December, 2006 Archive

December 4, 2006, 4:33 pm


foxPardon my shouting, but I’m just a wee bit excited at the moment!

This is my “Extra!Extra! Read all about it!” voice.

I just found out that Emergiblog was chosen by for their list of “Best Blogs: 10 Health Web Sites Worth a Click” !

And look who else is there: Amy from Diabetes Mine, Dr. Crippen from NHS Blog Doctor, Dr Lei at Genetics and Health, Mark Myers at Nee Naw and Matthew Holt, from The Health Care Blog.

On any given day I consider it a compliment to have Emergiblog mentioned in the same breath with any of these blogs, but to be with them in this list literally takes my breath away!

I can’t even pretend to be cool about this!

I am thrilled.

So here’s a huge thank you to Dr. Manny Alvarez, Health News Managing Editor of

You made my year!

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12:44 pm

How To Become A Nurse Blogtitioner


This little lady is very near and dear to my heart!

This is my one and only Barbie doll.

She was given to me on my 5th birthday in 1962. The date is even stamped on her behind, something they don’t do anymore.

The one thing she never had was a nursing outfit.

Forty-three years later, she got it!

I could have bought four sets of scrubs for what I paid for her nursing outfit last year, but it was in mint condition with all the accessories (including a diploma!).

Her lipstick is gone, her arms are covered in bite marks (for some reason cats love to chew on Barbie extremities), her legs are a bit grey and she has a pen mark on her back.

But she is still the Best.Doll.Ever.

And whenever I’m tired, frustrated or getting a little crispy around the edges, one look at Nurse Barbie and I remember why I wanted to be a nurse.

Corny? Absolutely. But it’s the truth!


So. You have discovered the medical blogosphere and have noticed that nurses make up a large portion of what you have found.

You are a nurse, and blogging looks interesting. The idea of starting a blog has crossed your mind, but you have no clue on how to start and besides, what would you write about?

Well, grab a cup of coffee, sit down and I’ll pass along what I’ve learned after 16 months as a blogger. I will tell you this: once you start blogging, you will be hooked.


Why should you even start a blog?

  • The first thing you need to understand: your everyday life is interesting!
    • I’m serious. You don’t have to be the nurse equivalent of Tom Clancy, you just have to want to talk about your life as a nurse. You don’t need a degree or any special certifications. Your unique voice is what the blogosphere is all about.
    • You will find people who will rejoice with you, commiserate with you, support you and occasionally disagree with you. The medical blogosphere is one big support group.
  • You will find your ability to withstand the stresses of the profession strengthened; you will rediscover the passion that brought you into the profession.

Think I’m exaggerating? Start a blog and find out.


Okay, first things first.

Read some nursing blogs. Read a lot of them. Get a feel for what they write and how they write. You will develop your own style over time, but you will be surprised at how much inspiration you can get from just reading.

You need to decide which software you want to use for your blog.

  • There are three main portals to blogging. They are: Blogger, WordPress and Typepad.
  • There are others, but those are the big three where blogs are concerned. Blogger can be a pain in the derriere, but it may be the easiest for those who really are beginners.

Each site will walk you through the procedure of setting up your blog. There are pre-designed templates for you to choose from, and they will show you how to customize them with your own choice of colors.

  • Name your blog.
    • It’s your blog and there are no rules, so be creative!
    • Let me warn you that if you name it something like “Aspects of Nursing Administration”, every nurse on the face of the blogosphere will run the other way. Your blog can be about nursing administration but make the title humorous, inviting or intriguing.
  • Write your first post
    • The blogging sites make it easy. You write and press a button. Wah-lah!
    • Once you write your first post of introduction and see it up under your heading, congratulate yourself. You are now a nurse blogger!

Don’t be freaked out by all the fancy blogs with a ton of ads and a million photos. That will be you eventually. All you need to be able to do when you start is write a post. The second thing you need to be able to do is make a link. Links, well, “link” you to the rest of the blogosphere. I’ll explain further in the next section.


You now have a blog. What you want next are readers! How do you let people know you are there?

