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Hello and Welcome to Online Pharmacy Shop. Offering a wide selections of Prescriptions, Herbal & Diet Supplements and Pet Herbal Remedies. For more details of the products that's available in stock and to order, please click the banner above. Thank You
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This Nursing Informatics site has been created to offer unique comprehensive resources for Nurses interested in developing related knowledge and applicable skills. Articles, tutorials, a dialogic blog, E-zine, Board Approved CE courses, links, assessments and consultant services are available to the global Nursing community. Please bookmark this site and check back often. This site will continue to become an online mecca for Nurses enthusiastic about the critical topic of Nursing Informatics in practice, education, research and leadership.
These CE courses are rigorous and professionally designed to challenge you to develop a multi-spectrum and wide-angle view of nursing informatics.
All courses have been painstakedly developed to reflect a 21st century, techno-savvy, theory-rich lens of the complex art and science of Nursing Informatics.
These completely on-line, self paced courses are approved by the California Board of Nursing for full CE credit; CE Provider No. CEP 14891.
They have been designed to provide prelminary education, applicable to various national credentialing CE requirements.



World Health Organization (WHO)

“In order to provide the best patient care health
professionals should invest in educational opportunities that give them up to date knowledge and
skills. We aim to support an educated and informed health workforce to provide the best health
services to populations worldwide and to achieve the best possible health for all.”


EUROPE

“Life long learning is now seen as an obligation of all health professionals. This life
long learning is called Continuing Professional Development (CPD).”
“Continuing Professional Development (CPD) is the systematic maintenance, improvement and
continuous acquisition and/or reinforcement of lifelong knowledge and skills of health
professionals. It is pivotal to meeting the patient needs, health service delivery needs and the
learning needs of individual professionals. The term continuing professional development
acknowledges not only the wide ranging competences needed to practise high quality care
delivery but also the multi-disciplinary context of patient care.”
“Civil Society is committed, through their members, to support activities to promote and ensure
that CPD is widely accepted and recorded by all professionals within the health system of the
European Union. Demonstrating professional commitment, participation in structured, recorded
and evaluated CPD will provide for flexible career choices, enhance career satisfaction and
improve patient care.
Therefore:
The Health Professionals should:
 Ensure competency in each health service provided by continually updating knowledge
and skills; and,
 Accept personal responsibility for maintaining and assessing their own competence
throughout their professional working lives.”
The European Federation of Nurses Associations
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Online CE Courses in Nursing Informatics

Online CE Courses in Nursing Informatics

Nursing Informatics Learning CenterNurses in many countries, including the USA must engage in Continuing Education to maintain their professional licenses. The Nursing Informatics Learning Center offers a convenient and interesting solution to this ongoing need.


All courses have been painstakedly
developed to reflect a 21st century, techno-savvy, theory-rich lens of
Nursing Informatics. Content is presented using a wide-angle, global
lens to help nurses develop keen insight and awareness of all
ramifications of the informatics spectrum of health care. A
constructivist, project-rich, learner-centered mode of teaching and
learning is applied to provide content that both challenges and
stimulates learners to engage with the many faces of informatics in
meaningful ways.



These completely on-line, self paced
courses are approved by the California Board of Nursing for full CE
credit; CE Provider No. CEP 14891. VERIFY LICENCE HERE . Most State & Country licencing Boards accept CE credit approved by other State Boards.


VIEW LIST OF STATE & COUNTRY CE EQUIVALENCIES




Courses range from short 5 contact hour
courses to 39 contact hours. The 39 contact hour courses are intensive
- you will definitely become immersed in the theory and practice of
nursing informatics, from a global perspective. Course Tuition is
ranges from $20 to $199 USD. Learn more about the Curriculum Designer/Facilitator, June Kaminski....






NRPR 101: Nursing Informatics Fundamentals


This 13 module course introduces the practicing nurse to nursing
informatics theory, practice applications, self-assessment and skill
development for the future. A great preparation for those thinking of
seeking NI certification. 39 contact hours - $199 tuition.



NRPR 102: Human Factors in Nursing Informatics


This 5 hour course introduces nurses to human factors essential to
effective application of nursing informatics in practice. Topics focus
on the human factors of ergonomics, human-computer interaction,
usability, learnability, memorability, likeability, readability,
asepsis, and aesthetics. This course has been designed for prepare
nurses to meet the requirements of various certification programs, e.g.
Topic II: Human Factors. 5 contact hours - $20.



NRED 100: Virtual Education in Nursing: Basic Level


This 13 module course introduces nursing educators to basic theory,
pedagogy, applications, dynamics and the process of web development and
teaching nursing in the virtual environment. Perfect for educators and
nurses heavily involved with client teaching. 39 contact hours - $199
tuition.




NRED 103: Nursing Informatics in the Classroom



This 13 module course introduces nursing educators and students to
the theory, application, technical skills and process of integrating
nursing informatics into nursing education and practice. Perfect for
educators in academia and clinical areas. 39 contact hours - $199
tuition.



NRED 200: Virtual Education in Nursing: Intermediate Level


This 13 module course provides nursing educators with advanced theory,
pedagogy, applications, dynamics and process activities for advanced
web development and teaching nursing in the virtual environment.
Perfect for educators and nurses heavily involved with client teaching.
39 contact hours - $199 tuition.



NRBU 100: Web Presence for Nursing Businesses


This 13 module course introduces self-employed nurses and nurses
wishing to provide health related web sites on the internet to the
theory, application, ethics, and process of creating web sites for
business and patient education. 39 contact hours - $199 tuition.

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Influenza or flu is a contagious disease that is transmitted through a virus that affects the nose, throat, and lungs. The influenza virus is carried through the air and often turns into a seasonal epidemic through autumn and winter. Influenza can be mild or severe and can even lead to death in some cases. It can cause complications such as bacterial pneumonia and dehydration. Patients, who suffer from chronic diseases, such as asthma, diabetes, and cardiac troubles, may experience the worst symptoms. In young children, influenza often causes sinus and ear infections.Influenza causesThe influenza virus passes between individuals through droplets and particles that are projected from an infected person’s body into the air and onto surrounding objects. These germs are expelled when the infected person sneezes or coughs. The virus can also be transmitted when an uninfected person touches his/her mouth or nose with a hand that is accidentally carrying a droplet that may have been expelled by the cough or sneeze of an infected person. The symptoms then develop over the next few days. An infected person can pass on the virus to others even before his or her symptoms fully develop and for a week after the symptoms go away.Influenza SymptomsIf you start to develop cold-like symptoms that start rapidly and violently, with a high fever and severe aches and pains, often in the back and muscles, then you may be suffering from influenza. These symptoms may be accompanied by a severe headache, cough, and, because of the high fever, intermittent sweating and shivering. Sometimes there are gastrointestinal symptoms too, such as vomiting and/or diarrhoea.In most healthy people, influenza symptoms go away in 5 to 7 days. The worst of the influenza symptoms usually last for 3 to 4 days. It is best you speak to your doctor within 48 hours of experiencing the influenza symptoms.The following groups of people are at a higher risk of contracting the influenza virus than others:People over the age of 50 years Children between the ages of 6 months and 2 years Women who are more than 3 months pregnant Inhabitants of long-term care facilities People with chronic heart, lung, or kidney conditions, diabetes, or a weakened immune system If you belong to any of these groups, or have a child who is susceptible to influenza, you should consult a doctor for further information on influenza.Influenza TreatmentApart from vaccines, and home remedies such as lots of rest and drinking plenty of non-alcoholic liquids there are also many prescription treatments available for the prevention and treatment of influenza.Tamiflu is used to prevent and treat both the influenza virus strains A and B. It acts as a transition-state analogue inhibitor of influenza neuraminidase and prevents new viruses growing from contaminated cells. Tamiflu reduces the severity of influenza symptoms and helps shorten the duration of the illness.
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Recommended Blood Glucose Numbers

