Nursing Notes : How Nurses provide Family Planning services during COVID-19

Providing family planning services during covid-19.

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Importance of contraception during COVID-19:

1. If the information is less about COVID 19 to the pregnant mother and aware about the effect of foetus especially during organogenesis.

2. Data available is only for 3 months old and we do not know the future of the diseases.

3. Important is  that patients have access to information and services during the outbreak.

4.Ensure that people have access to the contraceptive services will reduce the pressure on the health care system, to manage the consequences of an unintended pregnancy.

Contraceptive choices:

1. Advice to use the method that do not have many medical restrictions like mini pills, condoms, and fertility awareness- based methods

2. Women who are  already taking oral contraceptives can continue doing so.

Women who are  COVID -19 Positive and want IUCD and sterilization should delay and approach the hospital after the period of isolation.

3. Emergency contraceptive pills can prevent up to 95% of pregnancies when taken within 3 days after intercourse, and they can be taken by anyone with or without a health condition. 

 Responsibilities as a Family service provider :

Ensure that all women irrespective of their COVID 19 status receive:

1.Counselling on all contraceptive methods.

Contraceptive of their choices.

2.U proper hand hygiene and respiratory hygiene while delivering these services.

Provide emergency contraceptive pills as soon as possible after unprotected intercourse.

3. If given ECP, offer a supply of regular contraceptive of choice.

4. Do not refer women for sterilization at this time.

Keep in mind that:

1. Many migrant men have returned to villages, hence need for contraception in the villages may have gone up.

2. people get services at their homes, the travel will reduce and people will not need to go shops or centres for services.

Do's for women who is suspected/ confermed case :

1. In case the women is suspected/ confirmed COVID 19 positive:

2. She is using a method, should be encouraged to do the same  and delay visit to the hospital or clinic unless it is an emergency.

3. Advice her to use teleconsultations using helplines and telemedicine facilities

PPFP and PAFP

Post partum and post abortion family planning services should be offered to all women irrespective of her COVID status

Due diligence to provide standard care of management of COVID-19 positive should be followed.

ANTRA, MPA (Injectable contraceptive OCP's)

1. If the women is unable to visit the subcentre, Inform the women that there is flexibility in the use of MPA, Even if a user of Antra (MPA) goes a few days late (up to 28 days), her next injection can be given, similarly even if she goes a few days early, the injection can be given up to 14 days earlier the scheduled date.

2. The user is late for the next Antra (MPA) Injection, if she is more than 28 days late from the last injection :

Rule out the pregnancy, if not pregnant (give her next dose).

Note: Whether  a women is late for reinjection or not, her next injection of MPA should be planned for 3 months later.

3. If the women is switching from antara (MPA) to OCPs, it can be started any time , if she is within the scheduled date of due injection and start the method with a backup support, However if she is beyond 4 weeks of scheduled next dose, pregnancy should be ruled out and she may need a backup for 7 days.

4. How much time it takes to become pregnant after discontinuing Antara (MPA) Women who discontinue Antara have to wait  for an average 4-6 months longer to become pregnant than women who have other methods. 

5. women should not be worried if she has not become pregnant by 12 months after stopping use of Antara (MPA). The length of time a women has used Antara (MPA) makes no difference to how quickly she becomes pregnant once she stops having injections.

Can a ANM and staff nurse give ANTARA to a women who is a new user : 

1. Antara can be given by ANM Staff nurses to a women provided that they have been trained in it use, and have obtained the required skills. 

2. For the 1st dose, it is recommended that the eligibility screening is done under the guidance of a trained MBBS doctor at a PHC.

 3. If a women is only able to reach up to a subcentre for cannot reach a PHC\CHC for Antara (MPA) injection, then however, the new user should start only after ANM is supervised by a MBBS doctor. 

4. If the scheduled follow up visit for getting the next dose of MPA injection is in the lockdown period, A client should visit the nearest sub centre and get the dose from the ANM.

5. Or contraceptive pills, combined oral pills and CHHAYA.

6. In the lockdown period the OCP’s are easily available in the nearby chemist. If the supply is available should take a supply of 3 months period, so that the women not have to go repeatedly to buy.