  • Read other blogs and leave comments. This is very important to do.
    • When you leave a comment, you can put your blog address in so that your signature becomes a “link”. People can then click on your name and will be taken to your site. And they will click on you to find out more about who left the comment! Other commenters will also see you there and check out your blog!
    • If you read a post that you feel strongly about, leave a short comment on the blog, then go back to your own blog and turn your commentary into a post. As you do that, link back to the post that inspired you. Get a dialog going between the two blogs and your readership increases.
  • If you find a blog that you really like, put a “link” to that blog on your “sidebar” – there is a place on every template for links.
    • As people discover you and like what you write, you will find that they will put your link on their website.
    • The more websites that link to you, the higher up your blog will be when people search for topics on Google and the more likely they will be to check out your blog, hence more hits and more exposure.

Now you see why linking is so important. In addition:

  • Submit to Grand Rounds every week. Every week. Grand Rounds is a compilation of links to different posts by different medical bloggers (doctors, nurses, patients, scientists, and bloggers as varied as pastors and those who work behind the scenes with physician credentials). A post in Grand Rounds will raise your visibility immensely. A patient story is a great way to enter the Grand Rounds tradition.
  • Consider submitting to Change of Shift every other week. Change of Shift is a spin-off of the Grand Rounds concept, only all submissions are by or about nurses or nursing. Again, anyone can submit with a post on or about nursing and we’ve even had a doctor host the “carnival”! Readership of Change of Shift is growing, so it can be a pretty good way of getting exposure for your blog.


Here are some things to keep in mind:

  • Patient confidentiality is an absolute necessity! HIPAA laws are just as binding in the blogosphere as they are in the workplace. Never, ever discuss a specific patient. Most nurse bloggers (including me) discuss their patients in a “composite” description, combining many patients into one “person” and changing demographic information that doesn’t affect the story. For example: a female teenager may become a middle-aged mother of four or an elderly man may become a woman in her 20s.
  • You need to decide just how anonymous you want to be.
    • I will advise you not to put your full name on your blog, if only for security reasons, especially if you disclose your location.
    • I would advise giving yourself a “handle” or using your first name only along with a general description of your location. (“Midwest”, “Somewhere in Minnesota”, “Pacific Northwest”). You can always disclose more as your comfort level increases.

(My name is probably more “out there” than most and I’m comfortable with that because (1) I don’t give medical advice and (2) after almost 30 years and seven facilities I can scramble a patient story as easily as scrambling an egg. In my case, my city and facility remain incognito, yet all my co-workers know about my blog. So it’s all about what you are comfortable with. The main thing is that your patients, past and present, are protected.)


I think that pretty much covers the basics. Later, as you get comfortable, you’ll learn how to work with the html of the site template, how to add icons, site meters, etc.

But the important thing is to start. Emergiblog existed for three months before I even wrote my first post. Once I did, I never looked back.

You have a unique voice, both as a nurse and as a person outside your job as well. The nursing blogosphere, actually the nursing profession itself, will be all the richer for hearing it.

Share it with us!

Start a blog!


Some links to sites mentioned above:


Type Pad: www.

Word Press:


Grand Rounds:

Change of Shift: Schedule and Archives

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December 3, 2006, 1:12 pm

Doctor, May I Have A Word?

shoeNow this is a very cool shoe.

I know, because I wear it.

Or a reasonable facsimile thereof.

But this is a photo of a miniature, collectible nursing shoe.

Yes, apparently people actually collect miniature nursing shoes.

Why on earth someone would want to do that is beyond me. Way beyond me.

But it comes complete with a box and a collector’s card!

Now if I read correctly, because I wear this shoe I am youthful, sleek, trendy and cool.

I am Miss Popularity at work.

And ten of my co-workers just choked on their coffee…


I have worked with some pretty cool doctors in my time.

In fact, the majority of doctors I have worked with have been nice guys and gals. There is something about the emergency department that lends itself to collegial relationships, although I found the same comeraderie when I worked critical care.

And nothing beats the feeling of having of knowing a particular primary doctor trusts you implicitly, a trust usually earned after years of working with their patients.

The doctors who are the best to work with have an understanding of nurses and nursing and a respect for what nurses actually do. They won’t verbalize it, but a nurse can sense it.

The converse is also true, by the way. A nurse with an understanding of the practice of medicine a respect for doctors will be the best collaborator in the care of their patients.


Now, having said all that, there are a few things I’d like to ask every emergency physician.