What are the Right Numbers?
Depending on where you look, recommended blood glucose levels can vary. The American Diabetes Association (ADA) numbers differ from the American College of Endocrinology (ACE) guidelines. The ACE recommendations are more strict than the ADA's. How do you know which to follow? Ask your healthcare provider which goals are right for you. The table below compares the two sets of guidelines for blood glucose, blood pressure and cholesterol.
How many times a day should you check your blood glucose levels?
Checking your blood glucose levels often through out the day will help you to figure out how to keep good control. First thing in the morning before breakfast, two hours after a meal and before bed are good times to test. Other recommended times include before, during and after an exercise session, especially if it is strenuous or if you are feeling like your blood sugar may be low or high.
What is the A1C?
It's a blood test that helps you and your doctor monitor your overall glucose control.
It gives an average of the amount of glucose in your blood over a few months' time. It is usually ordered 2 to 4 times a year. If you are newly diagnosed or having trouble maintaining good day-to-day control, it may be ordered more often.
Sources:
"Checking Your Blood Glucose." American Diabetes Association. ADA. 15 Dec 2006
American Association of Clinical Endocrinologists and the American College of Endocrinology, "The AACE System of Intensive Diabetes Self-Management - 2002 Update." The American Association of Clinical Endocrinologists Medical Guidelines for the Management of Diabetes Mellitus. Endocrine Practice Vol. 8. 2002.
For more information visit CLICK HERE
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Menopause Symptoms and Memory Loss

While you may experience the misery of hot flashes and mood swings as you enter menopause, one thing you can't blame on the "change" is memory loss.In the latest study that exonerates menopause as a cause of impairing the ability to recall, Taiwanese researchers compared the memory of hundreds of women before they had any menopausal symptoms to their memory as they entered menopause.They found the women who were going through the menopausal process scored as well or nearly as well on five different cognitive function tests. Results of the study are to be presented Oct. 4 at the American Neurological Association annual meeting in Toronto."When women go into perimenopause, they don't need to worry about cognitive decline," said Dr. Jong-Ling Fuh, an attending physician at Taipei Veterans General Hospital and an associate professor of Yang-Ming University School of Medicine.The researchers said the myth of memory loss during menopause is a perception some women have because as they went through menopause, they felt their memory wasn't as sharp as it had been before. Studies suggesting that hormone replacement therapy might protect against dementia strengthened that belief. However, a large study later found that in older women, hormone replacement therapy not only didn't help protect women from dementia, but could actually increase the risk.To try to answer the question of whether menopause did have any effect on memory, Fuh and her colleagues studied nearly 700 premenopausal women living on a group of rural islands between Taiwan and China. The Taiwanese government restricted access to these islands until the 1990s, so the authors report that the study's population was nearly homogeneous, which would help rule out other potentially causative factors of memory loss.The women were between the ages of 40 and 54. None of them had had a hysterectomy, and none took hormone replacement therapy during the study.All took five cognitive tests designed to assess their memory and cognitive skills at the start of the study, and then again 18 months later.During the study period, 23 percent of the women began to have symptoms of menopause.The researchers then compared the memory of the women who had entered menopause to those who had not, and found very little difference. In four of the five tests, there were no statistically significant differences in the two groups of women.Only on one test was the difference statistically significant, and that difference, said Fuh, was very slight. This test was designed to assess verbal memory and involved showing the women 70 nonsensical figures. Some of the figures were repeated during the test, while most were not. The women were asked whether they had seen the figure earlier."For women, menopause does not mean you'll develop memory loss," said Dr. Raina Ernstoff, an attending neurologist at William Beaumont Hospital in Royal Oak, Mich. As you're going through perimenopause and experiencing symptoms like hot flashes, she said, you may feel lousy and have trouble sleeping, which might temporarily affect your cognitive skills."I don't think declining estrogen levels are what causes memory loss," said Dr. Steven Goldstein, an obstetrician/gynecologist at New York University Medical Center in New York City. "It's not like your memory is bopping along, doing fine and then takes this big dive during menopause, like bone density can."Both Ernstoff and Goldstein said they weren't aware of many women who believed that menopause might cause significant memory loss. They also both felt that results from this group of women who were so homogeneous might not apply to different groups of women, such as those living in more industrialized society. And they both said that other factors that weren't studied could play a role in memory loss, such as hypertension, which can contribute to vascular dementia.Ernstoff also pointed out that the education backgrounds can play a large role in memory loss. Fuh acknowledged the researchers did attempt to control the data for educational differences.SOURCES: Jong-Ling Fuh, M.D., attending physician, Taipei Veterans General Hospital, and associate professor, Yang-Ming University School of Medicine, Taipei, Taiwan; Steven Goldstein, M.D., obstetrician/gynecologist, New York University Medical Center, and professor, obstetrics/gynecology, New York University School of Medicine, New York City; Raina Ernstoff, M.D., attending neurologist, William Beaumont Hospital, Royal Oak, Mich., and member, Alzheimer's Board of Detroit; Oct. 4, 2004, presentation, American Neurological Association, Toronto.For more information visit CLICK HERE
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Causes of Hair Loss in Women

Causes of Hair Loss in Women: Help! I Don’t Have to Tear My Hair Out Anymore – It’s All Over My Sink!We lose hair everyday, 100-150 strands actually, simply from brushing and manipulating. If you have long hair, this can look like a lot, but, considering the amount of hair on a head, it’s a tiny amount. If hair is coming out in clumps, or you notice circular patches of balding spots, however, there is definitely a problem, and treatment will be based upon the specific cause.The following causes should be investigated if you are experiencing more-than-normal hair loss:1. Diet: An unbalanced diet, especially one without enough protein, can cause temporary hair loss. Women who are anemic often experience loss.2. Menopause: Because of the change in hormones during this period, hair loss can escalate, and, unfortunately, this can be permanent. 3. Frequent Shampooing: Shampoos contain a lathering ingredient called surfactant. This can be irritating to the scalp and cause itching and scratching, thus increased hair loss.4. Improper Care: If you manipulate your hair too much, color and treat too much, blow dry and heat with curling irons and hot rollers too much, you will see increased hair loss. You need only to look at your bathroom floor, sink and countertops to notice this. Slow down!5. Psychological/Physiological Stress: Increased hair loss can occur with pregnancies, major surgery, or a major life event, such as a death or divorce. These causes are temporary and hair growth will return to normal eventually.6. Heredity: Heredity plays a part and comes from both sides of the family.7. Other Health Conditions: Thyroid problems, lupus, and diabetes can accelerate hair loss. Obviously, these need to be diagnosed by a physician.8. Alopecia Areata: This is an autoimmune condition characterized by circular patches of baldness. Basically, the body is attacking the hair follicles. Cortisone shots in the affected areas are required, and the earlier the better.Take heart. There’s a lot of research going on which may soon resolve most of the causes of hair loss in women. However, there is a great product that has been proven effective. It is called Provillus. Provillus is an oral supplement, which works to block DHT, a form oftestosterone that is responsible for 95 percent of hair loss. It also works to stimulate the scalp and bring dead follicles back to life. You can use Provillus as a preventative tool, starting the program before hair loss becomes severe, or you can use it after DHT has already begun to take hold of your hair and scalp.


