December, 2006 Archive

December 7, 2006, 5:08 pm

The Center For Nursing Advocacy: One Nurse’s Opinion


I am happy to announce that my interview with Dr. Hsien Hsien Lei is up at Genetics and Health! The questions were very intriguing and made me think (always a dangerous proposition). Dr. Lei was chosen by in their Best Blogs: Ten Health Websites Worth A Click listing – Congratulations Dr. Lei!


helenwheelsI found this old ad when browsing the “Center For Nursing Advocacy” website.

Let’s get one thing straight, right off the bat; let’s address the most important issue here.

The cap is stunning.

10/10 on the Emergiblog Cap Rating Scale (ECRS). Perfectly situated and no “occipital slippage” in evidence.

Okay, now we’ll talk about the other stuff.


My first thought when I saw this ad was, “Heh! I’ve worked with that one!”.

My next thought was, “Oh man, I’ve been that one!”

According to the Center For Nursing Advocacy, this is known as the “battle-ax” stereotype.

And it’s a no-no to portray nurses in that fashion.

The campaign to get this ad off the pages of whatever magazine was an easy one. I think it took three letters, if I read correctly.

I say it would have taken no letters. It’s just an unpleasant ad.

Do I find this offensive as a nurse?

Not really.

What is offensive here? The fact that the nurse is ugly? The fact that the nurse is angry? Are nurses not allowed to be angry or does that further the “battle-ax” stereotype?

But wait! Nurses are not supposed to be portrayed as angels, either in print or on film. That’s another stereotype that is a no-no.

Hmmm…we’re not allowed to be pissed off and we aren’t allowed to be super-humanly long suffering.


But what about the fact that in real life I’ve been both a total b**** and I’ve put up with things that would have made Mother Teresa turn her nose up?

Was I acting like a stereotype then?

Or is the reason this ad is so offensive is that it hits too close to home for some (most?) nurses?


I was originally spurred to write by this post at Salad Tongs, Anyone?

I had pretty much made up my mind that the Center For Nursing Advocacy had a victim mentality and needed a sense-of-humor transplant. Badly.

That’s not what I found.

I actually went to the site. I looked at what they are about. What they actually do.

Some of the campaigns were pretty impressive. To me, if you are going to advocate in the name of my profession, you keep nursing in the forefront. You make sure that in real life, nurses’ opinions are sought…and given.

This is happening at the Center For Nursing Advocacy.

But for me, the operative word here is “real life“.

Television shows are not “real life”.


Stupid ads like this one are not “real life”!

Nurses don’t dress like this, we don’t carry needles that big and I daresay most of us don’t run around with our boobs hanging out.

And the general public knows that!!!!!

This ad is obviously using exaggeration and parody to sell tennis shoes.

Now, I am the minority here when I say this ad didn’t even make me think twice. Three-thousand of my colleagues did write and the ad was pulled. It did hit a nerve with many nurses.

In my experience, honestly, no one is going to mistake myself or any of my co-workers for a whore-ish looking Christina Augilera sex-kitten.

Frankly, she looks like an idiot and unless you are a seventeen-year-old hormone ridden male adolescent who likes to fantasize about nurses, this ad would have run it’s course and gone away anyway.


Which brings me to my point. The Center For Nursing Advocacy has the voice and the power to do very good things for the nursing profession. MY profession. I saw some good work in progress over there. I’ll be sending some letters.

But there is a problem.

My unsolicited advice? Pick your battles.

Right now the first “battle” is trying to get “Doctors Without Borders” to change their name. I’m not joking, here is the website! They think the name should be changed to show that nurses are a large part of that organization.

This is nonsense.

Imagine, if you will, the reverse scenario: a nursing organization called, say “Nurses International” travels to different countries to provide care free of charge. There are doctors who work with the nurses. But the doctors don’t like the fact that they aren’t mentioned in the name, so a (fictitional) “Group For Medical Advocacy” starts a campaign to get “nursing” out of the organization’s name.

The outcry from nursing would be deafening.

