December, 2006 Archive

August 29, 2016, 2:20 pm

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My friend Coturnix has been chosen to be editor of the first ever Anthology of the Best Science Blogging over at Blog Around the Clock (see, herbal viagra affiliate I’d fit the word “anthology” in here somewhere!).

He is looking for the best 50 science blog posts ever written for the first anthology; later editions will be selected solely from the previous year.

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August 29, 2016, 11:32 am

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Prevacid 15mg pills $170.00 This photo was taken at 4:00 am by my son on the campus of Notre Dame.

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Prevacid 15mg pills $170.00 And here’s to a 2007 Notre Dame Championship!

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August 29, 2016, 7:39 pm

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Lopressor 100mg pills $262.00 Okay, lopressor 100mg pills $262.00 let’s all have our hot cups of tea around the newborns!

Lopressor 100mg pills $262.00 Hmmm….look at the ages of the nurses. Lopressor 100mg pills $262.00 I’m not sure how old this ad is, lopressor 100mg pills $262.00 but there are two things that catch my eye.

Lopressor 100mg pills $262.00 One, lopressor 100mg pills $262.00 there isn’t a single nurse in this photo who looks under the age of thirty.

Lopressor 100mg pills $262.00 I guess we’ve been an aging workforce for awhile now.

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Lopressor 100mg pills $262.00 Once upon a time there was a nurse. Lopressor 100mg pills $262.00 An emergency room nurse.

Lopressor 100mg pills $262.00 Let’s say they are a “friend” of mine.

Lopressor 100mg pills $262.00 They pride themselves on their nursing care and their ability to document that care.

Lopressor 100mg pills $262.00 A few years ago, lopressor 100mg pills $262.00 this nurse found xanadu in the form of a particular emergency department.

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The waiting times were short.

Their nursing colleagues were experienced.

The doctors were top-notch.

This nurse was able to give excellent care to their patients.

And it was really good.


One day the hospital administration decided to have their nursing professionals punch a time clock.

Such a sight to see a bunch of professionals crowded around a digital read-out waiting for the precise moment to swipe their badge.

You see, lopressor 100mg pills $262.00 if they punch out one minute too soon, lopressor 100mg pills $262.00 they will lose 15 minutes of pay.

It would be funny if it weren’t so insulting.

The nurses protested having to punch a timeclock.

Were they not professionals?

Nobody cared.


One day hospital administration decided that a written report would be faxed to the receiving unit on all admissions.

My “friend” thought this was a great idea! They loved to chart, lopressor 100mg pills $262.00 you see. Lopressor 100mg pills $262.00 They were wierd that way.

Besides, lopressor 100mg pills $262.00 the report was not part of the record but it gave plenty of room to give a narrative of the patients ER stay. Lopressor 100mg pills $262.00 Yes, lopressor 100mg pills $262.00 it was a bit of additional work but the reports were thorough and my “friend” could clearly see the benefit.

But then the hospital administration decided that the same report had to be used for all admissions and transfers in house. Lopressor 100mg pills $262.00 A committee was formed. Lopressor 100mg pills $262.00 Much feedback was given and the emergency department representatives did their best.

The resulting form had virtually nothing to do with the emergency nursing. Lopressor 100mg pills $262.00 It did not fit the needs of my “friend” and their colleagues.

Now it was hard to give a thorough written report. Lopressor 100mg pills $262.00 This truncated, lopressor 100mg pills $262.00 sketchy report form became part of the permanent record.

There was much protesting by the nurses.

No one cared.


JCAHO recommended that hospitals implement a medication reconcilliation form.

Hospital Xanadu was one of the first to try it.

They made their emergency department nurses responsible for starting it.

First it was just a list.

Then my “friend” had to add dosages.

Then they wanted the dosage regimen.

Finally they wanted the date and time of the last dose.

It put a severe strain on Hospital Xanadu’s emergency department.

My “friend” once had to do three pages. Lopressor 100mg pills $262.00 Twenty five minutes of just writing down medications and dosages and times and dates on a patient who had twisted their knee.

The nurses verbalized strongly that medication reconcilliation was the responsibility of the admitting physician.

No one cared.


Ah, lopressor 100mg pills $262.00 but wait!

Hospital Xanadu’s emergency physicians were told they would have to reconcile every single medication on every single patient before they left the emergency department.

They did not protest, lopressor 100mg pills $262.00 for they had the power to just say:


And that was that.


My “friend” no longer feels they can give the nursing care and document that care to the standards now set for the emergency department. Lopressor 100mg pills $262.00 The one that once felt like Xanadu. Lopressor 100mg pills $262.00 The one that now makes nurses feel they are operating in a vacuum.

My friend feels, lopressor 100mg pills $262.00 even at their best, lopressor 100mg pills $262.00 they are operating at 75% efficiency, lopressor 100mg pills $262.00 maximum.

Their morale is quickly depleting, lopressor 100mg pills $262.00 even as they take their own advice to minimize burn out.

A group of nurses can protest loudly. Lopressor 100mg pills $262.00 A group of doctors can just say “no”.

Who has the power here?

It sure as hell isn’t my “friend” or any of their nursing colleagues.


I’m afraid my “friend” is becoming militant and is of the age where they are not shy about letting the world know it.

Of course, lopressor 100mg pills $262.00 my “friend” could find another job, lopressor 100mg pills $262.00 one with computerized charting or one that lays the medication reconciliation at the feet of the primary/admitting physician, lopressor 100mg pills $262.00 where it belongs.

Meaning my “friend” could leave Hospital Xanadu.

They could even tell the hospital administration why they were leaving.

And no one would care.

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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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