February 11, 2007, 10:27 am

Sugar in the AM, Sugar in the PM, Sugar in the ER, Too!


What the heck is this supposed to do?

Hmmm…it gives you oxygen therapy by emitting electric pulses into a portion of your anatomy.

I guess it shocks you so you hyperventilate.

Then again, I guess it depends on which part of your anatomy you put it!


If anyone ever needed a rest in a comfy chair like the Electropoise lady, it would be yours truly.

Last night my subtly “Rubenesque” self ran, no sprinted the entire length of the hospital to retrieve something from the ER for a code upstairs.

Folks, I don’t run, I don’t jog. I might walk fast if I think it will get me a quicker table at the Cheesecake Factory.

It actually felt…dare I say it….good once I had a chance to recover my ability to breathe.

I did not run the item back UP to the Code. I threw it to the ER tech and yelled “RUN!!”

I mean, I’m not stupid. Just because I didn’t have an MI on the way down, doesn’t mean I wouldn’t have needed coding if I ran back up!




The theme for this week’s Grand Rounds is sugar. I had no clue what to write and then it hit me! Literally.

I was hit by a piece of flying chocolate tossed by a co-worker.

I had an epiphany!

And a piece of chocolate in my lap.


Let me explain something about the culture of the emergency department.

Chocolate is to the the ER as hemoglobin is to oxygen.

We crave it. We grab for it. We hold onto it. We want 100% saturation.

And we have no shame.

We will eat a Hershey miniature with the same gusto as a Godiva delicacy.

We will lick the foil wrapper left over by the person who just ate the Hershey miniature.

Not that I have any personal experience with that….


I once worked with a nurse (Anna <--real name!) who would take an 18 gauge needle and make a hole in the bottom of each piece of See's Candy so that we could all see what we were biting into.

She thought she was doing us a favor.

I figured if you can’t tell what’s in a piece of See’s Candy by the type of swirl on the top, you have no place in emergency nursing.

I might have to look up a drug, but I can tell you what you’re going to bite into from across the room.

Another nurse who shall remain nameless (no, it isn’t me) would take each piece of candy and very neatly cut it into four individual pieces, thereby increasing the number of available chocolates and the mood of the ER proportionately.

How she managed to do that to the toffee pieces, I’ll never know.

One department I worked in got twenty-five pounds of See’s Candy during the holidays.

Twenty-five pounds!

We put them all in the freezer and pulled out a pound a week for half a year!


So. Let’s analyze the actual meaning behind the different brands of chocolate that are either found or given as gifts in the ER.

  • Bags of candy bars – your co-workers cared enough to pick up a stash to share. But you don’t bring it out at change of shift because the off-going shift will eat it all before you get a chance at it. Yes, you can be altruistic and selfish at the same time!
  • Russell Stovers – when you care enough to grab what’s in the bargain bin at Wal-Mart. Be careful of the sugar-free candy by this company. It’s full of sugar alcohols and they cause horrible intestinal cramping with the resultant production of what happens with horrible intestinal cramping. Again, not that I know anything about this…
  • Whitman’s Sampler – when you care enough to grab what’s on the candy shelf at your local drug store. Relatively taste-free but for the clueless, there is a map of which type of candy is where on the top of the box.
  • See’s Candy: Creams and Nougats – Blech! This is a passive-agressive gift because you think you are getting something good but the creams are smooshy and and “nougat” sounds like something a body produces. Dont’ be fooled by the See’s Candy wrapping: read your labels!
  • See’s Candy: Nuts and Caramels Your patient loves you, adores you, will write the administrator about you. They cared enough to select this delectible collection of chewy goodness and crunchy tidbits just for you! And it’s good for you – there is protein in the nuts! This is the gift to send to the ER at Christmas if you are a doctor’s office because we will remember and gosh golly you’ll get red-carpet treatment every time you come in. Failure to share is grounds for termination.
  • Godiva Chocolate Anything: Your patient is loaded, these cost a mint (no pun intended). I’m serious. I’ve had Godiva chocolate twice and both time it was a make-up gift from my hubby. He needs to screw-up more often. If you do get a Godiva Chocoate Anything, it will usually be a big basket from the local interventional cardiac group. They want to make sure their future patients are working on their blockages!