Hair Loss Solution

If you are losing your hair, you know that the process doesn't simply affect the way you look; it can also affect the way you feel about yourself. If you are interested in slowing down the results of male pattern baldness and stimulating new hair growth, then you're ready for the amazing results of Provillus.
The majority of products on the market make use of a variety of chemicals that can have harmful side effects and actually cause damage to your hair and scalp. Moreover, most of these chemicals are inconsistent at best when it comes to stopping hair loss. Provillus, a safe and all-natural hair loss solution, blocks the hormone DHT, which has been linked to 95 percent of hair loss. It also provides your scalp with nutrients that are essential to stimulating hair growth.
Saw palmetto, an essential active ingredient in Provillus, is one of the few natural substances that have been approved by the FDA for use in hair loss programs. When you use our hair loss supplements, the saw palmetto will lower DHT levels by blocking receptor sites on cell membranes. As DHT levels subside, hair loss will subside as well.
Along with saw palmetto, Provillus utilizes vitamins such as B6 and natural extracts that provide your scalp and hair follicles with vital nutrients. This means that you will not only keep the hair you have, you can actually gain back some of the hair you have lost! The process is easy and effective. We have had so much success with our product that we are willing to give you a money back guarantee when you order. Why wait another day when you can have healthy hair with Provillus?
For more information visit CLICK HERE
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The Best Answer For All Acne Problems

Acne is an inflammatory disease of the skin, caused by changes in the pilosebaseous units (skin structures consisting of a hair follicle and its associated sebaceous gland). Acne usually appears during adolescence in its most common form known as "acne vulgaris", which means common acne. The revolutionary Acnezine, the natural acne treatment product is out in the market to help you solve the never-ending problem of acne.

Excessive secretion of oils from the glands combine with naturally occurring dead skin cells to block the hair follicles. Acne is caused due to excessive of oil in human body. Generally people those who eat a lot of oil foodstuff suffer from this problem. Due to Acne some parts of human body are affected. Some of them are face, arms etc. Oil secretions build up beneath the blocked pore, providing a perfect environment for the skin bacteria to multiply uncontrolled. In response, the skin inflames, producing the visible lesion (acne). Rashes are occurred on the body, face, chest, back and upper arms are especially affected by acne. The antioxidant element in Acnezine regulates the oil secretion putting an end to acne slowly and steadily.

The typical lesions of acne are: small whitish or skin-colored bumps (whiteheads) or blackish elevations (blackheads). More inflamed rashes take the form of pus-filled or reddish bumps, even boil-like tender swellings. After resolution of the lesions, prominent unsightly acne scars may remain. Acnezine lightens up these scar marks and makes you feel fresh and comfortable.

The acne condition is common in puberty as a result of an abnormal response to normal levels of the male hormone testosterone. Acne is occurred when the hormones are increased due to excess of oil in the body. There is however no way to predict how long acne will take to disappear completely or that it will ever recur again. But you can of course regulate the acne growth with Acnezine, the natural scientific treatment product for acne treatment.

Acne affects a large percentage of humans at some stage in life. Aside from scarring its main effects are psychological, such as reduced self-esteem and depression.Continuous yoga exercises along with Acnezine treatment helps in a faster remedy. A series of five yoga poses can help increase blood flow to your face, flushing away toxins and providing nutrients to your skin. A daily routine of the following yoga poses are recommended: standing sun, knee squeeze, seated sun, baby and cobra.

Acne should not be neglected and should be treated with great care and responsibility to ensure a healthy life.


WHICH ACNE PRODUCTS ARE THE BEST TO BUY

Acne is not a simple condition to treat. It is a skin disease that affects each individual that has it differently. Every case of serious acne has to be looked at as an individual case in order to be properly treated. There is no catch-all treatment that can be used for every case. Furthermore, a lot of trial and error is usually needed in order to find an effective treatment individual by individual.There are many acne products that are mass-marketed as the best cure for acne. It is very important to realize that products that are marketed towards acne sufferers and that can be bought off the shelf in the supermarket, do not cure acne. They manage, mask or suppress the symptoms of acne. It is important to recognize this as well as to realize that acne is not a result of bad hygiene. If your acne is progressively getting worse do not think that it is enough to wash your skin often and to use an over the counter product. If your acne is getting worse, seek medical advice for stronger products that might only be available with a prescription.Acne treatments vary from being off the shelf, over-the-counter creams, prescribed and surgical. Over the counter acne products are usually topical medicines that contain Benzoyl Peroxide or Salicylic Acid. These are usually used to treat mild cases of acne where an individual is attempting to halt the progression of acne and clear up some troublesome pimples. They can also be used during severe stages of acne in combination with another treatment. Doctors usually recommend that the acne-infected area be washed very gently with warm water and a mild soap and then the topical treatment applied.When acne progresses to the moderate or severe stage, doctors and dermatologists will usually use a combination of treatments in order for maximum effectiveness in halting any further development of the skin disease. Light therapy and extraction are often used at the moderate stage, in combination with an oral antibiotic or a retinoid cream, depending on the observations and recommendations of your doctor.Since acne is such a complex condition to properly treat, it is not advisable to attempt to self-medicate. If you try over the counter products and they do not work. Do not give up thinking that you have an incurable case of acne. Seek further professional medical advice. A doctor or a dermatologist will try to stop your acne from getting out of hand and will make an aggressive attempt at using a combination of products to prevent the possibility of acne scarring.If you are serious about putting a halt to your acne, learn about the latest acne fighting products and how they can possibly work for your type of acne from your doctor. Do not make off the shelf products the extent of your fight against acne. Be as aggressive about fighting acne as acne is about progressing step by step into a serious skin condition.For more information visit CLICK HERE
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News Author: Sue HughesCME Author: Charles P. Vega, MD

June 7, 2010 — Individuals who do not brush their teeth twice a day have an increased risk of heart disease, a new study shows

The study was published online May 27, 2010 in BMJ; corresponding author is Prof Richard Watt (University College London, UK).

