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WHAT IS THE MOST ACCURATE TEMPERATURE READING IN THE HOSPITAL

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WHAT IS THE MOST ACCURATE TEMPERATURE READING IN THE HOSPITAL

1. Rectal Temperature

  • Accuracy: Most accurate.
  • Explanation: Rectal temperature is considered the gold standard, especially in infants and young children. It closely reflects core body temperature.
  • Considerations: It is more invasive and less comfortable but provides a reliable measurement. It’s especially recommended when precise measurement is critical, such as in infants, elderly, or critically ill patients.

2. Oral Temperature

  • Accuracy: Very accurate, but slightly less so than rectal.
  • Explanation: Oral temperature is a good estimate of core temperature, though it can be influenced by factors like breathing, eating, drinking, or smoking. It’s typically 0.3°C to 0.5°C lower than rectal temperature.
  • Considerations: The patient must keep the thermometer under their tongue with their mouth closed, which might be difficult for some patients.

3. Ear (Tympanic) Temperature

  • Accuracy: Accurate, with some variability.
  • Explanation: Ear thermometers measure the infrared heat emitted by the eardrum, which is a good reflection of core body temperature. However, accuracy can be affected by earwax, improper positioning, or the presence of ear infections.
  • Considerations: Easy and quick to use, making it popular in clinical and home settings, but requires proper technique to ensure accuracy.

4. Forehead (Temporal) Temperature

  • Accuracy: Moderately accurate.
  • Explanation: Forehead thermometers measure the infrared heat emitted by the temporal artery. While less invasive, they are more susceptible to external factors like sweat, ambient temperature, and improper use, leading to slightly less reliable readings compared to ear or rectal methods.
  • Considerations: Non-invasive, quick, and comfortable, making it ideal for screening, especially in children, but it may not always provide the most precise measurement of core body temperature.

5. Armpit (Axillary) Temperature

  • Accuracy: Least accurate.
  • Explanation: Armpit temperature is usually 0.5°C to 1°C lower than core body temperature. It can be less reliable due to its external location and the fact that it can be influenced by environmental factors and the presence of sweat.
  • Considerations: While it’s the least invasive and easiest to measure, it’s also the least accurate, making it less ideal for critical assessments. It’s often used for screening purposes or in settings where more accurate methods are impractical.

Summary of Accuracy Ranking:

  1. Rectal Temperature: Most accurate, best reflects core body temperature.
  2. Oral Temperature: Very accurate but can be affected by recent intake of food/drink.
  3. Ear (Tympanic) Temperature: Accurate if properly positioned, but can be affected by ear conditions.
  4. Forehead (Temporal) Temperature: Moderately accurate, good for quick screenings but less reliable under certain conditions.
  5. Armpit (Axillary) Temperature: Least accurate, often lower than core temperature and affected by external factors.

Practical Considerations:

  • Rectal temperature is ideal for accuracy, especially in clinical settings where precise measurement is crucial.
  • Oral and ear temperatures offer a good balance between accuracy and comfort, suitable for most patients.
  • Forehead temperature is convenient and non-invasive, making it popular for quick checks, especially in children.
  • Armpit temperature is the least invasive and can be useful for quick, non-critical assessments, but is not recommended when accuracy is crucial.

SECRET TO GET EXTRA INCOME AS OVERSEAS NURSE EXPOSED

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SECRET TO GET EXTRA INCOME AS OVERSEAS NURSE EXPOSED

1. Overtime and Extra Shifts

  • UK: Many NHS trusts offer overtime or extra shifts, especially during staff shortages. These shifts can often be paid at a higher rate.
  • USA: Hospitals and healthcare facilities often offer overtime pay, which can be 1.5 to 2 times the regular hourly wage. Some facilities offer “per diem” shifts, where nurses can pick up extra shifts with flexible hours.

2. Agency or Travel Nursing

  • UK: Working with nursing agencies allows nurses to pick up shifts in different hospitals or care settings, often at higher pay rates. Travel nursing is less common in the UK but possible within the NHS or private sector.
  • USA: Travel nursing is a popular option, with agencies offering assignments across the country. Travel nurses typically receive higher pay, housing stipends, and other benefits. Agency nursing also offers flexibility and higher hourly rates.

