March, 2009 Archive

March 9, 2009, 7:03 pm

Reflections from ENA: “Stop Counting Crayons, Start Drawing Pictures”

reno2I woke up early this morning, having changed my flight.

With the exception of a few glances out my hotel window, I had been incommunicado with the outside world for four days.

I had packed my sweatshirt, figuring I’d go from the shuttle to the airport to the plane and wouldn’t need it.

The casino was quiet. Not too many people up and about at 0630 on a Monday morning.

I checked out, headed for the revolving door and this is what awaited me outside!

A pristine blanket of snow, soft flurries falling sideways and dead silence.


I stood outside for as long as I could stand it and let myself get snowed on.



The title of this post comes from a story told by this man, Mark Scharenbroich.

Mark gave the keynote speech at the ENA Leadership Conference.

You can hear the original story right here on Mark’s site  I suggest you listen because it’s hilarious.

And profound.

My take on it is a little different than what Mark spoke of in his keynote. But not much.

Oh, and hey, Mark?  Nice bike.  Very nice bike.


My attendance at the ENA Leadership Conference confirmed one thing.

No way in hell am I cut out to be a manager.

Never. Nada. Not gonna do it. Don’t wanna do it. Never have wanted to do it. Never will want to do it. Don’t have the personality for it. Don’t have the stomach for it.

And I sure as heck don’t have the skills for it.

But thank goodness for the nurses who do.


As far as my managers go, I haven’t always been the easiest staff nurse to deal with. What? You thought I was the perfect nurse?

Well, you just keep on thinking that!

The reality of it is that sometimes my attitude really sucks.

It may come as a shock (not), but I gripe. A lot. Not necessarily to my manager, but being rather, um, verbal, the whole world knows exactly how I feel when I feel it and why I’m feeling it.

And griping begets griping. Before you know it, I’m ten times more ticked off than when I started, my blood pressure is sky high, I’m ready to quit (again) at 0700 and my co-workers are aren’t exactly uplifted.  Sometimes we feed off each other and have a regular group gripe session that lasts throughout the night.

On those shifts you would think we work in the depths of hell.


The truth is I don’t work in the depths of hell.

Here is where the crayons come in.

My department is like a very nice, brand new box of 8 Crayola crayons and at times it seems all I do is gripe that it doesn’t contain Cyan, Burnt Sienna, Magenta or Periwinkle.

If I stopped bemoaning what we don’t have and appreciated the primary colors we are able to provide, I’d be a lot less frustrated and my patients a lot more happy.

(And my co-workers very relieved!)

You can buck the system without getting anywhere or you can work within the system to accomplish what you want to accomplish.

It’s time to stop counting crayons and start drawing the best pictures I can with the colors at my disposal.

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March 7, 2009, 9:06 pm

Standing On Top of the World With ENA President Bill Briggs

billThe man never sleeps.

He says he does; I don’t believe it.

Meet William (Bill) Briggs,RN,MSN,CEN,FAEN, the current President of the Emergency Nurses Association.

Oh, he is also the Trauma Program Manager at Tufts University (Boston).

And he is a per diem staff nurse at Lowell General Hospital.

And he is a member of the Metro Boston Critical Incident Stress Management Team.

And he teaches TNCC and ENPC.

Geeze! I gripe when I have to work an extra four hours……


Bill was kind enough to sit down with me at the end of a busy Saturday and talk a bit about himself and about emergency nursing.

I had a blast.


Some people are born to be emergency nurses.  Bill was destined for the emergency department.  He wanted to be an EMT so badly that he took classes when he was seventeen so he could jump into the role on his 18th birthday.

He graduated from nursing school ready to hit the code room running!

Unfortunately, back in the late 70’s, you just about had to wait for someone to die before there would be an opening in ER.  Bill filled his time with gaining experience in med/surg and critical care, detouring to Saudi Arabia where he wound up managing the ER in a brand new, state-of-the-art hospital!

Bill’s been involved with ENA for so long it wasn’t even ENA when he joined, it was the “Emergency Department Nurses Association”.

Circa 1978.

Now he’s the president, and the professional organization for emergency nurses boasts a national roster of 36, 500 members.


There is a standing joke in ENA that if you get up to go to the bathroom during a local meeting, you’ll be appointed state president by the time you come back.

Around 1985, after being back in the states and involved again with his local chapter, Bill “came back from the bathroom” (so-to-speak) as the Massachusetts State TNCC Coordinator.  (Okay, he actually volunteered to do it, but the thought of getting an assignment while you’re in the bathroom was too funny for me to pass up!)


