October, 2008 Archive

October 31, 2008, 7:33 am

Army of One Needs Support of Many

Last night was a special night on the Doctor Anonymous Show on BlogTalkRadio. His guest was ER doc and law school graduate Symtym.

Fun show, some tech talk, lots of laughs.

And then a surprise caller. With a story.

A story that you need to hear.

*****

Robert Toland is a Staff Sergeant in the United States Army. He’s fought for our country and defended our freedom for eight years.

Robert is in the middle of the photo, with his wife Melanie and their three daughters. Lilia is 5, Skyler is 2 and Morgan is 1 1/2.

On November 1st, this family will be taking a vacation to Disney World.

It will likely be their last vacation.

Robert Toland has colon cancer. He’s been told he has just a few months to live.

*****

Back on October 25th, Kevin Haynes, Service Officer in the American Legion, Post #1460, Machias, York emailed Grunt Doc.

It seems that the Christian Youth Corps, a group of young people working in western New York, had earned enough money to send the family to Orlando. But the one thing they could not arrange was a “Princess Dinner” with Cinderella. Money was not the problem. Trying to get a reservation quickly was.

Did Grunt Doc have any connections?

Well he found out that he did, as an anonymous reader came through !

The Toland girls will have a (complimentary!) special dinner with their Daddy (and Cinderella).

But it doesn’t end there.

*****

You see, Kevin was the caller to Dr. Anonymous last night.

And I’m not being facetious when I say there was not a dry eye in the chat room.

The Toland family heads off tomorrow for Orlando.

But their house will not be empty.

I’m not sure how much of this I’m supposed to say, but let’s say there will be some, uh, extreme makeovering going on at the Toland house while they are gone. Changes that will help make Robert’s life a little easier as he faces the end of his life’s journey.

*****

Would you like to help?

There is no way I can’t, having heard this story.

The way I see it, Robert has given eight years of his life in the service of my country.

Surely there is something that I can do for this “Army of One”.

If you would like to join me in supporting the Toland Project, send your contributions to:

ATTN: Kevin Haynes, Service Officer
American Legion Post 1460
9688 Main Street
Machias, NY 14101

(Note: Put “Toland Family Fund” in the comment section of the check.)

My check is “in the mail” today.

*****

The story of the Toland family will be shown on the Fox network (Not sure if it will be “Hannity and Colmes” or “Sean Hannity’s America”). I’ll post the dates and times when I learn them.

I’m thankful for men and women like Robert Toland and I will keep Robert and his family in my prayers as they face a difficult time. It’s the blogosphere that allows us to hear stories and help people that we never would have known otherwise.

The blogosphere is an amazing place.

I’m happy to be a part of it.

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October 30, 2008, 8:33 am

So I Go Insane, Like I Always Do…

No, this is not a rehearsal for a Busby Berkeley musical.

These are student nurses!

Apparently calisthenics were part of the curriculum back in the day.

Nursing school was a lot more than studying and clinicals, you know.

One had to learn the niceties of society and proper etiquette, too!

I have an entire photo shoot on the life of a student nurse in the 1940s. When I post them, I’ll warn you ahead of time. You won’t want to be eating or drinking while you read, as aspiration is to be avoided at all costs!

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

Our Change of Shift host for the week, Amanda at Crazy Miracle Called Life, has just posted the new edition!

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

If you have not yet voted in our poll for topics to cover at next year’s medblogger conference, please do so! The poll stays up until the end of November.

I am amazed at the number of opportunities that are open for us next year! One minute it seems impossible and the next minute opportunities are there that we didn’t even know existed.

I’ll keep you posted on what is happening as details are finalized.

And now for our feature presentation:

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

Is it just me or has the nursing profession gone insane?

Let me give you a, shall we say, hypothetical situation.

Let’s say you work in a medium-sized community hospital.

The nurses in this medium-sized community hospital have busted their butts over the last year or two implementing Joint Commission standards surrounding medication administration.