3. Private Duty Nursing

  • UK: Private duty nursing involves working one-on-one with patients in their homes or private settings. This can be arranged through private healthcare providers or independently.
  • USA: Similar to the UK, private duty nursing in the USA offers opportunities to work with individual patients in their homes, often at a higher rate than regular hospital work.

4. Tutoring and Education

  • UK: Nurses with advanced knowledge or specialized skills can offer tutoring services to nursing students or those preparing for exams like the NCLEX (for those aiming to work in the USA), OSCE and CBT (for those aiming to work in the UK),
  • USA: Many nurses tutor nursing students or even teach part-time at nursing schools or community colleges. Online tutoring is also an option, especially for subjects like anatomy, pharmacology, and nursing theory.

5. Telehealth Services

  • UK: With the rise of digital health services, nurses can work remotely providing telehealth consultations, triage services, or health advice through platforms like Babylon Health or the NHS 111 service.
  • USA: Telehealth has grown significantly, with nurses providing remote care, triage, or chronic disease management. Companies like Teladoc, Amwell, or even insurance companies often hire nurses for these roles.

6. Medical Writing and Content Creation

  • UK: Nurses can write for healthcare blogs, medical journals, or patient education materials. Content creation for health websites or consulting for media on medical accuracy can also be lucrative.
  • USA: Similar opportunities exist in the USA, with higher demand for medical writers. Nurses can contribute to healthcare blogs, write CEU (Continuing Education Units) materials, or create content for nursing education platforms.

7. Health Coaching or Consultancy

  • UK: Nurses can offer private health coaching, focusing on wellness, nutrition, chronic disease management, or lifestyle changes. Consultancy work for healthcare organizations or start-ups is also an option.
  • USA: Health coaching is a growing field in the USA, where nurses can work independently or with organizations to provide personalized health advice. Nurses with expertise in specific areas can also offer consultancy services.

8. CPR and First Aid Training

  • UK: Offering CPR, first aid, or other life-saving courses can be a profitable side business. Nurses can become certified trainers and offer courses to individuals, businesses, or schools.
  • USA: Nurses can teach CPR, first aid, and other emergency response courses through organizations like the American Heart Association or independently.

9. Wellness Programs and Screenings

  • UK: Nurses can work part-time conducting wellness screenings for corporations, schools, or community organizations. This might include health checks, vaccinations, or health education workshops.
  • USA: Corporate wellness programs in the USA often hire nurses for health screenings, flu clinics, or wellness coaching. These programs are typically short-term and well-compensated.

10. Locum Work

  • UK: Locum work involves temporary placements in various healthcare settings to cover staff shortages. Nurses can find locum positions through agencies, often with higher pay rates.
  • USA: Similar to the UK, locum work in the USA allows nurses to take on temporary assignments, often in rural or understaffed areas, at a premium pay rate.

11. Create an Online Course or Blog

  • UK: Nurses with expertise in a particular area can create online courses or start a blog related to healthcare or nursing. This can generate passive income over time.
  • USA: In the USA, platforms like Udemy or Teachable allow nurses to create and sell online courses. Blogging or vlogging on platforms like YouTube can also generate income through ads or sponsorships.

12. Legal Nurse Consulting

  • UK: Nurses can work as consultants for legal firms, offering expertise in medical-related cases. This may involve reviewing medical records, preparing reports, or acting as an expert witness.
  • USA: Legal nurse consulting is a well-established field in the USA, where nurses assist attorneys with medical litigation, often at a high hourly rate.

COMPARISON BETWEEN NIGERIA AND GHANA GENERAL NURSING SCHOOLS

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COMPARISON BETWEEN NIGERIA AND GHANA GENERAL NURSING SCHOOLS
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FINE-BORE NASOGASTRIC TUBE INSERTION – NMC OSCE

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FINE-BORE NASOGASTRIC TUBE INSERTION – NMC OSCE

INTRODUCTION

Scene Safety and Privacy:

Assess for scene safety.

Provide privacy for the patient.

Hand Hygiene:

Perform hand hygiene using the 7 steps technique.

Patient Interaction:

Greet the patient to create rapport.

Introduce yourself and explain the purpose of the visit.

Gaining Consent and Positioning:

Obtain patient consent.

Position the patient in a semi-upright position.

Preparation:

Ensure a working suction machine and oxygen are near the patient (verbalize this).

