September, 2006 Archive

September 3, 2006, 6:50 am

Notre Dame 14. Georgia Tech 10. ‘Nuff Said.

nd Joe Montana ND jersey.

Check.

Brady Quinn signed football on TV.

Check.

Blue,gold and green rally beads in both football and shamrock shapes around my neck…

Check!

Blue, gold and green ND cheerleader pom poms in my hands…

Check.

Victory over the Georgia Tech Yellow Jackets…

DOUBLE FREAKIN’ CHECK!

WE FREAKIN’ WON!

NOTRE DAME FREAKIN’ ROCKS!

And now,

Let’s us stand and pay tribute to the greatest football team in the nation as we join our voices in the rousing chorus of the Notre Dame Fight Song…

Cheer, cheer for Old Notre Dame
Wake up the echoes cheering her name,
Send the volley cheer on high,
Shake down the thunder from the sky,
What though the odds be great or small
Old Notre Dame will win over all,
While her loyal sons are marching
Onward to Victory.

God, I do love my football…….

(History of present illness: My son graduated from ND in May is is now there for law school. No, he is not interested in medical malpractice. His mama didn’t raise no fool!)

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September 2, 2006, 12:12 am

I Know You Are, But What Am I?

rolex

Is it just me or have Rolexes changed over the years?

I mean besides the price.

Back then the glass didn’t break.

********************

I know you’re expecting a joke or two about nursing in a Rolex.

But I can’t joke about it….because I did it!

Hubby was going to the mall so I asked him to stop at the uniform shop and get me a cheapo wristwatch. I have baaaad watch karma – they always break, so I wanted the cheapest one they had.

He came home with a silver-colored Rolex. Fifteen hundred dollars.

Well WTF, I said as I picked myself up from my syncopal episode.

It wasn’t gaudy like the gold ones, it was beautifully professional. If you didn’t know it was a Rolex, it wasn’t obvious. It was just a pretty, functional watch.

Until I’m in the tub one day and hear, “Clink!”. The crystal just shattered. Right there on the sink. Three feet away from me.

Bummer. I guess they aren’t waterproof/steamproof anymore.

******************************

The following post is known in the blogosphere circles as a “rant”. Hang onto your caps, it’s going to be a bumpy ride….

******************************

I wish nursing would get its act together.

Why is it that in order to be accepted as a “profession”, we have to copy another profession?

Doctors diagnose, so therefore we have to diagnose our special things or we won’t be respected!

Doctors have one route to their degree/license, but between the ADN, BSN and entry-level Masters programs, nursing has three.

So let’s get rid of the one that produces the highest number of working bedside nurses for the degrees that will get us respected!

You know what?

Nursing won’t get the respect we deserve until we start respecting ourselves!

Until we are proud of our unique ability to work our way up the degree ladder while we practice our profession, if we chose to do so.

Until we stop looking down our educated noses at nurses who chose, for whatever reason, to obtain their ADN no matter how long it takes.

Until we stop referring to direct patient care and actual caregiving as “the dirty work”, which is exactly how one nurse blogger phrased it. It’s okay to teach a patient, but god forbid we touch them!

Until Nurse Executive IMA BIGSHOT, RN, MBA, PhDNsc, FAAN, CEN, CCRN, CRNA, RN,C and EMT-P gets off his/her high horse of an office chair and realizes he/she is no better and, in fact, is just as qualified to wipe an incontinent patient as the new ADN graduate three floors down.

And is willing to do it.

Until we stop trying to quantify what we do and who we are using medical models of documentation that are just bull s*** in black ink when it comes to actual patient care.

Constipation is constipation, dammit.

Not: “Elimination, impaired,

  • secondary to post-operative pain meds
  • required due to S/P hip surgery,
  • secondary to hip fracture,
  • caused by a mechanical fall at patient’s residence
  • because of improper lighting
  • resulting in hazardous living conditions
  • because of patient’s lack of ladder to remedy said lighting deficiency
  • secondary to patient purchasing cigarettes
  • instead of household items.”

(You think that’s funny? I lived it. There is a hospital in San Jose that required exactly that type of documentation! I exaggerate much less than you imagine.)

In fact, constipation IS a diagnosis. So we have to couch it in fancy terms because…..

We’ll be respected!

By whom?

By the doctors!

The patients already respect us, for the most part. We’re in the top three most respected professions according to a recent public poll I’d love to cite if I could remember where I saw it.

The hospital administrators damn well respect us, even though they never let us know. All we have to do to shut a hospital down is not show up for work.

We are the reason that patients are hospitalized. It’s called nursing care.

And only nurses can provide it

But the doctors!

You want a doctor to respect you?

  • Know your patients
  • Advocate for your patients
  • Give excellent, safe nursing care to your patients.
  • Act like a professional on the job
  • Dress like a professional on the job
  • BE the professional you are, no matter how many letters you do or don’t have after your name

Because I don’t care if you manage a nursing company, edit a respected nursing journal, conduct nursing research, provide primary care as a nurse pratitioner, teach at a nursing school, manage a med surg floor or stand at the bedside eight hours a day.