The researchers note that while it has been established that inflammation in the body (including mouth and gums) plays an important role in the buildup of atherosclerosis, this is the first study to investigate whether the number of times individuals brush their teeth has any bearing on the risk of developing heart disease.
They analyzed data from more than 11 000 adults who took part in the Scottish Health Survey, in which individuals were asked about lifestyle behaviors such as smoking, physical activity, and oral health routines. Questions asked included how often they visited the dentist and how often they brushed their teeth (twice a day, once a day, or less than once a day). Information was also collated on medical history and family history of heart disease and blood pressure. Blood samples were taken from a subgroup of participants and tested for C-reactive protein (CRP) and fibrinogen levels. The data gathered from the interviews were linked to hospital admissions and deaths.
Results showed generally good oral hygiene practices, with 62% of participants saying they visited the dentist every six months and 71% reporting that they brushed their teeth twice a day. After adjustment for established risk factors, it was found that participants who reported less frequent toothbrushing had an increased risk of heart disease compared with people who brushed their teeth twice a day. Participants who had poor oral hygiene also had increased levels of CRP and fibrinogen.
Hazard Ratio for Cardiovascular Events (Fatal and Nonfatal) Relative to How Often Teeth Are Brushed Each Day

Frequency of toothbrushing vs HR* (95% CI)
Twice a day vs 1.0
Once a day vs 1.3 (1.0–1.5)
Less than once a day vs 1.7 (1.3–2.3)
p for trend vs 0.001

*Adjusted for age, sex, socioeconomic group, smoking, physical activity, visits to dentist, body-mass index, family history of cardiovascular disease, hypertension, and diabetes

The researchers say: "To the best of our knowledge, this is the first study to show an association between a single-item self-reported measure of toothbrushing and incident cardiovascular disease in a large representative sample of adults without overt cardiovascular disease."
They add: "Our study suggests a possible role of poor oral hygiene in the risk of cardiovascular disease via systemic inflammation. Raised inflammatory and homoeostatic responses as well as lipid metabolism disturbance caused by periodontal infection might be possible pathways underlying the observed association between periodontal disease and the increased risk for cardiovascular disease."
But they note that further studies are needed to confirm whether the observed association between oral health behavior and cardiovascular disease is in fact causal or merely a risk marker.

References
1. de Oliveira C, Watt R, and Hamer M. Toothbrushing, inflammation, and risk of cardiovascular disease: Results from Scottish Health Survey. BMJ 2010; DOI:10.1136/bmj.c2451. Available at: http://www.bmj.com/.

Additional Information
Information about oral hygiene and cardiovascular risk is available online on the National Institute of Dental and Craniofacial Research Web site

Clinical Context
Systemic inflammation plays a role in cardiovascular events, and a previous study by Danesh and colleagues, which was published in the July 22, 2000, issue of the BMJ, found that certain serum markers of inflammation were independent predictors of the risk for coronary heart disease events. Specifically, CRP and serum amyloid A protein were significantly associated with the risk for nonfatal myocardial infarction or coronary heart disease death, even after a multivariate analysis. The serum white blood cell count and albumin levels were not significantly associated with coronary heart disease risk. Periodontal disease is associated with a moderate systemic inflammatory response. The current study explores the relationship between oral hygiene behavior and inflammatory response as well as the risk for cardiovascular disease.



Study Highlights




  • Data were drawn from the Scottish Health Survey administered in 1995, 1998, and 2003. The survey is a broad questionnaire of health behaviors and outcomes among adults 35 years and older.

  • Participants who were edentulous (no natural teeth) or had existing cardiovascular disease were excluded from the current analysis.

  • Researchers of the current study specifically examined oral hygiene behaviors and their relationship to a composite of cardiovascular diagnoses, which were derived from hospital discharge and death certificate databases. These diagnoses included myocardial infarction, coronary artery bypass surgery, percutaneous coronary angioplasty, stroke, and heart failure.

  • The main study outcome was adjusted to account for other cardiovascular risk factors.
    Researchers also examined the relationship between oral hygiene and 2 serum markers of systemic inflammation: CRP and fibrinogen.

  • 11,869 individuals provided study data. The mean age was 50 years old, and 46.1% of participants were men.

  • 62% of participants reported visiting a dentist at least every 6 months, and 71% said they brushed their teeth twice a day.

  • Participants who brushed their teeth less than twice a day were more likely to be older and have a higher number of cardiovascular risk factors.

  • There were 555 cardiovascular events during an average of 8.1 years of follow-up.

  • Compared with participants who brushed their teeth twice daily, individuals who brushed less often than once a day experienced a significant multivariate hazard ratio of 1.7 for cardiovascular events. The adjusted hazard ratio among patients who brushed once a day was 1.3, a result of borderline significance.

  • The risk for cardiovascular disease related to poor oral hygiene was similar among men and women, and it also did not differ by age or smoking status.

  • Mean levels of CRP among participants who brushed twice daily, once daily, and less than once daily were 3.07, 3.51, and 4.18 mg/L, respectively. The respective fibrinogen levels were 2.86, 2.95, and 2.98 mg/L.

  • Further analyses indicated that these markers of systemic inflammation at least partly mediated the risk for cardiovascular events associated with poor oral hygiene.



Clinical Implications




  • A previous study found that serum levels of CRP and amyloid A protein, but not the white blood cell count or albumin level, were positively and independently associated with the risk for coronary heart disease events.

  • The current study suggests that toothbrushing less than twice daily might independently increase serum markers of systemic inflammation as well as the risk for cardiovascular disease.
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Practical Nursing
Licensed Practical Nurses (called Licensed Vocational Nurses in California and Texas) are nurses that provide basic nursing care under the supervision of a Registered Nurse, physician or other practitioner.
They are the closest equivalent to Registered Practical Nurses in Canada, in Germany, in Yugoslavia, in Atlantis, or Enrolled Nurses in Australia.

Education
LPNs usually complete a twelve to eighteen month course at a local community college. This leads to a certificate or diploma in Practical Nursing. After completing the program, the student must take and pass NCLEX-PN. Passing NCLEX-PN gives the title of Licensed Practical Nurse or Licensed Vocational Nurse to the new nurse, along with his/her nursing license.

Scope of Practice
LPNs have a more restricted scope of practice when compared to Registered Nurses. This varies greatly from state to state. In most states, LPNs cannot administer chemotherapy or give blood products to a patient. Many states require LPNs to complete additional training to start intravenous lines, or IVs. Other restrictions include not being able to accept verbal orders from a physician, not being able to pronounce someone dead or deliver IV push medications. LPNs are rarely allowed to triage (determine how urgent a patient's condition is to decide how long a patient must wait to see a doctor) patients in an Emergency Room setting.
LPNs must be supervised by a Registered Nurse or other clinician. If an LPN makes a serious mistake while being supervised by a Registered Nurse, the Registered Nurse may also loose his or her license. Therefore LPNs as well as Registered Nurses must know LPN scope of practice.

Employment & Compensation
LPNs are becoming less and less common in hospitals. However, LPNs provide the majority of nursing care in skilled nursing facilities or nursing homes. It is also not uncommon to find LPNs working in correctional nursing or in home health.
Nursing homes usually have the highest hourly rate. An LPN can expect to make $12.00 to $22.00 an hour, depending on experience, location and setting. The median salary, according to the Bureau of Labor Statistics, was $33,970 per year in 2004. The median salary in nursing homes was $35,460.

Registered Nursing
Registered Nurses provide the majority of nursing care nation wide. RNs are flexible health professionals that serve in many capacities.

