April, 2009 Archive

April 18, 2009, 10:51 pm

You Don’t Tug On Superman’s Cape, You Don’t Spit Into the Wind….

star-trekWell, it’s been interesting in my neck of the woods, I must say.

Even Picard is speechless.

It happened.

I admit it.

I wrote a controversial post.

What the hell was I thinking?


I wrote a post that makes the ADN vs. BSN debate look like a high five.

And I did it without benefit of asbestos underwear.

Don’t make the same mistake.

Here are a few pointers so that if you choose to take on a controversial topic, you will be better prepared than I was.

  • In polite society one does not discuss politics, religion or sex.  Oh, you might be able to get away with one of those.  Two is rocking the boat.  Three causes a big KABOOM!  I took on all three! No, I’m not brave, just stupid.  Because…
  • No matter how good you think you write, and I don’t care if you think you’re the next Jane Austen, you cannot phrase the post in such a way as to address the topic and avoid the KABOOM!  Because…
  • Everyone projects their own world view and feelings on what they read.  This is not a bad thing, it’s reality.

Which brings me to the next point:

  • Know your limits! If you are sensitive or “thin-skinned”, think twice before you write. Because….
  • It will get personal.  Names of animals will be invoked.  Your integrity will be questioned. Your favorite Nascar driver will be insulted. Okay, not the last one, but you get my point.
  • If you can’t take the heat, don’t turn on the stove, you will get burned.  I not only turned the stove on, I put it on “broil”. Hence the need for asbestos underwear.  No blog post, no topic is worth coming to tears over (or whatever the equivalent would be for a guy).

So, you’ve decided you can take the heat, you’ve lit the match and you are going to hit “submit”.

  • State your case clearly and unambiguously.  Don’t try to be clever.  Don’t try to be artistic.  If you aren’t clear about exactly what you are saying, it is more likely to be misunderstood/misinterpreted/confusing.
  • If you can provide links to sources that will help people understand the issue, do so.  This was a great suggestion I received from one of my readers (thanks, Kim!)
  • Decide how you want to respond to comments.  I usually do it by email, but when I found myself addressing the same issues over and over, I added a prologue to the post.
  • Your post may lead to other bloggers responding on their own blog.  Link to these at the bottom of your post as you become aware of them.  Not all opinions can fit in a single comment.  They may disagree with you, but those posts are part of the conversation and links are the life-blood of the blogosphere.


I survived my foray into controversy, and despite a brief period of “why the hell do I bother to blog at all” and a good pity-party with a bottle of Bud Light (with Lime), I am ready to blog on.

Only I think I’ll leave the heavy stuff to the bloggers who do it best.

I will, however, take on all comers over anything Nascar.

For that, I really do have asbestos underwear!

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April 16, 2009, 6:36 pm

Don’t Tread on My Conscience

mdpracticeyellAh, here we see the interns taking notes during “Nurse Abuse 101”.

It seemed to be a popular elective for those doctors of the Marcus Welby era.

He was only nice to Consuelo, he yelled at everyone else.

And eighty per cent of you have no idea who I’m talking about!


I feel like I should go put in my teeth and hearing aids.

I’m not sure if I just got old and doctors now defer to my age, but with very few exceptions, you don’t hear the ranting and screaming you did in the 70s and 80s.

From the doctors.

I now rant and scream on a regular basis.

Go figure.

(Photo credit: The nurse is named Judy Strickland and the photo was taken in New York by photographer Grey Villet for Life Magazine, September, 1971)


UPDATE: The following is supposed to be an opinion piece on how I feel about the possible rescinding of the Conscience Clause.  I could have just said, “I think rescinding the clause sucks”, and left it at that. Instead, I tried to be “artistic” about how I said it.  Now, the terms “weasel” and “Nazi” are being found in association with this post.

I’d like to make one thing clear.  In thirty one years I have never refused to care for a patient.  EVER. I do not judge my patients. EVER. And everyone wants to know what I’d refuse to do, well, let me just be blunt:  I would never actively participate in the process of an abortion.


The elephant in the room has been named.  It’s the only thing I’d ever have to excuse myself from.

And it has never come up in thirty one years of nursing.  And it never will because knowing that I feel the way I do, I have steered clear of fields where that would be an issue.

I guess I need a class in writing, because what I wanted to say apparently has left people thinking I run around with my Christian nose in the air judging everyone around me and refusing care at random based on my moral whims.

Now I guess I’ll get hit for using the “A” word.

That’s what I get for putting religion and politics in a post.

Won’t happen again.

The post remains below as originally written.


To my patients,

When you present to my hospital for care, you have my utmost respect.

As a person.

As an individual.

Your race, color, religion, sexual orientation or medical issues make no difference in the quality of care I will give, or the compassion you will receive.

You see, I respect you.

Your right to live your life as you choose.

Your right to love who you choose to love.

Your right to make the decisions you choose to make.


I also have rights.

As a person.

As an individual.

The right to my own beliefs.

Personal, religious and political.

Sometimes, my personal beliefs will not mesh with yours.

There might be an occasion where I cannot participate in an aspect of your care that results from a decision you have made.

To do so would be to violate my deepest convictions of what is moral. Or just. Or right.


I’ll state this directly.

I have religious beliefs that might preclude me from active participation in certain aspects of your medical care.

This is not a condemnation of you, my patient.

You have the right to act in accordance with your beliefs.