Ensure the patient is comfortable, has no concerns, and the call bell is within reach.

Inform the patient you will be back with the necessary items.

Perform hand hygiene again.

GATHER ARTICLES

  1. Clean tray.
  2. Hypoallergenic tape.
  3. Enteral pH strip (check that the pack is dry, intact, and within the expiry date).
  4. Kidney dish (clean and dry).
  5. Enteral syringe (check that the pack is dry, intact, and within the expiry date).
  6. Fine bore nasogastric tube.
  7. Scissors.
  8. Drape.
  9. Glass with warm water (to be used as a lubricant).

PROCEDURE

Hand Hygiene and Personal Protection:

Perform hand hygiene.

Wear apron and gloves.

Patient Comfort and Communication:

Ask the patient if they are comfortable.

Inform the patient to use a hand signal if they need to stop the procedure.

Positioning:

Ask the patient to maintain a semi-upright position in the chair/bed, supporting their head with pillows to ensure no head tilt forward or backward.

Check Nostrils:

Check the patency of the nostrils by asking the patient to sniff with one nostril closed, then repeat with the other nostril.

Measurement:

Perform a NEX (Nose-Ear-Xiphisternum) measurement:

Measure the distance from the patient’s nose to their earlobe.

Add the distance from the earlobe to the bottom of the xiphisternum.

Add 5-10 cm to this measurement.

Note the measurement marks on the tube.

Lubrication:

Lubricate approximately 15-20 cm of the tube with warm water.

Inserting the Tube:

Ensure the kidney tray is ready.

Insert the proximal end of the tube into the nostril, sliding it backwards and inwards along the floor of the nose to the nasopharynx.

If any obstruction occurs, stop and try again in a slightly different direction or use the other nostril.

Ask the patient to start swallowing as the tube passes down the nasopharynx into the esophagus.

Advance the tube through the pharynx as the patient swallows until the measured indicator on the tube reaches the entrance of the nostril.

Monitoring:

Recognize any signs of distress such as coughing or breathlessness. If these occur, remove the tube immediately.

Securing the Tube:

Secure the tube with adherent dressing tape to the nostril and cheek.

Confirmation of Tube Position:

Aspirate a small amount of stomach contents using a 50ml or 60ml syringe.

Confirm the position of the tube by checking the pH of the gastric content using a pH strip. The pH should be equal to or less than 5.5.

Use the integral cap to cap the tube.

Post-Procedure:

Discard waste materials.

Ensure the patient is comfortable, has no concerns, and the call bell is within reach.

Perform hand hygiene.

Document the procedure.

Provide health education (e.g., instruct the patient not to pull out the tube, do regular mouth care, etc.).

Perform hand hygiene again.

Conclude by informing the assessor that you have finished the procedure, discarded used items according to hospital policy, documented as per NMC guidelines, cleaned the tray for next use, and ensured the patient is comfortable.

ASEPTIC NON-TOUCH TECHNIQUE (ANTT) – NMC OSCE

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ASEPTIC NON-TOUCH TECHNIQUE (ANTT) – NMC OSCE

Wound Dressing

CLEANING TROLLEY

Hand hygiene using the 7 steps of WHO

Take alcohol wipe, check the pack is intact and expiry in date

Do hand hygiene

Wear apron and gloves

Clean trolley from farthest side to nearest side in a zig-zag motion by using

Alcohol wipes.

First clean the upper part, then lower part including bars.

Discard the wipe, apron and gloves

Do hand hygiene

State that upper part is the sterile field and lower part is the clean field.

GATHER EQUIPMENT

Place the articles on the bottom shelf of the clean trolley.

Check the sterile pack – dry, intact and within expiry date.

Saline solution – package is intact, no precipitate, expiry in date

Sterile dressing – package is intact and expiry in date.

Alcohol swab – pack is dry and intact, expiry in date.

If possible extra sterile gloves – packet is intact, expiry in date.

Carry the trolley holding at the bottom part and carry near the patient without disturbing/less disturbing the curtain/environment.

INTRODUCTION

Hand hygiene

Now introduce yourself as one of the registered nurses coming to dress his/her wound.

Explain procedure to gain consent

PROCEDURE

Hand hygiene, wear apron

Place the dressing pack carefully on the sterile field and open the sterile pack by touching only corners of the paper.