We are ALL nurses.

NURSING IS NOT MEDICINE.

So, please, let’s stop trying to emulate what we think a profession should be and be what our profession is.

The profession of patient care. Be it in the research lab, the editorial office, the Cheif Nursing Officer chair, the nursing manager’s’ office or at the actual bed of the patient, be it with an ADN, BSN, MSN or PhDNsc.

We are all in this together. Stop trying to drive wedges between us. We have many unique ways to come to nursing.

Let’s embrace them all and let every other profession deal with us.

******************************

Whew!

If anyone is still with me at this point, here is a case of shameless self-promotion for a self indulgent post. Yep, an new post is up over at Scared To Health.

After this one, it’s rather tame!

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September 1, 2006, 2:35 am

Hanging On For Dear Life

docbox

Nurses!

Are you bothered by unsightly, unwanted ER patients?

Tired of feeling like the Narcotic Nanny?

Well, help is on the way!

Now available to your patients: the latest upgrade in medical accessibility!

The new, 2007 edition of “Doc In A Box”!

Patients simply open the box, remove the physician and get all the narcotics they want.

When they’re done, they return the MD to the box and store in a convenient location.

It’s that simple!

Available wherever nurses are employed.

(Use as directed. Reader takes all responsibility for any perceived insult to any physician or patient. Void where prohibited.)

******************************

Your father was ninety-nine years old.

You were the youngest of twelve children he raised while residing in Mississippi.

And god, you were a pain.

Pushy, continual questioning, repetitive requests and into the ER at least every other week with the same complaint for your father.

In you would come. Always with one of your dad’s caretakers in tow.

One of three full-time caretakers. He had the same caretakers for ten years while he lived in your home.

Ten years!

They did a great job.

But your dad was old. Very old.

*****

The staff thought you were crazy. They didn’t even want to get near your dad’s case.

So they assigned him to me.

Each time for the last six months.

I “had a way” with you, they said.

No I didn’t.

I just gave you the attention you seemed to crave so badly. I answered your questions.

Repeatedly.

But most of all, I listened.

*****

The turning point came when you suggested a treatment for what you thought was wrong with your dad.

What you asked for could not hurt, so it was ordered to appease you.

And it worked.

Dramatically.

Damn! I said, for once not watching my language in front of a patient.

I couldn’t believe my eyes as your father became alert and interactive.

Such a simple thing.

But you knew.

*****

After that, when he would come in, you and I would look each other in the eye and nod our heads over what was happening.

I got to know your dad and how he responded. What looked right and what did not.

You had even taken steps to decrease the number of ER visits by arranging to have his ongoing issue addressed on an outpatient basis.

And it worked.

For awhile.

*****

One night I came back from break to find you and your dad with his caretaker in one of my assigned rooms.

Something was horribly wrong.

One look and I knew.

Knowing your dad’s venous anatomy like the back of my hand, I inserted an IV in a most unusual spot, but I always knew that’s where I’d find access.

Your questions came fast and furious and I answered all of them. For once I was glad to be in a multi-bed room because I could be available consistently to answer your questions and I could watch your dad the entire time.

And he needed watching.

He was dying.

*****

You didn’t like the doctor who gave you the news that this could be “it”.

You looked like a deer caught in the headlights. You couldn’t spit the questions out fast enough. You said something about your dad not being a “throw away”.

You didn’t process a single answer.

Except that you asked me directly how bad it was.

It was bad, I said.

Very bad.

You looked right at me and started to sob.

And then just as abruptly pulled your emotions right back in.

*****

But it was too late.

I had seen the facade crack.

You weren’t crazy.

You were scared.

And in that one brief moment of emotional release I saw you as a human being who did not want to lose their parent. Not a controlling, off-the-wall family member who could drain you dry of energy in minutes.

You were a child who was afraid that your dad would be written off and that your obserations would be ignored.

And you fought for him. For you.

After all those visits in all those weeks…months…years, I realized your affect in the ER was a defense mechanism built after years of dealing with nurses and doctors who distanced themselves from you and would not listen or respond to what you said or what you wanted.

For your dad.

To keep from having to deal with what you were faced with right now.

Your dad was ninety-nine years old and dying.

And we had taken away the one thing that gave you stability.

We had taken away your hope.

*****

You said he was tough, that he had fought before and he would fight again.

I acknowledged that, indeed, one does not make it to ninety-nine unless they are tough.

Things were actually better by the time your dad was admitted, with his caretaker at his side. He drank some ice water. He spoke some words and seemed less lethargic than before.

I prayed that for your sake you would have more time.

*****

I learned after a couple of days off that you had one more day with your dad.

I wondered how you were doing.

And if I’d ever see you again in the ER.

And I learned to listen more actively when families (or patients) seem difficult or feel they need to push hard to be understood….or respected.

To appreciate the observations of someone who would know their family member much better than I would ever know them.

Sometimes you drove me crazy.

But it was an honor to be able to care for your father.

And you.

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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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