July, 2009 Archive

July 23, 2016, 7:35 pm

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Kerlone 50mg pills $1,064.00 menopauseI’m sure some women have issues during menopause, kerlone 50mg pills $1,064.00 but Benzedrine?

Kerlone 50mg pills $1,064.00 Apathy? Psychomotor retardation?

Kerlone 50mg pills $1,064.00 Sounds like me after four night shifts in a row.

Kerlone 50mg pills $1,064.00 And I thought all I’d have to worry about are hot flashes…or in the current PC vernacular, kerlone 50mg pills $1,064.00 power surges.

Kerlone 50mg pills $1,064.00 Puberty isn’t treated like a disease, kerlone 50mg pills $1,064.00 but apparently menopause was looked upon as a psychosis! Was it ever listed in the DSM?

Kerlone 50mg pills $1,064.00 Were all the women of the 1950s hyped up on bennies?

Kerlone 50mg pills $1,064.00 OMG – read the fine print – they actually talk about using Benzedrine with electric shock therapy.

Kerlone 50mg pills $1,064.00 Whoa.

Kerlone 50mg pills $1,064.00 We most certainly have come a long way, kerlone 50mg pills $1,064.00 baby!


Sometimes I think I’m my own worst enemy.

I feel guilty for being angry at a patient’s behavior, kerlone 50mg pills $1,064.00 shocked by an intensity of rage that is way out of proportion to what they have done.

After all, kerlone 50mg pills $1,064.00 it isn’t personal; their behavior is a component of their disease.

Or so I tell myself one month (and one post) after the fact.


I feel guilty for tearing up as a patient miscarries.

A week later she would have been far enough along to go to L&D.

The sadness stays with me the entire shift and I cry as I turn out of the parking lot that morning.

I kick myself for not being able to detach; am I not a professional?


I feel guilty for being on edge with co-workers.

Who are only being themselves, kerlone 50mg pills $1,064.00 but my perception is that of  too much, kerlone 50mg pills $1,064.00 too loud and too intrusive.

God only knows how I am coming across to them.


When did I become a walking raw nerve?

This isn’t burnout.

When you are burnt out you are apathetic.

Kerlone 50mg pills $1,064.00 I’m almost the opposite of apathetic; everything is very, kerlone 50mg pills $1,064.00 very acute.

Kerlone 50mg pills $1,064.00 All I know is that this isn’t me.

Kerlone 50mg pills $1,064.00 And I don’t like it.


And I feel guilty for feeling this way.

Why is it so easy to cut other people some slack, kerlone 50mg pills $1,064.00

And virtually impossible to do the same for myself?

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July 23, 2016, 11:30 am

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Deltasone 40mg pills $97.00 didnothearcallDoctor Ratched: “Nurse! I’m appalled! This woman has waited five minutes for her ice chips!”

Deltasone 40mg pills $97.00 Nurse: “Oh my, deltasone 40mg pills $97.00 how could I be so irresponsible! I should have predicted her dry tongue, deltasone 40mg pills $97.00 left my seizing pediatric patient and run to meet her need for moisture!”

Deltasone 40mg pills $97.00 Doctor Ratched: “Well there goes our Press-Ganey scores for the entire month. Deltasone 40mg pills $97.00 I hope you are satisfied, deltasone 40mg pills $97.00 Nurse!”

Deltasone 40mg pills $97.00 Nurse: “I’m so ashamed!”

Deltasone 40mg pills $97.00 Not.

Deltasone 40mg pills $97.00 But hey! Don’t let this happen to you!

Deltasone 40mg pills $97.00 With the Edwards Nurses Call System you know when a patient needs ice chips!

Deltasone 40mg pills $97.00 And look….one hand!

Deltasone 40mg pills $97.00 What will they think of next…answering call lights through a speaker in the wall?


Last call for submissions for this week’s Change of Shift to be hosted at Nurse in Australia. Deltasone 40mg pills $97.00 Ross is awaiting your submissions at “admin at nurseinaustralia dot com”.

