mad rush

there's a rumored new policy from the authorities (i don't know whether the authorities are the PRC, CHED or the nursing associations) that require all new second-courser applicants of nursing school to go through four years instead of the shortened two-year program. this rumored policy has caused a major stir in the nursing education community, where some schools, for example, are seeing their own admin staff quitting or taking some time off work to enrol and study nursing. some schools have also seen a strong rise in enrolment last summer as a lot of coursers made a mad dash to beat the implementation of the said policy, which supposedly took effect this June or the first semester of the school year.

old age

nearly a month into the school semester but i still have no clinical duty. my group was supposed to get some clinical experience at Golden Acres, a nursing home for the elderly, but some mix up in the school accreditation kept us away from the geriatrics. so we've already spent two weeks at school listening to lectures about growing old, the typical woes of aging, and the appropriate care for people above 60.

growing old is probably at the top of most people's list of phobias. although i don't dread old age, i am terrified by the thought of growing old alone. there's a difference between one's inability to do something because of weaker muscles and painful bone joints and one's inability to find help when it is needed. unless death comes knocking early, nobody can escape old age, but we can find comfort in people who can share the experience with us or at least help us adjust to our fate.

here are some theories about the reasons for aging:

1. genetic or mutation theory - it says that changes in replication of our DNA-RNA are the causes of aging. one's lifespan is programmed into our genes and us our cells change, we undergo the process of aging.
2. autoimmune or immunologic theory - our immune system is the key to aging. a virus or some other factor tells our immune system to weaken our own bodies.
3. wear and tear theory - we're just like the machines we use: our parts wear out and we break down eventually.
4. rate of living theory - the rate we grow old is fixed, so the faster we live our lives, the sooner we get to our graves
5. waste theory - we take in so much chemicals these days and these leave wastes in our bodies which lead to its deterioration and impedes in cell functioning
6. collagen theory - collagen stiffen with age, that why our skin and organs becomes less elastic and less functional
7. endocrine theory - our hormones are the main culprit, and the hypothalamus and pituitary are the master minds to the crime

another NGT story

i suppose many student nurses struggle with NGT-related procedures. inserting an ngt into a patient is fairly simple, but an inexperienced student may find the task very daunting. feeding someone through an ngt tube is fairly much simpler than inserting the tube for the first time. all it requires from the nurse is to make sure the end of the tube still leads to the stomach, and that the food can pass through the tube.

i've heard of one student nurse whose ordeal with ngt feeding almost ended in a disaster.

if you remember, i wrote in my previous blog that you need to pump a little air into the tube to check for gurgling sounds in the stomach. you pump this air through a device called an asepto syringe. it's just a large syringe with no needles on it. you connect a rubber stopper on one end that acts as the pump, and on the other end you insert the end of the tube. normally you press on the rubber stopper to push air into the tube.

now this student nurse knew that she had to check for gurgling sounds in the stomach to check the location of the tube's ending, but she forgot how to do it. so, she grabbed the end of the tube, put it in her mouth, and directly blew air into it. she then placed her right ear to the patient's stomach. after five seconds she looked up to her clinical instructor who was watching her and nodded to say she heard some gurgling.

the nurse instructor burst out in a laugh and everyone in the classrom began laughing hard. fortunately, this student nurse was in a classroom demostrating the procedure. i can't imagine what would have happened if she had done this to an actual patient in a hospital.

NGT

obviously, not all second coursers are smart. sometimes we make the stupidest comments and the rationalizations that would make florence nightingale turn in her grave.

a few weeks ago while on duty at the neuro icu of the v.luna hospital, we were preparing to feed a patient through a nasogastric tube--that's just a simple tube that passes through the nostrils down to the stomach and used for feeding patients who can't eat normally. one of the first things you do when fedding through an ngt is to test for gurgling sounds in the stomach to check if the tube is still properly inserted. this is done by pumping a small amount of air into the tube and listening with a stethoscpoe for gurgling in the patient's stomach. you don't want to feed a patient whose ngt has been displaced because food might get into his lungs.

so there i was at the patient's bedside performing the gurgling test. martin (let's hide his real name, ok?) came rushing to my side, panting and wide-eyed as if he was seeing an ngt feeding for the first time. as i removed my stethoscope, he tapped my shoulder and said with all seriousness, "Is that the way to check if the patient is hungry or not?" i wanted to roll on the ground and laugh. what kind of nurses are we producing?!

who am i?

i'm 30 years old and i'm a filipino student nurse. five years ago, this statement would have sounded so absurd. it would have been so weird for a 30-year old to be still enrolled in a BS degree course. the thought that i'm almost twice the age of my classmates would have been so incredulous. but times change and today when i meet people and tell them i'm a student nurse, i get, "wow! i wish i could do that!" or, "what school are you in? how do i get in?", or the worse comment i've gotten so far is, "gusto mong yumaman ha!" (you want to be rich, eh?).

thousands of second coursers are enrolled in nursing schools all over my country. i've had classmates whose ages are above 50 and they are the most eager and most consistent students of my class. they are the first to complain when classes or clinical duties get cancelled or when clinical instructors ask us to do nothing but take vital signs. you can't beat second coursers when it comes down to eagerness to learn.

for those of us who still need to have a regular day job to be able to study and pay for our own allowances and school tuition, it's a crime to have classes suspended or to spend an entire day at the hospital and do nothing but take BP levels. you need a fortune to get through nursing school and it's unforgiveable to waste away what we've paid just so we can be masters at taking vital signs. i spend over P60,000 in just one semester and that's more than what most filipinos earn in a year or even a lifetime! to waste away this much in taking BP levels and counting pulses, rightfully deserves the country's highest criminal penalty!

second coursers may have different reasons for going into nursing school, some may have been coerced by their in-laws or relatives while others may have voluntarily submitted themselves, but there's a common agenda: to grab an opportunity to work abroad and be financially rewarded.

the opportunities for employment outside the philippines is very tempting and very lucrative that even accomplished doctors, lawyers, engineers, business managers and military officers are going into nursing. there's a huge demand for nurses all over the world and developing countries like the philippines have become hard-pressed with the exit of its skilled workers wanting to work as nurses in countries like the US and the UK where the pay is ten times as much or if in the case of the US, it's 50 times as much.

i've heard on one travel agency who processes hundreds of travel papers in just one day just for nurses alone. nurses are probably the country's top exports today.

hopefully next year, i'll be one of those nurses going out to work abroad. leaving as a nurse does not mean abandoning the country, as what some people may believe. i think most people who go out of the country and find employment abroad do so not because they want to abandon the country, but they do so because they want to save the country. entire families, entire communities, and entire economies depend on foreign remittances from people who are willing to sacrifice and be away from their loved ones for a long time just to be able to put food on their families' tables. they are the real heroes and the country's true saviors.