August, 2007 Archive

August 21, 2007, 9:56 am

Be True to Your School at Grand Rounds! - Custom comment codes for MySpace, Hi5, Friendster and more

The textbooks have been purchased, the tuition is paid…the NFL is in pre-season and Notre Dame football starts September 1st.

Education is in the air, and Med-Source rings in the new school year with an education-themed Grand Rounds!

My classes start September 4th, and I’m truly excited to be starting a new semester!

Yeah I’m a dork.

I’m the only person who cried through their entire high school graduation because I didn’t want to leave!

Somewhere I have a pic of me as a cheerleader, if I ever run across it I’ll post it to the blog. Much laughter will ensue, most of it coming from the 1970’s shag I wore for most of my adolescence.



No, this is not a photo of me!

This is the upcoming ornament in the “Loralie” collection and is available for pre-order from “Over the Rainbow Quilt and Gift Shop” in Camano Island, WA.

Owner Laura Van Divier and her daughter Vanessa are very grateful for the nursing care Vanessa received during her hospitalizations.

Vanessa, diagnosed with diabetes at the age of four, was almost ready to graduate with her Master’s degree in education when she was hit with a series of strokes. Eventually, she was diagnosed as having Moyamoya disease

Read Vanessa’s full story.

Through your purchase of this new Loralie ornament (the latest of a series), you can help support Vanessa’s family as she continues her rehabilitation efforts at home.

Many thanks to Mary Lu Wehmeier, Online Community and Social Networking Diva for passing this information to me!



It’s time to pull those posts out for Change of Shift!!

This week, the best of the nursing blogophere will be found at Nurse Ratched’s Place.

Mother Jones is waiting for your submission! Send them to motherjonesrn at yahoo dot com or use the Blog Carnival widget on the sidebar.

(Note to Mother Jones: I’m writing as fast as I can! : D )

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August 18, 2007, 9:23 pm

Newsflash: The Physician is Not the Enemy


Yeah, that’s Yoko over there. I’ll wait for everyone to roll their eyes.

I’ve always had a soft spot for Yoko. Maybe because I “got” bagism back when I was an impressionable youngster. I always seemed to know what she was trying to say.

That doesn’t mean I didn’t cover my ears when she sang.

So I was pleasantly surprised and intrigued when I saw this CD on iTunes.

Maybe the world is ready for Yoko – she definitely fits into the techno scene. Who else could manage that in their 70’s?


Thank goodness I brought headphones with me. If I hear one more reggae song at Starbucks I am going to scream.

Never mind that I feel like running around calling everybody “mon”.

I like channeling my inner “Jamaica” as much as anyone but enough is enough.

So I’m listening to Journey the Band-That-Shall-Not-Be-Named. And Yoko.

In about five minutes I’ll be listening to the Browns vs. Lions game via the internet.



I really hate this T-shirt.

How is this supposed to promote collegiality between the professions?

My sense of humor is as good as that of the next person.

This isn’t funny.


As a nurse and patient advocate, I’m supposed to question any order by a physician that I believe detrimental to my patient. I can refuse to carry it out, respectfully letting the doctor know that they can give the drug/do the procedure, but in good conscience I cannot.

I have never once done that. I’ve never had to.

Once I had to explain to an intern that an order of Toradol 60 mg BY MOUTH was probably not what she meant. She was rather stern in her insistence that her order was correct. I called the hospital pharmacy to verify the PO dosing range – I was right.

On rare occasions I have to verify an illegible written order or I spot an incorrect dosage and I am responsible for informing the physician.

Should errors happen?


Are any of us perfect?


My point here is that I don’t “question” a doctor’s judgement.

Nursing heresy, you say! Hardly.

It does not mean I blindly accept everything written. I do not question, I ask for clarification. There is a big difference here. If I don’t understand why an order is written, I’ll ask for the reason behind it. That’s asking a doctor to clarify something for me. If it is a blatant error in dosing or treatment, I’ll ask the physician to rectify it. The patient benefits if the order needs changing and/or I learn from understanding the thought process behind the order.

Think about it. The difference between “WHY are you ordering THIS (you idiot)?????” vs “Would you explain the rationale behind this order for me?” or “Did you really mean to write for 250 mg of Atenolol”? vs. “WHAT do you mean by THIS?

