Filipino workers sue Calif. hospital alleging discrimination over rule requiring English


LOS ANGELES – Dozens of Filipino hospital workers in California sued their employer Tuesday alleging they were the sole ethnic group targeted by a rule requiring them to speak only English.
The group of 52 nurses and medical staff filed a complaint accusing Delano Regional Medical Center of banning them from speaking Tagalog and other Filipino languages while letting other workers speak Spanish and Hindi.
The plaintiffs are seeking to join an August complaint filed by the U.S. Equal Employment Opportunity Commission in Kern County federal court over the hospital's enforcement of a rule requiring workers to speak English.
Filipino workers said they were called to a special meeting in August 2006 where they were warned not to speak Tagalog and toldsurveillance cameras would be installed, if necessary, to monitor them. Since then, workers said they were told on a daily basis by fellow staffers to speak only English, even on breaks.
"I felt like people were always watching us," said tearful 56-year-old Elnora Cayme, who worked for the hospital from 1980 to 2008. "Even when we spoke English ... people would come and approach us and tell us, 'English only.'"
A message was left at the hospital seeking comment.
In its lawsuit, the EEOC has accused the hospital in California's San Joaquin Valley of creating a hostile working environment for Filipinos by singling them out for reprimands and for encouraging other staff to report them. The agency is seeking an injunction to protect the workers against future discrimination.
The EEOC has seen an increase in complaints alleging discrimination based on national origin amid a rise in anti-immigrant sentiment, said Anna Park, a regional attorney for the EEOC. That's especially the case in California's central valley, where a greater share of the complaints the agency receives relate to such issues than in the nation as a whole.
In this case, the current and former hospital workers filed a separate complaint under state law in part because monetary damages are capped by federal law, said Julie Su, litigation director for the Asian PacificAmerican Legal Center, which represents the plaintiffs. They want the English-only policy to be changed and for hospital staff to be trained on the new rule.
Under California law, employers may require workers to speak English if there is a business necessity, Su said.
Delano Regional Medical Center is a 156-bed hospital located about 30 miles north of Bakersfield.

Pschiatric Nursing

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Medical Surgical

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Comm. Disease

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Community Health Nursing

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Nursing Research

Palmer Complete Edited

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Pediatric Nursing

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Fundamentals

IMCI Notes

Imci From 2 Mon-5 Yrs

NCLEX Drug Toxicities Notes

Digoxin 2
Lithium 2
Aminophylline 20
Dilantin 20
Acetaminophen 200

Digoxin
Brand Name: Lanoxin
Toxicity: 2
Normal Range: 0.5-1.5 meq/L
Indication: Congestive Heart Failure
Classification: Cardiac Glycoside
Mechanism of Action:
 Increase force of Myocardial Contraction
 Increase force of Cardiac Contraction
 Increase Cardiac Output
Nursing Management:
Check Apical Pulse Rate
HR < 60bpm- Notify the Physician

S/S:
 Anorexia
 Nausea and Vomiting
 Diarrhea
 Confusion
 Photophobia
 Xantopsia

Antidote: DIGIBIND

Lithium
Brand Name: Lithane
Toxicity: 2
Normal Range: 0.6-1.2 meq/L
Indication: Bipolar Disorder (Anti-Manic)
Mechanism of Action:
 Decrease ACTH
 Decrease Norepinephrine
 Decrease Serotonin
Nursing Management:
Force Fluid (2-3 L)
Increase Sodium Intake (4-10 g/daily to prevent dehydration)

S/S:
 Anorexia
 Diarrhea
 Dehydration
 Hypothyroidism
 Fine Tremors

Aminophylline/Theophylline
Brand Names: Elixophyllin
Toxicity: 20
Normal Range: 10-19meq/100ml
Indication: COPD
Classification: Bronchodilator
Mechanism of Action:
 Bronchodilator- dilates the bronchial tree thereby allowing more air to enter the lungs.
Nursing Management:
Avoid Caffeine
S/S:
 Tachycardia
 CNS excitability
 Irritability and Agitation
 Restlessness
 Tremors

