March, 2006 Archive

March 22, 2006, 5:10 am

Baby, It’s 5 AM and It Must Be Grand Rounds

I cannot believe I did this.

I forgot to link to Grand Rounds at

I complimented Elisa on the website and then totally blanked out when I posted yesterday. A great job was done and I’m still reading!

So a big shot in the gluteus maximus for me and a thorough washing out of my synapses with Wisk.

(I knew I’d find some way to work this photo into the blog! The title of this post is supposed to be a humorous take on an old Matchbox 20 song, but it really IS 0500 and it sure seems witty at the moment. I’ll have to see what it looks like after some sleep.)

Read »

March 21, 2006, 3:55 pm

Tuesday Afternoon

I’m speechless.

And this is the improved version.

Does it come with stirrups?

Absolutely everything that comes to mind is totally inappropriate.

Oh, gee, my uterus is hanging out, I better go get a Mellier’s!

They’re on sale!


When will I ever learn to say “no”?

Today was supposed to be a day off but I am picking up four hours for a co-worker tonight.

No biggie, we help each other out at work all the time.

But I forgot….

Tonight is American Idol!


And it’s voting night, too and I can’t vote because I’m working until 2300.

I’m like an addict missing their visit to the methadone clinic.

If you are reading this, do a fellow blogger a favor and vote for Taylor, the grey-haired guy.
He is quirky and reminds me of Joe Cocker and quirky guys rock!

Thank you.


Speaking of people who rock, we have had nursing students in the ER for awhile now. They are a blast to have in the department.

Usually there are one or two which is perfect for our department size.

We have a great ER, so they get to see what a nice community department is like and not get freaked out at the “Super Famous Medical Center With Super Hard To Get Into Medical School Whose ER Was Last Remodeled In the 1950s”.

I don’t have a student with me, because teaching is not one of my strong points. I’m more of the “Run with me and observe, Grasshopper. When you can grab the Ativan from my hand, you will be ready” type.

I know what I’m doing (usually) and in ER it’s a combo of experience and instinct.

But students like to ask questions.

And I don’t think “Uh…duh….let me stop and think about that….” gives off a good professional impression.

It is, however, good for me to do that once in awhile.

It’s the “stop” part of the equasion that trips me up.

I decided I needed a make-over. So I cut my hair off.

We are talking Natalie Portman here, folks. Like if I was wearing a cap, I’d have a hell of a time finding hair to pin it to.

So short that parts of my face that had not seen the sun for a year were fluorescent white.

I had kind of an early John Denver thing going, with wire glasses and overgrown bangs that met them. Not attractive.

So I put on my contacts and actually wore a complete face full of make up. Eye shadow, the works.

Apparently I now look younger, which is great, but good lord, what DID I look like before!


I don’t often lose it at work. Usually I can wait, hit my mental “Save” button and open the “Emotion” program at a more appropriate time. But every once in awhile, there is a tragic case/outcome and I start to lose it.

They say you should take time to decompress after something like that, but there is no time in the ER to go in the back and sob for twenty minutes and then come back out. No matter what happens in one room, you have a department full of patients you still have to deal with, and you have to look professional.

Being female, here are some tips that work for me, personally. Take from them what you will.

  • Don’t dwell. Stop thinking about the ramifications of what just happened. If you aren’t directly involved in the care and came into scribe or be a “runner” leave the area and get back to your assignment.
  • Distract yourself – get into another patient’s room, bet back into triage. Get busy. Put on a smile and focus on the next patient, even if it takes an Academy Award performance to do it.
  • Don’t make eye contact with your co-workers for a few minutes after a tragedy/bad outcome. The last time I was faced with this, I glanced at my supervisor who was tearing up and I lost it.
  • Wear waterproof mascara. I’m not joking.

Well that was a rather disjointed post! From uterine supports to waterproof makeup.

Such is my life.

Read »

March 20, 2006, 12:55 am

Once Upon A Time

What on earth does Journey have to do with Emergency nursing?


So why is this old 1979 ad for a rock band on my professional blog?

Because I’ve had the, um…pardon my language, “hots” for Steve Perry for 21 years. (For the uninitiated he is the one on the far left.)

And because every single doctor and nurse I have worked with has gotten to take care of someone famous.

Except me.

I always “just miss” someone.

My only claim to fame is that I got to hold a real Super Bowl ring back in the early 80s.

Sadly, the owner is no longer with us.

But will the rest of you famous people kindly come into the ER when I’m working?

Thank you.


Let me tell you a story.

Once upon a time there was an elderly patient. Tiny, petite and frail. Ninety-something. Bedridden most of the time, her caregivers sent her to an ER when they happened to notice a change in her vital signs, along with a depressed level of consciousness.

She wasn’t, as health care givers sometimes say, “out of it”. In fact, she mumbled something to her nurse about a “mother picking someone up”. “Your mother?”, the nurse inquired. At which point the patient opened her eyes and said, rather clearly, “My dear, I am over ninety years old. My mother is dead. I’m talking about your mother!”

Oh. Well that’s different.

The tiny, elderly patient was with it enough to cooperate with a foley catheter insertion.

And to thank her nurse.

When undisturbed, the elderly patient would snore. And some of her vital signs would change, necessitating a bit of oxygen by nasal cannula.

As the care of the patient progressed, it was noted by a health care giver that that patient had on many medicinal patches. Patches that could account for a decreased level of consciousness. Patches that are often used for chronic pain conditions.

These could certainly account for the decreased mentation. It needed to be ruled out.

Would she wake up if a very tiny amount of a medication was given to this tiny, elderly lady?

A medication that would block the effectiveness of these patches for a brief 20-30 minute period?

She went into withdrawl within sixty seconds.

Every osteoporotic-related pain receptor in the poor woman’s body blasted wide open.

She cried . She writhed in agony. She shook, curled up in a fetal position as she held the hands of her nurse and recited continual “Hail Mary”s. This poor woman went from sleep to incomprehensible agony without ever understanding what happened.

The nurse calmly and repeatedly assured the patient that this was temporary, and her pain would soon be gone.

The nurse was not calm inside. Indeed, she was nauseated at the suffering she was witnessing. In fact, had caused. The nurse kept down the lump that was forming in her throat. She held the patient’s hands and prayed with her.

Twenty-to-thirty minutes was all it would take and she would be painfree again.

It took an entire hour.

The patches that were so necessary for her comfort finally kicked back in and the patient once again appeared relaxed and with a depressed level of consciousness.

But not that depressed.

Upon hearing her nurse sneeze as she was being transfered to her hospital bed, she said “Honey, take care of that cold. You don’t want to get sick!”


The preceding story may or may not be true.

The patient may or may not exist.

And the nurse may or may not have held in the tears when she got home that morning.

Read »

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...

Continue reading »

Find Me On...
Twitter     Technorati

Subscribe to Emergiblog

Office of the National Nurse

Zippy Was Here

Healthcare Blogger Code of Ethics

  • Perspective
  • Confidentiality
  • Disclosure
  • Reliability
  • Courtesy