August, 2006 Archive

August 21, 2006, 6:03 am

The Answer Nurse Returns

Emergiblog is proud to announce that this post at Scared to Health has won the Bronze Medal post award in this week’s Patient Consumer Parade at Six Until Me.



Ladies and Gentlemen, it is time, once again, for a visit from our favorite repository of all things nursing.

Yes, The Answer Nurse is back!

The Answer Nurse would like to note that “repository” sounds like “suppository”.

She would like to make clear that while the former is a place of storage, the latter is something to be stored.


She hopes that we are aware of the difference.

Emergiblog duly notes that readers will be advised.


Question Number One: “If you weren’t a nurse, what profession would you seek?”

The Answer Nurse: A most personal question, but one which amuses me. I would seek the office of the lead singer of Heart, thereby dethroning Ann Wilson. The Creator of The Answer Nurse has seen fit to allow her the figure of Ms. Wilson, but has denied her the voice. This has kept The Answer Nurse from becoming The Greatest Female Rock and Roll Singer of All Time. Not that The Answer Nurse is bitter. Or anything.

Question Number Two: The Answer Nurse sounds very much like Miss Manners. Did she get inspiration from her?

The Answer Nurse: The Answer Nurse is inspired only by our wonderful nursing forebears: Florence Nightengale. Clara Barton. Dorothea Dix. Cherry Ames. Jessie Brewer. Dixie McCall. Major Houlihan.

Question Number Three: When would you advise a parent to bring a child to the ER? What don’t you consider part of the 70% non-emergencies?

The Answer Nurse: Ah, The Answer Nurse is not un-sympathetic to the anxieties of pediatric illness, having raised three (impeccably mannered) children herself. She isnot able, however, to give medical advice. She can, however, give you her opinion.

  • Breathing difficulties most certainly qualify.
  • Fever does not (with the exception of a first-time febrile seizure).
  • Basically, if your child is alert and talking to you without difficulty, call your Pediatrician first.

The Answer Nurse has a very high regard for Pediatricians. Unfortunately, when you do call them, 99% will tell you to go to the ER, unless your Pediatrician is Dr. Flea. The Answer Nurse appreciates Dr. Flea.

Question Number Four: How many times have you seen a patient shocked? not stacked shocks, but shocked before they die (intubated), and drips will no longer work?

The Answer Nurse: While difficult to give a number, The Answer Nurse can state that her longest “code” with the most actual defibrillations occuring during that time was during a pediatric arrest. The code lasted one hour after arrival with the paramedics. A very rare, very sad situation.

Question Number Five: How effective ARE compressions.

The Answer Nurse: The Answer Nurse feels that if the patient able to leave the emergency department for the ICU rather than the morgue, the compressions were effective.

Question Number Six: Why does my hospital no longer stock fracture pans?

The Answer Nurse: The Answer Nurse believes this will change once someone in the Purchasing department who wears a suit to work fractures a hip and comes to your facility. You will thereafter be innundated with three different styles of fracture pans in four different colors. The Answer Nurse suggests giving said administrator a foley catheter instead.

Question Number Seven: Was I truly expected to believe “I was walking drunk along the side of the highway and fell down, and that’s why I have a mid-shaft femur fracture.”

The Answer Nurse: Yes. (The Answer Nurse must often run to the bathroom to see if she has “STUPID” stamped on her forehead.)

Question Number Eight: Why does work call me when I have n/a after my name on the schedule?

The Answer Nurse: The Answer Nurse believes that a mere “not available” encourages your colleagues to call to inspire guilt. They could be desperate. Pity, really. Then again it may have been a joke at your expense and you are on speaker phone so everyone can hear you. The Answer Nurse is sorry that you have experienced saying “no” to your understaffed, overworked colleagues, but she is sure you must have done something to deserve it.

Question Number Nine: Why does no one read my blog on the weekend?

The Answer Nurse: The Answer Nurse can only assume that your readers are sneaking peaks at your blog on company time. This would explain their resumption of a regular life on the weekends, leaving little time for blogservation. The Answer Nurse just invented that word.

Question Number Ten: I confess, like many such young, inexperienced, greenhorn, of-the-all-thumbs doctors, I am male.…the nurses will thereupon commence to “train,” “educate,” “be-spine-ify,” and otherwise mercilessly and cruelly torture “The Intern”…

My question is, how does this process change if the doctor is female, single, and good-looking?

The Answer Nurse: It doesn’t. The Answer Nurse appreciates your need to ventilate and would like her readers to know the entire text of your amusing anecdote can be found at Wicked on your blog The Budding Emergencist.

And that concludes our most recent interview with The Answer Nurse. Emergiblog hopes she will grace us with her presence for a future interview.

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August 20, 2006, 5:00 pm

Encouraging the Dream


There are just two things I want to do before I can die a happy woman.

One, I want to shake hands with Barry Gibb.

The bonds of matrimony would restrain me from anything else.

Not that I was even thinking along those lines…..

And I want to dance with John Travolta.

Just once.

The Tango Hustle.

In leotards and heels.

At a dance studio.

To “More Than A Woman”.

By the Bee Gees, of course.



It seems that everyone wants to be a nurse, lately.

I have had four people in the last week, two guys and two gals, tell me they were in the process of getting their pre-requisites out of the way so that they could apply to nursing school.

I spoke to one woman who was waiting for her acceptance (or rejection) letter from two different universities in the area.

When I hear this, I don’t just say “Oh, that’s nice” and go on with my duties. I take a minute to sit and talk with them.


First of all, I let them know I am truly excited to hear that they are choosing nursing as a career.

I literally say to them, “That is fantastic. We need you badly! Nursing needs you badly!

