By the way, this isn’t one of our normal blog posts—but I’ve been slightly obsessed with researching
diabetes. Bear with me! We will return to regularly scheduled programming soon.

However, vegetarianism isn’t necessarily friendly to diabetics. After all, what could be more vegetarian
than rice and pasta? My comfort foods were all carbohydrate based: ice cream (nothing wrong with a
whole pint, is there?); Girl Scout cookies (yes, a whole box of Tagalongs can be a single serving);
potatoes in any way, shape, or form; candy bars as a reward for going to the grocery and sticking to my
list; Cokes when I’m hot, hot chocolate when I’m not.

Alas, that emphasis on carbs has caught up with me, like it does with more than 10% of the US
population, and that number is rising. Fortunately, so far, mine can be controlled with one pill a
day — and a change in diet.

But this isn’t a rant on how we need to eat more veggies, consume less sugar, lose weight, and so forth.
It’s about all the things I didn’t know—and am still finding out.

Did you know:

 Diabetes can lead to leg cramps, most likely to attack a person when they are sleeping. I get
them four or five times a night, which leads to less sleep, which adds stress, which leads to
higher blood sugar—you get the drift. (Yes, I’m taking extra calcium. So far it helps, but doesn’t
eliminate the leg cramps.)

 As your sugar level changes, so does your vision. So if your glasses seem okay sometimes and
not so okay other times, see your doctor and get checked for diabetes. (Naturally, other things
can cause vision changes, so don’t take my word for it.)
 Urban residents have a greater propensity for diabetes than rural residents, though no one
knows exactly why. Possibly it is exposure to more pollutants. (Maybe now’s the time to move
to the country?)

 My favorite headline? “Diabetes Type 2 Is Preventable.” It goes on to say that aging is a primary
cause. I’m sorry, but if the alternative to aging is to stop aging (i.e., die), isn’t that a rather
extreme reaction?

 A person with diabetes has sweeter urine than a person without. (I believe it, but who found this
out—and how?)

 In 1500 BCE, diabetes was mentioned in manuscripts. (Humans started eating cane sugar in
8000 BCE, so by my math, they were in denial (de-Nile) for 6500 years.)

 At one point, opium was considered a treatment for diabetes. (If it didn’t cure it, the opium
might have made a person forget they had it…) Another doctor advised his patients to stop
eating vegetables (he probably had picky-eating kids).

 And one last thing: sores take longer to heal for diabetics, especially on legs and arms. Keep that
in mind for first aid treatment (and now I’ve justified the blog.)

 by Kate Wood

The brainchild of Meg Gustafson COHN-S and OSAOHN Board Member and Membership Chair. It is an offshoot of a program Meg developed over her ten years in Occupational Health. Covering 14 lumber mills over three states, Meg found that having educated team members at each location, consistent protocols and correct supplies assured effective first aid for most minor injuries.  

“Once a nurse…” Meg’s younger sister, a distance runner, would often call “Big Sister” Meg for advice on blisters, rashes, sore muscles and painful joints. Meg filled a zip lock bag with basic supplies, detailed instructions on use and advice – what to expect and what to do for the unexpected – pretty much the same thing as her workplace “first aid playbook” program at the mills. Her sister was impressed. “Big Sister in a Bag” didn’t sound quite right. But “Nurse in a Bag” was born. 

The venture has finally made a small profit for the first time. The sisters plan to give a portion of profits to a worthy non-profit. Oregon State Association of Occupational Health Nurses is pleased to be their first recipient and will use this donation to further networking and educational opportunities in occupational health for its members.               

Since her retirement, Meg and her sisters are working on growing the Nurse in a Bag program. In July they did a 3-minute, shark tank-type pitch to SCORE – a nonprofit association dedicated to helping small businesses get off the ground, grow and achieve their goals through education and mentorship. They hope an “angel investor” will show interest and give them the boost they need to get this worthy kit to many more people. OSAOHN thanks them for their donation and wishes them the best of luck! 

Thank you for such a wonderful write up, Kate! Nurse in a Bag is honored to donate its first % of net profits to such a great organization full of wonderful nurses – networking and education is the best things for the donation to go for!

Meg Gustafson, Nurse in a Bag

In 2018, OSHA issued penalties of more than $73 million in the construction industry alone, based on 25,294 citations and with an average fine of $2,900. The recent emergence of coronaviruses has only complicated matters. Individual states may even have requirements that exceed federal regulations. The cost comparison of having a few Nurse in a Bag first aid bags around – even buying mini first aid kits in bulk – is negligible compared to the fines you could receive for not being prepared.

