Friday, November 18, 2011

Extravasation Follows Chemotherapy Administration, Potential Complication or Nursing Negligence

Extravasation Follows Chemotherapy Administration, Potential Complication or Nursing Negligence

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Extravasation Follows Chemotherapy Administration. Potential Complication or Nursing Negligence
Iacano v. St. Peter’s Medical Center, 334 N. j. Super. 547 – NJ (2000)

Summary: Intravenous therapy has inherent risks and potential complications. When you introduce chemotherapeutic drugs and known vesicants, those risks increase dramatically. In this case, a known risk, extravasation, occurred following administration. The question arises, could the nurses have acted sooner to prevent the extravasation and resulting tissue damage.

The patient was an Oncology patient being treated as an outpatient for non-Hodgkin’s lymphoma, a cancer of the lymphatic system. On a regular basis (every third Friday), she would come in for her treatments. Her Chemotherapeutic regimen consisted of four different drugs, three of them given intravenously. The IV drugs were Cytotoxan, Oncovin, and Adriamycin.

Oncovin and Adriamycin are known vesicants (chemicals which can cause tissue damage and destruction if they leak into surrounding tissues) and typically administered via “IV Push” meaning they are injected directly into the bloodstream through an IV access device. It is critical that the patient be monitored for signs/symptoms of adverse reactions or complications during and after this type of administration.

“Extravasation of chemotherapeutic vesicant agents can result in significant tissue damage, alteration in limb function, and pain. Quality of life for long-term survivors can be severely impacted by negative sequelae from vesicant extravasation. Currently, there is no known preventive therapy. Early detection and intervention are paramount to halt tissue damage and reduce the chance of permanent disability or disfigurement.”2

On this day, the patient was accompanied by a friend who witnessed her treatment. She would attest to the patient’s account of administration of the medications and complaints of discomfort soon afterwards. She would state that the nurses on duty had been informed of this discomfort not once but twice but did nothing. Reports of a red, swollen and puffy hand appearance were allegedly made to the nurse with no action taken.

The patient was initially given Cytotoxan (not a vesicant) through a peripheral IV line in her right hand. Shortly after the infusion began, the patient would begin her complaints of discomfort in that hand.

The patient would state that even after describing her hand discomfort, the nurse injected the vesicant medications into the right hand IV site.

The nurse would later state that she got “good blood return” from the site and did not recall any complaints of pain by the patient. No nurse’s notes were available to collaborate her testimony.

Soon after administration of the vesicants, there were further complaints of pain, and new complaints of “burning.” An extravasation was then reported to the physician. Orders were obtained to discontinue the IV in that hand and treat the extravasation with cold compresses. Apparently, it was not until the patient reported a “burning” sensation that the nurse took notice and took action on the patient’s concerns.

“What is Extravasation? The leakage of intravenous drugs from the vein into the surrounding tissue.(1) Extravasation injury usually refers to the damage caused by leakage of solutions from the vein to the surrounding tissue spaces during intravenous administration. Once an extravasation has occurred, damage can continue for months and involve nerves, tendons and joints. If treatment is delayed, surgical debridement, skin grafting, and even amputation may be the unfortunate consequences.”3

(Please visit http://www.extravasation.org.uk/Definition.htm for a photo example of the type of injury involved in this case (center photo))

It is important to note that despite the patient’s complaints of pain, and witness reports, despite the documented report of an extravasation and resulting physician orders to deal with it, despite the restarting of the IV to continue therapy, no mention of these events was available in the nursing portion of the chart when it was reviewed after the fact.

The patient would need an Orthopedic consult to deal with the extensive damage caused by the extravasation. Debridement and tissue repair would leave permanent scarring and irreversible damage.

The patient sued the Nursing staff on duty that day for negligence. The courts returned an award of 1.5 Million dollars. This would later be ruled excessive and reduced to 0.5 Million dollars.

The defense appealed for a new trial based on the excessive award initially granted.

Questions to be answered.

1. Who was responsible for monitoring the patient for potential complications, and was this monitoring carried out within acceptable standards of care?

2. Special precautions/monitoring must be in place when administering vesicant medications. Were the nurses negligent in their duty to monitor for complications of chemotherapy?

3. Was the patient in fact having pain and discomfort well before the administration of the vesicants? If so, was the nurse in error, to administer the medication despite the patients concerns and complaints?

4. Was there appropriate documentation to support either the nurses or the patient’s account of the situation.

5. Could the extravasation and resulting tissue damage have been prevented?

6. Did the jury in the initial trial award an excessive amount based on flawed information in the initial trial.

The two nurses on duty were clearly responsible for monitoring this patient (and all the other patients in the office as well). It is recognized that the greatest responsibility would fall on the nurse who was administering the vesicant-type medications. Before administering any medication into an IV site, it must be assessed for signs/symptoms of irritation, patency and proper placement.

It would seem incredible, that a patient’s complaints of first discomfort, pain, and then burning would not be investigated by the nurses on duty. These are obvious signs/symptoms of potential vesicant complications. Due to the lack of documentation, this is what we must assume happened.

Of the two nurses on duty, at least one of them would have been made aware and had the responsibility to notify both the other nurse and the physician when appropriate. In light of the fact that an extravasation did occur and resulted in tissue damage, a case for negligence in the monitoring of this patient is established.

It can be argued that the “prudent nurse” when made aware of a patient’s discomfort, would have either slowed or stopped the intravenous infusion and checked the site before proceeding. With the patient’s companion echoing complaints of both pain and a “puffy, red” appearance, that IV site should have been discontinued immediately.

It is unfortunate that no nurses notes were available to give the nurses’ side of the story. It can only be assumed that there was in fact a problem with the site (based on the later reported extravasation and tissue injury).

"Each state has enacted a nurse practice act that authorizes an individual to practice as a registered nurse if the applicant meets specific criteria. Laws or administrative rules in each state further outline documentation issues, such as handling of records, falsification of records and confidentiality.6 Regardless of your work setting or nursing specialty, you must document care based upon the requirements of your state’s nurse practice act. For information on your state’s nurse practice act, contact the National Council of State Boards of Nursing at www.ncsbn.org.”4

There is an inherent duty which a nurse (like a physician) owes to a patient which is to do no harm, and protect them from foreseeable complications. In this case, when the nurse injected the vesicants into an IV site that had already been reported as “causing discomfort,” that duty was clearly not adhered to. Her testimony later that she had “good blood return” from the site was clearly an inadequate assessment.

