September 8, 2006, 10:43 am

Oh No, I Did NOT Just Read This…


You can tell this is from a different era.

No longer do we hawk materials destined to end up in the vast land fill of discarded consumerism.

The milk carton.

Your…personal….milk carton.

Use it once and throw it away.

Discard like any other empty food package and don’t you dare feel a twinge of guilt!

Lord knows we can’t have our milkmen carrying heavy things like glass.

I am old enough to remember the milkman.

(That creaking you hear? I just crossed my knees.)

Obviously nurses stood for purity and wholesomeness back then.

If a nurse says it’s okay, it’s okay!

Nurse = milk.

Oh. I get it now.


There’s a new NHS doctor in town! He’s an A&E doc and he’s angry! He is also entertaining and it will be interesting to get an A&E doc’s take on emergency medicine. Check out Why Do We All Lie? at Angry NHS Doctor . If his comments aren’t working yet (new to Blogger, he is!), send him an email and say hi!


And don’t forget the Carnival of Hope coming up on September 15th at Rickety Contrivances of Doing Good Susan reminds us: “…the deadline for Carnival of Hope is fast approaching! Please e-mail your submissions to SusanPal(at)aol(dot)com by 5 PM Pacific time this coming Thursday, September 14.”


Ah…Starbucks is offering some good music this morning. Walked into a bit of Jackie Wilson, followed by some Sam Cooke, a little Motown. This should make waiting for my tires fun! I was just called and told the steel belts were showing.

And a lady never has her steel belts showing…


While researching the local hospital that we would be using prn now that hubby has a new doctor, I decided to check out the “Careers” section.

You can tell a lot about a hospital by how many positions it has open for RNs. If there aren’t too many, it’s probably a good place. If you see twenty open positions for the ER or the med/surg unit, you might want to think twice about what sort of hospital it is.

Very pretty, easy-to-navigate web site, nice looking facility.

And then I ran across this at the bottom of the description of the ER nurse position:

We think you’ll like our campus and our work environment. We like to brag about our upscale patients, our upscale medical staff, and our upscale employees.” (emphasis mine)

Here is the link, if you would like to see it in context.

Would someone please tell me what in heaven’s name is an “upscale patient”?

This hospital does reside in a high-income community, but so have other hospitals I have worked at and never, ever did they make refererence to the social rank of their patients.

And I have never, ever seen anything that categorizes patients by their income.

Does this mean that they suffer no homeless, no un-insured? They can’t turn them away, so how do they deal with those of us who are not “upscale”?

And what about “upscale” employees?

I live in a San Francisco suburb that is a microcosm of the entire world. I live with all races, creeds and income levels. We have our homeless, our renters, our homeowners and those whose income will far exceed what I will ever make all within one block of my home.

Am I “upscale” enough for this place? I might flunk the “looking-down-my-nose” part of the orientation. I’m not good at that. Never have been.

Then we have the “upscale” medical staff? Does this mean no laid-back, long-haired hippie-type docs? I happen to like that “model” – they make the best ER docs, in my experience (and I’m a sucker for a guy with long hair). But could they possibly be “upscale” enough for this place?

Nowhere else on this website does the word “upscale” appear in relation to a patient description.

I think this is a code word designed to let prospective nurses know they won’t have to deal with “riff-raff”.

Well, the “riff-raff” need health care, too. Some of my best friends are “riff-raff” and some of my favorite patients have been street people.


Somehow I can’t get the Billy Joel video of “Uptown Girl” out of my head.

I guess in this case it might be an “Uptown Appy” who has never had a “Backstreet Doc”.

Heck, I’d take a doc who looked like a Backstreet Boy anyday..

But I digress.


So, go ahead and brag about your “upscale” patients. We are one of the lucky folk, the ones with insurance, so I’m sure we will meet the “upscale” requirement should we need to utilize your services.

But you won’t ever find me working for you.

You see, I don’t care about the social class of my patients.

And if all you see in your ER are the “upscales” of the world, your employees are missing out on the rich tapestry that is American society.

Despite your elitist attitude, it’s nothing I would brag about in an employment ad.


