June 19, 2009

Nurses on call where and when needed 24 hrs x 365 days


Star-News Tuesday June 16, 2009

NURSES ON CALL
By PATSY

Home nursing, though relatively new in the country, provides a much sought after service for patients and care-givers alike.
WHEN Ardy Susanto’s mother was diagnosed with Parkinson’s disease 15 years ago, she knew it would be a long road ahead. Her mother’s deterioration was gradual but eventually, she lost all mobility and could not even feed herself.
In the last five years before she passed away, Ardy and a maid had to help her with the most basic of needs. This included feeding her through a tube (that had to be changed every three months), and helping her with physiotherapy and occupational therapy every day.
Real helping hand: Mohd Naim Mohammad (left) and a nurse from Home Nursing Providers helping his mother, Wan Maimunah Wan Hassan, into a wheelchair at his house in Shah Alam.
Ardy, 48, became a part-time nurse as she learnt how to change, feed and attend to her mother’s other needs. She also learnt how to operate a suction machine used to help extract phlegm.
“My mother had to go to the hospital quite often. Sometimes we would get a doctor to come over. A general practitioner could also see to her medical needs but then that would be no different from making the trip to the hospital,” says Ardy, a senior manager in a publishing company.
That was when she discovered a network of nurses and even therapists, who were willing to make house calls. The private hospital which treated her mother as well as a shop that sold medical supplies recommended a list of places where she could find these “freelance” nurses.
“This was a boon to working mothers like me as it cut down travelling time. It saved the hassle of transporting my invalid mother and queuing at the hospital,” she says.
“These were nurses who had either retired or left their jobs at the hospital. I also managed to get a therapist working at a medical college to drop by after working hours. A nurse helped with the physiotherapy, phlegm extraction and changed the dressing (when my mother had bed sores). They were very helpful and taught my family some of the procedures so that we could do them ourselves to minimise hospital expenses and nurse visits.”
Mohd Naim’s father Mohd Che Leh, a stroke patient, being cared for by a nurse.
Costs varied between RM50 and RM80, depending on the procedure required and this, says Ardy, was reasonable as most private nurses usually charge between RM12 and RM17 per hour for their services.
Placing his aged parents in a nursing home was not an option for Mohd Naim Mohammad, 45, who’s in the construction line.
“I feel it’s our filial duty to take care of our parents. Besides, it’s better to have family members to take care of them and provide company rather than strangers,” he says.
Mobile nurses come in on a daily basis to attend to his mother, 74, who suffers from diabetes and since August last year, has to go for dialysis twice a week. Apart from bathing her, they check her blood pressure and sugar level, and attend to her other medical needs.
A doctor also drops by to provide physiotherapy three times a week for his father, also 74, who had a stroke in 2000. Although he is wheelchair-bound, he is quite independent, and eats and bathes by himself.
“My father is still quite jovial and I think interacting with the family helps keep his spirits up. A friend introduced us to Home Nursing Providers (HNP) and my father has been using their services since 2003 while my mother, who’s now bedridden, started last year,” says Mohd Naim.
Based in Selangor, HNP extends its services to other parts of the country as well. The company offers a team of medical professionals, nurses, physiotherapists and nursing aides. Its core values are geared towards improving the quality of life of the sick, disabled and elderly, and facilitating patient rehabilitation and empowerment.
“My siblings and I take turns to take my mother to the hospital for dialysis, and my children help their grandparents whenever they can,” adds Mohd Naim, who has six children aged five to 14.
“My mother is quite weak but still conversant, and although the two maids help spoonfeed her, we make it a point to eat together with her at the dinner table as a family.”
Although the standard of healthcare in Malaysia is admirable compared to our Asian neighbours, the concept of home nursing is relatively new in Malaysia. Nursing homes or rehabilitation centres differ from mobile nurses as patients usually opt for daycare or long-term stay. The main focus is basic and companion care whereas mobile nurses offer professional medical care. Mobile nursing services is usually made available through:
> A community outreach programme, often initiated by the government;
> Part-time individual agents providing part-time nurses (sometimes foreign nurses) or caregivers;
> Nurses who work full-time in hospitals and make house-calls on their own personal time;
> Private hospitals that extend their services to their own patients as a follow-up service.
Generally, charges are probably cheaper than a hospital visit but if you need a night nurse or nursing aide for longer stays, it may add up to quite a bit. But it’s still more cost-effective than being admitted into hospital (depending on the medical problem).
