January 14, 2009, 12:52 pm

What Have You Done for Me Lately?

I know I usually try and put something funny at the top of my posts, but I was taken by this photograph.

Images like this are what re-enforced my decision to be a nurse long after Cherry Ames had lit the fire.

This is what I wanted to be.

*****

The photo was taken in 1955, in Detroit, by a Mr. John Dominis for Life Magazine and is from a photo essay of the Polish community in that city.

If it’s an iconic photo, this man probably photographed it.

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Well, I’ve lost 15 pounds in 11 weeks and managed to do it over the holidays

Yep! Over the holidays!

And it’s all due to Richard Simmon’s Food Mover Program.

You move the little covers over the food exchanges as you eat and you move your butt and off the weight comes. No magic. Less in, more out, less of me.

But he really makes it fun!

God Bless him and his sequined shorts!

******************************

The nursing profession is fragmented.

The are a million nursing organizations that all claim to speak for the American nurse.

But do they really?

Let me give you the images that come to mind when I think of three specific organizations.

Only one of them is worth my time and effort.

Keep in mind that my ignorance will be wide open for all to see – this is just my gut response.

I will opine on the California Nurses Association, the American Nurses Association and the Emergency Nurses Association in that order.

No mysteries here. ENA gives the most bang for the buck. We’ll look at why that is, and why the others do not.

*****

Let’s start with the California Nurses Association. Or more specifically, the CNA/NNOC.

Somewhere along the line my state nursing professional organization turned into a national nurses organizing committee engaging in an ongoing, pardon my expression, pissing-match with the SEIU.

Every year I give over one-thousand dollars to the CNA/NNOC. I have no choice.

The good:

  • High salaries and good benefits
  • Legislation that has improved working conditions, nurse-patient ratios for example. Not that we have any semblance of that in my ER. Sorry, administrators-of-my-hospital, but we don’t. Glad to give you examples if you want ’em.
  • They are partnered with the Physicians for a National Health Plan, a single-payor plan I actually can get behind.
  • Backup to fight for ourselves and our patients. I don’t know why contract negotiations have to be so adversarial, but hospitals negotiate to the bottom line only. (Nice try, Sutter!) IMO, they put more into glossy ads than they do into nursing! You want stats to back that up? Ooops, just my opinion. Sorry.

The bad:

  • They support legislation I do not agree with. One example: they opposed parental notification of pregnancy/abortion for girls under 14. I opened my voter’s guide to see Rose Ann DeMoro’s name at the bottom of the opposition argument. Excuse me?
  • They fought like hell to stop the proposition that would have required unions to get members’ permission before spending their money on political measures. When I called to try and get my dues lowered so angry was I that I had to pay for this, I was told that my particular dues would be added to the “general fund” and used for salaries and overhead and not political purposes. This was good. Except I have no proof that this is what is happening.
  • They gave money to political candidates that I did not, and would not have, supported, including commercials I did not appreciate. I helped pay for those.
  • There is no way I can cease to be a member because membership is mandated at my place of employment.
  • There is no way I can be an “employment only” member, paying only for the cost of what it takes to represent me. I have to be a full member, paying full dues.

So, essentially, CNA/NNOC has me by the proverbial cohones by fighting for decent work environments, while giving me no voice or any chance to oppose their political activities.

The ugly:

  • For months, my daily mail delivery was an ongoing “battle of the junk mail” from CNA and SEIU bashing each other. How much did they pay for those glossy, fancy brochures?
  • I am really tired of seeing angry nurses on my CNA literature, or hearing about them breaking laws and police barriers to get a message to the governor (for example).

This is NOT the 1960s, folks. And we are professionals. We do not break laws.

You want to protest? Berkeley always has something going down.

A picket line? Fine. We need backup to fight for our patients.

A protest? Get Bob Dylan to write you an anthem.

Oh wait, he already did:

“You don’t need a weatherman to know which way the wind blows.”