We often think of our managers and leaders as not being “hands on” or not really being involved in patient care.  Bill repeated a theme I heard often this weekend: that as a nurse leader/manager he could affect patient care on a more global scale, having much more influence than he could at the bedside.

But, two times a month, Bill dons the scrubs of a staff nurse and walks the talk in his per diem job at Lowell General, keeping himself connected to the patients and the staff nurse perspective.  “It’s just in me,” he notes.

And by the end of a Sunday PM shift in triage, he is more than ready to shift back into the leadership role!


This year, the ENA put a call out for committee members.  Eighty positions were available.  Over four hundred applications were received. It’s an organization record.

Bill believes that the surge in interest comes because the issues being studied are extremely important to ER nurses everywhere: crowding/boarding (the #1 issue for ER nurses), psychiatric care in the ED and workplace violence, to name just a few.


Emergency nursing requires passion for the work, passion that can become depleted as we get caught up in the day-to-day minutiae of patient care or management obligations, putting us in danger of burn-out.

That’s where the ENA comes in.

By attending local meetings (or national conferences!) and networking with colleagues, we are able to reconnect with that passion.

And Bill Briggs is passionate about emergency nursing.

It’s contagious.  One meeting, and I felt re-energized.  Many, many thanks to Bill for taking the time to sit and talk with me and to Tony Phelps for arranging the interview.

(I still don’t believe he ever sleeps…..)

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March 6, 2009, 9:38 pm

Soarin’ With ENA and Havin’ A Blast!

img_0203Yes, that is a plane onstage!

Is that cool, or what?

This was the opening of the ENA Leadership Confererence this morning at the Grand Sierra here in Reno.

That’s Bill Briggs at the podium.  He’s the President of ENA.  Trust me, he does not look like an alien in person.  It’s the glare of the lights.  Tony, PR dude extraordinaire, is going to get me a better photo.

I get to interview Bill tomorrow.

This was such a great opening to the conference!  I’m sitting there, minding my own business and trying to answer mail via my iPhone.

One. Letter. At. A. Time….

When all of a sudden, blasting out of a sound system I’d kill to have, comes Steve Miller singing “Jet Airliner”.

Well, good morning!  You play Steve Miller, you get my attention!

As the theme for the conference is “Soar!”, the plane is quite apropo!img_0201

Why am I showing food, you ask?

This was my breakfast.


At least until Susan from Shreveport came and joined me!

There goes my diet. Forgive me Richard (Simmons) for I have eaten a scone and counted it as a fruit. My penance? Losing $40 at Caveman Keno. I’m a high-roller….of nickels.

The entire theatre was set for tables of six and this was on every table.

Knowing this is waiting will make it a lot easier for me to get up at 6 am tomorrow, I’ll tell you that!



But I can’t announce it yet.

Forget the poll on the sidebar, it’s old news.

Let’s just say the city I can’t announce has a Nascar Cafe and hosts a race every year.

I am chomping at the bit, ripping at the seams, bursting like a bubble…

And I’m out of metaphors.


Quick note: Change of Shift is up over at the Nurse Practitioner’s Place so head on over and say hi to Jen.

She hosted during what turned out to be a very difficult period. You rock, my friend!

The next edition’s host is…let me check…oh, it’s ME!  LOL!

Get those submissions flying into my mailbox!

Don’t MAKE come out there!  : D



Now back to ENA…

I spent the day indulging my new interest in nursing research and spent a fair amount of time checking out the poster presentations.

This is Gina Harrison, RN, BS, an ER nurse from Inova Loudoun Hospital in Leesburg, Virginia.  Gina was one of the authors of a research study comparing blood specimens drawn by EMS vs. ER staff.

A beautifully presented research study and many congrats out to Gina and her co-researchers because their article has been accepted for publication in the Journal of Emergency Nursing!

I can say I knew it when it was a poster!

Thanks for taking the time to talk with me about research, Gina!


One of the highlights of these conferences it networking with other nurses, and I had a great talk with Steve Stapleton,  a member of the ENA Institute on Emergency Nursing Research.  Steve is thisclose to having his PhD (University of Chicago, Illinois)  and I was able to learn so much from talking to him about his experiences.

So basically, I spent today getting oriented, buying a ton of books, donating to a worthy cause (no, not the slot machines) in the ENA Foundation and feeding my appetite for research.

Tomorrow?  Interviews, sessions, and the Exhibit hall awaits!

Right now.  I’m exhausted from travel and studying.

Yes, I’m the only person I know who comes to Reno, Nevada with textbooks.

Go ahead and say it!  I know you wanna….

It’s true….I am…..a nerd.

But a cool one.

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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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