Justice for Ursula

Have you already watched the famous Disney movie “The little mermaid” (1989), with the musical scores created by Alan Menken?

The little mermaid is a literary fairy tale written by the Danish author Hans Christian Andersen. The tale was first published in the year 1837 in Denmark as “Den lille havfrue“. The story is about the journey of a young mermaid who is willing to give up her life at the sea as a mermaid princess to gain a human soul to be with a prince.

This story is a tragedy but it has a happy ending. Isn’t it ironic? How can you call an ending, happy?

Moreover, in this movie, there was a sea witch named Ursula, whom Ariel, the mermaid had an agreement to exchange her golden voice and mermaid tail with a human soul and legs. Ursula was the antagonist of the tale, but if you would look at her side of the story; she needed justice.

Ariel, the mermaid was not forced by Ursula to sign the scroll of the agreement for her to have human legs and a human soul. In fact, Ursula was perfectly clear on the terms of service. (She even sang a song about it) Ursula sang about the poor unfortunate souls. The song was written by the Academy-Award winning composer Alan Menken and the late lyricist Howard Ashman.

Poor Unfortunate Souls (Disney)

[Ursula, spoken]
The only way to get what you want is to become a human yourself

[Ariel, spoken]
Can you do that?

[Ursula, spoken]
My dear, sweet child. That's what I do. It's what I live for.
To help unfortunate merfolk, like yourself; poor souls with no one else to turn to

[Verse 1: Ursula]
I admit that, in the past, I've been a nasty
They weren't kidding when they called me, well, "a witch"
But you'll find that nowadays I've mended all my ways
Repented, seen the light, and made a switch
True? Yes

And I fortunately know a little magic
It's a talent that I always have possessed
And here lately, please don't laugh
I use it on behalf of the miserable, lonely, and depressed
"Pathetic"

[Chorus: Ursula]
Poor unfortunate souls in pain, in need
This one longing to be thinner
That one wants to get the girl
And do I help them? Yes, indeed
Those poor unfortunate souls
So sad, so true
They come flocking to my cauldron
Crying, "Spells, Ursula, please!"
And I help them!
Yes, I do

[Verse 2: Ursula]
Now, it's happened once or twice
Someone couldn't pay the price
And I'm afraid I had to rake 'em 'cross the coals
Yes, I've had the odd complaint
But on the whole I've been a saint
To those poor unfortunate souls

[Ursula, spoken]
Now, here's the deal: I will make you a potion that will turn you into a human for three days. Got that? Three days. Now listen, this is important: before the sun sets on the third day, you've got to get ol' princey to fall in love with you, that is, he's got to kiss you; not just any kiss, this kiss of True Love. If he does kiss you before the sun sets on the third day, you'll remain human permanently! But, if he doesn't, you turn back into a mermaid and... you belong to me!

[Sebastian, spoken]
No, Ariel!

[Flotsam and Jetsam the eels gag Sebastian, muffling his cries]

[Ursula, spoken]
Have we got a deal?

[Ariel, spoken]
If I become human, I'll never be with my father or sisters again!

[Ursula, spoken]
That's right!
But, you'll have, your man
Life's full of tough choices, isn't it? Oh!
And there is, one...more...thing!
We haven't discussed the subject of payment

[Ariel, spoken]
But I don't have any—

[Ursula, spoken]
I'm not asking much. Just a token, really, a trifle. You'll never even miss it. What I want from you is... your voice.

[Ariel, spoken]
My voice?

[Ursula, spoken]
You've got it, sweet cakes. No more talking, singing, zip-

[Ariel, spoken]
But without my voice, how can I—

[Ursula]
You'll have your looks! Your pretty face!
(spoken)
And don't underestimate the importance of body language, Ha!

[Verse 3: Ursula]
The men up there don't like a lot of blabber
They think a girl who gossips is a bore
Yes, on land it's much preferred
For ladies not to say a word
And after all, dear, what is idle babble for?

Come on, they're not all that impressed with conversation
True gentlemen avoid it when they can
But they dote and swoon and fawn
On a lady who's withdrawn
It's she who holds her tongue who gets a man

[Chorus: Ursula]
Come on, you poor unfortunate soul
Go ahead, make your choice!
I'm a very busy woman
And I haven't got all day
It won't cost much
Just your voice!

