November, 2007 Archive

November 14, 2007, 9:19 pm

Change of Shift: Vol. 2, Number 11

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Welcome to Change of Shift, the best of the nursing blogosphere!

Before we get started, I shall engage in a bit of shameless self-promotion! Tonight Dr. Anonymous will be interviewing me on BlogTalkRadio, and I have no idea what the topics will be! Should be fun, but I’ll have stage fright even though I’m talking from my bedroom!

Then, for those of you who read “Fitness” magazine, there is an article in the December issue on staying healthy and I’m quoted in it! I’m as far from a Fitness cover model as you will ever get, but I know how to stop the spread of bacteria!

Enough about me, time to get to our submissions!

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Keith at Digital Doorway is taking a sabbatical from work/nursing and muses on what the next weeks will hold in Taking Leave: Exit Stage Left. He also introduces us to the concept of “Vicarious Traumatization”. Most interesting, and I wish him well on his search for balance, rest and self-renewal

We all have to deal with death eventually, but few of us have to deal with on our very first day. Our student nurse at Brain Scramble gets some experience in exactly that, as detailed in her Change of Shift submission: An Unforgettable First Clinical Day.

Beth at Pixel RN has some great suggestions in the post 5 Websites to Help You Survive Nursing School, but you don’t have to be a nursing student to take advantage of them. In fact, I’ll be checking out the Medline drug information site, myself!

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Sometimes we feel so overwhelmed with emotion it’s hard to even move. Flight nurse Emily presents a poignant story of courage and letting go in Mourning posted at crzegrl.net. Kleenex alert!

(Whoa! Lost on the Floor not only has a new template, but a new home on WordPress!) There’s a saying in the ER: The longer you stay, the longer you stay (trust me!). ER isn’t the only unit with issues. What do you do when the patient really doesn’t need Intensive Care, but the doctor says “Go!”? Check out Inappropriate ICU Transfer of the Week. (PS: interesting link at the bottom. No more Coke for me!)

Patients can’t tell what they look like, but they are there when we are at our most vulnerable. Terry, our resident nurse anesthetist at Counting Sheep discusses how you can communicate Behind the Mask. Terry also hosted Grand Rounds a couple of weeks ago, be sure to check it out if you missed it!

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I have absolutely nothing to add to this post except to say I wish I had written it. Madness, Tales of an Emergency Room Nurse introduces us to the inhabitants of that very special place: the ER waiting room in The ER Waiting Room is a Jungle. Oh, I will add that Burger King seems to be the preferred dining experience in my ER.

Dang! Ever wonder what a severe allergic reaction feels like from the other side of the gurney? Unfortunately, Azygos found out and recounts the frightening adventure in Angioedema. The culprit? Lisinopril, which I started taking a week ago. Greaaaat….

Still got your Kleenex nearby? Good, you are going to need it. ER Nursey uses a short post to say a million words in Watching Mama Die.

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Perspective. Julia develops it as she cares for a young man in A Lesson in Fairness, posted at her blog This Won’t Hurt a bit.

Every now and then, a submission comes into Change of Shift that is not nurse-related, but is something nurses can relate to. Meet Kal, a medic in England and writer of the blog Trauma Queen. He recalls one particularly difficult call in Enter the Dragon. Restock the Kleenex.

Tired of bedside nursing? If you have considered a career in clinical research, check out Kate’s post at Alternative Nursing Careers! And no, you don’t need your PhD to be a clinical research assistant!

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Katherine at My Midlife Nursing School Adventure wonders how we expect our patients to keep up with new developments when concepts change (and then change back) so quickly. She tackles this topic in Turn and Face the Strange.

Ever gone into work and found yourself sicker than the patients? Mother Jones tackles our penchant for showing up sick in Dead Nurse Walking, posted at Nurse Ratched’s Place.

Caring comes in all forms and it doesn’t always have to come from a nurse. Fellow yarn fanatic Alison tells a tale of knitting needles, ESP and breast cancer in Marguerite. You can find Alison at her blog, SpinDyeKnit. I’m happy to include this post in Change of Shift for Alison!

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That concludes this edition of Change of Shift! I have some host bloggers lining up but I’m still confirming! So, for now you can send all submission for the next edition to me using Blog Carnival or the contact button up top.

Thanks to all who submitted and to all who are reading!

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November 13, 2007, 1:03 pm

On Location With Grand Rounds!

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Dr. Anonymous takes Grand Rounds on location!

The beautiful state of Arizona is the setting for this week’s compilation of medical blogging, and what a compilation it is!

(Check out the red-shirted cacti, while you are there!)

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Talk about feeling totally out of the loop, it’s been a week since my last post and two weeks since I was last in Grand Rounds.

