January 21, 2010, 1:23 pm

Change of Shift – Volume 4, No. 15

OffwhitelogoIt’s time again for Change of Shift, the bi-weekly nursing blog carnival!

It’s an eclectic selection this week: hospital to office, students and veterans, money and…well, poo-poo, disasters and preparedness.

Quick note: I have a “mailing list” that I use to mail out CoS notifications. If you are not on the list and want to be, drop me a line. If you are on the list and do not want to be, *sniff*, drop me a line!


Hmmm..it seems that NPs Save Lives has been hearing a few excuses lately! Learn How Not To Choke Your Non-Compliant Patients over at www.npplace.com.

The situation in Haiti is critical. Nurses are lining up, ready and willing to serve. But, as  the Muse, RN notes, there are  10,000 US Nurses Sign-Up for Haiti! Can’t Go. Find out why. Frustrating.

On a similar note, Shawn Kennedy writes a post giving Praise for Haiti Nurse Volunteers – and a Word of Caution. Important info, to be found at the American Journal of Nursing’s blog Off the Charts.


Laney at Nursing Student Chronicles has a new look and a great post on The Good and the Bad of nursing school. (They do uniform inspections?)

Thought your New Year’s Eve was exciting? Nurse Me can top that, easily! Check out Rave On, and see for yourself why I don’t work in a trauma center!

Dr. Dean at the MillionaireNurse.com Blog is right. I, for one, am totally clueless on my retirement info. Find out what you need to know in 401k 101: The Basics of Retirement Investing for Millionaire Nurses. Time to go look up my funds!


On her Medscape Blog, On Your Meds: Straight Talk on Medication Safety, Barbara Olsen gives a beautiful take on what patient safety actually means and how it has evolved. Check out Welcome Changes.

I have absolutely no doubt this story is true – chalk it up to two decades in an ER. Submitted by a co-worker of NYCRN, author of Pee and Sympathy: True Stories from an RN, I give you One Flew Over the Poo-Poo’s Nest. Seriously.

At Career Transitions and Other Nursing Topics, Laura at Nurse Connect discusses disaster preparedness on a personal level.  Living directly on the Hayward Fault gives me reason to agree that A Prudent Nurse is Always Prepared.


Keith from Digital Doorway takes time out from exploring the country (and dealing with aggressive Armadillos!) to submit The Demise of the Public Health Nurse. Sadly, I witnessed this first-hand during my community practicum last semester. Keith may be contemplating his “occupational navel”, but he describes it beautifully in Of Nursing and Soulful Employment.

Feeling a little restless at work? Not as happy as you used to be? Nurse Connect blogger Kathy discusses the possible reasons behind these feelings in Job Satisfaction, Have You Found Your Niche?

From the “Egg On My Face” department – in the last CoS, I told Max. E. Nurse from It Shouldn’t Happen in Health Care that if he stopped blogging I’d go down to Australia and punch him. He thanked me profusely….because he lives in the U.K! Seems Max has a new job and needs us to send him some blog love on The Flip Side…


TC at donorcyle is posting again! Still hard at work, this time from an office, she answers that all important question Mama, What Do You DO All Day? Responsible for 250 patients? I need a nap just reading the post!

At NurseZone, E’Louise’s RN Talk blog discusses Web-Based Medical Records: Dream or Nightmare? Weigh in with your opinion!

Student nurse Cassie, in her NurseZone blog Campus Corner, talks about opportunities for Volunteering for Student Nurses. She names a few, can you think of any more?


And that, my friends, concludes this edition of Change of Shift! Thank you for reading, thank you for linking and thanks to all those who submitted this week!

UPDATE: The next CoS will be over at RehabRN, so send submissions to “hotelrehab at nyms dot net”.

BTW, I’m hosting Grand Rounds on Tuesday, so post away and send ’em my way!

(Remember, Change of Shift now has subscription options; you can follow by email or RSS feed. An aggregated feed of credible, rotating health and medicine blog carnivals is also available. Many thanks to Walter Jesson at Highlight Health for setting those feeds up!)

January 18, 2010, 12:58 pm

Anatomy of a Pain Shot

druggie:locThis has me stumped.

What on earth is she doing?

She is drawing something up from a spoon, I assume it is a medication.

But what?

I usually associate this sort of activity with heroin addicts, but obviously this is a clinical environment.

Okay, all you nursing historians out there…

What medication would need to be drawn up from a spoon instead of a vial or an ampule?



It’s carnival time at Emergiblog!

Not only is Change of Shift going to be here on Thursday, but I’ll be hosting Grand Rounds next Tuesday!

Nurses, get cracking for Change of Shift – I’ll be taking submissions until Wednesday night.

Those of you who forgot to submit last week, now is your chance for redemption!


For Grand Rounds, it’s all comers and submissions until Monday evening at 5 pm Pacific time!

There is no theme, I’m put one together out of the submissions that come in.

Click the “Contact” button to send your submission for either carnival!



Three days.

Out of pain medication and vomiting so you wouldn’t keep it down, anyway.


Emergency department.


You’re in luck – no one in triage!

A bed opens up, the nurse takes you straight to a room.

Gown, blanket.


Two minutes later you send your cousin out to ask how long it will be until you get your pain med.

Excuse me?


There is an unrealistic expectation of just how long it takes to get pain medication in an ER.