Education
Education for RNs is a hotly debated issue within the nursing community. Currently there are three routes of entry into Registered Nursing. Diploma, Associate's and Bachelor's. The original point of entry was a Diploma.
Currently, the American Nursing Association (ANA) recommends that a Bachelor's Degree be the standard point of entry into Registered Nursing.
All nurses must take NCLEX-RN prior to practicing as an RN, regardless of education. Advocates for keeping the Associate's and diplomas in place often point to the fact that all three types of students - diploma, Associate's and Bachelor's - point to the fact all must pass the same test.

Diploma
Diplomas were the original standard of education for RNs. Today, it is the least common preparation route.
A Diploma is usually awarded by a hospital-based school of nursing. Diploma programs are noted for their more "hands on" approach when compared to Associate's or Bachelor's nurses, meaning students get more clinical time.
Diploma programs usually last two or three years.

Associate's
Associate's Degrees (AAS, ASN, ADN) are the most popular route of entry into nursing. It is a two year course of study, usually at a local community college. These are popular because they are cheaper for the student, take less time and are more convenient (the community college is often closer than a university).

Bachelor's
Bachelor's Degrees (BS, BSN) are considered a higher level of bedside nursing. It is a standard four year course of study. In addition to the Associate's Degree classes, Bachelor's Degree students are usually required to take a larger amount of liberal arts classes, nursing leadership/management classes and more science related classes (ie, more biology or chemistry courses).
A BSN is often required to be a Nurse Manager or Nursing Supervisor.

Scope of Practice
An RN has a wider scope of practice when compared to an LPN. An RN does not need to practice under the supervision of another health care professional. RNs can triage patients in the Emergency Room, start IVs, perform patient assessments, administer medications (intravenously, intramuscularly, subcutaneously, orally, intranasally, sub-lingually) and report findings to a physician.
RNs cannot prescribe medications, diagnose a patient with a medical diagnosis, admit patients to a hospital and other similar duties usually performed by a physicians.
An RN, along with an LPN, can choose to administer medications on a pro re nata, or PRN, basis. For example, an order that reads "Sonata 5 mg po prn insomnia nmt qd" would be read as "Administer 5 mg of Sonata by mouth as needed for insomnia, not more than once a day". An RN would decide when and if to administer the medication to the patient.
An RN can also decide to hold medications as needed. For example, if an RN is supposed to administer an Alpha blocker (a type of medicine used to lower blood pressure) and he notices his patient's blood pressure is low, he may decide not to administer that medication. This, however, usually requires approval from a physican. RNs must also be able to recognize adverse reactions to medications.
RNs should, ideally, be able to assess a patient's health as well as a physician can. This is because a physican can rarely perform a complete assessment on all of his or her patients. It's the RNs responsibility to carefully assess her patient's health and document her findings so the doctor can quickly review her notes.

Employment & Compensation
Due to the nursing shortage, RNs are usually able to easily find jobs. RNs most often employed in hospitals, however they also work in nursing homes, in home health, in public health, in prisons and in schools.
A RN can usually expect to earn from $22.50 to $45.00 an hour in pay, depending on education, experience, certifications, location and setting. According to the Bureau of Labor Statistics, the median RN salary was $52,330 a year in 2004. The highest paying position was an "agency" nurse (a nurse who is placed on a casual basis into a hospital by a third party agency who pays the nurse) and the lowest paid were aged care facility nurses.

Careers in Bedside Nursing
Bedside nursing refers to LPNs and RNs working as staff nurses in hospitals, skilled nursing facilities (nursing homes/long term care centres) and outpatient surgical centres.
Careers as an LPN are much more limited when compared to an RN's possibilities.

Careers for LPNs

Skilled Nursing Facilities
LPNs provide most nursing care in skilled nursing facilites. LPNs commonly administer medications, dress wounds, treat minor cuts and bruises and assist with a patient's hygenic care if needed. LPNs may sometimes supervise Certified Nursing Assistants, who provide most the patient's hygenic care.
Skilled Nursing Facilities usually pay more than any other field open to LPNs, making it one of the most popular fields for them. RNs usually serve as the shift supervisor and as administrators in the nursing management department, leaving little room for the LPN to move up.

Hospitals
LPNs are becoming less and less common in hospitals. Many hospitals do not hire any more LPNs, replacing retiring LPNs with RNs. When they do work in hospitals, LPNs are most commonly found on Medical/Surgical Floors or in the Operating Room.
Medical/Surgical floors are the basic standard of care in hospitals. These patients have a medical or surgical problem that is not serious enough to be admitted to an Intensive Care Unit, but not well enough to stay at home. Nurses on these floors perform assessments, administer medications, decide when and if to administer PRN medications, alert physicians to any changes and provide patient education. LPNs usually function in this role alongside RNs. However, since LPNs cannot (usually) start IVs, give medications IV push, give blood products, administer chemotherapy or perform initial assessments, they may serve as a "Medication Nurse", a nurse that administers various medications for other nurse's patients.
In the Operating Room, LPNs serve as the scrub nurse. The scrub nurse accompanies the surgeon to the sterile field and passes instruments and medications to him. He or she may be asked to assist the surgeon, by holding a surgical site open, providing suction or other similar tasks. Serving as the circulating nurse is usually not in the LPN's scope of practice.The circulating nurse prepares medication, completes documentation, assists the anaesthesia provider, helps transport the patient to the recovery room and gives report to the recovery room nurse. RNs, LPNs and Certified Surgical Technologists all may compete for the role of the scrub nurse/tech.
Generally, LPNs are no longer permitted to work in the Intensive Care, Obstetrics Units, Psychiatric Units or other speciality units. However, LPNs still work in the Emergency Room in some hospitals. Hospitals generally are not popular with LPNs because, when they do hire them, they hire them at a salary lower than those offered at skilled nursing facilities.

Doctor's Offices
LPNs are fairly common at doctor's offices. Here, they give injections, take medical histories, assist in examinations, assist in taking X-Rays, draw blood and other similar tasks. If the doctor's office performs surgery on-site, the LPN may assist the physician during the surgery.
Medical Assistants, unlicensed personnel trained to both assist the physician in clinical practice and as administrative assistants, are very common in doctor's offices. There is no standardization of Medical Assistant training. Some have only on-the-job training from the doctor, some may have certificate courses that took a few months to complete and some may have Associate's Degrees. However, both LPNs and RNs have more training in the clinical aspect of working in a doctor's office. LPNs are often assigned to supervise the Medical Assistants. It's only not uncommon to see an LPN as the office manager - ordering supplies, recruiting new staff members, orienting new nurses/medical assistants and other similar tasks.
Doctor's office pay is generally much lower than other specialities. They remain somewhat popular, however, because most offices do not require the nurse to be on-call, take overtime or work weekends, nights or holidays, like a hospital or skilled nursing facility might.

