloves on,  and face masks in case of pulmonary diseases

4. Violence 
A research result says, 80 percent nurses who work in emergency services report violence each year; 39 percent of nurses experience verbal assaults yearly and 13 percent of nurses report battery and domestic abuse yearly. So much has been said about violence in the ward,  and we hope the government can do something to address the issue of violence and assault towards nurses.

Prevention
• Be patient not to reply a patient relative in anger
• Ask questions before retaliation
• Never insult anyone
• In cases of death, don’t break the news of the deceased in a close formation. You tell them and leave immediately
• Be smart and know your right as a nurse

Above are the 4 common hazards in nursing and ways out. 
Drop a comment and share this with a friend that needs it. 

Labetalol is a medication used to treat high blood pressure. It can be administered intravenously in severe hypertension or orally for long term hypertension management. Labetalol is a Beta- Alpha blocker, it has effects on both short and long term situations.

In short term,  it decreases blood pressure by decreasing systemic vascular resistance with no increase in stroke volume. 

In long term, it reduces the heart rate during exercise while maintaining cardiac output by an increase in stroke value.

Labetalol is available both in tablets at 100mg, 200mg, 300mg by different trade names, and injection at 50mg.



Mode of administration 
It can be administered both intravenously and orally.
Labetalol should be given slowly
In hypertensive emergency cases, the initial dose which is usually 20mg should be given over 2 minutes


Side effects of labetalol
- Dizziness
- Tingling scalp or skin
- Headache
- Stuffy nose
- Upset stomach
- Difficult breathing
- Signs or hear problems,  (fast heartbeat, chest tightness)

Contradictions
- Severe hypotension
- Any obstructive airway disease, including asthma

Nurses Responsibility in the administration of labetalol
Before administration
- Check the drug and dosage
- Check for allergies
- Check vital signs
- Explain procedure to the patient. Patient must give you consent as a nurse.

After administration
- Monitor  patient for side effects. Patient is likely to sleep after administration, or complain of headache.
- Check vital signs. In case of side effects like chest tightness, rapid pulse rate.
- Psychologically reassure patient if side effects persist for longer hours

I hope this helps?

Nobody wants to be a good Samaritan any longer, you know why? The world is so filled with dangers, and corruption that we are so scared of going out of our houses because we are not sure of what can happen to the house few minutes after our departure. Nurses by virtue of their jobs should be good Samaritans, they should see a woman who is sick and weak and render help to her even if it means offering her a bottle of water: ask the next man who is suddenly sweating profusely if he is well. Most of us nurses are nurses within the hospital walls and outside the hospital we are like every normal citizen, we are scared to render help.

The question is why?


Nurse Robert returned from work at 6pm, she was too tired to change her clothes, like every other day she pulled off her trekkers and jumped on her bed to catch some sleep before fixing her dinner. 20minutes later,  she heard a knock on the door, with a woman who seemed to be panting behind the door asking if Nurse Robert was at home. Without hesitation, Robert opened the door only to see the woman who owned the stall close to her house. She stared at the woman,  tried to ask if she was well,  but the question will sound stupid, the woman was apparently not well,  so she asked what the problem was.
“come and help me, my child is sick. He is shivering, he is coughing, I have given him paracetamol, it is not working.” She said,  and continued panting simultaneously

Nurse Robert smirked, and muttered underneath her breathe, “who gives paracetamol to a child that is coughing in this century?” she stared at the woman, she wanted to tell the woman to take the child to the nearest hospital, then she felt her neighbors would say she does not know anything that was why she asked them to go to the hospital. She picked her first aid box,  and followed the woman behind.

Robert wondered what exactly could be wrong with the child, she had administered antipyretic medications, yet it proved abortive, to make matter worse,  the patient had three episodes of convulsions after her arrival. She lived in a rural area,  there was no way she could get an anticonvulsant, she only had to assure the mother that the boy will be well. She tried taking history from the mother to know when the boy presented the symptoms, she said it all started an hour before she called her and her baby never had a convulsion.

Robert was worried, she rushed back home to take her purse so she can take the boy to the hospital, by the time she returned the boy had given up the ghost. On arrival at the scene, she saw a spoon in the boy’s mouth, he must have had another episode of convulsion, she wished she could saved him, but alas it was too late.

The deceased father returned from work and arrested Robert for killing his son with the wrong medication.

This is one of the dramatic and sad stories we hear and see around us. Should in case it happens around you, how should you act?

You should act like the good Samaritan, but a wise one this time around.
Good Samaritan acts are laws designed to protect people who provide assistance at the site of an emergency. The act keep citizens who stop to render aid from being charged or sued for any injuries or liability. In some countries,  the law applies to everyone. The law protects heath care providers like nurses and doctors who give first aid care.

What you should do before you become a good Samaritan 
- Make sure the patient is free from further dangers: In cases of road traffic accidents, endeavor that the patient is free from another car accident, move the patient from the road side before going around to seek for help. If it is at home, take the patient away from water, fire of whatever can also put the person in danger.

- Call for help: Imagine if Robert had called for help, perhaps she had taken the boy to the hospital on the next bike, the boy could have survived it, if he never survived it, she would never had been accused of administration of the wrong medication.