This is an example of a battle that doesn’t need to be fought.

Fighting TV shows that show stupid nurses need not take up so much effort; frankly the doctors are treated like they are stupid as well.

The doctors are so stupid in these shows they don’t know how to practice medicine and have to practice nursing in order to look intelligent.

I mean really. Did you ever look at it from that angle?

Now, if a TV show depicts a nurse doing something illegal or unethical, I’ll write a letter. I did so when the BBC America show “No Angels” depicted nurses desecrating a dead body.

But are we as a profession so insecure that we have to jump on every single ad that may not show us as the epitome of professionalism?

You want nurses to be depicted as professionals? Then act that way every single moment of your workday.

The public isn’t stupid. They know a “real” nurse from a phony portrayal.

The public knows that a duck quacks and a duck in a nurse outfit that is called a Nurse Quacktitioner is not meant to insult. (Would it have been better to make it a dog and call it a “Nurse Barktitioner”? A Meow-titioner?).

Another battle that didn’t have to be waged. Yes, I know 2000 of my colleagues wrote. Maybe I’m the one who is off the wall here.

I don’t think so.

I’m not stupid, either. I’m comfortable in my professionalism and my position as a nurse no matter what the television is or isn’t showing or what ads are or aren’t being published.

If my patients have any misconceptions, then they are set straight the minute they meet me. Me. A real nurse.


The Center is doing some fantastic advocacy work.

I believe their effectiveness is diluted by some of the battles they are choosing to fight.

Give the public some credit.

Give us some credit.

The public will listen; the nurses will act.

If…you pick the battles that mean something.

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December 5, 2006, 6:55 pm

Birthin’ Babies


Ah…one of my favorite movies is “Gone With the Wind”.

Prissy and I have something in common!

Neither of us know nothin’ ’bout birthin’ babies.

But Scarlett and I have something in common, too.

We were both faced with the prospect of having to “birth” a baby.

And just like good ol’ Doctor Mead in Atlanta, the ER doctor was needed elsewhere for more pressing matters.


The call came from the intensive care unit, right next door to the emergency department.

A patient had self-extubated and was decompensating rapidly. Would the ER doctor rush over and re-intubate this patient?

He was through the double doors before I even hung up the phone.


I was the night charge nurse at the time.

The night was surprisingly slow for that little “mini-county” of an ER. It was just a smidge before two am and only one or two patients were over on the “clinical” side.

This particular ER required that all pregnant women, even if they were at term with ruptured membranes, sit down at triage and get their vitals taken along with a bunch of other busy work that could have and should have been done up in labor and delivery.

Emergency: the dumping ground for everyone else’s scut work.


So here comes a very pregnant young lady. She wasn’t a child but resided somewhere in the nebulous area between the state saying you are an adult and actually being one. Her mother pushed her through the ambulance entrance in a wheelchair.

“Hi!” I said. “Is it time?”

“I do believe it is” answered the soon-to-be grandmother. “She’s been havin’ pains for about six hours and her water broke ’bout half an hour or more ago. Now she says she has to go to the bathroom.”

First baby. A week from scheduled due date.

Ding!Ding!Ding! The little bell in my head went off.

(Actually what went off in my head was “Oh s***!” )

But I just smiled and said “Okay, let’s have you lay down on the bed here and see what’s happening!”

The patient herself was quiet, withdrawn and seemed not quite “all there”. As the wheelchair was pulled parallel to the gurney, the patient stood up and began to walk away!

“Whoa! Hon, where are you going?” Seemed like a natural question at the time.

“I’m goin’ to the bathroom.” Ask a silly question…

“Oh no you’re not! You need to lay down right now.”

She just looked at me wierd. Didn’t budge.

I repeated the need for her to lay down, like, yesterday.

No response. Just stared at me. No crying, no clutching her abdomen. No hysterics. Just a straight stare.

So we, uh, assisted the patient into a supine position and I told her I needed to take a “peek” at what was happening “down there”.