Many companies treat OSHA recordables as simply a cost of business, but it doesn’t have to be. Chris Lawrence, a regional manager of a large wood products manufacturer, reports that “along with the work-hardening activities [such as a strengthening program using resistance bands], PRE-tasks, and automation, the use of employee care kits [prepared individual first aid bags for a specific injury, such as one for strains, another for splinters, etc.] helped a sustained reduction of 57% in injuries requiring medical attention.” Translated into fiscal terms, such a reduction can result in a savings of thousands of dollars per year. OSHA issues both recordable (lesser injury) penalties as well as reportable (major injury) fines. Not only do these affect the bottom line, employee absence for recovery reflects an additional burden. It behooves every company interested in profitability and employee health to lower its recordable and reportable rates.

Here are 8 steps to take to lower your business’ recordable rate.

1. Review your industry’s history. There are four categories of OSHA standards: General Industry, Construction, Maritime, and Agriculture. Which one (or more) applies to you? What injuries occur most often in your line of business? Are they preventable or one-offs? Have you taken measures to prevent the sorts of injuries that are most common in your industry, or have you been relying on luck and employees’ sense of self-preservation? List the ones that apply to you.
2. Now dial down to your company in particular. Have you had OSHA recordables in the past, and what were they? Have you taken steps to mitigate those accidents? If not, do so immediately. For example, if you have been cited for failure to provide adequate eye- and face-protection measures, take steps now to have the proper equipment in place. Repeat citations are more costly and damaging to employee morale. Buying a few mini first aid kits wholesale is a great place to start to mitigate small, predictable injuries.
3. Take that list you created in step 1 and look around. Take a walk on the shop floor, the lumber yards, and even the offices. Look for places where accidents might occur. Don’t just limit yourself to big machinery; is an office desktop copy machine precarious? Is a broom left where someone might trip over it? Are the floors slippery when cleaned?
4. Take it a step further. For those injuries that you have had in the past, what could you have done to eliminate them? For sprain and strain injuries, could you educate your employees on how to move so that such injuries don’t occur? If trash is piled in a corner and might become flammable, put a trash can there and have it regularly emptied. Take action.
5. Talk to your medical staff, whether it’s a visiting nurse, full-time professional, or anyone who deals with employee injuries. What sorts of issues do they see? Can you prevent those? If you have part-time medical help, what happens if that person is not on the premises? Can a supervisor access the everyday first aid equipment (bandages, antibiotic cream, cold packs, and
   so forth)? What about truckers? Do they have first aid supplies available?
6. Talk to your employees. What are their concerns? Is equipment moving too quickly or too slowly? Are forklift drivers attentive to what’s around them? Are floors slippery, even when dry? Make health education a priority company wide, not just for line workers. Not only do you need at least one person well versed in OSHA regulations—and this person needs the authority to
   enforce them–you need a chain of command to make sure everyone knows the regulations that pertain directly to them and their coworkers. If necessary, have the responsible person attend webinars or seminars on updated requirements.
7. Have a budget for OSHA requirements. Those posters you have to put up in common areas aren’t expensive, but fines ranging from $110 to $17,000 (deliberate, repeated infractions) are. Ignorance is no excuse and posters are updated frequently.
8. Have a written manual outlining what to do in the event of an injury accident. What you don’t need are employees who think they feel fine but two weeks later are filing a complaint. Take immediate action for every injury—and document it.

One of our clients, after putting in place his program:

The end result was a significant reduction in lingering discomfort conditions for new hires and existing employees moving to new positions…. We now have very few injuries requiring medication attention and of the ones we do have, they are minor in nature and are usually self-induced by mishandling tools such as rakes, pike poles, and such.

In addition to all the other perils (and rewards) that affect restaurants these days, there’s no reason to risk your bottom line because you failed to heed the Occupational Safety and Health Administration’s (OSHA) guidelines. (Note: If you haven’t already reviewed the US Department of Labor’s guidelines for COVID, do so here: https://www.osha.gov/coronavirus/safework.)

In this article, however, we’ll break down easy ways we’ve heard from our customers to make sure you don’t run afoul of OSHA’s first aid and medical services rulings.

First, have someone on your restaurant’s staff trained in first aid whenever you are open, or get trained yourself. This not only benefits you and your staff, it helps customers too, in the unlikely event of an injury or sudden accident. American Red Cross offers inexpensive first aid classes. Some states require CPR and/or choking first aid, but even if your state doesn’t legislate the requirement for training, it’s a good idea.

Second, keep a log of all restaurant-related injuries — even the minor ones. A knife cut while slicing carrots? Treat it and log it. Even small injuries can become infected or can cause further problems down the road. Review those logs periodically. Are you seeing an increase in strains and sprains from lifting heavy food items? Maybe you should start employee training on how to lift. Are griddle burns on the uptick? Review your procedures and train your employees to avoid burns in the kitchen.