You poor unfortunate soul
It's sad, but true
If you want to cross a bridge, my sweet
You've got to pay the toll
Take a gulp and take a breath
And go ahead and sign the scroll!
Flotsam, Jetsam, now I've got her, boys!
The boss is on a roll!
This poor unfortunate soul

[Interlude: Ursula]
Beluga, sevruga
Come winds of the Caspian Sea
Larengix glaucitis
Et max laryngitis
La voce to me

(spoken)
Now, sing

[Ariel]
Aa-aa-aah, a-aa-aah

[Ursula, spoken]
Keep singing!

[Ariel]
Aa-aa-aah, a-aa-aah
Song: Poor Unfortunate Souls by Ursula and Ariel of the little mermaid.
Enhanced Community Quarantine (ECQ day 26) from night shift

Moreover, Ursula gave her terms of the service to Ariel. Since what Ariel wanted was to become a human, Ariel became human in the process. As the story unfold, Ursula in turn was supposedly about to marry Prince Eric. But then, Ariel crashed Ursula’s wedding. Ariel had her friends run to King Triton of the sea, Ariel’s father and have had Ursula killed to avoid Ariel’s payment of exchanging her mermaid tail with human legs. Ariel stole an almost married man. Ursula was killed in the process. Ariel together with her family and her friends need to be locked up as accessories to murder.

Matthew 16: 26 ESV
For what will it profit a man if he gains the whole world and forfeits his soul? Or what shall a man give in return for his soul?

Oxygen Administration

Materials:
- Oxygen source (Wall outlet: White [CI-G], Green, [...], oxygen tank or cylinder, portable oxygen tank
- Oxygen gauge with Flow meter
- Appropriate oxygen delivery system (nasal cannula, simple oxygen mask or non rebreather mask)
- stethoscope
- pulse oximeter and probe (if necessary)
- oxygen guard (if oxygen tank is used)

What to do:

  1. Verify the practitioner’s order for oxygen therapy
  2. Confirm the patient’s identity (Name and birthday)
  3. Explain the procedure to the patient, and let him know why he needs oxygen
  4. Do hand hygiene
  5. Gather the needed equipment
  6. Select the most appropriate oxygen delivery device based on the order and the patient’s status.
  7. Assess the patient’s condition, baseline vital signs, and breath sounds, and ensure a patent airway.
  8. Check the patient’s room to ensure safety for administration
  9. Place and Oxygen Precaution sign above the patient’s head and on the door.
  10. Put on personal protective equipment, as needed.
  11. Place the oxygen delivery device securely on the patient, ensuring proper fit.
  12. Adjust the oxygen flow rate as ordered.
  13. Monitor the patient’s response using a pulse oximetry.
  14. if the practitioner has ordered an ABG analysis, check values after allowing sufficient time for the patient’s oxygenation to return to a steady state.
  15. Assess the patient frequently for signs of hypoxia.
  16. Observe skin integrity
  17. Remove and discard your PPE if worn
  18. Do hand hygiene
  19. Clean and disinfect your stethoscope using a disinfectant pad
  20. Do hand hygiene.
  21. Document the procedure.

Enteral Feeding

Materials:

  • Stethoscope
  • Feeding solution
  • Sterile Water
  • Towel
  • Tray
  • Calibrated glass (for flushing solution)
  • Toomey syringe (See image) / Asepto syringe

What to do:

  1. Charge nurse/ Bedside nurse/ Ward Clerk encodes the doctor’s ordered tube feeding solution via Diet Data Entry (include the type of feeding solution, caloric requirement per day, volume per day and concentration)
  2. Charge nurse verifies the feeding bottle/ solution’s label delivered by formula man against doctor’s order sheet, tube feeding card and Kardex and shall check for the following: Type of feeding solution, caloric requirement/ day, concentration (calories/cc)
Nota Bene:
Computation for volume per day and per feeding:
(Caloric requirement per day – 2000 kcal/day)
(Concentration – 2 cal: 1 cc in 6 equal feeding per day. Compute for the volume to be given per feeding)
Formula:
Total caloric requirement per day/ Concentration (calorie/cc)/ # of feeding per day.