And I don’t like the direction it’s blowing.

Too bad I have no power within my “professional organization” to “protest” when I disagree with them.

January 10, 2009, 3:08 pm

Change of Shift, Nurse TV and a New Kid in Town

Oh, the shame.

She looks like she slept in that cap.

In fact it looks like she slept in her uniform!

Maybe that was the style of the ’30s.  The droopy look.

Even the button on her left chest pocket is drooping.

I don’t know the movie, but I know the actress is Bebe Daniels.

Wait, this could be the movie “Registered Nurse” from 1934 (via imdb.com).

Mayo Methot was also in the movie. She was married to Humphrey Bogart before his marriage to Lauren Bacall. They were called the “Battling Bogarts” because they fought so much!

I’m a major Bogart fan; that’s how I know all this stuff.

My mind is full of useless trivia.

********************

Holy freaking cow!
Emily over at Crzegrl, Flight Nurse not only hosted this new edition of Change of Shift, but she went out and recruited new submission/submitters AND did an entire post on how to host a blog carnival!

And she was worried because she didn’t have a “theme”. Good lord, girl, with an edition like that you don’t need a theme, you ARE the theme!

Thank you SO much for a wonderful edition. Next edition is back here at Emergiblog, so the submissions can come to me through Blog Carnival or to “kmcallister911 at mac dot com”.

********************

There’s a new kid in town!

Trauma Junkie, RT student extraordinaire and proprietor of Surviving RT School has put together a carnival, well, of breathing!

Introducing: A Source of Inspiration!

This is his fantastic logo – the quote alone is amazingly appropriate for the respiratory therapy focus.

But it’s not just limited to respiratory therapists – it’s for everyone who has ever had, dealt with or treated respiratory conditions. I know I have a few oxygen (or lack thereof) related stories that I’ll be submitting.

First issue, Friday, February 13th so deadline for submission is February 12th. “All submissions should be sent to js0095001 {at} gmail {dot} com no later than Thursday, February 12, 2009 at midnight CST.”

I am really looking forward to this – carnivals are a wonderful way of staying in touch as a blogging community and I welcome Trauma Junkie to the wide world of blog carnivals!

*********************

Well, I nearly fell over.

While I was writing this post, a show came on called “NTV – Nurse TV“.  Real nurses and real cases.  I’d love to give you a link to the website, but either Comcast is running through molasses right now or the site is not working.

It was a decent episode, talking to a cath lab RN who was working with a nine-year-old girl with severe coarctation of her aorta. They ballooned and stented and the before and after photos were stunning.

But the neat thing was, they showed the nurse talking to the family after the procedure (the doctor had talked to the family also, but that was not shown, the focus here is nursing), showing them with the patients before the procedure and what they do to assist during the procedure.

(About the only flaw I saw was that when it came time FOR the procedure, the child looked like she was in a science fiction nightmare – staring wide-eyed at the equipment around her and probably not too overly comforted by a nurse pointing out the “choo-choo train”. After all, she was nine. Perhaps more familiarity with the surroundings would have helped with the anxiety.)

Then we got to see student nurses run a code on a mannequin (pretty realistic).

If you live in the San Francisco Bay Area, the show is on Comcast Cable KICU, channel 36 (Cable 6) at 1 pm on Saturday afternoons.

It took a long time to find the show on the site (when it finally loaded) and then it barely gave any information. It should be up front and center on the main site.

January 9, 2009, 3:06 pm

Pain, Potty and Position Protocol for the Professional Peon

Wow – that is a mega cap!

There must be 2.5 inches between the black stripe and the top of that thing.

Too much space there. I give it a 8.75 on the Emergiblog Cap Rating Scale.

I see this nurse is making sure the doctor does all his documentation.

Some things never change.

If I had a nickel for every time I was told, as a nurse, to put the appropriate order form in front of the doctor’s face if he wasn’t using it, I’d be flying to every Nascar race this season.

