Nurse Deployment Project - Monthly Journal

March 1 31, 2015

Name:
Villanueva, Jenness Jeanne J.
Municipality/Province: Santa Maria, Laguna
Area of Assignment
Health Unit
I.

: (X) Rural

Activities:

Every morning I started off early, taking on journeys that will help me understand
that true knowledge comes only from experience. I started the days by logging in to our
Logbooks. Our shift is 8am till 12nn and will be back by 1pm to 5pm, Mondays to Fridays. I
also attended the Flag Ceremony with other fellow government employees at 8:00am of
every Mondays in the towns plaza. Having barely made it through our 15 th month at the
Rural Health Unit, I was amazed at how relieved I felt to return to the familiarity of daily
activities in the facility. The group moved though each day with greater ease than I have
anticipated. I was assigned to have my duty in TB-DOTS area on the first 2 weeks of March.
The last 2 weeks will be my duty on the Out-Patient Department. We also have
arrangements in doing health teachings to the patients so that everyone will have a chance
to do health teachings in different topics. We have decided to include the topics: Personal
hygiene and Hand washing, Pre-natal care and Post-natal care, New Born Care, Maternal and
Child Health Care, New Born Screening, Expanded Program on Immunizations, Diarrhea,
Pulmonary Tuberculosis and Dengue Fever. On my first day of duty, I dispensed appropriate
medicines to TB patients, assessed them correctly, conducted health teachings and updated
their records. After that, I decided to check all of the records of the patients for updating and
getting information on their schedule of follow-up check- up and sputum examination if ever
there are patients who needs to have their follow up sputum examinations, and if there are
patients who started to quit the treatment. After arranging and updating records, I made a
list of patients who is about to have their follow-up sputum examinations and their due date.
I also checked every medicine for every TB patients to check for their potency and expiration
date. Afterwards, I arrange every form needed in admitting new patients both for adults and
children. In my 2 weeks of duty, I have learned a lot of knowledge, skills and attitudes in
dealing with different patients and hopefully I have helped all of the TB patients. I also
admitted 1 new patient diagnosed to have pulmonary tuberculosis, assessed them for signs
and symptoms that they had experienced or presented, due to the signs and symptoms
presented by the patients referred them to the physician and nurse supervisor, carry out the
doctors orders, instructed them on proper sputum collection for sputum examination as a
confirmatory tests and an X-ray, referred the results of sputum examination and X-Ray result
to the physician and nurse supervisor for further assessment and evaluation, admitted the
patients under the DOTS program of the DOH, categorized the patients according to their
condition, I conducted health teaching to the patients and their significant others about the
Tuberculosis the disease itself, signs and symptoms, communicability of the disease,
prevention, diagnosis, and the course of treatment, I filled up all of the forms and records
containing all the necessary information of the patients needed in the treatment, opened an
NTP card and treatment pack for every patient. Instructed the patients how to use the NTP
Card. Released appropriate medicines for every patient. Provide instructions on the
frequency, dose, possible side effects, the ideal time and how to take the HRSZE. I also
encourage them to continue the treatment, adhere in strict treatment regimen, and to finish
it for their own good. I have given them their schedule of follow-up check-ups and follow up
sputum examinations.
We received patients, assess their condition, provide health teaching, facilitate
laboratory exams if there are any, secure lab results and relay them to Physician, give oral
and IV medications carry out doctor's orders, do charting and other paper works. Our daily

routine is to take vital signs of patients, getting records before our Municipal Health Officer
prescribe any medications, give medicines if available as prescribed, refer to tertiary
hospital if the patients case needs more intensive care or treatment, take charge of the
facilitation of initial treatment to patients coming in. During 2 nd Wednesdays of every month
we help in the EPI for newborns and infants under 5 yrs. old. As part of the routine, I
conducted a health teaching regarding the expanded program on immunization. We
administered the vaccines at the right child, right vaccine, right site, right route, right dose
and right dosage. After the vaccination, we make sure that we put everything into record at
the yellow card of the child. Every Tuesdays and Thursdays of the month was the schedule
for Pre-Natal Checkups for pregnant women. As part of the routine, I conducted health
teaching regarding proper breastfeeding, proper nutrition, and proper hygiene. We always
emphasized the importance of breastfeeding up to 6 months. I assessed pregnant mothers
by getting their basic information, health history, past health history, weight, vital signs, last
menstrual period, expected date of confinement, computing the age of gestation, measuring
fundic height, counting fetal heart tone, injecting Tetanus-Toxoid Vaccines 0.5ml at right/left
deltoid muscle, prescribing micronutrient supplementation according to doctors orders,
securing lab results and ultrasounds and lastly I put everything into record by updating their
Home based mothers record for all of the assessments and interventions rendered.
This month was celebrated by the Department Of Health as the Tuberculosis
Awareness Month. In celebration of the Tuberculosis Awareness Month, Santa Maria Rural
Health Unit planned a fundraising 1k, 2k and 3k Fun Run event called Fun Run For a Healthy
Lung. The proceeds of this fundraising event were for bringing Tuberculosis awareness to
the towns people and to gather money that will be used as a budget for the Multivitmains
given to people with Tuberculosis. This is a non-competitive 1k, 2k and 3k fun run for person
ages 10 years old and above. Running is arguably the popularly sport these days. Every day
we see people jogging and exercising in the streets. But whats truly amazing about this
sport isnt about the training or the fun alone, but through the promotion of good health
(especially the lungs). Everyone in the Rural Health Unit of Santa Maria, Laguna and we, NDP
Nurses assigned here helped in the planning and implementation of this event. I was
assigned by our Municipal Health Officer Cynthia S. Tamares in the Registration. This event
was scheduled today, began at 5:00 in the morning and finished at 9:00 in the morning. The
starting line was at the towns plaza. I came at the plaza at around 4:00 in the morning to
start the registration. After that, we joined the said event. This was only the 2 nd time I had
ever joined a fun run. Like the first it was just as exciting. We woke up as early as 4:00 a.m.
and we went to the site where the starting line was, had stretching and a pre - Zumba
workout. It was during the run which really gave me the most excitement. The run was very
exciting from the start til end and I hope in the future that I can participate in more fun run
events like this. Another reason I was very excited to join the fun run because it was for the
benefit of people with tuberculosis. This fun run was not only about the joy, but also
remembering the lives that we are trying to save.