A few procedures that need to occur before that shot gets to its destination.

  • Registration – We must have the information. The admitting clerk is not trying to hassle by asking for your address and birthday and ID.? We need that information to officially identify our patients when we give medication.
  • Examination – There must be an evaluation by the physician or the nurse practitioner before medication can be given. There may be patients who arrived before you who have yet to be evaluated; there may be patients who arrived after you experiencing life-threatening issues. Either way, they will be seen first.
  • Orders – The physician/NP writes the order for your medication. Your nurse, also responsible for other patients, may be busy in another room. They will notice that medication has been ordered and take the chart to prepare the meds.
  • Medication Preparation – The nurse pulls the medications from the medication dispensing system. The medications are carefully drawn up and all syringes are labeled before they leave the med room. The nurse will bring them to your bedside.

And you get your shot.

It’s so basic, really. Organized. Logical.

But it is not instantaneous.

Nothing in the ER is instantaneous except CPR when you go into cardiopulmonary arrest.

So, understand that you will probably have to do a certain amount of waiting before you receive your pain medication. It’s okay to ask for an update if you aren’t sure of what is going on.

But at least let your cousin sit for longer than two minutes before you send him out to remind us that you are in pain.

We didn’t forget.

January 7, 2010, 11:27 pm

Change of Shift – Volume Four, No. 14

OffwhitelogoHappy New Year and welcome to the first Change of Shift of the new decade!

Are you still writing “09”? I’m not! For some reason I have converted to “01”. Lord knows how many of my charts have the wrong dates on them!

It’s a new decade and the new year finds the nursing blogosphere is still going strong. Let’s get started!


Melody Stenrose is an RN and a writer. She and I graduated from nursing school together, and I am excited to announce her new book! Chronicling her 30 years as a critical care nurse and educator, Inside the ICU: A Nursing Perspective is now available. I knew the book would be great. What I did not know was just how hard it was to get published. Think bloggers face objections? Check out this page at Melody’s site for the full story.

Caroline at Brain Scramble, RN writes An Open Letter to the ICU. I can’t add a single thing; what a wonderful post!

Now let’s switch to a night in PICU as Laney of Nursing Student Chronicles notes that there is No Rest for the Weary! I’m pooped just reading it!

It’s unit time at Change of Shift! Jo at Head Nurse has completed her CCU internship and is now Off the Leash. Congratulations!


This is freaking hilarious! Shrtstormtrooper at New Nurse Insanity: Fundus Chop! manages to blend myocardial infarctions, practical jokes, tires and the Burger King getting hit in the, uh, groinal region in Crisis Averted. Warning: remove all liquids from your oral cavity before reading!

And a huge Change of Shift welcome to (relatively) new nurse blogger The Muse, RN! This is a post I wish I had written! Find out about Nursing’s Image & Ability to Influence Politics. And then give yourself ten minutes for your BP to return to normal.

The nursing blogosphere continues to expand as we give another first-time welcome to Voice of Reason, a nurse from Australia and author of the blog, Shades of Grey. This first submission is a beautiful poem on caring for a dying patient, entitled The Nurse’s Heart.


Nurse Practitioners Save Lives looks at the practice (or non-practice) of Using Nurse Practitioners to Reduce Emergency Room Waiting Times. Preachin’ to the choir here, honey! LOL! I think all EDs should utilize NPs!  Read for yourself at The Nurse Practitioner’s Place.

Dr. Dean, hubby to nurse and writer of the MillionaireNurse.com Blog has some observations about nurses who just can’t seem to stay on a budget in Blood From a Turnip: The Millionaire Nurse Way! All I can say is that I would die without RaceView during the NASCAR season…really

Mother Jones has been busy lately. Snowed in! Twelve hour shifts! Dogs and cats, living together…okay, not that last part. So I thought I’d dig into her archives and pull up a classic Nurse Ratched’s Place post. This is one of my favorites. See if you don’t agree after reading The Abandoned House.


Nosokomaniac is starting his nursing career as a CNA and gives a great description of Week One, the Awakening.  There is something about getting tied to a bed and a practice massage, but don’t take it from me. It’s over at Nosokomania.

Over at Code Blog, Geena has A Rambling and Some News and Some Other News! I don’t want to spill the beans here, but I will say a HUGE Happy Blogiversary as she enters her SEVENTH year as a blogger!  Seven! Holy cow! Gina was one of the first (if not THE first) nurse blogger I ever read! She blazed the trail upon which we hike! <– very poetic, yes? : )

I think we all better get over to see Max at It Shouldn’t Happen in Health Care, STAT! In Welcome to 2010, he’s making predictions and one of them is that he may stop blogging! I don’t think so, buddy! Don’t make me fly all the way to Australia and smack you!


Thanks for reading this edition of Change of Shift! If you would like to host an edition, drop me a line – I’ll be in contact with those who have expressed an interest already!  The next edition will be here at Emergiblog – submit using the contact button above or Blog Carnival. If you have issues with either one of those routes, you can always DM me through Twitter (@Emergiblog).

(Remember, Change of Shift now has subscription options; you can follow by email or RSS feed. An aggregated feed of credible, rotating health and medicine blog carnivals is also available. Many thanks to Walter Jesson at Highlight Health for setting those feeds up!)

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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