Is Colored Bath Tissue Safe?

About twice a year someone will ask me this question. The answer is yes and no. If you've ever had an allergic reaction to any dye products or have just given birth, it's best to stick to plain old white. It's also best for the environment, according to green mavens, especially where septic tanks are concerned.

Assuming you still want that extra splash of color in your guest bath, where do you find it? It is still out there, even though Northern discontinued making colored tissue in the early 1980s. Apparently cost was as much a factor as any concern for customers' allergic reactions. Scott still makes pastel tissue under its own brand and for several smaller companies. The top selling bath tissue is white, with pink and peach following a distant second and third.

However, with the advent of new hypo-allergenic dyes, colored TP is making a comeback. The Renova Company offers specialty bath tissue in black or fuchsia, but it will cost you. Six rolls go for around $13.50 plus shipping.

By now I'm sure you're wondering why such a long answer to such a short question. While I was in nursing school, a co-worker had recently given birth and was concerned about using the tissue at her sister's. When I asked an instructor about the safety of such products, I was promptly told that no one made colored toilet paper anymore-period. I decided not to contest her opinion since she held at least part of my grade in her hands; however, I did write her a poem. Did she like it? Don't know--I never had the bad judgment to send it to her, but here for your reading enjoyment:

We looked around and easily found
Umpteen hundred emporiums
With TP in hues galorium.
So, new mothers won't find it sparse,
But is it safe to wipe their arse?

Now, don't all of you want to redecorate your powder rooms?

Nurse Nan

Nurses on Drugs - What You Can Do

A number of years ago I was involved in a serious automobile accident resulting in broken bones and surgery. The standard pain treatment at the time was Demerol--and not too much of that. Now it's common protocol to control severe pain with morphine; a few weeks of sedation will lead to improved healing--not drug addiction as was once feared.

Even though I was fairly young, I remember one nurse who visited me daily at the beginning of her afternoon shift, asking if I needed more pain meds. At the time I thought she was being kind, but I also wondered why she was the only nurse to inquire about my need for narcotic pain killers.

My curiosity concerning her kindness was answered a few months after I left the hospital. It seems this angel of mercy was pilfering from the medicine cabinet, often stealing half of the patients' meds. Was this nurse a rare exception in the sisterhood of Nightingales? Hardly. A few years later a medicine nurse at ECM was killed over a cocaine deal gone bad. I doubt this nurse started her drug habit with cocaine; I also doubt the hospital's medicine stash had never been the object of her quest for narcotics.

Does a drug habit make a bad nurse? Well...I certainly don't think it makes a better nurse. She or he is often impaired while giving patient care and, as in the the two cases we mentioned, often stealing from the hospital or patient. Obviously there have been enough incidents over the years that the general public is aware of this problem, so why am I addressing it now?

Three weeks ago a candidate for the University of North Alabama's BSN program was arrested for felony drug possession. We understand the charges may either be upgraded...or downgraded to that of a juvenile offender. The question is: Do you want this young man to be your nurse? He may become the best nurse in the history of the profession, but do you want to risk that?

We feel for this young man in many ways, but there is also another reason that we have chosen to make a political and perhaps controversial statement considering this would-be nursing student. A friend of ours died at ECM hospital on Monday. I sincerely hope that Bill's nurses were all caring and competent. Let's make sure that we can say that about all of them.

If you have questions or qualms about any nursing or proposed nursing student at UNA, please use the above numbers to make your feelings known. Nurses aren't perfect, but they should at least be drug-free.

Nurse Nan

Kudos to Discovery Middle School Nurse in Madison, Alabama

School nurses deserve a special place in our prayers. Certainly the nurse at Discovery Middle School on Hughes Road in Madison deserves to be called a hero. When she signed on for the job, I doubt she even considered the possibility of attending to a gunshot victim. Yet, by the accounts we have at this point, this is what she did and did well.

I don't know how much training this nurse had in emergency medicine, but unless she had worked previously as an EMT, probably not much. When she reached the scene of the shooting victim this afternoon, she had to make some decisions and make them quickly.

Emergency medicine uses the "ABC" rule. As she approached the wounded student, he would have probably been lying on his back. No matter the direction of a gunshot, a head wound will usually cause the victim to fall backward. Next she would have seen the blood surrounding his head. Using the "ABC" rule, she would have first ensured a patent airway. His chest would have been rising and falling, even with shallow breaths, so she would have known his airway was patent. Breathing, or respiration, is the second part--she would have ascertained this at the same time she checked the rise and fall of his chest.

The third part of the assessment is circulation. The flowing blood indicated that he needed pressure applied to the wound immediately, but that would have meant turning him over. Did he have a second wound she couldn't see? Had he damaged his spine in the fall? She had to consider these things, but still stop the blood flow. The Discovery Middle School nurse did all these things, from what little we have been told, and she obviously did them in a short period of time with throngs of traumatized students looking on.

If you know who your school nurse is, send her a note of appreciation next week. When the name of the Discovery Middle School nurse is published, I hope everyone realizes what a hero she was in a situation no one should have to face.

