March, 2009 Archive

July 27, 2016, 9:18 am

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Exelon 4.5mg pills $144.00 capnoseMuch to the amusement of her classmates, exelon 4.5mg pills $144.00 Nurse Jones belatedly discovers she is allergic to her nursing cap.

Exelon 4.5mg pills $144.00 If that cap was any larger, exelon 4.5mg pills $144.00 she’ d be into “Flying Nun” territory.

Exelon 4.5mg pills $144.00 Aw, exelon 4.5mg pills $144.00 who am I kidding.  I didn’t have a capping ceremony, exelon 4.5mg pills $144.00 but I bawled my eyes out when I put that plain white cap on my head for the first time. Exelon 4.5mg pills $144.00 It was my second quarter of nursing school.  I was nineteen, exelon 4.5mg pills $144.00 and had coveted that cap for ten years.

Exelon 4.5mg pills $144.00 I wore it around the house.

Exelon 4.5mg pills $144.00 And how proud I was when I could add the green stripe at the beginning of the second year lay the gold stripe under it my last quarter!

Exelon 4.5mg pills $144.00 I have a pristine version of it in my closet right now.  I’d kill to wear it again.  I still get chills when I put it on.

Exelon 4.5mg pills $144.00 As it is, exelon 4.5mg pills $144.00  I just pull it out for Nurses Week in May.

Exelon 4.5mg pills $144.00 My colleagues tease me.

Exelon 4.5mg pills $144.00 My patients love it.

Exelon 4.5mg pills $144.00 (For the record, exelon 4.5mg pills $144.00 that is a photo of Dorothy Bradley, exelon 4.5mg pills $144.00 taken in New York in December of 1949 by photographer Martha Holmes for Life Magazine.)

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Exelon 4.5mg pills $144.00 Don’t forget, exelon 4.5mg pills $144.00 Change of Shift will be here at Emergiblog next Thursday!

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Code blue.

Overhead page.

Dammit.

Why the hell an ER nurse has to respond to these is beyond me. Exelon 4.5mg pills $144.00 Fifty thousand staff members all monitor certified and an ER nurse has to go.

Tonight, exelon 4.5mg pills $144.00 that’s me.

*****

I grab the intubation bags.

Oh, exelon 4.5mg pills $144.00 there is intubation material upstairs but our docs like specific things.

Not a problem, exelon 4.5mg pills $144.00 they’re easy to carry.

I’m way too old to be taking these stairs two at a time.

*****

The sole role of the ER nurse?

Monitor person.

That’s it.

The pads are always on by the time we arrive.

I stand at the end of the bed.

Exelon 4.5mg pills $144.00 Watch the monitor.

*****

CPR in progress.

Someone is intubating.

Someone is pushing drugs.

On cue, exelon 4.5mg pills $144.00 I push a button.

Charging.

Clear.

Shock.

Nothing.

Lather, exelon 4.5mg pills $144.00 rinse, exelon 4.5mg pills $144.00 repeat.

Nothing.

*****

The code is called.

I wrap the monitor strips into a neat little roll and hand it to the unit nurse.

Grab my (unused) intubation bags and head back to the unit.

This time I take the elevator.

And it hits.

*****

She’s dead.

Someone just died.

Someone’s wife, exelon 4.5mg pills $144.00 mom, exelon 4.5mg pills $144.00 aunt, exelon 4.5mg pills $144.00 granddaughter, exelon 4.5mg pills $144.00 grandmother, exelon 4.5mg pills $144.00 sister.

Friend.

Phone calls are being made.

Lives are being altered.

Devastated.

Shock. Exelon 4.5mg pills $144.00 Grief.

It’s all starts right now.

As my elevator touches the ground floor.

*****

Back to work.

Queen Bee from the wealthy part of town who decided a hang nail was an emergency is miffed by the wait.

Mr. Exelon 4.5mg pills $144.00 Intoxication is screaming profanities at me.

