TOP 10 AMERICAN HOSPITALS

Hospital Name & Link	Job Opportunity Bulletin	Employment Office
1. Johns Hopkins Hospital, Baltimore	Click	Human Resources Divisional Offices Homewood Shriver Terrace Suite 5 3400 North Charles Street Baltimore, MD 21218-2688 Phone: 410-516-8048
2. Mayo Clinic, Rochester, Minn.	Click	200 First St. S.W. Rochester, MN 55905, Tel: 507-284-2511
3. Cleveland Clinic	Click	9500 Euclid Avenue , Cleveland, OH 44195 , Tel: 216.444.2200 or 800.223.2273 ext. 48950
4. Massachusetts General Hospital, Boston	Click	Central Employment Resources, 101 Merrimac St., 5th Floor, Boston, MA 02114, Email careers@partners.org, or Call 617-726-2210.
5. UCLA Medical Center, Los Angeles	Click	CHS 17-253, Los Angeles, CA 90095-1731, Human Resource call (310) 794-0500
6. New York-Presbyterian Univ. Hosp. of Columbia and Cornell	Click	Main Campus 622 West 168th Street New York, NY 10032 Tel: (212) 305-2500
7. Duke University Medical Center, Durham, N.C.	Click	Personal Assistance Service, 2200 West Main Street, 7th Floor, Suite 700, Wachovia Plaza, Durham, NC 27708, Tel: 416-1727
8. Barnes-Jewish Hospital/Washington University, St. Louis	Click	One Barnes-Jewish Hospital Plaza Saint Louis, MO 63110, Phone: 314-747-3000
9. University of California, San Francisco Medical Center	Click	HUMAN RESOURCES 3333 California Street, Suite 305 San Francisco, CA 94143-1202 Phone: 415/476-1645 · Fax: 415/476-4672
10. University of Washington Medical Center, Seattle	Click	1959 NE Pacific, Seattle, WA 98195, Tel : 206-598-3300

Source: US News and World Report

CHECKLIST REQUIREMENTS FOR CEBU HOSPITALS

(Post Submitted by Testis)




CEBU DOCTOR'S UNIVERSITY HOSPITAL:
1. applicaiton letter aadressed to: Engr. Oscar A. Tuason: Administrator, Cebu Doctor's university hospital
2. biodata/resume
3. Two (2) letters of recommendation from the Dean of the college last attended & or from the company where the applicant has been employed last.
4. I.D picture- 8 pcs. (1x1) in uniform (bluebackground)
5. photocopy of the following:
TOR and RLE ,
College diploma ,
Board rating,
Board certificate,
Prc license,
PNA card,
NBI or police clearance,
birth certificate,
marriage contract (if married),
SSS E-1 form

*(SSS E-4 if married PLEASE PRESENT YOUR ORIGINAL DOCUMENTS UPON SUBMISSION OF YOUR REQUIREMENTS)




CHONG HUA HOSPITAL:
3 pcs, 2x2 picture 2 photocopies each of the following and segregate Application letter
(adress to Mrs. Susan V. Canono: HRD manager : chong hua hospital: Fuente Osmeña, Cebu City 6000 ,

Recommendation letter from the dean,
PNA card,
PRC license,
SSS no., TIN no.,
SSS no.,
Philhealth no.,
Certificates of previous employer (if any) ,
community tax,
Professional Tax Receipt(PTR) ,
TOR, RLE, Board rating,
Board certificate,
College Diploma,
NBI Clearance, Birth certificate, ,
Marriage contract (if married)
NOT MORE THAN 35 YRS OLD

DRUG FOR SMOKERS

The drug varenicline tartrate, was approved by the U.S. Food and Drug Administration.

Indication :
Short and Long term Smokers trying to Quit

Action:
Mimics the effects of nicotine to help offset cravings, and in the presence of nicotine it helps suppress some of the reinforcing effects of smoking.