The presence or absent of “blood return” is not a reliable indicator of an intravenous line’s proper placement or appropriate location.

Again, it would seem incredible that a nurse would inject vesicants, chemicals known to damage tissue and cause significant complications, into an already problematic intravenous site. Due to the lack of documentation in the medical record, we must assume this is what took place based on the end results.

If in fact the patient was complaining of discomfort from the site, then the vesicants should never have been injected. It is dictated by standards of care that, the existing site be discontinued and treatment initiated if warranted by nursing judgment or physician’s orders, another intravenous site be initiated and the medications placed in an alternate location. If no other location was available, or accessible a call would need to be placed to the physician for further orders.

Summary: In the end, the appeals court would find that even though the initial award was excessive, it was not based on an error or misinterpretation of fact. The request for a new trial was denied and the $500,000 award for the negligence on the part of the nurses was upheld.

Related Link Sections:

Clinical Charting and Documentation, Nurses Notes:
http://www.nursefriendly.com/nursing/directpatientcare/clinical.documentation.nurses.notes.htm

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Cancer, Oncology, Malignancy, Tumors (over a thousand sites):
http://www.nursefriendly.com/cancer/

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Direct Patient Care Links :
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm

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Extravasation, Vesicant Infiltrations, Complications of Intraveous (IV) Therapy:
http://www.nursefriendly.com/extravasation

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Informed Consent
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/informed.consent.medical.legal.htm

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Intravenous Therapy, Nursing IV Team
http://www.intravenousnursing.com

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Nurse Practice Acts, Legal and Medical Links
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Nursing Professional Malpractice & Liability Insurance
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Starting An IV Line, Intravenous Therapy, Infusion Resources:
http://www.nursefriendly.com/nursing/directpatientcare/intravenous.iv.therapy/starting.an.iv.line.htm

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Torts Law & Personal Injury, Legal Resources
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/law/torts.htm

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Related Nursing Malpractice Cases:

August 1, 1999: Nursing Duty To Patient, "Does Not Guarantee" Safety Or
Quality Of Care
.
Summary: When a nurse accepts report and responsibility for the care of a patient a duty to the patient is also accepted. This duty is to provide a reasonable standard of care as defined by the Nurse Practice Act of the individual state and the facility Policy & Procedures. In this case, a post-op abdominal aneurysm repair patient was injured after falling from his bed to the floor. When a lawsuit was filed the court initially mistook expert testimony to imply the role of the nurse includes a guarantee of safety.
Downey v. Mobile Infirmary Med. Ctr. - 662 So. 2d 1152 (1995).
http://www.nursefriendly.com/nursing/clinical.cases/080899.htm

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August 8, 1999: Pregnant Prison Inmate Complains of Miscarriage, Corrections Nurse On Duty Ignores Symptoms?
Ferris v. County of Kennebec, 44 5. Supp.2d 62 –ME (1999)
Summary: Nursing assessment skills are one of our most valuable assets. They allow us to effectively evaluate our patients and communicate significant findings to physicians and other members of the healthcare team. In this case, a pregnant woman with a previous history of miscarriage complained of vaginal bleeding and abdominal discomfort. The assessment performed by the nurse fell negligently short of the required standard of care.
http://www.nursefriendly.com/nursing/clinical.cases/080899.htm

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September 12, 1999: Sleep Apnea Monitor Turned off or Ignored By Nursing Staff, Patient's Coding Goes Unnoticed.
Monitors and Monitored patients present special challenges to practicing nurses. Like a call bell, when alarms on a monitor are activated, they can signal benign or life-threatening events. In this case, a patient's monitors did not alarm as expected. The patient was in distress and would be found without respirations and pulseless by the nurse on duty.
Odom v. State Dept. of Health and Hosp., 322 So. 2d 91 -LA (1999)
http://www.nursefriendly.com/nursing/clinical.cases/091299.htm

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October 3, 1999: Grand Mal Seizure Follows Cervical Myelogram, Anticipated Risk or Nursing Negligence?
Cascio v. St. Joseph Hosp., 734 So.2d 1099 - FL (1999)
Summary: With a proper Informed Consent obtained, it is accepted that a patient is aware of potential risks & complications prior to a procedure. In this case, following a cervical myelogram, a patient developed seizures and suffered an injury. The physician would blame the nursing staff for causing an "increased risk" by not following procedures.
http://www.nursefriendly.com/nursing/clinical.cases/100399.htm

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References:

1. 41 NLRR 6 (November 2000)

2. Kassney, Elizabeth. (6/1/2004). Evaluation and Treatment of Chemotherapy Extravasation Injuries. National Extravasation Information Service. http://www.extravasation.org.uk/Eval.htm (21 January, 2004)

3. Stanley, A. (6/1/2004). What is Extravasation. National Extravasation Information Service. http://www.extravasation.org.uk/Definition.htm (21 January, 2004)

4. Habel, Maureen. (1/13/03). Document It Right. Would your charting stand up to scrutiny? Nurseweek.com. http://www.nurseweek.com/ce/ce670a.asp (21 January 2004)

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Nothing Is More Important Than Relationships, Inspirational Poems, Touching Stories

Nothing Is More Important Than Relationships, Inspirational Poems, Touching Stories

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I sat next to the bed of old man, a friend for over twenty years, and held his hand. Hal was dying. We both knew these next few days would be his last.

We spent time reminiscing about his long and fruitful career as a church pastor. We talked about old friends. We chatted about his family. And I listened as he offered sage wisdom and advice to a member of a "younger generation."

At a lull in the conversation, Hal seemed to carefully consider what he was about to say next. Then he squeezed my hand, gazed intently into my eyes and whispered, just loud enough for me to hear, "Nothing is more important than relationships."

I knew that this was somehow near the pinnacle of his life's learnings. As he considered all of his experiences -- personal, professional, spiritual and family, this one ultimate observation surfaced above the rest: "Nothing is more important than relationships."

"Don't get overly caught up in your career," he seemed to be saying to me. "Likewise, don't use people in order to achieve your goals, then throw them away. No project, no program, no task should be pursued at the expense of friends and family. Remember," I heard him saying, as clearly as if he were speaking the words, "that in the end, only your relationships will truly matter. Tend them well."

