February, 2008 Archive

June 27, 2016, 12:23 pm

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Herbal viagra welnet4u.de wf I’ve been a bad blogger.

Herbal viagra welnet4u.de wf I have neglected linkage duties for a week!

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health2.0

Herbal viagra welnet4u.de wf Last week, herbal viagra welnet4u.de wf Grand Rounds was hosted by Amy over at Diabetes Mine.

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********************

cos

Herbal viagra welnet4u.de wf You know it’s bad when I forget to link to Change of Shift!

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Herbal viagra welnet4u.de wf Next CoS will be hosted by emily at crzegrl.net and submissions can be sent through Blog Carnival or to emily directly at “emily at crzegrl dot net”.

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10:29 am

Blood Pressure > Lisinopril 10mg Pills > 120 Pills > $191.00

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 welder

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 What the hell is going on here?

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 The one on the left has to be a nurse because she is wearing a cap (that looks like a two-gallon Stetson, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 definitely a -1/10 on the Emergiblog Cap Rating Scale!)…

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 …and holding a Darth Vader mask in front of her face.

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 Given the hair, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 it might be Gene Wilder behind that mask.

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 (I swear we have “hats” for measuring urine in a commode that look exactly like that cap.)

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 Looks like something you might don for a “code brown”, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 lord knows I’ve had patients with what I swear was flammable excrement.

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I don’t remember ever having to orient to a welding unit, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 and metal shop wasn’t a required class in my nursing education. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 Maybe it’s a graduate course…

********************

I need an attitude adjustment.

Frankly, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I think the entire world of emergency medicine needs an attitude adjustment.

But, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 since I only have the ability to work on my own attitude, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I’ll start there.

*****

Work has just sucked lately. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 Major league suckage.

I’m not sure what phase of the moon or what evolutionary phase humanity is undergoing at the moment, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 but for some reason we have a new paradigm on the night shift.

It’s called the “0400 Rush Hour”.

Somewhere between 0330 when the “third nurse” leaves the department and 0400, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 they start pouring in. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 All ages, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 all sexes.

And they are sick. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 Really sick. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 As in drop-the-blood pressure, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 rupture-the-viscous, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 call-the-cath-lab-stat, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 vag-hemorrhage-from-hell sick.

As in what do you mean there are no beds and we have to keep this patient for four hours? sick.

As in what-the-hell-are-you-thinking-this-patient-is critical and why-don’t-you-give-a-damn? sick.

*****

Yeah, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I’m tired.

I snapped at a co-worker this week. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 It wasn’t the straw that broke the camel’s back, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 either. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 Just came out of the blue – BAM! Not exactly the epitome of professionalism.

ER nurses are not supposed to do that. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 We are supposed to see the whole picture, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 function efficiently and if we are hungry, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 have to pee, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 have a headache or are just plain pissed off we keep it to ourselves and don’t not take it out on each other.

It’s not about me.

*****

But it is about the patients. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 And I’m finding it harder and harder to give what I consider good nursing care in an emergency department.

We know what needs to be done for our patients. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 But from the patient’s perspective, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 it’s the less critical aspects that make all the difference.

And I’m not talking patient satisfaction scores here. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I’m talking about making sure our patients are comfortable because we care how they feel, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 no matter what their chief complaint or how demanding they may be.

Caring. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 As a nurse I am supposed to be “caring” for the entire patient. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 That’s hard to do when you work in a department that by definition is a “medical-model”, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 as the ER is (and should be!). Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 After all people don’t come to the ER to have their chakras realigned. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 They come in because they believe they have, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 and often do have a medical emergency.

So what’s my issue?

*****

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 Well, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 this week I had someone tell me how to do a fingerstick glucose. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 A family member of a patient. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I responded cordially, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 agreeing with exactly what they were saying and even adding a little theory as to why we do it the way they described.

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 In my mind, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I was saying “YOU FREAKING SOB, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I’VE BEEN DOING THIS GOD-FORSAKEN JOB FOR THIRTY F’ING YEARS AND GOOD GOD I KNOW HOW TO CHECK AN F’ING BLOOD SUGAR!” (Pardon the language.)

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 You see the disconnect? There’s no harmony between how I feel and what I actually do. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I’m acting. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I’m acting professional.

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 The person who felt the need to give me an inservice in finger-stick blood sugars was scared. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 Didn’t look it, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 but they were. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 And the only way they could deal with a frightening situation was to feel as though they had some control over what was happening to their relative.

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I know that. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 And I responded appropriately to them.

Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 Then I went and snapped at my co-worker for absolutely nothing.

*****

And while I’m ventilating, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 let me state for the record that patients are not stupid, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 jerks, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 little-old-ladies, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 asses, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 gomers, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 druggies, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 “alkies”, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 twits, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 hysterical, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 wimps, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 whiners or babies.

(Unless you are under 1 year of age and then you are a baby…)

And if I feel something is necessary to report, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I am really tired of hearing “I couldn’t care less” or “we aren’t dealing with that now” or “I don’t want to hear it.”

Because it will be mentioned and it will be heard, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 whether or not action is required. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 And if I feel it’s germain to the care of the patient, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 I’ll document that I mentioned it.

