November, 2006 Archive

November 10, 2006, 4:33 pm

Submit to Your Future…Change of Shift, That Is!


Hey Girls!

See how easy it is to be a nurse?

1. You sit at a desk holding paperwork and staring at the recruiter’s nursing cap.

2. You watch an operation.

3. You dance with Mr. Slick Hair.

4. And you have 2.3 kids!

Apparently the future is a man and two kids.

Only one out of four photos shows anything remotely health related and even that is in surgery where you can’t even tell who the nurse is.

Ironically, this is pretty much how my life did turn out!

  • Except John doesn’t have slick hair, it’s rather nicely layered.
  • I could not figure out how to produce a 0.3 kid, so I just went ahead and produced a whole third one.
  • Oh…and I watched two operations.

So what’s in your future?

I hope it is a submission to next week’s “Change of Shift”!

This time we travel all the way across the Atlantic to Julie and Life in the NHS, our hosts for the next edition.

As always, you can submit through Blog Carnival (see my sidebar) or send your submissions directly to Julie at “lifeinthenhs at btinternet dot com”.

That includes all you guys, too, something the ad above seems to have forgotten!


I love my British television. I really do. I go to BBC America on a regular basis.

Usually I like the classic British comedies. “Are You Being Served?”, “Keeping Up Appearances”, “As Time Goes By”, “Monty Python’s Flying Circus”, “A Fine Romance”….

You get the picture.

Well there is a show being televised on BBC America right now that is THE most offensive show I’ve ever seen in its portrayal of nurses.

Now lest you think I have no sense of humor, I laughed at the Quactitioner dolls and I think most nursing groups need to grow a bit in their humor divisions.

But…I’ve never seen a series television show portray nurses as incompetent whores in prime time. And that was only the first ten minutes.

I couldn’t take anymore.

The show is called “No Angels”.

The first scene of last night’s show concerned a nurse who found her patient dead. Apparently she forgot to check on the patient in a timely manner.

No CPR was started, no airway attempted.

Instead, they stripped the patient (a 70ish woman) and threw her into a hot bathtub so that the “SHO”, a doctor I presume, would not get pissed off and would think the patient had just died because she would be “warm”.

I’m nauseated just writing this.

And so, I am writing to BBC America and basically stating I am boycotting their station until this piece of garbage is off the air.

Every single thing BBC America offers I can get on DVD.

Am I out of my mind? Has anyone else seen this obnoxious piece of drivel?

I can laugh at nursing when it is appropriate but this is beyond the pale.

If the nurses in England have to deal with this sort of public perception, then God help them.

I’m surprised they have anyone willing to stay in the profession.

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November 8, 2006, 9:04 pm

Running in the Shadows


Now, most people would not describe me as “kinky”.

Whatever that adjective is supposed to mean.

Then again, I am a conservative Republican, so it might be an apt description depending on your viewpoint.

But I have to tell you, the sight of Tim Curry in fishnets in the “Rocky Horror Picture Show” sends me to the stratosphere!

You might say it fills me with



Sorry, I had to say it!

If you’ve never seen Rocky Horror, you may not know what I just said.

And if you ever do see the “Rocky Horror Picture Show”, you may actually be horrified, but not for the reasons you think.

It’s a hilarious send-up of the old B movie science fiction genre.

And certainly not for the morally sqeamish.

I had to watch it, nay, force myself to view it three times before I could get my jaw off the floor.

I mean really!

And no, I’ve never been to a midnight showing. Yes, I do know the words to “Time Warp”.

And I have been known to do the Time Warp in my family room. On occasion.


That was, I hope, a lighthearted intro into an emotionally loaded subject; namely sexual/gender orientation.

The impetus for this post came from a question posed by ER chaplain Susan Palwick over at Rickety Contrivances of Doing Good.

Susan asks, and I quote:

“What kind of education do emergency-medical personnel get about gender and sexual identity? If they don’t get any, how can that be changed?

The answer? None.


Oh yeah. We get classes on “diversity” and being “sensitive” to cultural differences, and occasionally sexual orientation is included in the general topic.

So where did I get my training on handling patients with sexual orientation/gender issues?

It’s called nursing school.

Remember that? Where we were educated to take care of a group of mammals known as “human beings”?

Did I have a class that actually focused on how to “deal” with those whose sexual mores or identity or behaviors might veer off the “normal” path?