Writer Og Mandino puts it this way: "Beginning today," he said, "treat everyone you meet as if he or she were going to be dead by midnight. Extend to them all the care, kindness, and understanding you can muster, and do so with no thought of any reward. Your life will never be the same again."

At the end of a long life, my friend Hal would have agreed.

Author unknown

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I sat next to the bed of old man, a friend for over twenty years, and held his hand. Hal was dying. We both knew these next few days would be his last.

We spent time reminiscing about his long and fruitful career as a church pastor. We talked about old friends. We chatted about his family. And I listened as he offered sage wisdom and advice to a member of a "younger generation."

At a lull in the conversation, Hal seemed to carefully consider what he was about to say next. Then he squeezed my hand, gazed intently into my eyes and whispered, just loud enough for me to hear, "Nothing is more important than relationships."

I knew that this was somehow near the pinnacle of his life's learnings. As he considered all of his experiences -- personal, professional, spiritual and family, this one ultimate observation surfaced above the rest: "Nothing is more important than relationships."

"Don't get overly caught up in your career," he seemed to be saying to me. "Likewise, don't use people in order to achieve your goals, then throw them away. No project, no program, no task should be pursued at the expense of friends and family. Remember," I heard him saying, as clearly as if he were speaking the words, "that in the end, only your relationships will truly matter. Tend them well."

Writer Og Mandino puts it this way: "Beginning today," he said, "treat everyone you meet as if he or she were going to be dead by midnight. Extend to them all the care, kindness, and understanding you can muster, and do so with no thought of any reward. Your life will never be the same again."

At the end of a long life, my friend Hal would have agreed.

Author unknown

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Death, Dying, End of Life, Hospice, Inspirational Poems, Touching Stories

Death, Dying, End of Life, Hospice, Inspirational Poems, Touching Stories

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Faith Friends by Nancy Haygood, Hospice Poems, Stories of Death and Dignity:"I don't want to say goodbye
Don't want you to see me cry
But in the end, that sweet by and by
We will meet again."
http://www.inspirationalnursing.com/faith

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Tribute to a Hospice Nurse by E.V. Stankowski, RN, Inspirational Poems, Touching Stories:"When it comes to death and dying
There's a special gift you share
One that Angels all admire
One that goes beyond just care

http://www.inspirationalnursing.com/hn

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A Trip To The Supermarket, Inspiration Poems, Touching Stories:"I walked into the grocery store not particularly interested in buying groceries. I wasn't hungry. The pain of losing my husband of 37 years was still too raw. And this grocery store held so many sweet memories."
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Inspirational Categories: Affection, Caring, Friendship, Angels In Our Lives, Watching Over Us, Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Love, Marriage, Matrimony, Loving Partners

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Always Say I Love You, Inspirational Poems, Touching Stories:"Brittney loved basketball Friends and parties too And when it came to painting That's all she wanted to do."
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Angels of Mercy, Inspirational Poems, Touching Stories:"Sorry if we woke you in the middle of the night But someone in your neighborhood is fighting for his life. Sorry if we block the road and make you turn around, But there's been a bad wreck with dying children on the ground."
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Beatitudes For Aging, Inspirational Poems, Touching Stories:"Blessed are they who understand My faltering steps and palsied hand. Blessed are they who know my ears today must strain to catch the words they say."
http://www.nursefriendly.com/nursing/inspiration/beatitudes.for.aging.htm

Inspirational Categories: Affection, Caring, Friendship, Angels In Our Lives, Watching Over Us, Parents & Parenting Death, Dying, End of Life, Hospice Poems, Living Life To The Fullest, Love, Caring, Self Esteem, Self Worth

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Butterfly Courage, by David L. Kuzminski:"Walking down a path through some woods in Georgia in 1977, I saw a water puddle ahead on the path. I angled my direction to go around it on the part of the path that wasn't covered by water and mud. As I reached the puddle, I was suddenly attacked!"
http://www.inspirationalnursing.com/courage

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Death Is Nothing At All, Poems About Death & Dying, Loss:"Death is nothing at all...
I have only slipped away to the next room...
I am I and you are you...
Whatever we were to each, that we are still."
http://www.inspirationalnursing.com/nothing

Inspirational Categories: Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Living Life To The Fullest

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Do Not Stand At My Grave, Inspirational Poems About Death & Dying:"Do not stand at my grave and weep, I am not there, I do not sleep. I am a thousand winds that blow; I am the diamond glints on the snow."
http://www.inspirationalnursing.com/grave

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Earthbound Angel, Inspirational Poems, Touching Stories:"Occasionally, we are graced with the presence of an earth bound Angel. They are unable to stay with us for long, but while they do, they bring unprecedented joy and happiness to all they touch."
http://www.inspirationalnursing.com/earthbound

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Gone From My Sight, Inspirational Poems, Touching Stories:"I am standing upon the seashore. A ship at my side spreads her white sails to the morning breeze and starts for the blue ocean."
http://www.inspirationalnursing.com/sight

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Hummingbird Man, The by Nancy Haygood, Hospice Poems, Stories of Death and Dignity:"He shows me tomatoes – red cherries, neatly hoed,
He naps in the sun, soaks up heat, sky aglow.
"Meet my new pup," proudly, "she's for squirreling."
His pain burns deep, he hides it, buried, gnawing."
http://www.inspirationalnursing.com/hummingbird

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I Found Jesus There, Inspirational Poems, Touching Stories:"The surgeon sat beside the boy's bed; the boy's parents sat across from him. "Tomorrow morning," the surgeon began, "I'll open up your heart..." "You'll find Jesus there," the boy interrupted."
http://www.inspirationalnursing.com/there

Inspirational Categories: Affection, Caring, Friendship, Babies, Children, Infants, Kids, Death, Dying, End of Life, Hospice Poems, Parents & Parenting, Religious Poems, Christian Stories

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If It Should Be, Animal Poems, Pet Stories:"If it be I grow frail and weak, And pain should wake me from my sleep, then you must do what must be done, for this last battle can't be won."
http://www.inspirationalnursing.com/be

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If Roses Grew In Heaven, Inspirational Poems, Touching Stories:"If roses grow in Heaven, Lord please pick a bunch for me, Place them in my daughters arms and tell her they're from me."
http://www.inspirationalnursing.com/roses