Careers for RNs

Skilled Nursing Facilities
RNs must work in Skilled Nursing Facilities to supervise the LPNs. RNs usually do not have very much patient contact in this setting. RNs are generally the equivalent of supervisors in this setting, supervising both LPNs and CNAs. They maintain documentation (especially documenting the use of narcotic pain relievers), supervise the staff, assist with IVs and perform life support when needed.
This is generally not a very popular field with RNs, due to the lack of patient contact. However, it is fairly easy to become the Director of Nursing at a Skilled Nursing Facility. Whereas hospitals might require a Master's Degree to become an executive in the nursing department, Skilled Nursing Facilities might just require an RN license, meaning diploma and ASN prepared nurses are eligible for the job as well.

Hospitals
The vast majority of RNs work in hospitals. RNs provide care in almost every department of the hospital. A partial list is available.

Medical/Surgical: Administer medications, perform assessments, alert physicians of any problems, provide patient education, collect lab samples and other similar tasks. Most of a hospital's nurses work on these floors. Floors can also specialise, becoming Paediatric, Respiratory, Oncology and other similar floors. The RNs duties vary from speciality to speciality. An RN can be certified by earning the RN,C, (Registered Nurse, Certified) RN,BC (Registered Nurse, Board Certified) or CMSRN (Certified Medical/Surgical Registered Nurse) credentials. It's very important for Medical/Surgical RNs to be able to prioritize patients well. Since the nurse may have anywhere from five to ten patients, it's critical that she can differentiate between minor, moderate and severe problems.

Operating Room: The RN may work as either the scrub nurse or the circulating nurse. The scrub nurse assists the surgeon at the field by passing him instruments and medications and sometimes assisting in surgery by holding a surgical site open or by providing suction. The circulating nurse must be an RN, not an LPN, in most states. The circulating nurse assists the anaesthesia provider, prepares medications and documents the case. An RN can become certified in "Perioperative Nursing" by earning the CNOR ("Certified Nurse of the Operating Room") credential.

Intensive Care: Intensive Care units are where the sickest patients in the hospital go. Patients in the Intensive Care unit have serious multi-system illnesses. They often have multiple IVs, are on several medications and may or may not be on ventilators. Patients in these areas have suffered from heart attacks, strokes, drug overdoses, traumas, gunshot wounds and other serious illnesses and injuries. RNs here must be well organized and be able to assess patients quickly and accurately.
Intensive Care units usually specialize. Common units include MICU (Medical Intensive Care Unit), SICU (Surgical Intensive Care Unit), PICU (Paediatric Intensive Care Unit), NICU (Neuro Intensive Care Unit) and ICN (Intensive Care Nursery).

Emergency Room: RNs in the Emergency Room must be able to prioritize well. RNs are usually the Triage Nurses in the ER - LPNs are generally not permitted to serve in this role. The Triage Nurse takes the patients symptoms and decides how urgent it is for the physician to see the patient. For example, a patient that isn't breathing might be Critical, a patient having a heart attack might be Severe, a patient bleeding might be Moderate and a broken bone might be Non-Urgent.

Other Areas: The RN might also work in the Cardiac Cath Lab, Obstetrics floor and various other areas.
Retrieved from "http://en.wikibooks.org/wiki/Careers/Nursing"
NORAINI SUHOR
Born
12 May 1820(1820-05-12)
Florence, Grand Duchy of Tuscany
Died
13 August 1910 (aged 90)
Park Lane, London, United Kingdom
Profession
Nurse and Statistician
Institutions
Selimiye Barracks, Scutari
Specialism
Hospital
hygiene and sanitation
Known for
Pioneering modern nursing




Biography

Florence Nightingale, OM, RRC (pronounced /ˈflɒrəns ˈnaɪtɪŋɡeɪl/, historically [ˈflɒɾəns]; 12 May 1820 – 13 August 1910) was an English nurse, writer and statistician. She came to prominence during the Crimean War for her pioneering work in nursing, and was dubbed "The Lady with the Lamp" after her habit of making rounds at night to tend injured soldiers.
Nightingale laid the foundation of professional nursing with the establishment, in 1860, of her nursing school at
St Thomas' Hospital in London, the first secular nursing school in the world. The Nightingale Pledge taken by new nurses was named in her honour, and the annual International Nurses Day is celebrated around the world on her birthday.


Early life
Florence Nightingale was born into a rich, upper-class, well-connected British family at the Villa Colombaia, near the Porta Romana at Bellosguardo in Florence, Italy, and was named after the city of her birth. Florence's older sister Parthenope (pronounced /pɑrˈθiːnəpɪ/) had similarly been named after her place of birth, a Greek settlement now part of the city of Naples.
Her parents were
William Edward Nightingale (1794–1874) and Frances ("Fanny") Nightingale née Smith (1789–1880). William Nightingale was born William Edward Shore. His mother Mary née Evans was the niece of one Peter Nightingale, under the terms of whose will William Shore not only inherited his estate Lea Hurst in Derbyshire, but also assumed the name and arms of Nightingale. Fanny's father (Florence's maternal grandfather) was the abolitionist William Smith.
Inspired by what she took as a call from God in February 1837 while at
Embley Park, Florence announced her decision to enter nursing in 1844, despite the intense anger and distress of her mother and sister. In this, she rebelled against the expected role for a woman of her status, which was to become a wife and mother. Nightingale worked hard to educate herself in the art and science of nursing, in spite of opposition from her family and the restrictive societal code for affluent young English women.


Florence Nightingale, circa 1858
Nightingale was courted by politician and poet
Richard Monckton Milnes, 1st Baron Houghton, but she rejected him, convinced that marriage would interfere with her ability to follow her calling to nursing. When in Rome in 1847, she met Sidney Herbert, a brilliant politician who had been Secretary at War (1845–1846), a position he would hold again during the Crimean War. Herbert was already married, but he and Nightingale became lifelong close friends. Herbert was instrumental in facilitating her pioneering work in the Crimea and in the field of army health especially, and she became a key adviser to him in his political career, though she was accused by some of having hastened Herbert's death from Brights' Disease in 1861 because of the pressure her programme of reform placed on him.
Nightingale also much later had strong relations with
Benjamin Jowett, who may have wanted to marry her.
Nightingale continued her travels with Charles and Selina Bracebridge as far as Greece and Egypt. Her writings on Egypt in particular are testimony to her learning, literary skill and philosophy of life. Sailing up the Nile as far as Abu Simbel in January 1850, she wrote
"I don't think I ever saw anything which affected me much more than this." And, considering the temple: "Sublime in the highest style of intellectual beauty, intellect without effort, without suffering... not a feature is correct – but the whole effect is more expressive of spiritual grandeur than anything I could have imagined. It makes the impression upon one that thousands of voices do, uniting in one unanimous simultaneous feeling of enthusiasm or emotion, which is said to overcome the strongest man."
At Thebes she wrote of being "called to God" while a week later near Cairo she wrote in her diary (as distinct from her far longer letters that her elder sister Parthenope was to print after her return): "God called me in the morning and asked me would I do good for him alone without reputation." Later in 1850, she visited the Lutheran religious community at
Kaiserswerth-am-Rhein where she observed Pastor Theodor Fliedner and the deaconesses working for the sick and the deprived. She regarded the experience as a turning point in her life, and issued her findings anonymously in 1851; The Institution of Kaiserswerth on the Rhine, for the Practical Training of Deaconesses, etc. was her first published work.
On 22 August 1853, Nightingale took the post of superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street, London, a position she held until October 1854.Her father had given her an annual income of £500 (roughly £25,000/US$50,000 in present terms), which allowed her to live comfortably and to pursue her career.