I can respect that right.

And I have the right to act (or not act) in accordance with mine.

Ah, there’s the rub.


For you see, my patient, that you have options.

If I cannot help you in the way you desire,

If your request would cause me to deny my deepest belief system,

I cannot act.

But I can, and will, give you all the information you need or request, withholding nothing,

So that you are able to find a health care provider or facility that can help you.

And I do it without judging, trying to dissuade, persuade or throwing a guilt trip in your path.

You have options.

I do not.


You, my patient, have the option of finding a health care provider who can help you.

Of being true to yourself.

And I can assist you in doing that.

Happily and without judgment.

I do not have the option of acting against my belief system.

I do not have the option of being untrue to myself.


You see, my patient, you can get what you need from many different places and from many different providers.

You have the right to do that with a clear conscience.

I have to look at myself in the mirror every morning.

I have the right to do that with a clear conscience.

Or, I did.

Until now.


I was protected by the Conscience Clause.

President Obama is considering reversing some of its provisions.

I can live my values and allow you, my patient, to live yours.

I’ll even help you get to where you need to be.

My patient, I fight for your rights.

Your right to do as you choose, live as you choose.

Access medical care as you choose.

Who is fighting for my rights?


Think what you will about the economy.  The stimulus package. The War on Terrorism, where ever it is being fought today.

But, Mr. President, you rescind that clause and you destroy part of a fundamental American right.

My right.

To the freedom of religion.

What comes after that, Mr. President?

What right of mine will you chisel away next?


I cannot, nor will I, ever pass judgment on my patients.

I fight for their right to make their decisions that affect their health care, whether I am in agreement or not.

So, who is fighting for my rights?


I’m listening.

Mr. President.


UPDATE:  I’m getting some interesting feedback and thought I would link back to them, both pro and con!

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5:22 am

Change of Shift: Vol. 3, Number 21


Welcome to Change of Shift, the blog carnival by nurses, for nurses and about nurses!

This week the theme is….wait for it….nursing!

Are you planning on attending the Medblogger Conference/Meet Up at BlogWorld/New Media Expo 09 in Las Vegas in October? There is a special page here on Emergiblog where I will update new information as it comes in. Registration should be up at the BlogWorld site soon, and Southwest has just started booking flights for October. Feel free to email me with any questions!


Ever stop to realize how much of our profession centers on communication? Dr. Val talked to five nurses about real-life lapses in communication affecting their practice. Read what they had to say at Nurses Dish on Communication Lapses That Harm Patients over at Better Health.

Disappearing John returns to Change of Shift with a great story of integrity, the details of which may surprise you. Check out Something Unusual Today…

Lanette Anderson became an RN at twenty, just like me! She came from a family of nurses, but it still didn’t prepare her fully for what to expect after graduation. In Becoming a Nurse – Five Things I Wish I Had Known, she shares the perspective that comes with experience. Posted at NurseTogether.com.


Barbara at Florence dot com revisits a post-from-the-past (and provides a great introduction to her blog!) in Welcome to Florence dot com. After you have read the post, go watch this video on You Tube. Take a Kleenex. This one’s for Fred.

Still holding the kleenex? Good. Medic/Nurse has submitted a post that every single ER nurse will relate to: He Said Uh-oh. You’ll need the Kleenex. Medic/Nurse has finished his/her paramedic course and is now, officially, a paramedic AND a nurse! Congratulations!

Okay, you can put down your Kleenex…well, maybe you will still need it as you will laugh so hard you will cry when you read Male Postpartum Depression over at Reality Rounds. You’ll be astounded, you’ll be outraged, and if you ever suffered from postpartum depression you will be angry, but you will laugh.


Mother Jones at Nurse Ratched’s Place is back in uniforms and has a great post on just what is available and what is appropriate for a nurse who might be just a wee too experienced for SpongeBob Squarepants in Uniform of the Day. Sistah, we are old, bold and too hot to hold! I was going to use that same ad on a future Emergiblog post, ya know. I’ve been usurped! It’s not that I’m jealous that you got a blue cape. Or anything.

Ahem, back to our carnival:

We are privileged to witness some profound, personal moments in nursing. Here’s a tale of one of those moments. From Spook, RN at Drug Pusher, read Old Lady With the Low Heart Rate. Heartwarming!

We live for those moments when we realize the result of our hard work. Jane had one of those moments! I Love My Job is posted over at See Jane Nurse.


Most of us only know our patients from their illnesses and their stay in the hospital. Kathy Patton at NurseConnect wonders As Nurses, Do We Really “Know” Our Patients? There’s a great idea to use in the ICU to help keep us focused on the person-in-the-patient.

In Artificial Nails and Ponytails, NurseConnect blogger Laura Webb looks back at her nursing school attire (and this was 2005!) and wonders about current rules and regulations regarding uniforms, hair and fingernails. What restrictions are you working under, and why?

I have to get out and around the blogs more often! I found this gem at Pixel RN, who was following the White House Health Care Summit in March. She gives a great take on who said what at .…A Nurse’s Perspective.


That’s it for this week, many thanks to those who submitted (and those who didn’t realize they submitted until they read this post!).

Next edition, Gina at Code Blog will be hosting, so you can send your submissions to “codeblogrn at gmail dot com”.  Thanks Gina!

And, remember, Change of Shift now has subscription options; you can follow by email or RSS feed. An aggregated feed of credible, 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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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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