Some government hospitals offer home nursing services, whereby patients are allowed to recuperate at home under the watchful eye of family members with regular visits from appointed nurses. Hospital Universiti Kebangsaan Malaysia has a home nursing programme – available at a nominal fee of RM10 per visit – but this is only for patients within a 20km radius of the hospital.
Ailments vary from terminal illness to accident cases, and apart from handling medical needs like changing bandages, inserting or removing catheters and feeding tubes, and administering injections, these nurses on call also teach family members how to give emotional support and get the patient’s confidence going.
The home nursing team is chosen from different disciplines. Since the programme involves making important decisions, only senior nurses with at least five years’ experience are chosen.
Private companies that offer mobile nursing services, however, are few and far in between. This niche market is one sector that both the government and private sector should explore to improve healthcare services for the public.
One of the largest healthcare groups in the country, Kumpulan Perubatan Johor (KPJ), the Healthcare Division of Johor Corporation, offers such a service.
Another company, Nurses@Home in Sunway, Petaling Jaya, operated by Sunmed@Home Sdn Bhd (nursesathome.com.my), is hospital-linked and prefers to be called “a nursing solution provider”. It offers simple follow-up visits to comprehensive care plans that include nutrition, physiotherapy, carer training and other disciplines to help the patient achieve full recovery.
“The biggest difference between us and free agents is that we work together with the doctor as part of the treatment cycle (whereas they have no obligation to report to the doctor). We also work closely with pharma-companies by giving progress reports and monitoring the patient (for reaction and side-effects),” says general manager Asok Nair.
Almost 80% of its patients are recommended by various hospitals.
Nurses@Home provides clients with an alternative to prematurely sending aged relatives to nursing homes. About 40% of its services is geriatric care.
The company was set up in 2002 and its work processes are built on healthcare practices in Britain, the United States, Australia and Singapore.
Basically, two main plans are available: Home Visit Plans in which nurses make hourly visits, particularly for patients who need wound management, procedures such as feeding tube changes, catheter changes and even elderly care; and Personal Care Plans, when patients need extended care.
Only patients who are under the care of a physician are accepted.
“Their ages range from infants who are a few weeks old up to a 103-year-old patient. There were instances when our nurses had to accompany sick patients abroad,” Asok adds.
Better known as home health nursing (or clinician) in the United States, the service is usually recommended for hospital patients who are required to stay for a length of time, such as in post-cardiac surgery or trauma (accident) cases.
Devi Ramphal-Edwin, 44, who hails from Trinidad, worked as a registered nurse in the United States before going into mobile nursing in 2000.
“I opted for home nursing after I had my son, as it offered flexible hours. Usually, the nurse takes the lead in such cases and decides on the medical course for the patient – whether his or her condition has improved or deteriorated; needs more or different medicines; and the following course of action. Then she informs the doctor after one or two hours of evaluation,” she explains.
However, the patient must have a clinical problem and be home-bound to qualify for the service.
“Home nursing is seen as the third option after hospitalisation and nursing home or rehabilitation centres. For certain patients, for example, someone who’s had joint replacement, it’s better to be in a home environment. Nurses can easily make a call if the patient gets into distress.
“It’s also good to have a nurse to come around to have a look at mothers after a Caesarean, rather than going to the hospital with a newborn baby and risk infection,” says Devi.
Home health services range from blood testing to dressing wounds, and inserting or removing tubes, or physical therapy.
Home nursing cuts down the need for revisits, risk of infection from the hospital, and medical problems are sometimes detected faster. If there are complications or a higher level of care is needed, then the patient can be re-admitted.
Probably the most significant point to note in the American medical system is that the insurance companies call the shots there, without which optimal medical attention would be difficult to obtain.
“Home nursing doesn’t include geriatric care, unless the patient is certified to have a clinical problem,” adds Devi. who now resides in Malaysia and has since given up home nursing.
HNP-Home Nursing Providers are also assisting patients in SUPPLY of MEDICAL OXYGEN in cooperation with MOX-LINDE Sdn Bhd to improve the efficiency and speed of private home supply of medical Oxygen

FOR FURTHER INFORMATION AS TO THE NURSING SERVICE KINDLY CONTACT:
WWW.HNP-MOBILENURSING.COM
OR NURSING@HNP-MOBILENURSING.COM
or call +603 78777202

June 18, 2009

Mobile nursing on the rise in Malaysia benefits every one in the health section


STAR-NEWS Tuesday June 16, 2009

NICHE nursing


TAKE the concept of meals-on-wheels and apply it to nursing services; that’s mobile nursing in a nutshell. Rather than trivialise the nursing profession, the imagery is intended to help people look beyond the conventional borders of the field.