7. If the women is an OCP user and she has missed pill, if a women has missed 1 pill she should take the next dose as soon as she remembers. If she has missed 2 pills, she should take 2 pills on each of the next 2 days. Then should continue to take one pill every day. If she had missed 3 or more pills then she should stop further pills and use condoms for the next 7 days. She should start a new packet of pills after her next cycle. 

IUCD

1. It is advisable that  women should avoid IUCD insertion during lockdown, to reduce contact with the health care centre.

2. IUCD is removed just because the duration is over, remember that a copper IUD continues to be effective for at least 1-2 years longer after its recommended duration, e.g. copper T 380A effective for 12 years.

3. A women wishes to have her IUCD removed because of an health issue such as bleeding or pain she can go to a nearby subcentres or PHC and get it removed.

4. If a women wants to switch an IUCD from some other method, she should be advised to use condoms or OCP till she is able to visit a health facility for removal, under the lockdown situation. 

Demands of emergency pills during covid 19 situation:

1. Many migrants have returned home, and the couple may not sing contraceptives earlier.

2.Problem  in travel and buying contraceptives greater risk of domestic violence, sexual coercion and unprotected sex.

3. Irregular supply of regular contraceptives.

Women could not get her scheduled injections of DMPA.

Ran out of supplies of OCPs/Condoms.

1. If there is any situation if did not have a supply of condom and had an unprotected sexual intercourse then in that emergency situation she can take ECPs, for such situation, ASHA should supply her for sufficient number of condoms and ECP, if she has sufficient stock availability.

2. If the women ask for supply of emergency contraceptive pill in advance, then provide her with sufficient supplies of ECP to cover the needs of emergency contraception, since it is better to prevent a pregnancy through emergency contraception rather than women having an unwanted pregnancy.

3.Women and men should have access to regular method of reversible contraceptive during COVID 19.

 Important points to remember:

1. Sexual and reproductive health services are being severely impacted by the pandemic, they must be prioritized.

2. Provision of contraceptives, information, counselling and services (including emergency contraception) is life saving and should be continued during the COVID 19 pandemic response.

3. In order to reduce workload on health facilities and to reduce the risk of crowding in hospitals , it is not advisable at this time to refer women for sterilization, hence focus on reversible methods, irrespective of number of children.

Career After B.Sc. Nursing

Career  after BSc Nursing 

Confused ? 

We have various opportunities after completing our under graduation of nursing and sometimes we are a bit confused what we should  do after our graduation in nursing.

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There are several questions which comes in your mind after completing B.Sc. Nursing, which I am going to explore here.
It is also depend on your mind setup that either you want to work on the bed side (hospital)  or in the college as a tutor or somewhere else.

Can you be a doctor after completing BSc Nursing ?

Yes you can, most of the nursing students have dream about becoming a doctor before choosing a nursing profession.

If you have completed your BSc Nursing you can give a NEET exam, but you have to remember that you have already been wasted your 4 years in B.Sc. Nursing and again if you are giving neet exam to do your MBBS then it takes more 5.5 years.

As MBBS is not enough you also have to do PG so almost you have to been there for 15 years of study,  this will be very bad idea to you think about doing MBBS after BSc nursing.

Can I be a tutor after BSc Nursing ?

Yes ofcourse, if you have completed your BSc nursing with good results, you just have to gone through interview with your resume and the college will select on the basis of of your UG results or they will take a demonstration class to watch your ability.

Can i choose for Staff Nurse ?

As the student you have gone through four year to complete your B.Sc. nursing most of the students will go for working in hospital only.
 You can also try for other states in India for staff nurse in hospital and for that you need nursing state council registration prior going to any other state or if you have decided to go in the other country you must have  experience of at least 2 or 3  years as well as National council certificate.
Basically, if you are interested to go other country you must have 2 to 3 years of experience.

Options of higher studies after B.Sc. Nursing?

After BSc Nursing if you want to level up in your career you can choose to do Masters in nursing in which  have an option of various branche like psychatric , obstetrics and gynaecology, community health, medical surgical nursing and pediatrics.
For obtaining masters degree (2yrs course) first you have to clear your entrance exam for masters. after passing on the exam the counselling will be held and according to your rank you will be selected.
You can also choose for diploma degrees  in your concerned subject.