Shhhh! Something is afoot over at Doc Gurley’s blog where Grand Rounds is surrounded by mystery, deltasone 40mg pills $97.00 intrigue, deltasone 40mg pills $97.00 foggy London nights, deltasone 40mg pills $97.00 Peter Lorre running through the posts…..okay, deltasone 40mg pills $97.00 not that last one, deltasone 40mg pills $97.00 but if you are up for a good suspense-filled read, deltasone 40mg pills $97.00 this is where you need to be!


You showed up to the ER.

You presented your case.

Deltasone 40mg pills $97.00 You got your narcs.

Deltasone 40mg pills $97.00 Good ones, deltasone 40mg pills $97.00 too. Deltasone 40mg pills $97.00 Nice, deltasone 40mg pills $97.00 big, deltasone 40mg pills $97.00 fat dosage for the 50/10 pain you calmly reported.

I served it up with a smile next to a side of compassion.

After all, deltasone 40mg pills $97.00 pain is what you say it is and we are there to meet your needs.

Patient satisfaction – we are all over it!


Wait a minute……


You don’t have someone who can come and pick you up?  How did you get here? Oh, deltasone 40mg pills $97.00 your Aunt dropped you off? Why don’t you….oh, deltasone 40mg pills $97.00 she doesn’t carry a cell phone? Huh. Deltasone 40mg pills $97.00 That does pose a problem!

No, deltasone 40mg pills $97.00 I’m sorry, deltasone 40mg pills $97.00 I can’t have you walking out of here in the dead of night to the bus station after an injection of that magnitude. Deltasone 40mg pills $97.00 It isn’t safe. Deltasone 40mg pills $97.00 Why, deltasone 40mg pills $97.00 look! Your sister’s number is right on the chart and she lives right here in this area! Oh…she isn’t picking up the phone at this hour?

Let me go try and see if I can get through for you.

(How odd, deltasone 40mg pills $97.00 as I am walking to the nursing station to make that call, deltasone 40mg pills $97.00 I hear the dialing of the room phone and I hear you say something in a very low voice. Deltasone 40mg pills $97.00 I walk back in to see if you had reached someone. Deltasone 40mg pills $97.00 No, deltasone 40mg pills $97.00 no, deltasone 40mg pills $97.00 no one is picking up at Auntie’s place. Deltasone 40mg pills $97.00 It just rings and rings, deltasone 40mg pills $97.00 you say.)

Funny, deltasone 40mg pills $97.00 when I try the number it’s a solid busy signal. Deltasone 40mg pills $97.00 For ten minutes. Deltasone 40mg pills $97.00 At three am.


Gosh, deltasone 40mg pills $97.00 I’m really confused!

You see, deltasone 40mg pills $97.00 the ER security tape shows you walking up to the ER alone all the way from the street! Ah, deltasone 40mg pills $97.00 I see that you reply with a shoulder shrug. Deltasone 40mg pills $97.00 Interesting. Deltasone 40mg pills $97.00 I’m sorry, deltasone 40mg pills $97.00 we don’t have taxi vouchers in the ER. Deltasone 40mg pills $97.00 Oh, deltasone 40mg pills $97.00 you have money at your Aunt’s house? Uncle George will have it, deltasone 40mg pills $97.00 you are sure of it? And you want us to call a taxi for you? Well, deltasone 40mg pills $97.00 that’s fine then!

Happy to make that call for you!


Wow – never stiff a taxi driver who has traveled thirty miles to pick you up.  Jumping out of the taxi as they round the building really makes them mad!  And they want us to know that you said you had no intention of paying anything and that you had your car down on the street.

Holy cow! That means you will be driving under the influence of a narcotic! We try to find you, deltasone 40mg pills $97.00 after all, deltasone 40mg pills $97.00 your safety is our responsibility! You made it off the premises so fast you were long gone before we made it to the end of the driveway!


That’s it.

No more.

I can’t play anymore.

Deltasone 40mg pills $97.00 I am nothing but a legal pusher of narcotics to addicts who know we know that they know we know….it never ends.

Deltasone 40mg pills $97.00 Emergency departments hand it out like candy. Deltasone 40mg pills $97.00 We invite this behavior. Deltasone 40mg pills $97.00 We abet this behavior. Deltasone 40mg pills $97.00 We will give you what you want, deltasone 40mg pills $97.00 when you want it and how you want it even when we know it is bogus!

