November 4, 2008, 1:58 pm

Elect to Read Grand Rounds!

It’s time for the Election Day edition of Grand Rounds!

Mother Jones has put in a great deal of research and effort to produce a wonderful Grand Rounds of history and Presidents!

It’s not widely known, but I am a history buff and especially a Presidential history buff! This is right up my alley and a post after my own heart. Head on over to Nurse Ratched’s Place , check out the information, check out the topics and if you haven’t done so yet, be sure to vote!

“I Voted” – the one sticker you can wear on your shirt as an adult and not feel silly!


Speaking of elections, I was pleasantly surprised when I went to the polling place today. I usually go mid-day because it is sloooooooow. But not today! We were lining up to vote and everyone was talking enthusiastically about the election. Not the candidates or issues, but the fact that it was Election Day!

The poll workers, usually around 80-something years old, were young! As in 20s and 30s young! There was an energy that is not normally felt at this elementary school entrance hall where my neighborhood votes.

No matter who wins or loses tonight, we all had the chance to make our voices known! And while I have a severe case of chronic election fatigue, today I was excited to be a citizen and cast my ballot.

Corny? Maybe to some. But it’s a genuine emotion and I intend to enjoy it, no matter what the outcome!


Emily at Crzegrl, Flight Nurse is hosting the next Change of Shift and although it won’t be “Pirate Day” like the last time she hosted, I’m sure it will be just as entertaining!

Send submissions to Blog Carnival or to “emily at crzegrl dot net”.

Emily is in Minneapolis for a convention right now! Hey Emily, where ya stayin’?


Well, there are blog carnivals and then there is the mother of all carnivals, the Metacarnival!

The brain child of Alvaro at Sharp Brains, the Metacarnival takes the best of the carnival blogosphere (medical and non-medical) and puts it all together in a once-a-month extravaganza!

Individuals don’t submit to the Metacarnival. The “keeper” of each Blog Carnival chooses one or two of the best posts sent in that month and they submit to the host-of-the-month at Metacarnival.

From birds to biology to anthropology to medicine to nursing to oceans and more! Think of it as a neighborhood block party where all the different neighborhoods can get to know each other!

And, if I’m not mistaken, that block party is going to be here this month!

I’ll keep you posted on the details.


Remember the post I did on the Robert Toland family? Well, Kevin from the American Legion has sent in a link of some photos of the project taken while the family was away.

And the story was filmed for “Hannity’s America” on the Fox News Network.

Many thanks to those who have sent in checks to help the family!


Well, I started my 50,000 word novel for the National Novel Writing Month on November 1st. The event is hosted by the Office of Letters and Light. They help students and adults find their creativity via writing through special programs, in addition to hosting the NaNoWriMo.

I’m looking to raise $200 in donations so that I can go to the big Write-a-thon in San Francisco on November 15th where 200 novelists will sit and write for six hours with much food and fun for all. If you would like to help me get to $200 (or more!) in donations, my FirstGiving page is here.


There are lots of great opportunities to help out there. Beka, our favorite Medscape Nurse blogger, suffers from dystonia and yet manages to work as an intensive care nurse. Once an avid cycler, Beka is no longer able to ride (and suffered an inability to walk recently that kept her bedridden for a week!).

Well, has put together a Bike4Beca ride, where you can ride, walk or hike along the “virtual bike trail” to help earn funds for research into the disabling disease of dystonia. Beka is actually the founder of Care4Dystonia, and the story is truly amazing. Check out the links on the left sidebar when you visit Beka’s site.

October 31, 2008, 7:33 am

Army of One Needs Support of Many

Last night was a special night on the Doctor Anonymous Show on BlogTalkRadio. His guest was ER doc and law school graduate Symtym.

Fun show, some tech talk, lots of laughs.

And then a surprise caller. With a story.

A story that you need to hear.


Robert Toland is a Staff Sergeant in the United States Army. He’s fought for our country and defended our freedom for eight years.

Robert is in the middle of the photo, with his wife Melanie and their three daughters. Lilia is 5, Skyler is 2 and Morgan is 1 1/2.

On November 1st, this family will be taking a vacation to Disney World.

It will likely be their last vacation.

Robert Toland has colon cancer. He’s been told he has just a few months to live.


Back on October 25th, Kevin Haynes, Service Officer in the American Legion, Post #1460, Machias, York emailed Grunt Doc.

It seems that the Christian Youth Corps, a group of young people working in western New York, had earned enough money to send the family to Orlando. But the one thing they could not arrange was a “Princess Dinner” with Cinderella. Money was not the problem. Trying to get a reservation quickly was.

Did Grunt Doc have any connections?

Well he found out that he did, as an anonymous reader came through !

The Toland girls will have a (complimentary!) special dinner with their Daddy (and Cinderella).

But it doesn’t end there.


You see, Kevin was the caller to Dr. Anonymous last night.

And I’m not being facetious when I say there was not a dry eye in the chat room.