Generally, the public is more familiar with nursing services in institutional settings like private and public healthcare facilities, clinics or nursing homes. In these environments, the nurse has clearly defined roles and scope of services.
‘Over 40% of patients in long hospital stays are only retained for nursing purposes,’ says Yakob Scholer. She (or he) is usually responsible for many patients at the same time, instead of just one exclusive patient.
In the hospital there’s easy access to doctors, where the nurse can call on for consultation, thereby creating the perception in the public that nurses are mere assistants to doctors.
“This is a misconception as both are professionals in their own right, and their respective duties and responsibilities are complementary to one another,” says Yakob Abdul Rahman W. Scholer,
founder of Home Nursing Providers Sdn Bhd (HNP), claimed to be Malaysia’s first fully-integrated mobile nursing provider. It offers a comprehensive range of medical and nursing services in the comfort and convenience of the patient’s home.
“Mobile nurses are expected to have a higher degree of independence and discretion, and beyond observing medical conditions and administration of prescription, they are supposed to make initial investigations of the patient’s overall health. This is then communicated to the main caregivers with recommendation for further consultation with a doctor,” he adds.
Originally from Mainz, Germany, Nursing Consultant and Applied Psychologist, Yakob first came to Malaysia in 1963. He has since contributed to many health institutions in the country, including Yayasan Pusat Pertolongan and Yayasan Alkoholisma Malaysia in Ipoh, and initiated the first Aid Hot-line and the creation of Malaysia’s first AIDS Awareness Committee (now known as the Malaysian AIDS Council).
Today, Yakob helms HNP as its Nursing Consultant, and conducts various local and international seminars on proper patient care in the home environment. as well as lectures on prevention of bed sores. The nursing services provided by HNP are usually taken up by individuals who need post-hospitalisation care such as those who have had a major procedure done in a hospital, require proper wound management or even terminally-ill patients who need palliative care.
The main criterion is whether the family needs professional support in the care and management of a patient at home. This has to take into account time constraints, or the need for a skilled and qualified nurse due to the patient’s complex condition.
“For example, whilst the family can be coached to perform proper general nursing care such as bathing and feeding a patient, they will still need a qualified nurse to perform other tasks such as taking blood samples, changing the feeding (Ryle’s) tubes or urethral catheters, or performing complex wound management.
Devi Ramphal-Edwin: ‘Home nursing is seen as the third option after hospitalisation and nursing home or rehabilitation centres.’
“I’ve noticed that families who exhibit a deep sense of devotion and filial piety towards their sick family members are more inclined to engage mobile nursing services as they want to assure that the best care is given to the patient,” adds Yakob. If you look at the big picture, the nurses are also regarded as educators, councillors and motivators to the patients and their family members. Mobile nurses are also helpful for stroke patients who need to undergo full mobilisation training to regain strength and functionality in the affected body parts. Apart from having the right physical skills, they can also help motivate and encourage patients to push themselves to the limit. By having a qualified nurse to visit, the length of hospitalisation is reduced, thereby reducing medical costs and expenses for the patient. He or she is also spared the long waiting hours and repeated visits for simple procedures such as blood drawing or wound management at the hospital.
“It is reported that over 40% of patients in long hospital stays are only retained in the hospital for nursing purposes. A recent study in the United States revealed that patients suffering congestive heart failure who receive home nursing care services will require only half the length of acute hospitalisation in their lifetime as compared to those who did not,” explains Yakob, who feels that some patients can recuperate faster in the family setting.
“Then the patient will not feel a sense of loss or rejection which can lead to severe depression, a common occurrence with the sick or elderly placed in a nursing home or long-term hospital care.”
In countries like Germany, the United States and Australia, mobile nursing is officially recognised by government institutions and covered by government-funded social insurance programmes. The family will receive financial support for taking care of the patient at home, based on the severity of the illness and nursing dependency.
There are a total of 11,500 mobile nursing agencies in Germany while the United States has over 10,000 agencies, the majority of which participate in the government’s Medicare insurance programme.
Some countries have streamlined their mobile nursing operations based on areas of specialty and scope of services such as geriatric or paediatric home care, and some focus specifically on terminal and respite care.
“In Malaysia, however, mobile nursing is still a new venture and there is a lack of public awareness of this niche area of medical nursing services. As such, it is yet to be recognised for government financial assistance purposes or private health insurance coverage,” says Yakob.
Based in Kelana Jaya, Selangor, HNP provides consultancy and education, basic and professional nursing, disease and wound management as well as mobilisation, physiotherapy and rehabilitation services. The independent company is private-owned and not attached to any organisation.
Currently, its services are available in Kuala Lumpur, the Klang Valley, Seremban, Malacca and Ipoh. Upon special request, the company has provided services to patients in Penang and Langkawi as well.
The medical and administrative personnel are full-time employees and the nurses, mostly Malaysians, are qualified State Registered Nurses, including male nurses who cater to the needs of male patients.
Recently, HNP has also established its Home Oxygen Therapy arm in collaboration with MOX-Linde Gases Sdn Bhd to supply the products and administer Medical Oxygen Therapy to the Home of patients. – By Patsy Kam