I’ve spent the last two weeks drowning in a paper on the Terri Schiavo case, coming up for air from the chaotic body of water known as statistics and trying to understand why a textbook on health and physical assessment would have this line in it:

The right atrium and the right ventricle make up the right side of the heart.

This is from a textbook being used in an assessment class for those who are already registered nurses!

I kid you not.

Never mind that my kids learned this around sixth grade. Never mind that every single RN I’ve ever known, from any state (or country, for that matter) had to pass Anatomy. Granted, I worked in Coronary Care for eight years so maybe I have a bit of background, but geeze!

I must admit that the text went on to provide a very detailed account of heart sounds….that was boring as hell.

And I paid $1,440 for that one class. Okay, I have become somewhat proficient at tympanic membranes, and I can see an optic disc with an opthalmoscope. A thrill a minute, my life is.

Screw heart sounds, though. I just bought an electronic stethoscope. Got an S3? Bring it on, baby! Go on and split yo’ bad ol’ S1 ‘cuz I am gonna hear it from the door!

Seriously, the price of electronic stethoscopes have dropped dramatically – Littmann has them for $300 and now on sale for $265 at amazon.com. Those of us who suffer from chronic rock-n’-roll induced hearing deficiency can now find a rale with the best of ’em!

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Lest you get the idea that I am totally burned out with taking a full load of classes, let me assure you that I am so burnt I make the 1906 San Francisco fire look like a hibachi.

What the hell made me think a full load would be easy? Well…I’ve come to a drastic decision.

Only four units next semester. I would have taken seven but I didn’t have the money.

If ten is too many, and four is not enough, seven should do it.

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Speaking of money for education, the Army Reserve is now taking nurses under the age of 55, with ADN degrees! A 13,000 – 15000 dollar bonus. My husband had to physically restrain me from running to the recruitment office. I mean, here is my chance. A baby during the first Gulf War – had to stay home. Too old for this war….until now! Hubby says no, said it was “stupid”.

There is one thing you do not say to me when I want to do something and that is, “It’s stupid.” Them’s fightin’ words.

They probably need us old war horses for stateside coverage while the young whippersnappers get to see action, anyway.

I haven’t given up.

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Keep on sending in those Change of Shift submissions! You have until tomorrow at 1700 Pacific Time! Blog Carnival or email me, either way is just fine! It will give me a great excuse to get my nose out of a book!

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November 6, 2007, 2:09 am

ER on Jeopardy, Baby!

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This photo would never pass muster in today’s hospital world!

Look at that fan precariously balanced on a platform with the cord hanging down – safety hazard!

The nurse on the right is discussing a case in the waiting room – HIPAA violation!

I actually worked in an ER that had a full bank of vending machines right outside the waiting room – when waits get over six hours, I guess people feel the need to have something. So much for NPO.

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Ladies and Gentlemen, it’s time for….Jeopardy!

First category: “I’m Really Sick, You Know” for $200

  • The answer: “I always run low so that is a fever for me!”
  • The question: “What does a patient always say when you tell them their temperature is normal?”

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Second category: “Doctor, It Hurts When I do ‘This’!” for $400

  • The answer: “I have a high tolerance for pain, so this is really bad.”
  • The question: “What does every single patient say when describing their pain?”

Same category, for $600:

  • The answer: “I don’t want to get addicted.”
  • The question: “Who is unclear on the concept of pain medication?”

Same category, for $800:

  • The answer: “I’m allergic to Morphine, Stadol, Toradol, Dilaudid, Percocet, Percodan, Vicodin, Norco, Fentanyl, Oxycontin, Compazine, Zofran, Tigan, Protonix, Pepcid, Tagamet, Zantac, Reglan, Prilosec, Maalox, Donnatal, Bentyl and viscous xylocaine.”
  • The question: “Who wants Demerol and Phenergan?”

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Third category: “Forewarned is Forearmed”, for $1000

  • The answer: “I want to know if Dr. Generous is working right now.”
  • The question: “Who wants to know the chances of getting a pain shot before coming to the ER?”

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Fourth category: “Where’s Cherry?”, for $400

  • The answer: “I need to speak to a nurse now!”
  • The question: “What part of ‘we don’t have advice nurses’ didn’t they understand?”

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Final Jeopardy Category: “Believe it….or Not

  • The answer: “My wife had surgery two days ago and can’t sleep. I want you to call her primary doctor and have a couple of sleeping pills waiting for her at the front desk for me to pick up in fifteen minutes.”
  • The question: “What is an actual request/demand made of ER personnel by telephone?”

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Thanks for playing along!

I hope you wagered all your money on the final category because it really, honestly did happen.

The doctor says my jaw should come up off the floor within three days.

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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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