July, 2009 Archive

July 1, 2016, 7:35 pm

Does Viagra Expire

Does viagra expire menopauseI’m sure some women have issues during menopause, does viagra expire but Benzedrine?

Does viagra expire Apathy? Psychomotor retardation?

Does viagra expire Sounds like me after four night shifts in a row.

Does viagra expire And I thought all I’d have to worry about are hot flashes…or in the current PC vernacular, does viagra expire power surges.

Does viagra expire Puberty isn’t treated like a disease, does viagra expire but apparently menopause was looked upon as a psychosis! Was it ever listed in the DSM?

Does viagra expire Were all the women of the 1950s hyped up on bennies?

Does viagra expire OMG – read the fine print – they actually talk about using Benzedrine with electric shock therapy.

Does viagra expire Whoa.

Does viagra expire We most certainly have come a long way, does viagra expire baby!

********************

Sometimes I think I’m my own worst enemy.

I feel guilty for being angry at a patient’s behavior, does viagra expire shocked by an intensity of rage that is way out of proportion to what they have done.

After all, does viagra expire 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, does viagra expire but my perception is that of  too much, does viagra expire 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.

Does viagra expire I’m almost the opposite of apathetic; everything is very, does viagra expire very acute.

Does viagra expire All I know is that this isn’t me.

Does viagra expire 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, does viagra expire

And virtually impossible to do the same for myself?

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July 1, 2016, 11:30 am

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Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 didnothearcallDoctor Ratched: “Nurse! I’m appalled! This woman has waited five minutes for her ice chips!”

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Nurse: “Oh my, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 how could I be so irresponsible! I should have predicted her dry tongue, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 left my seizing pediatric patient and run to meet her need for moisture!”

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Doctor Ratched: “Well there goes our Press-Ganey scores for the entire month. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 I hope you are satisfied, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Nurse!”

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Nurse: “I’m so ashamed!”

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Not.

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 But hey! Don’t let this happen to you!

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 With the Edwards Nurses Call System you know when a patient needs ice chips!

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 And look….one hand!

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 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. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 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, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 intrigue, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 foggy London nights, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Peter Lorre running through the posts…..okay, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 not that last one, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 but if you are up for a good suspense-filled read, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 this is where you need to be!

*****

You showed up to the ER.

You presented your case.

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 You got your narcs.

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Good ones, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 too. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Nice, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 big, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 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, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 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……

What?

You don’t have someone who can come and pick you up?  How did you get here? Oh, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 your Aunt dropped you off? Why don’t you….oh, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 she doesn’t carry a cell phone? Huh. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 That does pose a problem!

No, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 I’m sorry, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 I can’t have you walking out of here in the dead of night to the bus station after an injection of that magnitude. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 It isn’t safe. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Why, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 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, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 as I am walking to the nursing station to make that call, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 I hear the dialing of the room phone and I hear you say something in a very low voice. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 I walk back in to see if you had reached someone. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 No, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 no, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 no one is picking up at Auntie’s place. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 It just rings and rings, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 you say.)

Funny, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 when I try the number it’s a solid busy signal. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 For ten minutes. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 At three am.

*****

Gosh, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 I’m really confused!

You see, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 the ER security tape shows you walking up to the ER alone all the way from the street! Ah, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 I see that you reply with a shoulder shrug. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Interesting. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 I’m sorry, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 we don’t have taxi vouchers in the ER. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Oh, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 you have money at your Aunt’s house? Uncle George will have it, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 you are sure of it? And you want us to call a taxi for you? Well, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 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, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 after all, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 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.

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 I am nothing but a legal pusher of narcotics to addicts who know we know that they know we know….it never ends.

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Emergency departments hand it out like candy. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 We invite this behavior. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 We abet this behavior. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 We will give you what you want, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 when you want it and how you want it even when we know it is bogus!

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 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, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 but this behavior looks like drug seeking to us”?

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 It does no good to confront after the fact. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 The narcotic is given, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 the fix is in, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 yadda, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 yadda, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 yadda. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 They scored again.

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 And they will be back, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 believe it or not. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Even when we confront them with previous alterations in prescriptions, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 tell them we have personally witnessed them driving away in their vehicles, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 let them know that taxi drivers will rat them out every time…it makes no difference. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 And soon it is known all around the area that if you want it, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 you will get it at Hospital Hotel.

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 And before I’m accused of being elitist, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 not knowing the “true face” of addiction, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 having no compassion, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 riding my high horse or being a bitch, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 let me assure you that addicts come in all shapes, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 sizes, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 colors, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 genders, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 occupations, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 income levels, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 hair colors and ages.  None of that matters. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 They will lie, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 manipulate and ingratiate to get what they want.

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 So, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 please tell me.

Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 When will somebody grow a pair and stop this insanity?

****************************************

Narcotics in the ER is a hot topic that always engenders a hot debate. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 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, skin care & dermatology clarina anti-acne gel 30ml tube $109.00 please keep your comments passionate but polite. Skin care & dermatology clarina anti-acne gel 30ml tube $109.00 Thanks.

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July 1, 2016, 10:01 am

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Antibiotics minomycin 100mg pills (generic) $207.00 RyanPodiumThis is Congressman Paul Ryan of Wisconsin, antibiotics minomycin 100mg pills (generic) $207.00 speaking at the Better Health “Putting Patients First” event  in D.C.