Inspirational Categories: Babies, Children, Infants, Kids, Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Motherhood, Mothering, Moms, Parents & Parenting, Prayers, Requests, Praying, Religious Poems, Christian Stories

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If There Were No Tomorrow..., Inspirational Poems, Touching Stories:"I would tell you today
That you are the one that fills my life,
Whose smile I cannot wait to see,
Whose arms I long to have wrapped around me,
Whose lips I live to kiss,
Softly, passionately, in every way."
http://www.inspirationalnursing.com/were

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Inheritance, Inspirational Poems, Touching Stories:"There is a lovely story told about a famous art collector who learned that his son had been killed in the war, killed saving the life of another soldier. Some time past and the soldier who survived and who himself was an amateur painter, gave the art collector a simple portrait he'd sketched of his son. It was nothing like a masterpiece but it became very special to the man in his loneliness."
http://www.inspirationalnursing.com/inheritance

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Life Still Has A Meaning, Inspirational Poems, Touching Stories:"If there is a future there is time for mending- Time to see your troubles coming to an ending."
http://www.inspirationalnursing.com/meaning

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Men Do Cry, Inspirational Poems, Touching Stories:"I heard quite often "men don't cry" though no one ever told me why So when I fell and skinned a knee, no one came by to comfort me."
http://www.inspirationalnursing.com/men

Inspirational Categories: Babies, Children, Infants, Kids, Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Parents & Parenting

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My Brother Has Fallen, Inspirational Poems, Touching Stories:"My Brother has fallen; no, I don't know his name. Have not the same parents still family all the same. He lives in this town, I live in another, It doesn't really matter 'cause this man is my Brother."
http://www.inspirationalnursing.com/fallen

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My First Christmas In Heaven, Inspirational Poems, Touching Stories:"I see the countless Christmas Trees around the world below, with tiny lights, like heaven's stars, reflecting on the snow. The sight is so spectacular, please wipe away that tear, for I am spending Christmas with Jesus Christ this year."
http://www.inspirationalnursing.com/my

Inspirational Categories: Angels In Our Lives, Watching Over Us, Babies, Children, Infants, Kids, Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Holiday Thoughts, Christmas, Easter, Thanksgiving, Etc., Living Life To The Fullest, Love, Caring, Self Esteem, Self Worth, Religious Poems, Christian Stories

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Nothing Is More Important Than Relationships:"I sat next to the bed of old man, a friend for over twenty years, and held his hand. Hal was dying. We both knew these next few days would be his last. We spent time reminiscing about his long and fruitful career as a church pastor. We talked about old friends. We chatted about his family. And I listened as he offered sage wisdom and advice to a member of a "younger generation."
http://www.inspirationalnursing.com/relationships

Categories: Affection, Caring, Friendship, Bereavement, Grief, Sadness, Sorrow, Death, Dying, End of Life, Hospice Poems, Living Life To The Fullest, Love, Caring, Self Esteem, Self Worth, Religious Poems, Christian Stories

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Old Man and His Dog,The, Inspirational Poems, Touching Stories:"An old man and his dog were walking along a country road, enjoying the scenery, when it suddenly occurred to the man that he had died. He remembered dying, and realized, too, that the dog had been dead for many years. He wondered where the road would lead them, and continued onward."
http://www.4nursing.com/inspiration-the-old-man-and-his-dog.html

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Remember Me, Inspirational Poems, Touching Stories:"To the sorrowful, I will never return To the angry, I was cheated But, to the happy, I am at peace And to the faithful, I have never left."
http://www.inspirationalnursing.com/me

Inspirational Categories: Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Religious Poems, Christian Stories

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Sarah's Tears by Tony Collins, LVN:"Late one December night on the cancer ward the halls were quiet and solemn, the patients were asleep and most of the visitors were gone. The nurses were gathered about the nurse's station preparing for shift change. Sarah, one of the nurses, was especially tired, having worked seven straight 12 hour days. The kids had needs, her husband had been laid off, and the house payment was due."
http://www.inspirationalnursing.com/inspire.inspirational.inspiration.sarahs.tears.htm

Inspirational Categories:

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The Hummingbird Man by Nancy Haygood, Hospice Poems, Stories of Death and Dignity:"He shows me tomatoes – red cherries, neatly hoed,
He naps in the sun, soaks up heat, sky aglow.
"Meet my new pup," proudly, "she's for squirreling."
His pain burns deep, he hides it, buried, gnawing."
http://www.inspirationalnursing.com/hummingbird

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To The One Left Behind, Bereavement Poems, Stories of Grief:"Here my body lies But I am gone I'm sorry I left you behind I ask you to carry on."
http://www.inspirationalnursing.com/behind

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Too True, Too Often, Inspirational Poems, Touching Stories:"Too often we don't realize
we have until it is gone
Too often we wait too late to say
"I'm sorry - I was wrong."

http://www.inspirationalnursing.com/often

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Why? Inspirational Poems, Touching Stories:"Perhaps one day we'll understand Why God decided to take your hand And lead you into Heaven above surrounded by his tender love."
http://www.nursefriendly.com/why

Inspirational Categories: Bereavement, Grief, Loss, Sorrow, Death, Dying, End of Life, Hospice Poems, Parents & Parenting, Religious Poems, Christian Stories

See also:

Poetry, Blessings, Toasts, Quotes, Prayers and Words of Comfort, About.com: Death & Dying:"Sometimes, it seems that all you need is the right quote, poem or inspirational message at the right moment to help provide perspective, insight and aid in surviving a loss or crisis. When coping with a death, a significant loss or crisis, it can help to read the words from others who have "been there," coped and survived. This section contains comforting poems and quotes that may be helpful when writing eulogies or obituaries, or used in memorial services, blessing helpful in the healing process, quotes about death and dying and famous last words."
http://dying.about.com/

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For Health Information you can use, Follow, Connect, Like us on (Most Invites Accepted): http://www.nursefriendly.com/social/:

Twitter! http://www.nursefriendly.com/twitter

What's New

Blogger: http://4nursing.blogspot.com

Facebook: http://www.nursefriendly.com/facebook

Linked In: http://www.linkedin.com/in/nursefriendly

Nursing Entrepreneurs, Nurses In Business, http://nursingentrepreneurs.ning.com/

Posterous.com, http://nursefriendly.posterous.com

StumbleUpon, http://www.nursefriendly.com/stumbleupon


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NursingA2Z.com Travel, Tickets, Discount Airplane - to - Twelve Step Programs, A to Z Nursing Links, Alphabetical Nursing