Take out clinical waste bag without compromising sterility, insert hand inside and wear like gloves.

Place other materials in the dressing pack on the centre of a sterile field by using clinical waste bag.

When done upside down the clinical waste bag and stick to one side of the upper part of the trolley. Mostly to the nearest side the patient.

Take sterile dressing from bottom part, remove the pack and drop it on the sterile field

Take the alcohol swab from the bottom shelf and open it and discard packet in the clinical waste bag.

Take the saline solution and clean the neck of the saline solution for 30sec and allow it to dry for 30sec. (count till 5 sec)

Open and pour saline solution into gallipot and discard saline solution pack to clinical waste bag.

Hand hygiene

Put on sterile gloves from the sterile field/the extra.

Drape the sterile field around/under the wound.

Maintain sterility while draping

Verbalize which hand is ‘clean’ and which will be ‘dirty’ (or sterile hand and clean hand)

Dip gauze in a saline solution and move from clean to dirty hand

Clean wound from clean to dirty in a single stroke (two times)

Don’t over-clean the wound

Apply new dressing and remove the drape

Replace bed cover

Remove the clinical waste bag and dispose waste appropriately

Discard apron and gloves and do hand hygiene – if more time clean the trolley.

Give health education to your patient

Do documentation

Ensure the patient is comfortable, does not have any concerns and call bell within reach.

Do final hand hygiene

Conclude by saying; Assessor i have done my procedure, discarded used items according to the hospital policy, did documentation as per the NMC guidelines, cleaned trolley for next use &my patient is comfortable.

NHS BOSS TOLD BLACK AFRICAN TO BLEACH AND TURN WHITE BEFORE COMING TO WORK – UK

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According to reports from the tribunal, Adelaide Kweyama, a black nurse from South Africa, was advised by an NHS manager to “bleach her skin” so that she would “come back white and the patient will be nice to you.” This occurred after she had reported racial abuse from a patient who feigned inability to communicate in English. Ms. Kweyama, who was employed as an agency nurse at an immigrant removal centre in Heathrow, expressed shock at the comment. The senior nurse further remarked to a colleague that she was tired of employees claiming to be unwell and suggested Ms. Kweyama should “go and bleach her skin.”

Subsequently, Ms. Kweyama experienced racial abuse from male detainees at the centre who called her derogatory names. Despite raising concerns and filing incident reports, she felt unsupported by her managers. Following a separate incident where a detainee was racially abusive towards her, she was again told by the senior nurse to “bleach her skin.” This incident left Ms. Kweyama feeling depressed, prompting her to email her agency, Athona, stating her inability to continue working at the Heathrow centre due to emotional and psychological distress.

Despite her complaints of racial abuse and lack of support from the NHS Trust, Ms. Kweyama’s contract was terminated, with the reasoning cited as concerns about her mental health based on her statement. The tribunal concluded that Ms. Kweyama had been subjected to race-related harassment and victimization, both by her boss’s remarks and the termination of her agency role. However, her claim of direct race discrimination was dismissed. A hearing to determine remedies will be scheduled later.

What is your take on this crucial matter?

Source: MAIL online

FRAUDSTER CARER JAILED IN THE UK

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FRAUDSTER CARER JAILED IN THE UK

Detective Constable Emma Maders of GMP’s Criminal Investigation Department stated that Petula Hatzer, residing on Mortlake Drive in Manchester, had been sentenced to 1 year and 1 month in prison after admitting to 10 counts of fraud by false representation and 1 count of Fraud by Abuse of position at Minshull Street Crown Court on March 13, 2024.

Hatzer, who had been caring for the victim for approximately 17 years, was arrested in 2021 following allegations made to the police by another caregiver. This caregiver had expressed concerns in October 2020 about Hatzer opening credit card and catalogue accounts in the victim’s name over several years. The victim, who is extremely vulnerable and receives round-the-clock care, had never possessed the capacity to open such accounts.

After receiving the report, detectives initiated an investigation and discovered evidence of 10 accounts opened in the victim’s name. Hatzer was subsequently arrested, and various credit cards and letters were seized from her home. During initial questioning, she admitted to the fraudulent activities but showed little remorse. Subsequent interviews yielded no comments from Hatzer.