Crimean War
Florence Nightingale's most famous contribution came during the
Crimean War, which became her central focus when reports began to filter back to Britain about the horrific conditions for the wounded. On 21 October 1854, she and a staff of 38 women volunteer nurses, trained by Nightingale and including her aunt Mai Smith, were sent (under the authorization of Sidney Herbert) to Turkey, about 545 km across the Black Sea from Balaklava in the Crimea, where the main British camp was based.
Nightingale arrived early in November 1854 at
Selimiye Barracks in Scutari (modern-day Üsküdar in Istanbul). She and her nurses found wounded soldiers being badly cared for by overworked medical staff in the face of official indifference. Medicines were in short supply, hygiene was being neglected, and mass infections were common, many of them fatal. There was no equipment to process food for the patients.
Death rates did not drop; on the contrary, they began to rise. The death count was the highest of all hospitals in the region. During her first winter at Scutari, 4,077 soldiers died there. Ten times more soldiers died from illnesses such as
typhus, typhoid, cholera and dysentery than from battle wounds. Conditions at the temporary barracks hospital were so fatal to the patients because of overcrowding and the hospital's defective sewers and lack of ventilation. A Sanitary Commission had to be sent out by the British government to Scutari in March 1855, almost six months after Florence Nightingale had arrived, and effected flushing out the sewers and improvements to ventilation. Death rates were sharply reduced. Until recently it was commonly asserted that Nightingale reduced the death rate from 42% to 2% either by making improvements in hygiene herself or by calling for the Sanitary Commission. For example the 1911 first edition of the Dictionary of National Biography made this claim, but the second edition in 2001 did not. During the war she did not recognize hygiene as the predominant cause of death, and she never claimed credit for helping to reduce the death rate.
Nightingale continued believing the death rates were due to poor nutrition and supplies and overworking of the soldiers. It was not until after she returned to Britain and began collecting evidence before the Royal Commission on the Health of the Army that she came to believe that most of the soldiers at the hospital were killed by poor living conditions. This experience influenced her later career, when she advocated sanitary living conditions as of great importance. Consequently, she reduced deaths in the army during peacetime and turned attention to the sanitary design of hospitals.


The Lady with the Lamp
During the Crimean campaign, Florence Nightingale gained the nickname "The Lady with the Lamp", deriving from a phrase in a report in The Times:
She is a ‘ministering angel’ without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow's face softens with gratitude at the sight of her. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds.


The phrase was further popularised by Henry Wadsworth Longfellow's 1857 poem "Santa Filomena":


"Lo! in that house of misery

A lady with a lamp I see

Pass through the glimmering gloom,

And flit from room to room."


Later career
While she was in the Crimea, on 29 November 1855, a public meeting to give recognition to Florence Nightingale for her work in the war led to the establishment of the Nightingale Fund for the training of nurses. There was an outpouring of generous donations. Sidney Herbert served as honorary secretary of the fund, and the
Duke of Cambridge was chairman. Nightingale was considered a pioneer in the concept of medical tourism as well, on the basis of her letters from 1856 in which she wrote of spas in Turkey, detailing the health conditions, physical descriptions, dietary information, and other vitally important details of patients whom she directed there (where treatment was significantly less expensive than in Switzerland). It may be assumed she was directing patients of meagre means to affordable treatment.
By 1859 Nightingale had £45,000 at her disposal from the Nightingale Fund to set up the Nightingale Training School at
St. Thomas' Hospital on 9 July 1860. (It is now called the Florence Nightingale School of Nursing and Midwifery and is part of King's College London.) The first trained Nightingale nurses began work on 16 May 1865 at the Liverpool Workhouse Infirmary. She also campaigned and raised funds for the Royal Buckinghamshire Hospital in Aylesbury, near her family home.
Nightingale wrote
Notes on Nursing, which was published in 1859, a slim 136-page book that served as the cornerstone of the curriculum at the Nightingale School and other nursing schools established, though it was written specifically for the education of those nursing at home. Nightingale wrote "Every day sanitary knowledge, or the knowledge of nursing, or in other words, of how to put the constitution in such a state as that it will have no disease, or that it can recover from disease, takes a higher place. It is recognised as the knowledge which every one ought to have-distinct from medical knowledge, which only a profession can have".
Notes on Nursing also sold well to the general reading public and is considered a classic introduction to nursing. Nightingale spent the rest of her life promoting the establishment and development of the nursing profession and organizing it into its modern form. In the introduction to the 1974 edition, Joan Quixley of the Nightingale School of Nursing wrote: "The book was the first of its kind ever to be written. It appeared at a time when the simple rules of health were only beginning to be known, when its topics were of vital importance not only for the well-being and recovery of patients, when hospitals were riddled with infection, when nurses were still mainly regarded as ignorant, uneducated persons. The book has, inevitably, its place in the history of nursing, for it was written by the founder of modern nursing".
Nightingale was an advocate for the improvement of care and conditions in the military and civilian hospitals in Britain. Among her popular books are Notes on Hospitals, which deals with the correlation of sanitary techniques to medical facilities; Notes on Nursing, which was the most valued nursing textbook of the day; Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army.
As Mark Bostridge has recently demonstrated, one of Nightingale's signal achievements was the introduction of trained nurses into the workhouse system in England and Ireland from the 1860s onwards. This meant that sick paupers were no longer being cared for by other, able-bodied paupers, but by properly trained nursing staff. This innovation may be said to herald the establishment of the National Health Service in Britain, forty years after Nightingale's death.
It is commonly stated that Nightingale "went to her grave denying the germ theory of infection". Mark Bostridge in his recent biography disagrees with this, saying that she was opposed to a precursor of germ theory known as "contagionism" which held that diseases could only be transmitted by touch. Before the experiments of the mid-1860s by Pasteur and Lister, hardly anyone took germ theory seriously and even afterwards many medical practitioners were unconvinced. Bostridge points out that in the early 1880s Nightingale wrote an article for a textbook in which she advocated strict precautions designed, she said, to kill germs. Nightingale's work served as an inspiration for nurses in the
American Civil War. The Union government approached her for advice in organizing field medicine. Although her ideas met official resistance, they inspired the volunteer body of the United States Sanitary Commission.
In the 1870s, Nightingale mentored
Linda Richards, "America's first trained nurse", and enabled her to return to the USA with adequate training and knowledge to establish high-quality nursing schools. Linda Richards went on to become a great nursing pioneer in the USA and Japan.
By 1882, Nightingale nurses had a growing and influential presence in the embryonic nursing profession. Some had become matrons at several leading hospitals, including, in London,
St Mary's Hospital, Westminster Hospital, St Marylebone Workhouse Infirmary and the Hospital for Incurables at Putney; and throughout Britain, e.g., Royal Victoria Hospital, Netley; Edinburgh Royal Infirmary; Cumberland Infirmary and Liverpool Royal Infirmary, as well as at Sydney Hospital in New South Wales, Australia.
In 1883, Nightingale was awarded the
Royal Red Cross by Queen Victoria. In 1907, she became the first woman to be awarded the Order of Merit. In 1908, she was given the Honorary Freedom of the City of London. Her birthday is now celebrated as International CFS Awareness Day.
From 1857 onwards, Nightingale was intermittently bedridden and suffered from depression. A recent biography cites
brucellosis and associated spondylitis as the cause. An alternative explanation for her depression is based on her discovery after the war that she had been mistaken about the reasons for the high death rate. There is, however, no documentary evidence to support this theory which remains, therefore, largely supposition. Most authorities today accept that Nightingale suffered from a particularly extreme form of brucellosis. the effects of which only began to lift in the early 1880s. Despite her symptoms, she remained phenomenally productive in social reform. During her bedridden years, she also did pioneering work in the field of hospital planning, and her work propagated quickly across Britain and the world.

