Nursing Documentation Quotes

If the ghost that haunts the towns of Ypres and Arras and Albert is the staturory British Tommy, slogging with rifle and pack through its ruined streets to this well-documented destiny ‘up the line’, then the ghost of Boulogne and Etaples and Rouen ought to be a girl. She’s called Elsie or Gladys or Dorothy, her ankles are swollen, her feet are aching, her hands reddened and rough. She has little money, no vote, and has almost forgotten what it feels like to be really warm. She sleeps in a tent. Unless she has told a diplomatic lie about her age, she is twenty-three. She is the daughter of a clergyman, a lawyer or a prosperous businessman, and has been privately educated and groomed to be a ‘lady’. She wears the unbecoming outdoor uniform of a VAD or an army nurse. She is on active service, and as much a part of the war as Tommy Atkins.

Some studies have reported C. diff in food purchased in a supermarket. Dogs, horses, pigs, and rabbits can also be carriers of C. diff, although spread of disease from pets or domestic animals to humans has yet to be documented. Like most infections, it is usually impossible to pinpoint the source of C. diff.

To the men and women who changed Cheryl Hersha's life, she was a continuation of the research that had first been conducted in the late nineteenth and early twentieth centuries by Dr. Morton Prince. He encountered a woman named Miss Beauchamp, a nursing student who was referred to the psychiatrist because of health problems. As he worked with her, Prince discovered that she had four separate personalities (dissociated ego states) that existed independently of one another within the same body. Though he tried, Dr. Prince never understood Miss Beauchamp, nor was he able to help her. When he died, his wife had the woman committed to an insane asylum for the rest of her life. However, Prince's careful documentation of Beauchamp's symptoms, actions and family history (extreme child abuse beginning before the age of seven) provided information needed to develop the techniques for contemporary, routinely successful treatment of what would be called Multiple Personality Disorder.

Thus, in the course of the civil war the Palestinian Arabs, besides killing the odd prisoner of war, committed only two large massacres-involving forty workers in the Haifa oil refinery and about iso surrendering or unarmed Haganah men in Kfar `Etzion (a massacre in which Jordanian Legionnaires participated-though other Legionnaires at the site prevented atrocities). Some commentators add a third "massacre," the destruction of the convoy of doctors and nurses to Mount Scopus in Jerusalem in mid-April 1948, but this was actually a battle, involving Haganah and Palestine Arab militiamen, though it included, or was followed by, the mass killing of the occupants of a Jewish bus, most of whom were unarmed medical personnel. The Arab regular armies committed few atrocities and no large-scale massacres of POWs and civilians in the conventional war-even though they conquered the Jewish Quarter of the Old City of Jerusalem and a number of rural settlements, including Atarot and Neve Ya`akov near Jerusalem, and Nitzanim, Gezer, and Mishmar Hayarden elsewhere. The Israelis' collective memory of fighters characterized by "purity of arms" is also undermined by the evidence of rapes committed in conquered towns and villages. About a dozen cases-in Jaffa, Acre, and so on-are reported in the available contemporary documentation and, given Arab diffidence about reporting such incidents and the

In March 2002, the National Academy of Sciences, a private, nonprofit society of scholars, released a high-profile report documenting the unequivocal existence of racial bias in medical care, which many thought would mark a real turning point. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care was so brutal and damning that it would seem impossible to turn away. The report, authored by a committee of mostly white medical educators, nurses, behavioral scientists, economists, health lawyers, sociologists, and policy experts, took an exhaustive plunge into more than 480 previous studies. Because of the knee-jerk tendency to assume that health disparities were the end result of differences in class, not race, they were careful to compare subjects with similar income and insurance coverage. The report found rampant, widespread racial bias, including that people of color were less likely to be given appropriate heart medications or to undergo bypass surgery or receive kidney dialysis or transplants. Several studies revealed significant racial differences in who receives appropriate cancer diagnostic tests and treatments, and people of color were also less likely to receive the most sophisticated treatments for HIV/AIDS. These inequities, the report concluded, contribute to higher death rates overall for Black people and other people of color and lower survival rates compared with whites suffering from comparable illnesses of similar severity.