For more details on Nursing Service and Oxigen supply, call the 24-hour hotline ( 03 -7877 7202) or log on to http://www.hnp-mobilenursing.com/. or nursing@hnp-mobilenursing.com

June 15, 2009

Psychological Family Implication in Mobile Nursing


Psychological Implications in Families with a Nursing-dependent Family Member BY
Yakob Abdul Rahman Wilhelm Scholer

Home Nursing is a fledging program in our country (Malaysia) and perhaps in Asia.
While it is regarded in most European countries as a solid Pillar of the Health System, here, mobile home nursing is a rather un-systemized, with various forms of home nursing care, and its importance for the future is grossly under estimated.
We are faced with a series of difference although the pure nursing aspect and the patients’ needs do not differ from that in other countries, or anywhere in the world.
Let me highlight a few differences between the mobile nursing here and those in the European countries.
Finance
In Europe
The cost is borne by the insurance system or public health care funds, or welfare aid.
In Asia
The cost of mobile nursing services has to be borne exclusively by the clients or their families.
Medical Home-Care
In Europe
Family (house) doctors are compelled to visit and attend to very sick people even in their home setting – during regular working time. Some doctors even set aside an afternoon a week to make regular house calls to chronically ill patients and impaired Senior Citizens.
In Asia
There is no regulated house-call system and doctors are generally reluctant or even refuse outright to visit patients in their home, even if the same doctor has attended them in the clinic for decades.
Family System
In Europe
Most senior citizens live in their own residence alone, and their children are wage earners, staying away from the city or region.
In Asia
There is still a common practice of extended family system where 2 to 4 generations live under the same roof. The role of the matriarchal/patriarchal system is not to be underestimated.
Treatment Regime
In Europe
The majority of patients receive treatment according to “Western Medicine” standard medical procedures
In Asia
Still a lot of patients follow traditional medicines and customs, simultaneously or intermittently also the classical western approach of “Western Medicine”
These factors alone have enough potential for conflicting situations, since the more ambiguous situations exist the more space is available for conflicts.
Case descriptions
(All Names have been changed)
Case 1
En Mokhtar, an 84 year old patient suffering of multiple strokes, dementia and diabetes was admitted to a Private Hospital, for removing of slough from a bed sore at the sacrum. The Private Hospital requested the family to contact us for further wound management. Initially we met only two of the daughters of the patient. On discharge from the hospital the rest of the family “surfaced”, lastly the only son who was a medical Doctor. The Patient had developed multiple bedsores, 6 all together. The family of one of the daughters where the patient put up could be described as a real caring “motherly type”. Always interested in what was needed to be done. The wife of the patient being the “matriarch” of the family (after the incapacitation of her husband) would rather listen to the son, “who as a medical doctor is most qualified to judge on medical aspects”. However, this son hardly ever appeared on the scene and met with the nursing staff only after more than 7 months since HNP has taken over the nursing of the father.
The female siblings noting the lack of interest of the brother and the total absence of monetary responsibility, could hardly accept that for any issue of nursing care, the mother would consult the son, who without seeing the father would give some “pacifying advice to the mother” usually agreeing to her opinion, and thereby giving the mother the needed lever to direct whatever kind of nursing and wound management was suppose to be ‘appropriate’.
The modern style of moist wound treatment was for her not acceptable (“it caused smell”) and on pestering the son to change it to a method of drying out the wounds, he finally consented and used “a traditional Indonesian treatment” to dry out the wounds only to terminate the same again 4 days later after noticing the increase of tissue damage caused by the herbal application on the wounds, which were indeed dry, but also caused additional tissue damage. As time went by and the patient suffered a few more minor strokes, the issue of sufficient nutrition consumption arose and to the nursing opinion enteral feeding was pertinent and was recommended by the Hospital on discharge.
However here again the mother/son bond went against the professional opinion of the consulting doctor and the nursing team, causing stress to the rest of the siblings who could observe the decline of their father’s condition and were helpless, as the mother would not allow the insertion of a Ryle’s tube. Ironically, only when the condition became imminently serious, did the mother attempt to ask her son to come and do the needful to improve the condition. Despite of several days of pleading the son did not turn up and only arrive when the cortege had left the house.
Comment
Much suffering of hunger and thirst by Mr. Mokhtar could have been avoided if the family, the son in particular, would have liaison with the nursing team. The atmosphere of tension in the house could be much lessened and be more conducive to the patient’s condition.
Case II
Mr. Firuz is another patient with multiple strokes, diabetes, Parkinson’s, dementia and bedsore.
His children are highly educated and holding responsible position in the society.
Mr. Firuz actually lives in a neighbour state, but due to his illness and the age of his wife the children decided to take him in their own home setting.
We were called by the son with the hope to assist in the professional care of the father.
After the Assessment we made out a plan for a twice-weekly visit, which would include a full bath (shower), colonic washout (due to chronic constipation) and mobilization.