(Son of a B****!!!!!!!!!!)

She was crowning.

(Okay. Stay calm. You have had your class in Neonatal Resuscitation. You know what to do.)

I quietly surveyed my staff. Has anyone delivered a baby before?

Nope. So that made me the senior nurse on duty.


Anne, run next door and tell Dr. Emergency that we have an impending delivery. Margie, call nursery; have them run a warmer down STAT. Joe – can you hand me a pair of sterile gloves and get the precipitous delivery pack from the top shelf and get out the bulb syringe.

(Oh s***, oh s***….newborns are nose breathers, suction mouth first…..or is it the other way around?????)

“You are doing just great!” Outwardly I was as calm as you could imagine. You would have thought I did this every single day of my life. “I see the top of the baby’s head!” Big smile.

(My pulse was 186. At least. Probably V-tach for all I knew.)

I put on the gloves just as Anne came flying back to tell me the doctor couldn’t come, the intubation was difficult.

(Holy s***!)

“Just go with what your body tells you to do,” I instructed the patient. “If the urge comes to push, you just go right along with it”. None of this telling the patient not to push. The baby’s crown was right there.

So there I am with my hands about three inches away from the woman’s peri area and a bulb syringe at my right hand.

And nothing happens.

Ummm….shouldn’t she be pushing? Oh, wait…there’s one and here comes the…no, not that time.

And all around the gurney, in a half-circle about five feet behind me is every single staff member on duty that night, plus the two nursery nurses who aren’t even coming up to help, they are just standing behind the ER staff with their warmer!

(Good god, ladies, you’ve done this before, why the hell don’t you come over and help…do I look like I know what I’m doing?)

I guess I did.

More encouragement for the patient. Found out the baby was a girl. No name yet. “She has a ton of hair!” I noted.

Here comes the head! Okay honey….good girl…go ahead and pu…..

Right as that baby’s head popped out a huge mass moved my considerable bulk out of the way and a big blue hand caught that baby’s head and the rest of her, too.

The doctor had rushed through the curtain at the last minute and literally pushed me out of the way to catch the baby.


You might think that.

Loss of a teaching moment? I mean, he could have talked me through the delivery.

You might think that, too.

But I could have kissed him.

Right there in front of God, country, patient and co-workers. He’ll never know how close he came to the biggest smooch ever smooched in history.


The new mom? She did great.

After it was all over, the enormity of what just happened seemed to dawn on her and she was no longer “out of it”. She held the baby briefly and then the nursery nurses did their thing, taking the baby back to the nursery.

New Mom asked New Grandma to go up with the baby.

For the next hour-and-a-half, our ER tech held the patient’s hand and talked to her and told her what to expect post-partum. And the tech was the perfect person to do the patient teaching – she was the mother of six herself, having had the first at the same age as our patient!

It meant a lot to the patient to have that support. So much so that there is a little girl, probably in the second grade by now, running around with the same name as the ER tech!


I should have gotten the Academy Award for Best Actress (In a Stressful Situation).

Then Scarlett and I would have had two things in common.

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9:51 am

Tuesday’s Antidote: Grand Rounds!


Ah, a good after-dinner discussion on proper elimination!

Something tells me this doctor doesn’t get invited over for dinner very often.

He probably brought a bottle of Phillips Milk of Magnesia as a hostess gift.


If MOM isn’t the antidote you need to rev you up for today, head on over to The Antidote: Counterspin for Health Care and Health News!

Emily Devoto, PhD and independent health care consultant took on the hosting duties for this week’s Grand Rounds. Nice job, Emily!

A splendid time is guaranteed for all.

Grab your coffee and head on over!


Thank you to all who sent congratulations on the announcement!

My husband thought I was insufferable before; there is just no living with me now! : D


I intend to spend the rest of the day reading Grand Rounds, catching up on some blogs and bringing out the first wave of Christmas decorations. I have so many it takes a week to get them all up and a week to take them all down.

The inside of my house resembles Snoopy’s in A Charlie Brown Christmas.

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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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