May 19, 2010, 1:31 pm

Dysorientation in the ER

Found this pic in the Library of Congress collection.

Perhaps this was a “Nurses Week” gift: a ping pong table in the break room!

This looks like a combination of ping pong and marital arts (Tae Kwon Pong?).

Either way, who plays ping-pong in their cap?

Nurse Ratched has discovered the same LOC collection.

Not that I have to use them before she does….

But it’s more fun if I do!


Change of Shift is up at The Muse, RN! Many thanks to our “muse” for hosting a great edition!

The host for May 27th will be Nurse Teeny at The Makings of a Nurse.

Submissions can be sent via Blog Carnival or to “nurseteeny at gmail dot com”.


Congratulations on your new job!

For the next six weeks (or so), you will be center stage, in the spotlight.

The play is called “Employment”, the audition is called “Orientation”.

You may embark on a long, successful engagement, or you could go dark on opening night.

Your audience decides.

Your audience = your colleagues.


Let’s face it: orientation is all about evaluation. Your actions directly affect whether or not you are successful in keeping your new role.  I’ve seen many an orientation turn into a “dys-orientation”.

How can you tell a successful orientation vs. a “dys-orientation”?

  • Orientation: You’re the first to get up and the last to sit down.
  • Dysorientation: You think the night shift is for relaxation and spend the down time texting, reading five-year-old editions of Better Homes and Gardens and snoozing. At the desk.
  • Orientation: You  realize the only way you will get the routine of the department is to be responsible for patients. A slow shift means you have to take the patients that do come in to get that experience.
  • Dysorientation: You pout when it is suggested that you take those patients, even if they are coming in only once an hour with simple chief complaints.
  • Orientation: You document your nursing care clearly and legibly.
  • Dysorientation: You think scribbling “IV” in the narrative is enough.
  • Orientation: You get to know your new co-workers.
  • Dysorientation: You spend time trading giggles with the guys/gals in the corner while you have four charts in the rack with orders.
  • Orientation: When your work is done, you ask your co-workers if they need any help.
  • Dysorientation: When your work is done, you sit.


I see an entirely different attitude toward orientation in younger hires. The focus is less on “how much can I learn during this time?” and more on “how little do I have to do before I can sit?”.

“What can you do for me?”  vs. “What do I need to learn here?

It’s the difference between seeing employment as a registered nurse as a “job” or embracing it as a “career”.

Have I turned into the dreaded “old fogey”?  T. Rex, RN?


Orientation is supposed to be the time when you put your best foot forward; a time for making a good first impression.

There will be time for socializing or “downtime” activities once you get the rhythm of the department. Time for splitting a slow workload with your co-workers. Time for knowing when you can relax and when you need to be on alert.

Orientation is not that time.

May 9, 2010, 8:51 pm

When God Closes a Door…

I would have loved to have seen just how far I would have gotten inĀ  nursing with this “Symbol of Success”!

This looks like an ad in the back of “movie magazines” like Photoplay. Anybody else remember “Photoplay”? Or am I hopelessly dating myself with that question?

Ten weeks….

Wish someone had told me, I just finished three years!

Learn at home…

Gee, I guess they were ahead of their time where online classes were concerned!

(P.S. For the rest of you old folk that remember Photoplay, wiki says it folded in 1980 and the staff went to “Us” Magazine.)


Change of Shift will be hosted by The Muse, RN this Thursday. There is a theme, so be sure to check the site! Submissions will be accepted up until Wednesday evening and can be sent to “themuse at themusern dot com”. You can also submit via Blog Carnival.


I cannot shake this feeling that something needs to be done.

Something is due. An assignment. A paper.

It’s like having phantom limb pain – I’m having phantom assignment pain!

But nothing is due! I made it! I can now officially write “BSN” after my name! As of the 15th I am a graduate of the University of Wisconsin – Green Bay Program in Professional Nursing.

I actually haven’t seen my new title in writing yet, so I’ll write it here:

Kim McAllister, RN, BSN

Now that’s what I’m talkin’ ’bout!


It actually took awhile to sink in, because the accomplishment was overshadowed, briefly, by a huge disappointment.

I did not get into the PhD program at Davis.

Talk about feeling like being dropped-kicked in the chest! I can’t describe it any other way.

So there I am, feeling smaller than an itteh bitteh kitteh without a committeh, when what should appear but the reason I was not accepted!

I was “not competitive” with other candidates based on my “Statement of Purpose/written work”.


Not only was I not competitive, but I was not competitive in the area I thought was my biggest strength!

And if I had any sort of an ego before, it’s now so small even Viagra couldn’t revive it.

So much for blogging being my ticket to nursing academia/nirvana.


So. The next step.

Well, it looks like I’ll need to get my PhD via the MSN route, and I am hoping to do that through Cal State.

Trouble is, the admissions are closed until next year.

Good lord, no school for an entire year?

What the hell am I supposed to do with myself?

They say when God closes a door, He opens a window.

The life of a NASCAR groupie is looking mighty good…but something tells me that’s not the open window He has in mind.

April 29, 2010, 11:07 am

Change of Shift – Vol. 4, Number 22

Hi – welcome to this edition of Change of Shift, the nursing blog carnival.

We have a diverse group of submissions this week. Some will make you laugh, some will make you cry and some will make you think.

So, without further ado, I give you….

Change of Shift.


Sure, we can save a trauma victim physically, but how do we help the deal with the aftermath? Check out A Crash Course in Trauma Psychiatry posted at The Man-Nurse Diaries.

Lisa at Experiences of an ICU Nurse tells a beautiful story of life, death, love and relationship in The Ugly Cry. Get a Kleenex.

The full moon approaches and RehabNurse muses on life at the Hotel in Dashed Dreams, found at RehabRN.


LOL – this is too funny! Gina at Code Blog recalls a tale of medicine and kidnapping in The Kidnapped Napper. Wish I had someone to kidnap me like that!

Laney at Nursing Student Chronicles learns the meaning of “tell your friends you will see them in two years” in Minor Meltdown.

We care for elderly patients, we may have elderly parents and someday (a loooong time from now) we will be elderly ourselves! Which makes Dr. Dean’s post at The Millionaire Nurse Blog so very relevant. Check out Financial Fraud and the Elderly, are Your Parents at Risk?


At Your Cervix (best blog name EVER!) looks at a particular Bias in Healthcare. Have you ever run across it in your practice?

After finishing an assignment on leadership and influence, this post hit home. Julianna at JParadisi RN’s Blog submits Consensus and Majority Rule are Siblings not Twins.

Over at Madness: Tales of an Emergency Room Nurse, things are heating up as contract negotiations hit a stand still. It always amazes me what hospitals will try and get away with, even if it means A Strike is Coming.


Jennifer Kingsley from the Nurse Practitioner Education site sends in 10 Essential Web Tools for Nurse Practitioners. Some good links here! NP’s, what do you think of the list?

Whoopie Patterson presents 25 Essential iPad Apps for Your Health and Wellness posted at Online Nurse Practicioner Programs.

Elle integrates holistic health practices with traditional western medicine. In The Power of Touch for Healing, she describes a poignant moment in caring for a terminal patient, posted at her website The Body Window: Healing Body, Mind, Soul


That concludes this edition of Change of Shift!

Thanks so much for reading!

Our next edition will be on May 13th and hosted by The Muse, RN. Contact information will be updated here ASAP. In the meantime, submissions can be sent to me and I will forward.

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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