October, 2006 Archive

October 24, 2006, 3:58 am

Set Your Sights On Grand Rounds!


“A picture is worth a thousand words.”

If you’ve ever hosted Grand Rounds, the picture here says it all.

Actually, so does attorney Bob Coffield in this week’s edition of Grand Rounds!

You can find Grand Rounds 3.5: A Visual Tour posted at the Health Care Law Blog.

It’s 0300 and my screwy night-shift physiology has me wide awake and something tells me by the time I finish this fantastic addition of the ‘Rounds, I’m going to BE the guy in the photograph!

Check it out: There is a post that talks about Jeff Goldblum being a science role model! And after I just posted about how sexy he is – in professional terms, of course.

Guess which post I’m reading first?????

Bob, you may feel like ground round, but this edition is pure prime rib!

Congratulations on a job well done (and a rest well earned!)!

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October 23, 2006, 10:38 am

The Five “Rights” of Nurses



Who snuck the camera into my waiting room?

Actually, we don’t have waits like this. Our patients are so spoiled that I’ve had them complain that it has taken 90 minutes from start-to-finish, including the placing of a splint!


Besides, what kind of waiting room is this?

No decorations? No artwork? No TV? Everyone in a straight line?

This room needs some serious work on its Feng Shue.


First of all, I want to send out kudos to Monika at Becoming A Nurse for, well, becoming a nurse !!! I’ve moved her blog from the “Student” to the “Nurses” section!

There is a new blog under “Medical Bloggers of Interest”! Check out The Foot Blog. It’s the first blog I’ve seen by podiatrists and it’s very well done.

Having a husband with diabetes and a daughter running cross-country, we have been dealing with feet on a regular basis, so running across this blog was very timely!


All new nursing students learn the “Five Rights of Medication Administration”.

Later, they learn to use new technologies and systems to enhance those “rights”, but the basic concepts are used to help the students provide safe patient care.

It occurred to me that perhaps there should be basic “rights” for nurses.

In fact, there should be five of them.

So, here they are, as proposed by yours truly:

The Five Rights of Nurses

1. The Right To A Quality Nursing Education, Unimpeded By Lack of Access

All qualified applicants have a right to a nursing education. The nursing shortage is acute. The future nurses are there, but we are losing them to other professions due to a lack of space in existing programs, exacerbated by a shortage of nursing instructors.

If there was ever a program to invest in, the nursing profession is it. The health care delivery system in this country would collapse without nurses.

Money should be provided at both the community college and state university level to

  • Expand exisiting programs to accomodate additional students.
  • Provide a financial incentive to lure the best and the brightest into becoming nursing professors. You can’t educate until you have the educators in place.


2. The Right To Nursing Leadership

Nurses have the right to expect their leadership to:

  • Focus on (and fight for) the basic problems of education access and nurse recruitment before they debate advanced practice entry levels and how many doctorates are necessary in one profession.
  • Maintain clinical skills so they understand what the rank-and-file nurses in this country face on a day-to-day basis.
  • That means coming out of their office, putting on a set of scrubs and actually spending time with those whom they profess to lead. Once, twice a year. That isn’t asking too much.
  • We all started at the bedside. That is where basic nursing care is taught and perfected. It is where the majority of nurses still remain.
  • Treat basic nursing with the respect and attention it deserves, not as a stepping stone to advanced practice away from the beside.

If you are in a nursing leadership position, ask yourself why bedside nursing is no longer your “thing”. Then go to work on fixing the problem.


3. The Right To Give Excellent Patient Care

This includes:

  • Adequate staffing, with the expectation that their employers actively recruit and provide incentives to maintain the best staffing possible, going above and beyond just the basics required by law.
  • Access to the latest equipment, adequate supplies and access to inservice education provided equally to all three shifts.
  • Employer paid required classes. You required to have ACLS, PALS or TNCC for employment? The employer should be providing those classes or paying for them from another provider.

This also means that there is adequate ancillary staff so that nurses:

  • Are not: (1) answering phones (2) cleaning wastebaskets (3) being used as phlebotomists or EKG technicians or (4) Passing or cleaning up trays because these other departments have “downsized”
  • Are available for hands-on patient assessment, planning, intervention and evaluation; in other words, they are able actually practice their profession. You know, the Nursing Process? What a novel concept!