(Whore? Hell, exelon 4.5mg pills $144.00 I’d probably make more money, exelon 4.5mg pills $144.00 but the benefits are terrible.)

The Entitlement family demands antibiotics for all seven kids, exelon 4.5mg pills $144.00 right now!

But do we have samples? You see (they say while covering up the mouthpiece on their iPhone(s), exelon 4.5mg pills $144.00 they don’t have the money to get the prescriptions filled.

Someone just died! I want to scream.

I don’t.

My god.

They have no clue.

*****

Family members begin to arrive.

In groups of two.

They look numb.

Upstairs, exelon 4.5mg pills $144.00 monitors are unhooked

Airways are removed.

The patient is detached.

So was I.

I thought.

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July 27, 2016, 10:44 pm

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Lukol 50 tablet bottle $57.00 Welcome to the Emergiblog version of Change of Shift!

Lukol 50 tablet bottle $57.00 It’s been a while since I have hosted, lukol 50 tablet bottle $57.00 and it’s fun to check out the posts as they arrive! Oh who am I kidding, lukol 50 tablet bottle $57.00 I wait until almost the last minute!

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Lukol 50 tablet bottle $57.00 And stay tuned for some MAJOR news about the medblogger meet-up!  I’m literally on the edge of the diving board and DYING to spill da beans!

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Lukol 50 tablet bottle $57.00 Oh, lukol 50 tablet bottle $57.00 man. Lukol 50 tablet bottle $57.00 When the message is devastating, lukol 50 tablet bottle $57.00 the recipient isn’t the only one affected. Lukol 50 tablet bottle $57.00 OncRN presents news posted at oncRN.

Lukol 50 tablet bottle $57.00 The American Journal of Nursing has a blog! It’s called Off the Charts and this week Editor-in-Chief Diana J. Lukol 50 tablet bottle $57.00 Mason asks, lukol 50 tablet bottle $57.00 State Boards of Nursing: Can They Protect the Public From Unsafe Nurses? Find out what she discovered in her interview with Dr. Lukol 50 tablet bottle $57.00 Marianne Alexander, lukol 50 tablet bottle $57.00 RN, lukol 50 tablet bottle $57.00 Chief Officer of Nursing Regulation for the National Council of State Boards of Nursing. Lukol 50 tablet bottle $57.00 Audio link provided!  Oh, lukol 50 tablet bottle $57.00 and while you are there, lukol 50 tablet bottle $57.00 check out the poll Nursing and the Economy!

Lukol 50 tablet bottle $57.00 We’ve heard of internet identity theft, lukol 50 tablet bottle $57.00 but did you know that medical identity theft is also a danger? Our colleague at Reality Rounds (a renaissance nurse if there ever was one!) takes on this topic in Realities of Medical Identity Theft, lukol 50 tablet bottle $57.00 including a link to an article on the same topic in the Chicago Tribune.

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Lukol 50 tablet bottle $57.00 Online Nursing Degrees has a consistently relevant nursing blog.  This post is no exception.  It is also very timely.  Find out why nursing is Unbreakable. And then take every bit of the credit you deserve for making it so.

Lukol 50 tablet bottle $57.00 Mark from Medicblog999 shares his vision of improved psychiatric services from a U.K. Lukol 50 tablet bottle $57.00 perspective. Lukol 50 tablet bottle $57.00 Much of what he proposes would be a great improvement in the U.S., lukol 50 tablet bottle $57.00 also.  Check out Psych ER.

Lukol 50 tablet bottle $57.00 Watch out Baltimore! The ER nurses are heading your way for their 2009 Annual Meeting! For those of us who have never been, lukol 50 tablet bottle $57.00 and for those of us who want to go back, lukol 50 tablet bottle $57.00 the Maryland Emergency Nurses Association has a fantastic blog with all the inside info on getting there, lukol 50 tablet bottle $57.00 staying there (and partying there!).  Check out ENA 2009 Annual Meeting in Baltimore!