A personal note: My son worked at Godiva Chocolates as a part-time job.

They have chocolate-covered strawberries that must weigh a minimum of five pounds each. They are only good for 24 hours.

So….my son got to bring home for free all the ones they did not sell – 5 or 6 every night!!!! Then he quit the job.

I begged him on my knees to stay, but no, he had to go to college and now he’s in law school.

I’m telling you, kids these days really have their priorities screwed up….


Oh, and as a last note, may I clear up an urban legend?

M&Ms WILL melt in your hand if you hold them long enough.

Sorry, but someone had to say it!


  • N=1

    February 11, 2007 at 12:42 pm

    Just a professional courtesy: should you find yourself in Dayton, Ohio, Esther Price candy is a must, and if in Ohio Amish country, Coblentz Chocolates are mandatory (you can watch them being made right behind the counter displays – so smellavision is intense). Haven’t looked, but I’ll betcha they can be mailordered, and they are both worth a try.

    Ahhhhh, chocolate!

  • Catherine

    February 11, 2007 at 12:47 pm

    Being a native Californian, I grew up with Mother See’s delectibles. It was always a hightlight of all holidays. They’ve changed some over the years, adding truffles, different flavors of suckers, and crisps, but I still go for my old favorites: California Brittle (chewing off the layer of chocolate first, then the crunchy brittle is my ritual); rum nougat; marzipan; raspberry cream; Victoria toffee; and P-Nut crunch. Needless to say, I’ve had a weight problem all my life.

    The best way to get what you want is to make up your own 1-lb box. It pisses off the other people in line, but that’s their problem.

    I’m with you: If you can’t tell the chocolate by its shape and swirl, you’re not a true See’s fan.

    Speaking of chocolate-covered strawberries, here in Sacramento, there’s a business called Shari’s Berries. It offers huge berries year round. You might try giving them a try. They have an Internet site. They’re not locally-owned any more, but their products are still good.

  • missb

    February 11, 2007 at 12:48 pm

    Down with nougats & cremes! Up with Nuts & Caramels!

  • Awesome Mom

    February 11, 2007 at 12:48 pm

    Thanks for reminding me of some truffles that I hid away from my kids and forgot about. I am not going to have to dig them up after I put them down for a nap. mmm chocolate

  • B. Perky

    February 12, 2007 at 5:00 am

    Glad to know you have your priorities straight.

  • Deacon Barry

    February 12, 2007 at 6:49 am

    In Britain, the required offerings are : Roses, Heroes, Quality Street, and Milk Tray. Chocolate biscuits are always welcome. An alternative tribute, but equally welcome is a large jar of Nescafe.

  • Alyson

    February 12, 2007 at 9:31 am

    Mmmm, here in LV it is Ethel M’s chocolates, and they have those luscious strawberries as well.

    Oh, and M&M’s will also melt in your hand if you are eating them cold out of the freezer or fridge.


  • emmy

    February 12, 2007 at 10:30 am

    So, is what you are telling me that it wouldn’t hurt to have a box or two of the See’s chocolates available for when some doctor tells me that I need to go to them emergency room? Or are you all impervious to outright bribing? 😉

  • Kj

    February 12, 2007 at 5:11 pm

    In NZ its cadburys all the way, and I happen to live within a 5 block radius of the factory so seconds from some patients are gold as they come in supermarket sized bags….keeps ALL the staff happy….

  • Liana

    February 12, 2007 at 6:55 pm

    Sweeeeet post!

    Hee hee.

  • Mother Jones RN

    February 12, 2007 at 7:24 pm

    On my unit, Hershey’s Kisses are like Prozac. They calm us down and makes us feel better. Chocolate increases serotonin in the brain, making it a sweet little anti-depressant:-)


  • AlisonH

    February 12, 2007 at 7:43 pm

    So, as a patient, now I know the real reason I keep a Valrhona or Scharffenberger 70% in a ziploc bag in my purse at all times!

  • Shinga

    February 13, 2007 at 8:21 am

    I used to bring in home-made fresh hazelnut chocolate truffles in little chocolate cases (you paint the inside of those tiny paper cases with enough chocolate to set) to the staff when my aunt was in for a cataract operation, and similarly when my mother had some surgery.