I have worked exclusively ER for the last 16 years and I have run across these issues in every single ER I’ve worked in.

The examples given below are composites of many incidents over the last 16 years.

I do believe these issues are ubiquitous to every emergency department.


Dear Doctor:

  • Please clear your sharps off the mayo stand.
    • It’s a good thing I’m always careful when dealing with any dirty tray, because I have learned from experience to trust no one but myself when it comes to sharps disposal. Still, it was a bit of a shock finding the blood filled syringe with the uncovered needle that was hiding under the disposable tray.
    • I do believe that disposing of your own sharps has been standard operating procedure for the last twenty five years now, no matter how busy the department is.
    • While I am duly innoculated against Hepatitis B, I don’t have that luxury when it comes to HIV. Let me put this delicately, had I been stuck by that particular needle, my life as I knew it would have ended. Be more careful.
  • Please let me push the drugs
    • It’s my job.
    • While I can appreciate the willingness to facilitate the procedure, did you not notice that the saline lock cap had dislodged and that the patient was bleeding back through the opening?
      • You had to have seen it, it was an 18 gauge needle and you stood at the bedside for five minutes.
      • While I would not have expected you to change the patient’s bed or wash all the blood off the patient, I would have expected you to tell me what happened so that I could mitigate the result.
      • Instead, I had a huge bloody mess to clean and the patient required a restart of their IV. I would have caught the dislodgement immediately, because maintainence of the IV is my job and a priority in patient care.
      • IF YOU MAKE A MESS, EITHER CLEAN IT YOURSELF OR TELL THE NURSE IN A TIMELY MANNER. An apology for causing the loss of an IV site would have been nice, too.
  • Please don’t bogart my nursing notes
    • I can appreciate the fact that you find the nursing notes indispensible. I’ve worked with doctors who could not have cared less if I had written haiku all over the front of them, so your appreciation of my documentation is admirable.
    • Your willingness to take my notes from me at any time, regardless of how critical my patient is or how imperative it is for me to chart-as-I-go is NOT admirable.
      • You are able to dictate your notes. I am not.
      • I’m sure you can imagine the frustration if I just walked up to you and took your documentation page anytime I felt I needed it.
    • The pressure to complete increasing amounts of paperwork makes it imperative that I have access to my required paperwork when I need it. Your inability to understand that shows a lack of respect for my responsibilities.
    • A nice compromise would be for you to ask if you can borrow the notes to make a copy and then return them immediately to me. Hell, I’d be happy to take five seconds and make a copy for you next time.
  • Allow me to do my job in triage
    • When a family comes in with five children because they were all involved in a MVA and they all want to be seen, I must do a full triage on every single one of those patients, including documenting the mechanism of injury.
      • I apologize for the fact that it takes me 45 minutes to triage the entire family. That is a little over six minutes per person, including two infants and all the required documentation.
      • I understand you are antsy to get busy on this motely group, but
        I am working as hard and as diligently as I can.
        • Sending in the ER tech and one of my colleagues to hover over my shoulder is not appreciated, nor helpful.
        • Had I been able to send the triaged ones back with one parent, I would have. In between the parents not wanting to separate and three kids needing to go potty, I could not get a single child back!
      • Your sense of urgency does not negate my responsibilities at the triage desk. All your “hurry-up, I’m ready to see the patient” attitude does is
        • Show a lack of respect for my responsibilities as a triage nurse and by extension, I feel disrespected which…
        • …Causes feelings of resentment that I will spend the better part of the next hour trying to overcome.
      • Allowing me to complete the triage/registration process allows me to present the patients in an orderly fashion and with all “i”s dotted ant “t”s crossed.
        • While that may not matter to you in the slightest, I’m required to do it.
        • When all is said and done, you will find your job a lot easier if you let me do my job. Trust me.
  • Please don’t take report from the paramedics until a nurse is at the bedside.
    • It really is important that the nurse hear the report and not fair to the paramedics to have to repeat it, and they will be repeating it if a nurse doesn’t hear it.

Okay, I’ll be honest.

I feel better having written this post.

My blood pressure is back within normal limits.

I can face my next shift with enthusiasm.

I may even turn over my nurse’s notes with a smile the next time I’m asked.

Or at least make the doctor a copy.

I really am attached to those notes…….

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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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