Antibiotics minomycin 100mg pills (generic) $207.00 I should talk about how passionately he spoke about health care reform (he did), antibiotics minomycin 100mg pills (generic) $207.00 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).

Antibiotics minomycin 100mg pills (generic) $207.00 And I will talk about these things.

Antibiotics minomycin 100mg pills (generic) $207.00 But first, antibiotics minomycin 100mg pills (generic) $207.00 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.

Antibiotics minomycin 100mg pills (generic) $207.00 Whoa.

Antibiotics minomycin 100mg pills (generic) $207.00 Seriously, antibiotics minomycin 100mg pills (generic) $207.00 is it just me or are politicians getting better looking?

Antibiotics minomycin 100mg pills (generic) $207.00 There. Antibiotics minomycin 100mg pills (generic) $207.00 Now I can move on to the meat of the matter.

Antibiotics minomycin 100mg pills (generic) $207.00 (I had to say it because you all know I was thinking it!)

*****

This event marked my first time in Washington, antibiotics minomycin 100mg pills (generic) $207.00 and just being there is awe-inspiring. Antibiotics minomycin 100mg pills (generic) $207.00 Seeing the White House from the car window took my breath away, antibiotics minomycin 100mg pills (generic) $207.00 literally. Antibiotics minomycin 100mg pills (generic) $207.00 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, antibiotics minomycin 100mg pills (generic) $207.00 but he must have been off doing neurosurgery or something.

*****

By now, antibiotics minomycin 100mg pills (generic) $207.00 you’ve probably read who was on the panel (Dr. Antibiotics minomycin 100mg pills (generic) $207.00 Wes, antibiotics minomycin 100mg pills (generic) $207.00 DrRich, antibiotics minomycin 100mg pills (generic) $207.00 Dr.Rob, antibiotics minomycin 100mg pills (generic) $207.00 Dr.Kevin, antibiotics minomycin 100mg pills (generic) $207.00 me, antibiotics minomycin 100mg pills (generic) $207.00 and Better Health contributors Dr. Antibiotics minomycin 100mg pills (generic) $207.00 Alan Dappen, antibiotics minomycin 100mg pills (generic) $207.00 Valerie Tinley, antibiotics minomycin 100mg pills (generic) $207.00 NP and “token” – his words, antibiotics minomycin 100mg pills (generic) $207.00 LOL – surgeon Dr. Antibiotics minomycin 100mg pills (generic) $207.00 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. Antibiotics minomycin 100mg pills (generic) $207.00 Some of us had notes, antibiotics minomycin 100mg pills (generic) $207.00 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, antibiotics minomycin 100mg pills (generic) $207.00 those of us on the panel were not told what to say, antibiotics minomycin 100mg pills (generic) $207.00 how to say it or what to believe, antibiotics minomycin 100mg pills (generic) $207.00 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, antibiotics minomycin 100mg pills (generic) $207.00 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, antibiotics minomycin 100mg pills (generic) $207.00 not just what is wrong with them.  We don’t have to emulate them, antibiotics minomycin 100mg pills (generic) $207.00 just learn from them, antibiotics minomycin 100mg pills (generic) $207.00 and that includes the good and the bad.  It also applies to any universal form of coverage, antibiotics minomycin 100mg pills (generic) $207.00 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, antibiotics minomycin 100mg pills (generic) $207.00 as the case may be).

*****

There was some controversy about not having any patient bloggers on the panel.  There should have been. Antibiotics minomycin 100mg pills (generic) $207.00 I hope that, antibiotics minomycin 100mg pills (generic) $207.00 as a nurse, antibiotics minomycin 100mg pills (generic) $207.00 I spoke for patients, antibiotics minomycin 100mg pills (generic) $207.00 but it was not the same as having someone there who navigates the system as a patient every single day.

patientbloggers

The patient bloggers were in the audience, antibiotics minomycin 100mg pills (generic) $207.00 though, antibiotics minomycin 100mg pills (generic) $207.00 and if you go to Twitter you can find the live tweeting at “#patientsfirst”. Antibiotics minomycin 100mg pills (generic) $207.00 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). Antibiotics minomycin 100mg pills (generic) $207.00 Duncan Cross was also there, antibiotics minomycin 100mg pills (generic) $207.00 but my pic was blurry!

*****

While health care reform has been a hot topic for awhile, antibiotics minomycin 100mg pills (generic) $207.00 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, antibiotics minomycin 100mg pills (generic) $207.00 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), antibiotics minomycin 100mg pills (generic) $207.00 that can’t possibly be business as usual.

Can it?

*****

I’ll say one thing: no matter what we believe, antibiotics minomycin 100mg pills (generic) $207.00 why we believe it or what our role is in the health care system, antibiotics minomycin 100mg pills (generic) $207.00 it is a conversation rife with strong opinions and passionate debate.

And, antibiotics minomycin 100mg pills (generic) $207.00 in the end, antibiotics minomycin 100mg pills (generic) $207.00 because we are all patients in one form or another at some point in our lives, antibiotics minomycin 100mg pills (generic) $207.00 the conversation is about us.

So, antibiotics minomycin 100mg pills (generic) $207.00 when you hear the phrase “putting patients first”, antibiotics minomycin 100mg pills (generic) $207.00 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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