For pursuing PhD in nursing you must have a degree of MSc nursing.

You also have a chance of doing  Sectoral MBA in which you can persue Pharmaceutical management and MHA i.e. (Masters in health administration).

Students who want to pursue MBA degree can give an exam of CAT XAT or MAT. after pursuing this course you have an option of HR, finance, supply chain.

Thinking about government job after B.Sc Nursing?

Nowadays it is very tough to compete the government exam.
You can also take coaching classes to appear for Government exam.
After B.Sc. nursing you can try for, SSC UPSC, banking and Railway government jobs, as well as you can be recruited for hospitals like Central Government hospital.
 For the central government job or any other type of government jobs in Nursing field you have to compete the competitive exams.

Military Nursing  After completing B.Sc. Nursing?

If you want to become a military Nurse you should have completed your B.Sc. nursing/M.Sc. Nursing.
After completing it you have to prepare for SSC (short service commission)  which is only available for the female aspirants.
To become an Indian Military nurse you can serve anywhere  as Air force, Armed force or Navy force, and there will be a tenure of 14 years.

How student Nurses should study or concentrate ?

How student Nurses should Study or concentrate

It is very common as every RN is known about life of their student Nurse. Practically or Theoretical it is tough to balance both.

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 As usually if the student Nurse is planned to come in the Nursing profession then she/he will make more success and confidence in life rather then  those who are not mentally prepared to do Nursing.

Nurses Student life is tough though!
Mixing up both Theoretical and clinical practical life is as tough as doing MBBS. I am not comparing the degrees here but telling the truth.

In the beginning of your student Nurse life is very hard, competitive and full of struggle. 

Certain tips which should follow by the student Nurses :

For being a good Nurse should always be regular in the clinical duties, through  we learn IPR with patients as well as with other health care practitioners. Also we see the live work and can make your self skillful.

The hospital is the only place where we can get a lot of information about Nursing.

You should have general informations related to the ward updates and should be present in the Doctor's round, It is very essential to go in the doctors round so that the student Nurses get to know about the  recent updates of patients  progress.

If you Don't know anything in the first day of your clinical duty, have patience and ask everything to the senior nurse before you do  anything.

Study daily whatever the teacher have given a lecture in the class, Revise it after completing your college session.

Difficulty in study? or not able to memorize the answers?

We all know that memorizing the answers is the most difficult thing,
if you are have difficulty while study in any topic you should try to study with the help of mnemonics.

Mnemonics means we make a word which assist to learn very easily.
In every type of study which are theoretical mnemonics will be very helpful to study difficult content.
whatever you are studying the first letter of each and every topic make together and make a word that word will be known as mnemonics and through that word we can named, which can be easily memorized.

Mnemonics is commonly used in pharmacology subject because pharmacology has difficult terms which cannot be easily memorized.

Are you not able to concentrate in your studies ? 

 If you are not able to concentrate in studies do meditation it will be very helpful to concentrate in everything, keep hydrate yourself.

prepare your notes so that it will be helpful in your exams.

 Be focused whenever you planned to study.

Take breaks dont study continuously for hours.

Do you get confused before your exams that the topic you have studied is from which book ?

whenever you start study take the syllabus and write with the pencil  that you have completed the topic from which book.

because in the exam time you may get confused that from where you have studied the topic.

or if you have studied the topic from the internet or any website write the the site it in your syllabus, show that in the exam time you should know the site from where you have studied.

 Make your study environment peaceful 

The more your study environment is peaceful the higher your concentration will be. but it is not important that the area will always be noise free sometimes we have to adjust ourselves and make our study area to the other place for temporary.

 Evaluate your performance
Whatever you study evaluate yourself, keep memorizing in your mind what you have studied.

How to write Answers in the exam of B.Sc. Nursing/ M.Sc. Nursing mainly in Ayush Health University C.G.