Travel, Tickets, Discount Airplane - to - Twelve Step Programs, A to Z Nursing Links, Alphabetical Nursing

Travel, Tickets, Discount Airplane, Airline
http://www.nursefriendly.com/airlines/

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Travel and Vacation, Maps & Directions, Resources
http://www.nursefriendly.com/maps/

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Traveling Angels, Inspirational Poems, Touching Stories:"Two traveling angels stopped to spend the night in the home of a wealthy family. The family was rude and refused to let the angels stay in the mansion's guest room. Instead the angels were given a space in the cold basement. As they made their bed on the hard floor, the older angel saw a hole in the wall and repaired it."
http://www.inspirationalnursing.com/traveling

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Treating A Cold, Medical Jokes, Patient Humor:"When Pat and Mike met each other on the street one day, Pat noticed that Mike had a terrible cold. "Have you seen a doctor about that cold?" he asked."
http://www.nursinghumor.com/treating

This link can be found in our http://www.nursinghumor.com section, http://www.nursinghumor.com

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Treatment Research_20 , Addictions, Drug and Substance Abuse on The Nursefriendly

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Trepostinil Sodium, Remodulin, Pulmonary Hypertension, Prescription Drugs, Medications
http://www.prescriptionforviagra.com/remodulin/

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Tretinoin, Renova, Wrinkle Prevention, Blemish Control, Skin Care, Acne, Vitamin A Derivatives

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Trexall, Amethopterin, Folex, MTX, Methotrexate, Rheumatrex, Anticancer, Antimetabolite, Chemotherapy, Anti-Arthritis, Anti-Psoriasis, Cancer, Oncology, Chemotherapy, Drugs, Medications, Prescriptions:"Methotrexate is an anticancer drug used in the treatment of lymphoma (cancer of the lymph nodes) and certain forms of leukemia. It is also given to treat some forms of cancers of the uterus, breast, lung, head, neck, and ovary. Methotrexate is also given to treat rheumatoid arthritis when other treatments have proved ineffective, and is sometimes used to treat very severe and disabling psoriasis (a skin disease characterized by thickened patches of red, inflamed skin often covered by silver scales)."
http://www.prescriptionforviagra.com/methotrexate

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Triage Nursing (Emergency Department)

    Physicians in the Triage Room:"I've been a nurse for 16 years ; 11 ICU and the past 5 in ER. We are trying institute having a Physician in the Triage Room with the Triage Nurse during peak hours 11a-11pm. We are trying to work out some of the glitches before we go LIVE in April. We use IBEX as our computer Triage/Nursing Documentation which means that the Triage Nurse has to have the triage in before the doc can start his writeup on the patient. We anticipate that this will be a great idea for those that don't need to spend more than a few minutes with a doc ie: wound care check, nurse maid elbow, simple stuff."
    http://www.nursingdiscussions.com/ed


Tribute To A Graduate Nurse, by E.V. Stankowski RN:"On this graduation day There's a special song that's played High above this earthly sky By a choir dressed in jade."
http://www.inspirationalnursing.com/graduate

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Tribute to a Hospice Nurse by E.V. Stankowski, RN, Inspirational Poems, Touching Stories:"When it comes to death and dying
There's a special gift you share
One that Angels all admire
One that goes beyond just care

http://www.inspirationalnursing.com/hn

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Tribute to a Medical Missionary by E.V. Stankowski RN, Inspirational Poems, Touching Stories:"You're an Angel sent from God
For the suffering souls of earth
Who have seen no ray of hope
Nor believe in their great worth."
http://www.inspirationalnursing.com/missionary

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Tribute to a Nurse Practitioner, by E.V. Stankowski RN:"High above the earth and moon
Where Angels dwell on high
There is a place in heaven's home,
A place called Rainbow Sky."

http://www.inspirationalnursing.com/np

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Tribute to a Pediatric Nurse, Inspirational Poems, Touching Stories:"Within the heart of Heaven's home
A special tribute shines
In honor of your "child-nurse" role;
Botanical designs.
http://www.inspirationalnursing.com/pediatric

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Tribute to a Student Nurse, by E.V. Stankowski RN:"In God's eternal home
Above the clouds and stars
A banquet sits prepared
Among crystal guitars."
http://www.inspirationalnursing.com/sn

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Tribute To Nursery Nurses, by E.V. Stankowski RN:"Oh what a precious sight Each Nursery Nurse portrays When caring for our young They all deserve bouquets."
http://www.inspirationalnursing.com/tribute

Inspirational Categories: Angels In Our Lives, Watching Over Us, Babies, Children, Infants, Kids, Nursing Stories, Nurse Tales, Poems, Religious Poems, Christian Stories

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Tribute to Rebecca Anderson by E.V. Stankowski RN:"Rebecca was an LPN that responded to the Oklahoma City Bombing and courageously gave of herself to help the injured. While she was inside the Federal building caring for the sick, she was struck by a piece of concrete debris from a falling wall. The incident ultimately led to her death (five days later)."
http://www.inspirationalnursing.com/anderson

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Tricalma (Alprazolam), Anti-Anxiety, Sedatives, Hypnotics
http://www.prescriptionforviagra.com/xanax/

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Tricor, Fenofibrate, Antihyperlipidemics, Cholesterol Lowering Meds, Prescription Drugs, Medications
http://www.prescriptionforviagra.com/fenofibrate/

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Tri-Norinyl, Birth Control Pills, Oral Contraceptives, Prescription Drugs, Medications, Medicines
http://www.prescriptionforviagra.com/tri-norinyl/

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Triostat, Cytomel, Liothyronine, T3, Thyroid Hormone Replacement, Prescription Drugs, Medications, Medicines
http://www.prescriptionforviagra.com/liothyronine/

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Trivora, Birth Control Pills, Oral Contraceptives, Prescription Drugs, Medications, Medicines
http://www.prescriptionforviagra.com/trivora/

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True Friends, Inspirational Poems, Touching Stories:"There are many people that we meet in our lives. But only a very few Will make a lasting impression."
http://www.inspirationalnursing.com/true

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Truisms, Sign of The Times Jokes, Getting Older Humor:
http://www.nursinghumor.com/humor/geriatrics.senior.citizen.humor.truisms.htm