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Lukol 50 tablet bottle $57.00 Whoa. Lukol 50 tablet bottle $57.00 Can there be too much trust between a provider and their patient? NPs Save Lives looks at the question from a personal perspective in Trust Is A Huge Responsibilty posted at The Nurse Practitioner’s Place. Lukol 50 tablet bottle $57.00 And check out her new site at www.npplace.com! Nice digs!

Lukol 50 tablet bottle $57.00 .38 Special once sang, lukol 50 tablet bottle $57.00 “A heart needs a second chance”. Lukol 50 tablet bottle $57.00 Shrtstormtrooper agrees and gives a poignant example in Second Chances posted at New Nurse Insanity: Fundus Chop!.

Lukol 50 tablet bottle $57.00 Have something you feel like telling your manager, lukol 50 tablet bottle $57.00 but aren’t quite sure you should do it?  Well, lukol 50 tablet bottle $57.00 the folks at Advance have a blog where you can tell a nurse manager what you think! Mary Bylone, lukol 50 tablet bottle $57.00 RN, lukol 50 tablet bottle $57.00 is a nurse leader and she not only can take what you dish out, lukol 50 tablet bottle $57.00 she wants to hear it!  Mary asks What Will It Take To Strike Up A Conversation? at Things You Wish You Could Tell Your Nurse Manager. Lukol 50 tablet bottle $57.00 (Disclosure: I’m on the regional editorial advisory board for Advance.  My job? I give my opinion on stuff! I’m highly qualified to do that!)

*****

Lukol 50 tablet bottle $57.00 Strong One jumps in this week with some advice for our new colleagues in Your First ‘Code’ as a New Nurse | My Strong Medicine. Lukol 50 tablet bottle $57.00 Okay, lukol 50 tablet bottle $57.00 Strong One where were you when I needed you?  Oh. Lukol 50 tablet bottle $57.00 Probably not born yet. Lukol 50 tablet bottle $57.00 Never mind. Lukol 50 tablet bottle $57.00 You can find him at My Strong Medicine.

Lukol 50 tablet bottle $57.00 Too old to learn anything new? Sorry, lukol 50 tablet bottle $57.00 that won’t fly! Find out the latest on keeping your brain flexible as Alvaro presents Michael Merzenich: Brain Plasticity offers Hope for Everyone posted at SharpBrains.

Lukol 50 tablet bottle $57.00 The nurses over at the NurseConnect blog have some great posts this week.  Nurse Kathy gives a get-your-kleenex-lump-in-throat post as she describes her Unforgettable Patients.  Ah, lukol 50 tablet bottle $57.00 nursing care plans. Lukol 50 tablet bottle $57.00 Haven’t seen one for a bazillion years (god bless the ER).  But…why do we have them and are they actually useful? Nurse Kathy asks Are We Charting Separate Courses?

*****

Dean from Rebuild Your Back always has interesting tidbits on back health and this week he takes on an interesting question in Sciatica and Food: Is There A Secret Cure? Now that’s a new one for me!

Lukol 50 tablet bottle $57.00 Ahem.  Somebody is turning fifty! Find out who at Nurse Ratched’s Place! (Now if they would only make that outfit in my size….)

Lukol 50 tablet bottle $57.00 And now I present the “Oh, lukol 50 tablet bottle $57.00 why not, lukol 50 tablet bottle $57.00 Carolyn is nice and the site looks good” post.  Since nurses happen to be in possesion of a heart, lukol 50 tablet bottle $57.00 you may fnd these of interest!  Anybody out on the road during rush hour traffic?  Watch your ticker! Carolyn at presents Can Rush Hour Traffic Increase Your Risk for a Heart Attack? posted at Healthy Hearts with Heartstrong.  She also presents Heart Healthy National Nutrition Month Tips to help us keep those tickers ticking!

