November 14, 2008, 9:55 pm

Presidential Advice Via Grand Rounds

Did you hear that???

No, it wasn’t an earthquake here in the San Francisco Bay Area.

It was the sound of, oh, about 200 of my friends and family hitting the ground after seeing a picture of Barack Obama on my blog.

You might say I didn’t vote for him.

However, there comes a time when you need to look ahead and as he will be my President, I figured I’d look at the bright side.

1. He’s the best looking President we’ve ever had. John Kennedy, the runner up, doesn’t even come close. Folks, I saw women at work fighting over the front page of the San Francisco Chronicle the day after the election so they could have the full page photo. No, I was not one of them, but yeah, he’s cute.

2. We’re going to have little kids in the White House again! For some reason, I like that idea. How cool for Malia and Natasha to see their dad elected President!

3. Michele Obama wears totally cool clothes. Wasn’t crazy about the election night dress, but she is so elegant. I may get a few pointers.

Now, I know that I say nothing of weighty matters like national security or health care, but come on, who can argue with the three points I just made? I have four years to look at the other stuff!


And now for a word from our sponsor: Change of Shift. Tomorrow. Crzegrl, Flight Nurse. Be there!


And all that was an introduction to Dr. Rob’s hosting of Grand Rounds over at Musings of a Distractible Mind, where he gives job advice to a guy who just got a job a few weeks ago and needs some pointers.

If you get my drift.

Here is why you should drift over to Dr. Rob’s:

1. Dr. Rob reveals he worked at Wendy’s and the thought of dry burgers stressed him out.

2. The picture of the Yoda spaniel. Srsly!

3. I did not know that Dr. Val was Canadian! See what you learn during Grand Rounds?

4. One of my Zippy photos is there!

5. One of my posts is there!

6. They are blaming autism on Disco. Oh come on! One day Barry Gibb is saving lives and then next minute we hear this? Oh, wait, they must mean Donna Summer’s music…

7. The funniest Macintosh cartoon ever written since the beginning of time. It’s all I can do not to swipe it and post it over here. Instead, head over there and check it out now!

It’s a great edition, full of llamas and goats and burgers and lobsters and the only thing missing is you!

I’m a day late, but I fully intend to forget the housework, forget the homework, forget the hubby (he’s at a hoity toity wine-tasing in San Francisco) and grab my coffee and catch up!

Nice work, Dr. Rob!

November 12, 2008, 11:31 am


Remember the Toland family?

It started over at Grunt Doc, picked up some steam at Dr. Anonymous’ radio show when Kevin Haynes called in with the story of Staff Sergeant Toland. I wrote about them here.

Well, they made their trip to Disneyworld and the family had their Princess dinner with Cinderella.

Now they are home.

And if you would like to know what your generosity helped build during the week they were gone , it’s all right here on CNN:

Dying Soldier Gets His Wish

If you can watch that video without getting teary eyed, you are a stronger person than I!

November 8, 2008, 12:49 pm

Livin’ La Vida ER

This may come as a shock, but in my entire nursing education, I never had my instructors help me get dressed.

“Dressings” had a whole new meaning by the time I was in college.

I wonder if this came from the “RN-to-Mrs.” degree program.

If Nursie McZip, RN, could not get your dress fastened all the way, did you flunk the course?

After all, if you were doing those calisthenics, your dress would close!

Wait a minute.

Now it all makes sense!

They were dressing up for Social Dancing and Etiquette 101

Perhaps this was a totally strict nursing school and dating boys was not permitted.

No fraternizing with the medical students!

Besides, you never knew when a formal dance would spontaneously erupt on the ward.


I had intended to write a somewhat scathing rant over another item from a recent “staff meeting”.

Lord knows it has given me enough material for a National Blog Ranting Month (NaBloRaMo?).

The latest “idea” is to take nurses from other departments (specifically medical/surgical and telemetry units), have them pass a few competencies and then come on down to the emergency department and fill in some holes in the schedule!

While the ER is immune from census issues, the floors are not. The floor nurses are getting canceled. A lot.

So why not utilize them down in the emergency department?

After all a nurse is a nurse is a nurse, right?



I read what they were planning to do and I went ballistic.


Emergency nursing is what is called a “specialty “. It takes a certain mind-set and a particular type of person to function efficiently in that environment. It takes skills that aren’t necessarily measurable in “competencies”.

Imagine taking those same nurses and telling them they are going to attain “competencies” and work in the intensive care unit or in labor and delivery or in surgery. Sounds ludicrous, right?

What makes the head honchos think it will be any more feasible in the emergency department?

We aren’t talking a helping hand for a shift here, folks. They are talking putting our med/surg colleagues in schedule holes as actual staff – as in given an assignment.

I am not disrespecting my colleagues, either. They are competent professionals in their fields and I’ll welcome an extra pair of hands for a shift any day. But to expect a non-emergency department nurse to function with a full assignment in a department they may see occasionally is ludicrous and unfair to not only the ER nurses, but to the nurse assigned to float to the department.

But…what if…..


It isn’t unusual for the hospital census to drop, particularly in the summer.

That’s how it was back in the mid-80s. Folks just weren’t requiring critical care, elective surgeries were down. Nurses at a certain hospital voted on whether to lay-off vs. “job-share”, dropping their work schedule by one day per pay period across the board.

Mind you, this was before the days of part-time schedules. You worked full time or per diem and nothing in between.

They voted to “job-share”.

It was great. The extra day off did not have to be covered by vacation, it was just “excused”.

The low census persisted. One day the manager of the Critical Care Unit made an offer.

Would anyone like to orient to the emergency department for three days, to help out during busy times or act as another pair of hands for a shift instead of taking an extra day off?

A few of the nurses raised their hands.


One of those nurses went down to the small emergency department to orient and observe. Over the next week she did that three times.

She was hooked after the first day.

She never considered working in an emergency department. Just the thought of it had been frightening, but not anymore. She dipped her toe into the world of emergency nursing and found the water quite inviting.

She transfered to the ER at the first opportunity.

With the exception of a brief foray into pediatric telephone triage, I’ve been working in emergency departments ever since.


I never would have considered ER nursing if I had not had the opportunity to observe and orient to the department.

How many other potential ER nurses are working in my very hospital? Nurses who, if asked today, would shudder at the thought of ever working ER, but would find their niche in the chaos we call a shift.

Seems I need to re-think my initial reluctance to show our colleagues what ER nursing is all about.

Sometimes it’s good to remember where you came from so you can help others who want to get to where you are.

Even if they don’t know it yet.

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...

Continue reading »

Find Me On...
Twitter     Technorati

Subscribe to Emergiblog

Office of the National Nurse

Zippy Was Here

Healthcare Blogger Code of Ethics

  • Perspective
  • Confidentiality
  • Disclosure
  • Reliability
  • Courtesy