DC Maders described the crime as particularly distressing, emphasizing that Hatzer, in her role as a trusted caregiver, had exploited the victim’s identity for personal financial gain. Hatzer not only opened fraudulent accounts but also accessed the victim’s existing bank account, depriving her of funds intended for daily necessities.

The impact on the victim’s family was profound, as Hatzer had been considered a part of their family. DC Maders assured continued support for the family, acknowledging the emotional trauma they experienced. She urged community members to report similar instances of exploitation, emphasizing the importance of protecting vulnerable individuals.

SOURCE: UK POLICE DEPARTMENT

UNDERSTANDING THE CONSEQUENCES OF FAILING THE NMC OSCE FOR OVERSEAS NURSES

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UNDERSTANDING THE CONSEQUENCES OF FAILING THE NMC OSCE FOR OVERSEAS NURSES

It was explained that the Objective Structured Clinical Examination, commonly known as the OSCE, serves as the conclusive assessment required by the NMC for overseas nurses seeking registration as nurses in the UK. The most recent iteration of the OSCE, as of 2021, mandates ten stations where candidate nurses are observed while demonstrating their skills and knowledge. This process bears resemblance to the return demonstration tests undergone by Filipino nurses in the Philippines, albeit with the distinction that UK OSCE candidates are obliged to verbalize each step demonstrated during the examination. The previous version of the OSCE, referred to as the Legacy OSCE, comprising merely six stations, is anticipated by the NMC to remain in effect only until July 31, 2022. For overseas nurses, the OSCE stands as the primary obstacle they must surmount upon embarking on their nursing journey in the UK.

The online Filipino nursing community has shared numerous success stories regarding the OSCE and offered abundant content on strategies for passing it with flying colours. However, there is minimal discussion about the consequences of failing the OSCE.

It was clarified that the OSCE, according to its grading criteria, yields either a pass or fail outcome, devoid of any numerical scoring akin to the Philippine Nursing Licensure Exam. Candidates receive their OSCE results via email within a few days following the examination.

Regarding a pass outcome, it signifies a favourable result leading to subsequent registration with the Nursing and Midwifery Council of the UK, thereby granting overseas nurses’ eligibility for a qualified nurse’s salary, albeit with heightened responsibilities, typically corresponding to Band 5 within the NHS. Furthermore, registration necessitates the payment of an annual fee; failure to comply risks the loss of nursing practice rights. Registration must also undergo revalidation every three years to avoid suspension or revocation of the nursing license in the UK.

In the event of a failure, the situation is more nuanced than a simple pass. A partial failure may occur if a candidate overlooks minor details during the examination, resulting in failure only in the specific section or station. A partial failure necessitates a resit of the same station under identical circumstances, albeit at a reduced fee. Conversely, a complete failure mandates a comprehensive resit of the entire OSCE, incurring the full examination cost.

Discussions with experienced Filipino UK nurses who underwent OSCE resits revealed that NHS trusts generally offer support for candidates undergoing resits, covering fees and providing additional training and study time for a second attempt. However, support might diminish beyond the second attempt, with trusts often indicating that failure to pass on the second try could halt the employment process, potentially leading to Home Office intervention and curtailment of residency rights.

To avoid OSCE failure, several tips were suggested, including ample practice, time management, utilization of learning resources, familiarity with marking criteria, calming techniques, and acclimatization to the new environment. Despite its familiarity to Filipino nurses, thorough preparation remains crucial for OSCE success, as it represents the final step toward fulfilling the dream of becoming a registered UK nurse.

Source: Filipino UK Nurses Community

“SILENCED SUFFERING: EXPLOITED MIGRANT CARE WORKERS IN THE UK”

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“SILENCED SUFFERING: EXPLOITED MIGRANT CARE WORKERS IN THE UK”

Abena, a migrant worker from southern Africa, recounted how she had been repeatedly raped by her manager at a UK care home but felt unable to report him to the police out of fear of losing her job and her visa.

Bernice, from the Caribbean, shared her experience of being sexually harassed by her landlord in the accommodation arranged by her employer, who sponsored her work in the UK.

Chidera, a live-in carer from Ghana, recalled a time when she went nearly four months without a day off. After complaining to a manager, she was threatened with dismissal and having her visa revoked.

