Breast care is done to improve blood circulation and prevent blockage of the milk ducts so as to expend milk. One of the breast treatments that can increase milk production is to do lactation massage, lactation massage types include oketani massage and oxytocin massage. Oketani massage is a breast massage that focuses on the areola and nipple area of the mother, this massage stimulates the strength of the pectoralis muscle to increase milk production so that the breasts become softer and more elastic. Oxytocin massage itself is a massage along the spine which is one solution to overcome the lack of smooth milk production. This study aims to determine the effectiveness of oketani massage and oxytocin massage in increasing the production of breast milk (ASI). This study uses quantitative research design with quasi experiment method, obtained samples using purposive sampling techniques as many as 34 respondents were divided into 2 groups of 17 respondents oketani massage and 17 respondents oxytocin massage. The measuring instrument used is an observation sheet of breast milk production volume with measurements before and after the action for 3 consecutive days. The statistical tests used are Wilcoxon test and Independent Sample T test. There is an effect of oketani massage and oxytocin massage on breast milk production with p value of 0.046 < ⑵ (0.05). The results of this study found that oketani massage and massage oxytocin effect in increasing breast milk production. This result is expected to be an alternative at the time of little milk production.

Background: Hypovolemic shock can be catastrophic rapidly unless recognized and treated promptly. Although gastrointestinal loses might be the cause of hypovolemic shock in the elderly, it rarely causes a change in the blood gas analysis results.Purpose: This study aimed to report a case of a 75-year-old male with signs of hypovolemic shock caused by gastrointestinal loses and discuss the effect of passive leg raising procedure as an early nursing intervention in patients presenting with shock.Methods: The method used in this paper is a case study. The subject in this study is a 75-year-old male presenting to our Emergency Room with signs of shock which was caused by gastrointestinal problems. Passive leg raising or also known as modified Trendelenburg Position was performed as the patient presenting with low blood pressure. The results of physical dan laboratory investigation, as well as the nursing and medical therapies were presented, analyzed and discussed based on the recent literature.Results: There was an increase in the Mean Arterial Pressure (MAP) after the intervention was given for five minutes followed by fluid resuscitation with 1000 ml of warm Normal Saline. The patient responded well to the intervention given in the ED and was sent to the Intermediate Ward for further treatments.Conclusion: Passive leg raising might be beneficial to be performed in patients with hypovolemic shock as it increases the venous blood return the heart.

Working with hi-tech life-supporting machines in the midst of rapid changes in regulations and settings has raised dilemmas among senior nurses who must inevitably work with fresh-graduate nurses during the COVID-19 pandemic. Staffing limitations in nursing, in terms of both quality and quantity, where the nurses must be dressed in hot personal protective equipment suits, have added a conflict in the intensive care unit. This research sought to reveal the reality in the ICU setting during COVID-19 based on nurses’ narratives of their experiences and feelings working in the COVID-19 ICU. This research was conducted in the COVID-19 ICU of one of the public hospitals in Riau Province. The purposive sampling technique was used to choose intensive care unit nurses. In-depth recorded phone interviews were performed from June to July 2022. The total number of participants joining this research until the researcher reached a data saturation point was five. This research used Colaizzi’s phenomenological method to uncover the meanings behind patients’ stories. The majority of participants were female, and there was only one male nurse. Sixty percent of the nurses had Bachelor’s degrees, and the remaining 40% had nursing diploma degrees. Four participants (80%) were government employees, and one (20%) was a freelance daily worker. The participants had been working for eight years on average. Five themes emerged: 1) work motivation, 2) COVID-19 protocol, 3) the competencies of nursing volunteers, 4) family roles, and 5) professional ethical dilemmas. Keywords: ethics, dilemma, nurses, COVID-19, intensive care unit

Performing electrocardiogram (ECG) recordings using the standard method presents a challenge to healthcare practitioners because of the need to precisely locate the six precordial electrodes or lead according to the six thoracic landmarks. A new method using precordial lead ECG SafOne was introduced to healthcare professionals and compared to the precordial lead standard. The study aims to identify the correlation between healthcare practitioners’ education and the usability of the precordial ECG SafOne. This study employed a quantitative descriptive design using a user-centered design survey method. Two hundred twenty-eight healthcare practitioners, including doctors and nurses from three hospitals in Pekanbaru, Riau, Indonesia, participated in this study and were selected using the purposive sampling technique. Evaluation variables assessment was collected using the precordial ECG SafOne questionnaire. The data analysis used was Spearman Rho to identify the correlation between the two variables investigated. Demographic data depicts that most of the participants were nurses 215 (94.2%), healthcare practitioners education background with Diploma 107 (46%), registered nurses 108 (47.4%), and Doctors 13 (5.7%), and average age was the early adult stage, 103 participants (45.2%). The bivariate analysis results show a correlation between healthcare practitioners’ education and usability of the precordial ECG SafOne with a p-value of 0.029 (p-value < 0.05). In conclusion, healthcare practitioners appraise the precordial ECG SafOne as an effective, applicable, practical, and renovate tool and valuable for electrocardiogram recordings in patients with cardiovascular diseases. Keywords: education, usability, electrocardiography, SafOne, healthcare practitioners

Background: COVID-19 is caused by the 2019 novel coronavirus (2019nCoV) which was identified on 7 January 2020 by the Chinese Center for Disease Control and Prevention (CDC) from the throat swab sample of a patient. This novel coronavirus is phylogenetically similar to the severe acute respiratory syndrome coronavirus (SARS-CoV) that caused SARS outbreak in 2002.Objective: To describe a case of a COVID -19 patient in a hospital in Indonesia.Case Report: A 55-year-old male was admitted to the Emergency Department of Arifin Achmad Hospital on 31 March 2020. He was transferred from a private hospital after three days of hospitalization. Previously, he came to another hospital complaining palpitation, cough, having difficulty of breathing, and intermittent fever. He then was advised to be admitted and tested for a COVID-19 test. At first, he did not admit to having traveled recently. After three days, the pharyngeal swab test was received confirming that he was contracted with COVID-19. The patient was then transferred to our hospital and hospitalized for ten days.Discussion: The patient was fully recovered after ten days of treatment with antiviral drug namely Oseltamivir 75 mg orally twice a day and chloroquine phosphate 500 mg twice a day orally. The combination of both drugs showed an immune-modulating activity which might increase its antiviral effects. Therefore, the use of this agent in COVID-19 patients might be worthwhile. During hospitalization, reducing patient anxiety was also one of our main goals as many studies has found that anxiety is associated with poor immune system.Conclusion: This case report demonstrated the current situation in Indonesia where people become reluctant to fully disclose their symptoms or travel history to the health care workers, which may put many others on the risk of being transmitted with the virus. Although the proven efficacy of chloroquine is still lacking, it has become the favorable choice at this moment as indicated in our study. Reducing the patient’s anxiety towards the disease may help to speed the patient’s recovery. Also, we need to educate public that COVID-19 might be a life-threatening disease but it is also a treatable disease.