Third, have first aid supplies handy and available, and check for needed replacements regularly. How often you check depends in large part on how many employees you have. Larger kits tend to be more toward construction and major injuries – much more than you need. We’ve created first aid kits for restaurants by the injury – smaller and more affordable first aid kits for specific injuries that fit neatly near common injury sites – available immediately in the event of an accident.

We can help with this! Our restaurant-ready first aid kits are perfect for tucking around the kitchen in higher risk areas. Near the grill or fryer burn first aid is at the ready with our Burn Bag minor burn first aid kit. Where cooks are slicing and dicing, place our restaurant ready Cut & Scrapes Bag minor cut and scrape first aid kit near the ingredient prep area, etc.

Restaurant First Aid Checklist

Adapted from the Rochester Institute of Technology self-inspection checklist for OSHA.

• Is there a hospital, clinic, or infirmary for medical care in proximity of your workplace?
• If medical and first-aid facilities are not in proximity of your workplace, is at least one employee on each shift currently qualified to render first aid?
• Have all employees who are expected to respond to medical emergencies as part of their work:
  1. Received first aid training
  2. had Hepatitis and COVID-19 vaccinations
  3. had appropriate training on procedures to protect from bloodborne pathogens, including universal precautions
  4. have available and understand how to use appropriate personal protective equipment to protect against exposure to bloodborne diseases?
• Where employees have had an exposure incident involving bloodborne pathogens, did you provide an immediate post-exposure medical evaluation and follow-up?
• Are medical personnel readily available for advice and consultation on matters of employees’ health?
• Are emergency phone numbers posted and easy to find?
• Are first-aid kits easily accessible to each work area, with necessary supplies available, periodically inspected and replenished as needed?
• Have first-aid kit supplies been approved by a physician, indicating that they are adequate for a particular area or operation?
• Are means provided for quick drenching or flushing of the eyes and body in areas where corrosive liquids or materials are handled?

There you have it… three steps to make your customers and employees safe, and your restaurant in compliance with official guidelines. What tips do you have for keeping your restaurant running smoothly and safely?

Living on a sailboat definitely has its benefits, and one of those in the sense of community we have on our dock. Elliott, my husband and Del, our dockmaster, had gone out to rescue a sailboat that had lost power and gone aground in the shoals of Sapelo Sound, an area with an ever-changing sandy bottom. Running aground isn’t uncommon – just a couple weeks ago, I’d gone (softly) aground in an area marked on the charts as 19 feet, and we only draw 4 feet 2 inches. It’s something we learn to live with here in coastal Georgia.

Del and Elliott towed the sailboat that had run aground, Glitter, several miles to our dock and had radioed in that we’d need to be on hand to catch lines to stop her once she came abreast of the dock. Six of us were there, only one of us under the age of 40 (and even maybe 50. 60? It’s hard to tell with active, fit sailors!).

Elliott untied Glitter from the towboat, and she rolled in a bit faster than we’d expected. One of the men on board threw a line to a waiting helper, but one line isn’t always enough to stop a 13,000-lb. sailboat, so he scurried back to throw another line to one of us waiting on dock.

One man caught the second line, but it pulled him forward a few feet. He braced himself, but the force of the incoming boat strained his shoulder. Two of us rushed to his side, looped the line around a post, and stopped the boat, and all ended well—except for the shoulder.

After Glitter was securely tied to the dock, I rushed back to Kathryn, our own vessel, intending to grab a RISE bag. Alas, I had cleaned out the head (where we keep our first aid supplies) and we had temporarily moved everything there into our car (there’s very little “dumping” space on a boat), and the car was a mile away.

Wouldn’t you know something would happen during the few hours my Nurse in a Bag RISE first aid kit wasn’t handy! If I’d had it right then, we could have used the instant cold pack to help stop his shoulder pain. He had ibuprofen on board his boat, and later on I offered the Biofreeze and Epsom salts to help with the soreness, which I’m sure was much appreciated.

Having the right first aid supplies on hand the moment they’re needed helps the injured person, of course, but it also gives those of us who want desperately to help the ability to do something other than gawk, express sympathy, and generally make nuisances of ourselves.

The nurse approved RISE kit would have been a real blessing. It’s why we got into bulk first aid supplies distribution, and chose to create a series of nurse first aid kits that treat minor injuries around the home and workplace.

Are you prepared for the next minor injury near you?

Creating custom first aid kits in one of our greatest challenges, yet probably the most fun. We also happen to be very good at it.

It brings out the junior scientist in all of us. I called the manufacturer of the eye lubricant we use to find out what storage temperatures they recommend. Turns out they tested in the 50–80-degree range, and so have no idea how it will react to extreme cold and heat.

