October, 2005 Archive

October 15, 2005, 7:01 pm

Life As A Nurse: One Decision, A Thousand Possibilities

I am a rational person.

I am a mature adult.

I detest USC.

I will detest USC forever.

I detest their football team.

I detest their band.

I detest their cheerleaders.

And now, in spite of the fact that I am going through all four stages of grieving at once, I shall attempt to turn my attention to my honorable profession. Thank you.

Go Irish!

hhhhhhhhhhhhhhhhhh

I sometimes find it funny that ol’ Cherry had so many different jobs as a nurse. I mean, whoever does that? Then I started to think about all the jobs in nursing that I’ve had. If a book series was written using my career as a guide you’d have:

  • Medical/Surgical Nurse
  • Coronary Care Nurse
  • Telemetry Care Nurse
  • Intensive Care Nurse
  • Nurse Preceptor
  • Psychiatric Nurse
  • Pediatric Telephone Advice Nurse
  • Emergency Department Nurse
  • Charge Nurse
  • Nurse Blogger

Okay, I’m kidding on the last one. But I’ve had all these opportunities and I’m still 22 years from retirement; who knows what I’ll want to do next?

The point is, as a nurse, you have the option of doing anything you want to do. On the Choose Nursing website there is a poster I was unable to reproduce here that states, “Nursing: One Choice, A Thousand Opportunities”. I cannot think of another profession that offers the flexibility and variety of nursing.

There are some nurses who will work all of their career in one hospital. Others will travel the country, experiencing a new environment every couple of months. Others will work per diem in many facilities at once. Some will find their niche early on, others will experiement with new specialties as their interests change. It’s all good.

Back in ancient times (when Disco ruled the world and nurses made $7.00 an hour), it was believed that nurses should pay their dues with at least a year on a med/surg floor before before being considered for any specialty. Now there are new graduate programs for emergency, intensive care, neo-natal intensive care and I’ve even seen some programs for labor and delivery.

With nurse/patient ratios being defined and salaries/benefits at an all time high, it’s a good time to be a nurse. With all the opportunities out there, it’s a great time to be entering the profession.

(I just realized that if I, God willing, am able to work until the age of 70, I will have been a nurse for 50 years. Oy vey!)

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October 11, 2005, 6:11 am

A Grand Round Was Had By All, Part Deux

If it’s Tuesday, it must be Grand Rounds! Welcome to all who are visiting Emergiblog through Doulicia.

As always, there are very interesting topics this week and I am happy and humbled to find that one of the Emergiblog posts made it into the list. Thanks, Doulicia!

I was fortunate to have discovered Doulicia prior to her hosting of Grand Rounds and it’s a joy reading about her experiences as a labor doula. Be sure to check out her other posts!

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October 10, 2005, 10:41 pm

Nursing: What Do You Think Hospitals Are For?

We didn’t have toys like this when I was a kid! Heck, I still want it! This is from Playmobil. Check out the bed; it’s adjustable! With a trapeze thingy! The drawer of the bedside table opens! All we need is a linen hamper and a sharps container and we’re in business.

It’s funny, nurses do not wear caps anymore, but caps are still recognized as a symbol of nursing. I noticed this in both the Playmobil and the Fisher-Price medical/nursing toys.

Do you realize that the only reason for hospitalization is the need for nursing care? Think about it. If you don’t need the 24 hour presence of a nurse, you can go home. You can come to the hospital for surgery and go home the same day unless you need nursing care. You can come in, have your baby and go home the same day unless you need nursing care. You can come to get your intermittent infusions from an infusion center nurse and then go home, unless you need nursing care. If you took away the nurses, you would not have a hospital.

Let’s take “downsizing”, for example. In the world of nursing this means:

  • Nurse as pharmacist: when they “downsize” pharmacy by not keeping it open 24 hours, the nursing supervisor delivers needed medications if they don’t lock the pharmacy. Or the ER nurses give out “starter packs” of medication during the off hours, including counseling the patient on the medication itself. Hmmm…that sounds a lot like “dispensing” and I thought only a pharmacist could do that…at any rate, the pharmacy budget looks great because nursing has taken up their slack.
  • Nurse as housekeeper: there is only one housekeeper at night for the entire hospital because they have “downsized” the department. That housekeeper is kept on the run by the ER and L&D units. So the nurses empty the garbage, the nurses change the linen bags and the nurses mop up the mess on the floor in addition to all their other patient care duties. Now that was okay in Florence’s time, but we have just a tad more responsibility these days, wouldn’t you say? So the Housekeeping department’s budget looks great because nursing has taken up their slack.
  • Nurse as Phlebotomist: why have phlebotomists come and draw blood when nurses are available? So let’s “downsize” the lab to a skeleton crew of a few techs and nurses will draw all the patients. Which means that all nursing responsibilities stop at 0500, so that the nurses can now take on the lab responsibilities; draw all the ordered bloods and get it to the lab on time. And the Lab budget looks great because nursing has taken up their slack.
  • Nurses as Registrar: why have a registrar when the nurses can take down all the information and copy the ID and insurance cards? So the nurses take the information and register the patient. The Admitting department budget looks great because nursing has picked up their slack.

But god forbid that a nursing floor EVER be overstaffed. Staff will be sent home mid-shift if the census drops due to the budget. Nurses will be cancelled if the census drops due to the budget. No chance of being able to spend extra time with fewer patients or more time with acute patients because the Nursing Department might be “overbudget”. I’ve had supervisors tell me that their hands are tied because they will get in trouble if they do not staff by specific acuity numbers. I’ve had supervisors tell the ER that they need “one more admission” or they will have to cancel a nurse.

None of the scenarios above are fictional; I’ve been witness to every one of them.

Who would take care of the patients if the nursing department were downsized? I can bet it wouldn’t be the pharmacist, the housekeeper, the phlebotomist or the admitting clerk. Not even the doctors have licenses to practice nursing.

Kinda makes you wonder why hospital administrations don’t treat us with a little more respect, doesn’t it?

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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