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Truphylline, Aminophylline, Phyllocontin, Theophylline, Asthma, Bronchodilators, Respiratory Drugs, Pulmonary:"Aminophylline is a bronchodilator. Aminophylline works in several ways: it relaxes muscles in your lungs and chest to allow more air in, decreases the sensitivity of your lungs to allergens and other substances that cause inflammation, and increases the contractions of your diaphragm to draw more air into the lungs. Aminophylline is used to treat the symptoms of asthma, bronchitis, and emphysema. Aminophylline may also be used for purposes other than those listed in this medication guide."
http://www.prescriptionforviagra.com/truphylline

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Truths About Parenting, Raising Children Poems, Child Rearing Stories:"A child will not spill on a dirty floor. A young child is a noise with dirt on it. A youth becomes a man when the marks he wants to leave on the world have nothing to do with tires."
http://www.4nursing.com/inspirational-poems-touching-stories-truths-about-parenting.html

Inspirational Categories:

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Trying To Help, Bar Jokes, Getting Older Humor:
http://www.nursinghumor.com/trying

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Trying Viagra, Medical Jokes, Geriatric Humor:
http://www.nursinghumor.com/trying

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Tumor Necrosis Factor (TNF) Inhibitors, Rheumatoid Arthritis (RA), Adalimumab, Humira:
http://www.prescriptionforviagra.com/humira

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Turbuhaler, Rhinocort, Pulmicort, Budesonide, Corticosteroids, Asthma Control, Crohns Disease, Prescription Drugs, Medications
http://www.prescriptionforviagra.com/budesonide

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Twas The Day After Christmas, Holiday Jokes, Christmas Humor:
http://www.nursinghumor.com/humor/holiday.christmas.twas.the.day.after.christmas.htm

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  • Twelve Step Programs_9 , Addictions, Drug and Substance Abuse on The Nursefriendly

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    Welcome to NursingA2Z.com.

    This website is owned, operated by Andrew & Melanie Lopez (RNs). It is our intent for this Alphabetical, A to Z index to be a comprehensive listing (In Progress) of Nursing-related resources on the Internet. It is indexed by Google and fully searchable. We'd ask that if you don't find what you are looking for, kindly contact us! If you are looking for a certain topic, it's likely you are not the only one. We will be adding to this index daily, be sure check back frequently.

    If your website is not listed here, we encourage you to submit it: Add Your Website/URL, please note, you do not have to install the nursingtop10.com linking code, to be listed.

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    For Health Information you can use, Follow, Connect, Like us on Facebook, Google Plus, LinkedIn,Twitter, etc. (Most Invites Accepted): http://www.nursefriendly.com/social/:

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    4nursing.com:"In this Nursing Portal you'll find information on Nursing Jobs, Nursing Schools, Nurse Degrees, CNAs, LPNs, RNs, Travel Nursing, Prescriptions Drugs, Medications, Nursing Associations and much more."
    http://www.4nursing.com

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    InspirationalNursing.com:"InspirationalNursing.com. Touching Poems, and Inspiring stories that touch the heart and occasionally bring a tear to your eye. Affection, Ambition, Angels In Our Lives, Animals, Babies, Bereavement, Caring, Caring, Children, Christian Stories, Christmas, Computers & The Internet, Death, Dependability, Determination, Dying, Easter, Emergency Medical Services (EMS), End of Life, Etc., Friendship, God's Creatures, Grief, Holiday Thoughts, Honesty, Hospice Poems, etc."
    http://www.inspirationalnursing.com

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    Jocularity.com (Former home to the Journal of Nursing Jocularity (JNJ)):"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
    http://www.jocularity.com

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    Legalnursingconsultant.org:"This website is intended to be a resource for Legal Nurse Consultants, Attorneys looking to use their services, and nurses looking to enter the field of Legal Nurse Consulting. On our site you'll find a directory of LNCs by state and specialty."
    http://www.legalnursingconsultant.org

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    Nursefriendly.com:"Nationwide Nursing Resources: In this Nursing Portal you'll find information on Nursing Jobs, Nursing Schools, Nurse Degrees, LPNs, RNs, APNs, Nursing Associations and much more."
    http://www.nursefriendly.com

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    Nursinga2z.com:"It is our intent for this Alphabetical, A to Z index to be a comprehensive listing (In Progress) of Nursing-related resources on the Internet. It is indexed by Google and fully searchable."
    http://www.nursinga2z.com

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    Nursingdiabetics.com:"Welcome to NursingDiabetics.com. Here you will find information on all aspects of Diabetes, a disease that afflicts millions of people world wide. I'll be adding pages as fast as I can research the information so remember to bookmark this page and return."
    http://www.nursingdiabetics.com

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    Nursingdiscussions.com:"This website will be a portal to Nursing Discussion boards throughout the Web. If your site has a discussion board we don't have listed here, please contact us."
    http://www.nursingdiscussions.com

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    Nursingentrepreneurs.com:"Nationwide Nursing resource to nurse entrepreneurs looking to nework and start home based businesses. On it you will find links to small and large business related resources."
    http://www.nursingentrepreneurs.com

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    Nursinghumor.com:"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
    http://www.nursinghumor.com

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    If your website is not listed here, we encourage you to submit it: Add Your Website/URL.

    See also:

    Nursing Topics, A to Z:


    Nursing Degrees, LPN-RN, RN-BSN, RN-MSN, Online/Offline College, University and more!:"Higher income. Career mobility. Now, no matter where you live or what your schedule, you can earn your Associate or Bachelor Degree to take your professional life to the next level — without putting the rest of your life on hold!"