So, right this moment, I have some eye lubricant in my freezer, testing how well it will hold up in cold winters in a glove box. (For my own future reference: thirty degrees doesn’t seem to be a problem, which is how low my boat freezer gets. But that’s not cold enough to test for winters in the Northwest, so next it’s off to stay in a friend’s freezer at even lower temperatures.) I’ve also got some sitting on a metal platform, with heat indexes here in the southeast up to 114 today. We’ll see how that goes.

Eye lubricant aside, we also added an eyewash cup and some sterile saline to this new “bag,” (even though it’s a tube) along with instructions on how to use the eyewash cup. It all fits handily into a six-inch cardboard tube- hence, Nurse in a Bag Eye Debris Tubes.

Is there something specific you need that we can help you develop? How can we help you keep your employees safe and healthy?

This is especially true with adults who are on various medications (as always, check with your medical provider) such as diuretics, those with kidney disease or hyperglycemia, older adults as well as children and pregnant women, and simply those who are out in hot weather for a long period of time. Those who work like this, construction workers, highway workers, or anyone who does gardening or landscaping suffer from dehydration often.

It can cause you to hallucinate, to have diarrhea (thereby losing even more fluids), to pass out, and can even be fatal if left untreated. Dehydration is also a risk factor for kidney stones and urinary tract infections.

Dehydration is often accompanied by an imbalance of chloride, potassium, sodium, and other electrolytes, which are often included in drinks such as Gatorade, Powerade, Pedialyte, and similar products. Be aware, however, that these products often also include sugars, and the low- or no-calorie drinks have artificial sweeteners. The loss of electrolytes by itself can cause an irregular heart rate, cramps, dizziness, fatigue, seizures, and convulsions, among other symptoms.

dehydration first aid kit. Stock up and prevent the symptoms of dehydration from affecting you.

It’s one of the easiest health problems to fix. How to treat dehydration: drink water! Add electrolytes! Cool down!

If you simply can’t abide water, go for products that are high in water content: watermelon, spinach, cucumbers, celery, radishes, grapefruit, cantaloupe, and strawberries. Avoid really salty foods, which tend to make you even more dehydrated. Soda won’t dehydrate you, but it won’t hydrate you as well as water either.

So the next time you go outside in this hot, hot weather, make sure you drink something before, during, and after – and stock up on our hydration first aid kits to prepare for future instances.

]]> 317 https://nurseinabag.com/perfectly-dopey-the-niab-origin-story/ Sat, 31 Jul 2021 00:24:33 +0000 https://nurseinabag.com/?p=303 After a one-year COVID hiatus, it looks like the Dopey Challenge is back on! Since that running event was the impetus that pushed my sister Meg and me to develop Nurse in a Bag’s prepackaged first aid kits, it seems like a good time to review how far we’ve come.

My sister Kate and I are, as the lingo goes, Perfectly Dopey. That means we’ve run each of the seven official Dopey Challenges (not counting 2021 when the in-person races were cancelled). I use the term “run” loosely—I tend to run a minute, walk a minute in the Galloway method.

A few years ago, considerably sore after the 5k, 10k, half-marathon, and full marathon on four consecutive days through all four Disney parks in Orlando, we wished we had a handy first aid kit for aching muscles. Though neither of us is 21 years old any more, we walked like we were 121 years old. Between us, though, we had all the makings of need for basic first aid kit for sore muscles: ibuprofen, Biofreeze, and ice. We turned to our sister Meg, an occupation RN, and asked what we were missing. At her recommendation, we added an instant cold pack, arnica cream, and Epsom salts to our sore muscle first aid kit.

Meg, who works out of several lumber mills in the Northwest, was simultaneously developing what she called her RISE bags (Rest, Ice, Support, and Elevate) for the sprains, strains, bumps, and bruises that employees would suffer from in the course of their work. Combined with employee education and prompt attention to injuries, the use of RISE bags had substantially decreased their OSHA reportable rate.

What if she could develop a runner’s bag for the next Dopey Challenge? One thing led to another, and we ended up with seven different bags for Nurse in a Bag.

The original RISE bag, which doubled as a runner’s bag when Band-aids and antibiotic cream were added, as well as first aid kits for splinters, first aid kits for burns, first aid kits for scrapes, eyes, dehydration, insect bites – you get the idea.

Our mission became: help people and companies keep themselves and their employees healthy and injury free on the job.

What I love most about it is that I can make the RISE bag the glove box first aid kit in my car and it’s there when I need it. And while I personally haven’t needed it yet, I’ve helped two other people who encountered trouble on the trails: a six-year-old who stumbled in the parking lot and bruised her arm, along with a runner who twisted his ankle on a tree root. And I’m sure I’ll need it in January 2022 after the next Dopey Challenge.

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