Study Overview:

Mitchell Nides, Ph.D., of Los Angeles Clinical Trials, and colleagues with the Varenicline Study Group conducted a randomized, double-blind, placebo-controlled study to evaluate the efficacy, tolerability and safety of varenicline for smoking cessation. Healthy smokers aged 18 to 65 years were randomly assigned to receive varenicline in a dosage of .3 milligrams once daily, 1 milligram once daily, or 1 milligram twice daily for six weeks, plus placebo for one week; to 150 milligrams of sustained-release bupropion hydrochloride twice daily for seven weeks; or to placebo for seven weeks.

"In this study, varenicline tartrate, 1 milligram twice daily, effectively helped subjects quit smoking, with response rates three times higher than those for placebo while demonstrating a good tolerability profile in this population of smokers who on average had smoked approximately 20 cigarettes per day for approximately 24 years," the authors write. "Efficacy was maintained in the non-drug treatment phase through week 52. The significant reductions in craving and in some of the rewarding effects of smoking seen with varenicline tartrate, 1 milligram twice daily, may assist in promoting abstinence and preventing relapse," they conclude. (Arch Intern Med. 2006;166:1561-1568. Available pre-embargo to the media at http://www.jamamedia.org/)

pfizer made it ;-)

Herbs: Toxicities and Drug Interactions

Chamomile

Uses: Chamomile is often used in the form of a tea as a sedative.

Reactions: Allergic reactions can occur, particularly in persons allergic to ragweed. Reported reactions include abdominal cramps, tongue thickness, tightness in the throat, swelling of the lips, throat and eyes, itching all over the body, hives, and blockage of the breathing passages. Close monitoring is recommended for patients who are taking medications to prevent blood clotting (anticoagulants) such as warfarin.

Echinacea

Uses: Largely because white blood cells in the laboratory can be stimulated to eat particles, Echinacea has been touted to be able to boost the body's ability to fight off infection.

Reactions: The most common side effect is an unpleasant taste. Echinacea can cause liver toxicity. It should be avoided in combination with other medications that can affect the liver (such as ketaconazole, leflunomide (Arava), methotrexate (Rheumatrex), isoniazide (Nizoral).

St. John's Wort

Uses: St. John's Wort is popularly used as an herbal treatment for depression, anxiety, and sleep disorders. It is technically known as Hypericum perforatum. Chemically, it is composed of at least 10 different substances that may produce its effects. The ratios of these different substances varies from plant to plant (and manufacturer). Studies of its effectiveness by the National Institutes of Health are in progress.

Reactions: The most common side effect has been sun sensitivity which causes burning of the skin. It is recommended that fair- skinned persons be particularly careful while in the sun. St. John's wort may also leave nerve changes in sunburned areas. This herb should be avoided in combination with other medications that can affect sun sensitivity (such as tetracycline/Achromycin, sulfa- containing medications, piroxicam (Feldend). St. John's wort can also cause headaches, dizziness, sweating, and agitation when used in combination with serotonin reuptake inhibitor medications such as fluoxetine (Prozac) and paroxetine (Paxil).

Garlic

Uses: Garlic has been used to lower blood pressure and cholesterol (Dr. Lucinda Miller notes that there is "...still insufficient evidence to recommend its routine use in clinical practice.")

Reactions: Allergic reactions, skin inflammation, and stomach upset have been reported. Bad breath is a notorious accompaniment. Studies in rats have shown decreases in male rats' ability to make sperm cells. Garlic may decrease normal blood clotting and should be used with caution in patients taking medications to prevent blood clotting (anticoagulants) such as warfarin /Coumadin.

Feverfew

Uses: Most commonly used for migraine headaches.

Reactions: Feverfew can cause allergic reactions, especially in persons who are allergic to chamomile, ragweed, or yarrow. Nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen (Advil), naproxen (Aleve) or Motrin) can reduce the effect of feverfew. A condition called "postfeverfew syndrome" features symptoms including headaches, nervousness, stiffness, joint pain, tiredness, and nervousness. Feverfew can impair the action of the normal blood clotting element (platelets). It should be avoided in patients taking medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin).

Ginko Biloba

Uses: This herb is very popular as a treatment for dementia (a progressive brain dysfunction) and to improve thinking.