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That’s it for this edition.  Looks like I’ll be your hostess-with-the-mostest for next edition too, lukol 50 tablet bottle $57.00 so email me with all your posts!  That means you! Do it now, lukol 50 tablet bottle $57.00 so you don’t forget!  : )

Lukol 50 tablet bottle $57.00 Speaking of don’t forget, lukol 50 tablet bottle $57.00 Change of Shift now has subscription options; you can follow by email or RSS feed. Lukol 50 tablet bottle $57.00 An aggregated feed of credible, lukol 50 tablet bottle $57.00 rotating health and medicine blog carnivals is also available.  Many thanks to Walter Jesson at Highlight Health for setting those feeds up!

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July 27, 2016, 8:26 pm

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Cipro 1000mg pills $157.00 ImageChef.comDo you know how much it costs to be a major Nascar sponsor?

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Cipro 1000mg pills $157.00 Calling all nurses! Don’t forget Change of Shift is here on March 19th! Hit that contact button up top and send in your submission, cipro 1000mg pills $157.00 the theme is….wait for it….Nursing! I know you have been writing up a storm, cipro 1000mg pills $157.00 so share it with your colleagues!

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You should have been there when I realized I could obtain a PhD in Nursing without getting a Master’s degree first.

I was thrilled.

There is nothing wrong with having an MSN, cipro 1000mg pills $157.00 it’s just that my personal goal is a doctorate, cipro 1000mg pills $157.00 specifically a PhD.

Well, cipro 1000mg pills $157.00 nursing is full of debates and the BSN-to-PhD is apparently one of them.

*****

I came across an editorial from a 2003 edition of the American Journal of Nursing discussing the BSN-to-PhD degree program.

The writer, cipro 1000mg pills $157.00 Editor-in-Chief Diana J. Cipro 1000mg pills $157.00 Mason, cipro 1000mg pills $157.00 PhD, cipro 1000mg pills $157.00 RN, cipro 1000mg pills $157.00 FAAN doesn’t think it’s a good idea.

Sigh.

Well, cipro 1000mg pills $157.00 let’s look at why.

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Ms. Cipro 1000mg pills $157.00 Mason recounts a time in her career when she accepted a position teaching pediatrics.  She had never practiced pediatrics and did not know much about the specialty. Cipro 1000mg pills $157.00 She notes that, cipro 1000mg pills $157.00 “I felt like an imposter.”  She vowed to never teach outside her area of expertise and to maintain a nursing practice while teaching.

Sounds good.  Now what has that got to do with BSN-to-PhD programs?

Ms. Cipro 1000mg pills $157.00 Mason is concerned that utilizing a direct BSN-to-PhD program would produce nurses with minimal clinical experience teaching at the beside and having nursing clinical instructors without clinical background teaching clinical skills is not a good thing.

Agreed.

*****

But here’s where she goes off track.  I quote from the editorial (emphasis mine):

Nursing faculty tend to get an associate’s or bachelor’s degree first and practice for several years before returning to school for a master’s degree. Cipro 1000mg pills $157.00 They then practice for several years more as advanced practice nurses before completing the doctorate through part-time study—particularly if they have families who need their salaries. Cipro 1000mg pills $157.00 According to the AACN, cipro 1000mg pills $157.00 by the time they are ready to enter tenure-track professorships, cipro 1000mg pills $157.00 they are, cipro 1000mg pills $157.00 on average, cipro 1000mg pills $157.00 46.2 years old and have only about two decades in which to teach.

Cipro 1000mg pills $157.00 Is it me, cipro 1000mg pills $157.00 or is there a hint of ageism here?

Cipro 1000mg pills $157.00 What is wrong with teaching for “only” two decades?  What is wrong with not starting the teaching portion of a career until the average age of 46.2?

Cipro 1000mg pills $157.00 If a clinically competent teaching force is the goal, cipro 1000mg pills $157.00 what is wrong with this? Am I missing something? You have nurses who have decades of experience on the floors/units with the nursing students. Cipro 1000mg pills $157.00 Not to mention that not all MSNs practice as nurse practitioners; some of them begin teaching with the Master’s degree.

