July, 2010 Archive

July 26, 2010, 11:35 am

That Does It……

This is me, laptop firmly attached at the hip!

Okay, I don’t wear white dresses (anymore) and I don’t have a 10 inch waist, either.

But my laptop might as well be surgically implanted; my life is pretty much pixelated!

I make travel decisions based on whether or not wireless is available.

Most people sleep, I “re-boot”.

In response to a funny story this week,  I said “LOL!”. As in the letters, not the words.

But I knew I had gone over the edge when my nursing notes started looking like tweets: “Amb 2 BR s diff; no able 2 p; abd dist; 16F cath 4 lg amt; tol OK; ? more narcs; allerg to tdol & MS; D.did given IM; pt said “OUCH, OMG!”

Addiction, thy name is Apple….


Big news coming soon re: BlogWorld/New Media Expo 2010. Discount codes for medbloggers are coming! I should have a post up with details in the next day or two.


“Physician Extender”.

Sounds like the name of a male-enhancement product.

It’s a phrase often used to describe a nurse practitioner or a physician’s assistant.

I hate it.

It’s insulting.


A nurse practitioner is not an adjunct physician. They do not supplement the care of a physician.

They provide essential advanced practice nursing services, services that include diagnosis and provision of medical care.

While some of these services overlap those of medicine, nurse practitioners are not extensions of another profession, they provide care in their own right, as educated, licensed practitioners.

Sometimes the only care provider for a community is a nurse practitioner.


A few years back, the term “extender” was used to describe nurse’s aides, as in “nurse extender”.

I hated it then, too.

It insulted the aides by implying they were less than individuals, not there to care for the patients, but to do the “lesser work” of the registered nurses.

Referring to nurse practitioners as physician extenders ignores the independent assessment and diagnostic skills possessed by advance practice registered nurses. It  insinuates that they function for the physician’s sake, not the patient’s sake.



I know it’s just a word. But words have power. Words convey attitudes. Words can confuse.

Nurse Practitioner. Educated, licensed, independent professional.

Nurse practitioner. Physician extender.

A rose by any other name…….?


Not this time.

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July 22, 2010, 9:25 pm

Change of Shift: Vol. 5 Number 2

Welcome to the latest edition of Change of Shift!

The nursing blogosphere came through in a big way this week, many thanks to those who have submitted.

I’m excited to showcase these colleague contributions!

So, without further ado,

I present…..Change of Shift!


Let’s start off with the “Editor’s Choice” of this edition! Shrtstormtrooper understands that nurses are Always Learning, posted at New Nurse Insanity: Fundus Chop!. Bravo!

Can we address the supply of professional nurses without addressing the state of nursing education? Chris at The Man-Nurse Diaries takes on this provocative topic in The Nursing Shortage.

Should the willingness to advocate depend on what one’s opinion of the patient?  Nurse Teeny finds the concept disturbing as developed in a  recent episode of HawthoRNe. Check out  Shackled, at The Makings of a Nurse.


Speaking of the nursing shortage, just how short are we? Is it a regional issue or a national concern? IsntSheLovlei finds an overabundance in her area in What Nursing Shortage??? posted at The Dog Ate My Care Plan….

Keith at Digital Doorway pens a beautiful story of the beginning of a beautiful client/provider relationship in A Visit to the Doctor,  followed by an exploration of aging and loss in A Kind of Life.

Laney loses her first patient. A moving look at the emotional impact of a code in Breathe Me, at Nursing Student Chronicles.


Can I get an “AMEN!” for this insightful look at just what (and who) constitutes “the nursing profession”? Katie Morales at NursesNetwork.com lays it out in A Rose by Any Other Name.

After a summer tracing the history of Florence Nightengale’s career, Susan Hassmiller gives us Parting Thoughts: 10 Lessons Learned from Florence Nightengale’s Life, at AJN’s Off the Charts.

Jo has been blogging at Head Nurse since 2004. It’s one of my favorite stops on the web. In  Reasons Why I Love This Blog, by the Author of Same, Jo describes how she benefits from the blogging experience.

