May 31, 2006, 12:24 am

Walk on Over to Grand Rounds!


Since when do patients leave the hospital looking like they are on a business trip?

This guy even has had his shoes shined!

The sentiment at the top of the photo is quite nice and very true.

However, on the new nursing cap rating scale instigated by KACNAC (Kim’s Accreditation Commission on Nursing and Caps), this nursing cap is a 6.75 on the 0-10 scale.

However, since very few nurses wear their cap, except me, I don’t believe this will put a cramp in anyone’s work habits.

And besides, I don’t think I have the authority to impose it.

But one can dream.


It it’s Tuesday if must be Grand Rounds! Today our host is our favorite New York nephrologoist at Kidney Notes.

I was surprised and honored to find that an Emergiblog post was selected as an “Editor’s Pick”.

Again, an amazing selection of stories, education and information. “Walk” your keyboard on over and check it out (with or without your suitcase!).


I was happily blogging via WiFi at a local Seattle’s Best this afternoon (see above) and it totally rocked! I’m going to do it on a daily basis. Being there during the day is wonderful because

  • Everyone who is studying is in school.
  • Everyone who works 9-5 is working 9-5.
  • Seattle’s Best, although owned by Starbucks, has better coffee and cleaner shops.
  • The coffee shop is attached to Borders bookstore so I am 20 feet away from a vast expanse of written literature and fun stuff like totally cool pens and stationery.
  • I’m easy to please.

During this idyll time I received an IM from my son who informed me of the results of my husband’s visit with his surgeon today.

His gallbladder was gangrenous.

I’ll save the full story for Scared to Health.

My reaction was one of total, retroactive shock. My legs went numb.

It’s a good thing I was sitting because blogging face down in a coffee shop would have attracted attention, I’m sure.

I then did the most stupid thing I could have done. I googled “gangrenous gallbladder mortality”.Wrong.

It’s between 25-50% if surgery is not done in time. The mortality rate was zero in one study of over 200 patients with a 21.5% incidence of gangrene when the surgery was performed on a timely basis.

The problem is that a gangrenous gallbladder presents no differently than a regular gallbladder in terms of symptoms – the type of symptoms that bring people to an ER.

How many times have we taken care of people with gallbladders that are, unknown to us, gangrenous, taken care of their pain, given them an ultrasound and sent them home to follow up with a surgeon in 1-2 days?

The surgeon said she was surprised hubby was not sicker than he was given the state of the gallbladder upon removal. It only had two tiny stones in it.

I took the last sip of my latte, closed down my computer and on legs that weren’t exactly steady, met the kids after their movie and drove them to cross-country practice.

Life goes on now, pretty much as it did two weeks before.

I said a prayer of thanks as I walked to my car, shedding a few tears in the process.


  • Brian

    May 31, 2006 at 9:33 am

    You are in our prayers.

  • may

    May 31, 2006 at 12:46 pm

    warm thoughts coming your way kim…hang in there…

  • Gimpy Mumpy

    May 31, 2006 at 4:34 pm

    I think anything with “gangrenous” in the diagnosis would scare the hell out of me. Although for some reason my brain keeps calling up an image of Oscar the Grouch from Sesame Street. Not sure why, probably some deeply rooted defense mechanism. 🙂

    I am sure your husband will be fine, he has the best nurse in the world!

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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