August, 2008 Archive

August 6, 2008, 11:59 pm

Change of Shift: Volume 3, Number 3

Welcome back to Change of Shift!

Many thanks to those who have signed up to host CoS – the page is updated, as is Blog Carnival . If you’d like to host (don’t be shy, it isn’t hard!), drop me an email (Contact button is up top).

A very fast two weeks has passed since the last edition and many contributions have been received, so let’s dive in!


Keith at Digital Doorway submits the first post of his Value Care, Value Nurses nurse blogger scholarship series with a look at The Nursing Shortage: A Global Crisis, Close to Home. Sobering statistics, and a great overview of the contribution of nurses to health care systems everywhere. Is there hope? Also, if you haven’t done so already, check out NurseLinkUp – Keith is a major part of the new networking site and you can read more of his work over there!

The award for best blog name (I just made that up) goes this week to goes to The Loco Days of Locolorenzo. Mr. “Lorenzo” , self described male nurse, performance poet and a bit of crazy-old-man, submits his first post to CoS in which he thoughtfully looks at why a nurse should NEVER Forget Where You Come From.

Why does this not surprise me one bit? ERMurse submits a provocative post noting: Spike in medication deaths. Could it beeeeeee ……. Satan – or perhaps “The Fifth Vital Sign” . I know I am giving more and more narcotics than I ever used to give, both in frequency and in higher doses. I wonder if the pendulum is starting to swing the other way now. You can find this interesting look at pain control at ER Murse.


It appears our colleague Disappearing John RN has discovered the joys of blogging at Starbucks! His submission this week deals with something none of us want to face, let alone confront. Find out what that is in A Painful Choice…

I thought I knew most of the networking sites in the medical blogosphere, but I discovered some new ones in 50 Social Media and Networking Sites for the Medically Minded posted by Sally Thompson at Nursing School Search Blog.

Glenna Murdock writes a blog for called the Nursing Diary. She writes a chilling post detailing just what can be heard (and by whom!) in a hospital setting. Next time you say anything at work Think About Who Might Be Listening.


Sometimes it’s the little things that count, particularly if you are dealing with a bedridden patient. Nurse practitioner Heather Johnson gives a thorough overview of what to provide in Caring for the Bedridden posted at Nursepractitionerblog’s Weblog

Just when you think you have heard it all…Maha assures us that This Really Happened posted at Call bells Make Me Nervous – Nursing Insights from a Student Perspective. You might need Kleenex, but only because you will be laughing so hard you’ll tear up!

Just when you think you’ve heard it all part deux: it seems the powers-that-be who run Mother Jones’ place of employment are upset. What do they have against diaper wipes, of all things? Find out at Nurse Ratched’s Place as you read about Potty Problems. Seriously.


The Nurse Connect bloggers are present and accounted for! Laura wonders if we are ever really off-duty as she cares for a family member in A Nurse’s Work is Never Done: Caring for Our Own. Kathy looks at the practice of starting IVs by premedicating with an anesthetic in IV Starts. This is something I have never done, but the research is making me rethink my practice

Nurse Connect is also unveiling their new Guest Blogger Column! Every month there will be a new blogger and a new column! Check out this month’s guest blogger; the topic is the nursing shortage. I would comment on how handsome the guest blogger is, but I’ll refrain as that would not be professional!

Dean of The Back Pain Blog is back (no pun intended) with a look at herniated discs. With the aging of the nursing profession, are we more prone to herniate than someone who is younger? Dean checks out some research and discusses the issue in Are Herniated Discs Caused by Age?


Just for fun: Therapy Doc tells a great story about why it’s cool to have your kids around (very timely just as my youngest heads for college in two weeks!). Check out Why It’s Good to Enmesh Your Children over at Everyone Needs Therapy. I wonder if they make sippy cups for adults <ducking!>

Alvaro at Sharp Brains weighs in this week with a look at the Top Ten Brain Training Future Trends. The one I see being used the most are Brain training podcasts! I had a chance to see some computerized brain training programs at BlogHer08 – very intriguing!


Thanks to all who have submitted to CoS this week. The next edition will be right here at Emergiblog on August 24th. Submissions can be sent to me directly or through blog carnival.

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August 5, 2008, 4:24 pm

Grand Rounds: Brought to You by Cheesy Poofs!

I’ve seen some fun Grand Rounds themes over the last few years, but this one takes the cake…or the cheesy poofs!