I tell them not to be discouraged by difficult classes or doubting whether they will ever make it, especially since most of the ADN schools around here actually have “lotteries” where all qualified candidates are placed in a pool and then chosen by chance.

Can you believe this?

I almost fainted the first time I heard that my future colleagues were being chosen “out-of-a-hat” so to speak.

And that qualified candidates were being turned away for lack of space, instructors or funding.


In 1976, my class had 40 openings and 350 applicants. I was required to apply to the community college assigned to where I lived, I could not apply to the one in the next town. I was stunned that I got in just one year out of high school. A classmate was one year behind me and was accepted right out of high school!

We were just selected. No lottery. Either you were in or you weren’t.

I spent a total of $700 when I went to nursing school. From start to finish. Community colleges in California were free. No tuition.

I heard yesterday that they now charge $26 dollars per unit.

State colleges are very, very expensive. Nowhere near medical school, obviously, but still up there, even for residents of the state.

For this reason, most of the future students I encounter are trying to go the ADN route first, even though it can take up to 3-4 years for the “two-year” degree (after factoring in all pre-requisites).

I tell them if they don’t get into nursing school the first time they apply, don’t give up.

Keep studying.

If necessary, get your AA in General Education, making sure all your classes are transferable to a state college or university and then apply to the BSN programs along with the ADN programs.

I’ve even told people with BA’s who have told me they want to be a nurse to look into entry-level MSN programs.

One of the advantages of nursing is that there are so many different ways to join the profession.

We’ve made it easier for RNs to get their BSNs or MSNs with innovative programs.

It shouldn’t be so hard for quality nursing candidates to join us at the entry level.


This is why I feel so strongly that we need nursing advocates at both the state AND national levels, why it is important that we encourage our colleagues with advanced degrees to consider teaching.

It’s why I’m always harping on the need for a National Nurse.

A spokesperson, someone who can advocate for nursing school funding at all levels, but especially programs that will help pay nursing instructors what they deserve.

In World War Two we had the Cadet Nursing Program. Full tuition for service to the nation during the war.

Are we not in a crisis mode regarding nursing right now? Why not a Cadet Nursing program today? Full tuition for two years service in a county facility or underserved area? Extra funding for participating nursing schools?

There has to be a way. When I am eighty I want to know there will be nurses to take care of ME, prn as opposed to ME still working because I’m needed so much.


I tell these future nurses that they will never work harder, or be more rewarded than they will as a nurse.

I’m lucky. I work in an ER that gives me the chance to actually sit and encourage these future colleagues.

But in addition to encouragement, they need nurturing as they travel the rough path into their chosen programs.

We are all examples of nursing to our patients and their families. To OUR families and friends.

Lets do our part.

Don’t talk down about the profession. Yes, sometimes nursing sucks but so does working at McDonalds, being a police officer, working an ambulance for 48 hours or being a partner in a law firm. Doctors don’t exactly have it easy, either.

Know any teenagers? Talk up the advantages of nursing. If you can’t think of any, you’re in the wrong profession.

Every occupation has it’s pitfalls. But, if you will pardon my expression, “bitching” about nursing doesn’t do our image, or our future as a profession, any favors.

The best and the brightest are waiting to join us.

Let’s encourage those with the brains, the will, the calling, the courage….to be a nurse.

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1:55 pm

Keep The Fire Burnin’


This is not a painting.

It is an actual photograph taken by my son from the back porch of our family farm in northern California.

Life is slow up there.

Peaceful. Quiet; the plaintive whistle of the train echoing through the town across the highway.

It’s a great place to relax, unwind and change gears.

The cable doesn’t cross the highway so we only get three channels on the old TV, and even then only two of them are clear.

If I stay up there long enough, it takes me at least a week to get back into “city mode”.

It has saved my sanity many times.


Sometimes I feel as though health care is like a siphon.

Somebody sticks a hose in your psyche and drains you dry.

You give and give and give and give.

Each patient gets something. Your care, your empathy, your energy.


Eventually, you feel as though the gauge is past empty, the light is flashing.

Emotionally you are sputtering and gasping your way just a little farther down the highway.

You can’t go any further and you shut down.

They call it “burn-out”.


I think everyone goes through burn-out, at least once.

It takes a bit of time to find your limits.

The best way to deal with burn out is to build your “farm” before it hits.

You need a sanctuary.

It need not be a physical place, but you need to have something outside of work that ignites your passion.

No, I’m not talking about Orlando Bloom (well, yes I am, but he isn’t available).

It could be a hobby, a sport, politics, music, personal time (shopping, anyone?).

It’s anything that you can do that allows you to recoup all that you have given during and for your work with patients.


Ironically, my passion turned out to be writing about my profession!

It started out as a fun new thing to try and has turned into something that keeps me excited and interested in what I do as a nurse.

Now, two blogs later, I’m looking to write a book series!

But it isn’t just a newfound, previously untapped love of writing that makes it so helpful to me, personally.

It’s the health-related blogosphere itself.

It’s learning about new specialties, seeing life through the eyes of doctors, patients and my nurse colleagues.

It’s finding my love and excitement for nursing re-kindled by reading about nursing students who are working so hard and juggling so many different responsibilities to be able to do what I sometimes take for granted after all these years.

Every single blog on my sidebar (and a few who I still have to put up) keeps me emotionally connected with why I went into nursing in the first place.

And reminds me, even after a hellacious string of non-stop Emergency Department nights, why I’m still willing to keep on doing what I was called to do so long ago.

I felt that this week, the occasion of the 100th posting of Grand Rounds was the perfect time to reflect, and thank, those who so wonderfully keep the medical/nursing/patient blogosphere a haven and a great place to hang out.

Thanks for being my “farm” when I can’t get to the real thing.

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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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