Once people believed her careful documentation, there was an easy answer—since babies are cute and inhibit aggression, something pathological must be happening. Maybe the Abu langur population density was too high and everyone was starving, or male aggression was overflowing, or infanticidal males were zombies. Something certifiably abnormal. Hrdy eliminated these explanations and showed a telling pattern to the infanticide. Female langurs live in groups with a single resident breeding male. Elsewhere are all-male groups that intermittently drive out the resident male; after infighting, one male then drives out the rest. Here’s his new domain, consisting of females with the babies of the previous male. And crucially, the average tenure of a breeding male (about twenty-seven months) is shorter than the average interbirth interval. No females are ovulating, because they’re nursing infants; thus this new stud will be booted out himself before any females wean their kids and resume ovulating. All for nothing, none of his genes passed on. What, logically, should he do? Kill the infants. This decreases the reproductive success of the previous male and, thanks to the females ceasing to nurse, they start ovulating. That’s the male perspective. What about the females? They’re also into maximizing copies of genes passed on. They fight the new male, protecting their infants. Females have also evolved the strategy of going into “pseudoestrus”—falsely appearing to be in heat. They mate with the male. And since males know squat about female langur biology, they fall for it—“Hey, I mated with her this morning and now she’s got an infant; I am one major stud.” They’ll often cease their infanticidal attacks. Despite initial skepticism, competitive infanticide has been documented in similar circumstances in 119 species, including lions, hippos, and chimps. A variant occurs in hamsters; because males are nomadic, any infant a male encounters is unlikely to be his, and thus he attempts to kill it (remember that rule about never putting a pet male hamster in a cage with babies?). Another version occurs among wild horses and gelada baboons; a new male harasses pregnant females into miscarrying. Or suppose you’re a pregnant mouse and a new, infanticidal male has arrived. Once you give birth, your infants will be killed, wasting all the energy of pregnancy. Logical response? Cut your losses with the “Bruce effect,” where pregnant females miscarry if they smell a new male. Thus competitive infanticide occurs in numerous species (including among female chimps, who sometimes kill infants of unrelated females). None of this makes sense outside of gene-based individual selection. Individual selection is shown with heartbreaking clarity by mountain gorillas, my favorite primate. They’re highly endangered, hanging on in pockets of high-altitude rain forest on the borders of Uganda, Rwanda, and the Democratic Republic of the Congo. There are only about a thousand gorillas left, because of habitat degradation, disease caught from nearby humans, poaching, and spasms of warfare rolling across those borders. And also because mountain gorillas practice competitive infanticide. Logical for an individual intent on maximizing the copies of his genes in the next generation, but simultaneously pushing these wondrous animals toward extinction. This isn’t behaving for the good of the species.

Meanwhile, administrative costs are eating up 15–30 percent of all health-care spending in the United States. That’s twice the rate of most other advanced nations. This money goes mainly into collecting money: doctors collect from hospitals and insurers, hospitals collect from insurers, insurers collect from companies or from policyholders. At some hospitals, billing clerks outnumber physicians. A third of nursing hours are devoted to documenting tests and procedures so insurers have proof.

War is incidental to ideology, and this was certainly true for the war instigated by Adolf Hitler. Historians have aptly documented that Hitler knew he needed the fog of war and a radicalized population in order to enact the most extreme policies. This was equally true for both Germans and the people of their conquered territories. The war allowed Hitler the cover and justification to radicalize the T4 Euthanasia program against those lives deemed “not worth living” by pointing to the costs of maintaining those “useless eaters” during a time of war. It allowed license for Karl Brandt to “clear hospital beds” in the name of the war effort. The war’s conquered territory also brought conquered populations and increased the number of “unfit” and “undesired” population, including the Jewish population of Eastern Europe. The methods and technology of the T4 Euthanasia program were subsequently transferred from the German hospitals to the extermination camps, doctors, nurses, equipment, and all. This transference and repurposing of resources was all decided in the infamous Wannsee Conference, which we now know was the beginning of the “Final Solution of the Jewish Question”:“The aim of all this was to cleanse German living space of Jews in a legal manner.” (From the text of the Wannsee Protocol)

documentation issues were more common in small private hospitals, where records were less standardized and notes were sparse because only the patient’s physician writes progress notes. In teaching hospitals, by contrast, there are multiple notes by residents, medical students, and nurses as well.

She had a hard time believing a woman who had gone to nursing school would risk her children’s lives over repeatedly disproven pseudoscience and the word of a former Playboy model. If anyone wanted a real-life documentation of the vital necessity of vaccines, they should look to the life of Helen

The next Task Force meeting also had a full agenda. As always, more items were listed than would be covered. At the end of the meeting, the VP remembered to squeeze in the testing guidance document, quickly asking for the added section on nursing homes in order to finish with the whole issue. Redfield distributed it around the table to everyone. It had no annotation of changes—all “Track Changes” indicators were now removed. I glanced through the document. It had been completely changed from the version approved by everyone at the previous Task Force meeting. True, a separate section on testing inside nursing homes had been added. However, nearly the entire document had been reverted to the original, old version of the guidance. Virtually none of the changes we had all agreed upon one week ago were present. I pulled out my notes from last week’s meeting. I was correct—that entire document had been ignored.

There had to be guide lines concerning who was needed, who would be allowed to stay. Since the Jewish community could not figure out what was intended or who was needed, they started registration of specialists. My former elementary school was within the Ghetto area and registration took place there. Everybody was desperate and lists were made for any kind of specialty. I registered where ever they would accept my name. You did not have to show a document, that would come up later. I was on a students list (who needed students?), on a chemists list, nurse, anywhere. I put Father's name on all kinds of lists, Yuda was in the same situation, although we had no contact at that time.

I got so good at recognizing these symptoms that Nurse Natalya once asked me to create a diagnostic assessment document (DAD) for the other nurses, in the hopes that it would streamline care and also make me feel useful.

Frontline nurses came up with and implemented two more elements of the patient safety system: Safety Action Teams and Good Catch Logs. Safety Action Teams were self-organized groups of nurses who met to identify and reduce potential hazards in their clinical areas. Second-order problem-solving indeed. The Good Catch Logs were a way of celebrating near misses: by documenting good catches, nurses identified additional opportunities for process improvement.