Example:
Volume per feeding = 2000kcal/ 2 cal x 1cc
  1. Gather and prepare the necessary equipment and the enteral feeding formula.
  2. Do hand hygiene.
  3. Assess the patient to determine the risk of aspiration and for presence of abdominal distention.
  4. Position the patient to prevent regurgitation/ aspiration of feeding solution according to the following:
Position:
Conscious: Semi Fowler’s (30-45 degree) as tolerated by patient or upright position.
Asleep : Gently wake up the patient and assist in Semi – Fowler’s position
Unconscious: Semi- Fowler’s position
  1. Assess for feeding tube placement before administering the tube feeding and at 4-hour intervals.
Steps for checking tube placement:
* Kink and remove cover of NGT
* Attach the syringe (Toomey) to the NGT
* Place diaphragm of stethoscope at the epigastric area
* Inject 5 ml of air into the NGT
* Listen with your stethoscope for presence of “whooshing” sound
* Aspirate the equivalent amount of air introduced
  1. Place towel over the patient’s neck and chest area
  2. Check for residuals by attaching a Toomey syringe into the port, gently pull back the plunger to aspirate for stomach content. Stop if resistance is felt. Do not use too much force or the tube may collapse.
  3. Re-check for correct NGT placement
Nota Bene:
* If residual formula is > 50 ml. Place in kidney basin, withhold due feeding and refer immediately to the MD.
* If <50 ml., measure gastric content and allow to flow back by gravity. Deduct the volume of the residual from the volume of the feeding solution to be given.
  1. If coffee ground aspirate is noted, hold feeding and refer to the doctor immediately
  2. Document in the I & O under drain column and nurse’s progress notes for quality/ quantity and characteristics (volume) and management done if any.
  3. If no residual is noted, proceed with feeding.
  4. Remove and discard your gloves. Do hand hygiene. Put on new gloves.
  5. Flush the feeding tube with ordered fluid, volume and frequency.
  6. Kink NGT and detach the syringe (Toomey)
  7. Connect the feeding tube bag containing the feeding solution to NGT securely.
  8. Make sure that the feeding bag is installed properly into its enteral pump, with proper data entered. (Volume to be infused and flow rate)
  9. In the absence of an enteral pump, use a feeding bag with a regulator and compute for the desired rate accordingly (drops per minute). Regulate the flow of feeding solution according to doctor’s order.
Formula:
Volume to be infused (volume per feeding) x drop factor/ # of hours x 60 minutes
  1. Hang the feeding bottle to IV stand at the height of not less than 12 -18 inches above the tube’s point of insertion.
  2. Assess for GI intolerance to tube feedings at 4-hour interval. Monitor patient for any signs of aspiration.
  3. After feeding solution has been infuse, remove cover of feeding bottle and flush it with the ordered fluid and volume. Kink and cover the NGT (for intermittent feeding)
  4. For continuous feeding, monitor the patient as often as every hour for complications of feeding.
  5. Instruct the patient/ relative to maintain semi-flower’s position/ upright position for 1 hour to prevent regurgitation.
  6. Wash with soap and water and dry (Toomey Syringe and rinsing glass). Put in a kidney basin/ wrap in ziplock plastic and place inside the bedside table.
  7. Re -assess patient for signs of aspiration/ feeding complications.
  8. Remove your gloves and do hand washing.
  9. Document.
Document:
* Feeding (Nurse’s notes and I/O sheet
* Type of feeding solution
* Caloric requirement/ day
* Residual feeding
* Assessment of patient (Nurse’s Notes)
* Condition of patient before, during and after procedure
* Signs of aspiration and other feeding complications (if any).
* Others (Nurse’s Notes)
* Doctor’s name, time, and response to the referral.
* Feeding time, dose, volume of feeding given.

Capillary Blood Glucose Monitoring

Materials:

  • Novastat CBG Machine
  • Test strip
  • Single use lancet
  • Alcohol swab
  • Cotton ball
  • Diabetic Record (MAR)
  • Operator ID

What to do:

  1. Gather and prepare the appropriate materials
  2. Do hand hygiene. Wear clean gloves.
  3. Confirm patient’s identity. (Name and birthday)
  4. Assess patient’s condition. Ask for patient’s last meal. Make sure the patient had 2 hours fasting for a pre-meals CBG. If the instruction is post-prandial, allow 2 hours gastric emptying time.
  5. Explain the procedure to the patient.
  6. Provide privacy.
  7. Select the puncture site. (Adults: finger, Infant: toe)
  8. Have the patient wash with soap and water and dry them.
  9. Using the machine from the Home Screen, press LOG IN.
  10. Scan the operator ID and press accept.
  11. From Patient Test Screen press ACCEPT.
  12. Scan Strip Lot #, then ACCEPT.
  13. Insert test strip to the bottom of blood glucose meter.
  14. Massage finger/ toe towards the chosen site of puncture. Do not touch the patient’s puncture site.
  15. Clean the intended puncture site with an alcohol pad and let it dry completely.
  16. Using a single-use lancet, placing the lancet perpendicularly to the surface.
  17. Inform that the patient he will feel a pricking pain then push the button to puncture site.
  18. Wipe away the first drop of blood using a gauze pad.
  19. Massage the finger to allow the blood to pool. Touch a drop of blood to the test area on the strip.
  20. Apply pressure to the puncture site using a dry cotton ball, if possible, instruct the patient to maintain pressure.
  21. Results appear in 6 seconds. Record the results in the diabetic record, refer the results if needed. (Refer to Medical Resident on duty or to an Endo Fellow On Duty)
  22. Discard the lancet in a sharps collector. Dispose the test strip in the infectious waste bin.
  23. Remove and discard gloves.
  24. Do hand hygiene
  25. Clean and disinfect the blood glucose meter.
  26. Do hand hygiene.
  27. Administer the appropriate medication or ask the patient to eat if needed.
Blood Glucose Level Chart