New post at Scared to Health in which one doctor is fired and another is chosen…


  • Dawn

    September 8, 2006 at 2:51 pm

    Re: Angry Doc. One word.


  • Crystal

    September 8, 2006 at 6:03 pm

    I’ve been reading your blog for about a week now. Your comments are very thought provoking. I especially like what you had to say today about social class of patients. I am a nursing student, also working as a nurse’s aide in a hospital. The discrimination I see in our hospital is unreal. We are currently adding onto our hospital and they are calling our new floor the “VIP” floor. It infuriates me that they would distigush between patients. Everyone deserves to be treated the same. No matter what. I have learned a lot in the year or so that I have worked in the hospital and continue to learn through clinicals and such. Thank you for your insight. Feel free to visit my blog at

  • Sid Schwab

    September 8, 2006 at 7:16 pm

    Re: your love of music. I discovered a cool website recently which allows you to input songs you like which are then analyzed for certain characteristics and they start streaming songs to you. You can give thumbs up or thumbs down to refine their assessment. And you can select several different “stations” in different genres. It’s called No axe to grind, here. Just think you’ll like it

  • Barbara

    September 8, 2006 at 10:07 pm

    Just found your blog – it is very interesting.

    Had to comment on the milk bottles – do you ever watch the tv show “keeping up appearances?” it is a bbc show sometimes on pbs. The main character there is a social climbing, fanatically clean woman. there is an episode where she bugs the milkman that she only wants bottles from the “best” neighborhoods, no bottles used by the working class for her. The show is from the 80’s but it is roll-on-the-floor funny.

  • Candy Goulette

    September 9, 2006 at 10:59 am

    I’ve visited this “up-scale” hospital on several occasions — the recruiters are VERY up-scale, the grounds are gorgeous, the patients all look rich AND old and they invite no commentary on paying their social dues. That’s what the other hospitals are for…

  • AmandaM

    September 9, 2006 at 11:00 am

    re: the VIP room….my uncle just recently had minor surgery, but his doc had him wait until he was “emotionally strong enough”, as my aunt, his beloved wife of nearly 40 years, had died just a few months before. For his surgery recovery, they put him in the biggest hotel…ooops did I say hotel? I meant hospital…room that I’ve EVER seen. It had a couch, a recliner, a table with 4 chairs, a panoramic view, a TV with DVD, a fridge and a microwave and it’s own shower and bathroom, and wood (at least they looked like wood) floors. I kid you not. When I went to visit I didn’t want to leave, it was just a sweet, sweet room.

    Anyways, that sort of “VIP” treatment suited my uncle just fine – he was the head of a major organization, lectures all over the world, bla bla bla – but the point is, he sees himself as a VIP and given the risks of surgery while grieving and the rate at which elderly men who’ve lost their wives join them, giving him the “VIP” treatment was a great call on the nurses/doctors part. He had little pain (less than I, with fibro, deal with on a daily basis actually), and bounced back in no time at all. 5 days I think – I was amazed. It could have been a very, very hard time for him, and it wasn’t, it went suprisingly well.

    Not that I support discriminatory treatment, but I was just amazed at the effect that it had….

  • PaedsRN

    September 9, 2006 at 12:26 pm

    You sure they’re not talking about ‘upscale’ as in body mass index? 😉

  • Susan

    September 9, 2006 at 9:26 pm

    Hi, Kim! Thanks for plugging my carnival again!

    And I’ve got an idea. Why don’t we give those “upscale” hospital rooms to *everybody,* with the very nicest suites reserved for the most “downscale” patients? Especially the homeless guys who think they’re in heaven if you just smile at them and give them a warm blanket?

    I volunteer in an ED because it *isn’t* a gated community, and forces me to face people and conditions it might be too easy for me to forget about otherwise.

  • dan freeman

    September 11, 2006 at 8:29 am

    thanks for the link to This guy is hilarious – have you see his last posts – why do walls lie.

    could you collaborate with him on some blog suff – or get a link from your site to his so other people can read his rabts!?

    AS always love your site

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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