February, 2009 Archive

February 13, 2009, 7:32 pm

A Shout Out to Respiratory Therapists: When You Absolutely, Positively Have to Breathe!


Dilaudid for cough?

And all this time I was taking guaifenesin.

Now that I think about it, there shouldn’t be any coughing within 20 miles of my department, I think we’ve dispensed enough Dilaudid to genetically alter the need to ever cough! Just kidding. Really.


Everything I know about airways, lungs, breathing, bagging and respirators I learned from respiratory therapists.

Oh, I had a little theory in school. I knew we had lungs. I knew that if we did not breathe we would die and that the “B” of “ABC” meant “breathing”.

Okay, I knew a little more than that.

Enough to know what I did not know.

And that’s where my respiratory therapist colleagues came in.


It was an RT who taught me about PEEP and CPAP.

The best way to suction.

What exactly an ABG meant in relation to the patient we were caring for.

How to trouble shoot a ventilator alarm.

I was pretty green when I started my nursing career.

Oh yeah, and I learned green sputum was not a good sign.


It was an RT who watched me proudly push atropine on a patient and then calmly asked if I would like him to circulate it for me.

Yes, please!

Then again, it was an RT who described, in detail, the interesting sputum a patient was producing. Sputum that mirrored the clam chowder we were eating at the nurses’ station (those were the old days, we could do that).

A description I can remember to this day. In detail.



I really began to appreciate respiratory therapists when I had to “become” one.

I was used to calling the RT whenever my patients required a breathing treatment. When my ER was moving from a full-service ER to a stand-by status, our RT staff transferred to the acute care facility.

We were now the respiratory therapists. We did the treatments, the peak flow measurements and the pre and post treatment assessments.

Basic stuff, yes.

But I realized how much work the “basics” took, how much encouragement patients required as they tried to work through the anxiety of air hunger during their treatment. How important it was to give the simple, but correct instructions to obtain a peak flow reading.

And I learned to appreciate the subtle changes in patients’ responses to treatment.


So here’s a shout out to respiratory therapists – those sputum specialists, airway activists, ventilator victors, wheeze whackers and stridor strikers.

We breathe easier because you’re around.

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February 12, 2009, 9:26 am

Grand Rounds Here on February 17th – UPDATED AGAIN!

Grand Rounds is here on February 17th, so send your submissions in –

UPDATE: the contact button up top may be out of commission so if you have sent in a submission, please resend to “kmcallister911 at mac dot com”; that way I will be sure to get it!

UPDATE NUMBER 2: Problem with contact button looks like it is solved (thank you, Shane!).  If I received your submission I have sent you an email.  If you have not received an email from me, please resend your submission.

(It’s always something with me and Grand Rounds!  LOL!  This time the submissions were going to my spam box.  The lesson learned: ALWAYS CHECK YOUR SPAM BOX BEFORE DELETING!)

No theme, and I’m not doing anything that has to do with Presidents or Valentines, so send in any and all topics!

I will say this: “It’s Grand Rounds, what do you think! GOSH!”

I shall say no more!  : D

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February 9, 2009, 9:51 pm

News Flash: Nursing Leaders Care!

Oh, give me a break!

I mean really. It would be a cold day in hell before I’d be helping a doctor put his coat on.

Even if he is Charlton Heston.

Okay, maybe I’d hand it to him.

Ol’ Charlie can’t believe she’s doing it, either.

That’s a mighty fine cap, by the way. Definitely a 10/10 on the Emergiblog Cap Rating Scale!

If I tried to wear my cap right now, it wouldn’t stay on. I got a haircut that makes Drew Carey look like Rapunzel. Epic haircut FAIL.


Grand Rounds is here next Tuesday, February 17th.

No rules, no theme, just send me your best and I’ll mold them into a masterpiece.

It would be very helpful if you would watch the movie “Napoleon Dynamite” before the 17th, if you have not already seen it.


I’m sitting here in a room at the Portola Hotel and Spa at Monterey Bay, blogging.

No, I didn’t come here to be pampered. At least not physically.

I’m here for the annual conference of the Association of California Nurse Leaders, of which I am a proud new member.

Let me just say that if you are feeling burnt and discouraged, you need a meeting.

I feel like my career has been to a spa!


And if you are like I was, you figure that “management” was way out of touch with what the bedside nurse has to deal with, all they cared about is “the bottom line”, and all we are as staff nurses are warm bodies to fill the schedule.


I’ve had the pleasure of meeting nurse leaders/managers from all over the state of California over the last two days, and they are a passionate group of professional nurses.

Yes, I used the term “manager” and “passionate” in the same sentence. Let me add “colleague” to that description.


True nurse leaders are not sitting in ivory towers out of the fray that is nursing practice. They are diving head-first in addressing the problems and the issue affecting patient care.

And folks, they care about the bedside nurse. About us. They are the ones working hard on the research that is a major part of evidence-based practice. Nursing leaders are the ones who are speaking out on political issues that affect our practice every day.

And they care. Passionately. About the bedside nurse and about the patients we care for.

I feel as though my career has gotten sub-q Epi.

I may have found the cure for burn out. Right here in Monterey.

Basically, we are all nurse leaders.


Fun notes:

Meeting Ruth Ann Terry from the California BRN. What a great (and fun) lady!

Seeing the lieutenant governor of California, John Garamendi, speak at the keynote.  I tell ya, that man could have me thinking like a Democrat in two seconds.

The most exciting part for me was finding out that the brand new Betty Irene Moore School of Nursing at UC Davis will begin their Nursing PhD program in Health Policy in September of 2010. Brand new. Ground floor – first class. Guess when I want to start?

And meeting the folks from the UCSF PhD program.

And this was just the first day!

What a ride!

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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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