How to Write Answers in B.Sc./M.Sc. Nursing Final year exams

As the University has changed the rules in the pattern of question paper and answersheet. Since 2019 Ayush health University has ruled out to not give the extra sheets to the students.following things students should remember before staring the answers.

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May be this happened because most of the students write their answers by expanding it, adding extra point by themself.

Note : The content which I have written here is my personal opinion not from the university. 

1. you will get 45 pages of answer copy in that you have to answer your questions.

2. Divide your answer sheet according to the number of question so that you will easily answer your all the questions, before starting the answers use your pencil, mark question numbers in each page whenever you end your first question.

3. Answer all the question in sequence, don't jumble your answers in answer sheet. otherwise checker may get confuse.

4.Understand the questions carefully,read it twice then answer it.

5.Prepare yourself before exam in which pattern you will write in the exam

6. Pattern for 15 Marks question

(a) Try to start your answer with Introduction, writting introduction will make an impression to the checker and shows that you know very well about the topic.

(b) Write the answer according to your question, always add atleast 3 definitions with authors name.

(c) The sign and symptoms and causes should be properly explained, don't use common sign and symptoms add the authentic symptoms which is related to your question.

(d) Make arrow symbol while writing pathophysiology.

(e) Try to add diagrams with labelling if the question is asked related to organ.

(f) Make atleast 3 Nursing care plans as asked in the management of your question.

(g) Add conclusion in your long answer type questions, it is not necessary to add but if you have good writing speed you can add conclusion.

(h) Underline your headings and sub-headings to make it clear.

7. Pattern for 10, 12, 8 Marks question it will be same as 15 marks question

8. Pattern for 5 marks question SAQ (Short answer Type questions)

(a)Th Answer should be either started from the Introduction or Definition depends on your time.

(b) Don't add conclusion in SAQ because it will take time and not meant for 5 marks question

(c) Write answers point wise. Never wirte your answers in paragraph.

9. Time management is very essential, you must divide your question according to 3 hours.

10. It is very important to put exact question numbers when you start your answer, dont forget to write question number.

11. In the last 2 minutes check your whole answers.

12. Add specific, senseful words in you answer.

13. Clear your doubts with the invigilator if you have any.

If there is any doubt comment me or mail me.

How to Prepare yourself for B.Sc. Nursing/ M.Sc. Nursing Final University Exams

How to Prepare yourself for B.Sc. Nursing/ M.Sc. Nursing University Exams

As we all know that every Nursing students life is very difficult now a days. also because of corona virus we are not able to study properly, and having deficiency in notes is the biggest issue now a days.

Image source - Google|Image by Gergely Kishonthy 

Basically Nursing profession is not that much easy as everyone thought about it.  Here i will give you suggestions to make your life easier while corona virus and study. Through some points i will explain you how to complete your syllabus with easy steps:

 1. If you are preparing  from the beginning of your session  :

That's tremendous if you are preparing for your better marks and good results. Preparing from the starting will make your schedule very easy to follow. 

(a) The first thing is complete your assignments as soon as you do. so that you start study with the stress free mind. completing your assignment will make your standard level in your own and you will be confident for further studies. 

(b) Make your schedule Start follow the scheduel which you had made. don't lose concentration otherwise you won't be able to follow the schedule.

(c) Gadgets timing As we are in the 21st era we use mobile phones and have an bad habbit to use it continue, which may affect your schedule. 

(d)Study material make sure that you dont use only one book for study. if you are studying  some topic go for library and make notes from different books.

Note: only one book will not make your answers complete. 

(e) Be serious  for your class tests and terminal exams. so that your revisions will go finely.

(f) Give yourself time enjoy your life with studying as well as make yourself stress free always. never skip your breakfasts. eat healthy and stay fit. 

(g) Always follow your syllabus during study. because in exams the questions always ask from inside the syllabus only. 

 

(h) If you want to come in the top 3 in your class or in your university you need to follow it. 

 

These rules will definitely work if you are preparing from the starting of your session. and obedient with yourself. 

2. If you are preparing from the mid of the session for your exams:

If you have wasted your half session of year by doing nothing, still you can recover your study soon

(a) Still you can make  the schedule, either you are preparing from the starting or mid. you need to follow the schedule. 