    If you do any Browsing or Windowshopping online, please visit our online Mall:
    http://www.nursefriendly.com/shopping/

    Gifts For Nurses:
    http://www.nursefriendly.com/gifts/

    4nursinguniforms.com:"Choose from Top Nursing Uniform Companies. All sizes, styles and popular name brands available. Large selection of accessories as well: Accessories Blood Pressure Cuffs, Sphygnomanometers Nursing Tote Bags, Carry-Ons, Medical Bags Clinical, Medical Supplies, Nurses Discount Outlet: Angels, Books, Clothing , Equipment, Figurines, Holidays, Home Decor, Jewelry, Nurses, Office Decor, Scrubs, Shoes, T-Shirts Footwear, Shoes, Sandals, Discount, Bargains Gifts For Nurses (Nurses Week) Hosiery, Socks, Stockings Hats, Jackets, Jumpers Jewelry, Earrings, Necklaces, Watches Luxury Spas, Facials, Manicures, Pedicures Perfumes, Fragrances, Phermones Shoes, Boots, Sandals, Footwear, High Heels, Slippers Stethescopes, Nurse Kits, Replacement Parts Swimwear (Tan-Through) Women's Lingerie "
    4nursinguniforms.com

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    Nursing Chat, Nurse Discussion Forums:
    http://nursingdiscussions.com

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  • Brainteasers, Medical Puzzles & Healthcare Quizzes on: The Nursefriendly

    Brainteasers, Medical Puzzles & Healthcare Quizzes on: The Nursefriendly

    Can you read the following medication order? Ok, who can read this: This page gives you the chance to test your skill at decyphering medication orders.
    http://www.angelfire.com/pa/cefola/

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    Confusing Words (not nursing or medical, but cool regardless):"Confusing Words is a collection of 3210 words that are troublesome to readers and writers. Words are grouped according to the way they are most often confused or misused. Some of these words are homonyms (words that sound alike but are spelled differently) and some are just commonly confused. What are Confusing Words? * affect and effect * there, their, and they're * capital and capitol * affluent and effluent * atheist and agnostic * ...and over 3000 more."
    http://www.confusingwords.com/

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    easyNCLEX.com:"At easyNCLEX.com, we know that preparing to take the nclex exam, or even considering taking it, can be a stressful exprerience. For this reason, we created this site to help ease the process, making it easy for you to understand the test and prep yourself to pass it. To make it even easier on you, we offer high quality test practice that is simple to use but at the same time effective. Since the NCLEX is given by computer, our NCLEX practice is designed with the interactive format to help you get used to taking the real exam."
    Address:
    1581 Route 202 Suite 143
    Pomona NY USA, 10970
    Phone: (845) 521-7553
    info@easynclex.com
    http://www.easynclex.com/

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    Interactive Medical Crosswords, The Doctors Lounge:"The Doctors Lounge is one of the most popular online medical resources for physicians, students and allied clinical professionals. It provides both clinical and technical information through multimedia tutorials and other study aids. Both patients and professionals can seek answers to medical questions via the public discussion boards. Please review our Terms & Conditions of Use. The Doctors Lounge was founded in April 2000 in South Dakota, USA; when two physicians, Dr. Tamer Fouad, M.D. and Dr. Yasser Mokhtar, M.D., decided to create a free online medical community that provides its visitors with premiere articles that can only be found in a paid service. webmaster@thedoctorslounge.net
    http://www.doctorslounge.com/studlounge/games/crosswords/

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    Endoscopy Quiz of the Month, Gastrolab:"Why not test your knowledge of endoscopic findings? This part of the home page should not be taken too seriously, and there are no prices to win, but it may be nice to see, if one can recognize typical findings. Please send the answer, and when a new question arrives, the old question will be answered, together with a list of all who have sent in the right answer."
    The Wasa Workgroup on Intestinal Disorders c/o Hans Bjorknas
    GASTROLAB
    Kyrkoespl 18 B 37 65100 Vasa Finland
    Europe, Phone/FAX +358-6-3124055 Email: hans.bjorknas@kolumbus.fi
    http://www.kolumbus.fi/hans/ks1quiz.htm

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    Endoscopy, Lung Function Tests, Cardiac Angiogram Quizzes:"Here are a number of reviews, either in the form of articles or mini-tests on topics likely to come up in the exam. Lung Function tests reproduced with thanks to the Department of Respiratory Medicine, Royal Prince Alfred Hospital Endoscopy Pictures reproduced with thanks to the Department of Gastroenterology, Royal Prince Alfred Hospital Physiotherapy Article courtesy of Ruth Dentice, Senior Respiratory Physiotherapist, Royal Prince Alfred Hospital Cardiac Angiograms and Questions reproduced with thanks to Dr Brian Bailey, Dept of Cardiology, Royal Prince Alfred Hospital."
    http://www.passthefracp.com/Reviews.htm

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    Fun Sites for Nurses:"We have setup this site to help nurses find information, web links and to have a place for a little enjoyment. We value your input, so please sign our guest book, add a joke, register for our contests, suggest a website link and mention our site to your co-workers. Also please visit our sponsors websites by clicking on their banners. We hope you enjoy and find this website useful."

    http://www.nursingfun.com/

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    Medical Gross Anatomy Crossword Puzzles, The University of Michigan:
    http://www.med.umich.edu/lrc/coursepages/M1/anatomy/html/crosswords/crossword_index.html

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    Medical Quizzes, Central Business School, Marquette, Michigan:"Human Anatomy, Human Anatomy, Medical Office Procedures, Medical Records Coding, Medical Records Coding, Medical Records Coding, Medical Terminology, Medical Terminology, Medical Terminology, Medical Terminology - Abbreviations, Medical Terminology - Abbreviations, Medical Terminology - Cardiology, Medical Terminology - Urology, Punctuation - Subject/Verb Agreement"
    Michaeleen O'Sullivan
    355 Forestville Basin Trail PO Box 1081 Marquette, MI 49855
    (906) 226-5270, fax: (906) 226-0169, e-mail: michaeleen@upfirst.com
    http://www.upfirst.com/cbstrain/medquiz.htm

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    Care to test your skills? Have found a few sites with case studies and NCLEX type questions. If you come across anymore, please send me the address.

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    • Kaplan's FREE NCLEX practice lab:"The NCLEX is a standardized test and by definition, standardized tests have "standard" ways of approaching questions and tested content. So to carry the argument a step further, there are "standard" ways of successfully approaching standardized tests. That's what Kaplan does. In the Practice Lab, you can acquaint yourself with the key concepts and content as tested on the exam—and get a clear understanding of what you're up against. Try some sample questions, access some of Kaplan's exclusive strategies, find out how beat test stress, and more. So go on, test yourself...see how you stack up against the NCLEX."

