September, 2007 Archive

September 14, 2007, 11:30 am

School Daze (or How to Study When You Are Eight Miles High)


Alas, my Irish are struggling.

I’ve been into college football long enough to understand that Brady Quinn hunky quarterbacks eventually graduate and young children new freshmen come in to take their place.

I take back everything bad I ever said about Jimmy Clausen. He’s the new starter and he throws the football like rifle shot.

I swear this kid doesn’t even break a sweat under pressure!

Now all Notre Dame needs is some sort of offensive line to (a) keep JC from getting sacked and (b) maybe catch a pass now and then.

I’ll let you know when Charlie Weis calls me for advice.


Not only was I dealing with gastroenteritis this week, but I also had a non-stop period of back spasms that sent me to my doctor after seven days of trying to do things like, well….walk, for example.

So I have been off work. I have not been idle, but let me tell you that trying to learn statistics when you are on Flexeril and Vicodin is an experience in and of itself.

I’ll leave it at that. Any more details and Emergiblog will become a patient blog instead of a nursing blog! Let’s just say I’ll be paying a visit to the blogs of Jolie Bookspan and Dean Moyer in the next few days!


I’m noticing a trend in nursing education.

Many colleges/universities are partnering up with hospitals to provide clinical experience to the nursing students.

The next logical question would be: “Isn’t that how it has always been done?”


Back in “the day”, our programs partnered with many different facilities. County hospitals, community hospitals, HMO hospitals and free-standing mental health facilities. We experienced different environments, different types of patients/clients and different nursing philosophies. One facility might be known for it’s maternity care. Another for its heart program. One hospital might be in an affluent area. The county hospital would be more culturally diverse.

We saw a wide variety of systems and received a great deal of exposure in a very short period of time. We learned to adapt. Quickly.


I discovered that the students who use my hospital for their clinical only use my hospital. They use no other facilities for their clinical experiences. Many of them are then hired as new graduates once their program is over.

I have no problems with new graduates – you have to start somewhere and it’s good to start in a place where new nurses are welcomed.

But I ask you, isn’t this concept of using only one facility for clinical experience a throwback to the old days of diploma programs being “attached” to a hospital? Granted, the students are not being used as staff, but I can guarantee you that they are not receiving a well-rounded view of nursing as a whole.

Here are the issues as I see them:

  • A lack of varied experience. Different hospitals have different ways of documentation, different procedures and different types of patients. They also have different nurses who give advice based on what they have experienced. The more you are exposed to, the more you learn. Spend your entire clinical time in Wonder Bread Hospital and not only will you be ill-prepared to adapt to different systems, if you are hired at Smorgasbord University Hospital, you will not be prepared for…
  • Culture shock. Big time. Depending on where you live, you will be dealing with patients from different cultures and patients from different income levels. No, this does not change your nursing care, but you may find the environment in which you are giving the nursing care to be foreign to what you are used to. The hospital where your clinical took place may be well staffed and well stocked with lots of money from wealthy donors. The hospital where you are hired may be the exact opposite.
  • New graduate assimilation. What does a facility hope to achieve by an exclusive partnership with a local nursing college or university? They want staff! But… how many new graduates can be assimilated effectively into one unit? Eight? Ten? There may be a lot of openings for the new grads, but those are there for a reason, reasons you probably won’t see as a student. Show me a unit with a million open positions and I’ll show you a unit that either burns its nurses out or has unit-based issues that nurses aren’t willing to deal with. Guess where you will be hired once you graduate?
  • Retention. The grass is always greener on the other side. If you’ve never experienced the other side, how do you know if this is true? The first year of nursing is the hardest. If a new nurse becomes frustrated, exhausted or just plain tired of dealing with issues encountered on their first job, they will leave to find one that fits. Of course, they won’t know that they may in one of the best hospitals because they have never experienced anything else! Perhaps a new nurse will thrive in a teaching hospital environment or at a county hospital. They won’t know because they never had the chance find out!

In summation, using only one facility for clinical nursing experiences is neither good for the student nor the facility who wants to hire the new nurse after graduation.

The student misses the opportunity to learn to adapt their nursing theory and skills to a wide variety of systems using a wide variety of materials. The facility will lose that new grad to the first sign-on bonus or advertisement that makes another facility look like Hospital Taj Majal.

Nursing education needs to provide as wide a range of clinical experiences as possible.

Anything less shortchanges the student and contributes to facilities losing the very nurses they helped educate.

Read »

September 11, 2007, 12:04 pm

Grand Rounds: New and Innovative!


Geeze, I hate missing Grand Rounds!

Joshua did a fantastic job this week over at The Efficient MD with his theme of Healthcare Innovations and New Technologies.

Seems the only innovation I had time for this week was using a Glad garbage bag for an emesis basin (Hey, it worked!).


Seems like Rosie from the Jetsons has become a nurse! That is what they are calling this cool machine in the photo.

No, they shouldn’t call it a nurse, that is inappropriate, but I’ll save that for another post. Give it another eye and put a nurse’s cap on it! (Yes, I know..shame on me…)

I’m very into artificial intelligence and these mechanical beings run all sorts of errands around the hospital and can even “talk” to each other so that one does not go where the other one is heading! I wonder if they gossip?

Hmmm….can they be programmed to give enemas in the ER? I’ll shove all the drugs you want, but enemas in the emergency department in the middle of the night should be banned.


Change of Shift is here next week – already the submisions are arriving so be sure and get yours in! Blog Carnival or directly to me (contact button up top), either way is fine. Remember – either by or about nursing – that is the running theme!

While you are here, please read my re-posting of my 9/11 memorial post to Mrs. Brenda Gibson who died in the Pentagon attack.

May we never forget.

Read »

September 8, 2007, 4:32 am

Another Viral Victory


If there is anything I hate it’s a passive-aggressive virus.

One day you think you are dying and you sleep for twenty-four hours.

Ah…it was a 24-hour bug. No harm, no foul. This is followed by another 24-hour period during which you resume your activities of daily living.

Then it hits you again.

It’s 0430, I slept through the entire evening so now I can’t sleep, I have a headache, my stomach hurts, my digestive track is churning like buttah, I’m too sick to study, to exhausted to fold clothes, I’m miserable and I just called in sick.

And to top it off, Notre Dame plays at 1500. I don’t care if I have to sit in front of the TV with an emesis basin and a commode – I’m watching the game!

(Please don’t make any cracks about how badly they played last week. I’m too weak to defend my Irish.)

And that concludes tonight’s whining broadcast. Thank you for listening. I don’t feel any better but hey, if you can’t whine on your blog where can you whine?

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...

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