The Toland family heads off tomorrow for Orlando.

But their house will not be empty.

I’m not sure how much of this I’m supposed to say, but let’s say there will be some, uh, extreme makeovering going on at the Toland house while they are gone. Changes that will help make Robert’s life a little easier as he faces the end of his life’s journey.


Would you like to help?

There is no way I can’t, having heard this story.

The way I see it, Robert has given eight years of his life in the service of my country.

Surely there is something that I can do for this “Army of One”.

If you would like to join me in supporting the Toland Project, send your contributions to:

ATTN: Kevin Haynes, Service Officer
American Legion Post 1460
9688 Main Street
Machias, NY 14101

(Note: Put “Toland Family Fund” in the comment section of the check.)

My check is “in the mail” today.


The story of the Toland family will be shown on the Fox network (Not sure if it will be “Hannity and Colmes” or “Sean Hannity’s America”). I’ll post the dates and times when I learn them.

I’m thankful for men and women like Robert Toland and I will keep Robert and his family in my prayers as they face a difficult time. It’s the blogosphere that allows us to hear stories and help people that we never would have known otherwise.

The blogosphere is an amazing place.

I’m happy to be a part of it.

October 30, 2008, 8:33 am

So I Go Insane, Like I Always Do…

No, this is not a rehearsal for a Busby Berkeley musical.

These are student nurses!

Apparently calisthenics were part of the curriculum back in the day.

Nursing school was a lot more than studying and clinicals, you know.

One had to learn the niceties of society and proper etiquette, too!

I have an entire photo shoot on the life of a student nurse in the 1940s. When I post them, I’ll warn you ahead of time. You won’t want to be eating or drinking while you read, as aspiration is to be avoided at all costs!


Our Change of Shift host for the week, Amanda at Crazy Miracle Called Life, has just posted the new edition!


If you have not yet voted in our poll for topics to cover at next year’s medblogger conference, please do so! The poll stays up until the end of November.

I am amazed at the number of opportunities that are open for us next year! One minute it seems impossible and the next minute opportunities are there that we didn’t even know existed.

I’ll keep you posted on what is happening as details are finalized.

And now for our feature presentation:


Is it just me or has the nursing profession gone insane?

Let me give you a, shall we say, hypothetical situation.

Let’s say you work in a medium-sized community hospital.

The nurses in this medium-sized community hospital have busted their butts over the last year or two implementing Joint Commission standards surrounding medication administration.

For example:

  • The chart containing the medication order is taken to the bedside so that the medication can be checked against the order before administering.
  • All medications are either drawn up at the bedside or labeled in the med room when they are drawn up.
  • All patients are identified with two identifiers – full name and birth date (and they must say both!).
  • Full and complete (as much as possible) medication lists are obtained on arrival to facilitate medication reconciliation.

Let’s say these procedures have led to a dramatic drop in medication errors, which is what they were designed to do.

Time for celebration? Time for kudos? Time for acknowledging that our work has been effective, that the patients are safe, that this is a wonderful statistic and good for us, let’s keep up the good work?


What the nurses in this hypothetical department get (and this has happened twice, hypothetically, of course) is a note from the pharmacy stating that their percentage of medication errors is not up to what is expected, ergo they are not reporting their med errors.


Pardon my language.

Maybe I’m crazy, but there is a certain percentage of med errors expected of us the nurses in this ER?

That isn’t even the most astounding part of this Catch-22.

What the pharmacy is saying is, if I can paraphrase, “We know you are making these errors but you are not reporting them, meaning you are not acting ethically or professionally.”

This is bull****.

Pardon my language.

And who was sticking up for the nurses in this hypothetical ER? Who went to pharmacy and said, “Hey, buddy, we’re a damn good group of professional nurses and did it ever occur to you that our errors are down because we have worked our asses off to GET them down.”

Pardon my language.

No one did. Nada. No chance for feedback, as this pharmacy feedback was first put on a post-it note on the Pyxis and then repeated in a note that functions as a staff meeting.

In this hypothetical ER.

So all of the work, the extra vigilance, the extra time in filling out extra paperwork, the time actually doing what we those nurses were supposed to do (and then some) led to an improvement in patient care.

So obviously they are doing something wrong in not having their medication errors up to par level.


Am I nuts? Have I gone insane? Does anyone else see the ludicrousness of this scenario?

All I know is that there is a hypothetical nurse getting fed up with a hypothetical middle sized community emergency department.

Tell me.

Are there ANY hospitals out there who treat nurses with any modicum of respect?

A hospital where someone might stand UP for their nurses when something like this is comes up?

Please, let me know.

Because I am losing faith in the ability of this profession to stand up for itself.

I’m thinking a letter to the hypothetical Chief Nursing Officer with a cc to the manager of this hypothetical emergency department might be in order.

Lord knows it won’t change a thing, but there is a hypothetical nurse who might feel better.

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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