Jamie Davis has started a new podcast called Insights in Nursing.  I’ve been participating with Jamie and Terri from Nurse Ratched’s Place. Jamie takes Terri’s sharp insight and my incoherent ramblings and puts them together in a sharp weekly show that looks at what’s new in nursing news. The latest episode – Physician Extenders – is up! (Caution: Rant on Board!)


Thanks for reading this edition of Change of Shift! The next edition will be right here at Emergiblog – so feel free to submit via Blog Carnival or by using the “Contact” button at the top of the blog.

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July 8, 2010, 11:31 am

Change of Shift – Volume 5, Number 1

Welcome to the Change of Shift anniversary edition!

Today marks the beginning of Change of Shift’s fifth year.

Thanks to everyone who responded with suggestions for our carnival! I’ll be compiling those thoughts into a future post (let’s just say link lists are out…).

Many thanks to those who contributed! This week, I’ve added a few new-to-me nursing blogs I’ve discovered along with favorite CoS regulars.

The next edition will be hosted here at Emergiblog, so submissions can be sent through Blog Carnival or to the contact link at the top of the blog.

In the meantime, enjoy Volume 5, Number One of Change of Shift!


NPs Save Lives writes a wonderful description of her responsibilities as an NP in Nurse Practitioners As Primary Care Providers, posted at The Nurse Practitioner’s Place. In the face of a primary care shortage, it’s hard to fathom the continued resistance to this concept. Over at her second blog, NP Place. com, she gives a Nurse Practitioner’s Opinion Regarding Medicaid Reimbursement To Specialists.

Nurse Me pens a poignant post on palliative care from a personal and professional viewpoint in The Beginning of the End.

Laney at Nursing Student Chronicles is working at her PNA externship and she is excited! Share her enthusiasm at PNA – Week 1.


Chris at The Man-Nurse Diaries wonders Do We Need Doulas in Critical Care? As Chris notes, “I ruminate over the idea of third-party patient advocates in the ICU. Can you imagine having a privately-hired patient advocate in the room while you’re taking care of a patient?”

In California, we have the ability to place those who are suicidal on a 3-day hold (5150). Florida seems to have a “loophole”. At AJN’s Off the Charts blog, nurse Marci Phipps writes of Reflections on the Freedom to Harm Yourself.

Oh, the joys of dealing with other departments…Shrtstormtropper gives vent to frustration in Lab, found at New Nurse Insanity: Fundus Chop.


For the past few weeks, Jamie Davis of The Nursing Show podcast and Terri from Nurse Ratched’s Place (and me!) have been discussing various nursing topics for a new podcast entitled Insights in Nursing. Click to hear the latest edition, Over Anxious, Over Testing, & Keep That NG Tube Away!

Oh, the joys of California Dreamin’ – Life and Times of a L&D Nurse Babyrndeb can call herself “Earthquake Nurse” after this week’s 5.4 in southern CA!

Sometimes we see things differently. Gina at Code Blog talks of her experience with this in Perspectives.


Nurse Teeny may be running ragged but she is doing just fine in One Step Forward over at The Makings of a Nurse.

If this were on a TV show, no one would believe it. Rachedy at You Can’t Fix Stupid describes Some Scary Shit. Everybody ready? All together now…”EWWWWW!”

The devil is in the details – as E.J. discovers in Beatdown, at Uncompromised Airways. Kudos to everyone in neonatal critical care; you guys deserve a medal.

Over at Nursing Birth, our colleague entertains Thoughts on Becoming a Midwife. Wish I had her as my nurse when I was delivering. Check out other posts while you are there, her desire to advocate for her patients will inspire you.

Over at Weird Nursing Tales, Tex encounters Things That Make You Go… And we wonder why our health system is ill.


And that concludes our anniversary edition!

If you are wondering if you should submit to CoS, the answer is yes! You don’t have to be Hemmingway, you just have to write about nursing. Frustrated at work? Have an idea about health care reform? Want to shout the praises of the profession? Want to brag about an award you received, a symptom you unearthed, a thank-you from a patient? Want to discuss nursing theory in all its glory (or is that only me that does that)? We want to read it!

So…what are you waiting for?

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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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