(b)  Your life may be stressed out by thinking of the future. and difficult to follow the schedule, if you are not able to not follow the schedule just leave it and study hard soon. 

(c) Be calm and start your study from the hard topic (Complex to easy), because you will be comfortable in studying easy topics as compare to hard ones.

(d) learn previous question papers which will  be very helpful to study the important topics as well as completing your syllabus too. 

(e) Donot compare yourself with others,this may lose your hope  and confidence. Be yourself and study well. 

3. If you are preparing in the last session for your exam: 

 Note:   WORRY, cause worrying for yourself is the only thing which will pressurize you to study.  

(a) If you are preparing for exam in your preparation leave you may not be able to complete your whole syllabus, but go through with the important previous questions. 

(b) The more you are pressurize the higher your concentration will be. and you start studying hard.

(C) Never skip any topic or chapter just understand the criterias of the topic and go through with the points so that you understand that what you have to write. 

(d) Donot allow your mind to go in the negative side. this may interfere in your studies and marks too. 

(e) Make good peer group so that your mind will be set for study always. 

 (f) Aviod using social media for interfernce in your study. keep studying with positive mind set.

Note : Think about your results, fear of results will allow you to study. Think about your parents who have given a lots of money to the college and study. 

How to balance your Nursing profession and Personal life.

Nursing profession is most hard working profession in which you are not able to get your personal time rarely.  

Some of the points, if u follow you will be completly balanced in your daily life with your nursing profession.   

1. Always be Punctual in the hospital from the first day. so that no one will make you realise that u have come late today or yesterday. if you come early you will go home in your time. 

2. Either you work in the Private sector Hospital or Government sector you should always maintain a good IPR (Interpersonal relationships) with your seniors.

3. Donot get personal with your colleagues which may cause conflict one day. 

4. Have breakfast on time, if you dont it may irritate you GIT and cause extream stress on your mind, and you will not be able to maintain your IPR with patients. 

5. Donot blame your colleague for any of the mistakes.

6. Analyse your work in the last, and donot give a burden of your work to your friend.

7. Make a  schedule for you personal and professional timing. 

8. Donot say "YES" in each and every call, first complete your work and answer the call. if the call is emergent then help others.

9. Have fun with the patients and enjoy your working life. don't make your professional life bore, Have a stressful life without any doubts.

10. The last but not the least, Never talk or share your hospital work with your non medico friends, and same as never share your personal life with your colleagues.

Tips on How to start your career in Nursing?

If you have completed your 12th and you are confused to choose a Nursing profession as a career, then don't be confused. In a recent senerio lakhs of people are having a degree of Nursing but yet not have job and facing many problems. just because they had not having a spark to make themself a better Nurse  

 Points which are necessary to be good nurse from the starting of your career:   

1. First of all it is very essential to have an interest in the Nursing career,  then only you will be able to be a good professional nurse.if you don't have interest you wont be able to clear the PNT ( Pre Nursing Test) test as we use to give before entering in the Nursing profession. 

2. Secondly, you have to study for the PNT exam as the rank will only decide that which college you will be admitted for you UG study. 

3. After admitting in college, you have to concentrate in studies from the 1st day because the demonstration via dummies and practicals are the main era of your gaining basic knowledge.

4. Nursing education and Nursing practice is an art if you are not interested in the beggining, you wont be able to continue in the last which results poor, And that may interfere with your career.

5. As soon as you complete your assignments on time. you will get more and more time to study for exams. If you leave your assignments for last months, either you  wont be able to concentrate in your studies nor get good result. 

6. It is very important that if you have any doubt just clear it with your teachers directly dont leave it.

7. Make good communication with teachers so that they will help you in your assignment activities if you have any doubt.

8. Never skip your clinical duties because clinical duty  gain your information and knowledge regarding Hospital.

9. A lot of students have issue that in nursing profession  they do not get time for self. so it is very important to make a schedule for daily basis. 

10.In Chhattisgarh, there are various Nursing College which are well and good to study,either you can also choose for other states. I have basically done my graduation from this CG state so i have cleared the stuffs.