Measuring Intake and Output

Materials:

  • Appropriate devices for measuring input (measuring cup, syringe, medication cup, kidney basin or water pitcher)
  • Appropriate measuring container for each type of output being measured, marked in ml.
  • Fluid balance sheet
  • Bedside intake and output worksheet
  • Clean gloves

What to do:

  1. Gather necessary equipment and label with patient’s name
  2. Place the intake and output record (labelled with sources of fluid I&O) and am IV flow sheet, if used in the patient’s medical record.
  3. Perform hand washing.
  4. Confirm Patient’s identity (Name and Birthday)
  5. Explain the process of measuring I&O to the patient and his family.
  6. Alert staff of the need to measure I&O.

Fluid Intake:

  1. Note the time, amount, and type of IV solution or tube feeding on the I&O sheet and on the other appropriate flowsheet.
  2. Measure and record amount of oral fluids ingested, type and amount of instillations and how administered, the amount of medication in liquid, amount of medications and normal saline flushes, amount of medications and water flushes through GI tube.

Fluid Output:

  1. Do hand hygiene.
  2. Wear clean gloves.
  3. Measure urine in graduated container and record
  4. If the patient has an indwelling urinary catheter, open the clamp on the drainage bag, allow urine to flow into the container without touching the drain to the sides of the container and record amount. Close and secure clamp.
  5. Nota Bene* Record: Color, clarity, and odor of urine.

I have few pointers to note as well. It is important to know if the urine of the patient is adequate in comparison with the patient’s fluid intake. Make sure to relay alarming signs to the doctor on duty.

Note: In general for adults, Urine output is adequate if it is 0.5 cc/ kg/ hr. (Dr. Infante, 2020)

A Story About Three Young Men

Once upon a time there were three young men traveling towards a destination. They travel each alone in a road somewhere. Their names were fool, stupid and wise.

One day, “fool” was walking along a road diverging into two paths. He chose to walk along a specific road and in that road, he did not notice that there was a pit, there was a trap set by hunters of wild animals, then what happened was “fool” fell on it while walking, he did not know that there was a pit. Upon falling, he died.

Unknowingly, while “fool” chose that specific road, this young man named “stupid” saw “fool” traversed the road he chose. “Stupid” also saw that “fool” fell on the pit. But guess what he did, despite knowing and seeing that “fool” fell, “stupid” still chose the road that “fool” chose. So what happened was, he was curious and just like what happened to “fool”, “stupid” also fell on the pit. Both of them could not redeem themselves from falling in the pit. The both of them died.

However, there was still another person walking, his name is “wise”. “Wise” saw what happened to fool and stupid on the road that they chose. So what he did was, he chose the other road that fool and stupid did not choose. He was spared from falling in the pit. He was spared from death. He is still alive.


In this generation, you can be able to witness this happening. These three young men named fool, stupid and wise is existing.

There are those people who have gone before us and made their certain mistakes in life, they suffered for it, they were punished because of their mistakes and sins. Until now, they still carry the burdens of the past. They got deeply hurt.

However, there are those people that despite knowing what already happened to those people who have gone before them, they still choose to follow those people. So, what happened to those people who have gone before them, also happened to them. They could have been spared from the consequences, but they still did it despite knowing what happened.

Nonetheless, I believe that you don’t need to follow the mistakes of others just to learn. You don’t need to experience them personally, because it’s going to hurt so bad, just like what happened to ‘stupid’ and ‘fool’. The people who learn from the mistakes of others will be spared from suffering the consequences of not so good decisions in life.