Deltasone 40mg pills $97.00 Why? Because it gets the addict out of the department faster? It’s less hassle to give them what they want? No one wants to confront and say “sorry, deltasone 40mg pills $97.00 but this behavior looks like drug seeking to us”?

Deltasone 40mg pills $97.00 It does no good to confront after the fact. Deltasone 40mg pills $97.00 The narcotic is given, deltasone 40mg pills $97.00 the fix is in, deltasone 40mg pills $97.00 yadda, deltasone 40mg pills $97.00 yadda, deltasone 40mg pills $97.00 yadda. Deltasone 40mg pills $97.00 They scored again.

Deltasone 40mg pills $97.00 And they will be back, deltasone 40mg pills $97.00 believe it or not. Deltasone 40mg pills $97.00 Even when we confront them with previous alterations in prescriptions, deltasone 40mg pills $97.00 tell them we have personally witnessed them driving away in their vehicles, deltasone 40mg pills $97.00 let them know that taxi drivers will rat them out every time…it makes no difference. Deltasone 40mg pills $97.00 And soon it is known all around the area that if you want it, deltasone 40mg pills $97.00 you will get it at Hospital Hotel.

Deltasone 40mg pills $97.00 And before I’m accused of being elitist, deltasone 40mg pills $97.00 not knowing the “true face” of addiction, deltasone 40mg pills $97.00 having no compassion, deltasone 40mg pills $97.00 riding my high horse or being a bitch, deltasone 40mg pills $97.00 let me assure you that addicts come in all shapes, deltasone 40mg pills $97.00 sizes, deltasone 40mg pills $97.00 colors, deltasone 40mg pills $97.00 genders, deltasone 40mg pills $97.00 occupations, deltasone 40mg pills $97.00 income levels, deltasone 40mg pills $97.00 hair colors and ages.  None of that matters. Deltasone 40mg pills $97.00 They will lie, deltasone 40mg pills $97.00 manipulate and ingratiate to get what they want.

Deltasone 40mg pills $97.00 So, deltasone 40mg pills $97.00 please tell me.

Deltasone 40mg pills $97.00 When will somebody grow a pair and stop this insanity?


Narcotics in the ER is a hot topic that always engenders a hot debate. Deltasone 40mg pills $97.00 I have to give a hat tip to girlvet at Madness: Tales of an Emergency Room Nurse for the idea for this post.

Speaking of hot debates, deltasone 40mg pills $97.00 please keep your comments passionate but polite. Deltasone 40mg pills $97.00 Thanks.

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July 23, 2016, 10:01 am

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Claritin 10mg pills $118.00 RyanPodiumThis is Congressman Paul Ryan of Wisconsin, claritin 10mg pills $118.00 speaking at the Better Health “Putting Patients First” event  in D.C.

Claritin 10mg pills $118.00 I should talk about how passionately he spoke about health care reform (he did), claritin 10mg pills $118.00 about why he does not believe government should be running health care (he doesn’t) or that he took the time to come and speak at 8 am even though he had been up until 2 am working on the health care bill (he did) or that he spoke right up until he – literally- had to run back to the House to vote (he did).

Claritin 10mg pills $118.00 And I will talk about these things.

Claritin 10mg pills $118.00 But first, claritin 10mg pills $118.00 let me state the obvious and get it out of the way so that I can go on to discuss the serious nature of the health care reform debate before us.

Claritin 10mg pills $118.00 Whoa.

Claritin 10mg pills $118.00 Seriously, claritin 10mg pills $118.00 is it just me or are politicians getting better looking?

Claritin 10mg pills $118.00 There. Claritin 10mg pills $118.00 Now I can move on to the meat of the matter.

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This event marked my first time in Washington, claritin 10mg pills $118.00 and just being there is awe-inspiring. Claritin 10mg pills $118.00 Seeing the White House from the car window took my breath away, claritin 10mg pills $118.00 literally. Claritin 10mg pills $118.00 I felt like Ellie May Clampett marveling at the ce-ment pond.  The National Press Club is a museum in and of itself.  Mother Jones and I were hoping we’d catch a glimpse of Sanjay Gupta, claritin 10mg pills $118.00 but he must have been off doing neurosurgery or something.