For example:

  • The chart containing the medication order is taken to the bedside so that the medication can be checked against the order before administering.
  • All medications are either drawn up at the bedside or labeled in the med room when they are drawn up.
  • All patients are identified with two identifiers – full name and birth date (and they must say both!).
  • Full and complete (as much as possible) medication lists are obtained on arrival to facilitate medication reconciliation.

Let’s say these procedures have led to a dramatic drop in medication errors, which is what they were designed to do.

Time for celebration? Time for kudos? Time for acknowledging that our work has been effective, that the patients are safe, that this is a wonderful statistic and good for us, let’s keep up the good work?

Nope.

What the nurses in this hypothetical department get (and this has happened twice, hypothetically, of course) is a note from the pharmacy stating that their percentage of medication errors is not up to what is expected, ergo they are not reporting their med errors.

WTF?

Pardon my language.

Maybe I’m crazy, but there is a certain percentage of med errors expected of us the nurses in this ER?

That isn’t even the most astounding part of this Catch-22.

What the pharmacy is saying is, if I can paraphrase, “We know you are making these errors but you are not reporting them, meaning you are not acting ethically or professionally.”

This is bull****.

Pardon my language.

And who was sticking up for the nurses in this hypothetical ER? Who went to pharmacy and said, “Hey, buddy, we’re a damn good group of professional nurses and did it ever occur to you that our errors are down because we have worked our asses off to GET them down.”

Pardon my language.

No one did. Nada. No chance for feedback, as this pharmacy feedback was first put on a post-it note on the Pyxis and then repeated in a note that functions as a staff meeting.

In this hypothetical ER.

So all of the work, the extra vigilance, the extra time in filling out extra paperwork, the time actually doing what we those nurses were supposed to do (and then some) led to an improvement in patient care.

So obviously they are doing something wrong in not having their medication errors up to par level.

*****

Am I nuts? Have I gone insane? Does anyone else see the ludicrousness of this scenario?

All I know is that there is a hypothetical nurse getting fed up with a hypothetical middle sized community emergency department.

Tell me.

Are there ANY hospitals out there who treat nurses with any modicum of respect?

A hospital where someone might stand UP for their nurses when something like this is comes up?

Please, let me know.

Because I am losing faith in the ability of this profession to stand up for itself.

I’m thinking a letter to the hypothetical Chief Nursing Officer with a cc to the manager of this hypothetical emergency department might be in order.

Lord knows it won’t change a thing, but there is a hypothetical nurse who might feel better.

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October 27, 2008, 9:00 pm

Gentlemen: Start Your Grand Rounds!

Welcome to the Emergiblog Speedway, where the Grand Rounds 500 is about to get under way! No chance of a rain delay – our bloggers are ready to roll!

Thirty-nine bloggers have shown up for the event. All entries have qualified; no posts were sent back to the garage.

And ladies, don’t worry, you’re welcome on the track, I just wanted to use the classic starting phrase!

*****

Kasey Kahne is THE best driver and my favorite, so here are some posts that I particularly liked.

You can say these have earned the “pole” position.

First of all, if you did not have a chance to hear Dr. Anonymous’ BlogTalkRadio interview with Carrie of NeoNurseChic, you must listen to the archive. An articulate, riveting story of living with chronic pain.

Next, I’d like to introduce a new blogger. MedicNurse has been reading us for about five years and has decided to enter the world of the medical blogosphere. I know I’m hooked. Check our Grumpy? or Misunderstood? at Medic/Nurse’s Blog. Welcome!

Wow. Rarely do I read a post that actually sways me on an issue. Is health care a right? Before you answer, or think you are convinced otherwise, read Duncan Cross’ post On Rights at his blog Ill. Humored.

Dr. Deb has wonderful news! Finally, finally Mental Health Coverage in the US is Law! No more arbitrary limits to visits, no one can be “cut off”. This is a huge step in mental health for everyone!

Barbara at In Sickness and In Health passes on a beautiful love story…and then ends with one of her own in Two Hearts Beat As One…Really!

