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.

November 6, 2008, 6:51 pm

Ah, but I Digress

Well, I’d love to write something on nursing right now, but my mind and heart are in Cleveland.

I may be responsible for the first NFL-related Twitter Fail Whale!

Brady Quinn has done great the first half of the Browns vs. Broncos game and even though it isn’t even over I have GOT to say it’s fun to have “my” quarterback back in the saddle!

I am so stoked! I have waited for this day since Brady graduated from Notre Dame.

It’s good to be a fan.

November 5, 2008, 1:10 pm

Michael Crichton

The most frightening book I ever read was “Jurassic Park”.

Far from the adventure movie we have all seen a million times, this novel was downright evil.

I read it in one sitting.

And trust me, if you want to hear every creak in the house, jump out of your skin when your cat meows, watch the hair on your arms stand straight up and feel your throat close because you have forgotten to breathe for five minutes,

Read it at 4 am when you are home alone.

I did.

And then I went out and bought every single book Michael Crighton had written.

Some of his work I loved (“Prey”) and some I found appalling (“Rising Sun”) and one of his projects has affected me every single day that I work (“ER” – via the public’s perceptions).

Geeze, I wish I could write like he does.

Like he did.

The fact that he is dead absolutely sucks.

We’ve lost a great talent, a great intellect.

I think I’ll start at the beginning and re-read the entire catalog. Wikipedia says his last novel will be released in May of 2009.

Time to pre-order.

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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