Reactions: Mild stomach upset and headache have been reported. Ginko seems to have blood thinning properties. Therefore, it is not recommended to be taken with aspirin, nonsteroidal anti-inflammatory drugs (Advil), naproxen (Aleve) or Motrin), or medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin). Ginko should be avoided in patients with epilepsy taking seizure medicines, such as phenytoin (Dilantin), carbamazepine (Tegretol), and phenobarbital.

Ginseng

Uses: Ginseng has been used to stimulate the adrenal gland, and thereby increase energy. It also may have some beneficial effect on reducing blood sugar .in patients with diabetes mellitus. (Dr. Miller emphasized that there is substantial variation in the chemical components of substances branded as "Ginseng.")

Reactions: Ginseng can cause elevation in blood pressure, headache, vomiting, insomnia, and nose bleeding. Ginseng can also cause falsely abnormal blood tests for digoxin level. It is unclear whether ginseng may affect female hormones. Its use in pregnancy is not recommended. Ginseng may affect the action of the normal blood clotting element (platelets). It should be avoided in patients taking aspirin, nonsteroidal antiinflammatory drugs (such as ibuprofen (Advil), naproxen (Aleve) or Motrin), or medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin). Ginseng may also cause headaches, tremors, nervousness, and sleeplessness. It should be avoided in persons with manic disorder and psychosis.

Ginger

Uses: Ginger has been used as a treatment for nausea and bowel spasms.

Reactions: Ginger may lead to blood thinning. It is not recommended to be taken with medications that prevent blood clotting (anticoagulants) such as warfarin (Coumadin).

Saw Palmetto

Uses: Saw palmetto has been most commonly used for enlargement of the prostate gland. (Dr. Miller emphasized that studies verifying this assertion are necessary.) Saw palmetto has also been touted as a diuretic and urinary antiseptic to prevent bladder infections.

Reactions: This herb may affect the action of the sex hormone testosterone, thereby reducing sexual drive or performance. Dr. Miller states that "While no drug-herb interactions have been documented to date, it would be prudent to avoid concomitant use with other hormonal therapies (e.g., estrogen replacement therapy and oral contraceptives...")
This listing represents only a small portion of herbal treatments. Nevertheless, the popularity of herbal therapies is unquestionable. Doctors routinely confront the unknown with their patients who are using herbs. Doctors simply do not have any way of helping you to decide whether these herbs are helpful or harmful for you, or whether they are interacting with your current medications. There are no data.

Black Cohosh

Claims, Benefits: A natural way to treat menopausal symptoms.

Bottom Line: Little is known about its benefits and its risks. If you try it, tell your physician, since it might interact with other medications you are taking.

Helpful Hints: Female Patient Urinary Catheter Insertion

With some female patients, insertion of a urinary catheter can be difficult. The level of difficulty can increased due to variations in anatomy, or swelling related to medical procedures or disease processes. These situations can serve to obscure visualization of the urinary meatus, thus complicating catheter placement.

Additionally, when a woman is supine for the catheter insertion procedure, it can cause the urinary meatus sink down, just inside the vaginal opening, resulting in the clinician being unable to visualize it.

The following “thumb method” of catheter insertion has worked well for me when I have had a female patient whose urinary meatus is not immediately visible.

Gather your supplies; include an extra catheter. Set up your supplies and prep the patient. Placing a folded towel under the patient’s lower back at the sacrum can aide in optimum positioning of the patient. If appropriate, a physician’s order for sterile topical lidocaine jelly can be obtained. Using this jelly in the place of KY Jelly can promote comfort and prevent pain from manipulation of the tissues in this invasive procedure. This is especially important with patients who may be sensitive due to trauma to the tissues, or disease processes.

With your non-dominant hand, use your thumb and place it approximately one half to one inch below the clitoris, pushing slightly in and upward at the same time. This will cause the urinary meatus to be visible, and places tension on the tissue, stabilizing it. If the tissue is wet due to bleeding or drainage, you can wrap your gloved thumb in a sterile 4X4 to prevent slippage.In this way, the meatus does not get pushed inward or "roll" when you insert the catheter. Additionally, positioning your thumb in this way holds the labia minora in a retracted position, keeping it out of the way.

