May 5, 2011, 11:12 am

Is It Just Me, Or….

Oh hai...Well, that was an extended blog break!

I’m still kickin’!

Stagnating, but kicking.

Restless. On edge. Waiting.

For something.


Love these uniforms!

I actually had the one on the right, albeit in a more ’70s updated version (aka: shorter). Not very practical, but boy did we look good back in the day! Her cap is floppy, though. Too wide, too. Only a 6/10 for that.

I’m not just waiting. I’m trying to be proactive. It’s time to make some changes.

It’s time to get off of night shift.

And it’s time to leave the emergency department.

And both of these realizations are killing me.


Right now, I have the perfect ER job. So, admitting that I can no longer physically handle working night shift or thinking that I have reached the end of my career in emergency nursing feels like failure.

But, I need to take care of myself, right?

So it’s time to be proactive and take the next step, right?

Time to take a breath, take stock of my skills, brush up that CV/resume and go forward! After all, I have 32 years of strong nursing experience behind me (including a stint as a shift charge nurse), that wonderful BSN I’m so proud of (and an MSN program pending), stunning communication skills (if I say so myself) and gosh darn it, anyone would be lucky to have me!


Uh, no.


I applied for jobs outside of acute care.

You know how new grads can’t find jobs because they all want experience, but they can’t get experience because they can’t get jobs?

Now I know how they feel.

I’m looking into working in case management. I’m smart, got the skills. Communication, check. Verbal, check. Written, check. Organized? Check. Able to priortize? Check. Self-starter? Check. Experience with acute care? Check.

Experience with utilization review, case management, managed care?


So I send in my resume anyway, along with a cover letter explaining my interest in case management, my skills and background and how they will translate over into this new (to me) field

No response. From anyone.

One company in particular looked absolutely fantastic. I’m talking perfection. As in “Kim, this was MADE FOR YOU!” I sent in my application. Followed it up with a cover letter directly to the manager of the Human Resources department.

No response. Followed it up with a follow up letter. No response.

Lather, rinse and repeat to three other employers.


And for the record? All those positions are still posted.


Now, I’m not saying that everyone should hire me. But what I am saying is that (a) there is no chance of making a first impression anymore and (b) where is the courtesy of at least making some contact with the applicant?

You can’t sell yourself anymore. There is no sitting with a manager or recruiter and discussing the job and what you may bring to it. You are just a screen on someone’s computer and if you don’t meet pre-determined criteria you are deleted. Without even the courtesy of a “thank you for applying, but…”

I’d make a hell of a case manager.

Right now, it doesn’t look like I’m going to get a chance to prove it.


Actually, one company did send a response. A form letter.

I applied for Charge Nurse in an ambulatory care clinic (dermatology) , at a company where clients “Thrive”. Got a form email that said I didn’t meet the minimum requirements. Well, the description said “willing to train” so I’m not sure what minimum requirement I missed.

I’ll never know because no one ever contacted me in person.

I’ve spent the last 32 years saving lives, but for some reason, they thought dermatology was more than I could handle.

Those must be some rashes!


Oh, by the way, after I posted that resume on

I was inundated with offers…

From nursing recruiters all over the country…

Looking for ER nurses.

How ironic.

April 4, 2011, 9:24 pm

Grand Rounds Gets Angry (Birds)!

Welcome to the Angry Birds edition of that weekly compendium of medical blogosphere goodness, Grand Rounds! I’ve chosen my addiction du jour, Angry Birds, as the theme for my 7th turn as host.

For those who are not familiar, Angry Birds is a game in which Green Pigs steal Bird eggs, causing the Birds to become angry, start screeching and begin catapulting themselves from sling shots in an attempt to destroy the Pigs, who house themselves in various structures and giggle at the Birds.

Got it?

Okay then! Let’s get started!


This picture of the Angry Birds characters, is actually a cake! I like it so much, I’m using it to illustrate this week’s “Editor’s Picks”. These are like my “Final Four”!

I was introduced to the John A. Hartford Foundation during my BSN program and as I’ll be working in gerontology during my MSN program, it was a no-brainer that their submission, Now Hear (and See and Use) This: New Geropsychiatric Nursing Video would be one of my Editor’s Picks!

Steve Wilkins gets the Editor’s Pick position this week for his post on One More Reason Patients Ask Doctors So Few Questions. It got me thinking about the differences between physician and nurse communication. See what you think over at Mind the Gap!

Chris Bayne’s teaching experience opened his eyes to what is lacking in medical education. He presents Three Ways To Improve Medical Education: Part 1 over at HokieMD. Tradition has its place, but it’s the 21st century. Great post!!!

At Healthline: Medicine for the Outdoors, Paul writes on Single Lens Distance Vision Glasses and Outdoor Falls. It makes sense. I had problems navigating my uneven backyard in bifocals, let alone hiking in them!


Poor Helmet Pig seems to have gotten the brunt of the Birds’ attack! He could use some meds, and he’s in the right place – drugs were on the mind of many Rounders this week!

I’m not an OB/GYN, but I’m with Nicholas Fogelson at Academic OB/GYN when he says Boycott Makena! Be sure to read the comments and see what is happening in Oklahoma. Also, read the companion post, Boycott Makena: March of Dimes Responds to K-V Pharmaceuticals.

But….there is more to the story! At InsureBlog, Henry Stern notes the FDA seems to be Picking and Choosing: The Makena Saga Continues. So pharmacies can still compound the drug? Or is the FDA just turning a blind eye if they do? Am I the only one confused?

Tony Chen at FDAzilla has great background information on what goes into drug pricing decisions, and yeah, Makena is the example! Check out K-V Pharmaceuticals and Drug Pricing 101.