These are just a few of the stories shared by migrant care workers who travelled to the UK to fill vacancies but found themselves exploited and silenced. The Bureau of Investigative Journalism (TBIJ), collaborating with Citizens Advice, gathered testimonies from almost 175 individuals working for approximately 80 care providers via the health and care worker visa. Their accounts revealed a pervasive fear among this crucial section of the social care workforce to raise concerns about labour abuses, largely due to the visa system tying their right to stay and work in the UK to their employers. Any complaint, even if upheld, could trigger a countdown, leaving them with barely two months to avoid the risk of deportation.

Kayley Hignell, interim director of policy at Citizens Advice, expressed deep concern, stating, “We work on a lot of difficult issues at Citizens Advice, but this is one of the most heartbreaking because of our limited ability to help people find a way forward.”

Andrew Gwynne MP, the shadow minister for social care, echoed these sentiments, emphasizing the government’s failure to address the crisis in social care and the urgent need to prevent the exploitation of overseas workers.

Early last year, staff at Citizens Advice observed an uptick in calls from individuals on the health and care worker visa in the UK, prompting the organization to collect information to assess the extent of the problem. A total of 150 workers provided evidence, though the true number affected is believed to be much higher.

The charity shared anonymized details about the callers with TBIJ as part of an investigation into exploitative working conditions faced by migrants in the UK.

In their accounts to Citizens Advice and TBIJ, care workers described experiencing various forms of exploitation, including wage theft, exorbitant recruitment fees, reduced hours, and destitution due to poor working conditions in the care sector. One recurring theme was the feeling of being trapped due to visa arrangements penalizing whistleblowing, with workers dependent on their employers for their right to remain and work in the UK.

Approximately 30% of those mistreated at work admitted to being afraid to raise concerns about their managers or employers, fearing reprisals such as losing their jobs and visas, as well as threats to their safety.

Abena, for instance, disclosed to Citizens Advice that she had been raped by her care home manager but chose not to involve the police, fearing repercussions. Bernice, who experienced sexual harassment from her landlord while employed as a carer, similarly refrained from lodging a complaint due to the risk of job loss outlined in her contract.

A Home Office spokesperson condemned the exploitation of health and care worker visa holders, pledging to crack down on illegal activity in the labour market.

The situation underscores a glaring power imbalance, with workers feeling powerless to speak out against abuses for fear of losing their livelihoods and facing deportation. Efforts to address this issue are imperative to safeguard the rights and well-being of migrant care workers in the UK.

source: The Bureau of Investigative Journalism

UK CARE ASSISTANTS RETURNING BACK TO AFRICA

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UK CARE ASSISTANTS RETURNING BACK TO AFRICA

A major provider of home care services in the UK has revealed that it is facing exorbitant expenses by paying migrant workers to stay idle due to delays in the renewal of immigration permits by the Home Office.

Last year, thousands of overseas care workers were invited to the UK to address the 152,000 vacancies in the sector. However, following instances of exploitation by scammers and certain care providers, allegations of modern slavery surfaced, prompting the government to tighten regulations.

As part of the regulatory changes, care workers are no longer permitted to bring their families to the UK as of March 2024.

These developments coincide with the issuance of 106,000 visas to carers by the government in 2023.

CEO Darren Stapelberg of Grosvenor Healthcare expressed frustration, stating, “The sponsorship process has swung from being overly permissive to nearly impossible. Despite the ease with which individuals were sponsored previously, the current system is making it extremely challenging to bring in new staff and renew existing contracts.”

Currently, Grosvenor Healthcare is reducing wages for 30 of its migrant workers, with plans to do the same for an additional 90 soon.

Stapelberg lamented the loss of eleven workers who returned home, noting, “We’re losing valuable contributors to our society precisely when there’s a dire shortage of staff.”

In response, a spokesperson from the Home Office stated, “Our guidelines ensure that individuals who have applied for visa extensions are entitled to the same benefits as their initial permits. Sponsors must demonstrate the existence of genuine job vacancies at the time of application. Applications lacking evidence of available work are not approved.”

Jane Townson, CEO of the Homecare Association, highlighted the challenges faced by ethically operating providers in sponsoring migrant workers due to the Home Office’s refusal to grant certificates of sponsorship. She emphasized the impracticality of guaranteeing hours in advance due to fluctuating care needs, resulting in workers being sent home and providers forfeiting hours of care.

Townson urged for a more balanced approach from UK Visas and Immigration to prevent further strain on health and care services.

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