Bwahahahahah! Vitum at Vitum Medicinus writes about the excitement of ER as only a medical student can in The Call Any Med Student In Emerg is Waiting For: There’s Been a Massive Accident. Hey Vitum, can you pass me a Kleenex? : D

There is a vlogger in town and her name is Kerri! Of course we all know Kerri from Six Until Me and today she is vlogging on Halloweenin’ Diabetes! We have a lot in common in that we both have Snickers on our minds, but I didn’t realize she was so pretty and I’m totally jealous but I put her in my favorites anyway. (Kerri, you can send the check for that last part to my PayPal account…)

Now I know very little ’bout birthin’ babies, so this story from Theresa at Rural Doctoring had me fascinated and biting my nails. I had no idea this was even possible. Here is Birth Story #388: A Successful Amnioinfusion.

*****

Tony Stewart is a controversial figure; he is never afraid to speak his mind. Here are some topics that can also be considered controversial.

Whoa! This can’t be good. Matthew Mintz at Dr. Mintz’ Blog discusses a patient-specific letter he received that raises some important questions and a few eyebrows. Check out Pharma and Pharmacy: CVS and Merck Team Up to Sell Drugs!

Jeffrey at Monash Medical Student takes on obesity and exercise in Australia in Pro-Obesity Melbourne?

Keeping it real: Sandy Szwarc makes swiss cheese out of a study linking obesity to an increase in Type 2 diabetes in children and adolescents in a post entitled A Costly Truism That’s Not True… at her blog Junkfood Science.

Over at Insureblog, Henry Stern looks at the Personal Genome Project, the attempt to put together a “massive genetic database” to be used by researchers in the search for disease cures. It gives a whole new meaning to the phrase, “Nice Genes!”

The thought of an epidemic of a vaccine-preventable disease is scary. Sam at Canadian Medicine wants to know, “Is CBC News guilty of sensationalizing a story about an extremely rare side effect of the flu vaccine?” Check out Rx: A Healthy Dose of Reason.

Going back to Pharma issues, David Williams from Health Business Blog notes that for every payout there is a recipient in Pharma and Physicians: It Takes Two to Tango.

*****

NASCAR may be American, but auto racing is international.

Juan Pablo Montoya, from Bogota, Columbia illustrates that the will to win (and health care!) is the same no matter where we live.

Sandnsurf at Life in the Fast Lane shares a letter from an ER doctor written for a local Australian newspaper entitled “Dear Potential Patient”.

Organ donation policies throughout the world are the subject of a post from Dr. Ramona at Suture for a Living. Check out her post entitled Organ Donation.

Bongi from Other Things Amanzi tells a great story of practical experience vs. by-the-book knowledge in So Clever…Bongi, you just plain rock!

*****

You can’t have a NASCAR theme without The King, Richard Petty. He is the elder statesman of auto racing. Here are some issues our future “elder statesmen” will be addressing!

Walter Jessen at Highlight HEALTH says, “Given the significance of biomedical research on healthcare, this article highlights the 2008 presidential candidates’ positions. Check out 2008 Presidential Candidates on the Issues of Biomedical Research and Healthcare.

In his inimitable style, Dr. Rich at The Covert Rationing Blog discusses More Implications of our Right to Healthcare. I have your book, Dr. Rich! It’s next on my to-read list!

Louise, blogging over at the Colorado Health Insurance Insider notes the staggering cost of caring for a child with autism and proposes a solution that has already been implemented with other illnesses in Autism and Health Insurance.

Universal health care sounds great, but who is going to provide it? Toni at Everything Health discusses the one missing piece to this puzzle in Universal Health Care is Doomed to Fail Without Primary Care.

*****

Carl Edwards is known for being in shape as he back-flips off his car after every win. Speaking of being in shape…

Dr. Doc at Mind, Soul and Body writes a moving essay on how we are the architects of our own brains (and the importance of brain health) in Building a Better You.

Dr. Shock writes that for overweight or elderly women, Walking 3 times 50 Minutes a Week Keeps the Doctor Away. Now where did I put those Reeboks….