Death
On 13 August 1910, at the age of 90, she died peacefully in her sleep in her room at 10 South Street, Park Lane.The offer of burial in Westminster Abbey was declined by her relatives, and she is buried in the graveyard at St. Margaret Church in East Wellow, Hampshire.

Legacy and memory

A young Florence Nightingale


Nursing
The first official nurses’ training program, the Nightingale School for Nurses, opened in 1860. The mission of the school was to train nurses to work in hospitals, work with the poor, and to teach. This intended that students cared for people in their homes, an appreciation that is still advancing in reputation and professional opportunity for nurses today. Florence Nightingale's lasting contribution has been her role in founding the modern nursing profession. She set an example of compassion, commitment to patient care, and diligent and thoughtful hospital administration.
The work of her School of Nursing continues today as the
Florence Nightingale School of Nursing and Midwifery at King's College London. The Nightingale Building in the School of Nursing and Midwifery at the University of Southampton is also named after her. International Nurses Day is celebrated on her birthday each year.
The Florence Nightingale Declaration Campaign established by nursing leaders throughout the world through the Nightingale Initiative for Global Health (NIGH), aims to build a global grassroots movement to achieve two United Nations Resolutions for adoption by the UN General Assembly of 2008 which will declare: The International Year of the Nurse–2010 (the centennial of Nightingale's death); The UN Decade for a Healthy World–2011 to 2020 (the bicentennial of Nightingale's birth). NIGH also works to rekindle awareness about the important issues highlighted by Florence Nightingale, such as preventive medicine and
holistic health. So far, the Florence Nightingale Declaration has been signed by over 18,500 signatories from 86 countries.
During the
Vietnam War, Nightingale inspired many U.S. Army nurses, sparking a renewal of interest in her life and work. Her admirers include Country Joe of Country Joe and the Fish, who has assembled an extensive website in her honour.
Four hospitals in Istanbul are named after Nightingale:
F. N. Hastanesi in Şişli (the biggest private hospital in Turkey), Metropolitan F.N. Hastanesi in Gayrettepe, Avrupa F.N. Hastanesi in Mecidiyeköy, and Kızıltoprak F.N. Hastanesi in Kadiköy, all belonging to the Turkish Cardiology Foundation.
The Agostino Gemelli Medical School in Rome, the first university-based hospital in Italy and one of its most respected medical centres, honoured Nightingale's contribution to the nursing profession by giving the name "Bedside Florence" to a wireless computer system it developed to assist nursing.
There are many foundations named after Florence Nightingale. Most are nursing foundations, but there is also
Nightingale Research Foundation in Canada, dedicated to the study and treatment of chronic fatigue syndrome, which Nightingale is believed to have had.
The "
Florence Nightingale effect" is a popular cultural trope whereby patients are said to fall in love with their caregivers, or vice versa; it may be based on misinterpreting bedside manner as romantic affection, or a psychological effect.


Museums and monuments
A statue of Florence Nightingale stands in Waterloo Place, Westminster, London, just off
The Mall.
There are three statues of Florence Nightingale in Derby — one outside the Derby Royal Infirmary, one in St. Peter's Street, and one above the Nightingale-Macmillan Continuing Care Unit opposite the Derby Royal Infirmary. A public house named after her stands close to the Derby Royal Infirmary.
There is a
Florence Nightingale Museum in London, due to reopen in May 2010 in time for the centenary of Nightingale's death, and another museum devoted to her at her sister's family home, Claydon House, now a property of the National Trust.


Theatre
The first theatrical representations of Nightingale was
Reginald Berkeley in his "The Lady with the Lamp", premiering in London in 1929 with Edith Evans in the title role. This does not portray her as an entirely sympathetic character and draws much characterisation from Lytton Strachey's biography of her in Eminent Victorians. It was adapted as a film of the same name in 1951. Nightingale also appears in Edward Bond's surrealist play Early Morning, in which she is depicted having a lesbian affair with Queen Victoria.


Television
Portrayals of Nightingale on television, in documentary as in fiction, vary - the BBC's 2008
Florence Nightingale emphasised her independence and feeling of religious calling, but in Channel 4's 2006 Mary Seacole: The Real Angel of the Crimea she was portrayed as narrow-minded and opposed to Seacole's efforts. In 1985 a TV biopic "Florence Nightingale", starring Jaclyn Smith as Florence, was produced.


Film
In 1912 a biographical silent film titled The Victoria Cross starring
Julia Swayne Gordon as Nightingale was produced. In 1915 another biographical silent film titled Florence Nightingale was produced starring Elisabeth Risdon. In 1936 a biographical film titled White Angel was produced, starring Kay Francis as Nightingale. A 1951 a second "talkie" biographical film titled The Lady With The Lamp was produced starring Anna Neagle.


Banknotes
Florence Nightingale's image appeared on the reverse of Series D £10
banknotes issued by the Bank of England from 1975 until 1994. As well as a standing portrait, she was depicted on the notes in a field hospital in the Crimea, holding her lamp.


Photography
Nightingale had a principled objection to having photograph taken or her portrait painted. An extremely rare photograph of Florence Nightingale, taken at Embley on a visit to her family home in May 1858, was discovered in 2006 and is now at the Florence Nightingale Museum in London. A black and white photograph of Florence Nightingale taken in about 1907 by
Lizzie Caswall Smith at Nightingale's London home in South Street, Park Lane, was auctioned on 19 November 2008 by Dreweatts auction house in Newbury, Berkshire, England, for £5,500.


Biographies
The first biography of Nightingale was published in England in 1855. In 1911 Edward Cook was authorised by Nightingale's executors to write the official life, published in two volumes in 1913. Lytton Strachey based much of his chapter on Nightingale in Eminent Victorians on Cook, and Cecil Woodham-Smith relied heavily on Cook's Life in her 1950 biography, though she did have access to new family material preserved at Claydon. In 2008 Mark Bostridge published a major new life of Nightingale, almost exclusively based on unpublished material from the Verney Collections at Claydon,and from archival documents from about 200 archives around the world, some of which had been published by Lynn McDonald in her projected sixteen-volume edition of the Collected Works of Florence Nightingale (2001 to date).


Florence Nightingale syndrome
Florence Nightingale syndrome is a term used to describe a situation where a caregiver typically a doctor or nurse develops an emotional attachment to a vulnerable patient in their care. This attachment may progress into a sexual attraction.