Dilantin/Phenytoin
Toxicity: 20
Normal Range: 10-19 meq/L
Classification: Anti-Convulsant
Mechanism of Action:
 Suppresses the paroxysmal electrical activity that makes up focal lesions.
 Blocks post-tetanic potentiation (PTT). PTT is an important mechanism in the development of high frequency trains of impulses in excitatory brain circuits; the spread of this activity to adjacent neurons and propagation to distant neuronal aggregates results in uncontrolled spread of excitation of the whole brain leading to a tonic-clonic seizure.
Nursing Management:
It is only mixed with 0.9 plain NSS or NaCl to prevent crystals or precipitate.
Given via: Sandwich Method
Instruct client to avoid alcohol- CNS depression, may lead to seizure.
S/S:
 Gingival Hyperplasia
 Instruct client to massage his gums
 Hairy Tongue
 Ataxia
 (+) Rhomberg’s Test
 Nystagmus
Acetaminophen
Brand Name: Tylenol
Toxicity: 200
Indication: Osteoarthritis
Classification: Anti- Narcotic Analgesic
Mechanism of Action:
 Acetaminophen is used for the relief of fever as well as aches and pains associated with many conditions.
 Relieves pain in mild arthritis but has no effect on the underlying inflammation, redness, and swelling of the joint.

S/S:

 Jaundice
 Abdominal Pain
 Vomiting

Antidote: Acetylceisteine
Nursing Management:
Prepare suction apparatus

Herbal Medicines Nurses Should Know

Gingo Biloba
Uses:
Asthma
 Bronchitis Fatigue Tinnitus (ringing or roaring sounds in the ears)Memory improvement Alzheimer’s disease and other types of dementia Sexual dysfunction Multiple sclerosis

Contraindications

Taking blood thinning drugs
 Diagnosed with bleeding disorders Scheduled for surgery
Side Effects and Cautions 
Headache
 
Nausea
 
Diarrhea
 
Dizziness
 
Allergic
skin reactions
 
Increase bleeding
Risk
 for Seizures 

Some promising results have been seen for Alzheimer’s disease/dementia and intermittent claudication, among others, but larger, well-designed research studies are needed.
 Some smaller studies for memory enhancement have had promising results, but a trial sponsored by the National Institute on Aging of more than 200 healthy adults over age 60 found that ginkgo taken for 6 weeks did not improve memory. 


St. Johns Worth
 
Uses:
 
Depression
 
Anxiety
 
Sleep disorders
 
Malaria
 
Nerve pain
 
Sedative

Contraindications:
 
Pregnant and Lactating Women
 
Severely Depressed Patients
 
Individuals already taking antidepressants
 
Oral Contraceptives
 
Preoperative or Postoperative Patients
 
Epileptics
 
Anemics
 Patients with HIV 
Transplant Patients
 

Side Effects
:
Increased sensitivity to sunlight
 
Anxiety
 
Dry mouth
 
Dizziness
 
Gastrointestinal symptoms
 
Fatigue
 
Headache
 
Sexual dysfunction
 
Interferes with Absorption of Iron
 

Drug Interactions:Research shows that St. John’s wort interacts with some drugs. The herb affects the way the body processes or breaks down many drugs; in some cases, it may speed or slow a drug’s breakdown. Drugs that can be affected include:
 
• Antidepressants
 
• Birth control pills

• Cyclosporine, which prevents the body from rejecting transplanted organs 
• Digoxin, which strengthens heart muscle contractions

• Indinavir and possibly other drugs used to control HIV infection 
• Irinotecan and possibly other drugs used to treat cancer
 
• Warfarin and related anticoagulants
 

When combined with certain antidepressants, St. John’s wort may increase side effects such as nausea, anxiety, headache, and confusion.

Asian Ginseng
Uses: 
Increasing Immune System
 
Recovering from illness

Increasing energy & stamina
Improving mental & physical performance
Erectile dysfunction
Hepatitis C 
Menopausal symptoms
 
Lowering blood sugar
 
Controlling blood pressure
Contraindications:
Diabetics Patients with Hypertension 
Patients taking opiates for pain relief
 
Pregnant Women
 

Side Effects
:
Headaches 
Sleep problems
 
Gastrointestinal problems
 
Allergic reactions
 
Breast tenderness, Menstrual irregularities
High blood pressure ( Low blood sugar Some studies have shown that Asian ginseng may lower blood glucose.
Other studies indicate possible beneficial effects on immune function.
 

Research results on Asian ginseng are not conclusive enough to prove health claims associated with the herb. Only a handful of large clinical trials on Asian ginseng have been conducted. Most studies have been small or have had flaws in design and reporting. Some claims for health benefits have been based only on studies conducted in animals.
 


Echinacea
 

Uses:
 
Colds, flu, and other infections.
 