4. The Right To A Collegial Work Environment

This means the right to work without fear of, or exposure to, verbal abuse from physicans of any specialty.

  • It is understood that disagreements will occur and that medicine/nursing are stressful professions. Tempers will flare, words will be said and apologies will be made. That’s life.
  • This “right” covers a more toxic type of behavior. Specifically: screaming, yelling, throwing objects, or other threatening behaviors occuring in the presence of other professional colleagues or in front of patients (including within their hearing).

The nurse has a right to expect that their employer and the Chief of the Medical Staff make available to nurses a recourse to address this behavior, including some form of sanction leveled against the perpetrator. This tends to be repetitive behaviour.

This is where hospital employers fall short.

A blind eye is turned because the doctor is the “rainmaker”, to use a legal term; they bring in the bucks.


5. The Right To Organize

All nurses should have the right to organize under a collective bargaining agreement.

Ideally, you will have nurses representing nurses.

No matter how supportive, how wonderful, how progressive a hospital administration is, they will give the absolute minimum amount of pay and benefits that they can get away with.

Nurses, are a big hit on their “bottom line”. They’re numbers. They on the “payout” side of the ledger. To the number crunchers, they are a paycheck.

Nurses need someone protecting their rights, their pay and their benefits.

Oh, I know the non-organized hospital nurses make close to what unionized nurses make, but it is never more! You’ll get paid just what the facility needs to give you to stay competitive.

(As an example: California nurses are now the highest paid nurses in the country – as far as I am aware. It isn’t an accident. I’m represented by CNA.

I don’t agree with everything the California Nurses Association does. In fact, I’m totally opposite them on about 90% of their political agenda.

But…the reason I make what I do, my job is protected, there are mandated staffing ratios and my benefits are solid can be directly traced to the fact that they are my collective bargaining agent.

So,I pay those dues willingly and designate them to the “General Fund” so they won’t be used to fund propositions or other political activities to which I am opposed. )

All nurses should have the right, by vote, to engage in collective bargaining.


And there you have it.

The Five “Rights” of Nurses as I see them.

Maybe I’ll take on the Five “Rights” of Doctors next time. I had a few thoughts pop into my head on their behalf.

ER secretaries, too. Now there is a topic that needs to be written!

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October 22, 2006, 12:08 pm

Today Is Independence Day!


Man, there is nothin’ like coming home to a bit o’ Will Smith and Jeff Goldblum!

I was exhausted, ready to nod off when my daughter announced “Independence Day” was on.

Like, I’m going to sleep through this?

Not a chance in hell!

Yes, I own the DVD but if Jeff Goldblum is on TV, I am soooo there!

And, because one of my co-workers decided to work for me today, it really is my independence day!

You were wondering how I was going to work my job into this topic, weren’t you?

Did I mention I just love Jeff Goldblum? And Will Smith isn’t chopped liver, either.

Oh, I am such a geek!


At some point during the last week, I noticed that Emergiblog amassed over 100,000 hits per my site meter.

I guess that’s a few too many for just my mom and the one post I did on Andy Gibb.

Or the searches for a certain 1976 Gold Medal Olympic Skater’s haircut (although I still get visits looking for it after all this time).

Thanks to everyone who has offered encouragment, criticism, comments, suggestions and most of all, to everyone who has taken the time to read Emergiblog no matter how you found it.

Your support encourages me to keep writing, to find the positive aspects of my profession when “burn-out” rears its ugly head and provides an amazing portal of information, friendship, and support through your own stories and blogs.

I’m proud to be a Large Mammal.

Thanks for carving a place for me in this entity known as the medical blogosphere.

(And I’m just 150,000 hits short of catching Dr. Crippen!)


Oh my, “The Fly” just came on! It’s a Goldblum fest!

It’s a great movie until his body parts start falling off.

I have to watch it with my glasses off and my ears plugged, and I have to be NPO for at least two hours before or I get nauseated.

Still, it is one of the best movies ever made and Jeff should have gotten the Academy Award for Best Actor.

I mean, how often does a horror movie have so much pathos that you cry when it’s over?

Not that I do.

Or anything like that.


I’ll return you to your regular Emergiblog after “The Fly” – and some sleep!

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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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