Important Information? Try Poster Putty...

Do you know the telephone number for poison control? No, well, you have it posted somewhere, don't you? No, you say there's no where to post it on today's phones?

We have the answer to that problem in two words: Poster Putty. Both 3M and Duck manufacture poster putty. It's available at most big box stores as well as office supply outlets for under $1.50. This miraculous putty won't harm most surfaces and is reusable.

We recommend that you place all your important phone numbers inside a plastic sheet protector and secure it to the wall next to your main phone. It's also great for parents of teenagers who insist on covering their walls with posters of groups you've never heard of. It's also perfect to anchor those small items that toddlers love to pick up and place in their mouths.

Now, you're ready to post all those important numbers; just be sure to tell your mother-in-law that you have no idea where the pizza take-out number came from.

Happy posting,

Nurse Nan

Is That Ankle/Knee Sprained or Just Strained?

After our blog on bandaging cuts and scrapes to knees, elbows, and other hard to wrap areas, we received several inquiries concerning the difference between sprains and simple strains. While a simple strain produces pain, swelling is usually minimal. If the injury is to an ankle, soaking the joint in warm water with Epsom salts is often the best and most economical treatment. Any cuts and abrasions to the area can be wrapped in a simple homemade bandage as we discussed earlier.

If the injured joint is extremely painful and presents with marked edema (swelling), it's best to see a physician for an X-Ray. Remember, docs-in-a-box are not usually set up for treating these kinds of injuries and will in all probability refer you to the emergency department of a hospital. If there are no cuts involved in this kind of injury, it's best to leave the joint unwrapped until you can seek medical treatment. Knees are much trickier to diagnose and often produce more debilitating injuries; they are always best checked out by physician.

If you've suffered previous knee injuries that have resulted in osteoarthritis (OA), you've probably been prescribed COX-2 inhibitors (Celebrex, etc.) to take on a daily basis. There are some new long-term treatments on the market--one, Synvisc-One, is listed in our ads to the right. If one of these treatments doesn't work for you, be sure to tell your physician you aren't getting the results you would like. He or she should be happy to work with you on long-term treatment plans.

Finally, remember if you injure yourself while playing baseball, basketball, football, etc., for the first time in twenty years, be sure to come up with a less humorous explanation for your family and co-workers.

Keep safe,

Nurse Nan

No Stuffed Animals in the Hospital?

What should you take a child in the hospital? That would depend on the child, but we can certainly say what not to take: Large stuffed animals. These stuffed creations look so cute in the gift shop, but in the hospital room much less so.

I've heard some visitors say, "Oh, but they make the child happy." Yes, they do, for a few hours until their pain returns or they begin to feel so much better their only interest is getting dressed and going home. Then the toys are relegated to a corner to take up much needed room or, even worse, set on the floor where they become a hazard in emergencies. Once the child is ready to leave the hospital, the stuffed animal becomes something Mom or Dad has to tote to the car and then find room for at home.

One of the best presents to take a child in the hospital is an activity or pop-up book. They take up little space when folded and are easily transported home to enjoy over and over. Depending on the circumstances, taking some coffee or sandwiches to a waiting parent can be a very much appreciated gift.

With flu season about to start, we hope none of your children becomes ill. Remember to call your physician as soon as possible to set up a vaccination appointment for your whole family.

Nurse Nan

You're Going to Give Me a Shot Where?

Due to a local physician having some problems at his office, we've had several questions concerning just who's who at the doctor's. Here's the run down of what type personnel you will usually find:

Physician - either a Medical Doctor or an Osteopath
Physician's Assistant - these are licensed and usually possess a Master's Degree
CRNP - these highly trained nurses are licensed and also usually possess a Master's Degree
RN - professional nurses; there are currently four kinds practicing in the state, but all have the same legal status
LPN - trade nurses that are called LVNs in some states
Medical Assistant - these are not licensed, do the basics, and do not usually administer injections
Phlebotomist - personnel trained in drawing blood, found in larger offices

If you have any doubt about who is assisting your physician or administering vaccinations, etc., feel free to ask. All competent personnel will be glad to answer your questions concerning their credentials.

The Alabama Department of Health is mounting a campaign for massive vaccinations this fall. Without vaccinations, their estimate is 30% of the state's population will contract swine flu. The vaccine should be available here in early to mid October.

And just where should you get your injection? We've actually had a question about this, and the answer is it depends. Some injections need to be given in a large muscle, usually in the buttock. Untrained personnel can easily injure the sciatic nerve while administering these injections--one big reason to ask who's who if you aren't sure.

If you take frequent injections that don't require a large muscle, standard protocol is to administer the medicine subcutaneously, avoiding the muscle; however, if you receive minimal injections each year, don't hesitate to ask for the shots to be given in the deltoid where less pain and soreness result.

Again, we urge everyone to begin making plans for this year's flu shot. Shots are no fun, but neither is the flu, and we don't want to lose any readers.

Wishing you good health,

Nurse Nan