Reporting rare, but frightening side effects can overshadow benefits of treatment. Rheumatologist Irwin Lim discusses this issue as it applies to osteoporosis in Finally, Some Good Press! Bisphosphonates & Death posted at BJC Health.

Not all drug news is controversial! Promising news in chemotherapy is noted by Elaine Schattner at Medical Lessons, where she posts When Less Chemo is Just As Good, In Treatment for Acute Myeloid Leukemia.

I don’t get why someone would request a brand-name medication, being a generic-requesting person myself, but the ACP Internist has a post showing QD: News Every Day–Brand Name Drug Requests Lead to Less Compliance, More Costs. Maybe they don’t realize it costs more until after they hit Walgreens…


The Birds may be angry, but they come in plushies and you can’t be angry with a plushy! Plushies are powerful, just like these posts:

The power of rhythms. The Algorhythms of My Mind. From Beth at the Happy Internist.

The power of the love/hate relationship. Friends? From Bongi at Other Things Amanzi.

The power of polite. Always Time Enough For Courtesy From Rita at Supporting Safer Healthcare. Indeed.

The power of love. Mend. From The Examining Room of Doctor Charles.

The power of connecting. The Disney T-Shirt Opportunity. From Bryan at 33 Charts.


The Birds seem confused by the empty nest. Maybe they need to gather a bit more information (or look behind them). Healthcare politics and legislation confuses me, I admit it. These posts help make it a bit clearer:

Dan Diamond at California Healthline shows us How March Madness Can Help Explain Health Reform. Worked for me! He even includes a “Final Four”!

David Harlow of Healthblawg is all over Accountable Care Organization (ACO) Regulations: First Look. Nice overview!? A member of the Society of Participatory Medicine, David notes: “Participatory Medicine is a cooperative model of health care that encourages and expects active involvement by all connected parties (patients, caregivers, healthcare professionals, etc.) as integral to the full continuum of care.” He encourages Grand Rounds readers to take note and become members if not already involved! In a related post at, he looks at Accountable Care Organizations and Patient-Centeredness.

But…there is more to the story! Doug Perednia wonders Are ACOS A Financial Suicide Pact? He notes, “…there is considerable reason to believe that, as designed, ACOs are likely to be money-losing propositions for the great majority of participating healthcare providers.” Posted at The Road to Health…

At Nuts for Healthcare, Jeffrey Seguritan comments on “Guidelines” for Salvaging Medical Malpractice Reform noting, “Ideally, these guidelines should be developed within a system of accountability that draws on consensus in the medical community and weeds out conflicts of interest.”


Well, apparently Angry Birds aren’t always angry! I most definitely was in a great mood perusing these posts!

At Suture for a Living, Ramona Bates discusses an article looking at Decision-Making in Severe Lower Leg Trauma, linking to a related story that is both heartbreaking and inspiring.

Hey, Mike Sevilla went to nursing school! Okay, he actually went to the initial HealthCamp 2011 held at Yale School of Nursing. He gives us his impressions in HealthCamp Yale 2011 Wrap Up over at Family Medicine Rocks.

If you are a doctor, nurse practitioner, or physician assistant seeing patients in an office practice, Dr. Pullen has a good suggestion on How to Avoid Being Behind Schedule.

“Health is local.” That’s a core value of the Washington Health Foundation, and at The Healthiest State in the Nation Blog, President and CEO Greg Vigdor looks at the future of the community health movement in Reflections: Promoting Community Health.

The ACP Hospitalist reviews a research study detailing obstacles to communication between ERs and primary physicians in Better Handoff Needed From ERs Back to Primary Care.

Julie Rosen, Executive Director for The Schwartz Center for Compassionate Healthcare discusses communication as a strategy to improve adherence in Are Your Patients Listening to You? at Bedside Manner.

My nursing colleagues have been suspiciously quiet this week, but Karin has, uh, sprouted Ten Bad Jokes You Can Play on a Nurse on April Fool’s. I don’t want to give anything away but much can be inferred by the fact that three of them are coffee related, yes? At Karin’s Nurse Blog.


Remember my hint with the three blue Peeps? In Angry Birds, when you launch the tiny blue bird and then tap the screen, it splits into three blue birds, hence the “hint”! No one got it – everyone thought I was talking about Twitter! : D

Many thanks for reading and submitting to Grand Rounds this week. It was an honor, again, to host. Please consider hosting, it’s a blast- I’ve done it 7 times! As always, thanks to Dr. Nick Genes, who started it all so many years ago and Dr. Val at Better Health for hosting the calendar. Be sure to follow @grandrounds on Twitter and “Like” Grand Rounds on Facebook.

As soon as I find out who is hosting next week I will update the post with the info!

March 29, 2011, 3:51 pm

Grand Rounds is here – April 5th

Grand Rounds returns to Emergiblog next Tuesday, April 5th!

Many thanks to Dr. Mike Sevilla, the Doctor Formerly Known as Anonymous, for hosting Grand Rounds: Volume 7, No. 27 over at Family Medicine Rocks this week!

Next week is wide open. No theme. All submissions, all topics, all comers. Bring ’em on!

Unless you are selling something akin to a medical Sham-Wow. That would be bad.

But hey! No one is going to do that so hit me with your best shot! Submissions accepted all the way up until 5 pm Monday evening, Pacific time, so no excuses for not having enough time! : D

Just hit the contact button at the top of this page, or send your submissions to “kmcallister911 at mac dot com”.


And I do have a general “theme” in mind.

Oh yes.

I’ll give you a hint in the photo above, and it ain’t Easter.

Think birdies.

Think blue birdies.

Three of them…

You have nothing to fear unless you are made of pork….

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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