Don’t know ’bout you, but the doctors I work with are professional men and women who can take responsibility for their own charting and ordering protocols.

I’m a Registered Nurse. I raised my kids. I don’t need to be babysitting doctors.

*****************************

It has been my belief that the ER technician is the unsung hero of the department.

Doctors and nurses come and go, but a solid ER tech (along with a solid unit secretary) are the foundations of a smooth running department.

One would think that management would understand and appreciate the never-ending work of the emergency department technician.

One would think.

Let’s examine this in a hypothetical situation and see if we can draw any conclusions.

*****

Pretend you are an ER tech in a medium-sized community hospital; we’ll call it Hotel Get-Well. You work 12-hour shifts.

Your duties? As varied as the patients you care for. You transport them to x-ray and you run their blood to the lab.

Some days, every bedpan and commode are filled just for you to specimize and measure the contents thereof. Those colorful suction canisters are changed by your gloved hands, the same ones that just helped change the diaper of a patient old enough to be Lincoln’s grandfather on his mother’s side.

*****

Every single ER patient is transported up to their room by you, and we don’t have the technology of beaming them up. Every single patient in the entire hospital who receives a Celestial Discharge is taken to the heavenly holding area. By you.

IF you are not busy (!), you are expected to help other departments take their patients to CT or go with the house supervisor to take a patient to the MRI.

“No!” is not an option, btw.

These expeditions can take up to 1-2 hours, during which time the ER is short-staffed.

To make it worse, sometimes you are asked to run and get medical records because it is scary down there and you’re a guy and the supervisor is female and, well, you won’t get raped/maimed/murdered or abducted by the the Homicidal HIPAA Hell-Cat.

Oh, and did I mention that you are not the house “orderly”? This isn’t even in your job description.

*****

You clean every ER room after discharge, you re-vital patients on a regular basis and you never rehydrate yourself because there is no time to pee anyway.

If any stock is low, it’s probably (sarcasm) your fault (/sarcasm) because you did not order it and either way you have to run to Central Supply and pick it up. And while you are on the way, you might as well take down all the instruments that you have cleaned and prepped for sterilization.

You are responsible for stocking every single 2 x 2 and every packet of Surgilube. God forbid you forget to do the QC on the One Touch.

*****

You dress wounds, you apply splints, you do crutch training and you act as the go-fer when the doctor is suturing. You run out with wheelchairs to help people who can’t possibly get out of their cars, even though they managed to walk to them and sit down on their own power.

You hold cricoid pressure and you knew the appropriate rhythm of chest compressions long before the Bee Gees became the poster boys of CPR.

At any given time you answer to one secretary, four nurses, a physician’s assistant and a doctor.

Simultaneously.

*****

Pretty intense job description, eh?

It gets better.

Now, in the name of patient satisfaction, you have been told it is your job to round on every patient every hour, including those in the waiting room.

Of course, you must document all of this.

Welcome to the “Pain, Potty and Position Protocol”.

And while our hospital, techs and all others discussed in this post are hypothetical, that title is not.

I wish I had made it up.

*****

When the hell are you supposed to do all this? If our hypothetical ER was the size of the Daytona International Speedway {second superfluous Nascar reference} , this could be an issue.

But it’s not.

The hypothetical managers, when faced with the hypothetical red-faced-spittle-producing anger of this new hypothetical protocol say, “Now, now.  It’s just a nice thing to do when you aren’t busy.”

When you are not busy.

Some folks just don’t have a clue.

*****

So on behalf of all those hypothetical ER techs at the Hotel Get-Well, allow me to join you as we hypothetically hurl.

Should the term “Joint Commission” come up in relation to this new program of patient satisfaction, I swear I’m going to become a Nascar groupie or a Starbucks Barista.

Just when you though you’ve heard it all, the inane garbage continues to spew forth from the Powers That Be.

Why not just let us be?

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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