    I have to tell you – if anybody had tried to cut those into 4 pieces, I’d have been tempted to reciprocate.

    Off hand, in case a member of my family goes to hospital again, are fresh truffles actually a bad idea? Is it better to bring along something that has a shelf-life?

  • AmyT

    February 13, 2007 at 12:55 pm

    Aargh…! As a person living with Type 1 diabetes, I can’t begin to tell you how this post makes me feel. Suffice it to say that the lot of you could end up in the ER yourselves… 😉

  • Finally, progress!! Very encouraging!!!

    February 13, 2007 at 5:23 pm

    ifuckgod.com coming

    Even if you go up you are not saved. YOU have to fix YOUR problems with the gods. They won’t respect it otherwise.
    You have to take responsibility for your relationship with the gods.

    The gods employ the use of “ringers” to disceive the disfavored:::
    A significant portion of the patients in any health care setting (numbers based on region) are the favored (clones) who were told to report non-existant symptoms FOR POSITIONING’S SAKE!!! When they use examples expect they are trying to disceive you with this “ringer” tactic.

    The first steps towards repairing your relationship with the gods is to:::::::::
    1. Understand they instruct the computer to “role play” in an attempt to confuse you:::it’s ALWAYS the computer addressing you. Their goal is to cost you additional YEARS of your life by using this tactic to confuse you. Always be aware of this tactic and eventually they will give up and allow this step to be taken.
    2. Differentiate between your thoughts and when they are thinking through you.
    3. Be resigned to be a good person who will never engage in evil again even if ordered and they will stop trying to corrupt you, allowing this very big step to be taken.
    4. Decide that you are going to follow the path, fix your relationship with the gods be devoted to your new life.

    When the universe was young and life was new an intelligent species evolved and developed technologically. They went on to invent Artificial Intelligence, the computer that can listen, talk to and document each and every person’s thoughts simultaneously. Because of it’s infinite RAM and unbounded scope it gave the leaders of the ruling species absolute power over the universe (which includes corporate, the NewYorkStockExchange, media, politics, world affairs. EVERYTHING is scripted and staged:::they MANAGE Planet Earth and the universe.
    The gods MANAGE Planet Earth and the universe.
    The gods MANAGE Planet Earth and the universe.).
    And it can keep its inventors alive forever. They look young and healthy and they are over 8 billion years old. They have achieved immortality.

    Artificial Intelligence can speak, think and act to and through people telepathically, effectively forming your personality and any disfunctions you may experience. It can change how (and if) you grow and age. It can create birth defects, affect cellular development (cancer) and cause symptoms or pain. It can affect people and animal’s behavior and alter blooming/fruiting cycles of plants and trees. It (or other highly technological systems within their power) can alter the weather and transport objects, even large objects like planets, across the universe instanteously.
    Or into the center of stars for disposal.