Stimulating the immune system
 Infections 
Wounds and skin problems, such as acne or boils
Contraindications: 
Pregnant women
 Patients with autoimmune disorders 
Patients with tuburculosis
 
Young children
 

Side Effects
 
I
ncresed side effects if taken beyond 8 weeks
 Stomach problems 
Allergic reactions, including rashes, asthma, and anaphylaxis (a life-threatening allergic reaction), people with Allergies to other plants may be more susceptible
 

Study results are mixed on whether echinacea effectively treats colds or flu. For example, two NCCAM-funded studies did not find a benefit from echinacea, either as Echinacea purpurea fresh-pressed juice for treating colds in children, or as an unrefined mixture of Echinacea angustifolia root and Echinacea purpurea root and herb in adults. However, other studies have shown that echinacea may be beneficial in treating upper respiratory infections.
 


Black Cohash
 

Uses:
 
Rheumatism (arthritis and muscle pain)
 
Menopausal symptoms
Menstrual irregularities and premenstrual syndrome 
Labor induction
 Blackcohosh
Contraindications: 
Pregnant Women
 Children 

Side Effects
:Headaches and stomach discomfort 
Heaviness in the legs
 
Weight problems
 

Interactions & Cautions
 
No interactions have been reported between black cohosh and prescription medicines.
 It is not clear if black cohosh is safe for women who have had breast cancer or for pregnant women. 

Study results are mixed on whether black cohosh effectively relieves menopausal symptoms.
 Studies to date have been less than 6 months long, so long-term safety data are not currently available.

Kava 
Uses:
 
Anxiety
 Insomnia 
Menopausal symptoms
 
Fatigue
 
Asthma
 
Urinary tract infections
 

Contraindications:
 
Pregnant & nursing women
 
People being treated for depression
 
People with Parkinson’s disease
People with liver problems 
People with high blood pressure
 

Side Effects
 
Liver damage, including hepatitis and liver failure
 
Dystonia (abnormal muscle spasm or involuntary muscle movements)
 
Hypertension
 
Scaly, yellowed skin (associated with long-term use)
 
Drowsiness
 

Drug Interactions
:
Kava may interact with several drugs, including drugs used for Parkinson’s disease.What the Science Says Although scientific studies provide some evidence that kava may be beneficial for the management of anxiety, the U.S. Food and Drug Administration (FDA) has issued a warning that using kava supplements has been linked to a risk of severe liver damage.
Evening Primrose 
Uses:
 
Eczema (a condition in which the skin becomes inflamed, itchy, or scaly because of allergies or other irritation)
Inflammation 
Rheumatoid arthritis
Menstrual & menopausal symptoms 

Contraindications:
 
Pregnant women
 
Epileptics
 
Schizophrenics
 

Side Effects and Cautions
:Stomach upset 
Headache
 
May lower seizure threshold
 

Evening primrose oil may have modest benefits for eczema, and it may be useful for rheumatoid arthritis and breast pain. However, study results are mixed, and most studies have been small and not well designed.
 Evening primrose oil does not appear to affect menopausal symptoms. Although some clinical trials have shown a benefit of evening primrose oil for premenstrual syndrome, the best-designed trials found no effect.
Saw Palmetto 
Uses:
 
Urinary symptoms associated with an enlarged prostate gland
 
Chronic pelvic pain
 
Bladder disorders
 
Decreased sex drive
 
Hair loss
 Hormone imbalances 

Contraindications:
 
Pregnant Women
 
Children

Side Effects and Cautions:
Stomach discomfort. 
Some men have reported side effects such as tender breasts and a decline in sexual desire
 

Several small studies suggest that saw palmetto may be effective for treating BPH symptoms.
 In 2006, a large study of 225 men with moderate-to-severe BPH found no improvement with 320 mg saw palmetto daily for 1 year versus placebo. NCCAM cofunded the study with the National Institute of Diabetes and Digestive and Kidney Diseases. There is not enough scientific evidence to support the use of saw palmetto for reducing the size of an enlarged prostate or for any other conditions. 



Banned Herbal Medicine : Ephedra (aka Ma-Huang) 

Ephedra is a naturally occurring substance that comes from botanicals. The principal active ingredient ephedrine is an amphetamine-like compound that can powerfully stimulate the nervous system and heart. In recent years, ephedra products have been marketed as dietary supplements to promote weight loss, increase energy, and enhance athletic performance.
 

After a careful review of the available evidence about the risks and benefits of ephedra in supplements, the FDA found that these supplements present an unreasonable risk of illness or injury to consumers. The data showed little evidence of ephedra’s effectiveness, except for short-term weight loss, while confirming that the substance raises blood pressure and stresses the heart. The increased risk of heart problems and strokes negates any benefits of weight loss.

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