Every family member was agreeable. The request for a hospital bed and a special wheelchair on hire was complied with. The intention was to provide optimal professional nursing care. Due to his mental state Mr. Firuz would scream at the slightest touch on his body, sometimes even before reaching his body.
The procedures of bathing, colonic washout and mobilization were accordingly accompanied by the “obligatory” screams of the patient. In many tests I showed the family that his screaming was not related to the actual procedures but rather part of his mental state.
While the children could observe the situation and were accepting the explanation, the devoted wife was showing her doubts. While the patient refused to sit in the wheelchair the wife insisted on a headrest to provide more “comfort”, and get his cooperation for mobilization. The patient however would only sit “normally” in the wheelchair when the attending nurse places him in it, he refuses to sit in the wheelchair when the family members wanted to place him inside - he refuses to bend his knees and hang in like a “pole”. This caused the family to return the wheelchair plus the special head support on the request of the wife, who did not want the husband to be under “stress”. Expectedly the service of the nurse was terminated, so as to conform to his wishes and the wife’s request. Only a short period later Mr. Firuz decided that decided that sleeping on the floor would please him more than on a hospital bed. Again the “devoted wife” would consent to the “wish of her husband” and requested the return of the hospital bed. The children were under quite a lot of duress created by this: for them it was illogical to conform to the father’s demands yet were unable to influence against the demand and desire of their parents. The attending nurse found himself in a conflict of nursing requirement and the demands of an irrational patient and devotion of the wife.
Consequently we had to withdraw from nursing the patient and allow the family to manage the case as best as possible.
Comment
Over devotion of the wife and the filial cultural mentality of the children were over ruling any sensible and appropriate nursing care. There was no question that the children disagreed with the father’s demand and the mother’s request. But not breaking with the culture and resisting parental request, they would rather allowed the matter to be left to the parents’ control.
Case III
Mrs. Lim, a lady in her early seventies, with unstable diabetes and multiple strokes (on medication) was discharged from hospital and stayed with youngest daughter. Her eldest daughter-in-law called in for our service for regulating the lady’s blood pressure, blood sugar and mobilization. The lady has been unable to swallow properly. We suggested naso-gastric tube feeding but the idea was rejected. However, the youngest daughter is a staunch believer in traditional Chinese medicine/treatment. She took matters into her own hands and stopped all medications from hospital, gave her mother ‘normal’ soft diet (porridge), which she could hardly swallow. One afternoon the maid found the lady unconscious and foaming slightly from the mouth. An emergency call was made to us and we found the lady in a severe hypoglycaemic state. We managed to revive the lady after emergency nursing administration rendered. Only then the youngest daughter consented to her mother to have a naso-gastric tube. Things went on well for a while. After a couple of weeks the old lady went into another crisis - aspirated pneumonia. Apparently the youngest daughter was ‘advised’ by a ‘traditional healer’ to remove the naso-gastric tube, believing that it was the cause that the old lady could not swallow and the tube would cause infection to the stomach. The young lady followed the advice and the mother ended up in a hospital.
The family conflict in traditional and modern medical management became so bad that the eldest daughter-in-law gave up (in order not to be blamed should anything happen to the mother-in-law) and curtailed our service.
Comments
Traditional believes and interpersonal siblings’ altered rolls was making it impossible to provide appropriate nursing that could have helped the patient to ensure a certain degree of life quality.
Summary
Most families here are still a closely-knit entity, where the role of each family member is not always as clear-cut as one may assume. This leads to certain conflicts, particularly when different siblings manage the needs and wishes of the patient and the financial aspect. This is especially so when the nursing requirements and financial limitations do not correspond.
Sibling-rivalry and family conflict may manifest when the issue of nursing care, and medical approaches are an unresolved entity. While on one hand a sibling may have to carry the sole financial burden, the other members of the family may not spare the making of suggestions and remarks as to how best the situation could be dealt with.
The position of a maid who may have made ‘in-road’ into the family system and the skillfully manipulates the family environment to her own end, placing the family at times in a position of being threatened and/or at her mercy.
The nurse, being subjected to manipulation, and solicited by the various sources must survive in this “emotional mine-fields”, perform one’s professional duty without getting entangled in the family dispute or conflict.
Evaluation/Response
The nursing personnel in a mobile-nursing setting must be made aware of these potential dangers and needs information on potential conflicts and guidance in dealing with such situations. To stay neutral and restrain her/his own emotional feelings a nursing agency must have a system where the nursing personnel can turn to in conflicting situations and get the needful guidance such as supervision, group session and individual counseling.
At the end of the day it is the patient who needs the care, and is mostly unable to intervene or make decisions.
Surely this problem is not limited to Malaysian families alone, but will always manifest in situations where:
A. A decision making member of the family has not been appointed,
B. Where money responsibilities play a role,
C. Where neurotic personalities are involved,
D. Where cultural aspects are abused for ones own end

