April, 2007 Archive

April 24, 2007, 6:59 am

Grand Rounds: It’s Outta This World!


Okay, I know that Liana chose a solar system theme for this week’s Grand Rounds over at Med Valley High, but I couldn’t resist using a photo of the Enterprise crew to illustrate it this week.

I really liked this show and not because Scott Bakula was the captain.

Although I must say it didn’t hurt.



Change of Shift is here at Emergiblog next week!

Submissions may be sent directly to me (see “Contact” button above) or through Blog Carnival.

Stories by or about nurses are always welcome.

Heck, I may even throw in a few that may be of interest to nurses, too!

So, if you have a post you would like to share, send it in.

After all, to do so would be quite…..logical!

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April 21, 2007, 10:04 am

Red Light, Green Light


Esteemed colleagues, fellow nurses and distinguished readers,

Allow me to introduce you to the “Yacker Tracker”!

This cute little mechanical advice was designed for use in a classroom.

You know, the place where children learn the difference between their “inside” and “outside” voice?

Green means, “very good, you aren’t too loud!”.

Yellow means, “Uh oh…you’re a bit on the noisy side!”

Red means you’ve hit the decible level of a Led Zeppelin concert, thereby triggering an alarm that is certain to bring the conversation of school children to a screeching halt.

This classroom gadget is found wherever fine goods are sold to elementary school teachers.



Guess where else you can find this machine for keeping children in line?

In my emergency department and every other nursing station in my hospital.

Not discreetly placed about the facility, but mounted on the walls!

Here we have a group of emergency department nurses demonstrating the actual appliance.

Note the look of shock as our cute little staff members realize they have entered the yellow zone.

Observe the JCAHO-mandated covering of the mouth to prevent any further vocalizations, thereby reducing the noise at the nursing station.

“Stop the yakking!”

Because we all know that emergency departments are supposed to be nice and quiet, right boys and girls?

And professional men and women do tend to yak, don’t they?



So…let’s insult them by installing insulting toys on the walls to keep them from yakking!


We wouldn’t want to provide an educational opportunity by providing data from, oh, evidence-based studies that show the effect of noise in the environment so that as professionals, appropriate behavior modifications can be made.

Why, that would be fighting fair and we all know bullies don’t do that!

Silly nurses!

All they deserve is a cutesy toy that is oh, so professional looking to patients and visitors!



So boys and girls, always use your inside voice when you are inside the hospital!

And remember:

Don’t set off the red if your patient’s in bed,

If you set off the light you’ll give the patients a fright!

Especially at night!



I’m beginning to think I’m working at Pee Wee’s Playhouse Medical Center.

This would be hilarious if every word of it wasn’t true (except the JCAHO covering-of the-mouth. That is next year’s policy…).

Pretty soon we’ll have Chairy, Globey, Miss Yvonne and Billy Baloney on staff.

What’s next, the King of Cartoons pulling a night shift as an ER doc?

Having to ask “Mother, May I?” before you give a medication? (Oh, wait, that’s already happening…..)

So here’s to the head honchos, whoever they may be, who have shown so much faith in the professionalism of their nursing staff.

Maybe you can skip the cute little keychains this Nurses’s Week and take down these obnoxious road signs that make my colleagues and I feel like we are in preschool.

Or, keep on dumbing us down. Eventually you will get what you play for.

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April 20, 2007, 1:04 pm

Money Honey, You Ain’t Got No Respect



It’s the return of the disembodied “head” nurse!

How would you like that mug staring at you at 0400?

Maybe it just creeps me out because Barbara Stanwyck creeps me out.

It was “The Thorn Birds” that did it. Watching her go after Richard Chamberlain was just… wrong!

I wanted Richard Chamberlain.

Big time!

What a hunk!

I subsequently found out that he pitches for the other team, if you get my drift.



Joint Commission says we can’t put anything on the tops of our cupboards. Big signs all over the department. Pretty soon they are going to be dictating the color of our underwear. Wouldn’t want to be the commissioner with that survey assignment!


Some where along the line, nursing got screwed up.

It’s backwards.

Specifically, the financial compensation aspect of the nursing profession.

This is what goes on in my brain at 0400 with no patients in the department.

I don’t get it…..

  • A hospital will advance a new hire rapidly up the pay scale, and then stop their most experienced nurses cold around the seventh step. To get to the eighth step, you must work an additional ten years. The final step comes after you have been in the same facility for over twenty-five years!

Who made up this system of financial compensation? Doesn’t it make more sense to reward the nurses who have spent the majority of their careers at the same institution? Make the new hires work a few years before advancing and give the older staff nurses the yearly step increase, and keep it increasing past nine steps. Wouldn’t that make more sense when it comes to retention?

  • Take these lovely sign-on bonuses, which I have received in the past. The hospital pays a $10,000 sign on bonus (for example) to a new hire, but no bonuses to the nurses who have stuck it out through all the horrible low staffing periods. After all, isn’t that why you to have to pay sign-on bonuses to begin with?

What if all those sign-on bonuses were paid to the existing staff after “x” number of years of employment?

  • The pay recieved as an RN is not commensurate with the level of education.

For example, I am an ADN grad and proud of it! But why do I make more than someone with a PhD in Nursing Science who is teaching? I’m talking almost twice as much. Why do I make more than my manager – I always have! Why do I get paid as much as someone with an MSN who is a clinical nurse specialist? Even if we are doing the same work, the MSN brings more education and (possibly) experience to the table.

I’m not trying to dredge up the entry-level-for-nursing debate here, believe me. I have just observed that no matter what your nursing degree, if you leave the bedside your pay will drop dramatically. If you stay at the bedside, you receive no additional compensation for your increased knowledge and/or education.

Where is the incentive to obtain more education; to go get that BSN or go for that MSN?

I can tell you from my personal experience that the incentive is not money. I’m putting out major bucks to obtain a degree that will not help me financially one iota.

But what if that advanced degree did increase my earning potential? Would I have gone back ten years ago? Twenty years ago?

How many more nurses would chose to go back to school if they had a financial incentive? How many more would choose RN-to-BSN programs or go back for that MSN if they knew it made a difference at the bedside?

I don’t have the answers.

It was just something to mull over at 0400 with no patients in the department….

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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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