I always have my patient’s welfare foremost in my mind. I like to think that the doctors I work with know that I have their back, too. That I am on top of orders that are wrong or just seem out-of-place. That I will follow up with them to clarify any order that seems problematic (or is just plain wrong).

I know nurses who firmly believe in the motto on that T-shirt. I’m sure it shows in their attitude toward physicians, too.

Call me crazy, but in my world the nurses work for the good of the patients with the physicians, not in spite of them.

In our haste to demand respect commensurate with our professional status, let’s not forget that we need to give the same respect to those we work with.

Including physicians.

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11:55 am

Online Nursing Degree – Are You Ready To Take It On?


Ah, August is in the air and Brady Quinn is back on the field.

This time in a Cleveland Browns uniform!

Here in the Bay Area we are so sports oriented, it never occurred to me that I would not see the Browns on TV every week.

Moving to Ohio was a little drastic, so I managed to get the NFL package online so I can at least listen to the games. Brady is supposed to take some fourth-quarter snaps against the Lions this week.

I’ve got to join the Bay Area Browns Backers to watch the games at a local club.

I also own the jersey Brady is wearing in this pic – is that cool or what?

I do love my football! Notre Dame starts in two weeks!!!

It doesn’t get much better than this!


(PS: Kasey Kahne qualified third in tomorrow’s NASCAR race!

I am having one great weekend!)


On September 4th, I will be starting my second semester of classes toward my BSN. My first semester experience was so positive that I chose to take ten units this time.

The online learning experience has been amazing. I’m not sure I would have “gone back” for my degree if online education was not available. I have been able to fit a top-notch education into my lifestyle instead of rearranging my life around a classroom.

It is not for everybody. There are certain characteristics you have to have to make it successfully in an online class environment.

  • Self-motivation – you’ve got to make yourself sit and do the work. While there are deadlines, there are no classes to keep you motivated. It has to come from within.
  • Focus – you need to be able to block out your surroundings. Online learning means studying at home (or, uh, at Starbucks) and if a sink full of dirty dishes or a pile of unfolded clothes (or Paul McCartney on the sound system) is going to distract you, this could be a problem. “Well”, you think, “I’ll just do all my chores first.” Right. Except the chores never end and often become a way to procrastinate.
  • Work Experience – my personal opinion is “the more experience, the better”. When I take these classes, I bring almost 30 years of nursing with me. This helps me put the class material into perspective. It is easier to learn and retain because I’ve “been there, done that, seen that”. Last semester my classmates had anywhere from 5 to over 30 years of experience behind them before starting the program. I firmly believe I would not have appreciated what I am learning now if I had done a BSN right out of high school.


The university you choose to “attend” via online classes is very important. I did not have to look far before choosing the University of Wisconsin – Green Bay. Here’s what you want to look for in a program:

  • Accreditation – you want to make sure that the program you are attending is accredited.
  • Credit for previous degree/classes – find the program that will offer you the most credit for your previous experiences. I had taken a lot of art history, English, paralegal and music classes for “fun” over the years. Every single one of those classes was transferable to the degree, not to mention my Associate’s Degree counting for a large number of units.
  • The ability to take non-major courses at a local college – online nursing programs are not cheap. Many classes will be general education: English, humanities, math, statistics, etc. You want a program that will give you credit if you take these classes at a local community college. This will save you quite a bit of money.
  • Local clinicals – having to travel to do the clinical component would have been a deal-breaker for me. Find a program that allows you to arrange your community nursing/public health nursing clinicals in your own county/community.


You don’t have to be a nurse for this to work for you.

I do not advocate getting your initial nursing degree via the online route. However, if you are thinking about nursing in the future but cannot attend classes now due to work or family responsibilities, you can take individual classes online from your local community college. It’s a great way to start accumulating units toward the eventual degree. Humanities electives work wonderfully online.

Research the requirements of nursing programs you are interested in and start taking those general ed classes. Whether you decide to go into nursing or not, they will come in handy for any degree.


As for me, I am entirely comfortable going for my BSN online, but will attend a traditional program when it comes to getting my MSN. If you already have your BSN, you may be comfortable with obtaining your MSN online. I’ve heard there are now doctorate programs online, also.

Better learning through technology.

I’m all for it!


Epilogue: If you are interested in learing about the BSN/LINC program through the University of Wisconsin, here is the BSN-LINC Home Page.

And no, they did not pay me to write that, but I am definitely paying them for a great education!

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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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