If you are looking for A MOBILE NURSING SERVICE OR A MOBILE DOCTOR PLEASE CONTACT US www.hnp-mobilenursing.com or
nursing@hnp-mobilenursing.com or Phone +603 78777202

June 12, 2009

Know more about Vital Datas


VITAL SIGNS STANDARD
By Yakob Abdul Rahman Wilhelm Scholer

The following are the standard readings applicable in most countries and as a guide to the layperson who may be at lost as to the actual interpretation.

However we recognize that other organizations and schools may vary slightly in the value and reading.
The guide is for persons while awake. In sleep the rates will be (normal) much lower.

Blood Pressure (BP)
(Adult
)
Normal 120-150/90,
High 160-180/100,
Very high >190/100,
Low 110-90/70,
Very low <90/60>
Pulse Rate
Adult
Normal 60-80,
High 85-100,
Very High >110,
Low 50-59,
Very Low <49>
Children
Normal 100-120
High 121-130
Very High >131
Low 80-99
Very Low <80>
Babies and Toddler
Normal 120-140
High 141-150
Very High>150
Low 100-119
Very Low <100>
Breathing
Adult

Normal 18 p.m.
High 25 p.m.
Very High >25 p.m.
Low 12-17 p.m.
Very Low <12>
Children (from 4 yrs)
Normal 25 p.m.
High 30 p.m.
Very High >30 p.m.
Low 20-24 p.m.
Very Low <20>
Normal 30 p.m.
Toddler (from 1-3 yrs)
High 35 p.m.
Very High >35 p.m.
Low 25-30 p.m.
Very Low <25>
Babies
Normal 40 p.m.
High 45 p.m.
Very High >45 p.m.
Low 30-35 p.m.
Very Low <30>
Temperature
Normal 36.0C-37.0C,
Increased 37.0C-38.0C,
Fever 38.0C- 39.0C,
High fever >39.0C
Difference resulting in;
Axillary
37.0 0C
Rectal 37.5 0C
Blood Sugar
Before meals 5-7.2mmol/l,
After meals (90min.) 10mmol/l,
Bed time 8mmol/l