- Check if the patient is alive: Nurses are smart people, don’t be too emotional not to notice if a person is alive or dead. The aim of this is to help you clear any form of crime in case anything happens.

- Do what you know how to do: Every nurse should have a basic knowledge on Basic life support, CPR, ALS. There are times when you face situations that you can’t seem to handle alone, don’t be embarrassed to work away. I read  a story of a midwife who tried to rescue her neighbor who was pregnant, and while delivering the baby, she lost both the child and the mother to complications, she was sued to court.

- Never assume that a patient is too well to die: There are several assumptions that goes on especially on home services or home treatment, as the case may be. Still using the case of Nurse Robert, we are not sure of what exactly caused the death of the child,  but we know he had several episodes of convulsions, cough and fever. What if the child was anemic, or he had a respiratory tract infection, or complicated malaria or one those diseases that attacks under 5 children. She assumed she could handle it, but it back fired.

Before you try to act like a good Samaritan, think wisely and make your choice.

When I picked up this book, I was wondering what the author had in mind to use such title, but, as a I read on I realized I also need to get a new cheese rather than asking who moved my cheese.


The book is divided into three categories: this is to help you understand the book better and help your mind get a clearer picture of what the author is saying.


The first category is the classmate reunion
The second category is the story; who moved my cheese?
The third category is the discussion.

Who moved my cheese is a short fable of four fictional characters; Sniff and Scurry, the mice, Hem and Haw, the little humans.



These four characters were in search of  a new cheese, they got into a maze and found one sooner. Without further ado, the cheese got finished and before this happened, Sniff and Scurry had always waited for the unknown, they never assumed the cheese they found will last forever. Rather, they had another plan lest the cheese got finished.

Hem and Haw refused to find a new cheese, when they found out that the cheese had finished. All they did all day was to analyze how the cheese got finished and ask who moved their cheese.

Sniff and Scurry moved on in search of a new cheese, while Hem and Haw lived in the memories of the old cheese and were scared of finding new cheese.

By the time I finished the book, I realized we the medical practitioners, especially Nurses are like Hem and Haw.

I understand how tiring nursing is in some places in Nigeria, have you tried searching for a new cheese?
A new cheese does not necessarily mean a new job, it could be doing something new in an old job, or learning to accept your mistakes and flaws, so you can move on soon.

Like Haw in the book, while he searched a new cheese, he wrote some things on the wall concerning his new journey, hoping his friend would read and learn from him.

How much are you willing to learn?
Is never wrong to try out something new, because nobody has ever done it does not mean it is not right?
Like Haw in the story, he picked up his jogging shoes and continued the journey.

Bottom line is never be too comfortable in your comfort zone, learn something different beyond your comfort zone.

You can get this book on Amazon

I hope you enjoyed my book review?
Do you have any book that you would like us to review, (must be useful for nurses, preferably a nursing book)?
Do send a copy of your book to our mail fellownurses@gmail.com
Please drop a comment about this book review.

NURSES AND 2019 GENERAL ELECTIONS, WHO DESERVES OUR VOTES? - Oluwatosin K. Odunayo

Which of the presidential candidates has promising manifestoes for nurses and our patients and who exactly deserves our votes? Sounds awkward right?
Here, Fellow Nurses Africa will be setting out some of what we should know.

Who's the next Nigerian president?

As the general elections approach, the public are faced with making a decision that will determine the fate of our country, our debilitating healthcare system and our future.


For the first time in the history of Nigeria, the Joint Health Sector Union (JOHESU) embarked on an industrial action for close to 2 months under the present administration where extreme paralysis and prostration greeted the nation’s healthcare system before they were coerced to call the strike off under the guise of alternative dispute resolution’s negotiations. 6 months after, nothing has changed, not even the reasons for the strike action. As a matter of fact, the striking workers were denied their salaries for the period the strike lasted further exposing the over utilized and under paid nurses to economy deprivation. Nurses who are the majority members of JOHESU will never forget this in a hurry.

Results of the presidential opinion poll conducted by Fellow Nurses Africa

On the 31st of July this year, Vice President Yemi Osinbanjo had through his twitter handle released a video portraying the Nigerian nurses as saucy, wicked, and the enemy of progress among other healthcare professionals in a video that was intended to sensitize the public about patients’ bills of right. This act, bereft of intellectual sagacity especially one associated with the person of the Vice President and the office did not go down well with Nigerian nurses and various attempts were made at the Vice President to pull down the video from his twitter handle but all proved abortive. With that singular act, one may wonder if the number 2 citizen of our dear country lacks orientation as to the roles and responsibilities of a nurse or the video was a deliberate attempt to further denigrate the already battered public image of the Nigerian nursing profession. Without doubt, 2019 general elections may just be a payback time  for the nurses to massively vote President Buhari and Yemi Osinbanjo out of office. Nigerian nurses are the largest workforce in the health sector and currently need a President that will reposition the Nigerian health sector for the healthcare workers and their patients in terms of healthy policies, infrastructural developments and adequate funding amongst others.