Dean over at The Back Pain Blog addresses questions about forward bending and sit-ups in, Sit-ups and the Herniated Disc. Touching on the risk factors associated with bending forward, he shares what he considers the proper way to do the sit-up.

*****

NASCAR is safer than it has ever been, but injuries still happen. Marcos Ambrose suffered a broken ankle this season, and it isn’t unusual for the guys to race when they are sick.

Jolie Bookspan at The Fitness Fixer has written an wonderful post on Fixing Foot Drop. I always thought foot drop was a complication of bed rest, but there is much more to it. Great information!

Laurie at A Chronic Dose says: “I love sports but it’s not often they collide with discussions of chronic illness and managing a career. This week I talk about Rocco Baldelli, (Politics, Sports…and Chronic Illness?)the Tampa Bay Ray who has mitochondrial disease, and what his prime time struggle means for patients with rare diseases.” Couldn’t have said it better myself!

*****

Dale Jarrett retired from NASCAR this year and now educates viewers as a commentator for ESPN.

Dr. Sudeep Bansal of Medicine and Man submits an educational, poignant and powerful post and videos on the HIV/AIDS epidemic entitled AIDS: Mortality in Numbers and Pictures. A powerful presentation.

Erica Kain, a fertility blogger at Poked and Prodded tells what it was like to find out she was actually pregnant in My Miscarriage Was Misdiagnosed. It’s rare, but she give good information on how to be sure before you have a D&C.

Paul Auerback at Medicine for the Outdoors discusses the need for recognition and rapid evaluation of stroke symptoms, including a basic neuro assessment review in Rapid Treatment for a Stroke.

Cogito ergo sum (“I think, therefore I am.”) T. from Notes of an Anesthesioboist looks at Descartes and mind vs. matter in Descartes’ Bones.

Nancy at Teen Health 411 takes a look at the influence of porn on our teens in Book Review: The Porning of a Generation. A serious issue for those of us who are raising teens or working with teens.

*****

Mark Martin is a well-respected racing veteran who is still on the circuit. (And only Mark Martin could get away with wearing a Viagra-sponsored suit!)Here are some posts from “veterans” (and soon-to-be veterans) of the health-care circuit.

Jordan from wrote a six-part story entitled “Obsession”. In In My Humble OpinionCommentary, written afterward, he mulls over what it means to be a physican…to “do no harm” when everything you do has that potential.

Anna Burkhead is a “veteran-to-be” as a medical student in North Carolina. She writes for The Differential at Medscape Med Students. Anna takes time to appreciate and marvel at her teammates in healthcare On the Bus.

Soon-to-be Doctor Rveblade at Twenty-Four Hour People muses on med school and his future as he approaches boards in Digging in For the Final Stretch.

Nick Jacobs discusses What Will I Miss as a Hospital CEO at Hospital Impact, by looking at what he has taken from many different fields.

*****

Now Michael Waltrip may have problems keeping his car off the wall, but he is known for his sense of humor. So are these bloggers!

How to Cope With Pain sends a light-hearted post about invisible pain. Take time to smile as you read 10 ways Invisible Can Be Funny.

Steven Spielberg, eat your heart out! Doc Gurley has written, directed and stars in a cinematic masterpiece! Emergiblog is proud to host the premier of the… Lost Tampon Video! To avoid aspiration, please do not eat or drink while viewing.

Peter over at Medical Pastiche has learned many things about medicine from film and he recounts them in Medicine in Media: Airplane! While you are there, check out the beta-blocker kitteh and the hyperkitteh!

Karin from Nurse’s Life Blog sends in the cutest story of a patient in Cute as a Pea Wise Old Lady. I nearly choked on my diet Pepsi at the end! : D

*****

Well, it looks like Kasey Kahne has won the Emergiblog Grand Rounds 500!

I mean, did you ever doubt it!

It’s been great hosting once again and I hope you enjoyed getting to know a few of the men I spend Sunday afternoon with!

Next week, Grand Rounds will be hosted at my cohort, colleague and co-conspirator Mother Jones’ locale at Nurse Ratched’s Place.

See you then!

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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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