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    Netmedicine: Monthly PhotoRounds.
    http://www.netmedicine.com/photo/unk-frm.htm

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    Paediatric Electrocardiogram of the Week...
    Welcome to "Paediatric ECG of the Week". A weekly ECG to challenge those learning and reading Paediatric ECG's. ...
    http://www.paedcard.com

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    Radiographic Anatomy of the Skeleton: Online x-ray images.
    http://uwmsk.org/RadAnatomy.html

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    Radiology Cases In Pediatric Emergency Medicine: Images and history.
    http://www.hawaii.edu/medicine/pediatrics/pemxray/pemxray.html

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    Real Vermont Nurse Stories, Nursing Quiz:"Quick Quiz. Take this quick quiz to test your knowledge and see what you know about being a nurse."
    Office of Nursing Workforce Research, Planning and Development
    School of Nursing, University of Vermont
    Burlington, VT 05405, phone 802-656-0023
    http://www.choosenursingvermont.org/becoming/quiz.php

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    USMLE Medical Crossword Puzzles, Studentdoc.com:"Medical Crossword Puzzles. Basic Sciences. Clinical Sciences ... All the medical crossword puzzles are interactive. Protein Biochemistry Cell Biology Anatomy: Thorax Anatomy: Abdomen Anatomy: Cranial Nerves Pediatrics OB/Gyn Neurology Internal Medicine: Pulmonary Internal Medicine: Rheumatology"
    http://www.studentdoc.com/msrg_cword.html

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    Medical Crossword Puzzles, Studentdoc.com:"Internal Medicine, Rheumatology."
    http://www.studentdoc.com/rheum.html

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    Contributing women to the nursing profession throughout history (Flashcards), Studyshack.com:
    http://www.studystack.com/studytable-2594

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    Brain Teaser World:"Optical illusions, riddles, puzzles, brain teasers and more!"
    http://www.brainteaser-world.com/

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    BrainBashers™:"Welcome to BrainBashers™, a unique collection of puzzles, games and optical illusions. With thousands of puzzles, over one hundred awards and millions of visitors per year, BrainBashers™ is the world's most popular puzzle resource and is updated with illusions and games regularly and has 5 new puzzles added each week. Many websites copy, very few lead."
    Add: 57 Albert Street Biddulph Staffs ST8 6DT UK
    Tel: 44 1782 512360 Fax: 44 871 7171976 Mob: 07939 063374
    Eml: kevin.stone@brainbashers.com
    http://www.brainbashers.com/

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    It Pays To Learn (Online Trivia):"Cash in on your brain! You can select your own subjects and knowledge levels anytime, and try your skills on the thousands of quiz questions available in several categories, ALL FOR CASH!

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    Japanese IQ Test:"This is an IQ test given to job applicants in Japan...so I've been told. "Everybody has to cross the river"
    http://www.robmathiowetz.com/

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    Brainteasers, Surfing The Net With Kids:""What always weighs the same no matter how large it is?" "No sooner spoken than broken. What is it?" "What dries and dries and keeps getter wetter?" If you enjoy a challenge, then today's mind bending riddle sites are for you."
    http://www.surfnetkids.com/brainteasers.htm

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    Mindbreakers.com:"Since 1995 the best free Puzzles, Riddles, Quizes and Games. Test your IQ with magic trivia. It is fun to see the online collection of puzzle and riddle files, some with visual illusion and some jokes as well. Solve the brain teasers with math logic. No crossword or jigsaw puzzles."
    http://www.mindbreakers.com

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    Quizilla.com:"How about the nickle tour, eh? We have a FAQ that you may want to check out and some longer Documentation too if you want to get deeper. For some fun we've got a list of the most Popular Quizzes on the system as well as a list of the ones that are the newest made. If you already have an accout here you can log-in and if you don't you're invited to sign up."
    http://quizilla.com/

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    For Health Information you can use, Follow, Connect, Like us on Facebook, Google Plus, LinkedIn,Twitter, etc. (Most Invites Accepted): http://www.nursefriendly.com/social/:

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    4nursing.com:"In this Nursing Portal you'll find information on Nursing Jobs, Nursing Schools, Nurse Degrees, CNAs, LPNs, RNs, Travel Nursing, Prescriptions Drugs, Medications, Nursing Associations and much more."
    http://www.4nursing.com

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    InspirationalNursing.com:"InspirationalNursing.com. Touching Poems, and Inspiring stories that touch the heart and occasionally bring a tear to your eye. Affection, Ambition, Angels In Our Lives, Animals, Babies, Bereavement, Caring, Caring, Children, Christian Stories, Christmas, Computers & The Internet, Death, Dependability, Determination, Dying, Easter, Emergency Medical Services (EMS), End of Life, Etc., Friendship, God's Creatures, Grief, Holiday Thoughts, Honesty, Hospice Poems, etc."
    http://www.inspirationalnursing.com

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    Jocularity.com (Former home to the Journal of Nursing Jocularity (JNJ)):"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
    http://www.jocularity.com

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    Legalnursingconsultant.com:"This website is intended to be a resource for Legal Nurse Consultants, Attorneys looking to use their services, and nurses looking to enter the field of Legal Nurse Consulting. On our site you'll find a directory of LNCs by state and specialty."
    http://www.legalnursingconsultant.com

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    Nursefriendly.com:"Nursing-Approved Healthcare & Consumer Resources: In this Nursing Portal you'll find information on Nursing Jobs, Nursing Schools, Nurse Degrees, LPNs, RNs, APNs, Nursing Associations and much more."
    http://www.nursefriendly.com

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    Nursinga2z.com:"It is our intent for this Alphabetical, A to Z index to be a comprehensive listing (In Progress) of Nursing-related resources on the Internet. It is indexed by Google and fully searchable."
    http://www.nursinga2z.com

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    Nursingdiabetics.com:"Welcome to NursingDiabetics.com. Here you will find information on all aspects of Diabetes, a disease that afflicts millions of people world wide. I'll be adding pages as fast as I can research the information so remember to bookmark this page and return."
    http://www.nursingdiabetics.com

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    Nursingdiscussions.com:"This website will be a portal to Nursing Discussion boards throughout the Web. If your site has a discussion board we don't have listed here, please contact us."
    http://www.nursingdiscussions.com

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    Nursingentrepreneurs.com:"Nationwide Nursing resource to nurse entrepreneurs looking to nework and start home based businesses. On it you will find links to small and large business related resources."
    http://www.nursingentrepreneurs.com

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    Nursinghumor.com:"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
    http://www.nursinghumor.com

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