No. I was educated in the nursing care of, let me repeat it again, human beings.

And guess what?

That guy in the sequined gown? That gal who looks like a walking ad for the House of Leather?

Human beings.

The two men who are obviously life partners and trying very hard not to show any public displays of affection because, well, it might be frowned upon?

Or the two young women who never use the word other than “my friend” but you can sense their feelings are deeper than the words they are using?

Human beings. All of them.

Are you detecting a pattern here?


I guess you can say my classroom in the nuances of sexual orientation/behaviors is the San Francisco Bay Area.

It didn’t come from instructors or textbooks.

  • It came from my patients.

I talked to my patients.

I wanted to know what it was like living the life of the opposite sex for that year before undergoing any surgery. I wanted to know what it was like to live with the changes after surgery.

I’d actually ask what bathroom they were more comfortable using, often eliciting some humerous anecdotes about visits to the potty gone awry.

I listened to my patients express humiliation that they wound up in my ER secondary to some form of sexual stimulation.

And yeah, I’ve raised an eyebrow or dropped my jaw over an x-ray with some unusual foreign bodies standing out in stark relief against the view screen. But those foreign bodies resided in a very scared, embarrassed human being laying in the gurney.

  • It came from many friends and some family members.

I wanted to know when they first knew that something was “different”, ie: when did they know they were attracted to the same sex. How did they handle keeping that secret? Were they ashamed? How did their families react?

In some cases I was well aware of it because I was talking to member of my own extended family.

I learned a lot. I learned that someone can be gay or lesbian and come from a stable, loving, two-parent, Christian heterosexual household.

I know for a fact that homosexual does NOT equal pedophile.

That two of the strongest Christians I’ve ever known in my life are gay men. If we are judged on our service to our fellow man, I’ll be a thousand miles behind these guys at the pearly gates.

I’ve had men I respected die from AIDS early in the epidemic.

That sucked. Big time.


As far as ridicule in the emergency department, perhaps there is less of that here in my area of the world, only because sexual identity and gender issues are so openly discussed.

What little I’ve ever been exposed to has been out of patient ear-shot (no excuse). And it shows , IMO:

  • The need for some people to ridicule to help them deal with their own discomfort in dealing with those whose sexual identity, behavior, mores are different than their own.

Truly, I don’t care what your sexual orientation is or whether your even male or female, your heath issues are the same health issues as every other member of your sex, whether it be the sex you were born into or the one you grew into.

And we’ll treat you accordingly.

I may ask, though, what you would like to be addressed as, who you consider to be your significant other (if any) and maybe, just maybe, if you’re up to it, sharing a bit of your life experience with me.


So, in terms of how to provide education to the ER staff, I don’t think you can force understanding or even tolerance though classes. Understanding comes through experience and the only way most of us will be exposed to the experience of what it’s like to live outside the societal, sexual “norm” is to TALK TO THE PATIENTS.

It’s truly amazing how willing people are to talk if they know you are interested in them.


Now lest you think I’m Mother Theresa when it comes to the gay/lesbian question, please understand that I struggle with many questions, politically, socially and spiritually where sexual orientation is concerned.

What I don’t struggle with is how to treat my patients, no matter how they present to the department.

That doesn’t make me a saint.

I hope it makes me a good nurse.


Epilouge: Emergiblog is a 99.9% politically free zone. Since I’ve already broached a politically sensitive topic, please be kind to any Christian, conservative Republicans today. To use a current phrase going around: we got “bitch-slapped” last night.

My cheeks still hurt.

The title to this post is a phrase from an old Fleetwood Mac song, “The Chain”. When I started this post, it seemed like a good title. It still is, but I wasn’t able to incorporate it into the post itself. But I really like it. So I’m keeping it!

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November 7, 2006, 10:50 am

The Rhythm of the ER


Buy. This. CD.

See. This. Man. In. Person.

If you do only one thing, go to the website. Songs from Under the Skin will begin streaming.

Click until you find “Cast Away Dreams” (PS: it works in Safari, not Firefox for some reason. Not sure about IE; I disavow any knowledge of Microsoft anything.)

Sometimes you need to be able to let a dream go before you can move onto the next level of your life.

If you have ever faced the need to do that, the song will resonate.

