September, 2007 Archive

September 6, 2007, 11:43 am

Change of Shift Goes to School and a Fellow MedBlogger Goes to 20/20!


Change of Shift is up this morning over at How I Spent My Nursing Education!

Someday Nurse has a theme to this edition, so if you are a student nurse, ever been a student nurse, ever worked with a student nurse or ever seen a student nurse there is something there for you!

Many thanks to Someday Nurse for hosting!

Change of Shift moves back to Emergiblog for the next edition,so you know the drill! Submit via Blog Carnival or to kmcallister911 at yahoo dot com. No particular theme, just anything to do with or by nurses!



I am so excited!

Steven Palter, our fellow blogger over at Doc in the Machine, is going to be featured on the ABC show 20/20 tomorrow night!

Steven has done some amazing work with technology in medicine and 20/20 originally wanted to interview him about his part in the National Geographic show that showcased his HD surgery.

Well, they expanded the segment and now it’s all about Steven and his work!

He writes about the experience here on his blog. Oh, and 20/20 blogged about him, too!

Steven, this is really exciting and I couldn’t be happier for you! I will most definitely be watching.

(P.S: Steven is on the far left!)



I would like to personally apologize to every patient who came in to my emergency department with gastroenteritis x one hour and received a silent but definite label of “wimp”.

I thought I was dying last night. I woke up with severe abdominal distension and pressure, nausea, dizziness and body aches.

Surely this could not just be gastroenteritis! I was sooooo sick!

My back had been hurting for two days…oh lord, it’s an aneurysm!

Oh no, it must be a small bowel obstruction and I’m going to get an NG tube!

Oh god, I might have perfed!

Now, why would I perforate my bowel? Who knows but I’m really sick!

I have gastroenteritis.

Geeze, this is miserable!

Perfect timing, too. First week of the new semester, two assignments due tomorrow.

Pardon me while I continue my pity party.

And my next patient who shows up because he vomited “once” gets an extra dose of Zofran on the house!

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September 5, 2007, 11:28 am

Nursing Students: Our Future, Our Lifeline


It’s no secret that I have had a life-long love affair with the Cherry Ames series of nursing books.

I am what I am today because of this one book.

Of course, there have been times I have rued the day I ever laid eyes on it, especially after a shift from hell!

I wonder if there are any student nurses out there today who became nurses because of Cherry. The books have been released for a new generation, but they have not been updated. Cherry is still scared of Dr. Wylie and gives up her seat to senior nurses and doctors.

Now Sue never did a thing for me.

I never even read the books. I just found out today the author was a nurse herself and served in World War I.

Why didn’t I read the books?

Because of the butt-ugly cap that Sue wears on the cover! Geeze, the thought of wearing that would have turned me off the profession forever!


When Someday Nurse told me she wanted to host a “Change of Shift” with a theme, I was a bit taken aback. Nursing is the theme of Change of shift! When I found out her theme was “Student Nurses” I became inspired!

All sorts of advice flooded my head. I imagined imparting three decades of wisdom to the intrepid students of the nursing profession. Never mind that it would all fit into one post! I am the Voice of Experience, hear me roar!

My enthusiasm was diminished by a sobering thought. Being fifty years old, the majority of the nurses that are being educated and graduating today will be the nurses who are taking care of me in my old age! Like when I’m like ninety six or so. Everyone knows that ninety is the new seventy!

It would be nice to think they are still enthusiastic about the profession in years to come, and will choose to make nursing their life’s work. We will need these new nurses to be there for us.

This means that those of us who are practicing nurses today have to look closely at how we are treating our newest colleagues, particularly the ones still in training. This post about nursing students is directed to us, the nurses of today.