Sometimes, in not so favorable conditions, people still get trapped in pits set by the enemy. If ever this happens to you, and you wouldn’t know what to do? Who are you going to call to save you?


Psalm 103 NIV
Of David.
Praise the Lord, my soul;
    all my inmost being, praise his holy name.
Praise the Lord, my soul,
    and forget not all his benefits—
who forgives all your sins
    and heals all your diseases,
who redeems your life from the pit
    and crowns you with love and compassion,
who satisfies your desires with good things
    so that your youth is renewed like the eagle’s.
The Lord works righteousness
    and justice for all the oppressed.
He made known his ways to Moses,
    his deeds to the people of Israel:
The Lord is compassionate and gracious,
    slow to anger, abounding in love.
He will not always accuse,
    nor will he harbor his anger forever;
10 he does not treat us as our sins deserve
    or repay us according to our iniquities.
11 For as high as the heavens are above the earth,
    so great is his love for those who fear him;
12 as far as the east is from the west,
    so far has he removed our transgressions from us.
13 As a father has compassion on his children,
    so the Lord has compassion on those who fear him;
14 for he knows how we are formed,
    he remembers that we are dust.
15 The life of mortals is like grass,
    they flourish like a flower of the field;
16 the wind blows over it and it is gone,
    and its place remembers it no more.
17 But from everlasting to everlasting
    the Lord’s love is with those who fear him,
    and his righteousness with their children’s children—
18 with those who keep his covenant
    and remember to obey his precepts.
19 The Lord has established his throne in heaven,
    and his kingdom rules over all.
20 Praise the Lord, you his angels,
    you mighty ones who do his bidding,
    who obey his word.
21 Praise the Lord, all his heavenly hosts,
    you his servants who do his will.
22 Praise the Lord, all his works
    everywhere in his dominion.
Praise the Lord, my soul.

The Road Not Taken 

ROBERT FROST

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;

Then took the other, as just as fair,
And having perhaps the better claim,
Because it was grassy and wanted wear;
Though as for that the passing there
Had worn them really about the same,

And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back.

I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.

Photo by Pixabay on Pexels.com

Sunshine Daisy

“The-oil-painting-daisy”is a good wallpaper, I like it very much, let’s take a look at it ~ Click here for details: https://themes.cloud.huawei.com/servicesupport/share/getSharing?type=0&hitopID=102706115&themeVersion=10.0&isoCode=PH&language=en_GB&shareTitle=The-oil-painting-daisy&imgUrl=https%3A%2F%2Ftheme.dbankcdn.com%2Fhitop%2Fwallpaper%2FFHD%2F800136316%2Fsmall_800136316.jpg

I would love to paint this on my Vacation Leave. Can’t wait. 🌞🌼 I pray to accomplish this painting. 🙏

#TheSW30 Day 23: Talk about a moment when you got annoyed with a married friend, a person in a relationship, or a person with kids.

If I were to relieve a moment in the past when I got annoyed from a person with kids was whenever I go to a school reunion or gatherings with relatives. I have not been annoyed. I was just uncomfortable. Especially when my aunties or some of my friends who are already married and already have kids, would ask if I already have a boyfriend. Obviously, I have none. Haha! They would ask me if what’s the reason why I don’t have a boyfriend, when I am at the marrying age already. Then, I would say that I am just focusing first with my career and my schooling, and that I still have not met Mr. Right. In that manner, he still has not revealed himself yet and I am still waiting.

They would as if want to tell me out of concern, to not be so choosy because I might become an old maid. Hehe.

Chase him

If you do this, it is the perfect recipe for pushing a guy away. Chase him.

They say, it’s a normal instinct for someone to run if you start running after them.

Do you agree?

But what if, you barely haven’t met each other. Would that still be considered as chasing? Unless, if they have built a serious connection with each other.

Is it possible for someone to fall for someone she have not even met yet?

A friend of mine said, “No, she will never fall especially for a person whom she have not even met.” Why? It’s because she is not sure if that person is really true or if the both of them jive together and if they are compatible with each other.

Is compatibility an issue here? or is there so much more?
Can you actually fall for a stranger? Maybe they just give you that feeling of excitement and mystery, because you don’t truly know the person yourself.

However, God orchestrates every relationship that transpires in this world. All the friendships that happen, I believe God intertwines the steps of each creature walking on the surface of this mother earth.

Is there a reason for you to meet this person? What can you learn from him or her?

Note: Be scarier than what scares you. Haha.

Photo by Cristian Dina on Pexels.com