President Buhari's policy on health

Taking a critical look at the policy documents of the two major contenders, President Muhamadu Buhari and his excellency, Atiku Abubakar,  while the former emphasizes on establishing health insurance for all Nigerians and N- Power medic (a process of attracting young doctors with monthly stipends to stay in the rural areas), the later focuses on addressing the shortage of Nurses and doctors,  reducing medical tourism, expanding healthcare professionals to the front line and attracting Nigerian doctors in diaspora to reverse brain drain amongst others.

Atiku Abubakar's Policy on health

It is worrisome that none of these two is addressing the major problems of Nigerian health sector which is under funding, mismanagement and incessant strike actions that have made the health care industry a shadow of itself.

One may wonder why this writeup is streamlined to the All Progressives Congress (APC) and the Peoples Democratic Party’s (PDP) candidates  when there are many others who seem to have all the solutions to the present predicaments of our dear nation. The likes of Omoyele Sowore,  Fela Durotoye, Donald Duke, Obi Ezekwesili, Kingsley Moghalu and others. It is imperative to note that except the unexpected happens, either  the All Progressives Congress  or the major opposition party, the Peoples Democratic Party will emerge winner of the 2019 presidential polls.

Taking cognizance of this, who then deserves our votes?
Despite all political parties publishing their beautiful manifestos in the lead up to the 2019 polls, there's no obligation for the winning party to follow through on any of the promises they have made ( more than half of President Muhammadu Buhari's 2015 election promises were not fulfilled ) and this is where campaign promises cannot always provide the answer.

Politicians and analysts need to answer the questions of over costing , budgets, details and most importantly the way these policies would be implemented. Massive underfunding of the health sector and mismanagement over the past decade have led us to where we are today and that can not be changed overnight regardless of which government is elected.

Ultimately, the only way our health sector can thrive with resultant decrease in brain drain, medical tourism, maternal and child mortality as well as increase in wages and allowances of the health care workers is through adequate funding of the sector. Any candidate with a master plan to do this should be given a chance.

Therefore as Nurses, we must strategically use our votes to make a strong political statements in the forthcoming elections across the states of the federation.

Edited by Ogunleye Ayodeji

Barely few hours to the release of the circular from the nursing and midwifery council of Nigeria indicating an upward review of the licenses verification fees from #8700 to #53,500, Nigerian nurses had taken over various social media platforms to communicate their displeasure about the development.
Below are some of the reactions to the development:

@Bodunde:  This is the part of the evidence that our leaders care less about our welfare but money! Imagine increasing verification fee from #8700 to #53,500

@merry : please what does this verification fees mean? I am not yet educated to that level of English, can someone please speak the language I understand before I start my ranting?
@Obasi : I think part of the problem is that we are always careful not to wash our dirty lines in public, it is high time we started exposing their gross incompetence and lack of foresight to the general  public.
@tunde: it is no longer nursing council but money council.
@ dessy: Nurses earn less in all spheres but pay more in all spheres, university education , they pay more, SOM/SON , they pay more .
@nrs Hilary: this is an evil policy, they saw the way nurses are leaving Nigeria to countries where they are loved and appreciated, and NMCN is now trying to restrict them by increasing the amount of verification of documents by 6 times the previous amount.
@~~~: Now I see they don’t want us to leave the country for them, no wonder they increased the verification fees. Nevertheless, we will still find our way.


@Nrs kethz: this is ridiculous, increasing verification fees from #8700 to #53500. Not double, not triple simply because they are aware nurses are now leaving the country in turns daily in search of greener pastures. What exactly are they verifying? NMCN has failed Nigerians and her nurses.
@hillary: the government is coming up with evil policies every day, instead of NMCN to think of how they will fight and eradicate quacks flooding the profession daily, they won’t do that. What is important to them is to help federal govt. generate money.

@susan: it is pathetic how nursing associations are always eager to milk us dry, yet, they will never make working conditions favorable. How can you make such an outrageous increase when you know that 80% 0f nurses do not earn up to that? I weep for this profession.
@austin : this is unbelievable ,why is that Nigerians in position of authorities are out of sync with reality? Have they ask to know how much nurses are paid in private, public and mission hospitals? In Some states nurses are owed salaries of 3 to 10 months. How long will it take a Nigerian nurse to save and be able to pay such amount? Why can’t good news come from Nigeria especially from government agencies? God help us.
@fellownurses: 1.an average Nigerian nurse is jobless. 2. Quacks are killing Nigerians on a daily basis.3.Nursing practices in Nigeria is no longer in line with the ICN recommendation 4. No meaningful development in nursing education. NMCN IS WATCHING AS IF ALL IS WELL, THIS IS TOO BAD.

@Newnurse coach: apart from issuing license what other thing do they do? I really need to be enlightened on that… How are they making sure nurses are cared for and paid well? What do they do when there’s a complaint from a nurse? They need to start telling us oo.
@Emu-VOKE: why is nursing council making things difficult for nurses? Why na? in this economy? There are other pressing problems that need to be attended to by nmcn. This increment is a no no.

Do you think this is the best decision NMCN can make at this particular time?
Join the conversation in the comment box below.