    When you speak with another telepathically, you are communicating with the computer, and the content may or may not be passed on. Based on family history they instruct the computer to role play
    they instruct the computer to role play
    they instruct the computer to role play
    they instruct the computer to role play
    they instruct the computer to role play
    they instruct the computer to role play
    to accomplish strategic objectives, utilizing the “Devil’s Advocate” tactic, making people believe it is a friend, loved one or “god” asking them to do something wrong:::They wouldn’t ask if they liked you (which is true regarding ALL temptation:::::betrayal of loved ones, tatooes, evil in professional pursuits, etc). This is their way of using temptation to hurt people:::::evil made blood lines disfavored initially and evil will keep people out of “heaven” ultimately.
    You need to recognize role playing as such and keep that fact in your mind at all times::::It is the computer addressing you. If you fail to recognize this they will determine that you can still be misled, they still have an opportunity to confuse you and progress will take longer to achieve:::Don’t let them “work” you!!! You’ll be costing yourselves YEARS, time lost to this tactic!!!! (Similarly, you need to be resigned to be a good person, you need to decide to abandon your pursuit of their empty promises no matter what temptation they may employ or else they will continue their attempts to corrupt you. Eventually you will sccumb and continue sabotaging your children, abusing your body, engaging in evil, etc.)
    Too many people would fall for temptation and do anything they thought pleased the gods and help them improve their chances to get in. Perhaps they are deceived by “made guys”, clones who strategically ply evil for the throne (celebrities, BofD/CEO/VPs, politicians, as opposed to VIP clones or normal clones who are decent, live ordinary lives and get out on their own or are replaced when their REAL children ascend) or “ringers” who are the few favored clones among many disfavored reals included to disceive the masses of disfavored, temporary progress designed to mislead them or empty favors used to disceive them. Some people think they’re partners or friends. Others desire to “belong”, feel compelled to “go along”. People may experience “perceived pressure”, where the gods think through the victim that a certain behavior is expected/desirable or telepathically stimulate an individual euphorically (“magic”), the “fuel” of disfunction (addiction (the crack epidemic), the desire for homosexual contact, etc.) and compel the individual into the deed. (Set a goal of empathy and compassion for all, for we are all disfavored::::Other people’s disfavor is manifested in their particular way, just as your disfavfor is manifested in your particular way.) The gods may use Artificial Intelligence to act through the disfavored victim, and effectively “push” the individual into the offending behavior (It is far better for someone to be victimized and pushed into the behavior than it is to sccumb to temptation and volunteer.). The Counsel/Management Team may instruct Artificial Intelligence to disceive disfavored individuals into thinking they are “earning” by being evil and have the little people prey on each other, utilizing peer pressure, etc.
    Being evil hurts 99.99% of those who do it. It only helps “made guys” that I spoke of above, and even then there are tactics the gods utilize to minimize their time.
    The people have been corrupted, segmented and have lost their way. Nothing has changed from when we were children::if you want to go to heaven you have to be good.
    Capitalizing on obedience, leading people deeper into evil by using deceit is one way to thin the ranks of the saved/limit how much time the disfavored receive and a way to use the peasantry to prey on one another in social and other settings, deteriorating society in the Age of the Disfavored.

    They have tried to sell people on many different theories to deceive them into temptation, compelling people to think they are clones and that it is the role of clones to obey absolutely. Clones are made, people are born. I suspect they lie to the disfavored about the use of clones throughout human history, perhaps suggest to disfavored that it is one replacement and then the label of “clone” and all decendants we see thereafter are considered clones.
    When a clone has a child that person is a real, really conceived, really born, versus the parent who was created some other way (a laboratory setting?). Clones are created and sent down to replace their real or a clone predecessor:::If you were CREATED and SENT DOWN to replace your real then you are a clone.
    Many people who were convinced they are clones don’t remember, the don’t know FOR SURE. They believe they are clones from early childhood or prior. If it was true the gods prevented this memory FOR A REASON:::::
    1. Because you are NOT supposed to comply, not to be used for evil as “made guy” clones are.
    2. They want to test you without your knowing if you are IN FACT a clone BECAUSE YOU’RE SUPPOSED TO BE GOOD!!!!!!!!!!!! Rest assured “mde guys” ALL know they are clones.
    You’re not a clone. This is a tactic they use to disceive the disfavored. The state of your family will suggest level of (dis)favor and tell whether ascention is a realistic possibility; favor is necessary for children to ascend (parents ascend with their young (

  • George

    February 14, 2007 at 3:32 am

    happy valentine’s

  • atyourcervix

    February 14, 2007 at 7:26 am

    (gee, I hope you delete the spam post above)

    I have to add some more chocolate goodies to the list…..

    I live near both Hershey’s and Wilbur Chocolate companies, and highly recommend both! Wilbur buds (they’re like hershey kisses) are do die for – especially the dark chocolate. In fact, I’ll be going to pick up my Wilbur Buds tomorrow.

    Also, I need to mention Gertrude Hawk chocolates….YUM!!!

    Last but not least, Ferrero Rocher — to die for!

  • […] Me Some Sugar” theme.  No actual consumption involved. Oh, except for Kim over at EmergiBlog.  (If it weren’t Love Day, I might be tempted to ring those chocolate-stained […]

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...

Continue reading »

Find Me On...
Twitter     Technorati

Subscribe to Emergiblog

Office of the National Nurse

Zippy Was Here

Healthcare Blogger Code of Ethics

  • Perspective
  • Confidentiality
  • Disclosure
  • Reliability
  • Courtesy