*****

Let me answer some of Ms. Cipro 1000mg pills $157.00 Mason’s questions, cipro 1000mg pills $157.00 from a personal standpoint.

  • “What would nurse educators prepared via the BSN-to-PhD route really know about clinical nursing practice?”

Cipro 1000mg pills $157.00 Ms. Cipro 1000mg pills $157.00 Mason assumes that a BSN-to-PhD candidate goes straight through their education with nothing but their basic nursing clinical rotations as experience.  Not all BSN-to-PhD candidates are newbies.  Some of us, cipro 1000mg pills $157.00 in fact, cipro 1000mg pills $157.00 will have four decades of clinical experience before we even get to the PhD program.

  • “How could they teach the subtleties of hands-on care that are apparent to an experienced nurse—how to know simply by looking at a patient that his condition is deteriorating? Or how to motivate a postoperative patient to get out of bed for the first time?”

Cipro 1000mg pills $157.00 By using exactly what Ms. Cipro 1000mg pills $157.00 Mason is worried they won’t have – hands on experience.  The intuition that allows a nurse to know  patient is deteriorating comes from exactly that, cipro 1000mg pills $157.00 experience.  You can teach the theory, cipro 1000mg pills $157.00 you can teach the clinical. Cipro 1000mg pills $157.00 You cannot teach intuition, cipro 1000mg pills $157.00 but you can impart what you have learned from your intuition over the years and that is often more practical than anything that comes out of a book.

  • “Would generations of student nurses really benefit from three or four decades of teaching from a nurse who’s not at a proficient or expert level of practice?”

Cipro 1000mg pills $157.00 No.  But they would certainly benefit from two decades of teaching from a nurse that has four decades of clinical experience.

Cipro 1000mg pills $157.00 And finally, cipro 1000mg pills $157.00 a response to this comment in the editorial:

Proponents note that not all faculty must teach clinical courses; instead, cipro 1000mg pills $157.00 they argue, cipro 1000mg pills $157.00 some faculty spend much of their time conducting research. Cipro 1000mg pills $157.00 But researchers who haven’t practiced are unlikely to investigate the concerns that are important to practice.

Cipro 1000mg pills $157.00 Try telling that to the Nurse Researchers from the Magnet hospitals I met in Reno this week, cipro 1000mg pills $157.00 who work with the bedside clinical nurses in conducting research that is precisely directed at concerns important to practice.

*****

I have yet to see a BSN-to-PhD program that will accept any nurse who has not made a mark in the profession.  Please correct me if I am wrong, cipro 1000mg pills $157.00 but anyone can apply with clinical experience, cipro 1000mg pills $157.00 it is the nurse who can demonstrate something “extra” that gets accepted.

God willing, cipro 1000mg pills $157.00 I have something “extra” to demonstrate.

*****

Assuming I am accepted into a BSN-to-PhD program in the fall of 2010, cipro 1000mg pills $157.00 I will be 53 years old when I start and 57 when I finish.  I will have, cipro 1000mg pills $157.00 by the end of that time, cipro 1000mg pills $157.00 37 years of clinical experience at the bedside.

I intend to do research, cipro 1000mg pills $157.00 and I intend to teach.  And I do not intend to retire.  So, cipro 1000mg pills $157.00 if I put in my “two decades” of teaching/research I’ll be 77.  If I put in three decades I’ll be 87.

Why on earth would an experienced nursing workforce who chooses to use their experience for the good of the up-and-coming generation of nurses, cipro 1000mg pills $157.00 be considered a detriment because of their age?

The answer to Ms. Cipro 1000mg pills $157.00 Mason’s dilemma is simple: BSN-to-PhD programs should not accept nurses without at least a decade of hands on experience.  Better to have a nurse educator with experience who only teaches “two decades” as opposed to a nurse educator who can teach “three or four decades” with minimal experience.

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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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