In case you look for Mobile Nursing Service or Mobile Doctor you may contact:
http://www.hnp-mobilenursing.com/ or nursing@hnp-mobilenursing.com or +603 78777202


The value of natural fruits and vegetable to the human body


Subhanallah... Alhamdulillah... Allahu akbar

I wonder if nature is trying to sent us message? Perhaps we need to be at times simplistic to understand more of what the CREATOR has provided us!

A sliced Carrot looks like the human eye The pupil, iris and radiating lines look just like the human eye...and YES science now shows that carrots greatly enhance blood flow to and function of the eyes.
A Tomato has four chambers and is red. The heart is red and has four chambers. All of the research shows tomatoes are indeed pure heart and blood food.
Grapes hang in a cluster that has the shape of the heart. Each grape looks like a blood cell and all of the research today shows that grapes are also profound heart and blood vitalizing food.
A Walnut looks like a little brain, a left and right hemisphere, upper cerebrums and lower cerebellums. Even the wrinkles or folds are on the nut just like the neo-cortex. We now know that walnuts help develop over 3 dozen neuron-transmitters for brain function.
Kidney Beans actually heal and help maintain kidney function and yes, they look exactly like the human kidneys.
Celery, Bok Choy, Rhubarb and more look just like bones. These foods specifically target bone strength. Bones are 23% sodium and these foods are 23% sodium. If you don't have enough sodium in your diet the body pulls it from the bones, making them weak. These foods replenish the skeletal needs of the body.
Eggplant, Avocadoes and Pears target the health and function of the womb and cervix of the female - they look just like these organs. Today's research shows that when a woman eats 1 avocado a week, it balances hormones, sheds unwanted birth weight and prevents cervical cancers. And how profound is this? .... It takes exactly 9 months to grow an avocado from blossom to ripened fruit. There are over 14,000 photolytic chemica l cons tituents of nutrition in each one of these foods (modern science has only studied and named about 141 of them).
Figs are full of seeds and hang in twos when they grow. Figs increase the motility of male sperm and increase the numbers of S perm a S we ll to overcome male sterility.
Sweet Potatoes look like the pancreas and actually balance the glycemic index of diabetics.
Olives assist the health and function of the ovaries.
Grapefruits, Oranges , and other Citrus fruits look just like the mammary glands of the female and actually assist the health of the breasts and the movement of lymph in and out of the breasts.
Onions look like body cells. Today's research shows that onions help clear waste materials from all of the body cells They even produce tears which wash the epithelial layers of the eyes

If you are looking for nursing care you may contact:
Home Nursing Providers www.hnp-mobilenursing.com or nursing@hnp-mobilenursing.com
or call us +603 78777202

June 11, 2009

A truly filial son


A truly filial son!
I home-nursed a 56 years old patient, suffering from lung cancer, with metastasis to the brain. The hospital had sent him home in the “care of the family”. Each time I visited that patient I noticed the 15 year-old son was sitting near his father, at times reading or reciting verses from the Holy Koran; or just to hold his hands, wipe his fore head, or show attention and affection to his father. The young man was of quiet nature and displayed an unusual “maturity” for his age.

I would just admire his way attending to his father and assisting in taking care of him.
On the day of the father’s demise had, I happened to follow directly behind the hearse, which arrived at the cemetery well ahead of the rest of the family members and friends due to severe traffic congestion at the time. This young son followed in the hearse and while we were waiting for the others’ arrival I approached him and asked, “How are you feeling?” He replied instantly with a certain smile, “I just feel good! I will deeply miss my very beloved father but I think I did all I could do for him while he was sick and that gives me a good feeling of contentment and inner satisfaction even though he is now no more around”.
This incident happened more than 3 years ago, yet it is so vivid in my mind that I just feel I to have share it with you.
Are we not all having a beloved parent or spouse or partner in our life? Can we one day feel the way this young man did and say the same? Can we live with the way we treat our parents and others close to us once they have left us?

In the process of caring for the sick particularly those close to us we should always be able to say:
“I did all I could for her/him while she/he was still with us”