Chances are you are working with or around nursing students during your shift. You may not be their instructor, but you can have a great impact on their confidence and self esteem:

  • Don’t just be available to answer their questions, be actively accessible to the students. Ask them if they have any questions! Sometimes they don’t yet know enough to know what questions to ask. If they are observing you, talk through your reasoning – why are you doing what you are doing? Just watching you will not help students with their critical thinking skills.
  • Don’t ever make the students feel like they are a problem, in the way, a pain or a waste of your time. Many of them are anxious, nervous or may seem clueless. They are. And so were we, back in the day. Yes, you’re busy and it may seem like extra work. Treat students with respect and you will reap a stronger profession down the line, one student at at a time.
  • When you see a student catch an error or observe a change in a patient through their assessment, give them positive feedback. That’s nurse-speak for a pat on the back. You can never be too effusive with your praise. The idea is to build self-confidence and pride in their professional accomplishments/growth. You don’t have to be a nursing instructor to do that.
  • If you are doing something interesting, tell the instructor and get the students involved. Some will jump right in, others will need encouragement. Provide that encouragement. The student with the caught-in-the-head-lights look who is hovering in the back corner just needs some confidence. Trust me, I used to inhabit that back corner.


Nursing today is complex and it is extremely hard for a brand new graduate to “jump in” and carry their weight immediately after graduation. We don’t have an internship/residency type of post-graduate easing into the new role. Maybe we need to provide a modified version.

  • Stop putting the new graduates into “orientation programs” and put them into transitional programs that last long enough to allow them to gradually acclimate to their new role as nursing professionals.
  • The new graduate is truly a “novice” and the definition of that means that they are not yet able to see the “big picture”. An appropriate transitioning program is especially important these days as brand new graduates are being hired for intensive care and emergency departments where critical thinking is paramount and seeing the “big picture” is de rigueur for functioning efficiently.
  • Gone are the days when a new graduate would cut their teeth on a med/surg unit and learn time management and priority setting before specializing. This is unfortunate, but the nursing shortage has made it a fact of life.
  • I’ll go out on a limb and say that a minimum of six months of increasing responsibility with a preceptor be the minimum transition period for a new grad, perhaps a year in a critical care unit. Pay preceptors a good differential to make that position attractive.

It is no secret that we lose nurses to horizontal violence. Perhaps these ideas will help encourage new nurses to stay and cause potential students to seek nursing as a career.

  • Stop slamming each other. The Three B’s of Nursing: Bitching, Bickering and Backbiting do more to damage our profession than any other single factor. No citation here, that is my personal opinion.
  • Stop bad-mouthing the profession. Yes, nursing has issues and problems and addressing them is healthy and appropriate. Continual whining is not. When you put down nursing as a profession in your everyday conversations, you may be discouraging future students from entering the profession. Maybe not directly, but your friends and acquaintances have daughters and sons who they may discourage from entering the profession.
  • Enccourage young people you know to consider the profession. We need the best and the brightest. Explain the difference between the nursing and medical professions. There are many good things about the nursing profession and we need to keep those positive aspects in the public eye.

The applicants are there, the instructors are not. Those of you with your BSN, have you considered getting an MSN and teaching? Or using your BSN to act as adjunct faculty with a local university?

You use your expertise every day for your patients. If we use it to help our nursing students, we are making a major investment in our own health and the health of our nation.

We owe it to our new colleagues.

We owe it to the profession.

We owe it to ourselves.

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September 4, 2007, 10:14 am

Dr. Emer Hosts Grand Rounds/Bob Dylan Has an Important Message re: Change of Shift!

Dr. Emer over at Parallel Universes is our host for this week’s compilation of the best of the medical blogosphere known as Grand Rounds!

I’ll be reading with iced coffee this morning. No, no Starbucks today but I’m making do with the McDonalds’s version of an iced coffee.




It looks like Bob Dylan has a special message for this week’s Change of Shift! View Bob’s video and find out what that is!

Hey, who slipped in that ad for the new CD – very slick, Bob!

Change of Shift will be hosted this week by Someday Nurse at How I Spent My Nursing Education. CoS will actually have a theme this week and the theme is “Student Nurses”!

All you veteran nurses, give us your best advice! Student nurses – what can we do to make things easier for you? Now is the time to let us know.

You can use Blog Carnival or send your submissions to somedaynurse at gmail dot com.

Just like Bobby says!

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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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