When you are ready to insert the catheter, be sure to grasp it no more than approximately one and a half to two inches from the distal end. This will aide in keeping the insertion end stable, and prevent it from moving and being inadvertently placed into the vaginal opening.

The "wink" method of locating the meatus by wiping with a providone iodine swab does not work if the meatus is just inside the vaginal opening, and not visible. With the tissue stabilized as stated above, you can then wipe with your swab, and you will plainly see the "wink". Then, drop your swab, and pick up your catheter. With the tip pointed at a slightly upward angle, and insert. If the catheter inadvertently goes enters the vagina, leave it there before attempting insertion of a new catheter. The misdirected catheter will serve as a landmark, which will assist you in correct placement on your next insertion attempt. You will be able to see where not to direct the catheter on your next attempt.

Utilizing this method has served to make difficult catheter insertions more comfortable for my patients, and less time consuming for me.

Patient Teaching Guide: Coumadin Therapy

This is an informational guide that I created for patients who are presently on Coumadin or expected to be on Coumadin upon discharge. It is in article form because it was a freelance article that I wrote. As we all know, it is up to nurses to do patient teaching, not the doctors! It is written in simple terminology that all patients can understand. When I was a home health nurse, it seemed that I was always doing research on diseases and conditions so that I could make up my own patient teaching guides. Not all hospitals have teaching resources on hand for nurses to use. Feel free to use this for teaching purposes if you wish.

The medication Coumadin is classified as a an anticoagulant. It is also known by its generic name, warfarin. Coumadin is, simply put, a "blood thinner". It thins your blood to prevent blood clots from forming. There are several medical conditions that warrant the use of Coumadin. Here, we will discuss just a few.

Pulmonary Emboli (PE): A pulmonary emboli is a blood clot in the lung. When you are hospitalized with a pumonary emboli, anticoagulants will be administered in either injection form (Heparin or Lovenox) or as an IV drip (Heparin drip). After the blood clot has resolved and you are discharged from the hospital, you will probably be given a prescription for Coumadin to take at home.

Deep Vein Thrombosis (DVT): A deep vein thrombosis is a blood clot deep in the vein. These usually develop in the legs. If the clot is serious enough to require hospitalization, you would be treated with either Heparin or Lovenox injections or a Heparin drip. Again, Coumadin is usually prescribed after hospitalization to prevent another blood clot from forming.

Atrial Fibrillation (A-Fib): Atrial fibrillation is an irregular heart rhythm. For some, this is a chronic condition, which means that their heart beats irregularly all the time. Patients with atrial fibrillation usually take Coumadin for the rest of their lives to prevent blood clots. With atrial fibrillation, blood clots can occur because the heart is pumping blood out at irregular intervals, so the volume of blood in the circulatory system is not consistent.

After hip and leg surgery: Surgery of the hips and legs requires some bedrest after surgery. This period of immobility can cause blood clots to form because your range of motion is compromised. Although precautions are taken to prevent blood clots after surgery, Heparin or Lovenox injections are usually used as well. Physical therapy is usually started in the hospital and then continued at home. When you are discharged home, you will be usually be on Coumadin short term.

What are the risks of taking Coumadin? The main risk is that your blood may become too thin. This is why your doctor will want you to have your blood drawn regularly to check the PT/INR. The PT/INR results will tell your doctor how long it takes for your blood to clot and adjust your Coumadin dosage accordingly. It is very important to follow your doctor's orders concerning the blood work and dosage changes. Signs and symptoms of abnormally thinned blood are bleeding from the gums, excessive bruising, black, tarry stools (very dark or black bowel movements the consistency of tar) and blood in your urine.

As with most medications, Coumadin should be taken every day at the same time. Ask your doctor what time he wants you to take it. Usually it is in the evening hours. If you miss a dose, you will need to contact your doctor so he can advise you what to do.

When you are taking Coumadin, there are some important things to remember. You should avoid an excessive diet of foods that are high in Vitamin K, such as green leafy vegetables, broccoli, green onions, asparagus and olive oil. Coumadin and Vitamin K work against each other. Vitamin K actually helps thicken the blood. It is given in injection form when someone's blood is dangerously thin. You should also avoid dangerous or hazardous activities which could result in bleeding or fractures. You should use a soft bristle toothbush when brushing your teeth. Carry a card with you at all times that states that you are on Coumadin. Be aware of any signs of abnormal bleeding and report them to your doctor immediately. Let all of your physicians know that you are on Coumadin.