By now, claritin 10mg pills $118.00 you’ve probably read who was on the panel (Dr. Claritin 10mg pills $118.00 Wes, claritin 10mg pills $118.00 DrRich, claritin 10mg pills $118.00 Dr.Rob, claritin 10mg pills $118.00 Dr.Kevin, claritin 10mg pills $118.00 me, claritin 10mg pills $118.00 and Better Health contributors Dr. Claritin 10mg pills $118.00 Alan Dappen, claritin 10mg pills $118.00 Valerie Tinley, claritin 10mg pills $118.00 NP and “token” – his words, claritin 10mg pills $118.00 LOL – surgeon Dr. Claritin 10mg pills $118.00 James Herndon).

I will tell you straight up that I learned much more than I contributed.

The panel shot from the hip and spoke from the heart. Claritin 10mg pills $118.00 Some of us had notes, claritin 10mg pills $118.00 some of us illustrated our comments with anecdotes and one of us (*cough*) had no clue what was going to come out of her mouth until that moment.

I’ll give you a hint….it wasn’t Valerie…..


For the record, claritin 10mg pills $118.00 those of us on the panel were not told what to say, claritin 10mg pills $118.00 how to say it or what to believe, claritin 10mg pills $118.00 nor were we chosen based on what we do believe.  Some discussed concepts that should be taken into account no matter what plan we end up with, claritin 10mg pills $118.00 others were definitely against a single payer plan run by the government (*raising hand*).

The inefficiencies of national health plans of other countries were illustrated/discussed.  This hit me later: we should look at what works in those plans, claritin 10mg pills $118.00 not just what is wrong with them.  We don’t have to emulate them, claritin 10mg pills $118.00 just learn from them, claritin 10mg pills $118.00 and that includes the good and the bad.  It also applies to any universal form of coverage, claritin 10mg pills $118.00 not just a government-run plan.

Wish I had said that at the time.

So much for thinking on my feet (or on my butt, claritin 10mg pills $118.00 as the case may be).


There was some controversy about not having any patient bloggers on the panel.  There should have been. Claritin 10mg pills $118.00 I hope that, claritin 10mg pills $118.00 as a nurse, claritin 10mg pills $118.00 I spoke for patients, claritin 10mg pills $118.00 but it was not the same as having someone there who navigates the system as a patient every single day.


The patient bloggers were in the audience, claritin 10mg pills $118.00 though, claritin 10mg pills $118.00 and if you go to Twitter you can find the live tweeting at “#patientsfirst”. Claritin 10mg pills $118.00 There was a pretty healthy debate going on in the Twitterverse while the panel was up on the dais.

Here I am with Lisa Emrich (Brass and Ivory) and Kerri Morrone Sparling (Six Until Me). Claritin 10mg pills $118.00 Duncan Cross was also there, claritin 10mg pills $118.00 but my pic was blurry!


While health care reform has been a hot topic for awhile, claritin 10mg pills $118.00 it was especially acute this week as the President was actively promoting a government run health care system and there seemed to be a huge sense of urgency to get what is called “America’s Affordable Health Choices Act of 2009” passed ASAP.

The bill is over 1000 pages long.

I just downloaded it.

And Congress has not read it.

Folks, claritin 10mg pills $118.00 our representatives are being asked to pass legislation they have not had a chance to read.

While I will admit to being a bit unsure of exactly what happens in the Beltway (Civics classes and Schoolhouse Rock’s “I’m Just a Bill” notwithstanding), claritin 10mg pills $118.00 that can’t possibly be business as usual.

Can it?


I’ll say one thing: no matter what we believe, claritin 10mg pills $118.00 why we believe it or what our role is in the health care system, claritin 10mg pills $118.00 it is a conversation rife with strong opinions and passionate debate.

And, claritin 10mg pills $118.00 in the end, claritin 10mg pills $118.00 because we are all patients in one form or another at some point in our lives, claritin 10mg pills $118.00 the conversation is about us.

So, claritin 10mg pills $118.00 when you hear the phrase “putting patients first”, claritin 10mg pills $118.00 think of it as “putting me first”.

That may help you get a foothold in the morass of information that is the health care debate.

It worked for me.

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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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