May, 2007 Archive

May 28, 2007, 6:47 pm

Two Be or Not Two Be


This nurse needs a vacation.


She is experiencing one of the rarer symptoms of burn-out.

The free-floating Coke bottle visual hallucination.

As long as she doesn’t reach for it, her co-workers will be none the wiser.

The minute her hand rises up to grab the non-existant beverage…well…it may be too late.

So, if you see your co-worker staring longingly into space, parch lipped and glassy eyed, intervene!

Go get them a Coke!

Better yet, a Pepsi! (I can’t stand Coke…)


It is present in every emergency department.

You don’t see it coming…

…until it is too late.

You’ll want to cry.

You’ll feel like screaming.

It can drive you over the edge on a busy shift.

You can’t control it.

You can’t stop it.

Yes, my friends it is…..

The Two-Fer!


What exactly is a “two-fer”?

The term is slang meaning “two for the doc”. It occurs when someone presents to the emergency room for treatment and someone in the group accompanying the patient decides that they, too, need emergency services.

Right then.


A two-fer can present in various forms:

  • The Upfront Two-fer

These patients usually walk in together but sign in as separate patients on the triage sheet. Often, they were in the same vehicle that was rear-ended at five miles-per-hour ninety minutes prior to arrival. Neither of them have any symptoms, but they feel they needed to be checked out because they were in a car accident, after all. Sometimes, a parent will present two children for treatment at the same time because they both have a fever or cough. Pretty straightforward – what you see is what you get.

  • The You-Have-GOT-to-Be-Kidding Two-Fer

A few examples will explain this form of the two-fer better than a dry description.

Example: a young female presents with abdominal pain and discharge, bringing along her friend for support. Sometime during the visit, the friend, like, thinks she might, like, have discharge too and like, wants to sign in.

Example: the patient presents with something simple like an ankle sprain. Their bring a posse of friends for support. Sometime during the visit, a friend tells the nurse they have itchy toes and wonders what it could possibly be. Wait…a….minute! They are in the emergency department and there is a doctor there, right? They go to triage to sign in. A seven-hundred dollar case of athlete’s foot.

Not all two-fers are actually comprised of only two patients. This brings us to our third category.

  • The Multiple Two-Fer

A two-fer can also come in as a multiple of two. You might have two. Or four. Or six. For some reason it is never an odd number.

It’s the family of six who have that bumper bump and demand that all of them be signed in and seen, even though five of them have no symptoms and the kids are playing and laughing on the floor.

It’s the mother of six who brings all of the children into the emergency department because they all have been coughing for over a week. She wants all of them signed in.

Now, there are some legitimate two-fers out there. The spouse of a patient who develops chest pain. A visitor who develops an allergic reaction while sitting in the ER. These are truly cases of being in the right place at the right time.

But the others? We have to see them all. Even if there are no symptoms, we are required to see every single one of the bumper bumps. Every single one of the kids with upper respiratory infections. Every athlete’s foot and “oh, gee, I may have an STD, too!” person who decides to take advantage of the fact that they happen to be near a doctor.

I once spent an hour triaging six children (from the age of six and down) from one family for something they should have seen a pediatrician for (and yes, they did have one!).

There are really no answers, just observations.

It’s just another form of the system abuse we all see everyday.

But…what is actually broken here? The program or the participants?

That sounds like a good topic for another post.

Read »

May 24, 2007, 4:14 pm

Eight Days a Week


This is totally cool.

I’m walking into Starbucks and right there on the door is a poster of Sir Paul himself!

Instantaneous tachycardia!

I had not even ordered my espresso drink!

On June 5th, Starbucks will be playing Paul’s new album, “Memory Almost Full” exclusively in their stores.

And I’m off that day!

Oh, I could buy the CD, stay at home and listen.

But think about it!

Starbucks + Paul McCartney + Blogging = Nirvana!

I am so freakin’ easy to please!


It’s a good thing I wasn’t watching “American Idol” this year, or I’d be thrilled that Jordin won.

Just sayin’


Oh, shoot!

Someone tagged me for a meme and now I can’t remember who it was. If you tagged me, and you are reading this, please email me so that I can give credit where it is due!

I’m supposed to write eight interesting things about me. Well frankly, my life is as interesting as a hot plate of scrambled eggs, but I’m in the mood for a light-hearted post so here they are:

  • I belong to the Richard Simmons Clubhouse online. Quit laughing, you guys! It’s fun, and I’ve always had a soft spot for Richard since the very first “Sweatin’ to the Oldies” videocassette. That was pre-computer era! It is still the best exercise video on the market. “Sweatin’ on Broadway” is a close second.
  • I was a cheerleader for seven years. Made Head Varsity in my senior year. No photos exist from that era. Really. That was before film was invented.
  • When the film “Sgt. Pepper’s Lonely Hearts Club Band was released in 1978 (Barry Gibb in CinemaScope!), I was at the very first matinee on the very first day it was released. I went home, got my sister and saw it again. Then I went home, got my (not yet) husband and went back and saw it a third time. Same day.
  • Speaking of husbands, we had our first date two weeks after we met and were engaged two weeks later. Married a year after that. We’ll celebrate 28 years this June. Any man willing to marry a woman who spent nine hours in a movie theater to see Barry Gibb is a keeper.
  • I’ve read the entire 3000 page Civil War trilogy by Shelby Foote. And the trilogy by Bruce Catton. And biographies on Lincoln, Grant, Lee, Longstreet, Jackson and Jefferson Davis. Been a Civil War buff for years. Would recommend “Team of Rivals” to anyone interested in Lincoln.
  • The farthest I ever traveled for a concert was 3000 miles. Puerto Rico. Steve Perry’s “For the Love of Strange Medicine” tour in 1995. Would do it again in a heartbeat.
  • I wanted to go to the Samuel Merritt Hospital School of Nursing in Oakland, CA. It was still a diploma program in 1975 and I wanted to have the same education Cherry Ames had. We couldn’t afford it. I was accepted into my community college program the next year and the rest is still unwritten (vague Natasha Beddingfield reference).
  • When I get into something, I am very passionate about it (in case that wasn’t obvious). Notre Dame. Cleveland Browns. NASCAR (Go Kasey!). British comedy. Spongebob Squarepants (is that the funniest thing ever or what?).

Okay, I hear the snores! Wake up people!

Now, I know what you are thinking.

Will she tag me or won’t she?

Only my hairdresser knows for sure…..

Read »

May 22, 2007, 8:33 am

Natural Selection Meets Grand Rounds


It’s time for Grand Rounds!

Ian at ImpactED Nurse asked us to send in what we considered our best posts, evah!

Medical bloggers everywhere “naturally selected” their favorite posts!

The result?

A wonderful selection of submissions from a wide variety of health-related blogs.

Some you may already be acquainted with, some you may have missed the first time around.

Don’t miss this chance to check them out!

(Oh, and the “selection” of nurse cookies is from Popcorn Papa, in Dallas, Texas!)


What: Change of Shift.

Where: Here.

When: May 31, 2007

How: Submit through the contact button up top or through Blog Carnival

Who: Any nurse or nurse-related post by a blogger

Why: Why not?


Read »

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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