Coumadin, when taken as prescribed, works very well. By knowing a little bit more about this medication and following these tips, you become an active participant in your medical care.

Some information in this article provided by Mosby's Nursing Drug Reference, 2007

TEST TAKING TIPS FOR NURSES

Parts of a Multiple Choice Test Question
The question contains several parts:

· the case (sometimes called scenario) - the description of the client and what is happening to him/her.
· the stem - the part of the question that asks the question.
· the correct response.
· the distracters - incorrect but feasible choices.

Key Words
The most important skill for the test taker is the ability to read the question carefully and determine the key elements in the question. Each question has key words. Key words relate to the client; to the problem; and to specific aspects of the problem

Client
Factors such as age, sex, and marital status may be relevant. When a child's age is given it often is very relevant to the answer. Vital signs vary with age. Preoperative teaching methods vary with age. Appropriate toys and diversional activities vary with age. Always pay special attention to the age of a client when it is given. Also, consider who is the client for this question. That is, who is the focus of the question? The client may be the identified sick person, or it might be a relative of the identified sick person, or even a staff member.

Problem / Behavior
The problem may be a disease, a sign, a symptom or a behavior.

Details of the Problem
· Is the question asking for nursing actions or client symptoms or family responses?
· Does the question ask about a specific aspect of nursing care assessment, planning, implementation, evaluation?
· Does the question ask details relevant to a specific symptom or behavior the client exhibits?
· Is there additional information about the client or the problem that is important?

Priority Setting
Many questions on the exam ask the nurse to set priorities. Priority can be asked in several ways.
"What action takes priority?"
"What should the nurse do first?"
"What should the nurse do initially?"
"What is essential for the nurse to do?"

Physiologic needs are first, followed by safety needs, then love and belonging, self-esteem and self-actualization.

The first step of the nursing process is assessment! When the stem of a question asks for the initial nursing action always look to see if there is a relevant assessment answer. The nurse will take an action only when there is enough data upon which to act. Call the physician only when there is not a nursing action that should be taken first. The stem of the question may ask for a nursing action and the correct answer may be to assess.

When the stem of the question asks what is essential for the nurse to do, think safety. Remember many of the test questions are safety questions.

What is the Time Frame?
Whenever a specific time frame is indicated in a question it may be very important. Pay attention to it. Time related words may be words like early or late in relation to symptoms, pre operative or post operative, care on the day of surgery or later post-operative care.

Repeated Words
Words from the question are repeated in the answer. Sometime the same word or a synonym will be in both the question and the correct option.

Opposites
When two answers are opposite such as high blood pressure and low blood pressure or increase the drip rate and stop the IV, or turn on the right side and turn on the left side, the answer maybe one of the two.

Same Answer
If two or three answers say the same thing in different words none can be correct. If the answers are too alike, then neither one is correct.

Odd Answer Wins
The answer that is different from the others may be the correct answer. It may be the longest or the shortest or simply very different in content or style.

Umbrella Answer
One answer includes the others. There may be more than one correct answer. One answer is better than all the others because it includes them.

Absolutes
Answers containing universal or absolute words are very apt to be incorrect. Very little in life or nursing that is always correct or incorrect. Answers stated in absolute terms should be looked at with great caution.

“Deadly”
All every total
Nothing always each
Only any nobody
Never none

“Dangerous”
Main chief avoid primarily
Major shall inevitable eliminate
Rarely impossible too

“safe”
Usually almost frequently probably potentially
may sometimes partial some might
should few essentially generally occasionally
nearly maybe could commonly average
seldom often normally

TEST ITEM CHECK LIST

Use this handy list to check yourself every time you answer a test question.

Say to yourself,
DID I CAREFULLY….

o Read the stem?
o Read all the options?
o Read the stem again?
o Look for key Words?
o Eliminate obviously incorrect options?


Goodluck!!! Tips from O'Grady Peyton International...Thank You!