II.

Learning / Insights:

Tuberculosis has been on the rise in the Philippines and its really important that
people understand how can it be contracted and how to spot the signs early enough so that
it can be properly treated. Funding to develop awareness has been and continues to be
woefully inadequate. We need to work together to improve awareness which in turn will
hopefully lead to more support. Only a force of many can stand up to the frightening rise of
tuberculosis. With everyones participation and help, our Fun Run For a Healthy Lung will
make a difference in lives that desperately needed it.
Male circumcision is the surgical removal of all or part of the foreskin of the penis. It is one of
the oldest and most common surgical procedures worldwide, undertaken for religious,
cultural, social or medical reasons. Recently, male circumcision has been shown to have a
protective effect on reducing HIV transmission. In light of this evidence, male circumcision
must be considered as one component of a comprehensive HIV prevention approach. It is

important that health care providers and the public have up-to-date information on the
health benefits and risks of male circumcision. Health care providers must ensure that men
and their sexual partners as well as young boys are given appropriate information to enable
them to make free and informed decisions about the procedure. Effectiveness of male
circumcision Observational studies indicates that HIV prevalence is generally lower in
populations that traditionally practice male circumcision than in populations where most
men are not circumcised. Recently three randomized controlled trials conducted in South
Africa, Kenya and Uganda confirmed that male circumcision reduces the risk of heterosexual
transmission of HIV in men by about 60%. A systematic review and meta-analysis of 28
published studies found that circumcised men are two- to three-times less likely to be
infected by HIV than uncircumcised men. Based on the evidence, WHO and UNAIDS
convened an international consultation and made policy and program recommendations in
support of male circumcision. Dispelling myths In order to avoid a false sense of protection
from HIV, adequate information must be provided about the benefits of male circumcision
and on the need to avoid risky sexual behavior. It is important that men and women
understand that male circumcision does not guarantee complete protection against HIV
infection. It must be considered as just one element of a comprehensive HIV prevention
strategy that includes the consistent use of condoms, reduction in the number of sexual
partners, delaying the onset of sexual relations, avoidance of penetrative sex, and testing
and counselling to know ones HIV status. Research shows that male circumcision is
associated with the following health benefits:
Lower rates of urinary tract infections in male infants who are circumcised.
Prevention of inflammation of the glans (balanitis) and the foreskin (posthitis).
Reduced health problems associated with the foreskin such as phimosis (an inability
to retract the foreskin) or paraphimosis (swelling of the retracted foreskin causing
inability to return it to its normal position).
Easier to maintain penile hygiene.
Associated with a lower risk of penile cancer.
Lower prevalence of some sexually transmitted infections such as chancroid and
syphilis.
Studies also suggest that female partners of circumcised men have a lower risk of
cancer of the cervix, which is caused by persistent infection with high risk oncogenic
(cancer-inducing) types of human papillomavirus.
The safety of male circumcision depends on the setting and expertise of the provider. When
circumcision is performed in a clinical setting, under aseptic conditions, by well trained,
adequately equipped health care personnel the level of risk is low. However, as with any
surgical procedure male circumcision carries a risk of post-operative infection. If performed
by unqualified or poorly trained persons, penile mutilation and even death can occur. The
surgery can lead to excessive bleeding, hematoma, inflammation of the opening of the
urethra, and increased sensitivity of the glans penis for the initial months. In addition,
adverse reactions to the anesthetic may occur.
Role of nurses:. Nurses with specialized training are well positioned to perform male
circumcision in a number of countries. Male circumcision also provides nurses with an
opportunity to reinforce HIV prevention messages. As circumcision is often associated with
cultural and religious beliefs, a human rights-based approach to introduce or expand male
circumcision services requires safeguards to ensure that the procedure can be carried out
safely, under conditions of informed consent, and without discrimination. Nurses must
implement male-circumcision programs in the context of a comprehensive HIV prevention
framework. Regulatory and quality assurance measures must be put in place to ensure
competence of nurses performing male circumcision.

III.

Issues / Concerns:

I have no issues and concerns observed in the community for this month.

IV.

Recommendations:
I have no issues and concerns observed in the community for this month.

Signed:
Jenness Jeanne J. Villanueva, RN
C. Braa, RN
NDP Nurse
Supervisor

Virginia