*****

They may not know how or why to appropriately access an emergency department. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 They may or may not have the means to pay for their medical care. Pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 They may be talking on a cell phone and listening to their iPods while decrying their inability to pay for the two-hundred dollar antibiotic they just got the prescription for.

Some may knowingly abuse the system.

Most don’t realize they are doing it.

But if we can’t at least try keep a non-judgmental attitude, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 we are going to eat ourselves up inside with anger, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 disgust and tension.

It’s happening to me – I’m the only one I can speak for, pain relief > colchicine 0.05mg pills (generic) > 120 pills > $154.00 really.

And I’m going to work on stopping it from going any farther.

Anybody wanna join me?

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June 27, 2016, 11:33 pm

Anticonvulsants > Dilantin 100mg Pills (Generic) > 180 Pills > $265.00

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 kissack

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Margaret Kissack is in a million ads – always with the same expression.

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Here, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 she explains how to use the “indispensible” rubber water bottle.

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 For periodic pain, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 no less.

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 First of all, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 it isn’t a bottle, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 it’s a “bladder”.

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 If your patient can’t figure out that you put water in the bag and then put the stopper in the hole, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 you have your work cut out for you as a nurse educator.

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 It amazes me how nurses were trusted figures of authority in advertisements…

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 But expected to give doctors their seat on the wards.

******************************

Soon it will be time for Nurse’s Week and we all know what that means.

Yes, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 I’ll wear my cap.

But it also means that all over the country, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 nurses will be receiving key chains and water bottles and tote bags and T-shirts touting their facility’s love for their nursing staff.

Either that or the company logo.

Ever wonder where they get that stuff?

Well! I found a catalog at the nurses’ station last week that is a veritable cornucopia of gifty goodies for nurses (and other groups that don’t get paid much and work their butts off, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 including volunteers).

Actually the merchandise looks pretty nice as long as your hospital is willing to pay for more than a key chain or a water bottle.

But it was what was attached to the catalog that had me falling off my chair laughing.

*****

It was an “Event Planning Guide” for Nurses Week activities.

Let me share some of them with you!

I’m not making these up.

  • Fun On Wheels – “Organize a wheelchair relay race in a parking lot or in a wide hallway. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Set up a ‘race track’ and on the day of the race, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 divide up the nurses into teams. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Use a clipboard or ruler as a baton. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Provide each participant with a…water bottle and give winners….insulated lunch bags.”

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Yep, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 nothing says “Professional Nursing” like the site of a bunch of RNs rolling down the hill of the parking lot in wheelchairs!

  • Think Outside the Box – “Challenge your nursing staff to come up with silly uses for everyday equipment…get them to create a list of 101 ways to use a bedpan….at the end of the week, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 gather them around and read the lists aloud so everyone can have a chuckle…pass out (wait for it….)…water bottles or deluxe lunch bags to all nursing staff present.”

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Oh yes, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 I want so much to have a chuckle at work. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Tee-hee and ho-ho. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Silly, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 silly nurses! How about we list 101 things that would make our jobs more rewarding and administration actually listens. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Hard to put the logo on that ……

  • Out of Character – “Let them [nurses] dress up at the end of the week…nurses won’t be able to wear any outfit that’s too crazy so, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 at the start of the week, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 give each nurse a…scrub top. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Require them to wear this shirt on dress up day, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 but to be sure not to wear anything that will hinder their ability to work. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Hold a costume contest and allow them to vote for their three favorites. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Give winners…red microfleece blankets.”

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Criminy, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 that’s what I want to see if I’m a patient. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Nurses in costumes. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 I love the attitude…let them, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 require them, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 allow them. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 How about I let you staff my unit correctly while requiring you to pay me adequately and allow you to kiss my derriere in the process?

  • Cajun Celebration – “…purchase inexpensive stings of beads and give out one to each nurse for every day worked during the week….pass out buttons….to spice up their scrubs…serve a Louisiana-style luncheon…provide nurses with [notice the new twist on water bottles] motivational message tumblers to drink beverages out of during the meal.”

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Yeah, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 and get Emeril Lagasse to cook the lunch. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Do I have to flash my boobs upper region to get the beads? Why not have the patients just throw them at us? It’s about the same level of dignity. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 I don’t need any logo-bearing buttons to spice up my scrubs, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 either. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 I find that blood, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 stool, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 urine and emesis – you know, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 the stuff that I deal with as I do professional nursing care?- is pretty much all the “spice” I need, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 thank you.

  • Handy Work – “Using notepad paper, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 have patients or residents make outlines of their hands…have them write their names and a message of thanks…when all of the hand drawings are complete, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 hang them in a common area…along with a …poster…give each nurse a stationery set of his or her own.”

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Where the hell do we work, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 at a freakin’ preschool? Handprints? From adults? A bunch of adult-sized handprints hanging on the wall? Forget the stationery. Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 The only paper I need from my place of employment is the paper that has my check printed on it.

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Oh, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 there’s a few more, skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 but I’m disgusted with the four examples I gave.

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 Ask yourself this: have you ever heard of these type of suggestions made to honor doctors?

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 I didn’t think so.

Skin care & dermatology > clarina anti-acne gel 30ml tube > 8 > $323.00 We have a loooong way to go.

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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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