In honor of the theme chosen by Jake at Pure Pedantry , I’ve co-opted the South Park theme (with apologies in advance to Matt and Trey…)

I’m goin’ down to Grand Rounds
gonna have myself a time.

Friendly bloggers everywhere
posting perfect posts on health care.

Grand Rounds read at Starbucks,
gonna leave my housework woes behind.

Ample parking day or night,
people shouting GIVE ME LATTES!

Clicking links at Grand Rounds
gonna see if I can’t find,

Funny, poignant, information – add my share of commentation

So come on down to Grand Rounds
and meet some friends of mine!


Okay! I have put up the Change of Shift schedule through the new year on both Emergiblog and Blog Carnival, so if you see a date that works for you and you would like to host, shoot me an email.

The next edition will be here, and I’m taking submissions until tomorrow night at 5 pm PDT so there is still time to send in your best posts!

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August 2, 2008, 10:40 pm

Etiquette in the ER

I don’t think I’ve ever had a patient plead for coffee.

Back in the old days (pardon me, sonny, while I put my teeth in…), patients in the Coronary Care Unit were not allowed to have caffeinated coffee.

No stimulating cardiac muscle in my department!

All we could give them was Sanka.

Freeze-dried Sanka.

It would be a cold day in Hades before I’d be pleading with anyone for coffee, leaded or unleaded. I’d get it one way or another!

Even if it meant my husband had to sneak it in under his coat!


While at the BlogHer08 conference a few weeks ago, I had the pleasure of meeting Emily Post’s great-great granddaughter, Anna Post. (Yep, THE Emily Post!). Anna writes a blog entitled What Would Emily Post Do? , focusing on modern etiquette and, along with other members of the Post family, contributes to The Emily Post Institute.

Our conversation turned to etiquette in the emergency department, something that was not covered in any of the great books on etiquette available that day.

I remembered writing a post on ER etiquette, and a quick search of the archives turned up “Mind Your Manners and Call Me in the Morning”, first posted back in 2005.

It holds up pretty well, but I thought it could use a bit of refining. So, here it is, The 2008 Emergiblog Guide to Emergency Department Etiquette.


The easiest way to understand emergency department etiquette is to realize that the majority of the issues revolve around privacy and confidentiality, both yours and that of other patients.


  • Don’t ask about the condition or status of other patients in the department. Staff can not and will not discuss another patient with you.
  • Stay in your room. Don’t congregate in areas where patient information can be overheard, including hallways or the nursing station. Use the nurse’s bell to summon staff for questions or requests.
  • Limit your visitors. Ideally, bring no more than two with you to the ER. However, if you do have more than two with you, the others need to wait in the waiting room.
  • Don’t stare into other patients’ rooms or at other patients as they go past on gurneys or in wheelchairs. Staring is just rude, period.
  • Keep it to yourself. Don’t repeat what you do hear. Sometimes it’s impossible not to hear what is going on in another cubicle, especially when separated by only a curtain.
  • If you are dealing with a very personal issue/condition yourself, it is perfectly okay to ask the staff to conduct your interview in a private area.

The next area of etiquette would revolve around cell phones. Cell phones are now permitted in some hospitals (in all areas except the intensive care unit), so it is important to discuss their use.

  • Before you enter the emergency department, tell your family/friends that you will call them once you have been seen at triage. It’s easier on you to have them wait for your call than to have to ignore multiple incoming calls. Because…………
  • Answering a ringing cell phone at any time while you are being examined or treated, either at triage or in the treatment room is a major breach of etiquette.

A major source of frustration in the emergency department is waiting. It’s inevitable. You will be waiting. You will wait to be triaged, wait to be treated, wait for test results and wait to be discharged.

  • Asking for a time frame, or an update on where you are concerning test results is perfectly reasonable. A specific time can not always be given, but staff is happy to give you an update on your progress.
  • Expressing frustration with the process can be therapeutic. Chances are the staff is just as frustrated as you are with any delays. Yelling, screaming and cussing at the staff is inappropriate and will not get you seen/treated/discharged any faster.

Etiquette in the ER is really no different than etiquette anywhere else. “Please” and “Thank you” go a long way. Treat others with the same respect with which you expect to be treated, and remember that the need to be polite does not end at the doors of the emergency department.

A visit to the ER is never easy. Observing etiquette in the ER makes your visit a more pleasant experience, not only for you, but for those around you.

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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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