February 20, 2010, 8:32 am

Why Don’t You Just Become a Doctor?

Ah, the Nursing Olympics!

Here we see the U.S Synchronized Study Team.

The judge, visible at the end of the table, will look for uniform cap placement, the exact angle of the binders, the uniformity of handwriting and the perfect 90 degree angle of the elbows.

Should they meet the stringent criteria, they will receive the coveted Gold Stethoscope.

Which will inadvertently be taken by a physician who asks to borrow it.

(Here’s how long I’ve been a nurse: I was once told by a colleague to get a pink stethoscope because no doctor, being male, would walk off with a pink stethoscope. Yeah, I’m old!)

But in defense of doctors, I recently worked with an ED doc who was frantically searching for his stethoscope. Could not find it anywhere. Finally, one of the nurses found it. Around my neck. Along with my own stethoscope. Truly a red-faced moment.


Change of Shift is now up at the INQRI Blog (The Blog of the Interdisciplinary Nursing Quality Research Initiative). The focus is on education, and was the inspiration behind this post. The next CoS will be hosted by Mamatrauma and submissions can be sent to “clynewarnr at earthlink dot net”.

Leslie at Getting Closer to Myself will be hosting the next Patients for a Moment blog carnival, so send your submissions! Check the link to her blog for the post with all the information!


It was a quiet night in the ED; we were shooting the bull about various topics. I said I would be graduating in May with my BSN and applying to a PhD program next month.

And then came the question.

“Hey Kim, if you are going to go through all that education, why don’t you just become a doctor?”

I explained how nursing is an independent discipline with it’s own body of knowledge and research, that nursing and medicine were separate professions…

I wasn’t getting my point across.

But then I thought of a better question.

“If you are going to go through all that education, why don’t you become a pharmacist?”

Doesn’t make sense, does it?

Neither does the nurse/doctor question.


Do you remember that old television commercial, “If caring were enough, anybody could be a nurse?”

Or this poster, which singlehandedly pulled me out of burnout?

Caring is the heart of nursing. I’d even say it defines nursing (see: Jean Watson).

But, the  foundation of nursing is comprised of anatomy, physiology, psychology, lifespan development, pathophysiology, philosophy, sociology, ethics, multicultural studies, critical thinking, leadership, statistics, research and

Nursing Science!

Why is this so hard for people to understand?

What is the problem?


Oh, I know the usual spiel: nurses used to be “trained” in hospitals, nurses deferred to doctors, nursing did not require a college degree, nurses could not practice independently, nurses just did basic care…yadda, yadda, yadda.

And that was all true.

About 70 years ago.

Well, it’s the 21st century, folks. Let’s drop those excuses once and for all.

There is absolutely no reason for anyone alive today to not understand exactly what nursing is and what nurses do.

We need to talk about it.

Hell, we need to bring it up. At every opportunity.

And please, spare me the nurse recruitment videos with the emotional music and nursing sitting there talking about how they feel they are making a difference. Show me a video with nursing talking about making a difference while discussing what it means to be a nurse. The education involved.  The ability to think critically. The ability to work under pressure. The ability to be flexible. The ability to stand up and advocate for your patient.

For your profession.

And why it is worth pursuing!


Frankly, it takes a good pair of “cohones” to be a nurse. The education is intense and the profession is challenging.

If you want to “help people”, go volunteer at a convalescent home.

If you want to care for people as a professional nurse, you’ll study harder and work harder than you ever imagined.

And when you’ve done that, you’ll “make a difference” in ways you never dreamed of.

So yeah, I’m a little sensitive when someone asks me “Why don’t you just become a doctor?”.

I don’t want to be a doctor.

I’m a Registered Nurse.

Now let me tell you why….

February 4, 2010, 3:05 pm

Change of Shift is Up; Next Edition Taking Submissions!

OffwhitelogoThe new edition of Change of Shift is up at Rehab RN!

The next edition will  be hosted at the Blog of the Interdisciplinary Nursing Quality Research Initiative, also known as the INQRI Blog. The Initiative is associated with the Robert Wood Johnson Foundation.

The theme for this edition of Change of Shift is nursing education.

Submissions can be sent to “INQRIChangeofShift at gmail dot com”.

5:31 am

The Kids Are Alright

iphoneapp:locNurse Jones was impressed with the NeoNatal App on her new iPad, but the device was much larger than she expected.

I plan to get an iPad.

I wonder if it comes with “wings”. Is the deluxe version called a Max-i-Pad?

Sorry, I had to get my feminine hygiene jokes out of the way.

I mean, Steve Jobs could hold up a toilet paper roll and I’d go into debt for it.

But, this time I’m waiting.

I will wait until the iPad runs OS X, supports video and runs more than one app at at time.

Don’t make me wait too long, Steve!


Speaking of Steve, he figures prominently in this week’s Grand Rounds over at Dr. Rob’s Musings of a Distractible Mind. Ground hogs and llamas and iPads, oh my!

Change of Shift will be up this evening at Rehab, RN!

Selena at Oh, My Aches and Pains is hosting the next Patients for a Moment carnival, so send your stories!


Something is in the air.

Work has been uncharacteristically crazy,nuts,bananas busy since I returned from my influenza-induced hiatus. Scores of very sick people, no real pattern. And a ton of pediatrics.

Feverish, coughing, runny-nose, wheezing, stridorous, vomiting, diarrhea-having, screaming, combative, medicine-spitting small humans.

It’s not easy triaging these little folks. You have to get the history over the crying/screaming, try and obtain vitals while they kick off any and all probes, do a rectal temperature if they are under 2 years old (wrestling to keep them still), and weigh them for medication dosing.

You have to do all this taking into account their developmental stage/age, which affects everything from how you approach a pediatric patient to what behaviors would be considered “normal”.

Then there is the “two-fer”. One child is sick? Well then, let’s check the other one, too! Never mind that the other one isn’t showing symptoms but might be incubating a virus as we speak, or had symptoms and is now on the mend, the logic of the parents is “might as well check them both!”


So that’s a double triage.

Time consuming. Energy consuming. Hearing-loss inducing. Nerve-grating.

And absolutely gratifying.


Didn’t expect that, did ya?

There is something about building a rapport with a child, starting at triage, that makes all the above worth it.

The smiles that you get when you first say hi (before they realize there is an assessment involved!)

The baby who verbalizes back when you talk to her.

The toddler who laughs when the oximeter probe falls off.

The tiny Disney Princess who is proud of her Ariel slippers.

The boy who scans the Wong-Baker pain scale with a serious expression so he can pick just the right number.

Giving Tylenol and/or Motrin to a cranky, miserable, feverish child and then watching them play peek-a-boo with the curtains 30 minutes later.

Hearing giggling from the room as they play with siblings.

Watching them snuggle the teddy bear you just gave them.

Seeing the look of excitement when they see you have a juice box (what is it about juice?)

The tiny hand waving good-bye as they leave the department.


In the midst of some hellacious nights, I’ve taken care of some wonderful kids.

It isn’t easy. Caring for kids can’t be rushed. They can be a challenge.

But when it’s all said and done, it is the most gratifying part of my work.

The kids are alright, indeed.

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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