I just returned from the Lindsey Buckingham concert at the Palace of Fine Arts in San Francisco; the best two hours I’ve spent in a long, long time.

An artist thinks outside the box.

Lindsey Buckingham doesn’t even acknowledge a box.



I have unfettered access to the most beautiful city in the world.

I had forgotten how much I loved San Francisco until I was flying “halfway to the stars” over the hills to the concert. When I left the concert I had no clue on how to find my way to the freeway and home.

“Who cares!!!” I yelled to the Marina. “We built this city on rock and roll and tonight you’re all mine!”

Okay. Occasionally I talk to myself.

It was a cool, clear, fogless night and I was alone in the City…ahhhh. I could have driven all night taking in the sights and sounds.

What an unexpected gift! Rock and roll cranked as high as my not-yet hearing impaired self could handle, windows down, I think I actually had “lift off” on some of those hills. I probably should have gotten a ticket, but I’m sure SFPD had bigger fish to fry than myself.

San Francisco. Loony, liberal, off-the-wall. It’s everything I’m not.

(Okay, I’ll admit to off-the-wall…)

So why am I so comfortable there?

Trust me people. You have not lived until you have crossed the Bay Bridge or turned the corner on US 101 and seen the skyline of San Francisco at night.

Tony Bennett isn’t the only one who left his heart in the City.

I think part of my right ventricle found a home on Van Ness.


There is a rhythm to be found in the emergency department.

You feel it when you walk in the door.

Initially, it resembles an orchestra anticpating of the arrival of the Concertmaster; the cacophony of tuning replaced by one tone that turns individual musicians into a symphonic cohesiveness.

In this case the symphony is the ED staff, under the direction of the emergency physician. The charge nurse is the Concertmaster.

Some shifts can rival a Beethoven concerto in their rhythm and harmony.

Others resemble a night with the Grateful Dead; the structure is there, but buried somewhere under extended sets with unremitting improvisation.

Occasionally your department channels the late John Cage. Instead of four minutes and thirty-three seconds of ambient sound, it’s eight hours, the “music” being whatever is tossed into the potential vaccum of your shift. Atonal. Unorganized. Disturbing.

There is a beauty at both ends of the spectrum.


Unlike a symphony, the emergency department embraces many guest musicians during each performance.

The patients.

Some will be delicate flute-like children accompanied by strident trumpet-blaring parents. Others are like haunting oboes, bringing with them a forboding of doom.

Then the violins will enter. Some of them melodic and soothing, others with a screeching dissonance in their presentation.

Some will bring with them the coolness of a jazz piano. Others will resemble french horns; monotonic, but consistent – unable to be suppressed or ignored.

Many will present as high-pitched obstructed harmonicas, working with all their might to make a sound. Any sound. Some will not breathe at all, providing an inadvertent and unwanted “rest” to the score, signalling the entire orchestra to mobilize.

While the world plays in 4/4 time, the emergency symphony will accomodate those whose hearts beat in 32/4 time. Or provide choral support for those who can barely manage 1/4 time.

And stand in awe of those whose movement in the symphony of life has simply ended.


Underneath it all: the steadying presence of the percussion section.

The unrelenting base drum of the unit coordinator, keeping the ED in rhythm. Rarely seen by the visiting musicians; earning the eternal gratitude of the “regular” performers and working tirelessly with the Conductor to ensure a seamless progression from one refrain to another.

The flowing sound of the bass guitar in registration. Changing chords as they encounter each new musician and working in tandem with the drumming of the unit coordinator, they provide a solid riff for the rest of the “regular” musicians to work off of.

Transient percussionists will make their way through the ED in any given performance.

The clash of the Cymbals of Administration, causing a brief ripple in the motif.

The stand-by tambourines of security; acoustically invisible but available on a moment’s notice.

The triangle and maracas of dietary, radiology, lab and volunteers who add their small but invaluable beat to the ongoing movement of the night.


No performance of the emergency department is ever the same.

Oh, the regular musicians are always there.

It’s the visiting musicians who steer the tone of the piece to it’s final destination and provide the highlights (or lowlights) of the evening.

They keep the regular musicians on their toes as they work to assimilate each new addition into the rhythmic flow of the selection.

In reality, each shift in an emergency department is a work in progress.

Until the last musician has left the stage, you really don’t know what you’ve heard until it’s over.

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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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