August 3, 2011, 12:15 pm

So, You REALLY Want To Be A Nurse?

Editor Kitty is pretty funny!

Actually, I’ll be hanging out with a bunch of “Editor Kitties” tomorrow!

I’m giving a talk on “Getting Started in the Blogosphere” at the annual conference of the International Academy of Nurse Editors, held at the Sir Francis Drake Hotel in San Francisco.

Check out their initals: INANE! 😀 Something tells me this is a fun group of folks!

Wish me luck. My biggest fear is they will introduce me and I’ll stand there with my mouth open and nothing will come out for an hour! Or all they will hear is Charlie Brown’s teacher: wah wah wah-wah wah…. 😀


I have a new blog! I’m now blogging over at – my first post went up this week. The site just underwent a revamping as did the blog, and I’m looking forward to posting twice a week on nursing education and other nursing related topics. I’ll be earning my MSN eventually, so this was a perfect fit for me! Learning new html stuff, too! It was bound to find me! LOL!


And if it looks like my MacBookPro is smokin’, well, it’s because it is!

I’m in blog heaven!

Twice a month you can find me at, where I am writing about my recent experiences in the job market (and my hard-earned education in what NOT to do!).

The easiest way to find me is to subscribe to the newsletter.


You want to be a registered nurse?

Let’s cut through the B.S. and get real about it.

Put a hold on all this soft-focus “I live to care!” or “It gives my life meaning…”

Here’s the reality.


You will study your ass off.

Nursing science is based on biology, chemistry, microbiology, anatomy, physiology, psychology, sociology and philosophy. Yeah, every single one of them. You will incorporate those into every decision you make in your practice. It’s called critical thinking. You master it and become a professional, or you don’t and you become a robotic technician.

Bottom line.

Your choice.

Oh, and the studying doesn’t stop after you graduate. Nursing school is just the warm-up.


The work is physically exhausting and emotionally demanding.

Are you tiny, petite? No? Neither am I and neither are your patients. You will push, pull, lift, turn, transport and transfer loads you wouldn’t even consider attempting at a gym. The lightest patient is dead weight when bedridden.

You probably won’t get a chance to eat. Need to pee? Should have thought of that before you left.

Legs that weigh 500 pounds each, feet that throb, backs that ache – welcome home after your shift. Give that ibuprofen bottle a hug; it’s your best friend.

Patients die. You are tough; it doesn’t bother you. But on your way home it hits that someone’s mother won’t be making Christmas dinner next week or you remember the father collapsing in your arms when his daughter was pronounced…

And you cry.

It sucks.

You really want to deal with that?


You’re first in opinion polls and first on the firing line.

Oh yes, the public loves nurses.

Until you are the nurse.

Patients get pissed off. They are tired, in pain, hungry, cold, upset, frustrated, agitated, ticked off at the doctor, bad food, had to wait. Guess what. YOU get the brunt of it. Family members, too. Decades of emotional baggage and they have to show they care for the patient by yelling at the RN.

In twenty different languages!

YOU are the one through which all things come, and never fast enough! Including explanations for why every single department in the hospital is behind, late, inept. My favorite is fielding questions as to why Doctor Holy Mother hasn’t shown up yet.

And when she does, expect to be totally ignored.


Body fluids.

If the body produces it, you will handle it. Feces (insert your own euphemism here); vomit; blood; infectious exudate, aka “pus”; vaginal drainage of every sort; amniotic fluid; saliva in the form of spit directed at your person and whatever secretions a trachea is producing on a given day.

Each fluid comes complete with it’s own odor. None of them are pleasant. Often, when these body fluids occur in combination, their odors combine to produce a new and distinct aroma. When alcohol has been consumed and is in the process of being metabolized even more unique olfactory combinations ensue.

Some of these linger and will come home with you, as they seem to settle in your hair and skin, even without contact.

You will gag and most likely at one time or another you will vomit yourself.

Just keepin’ it real here, folks.

If you are lucky, you will be wearing protective gear when said handling occurs.

Other times, all you can do is duck and pray.



They come from various state and federal agencies. You can be sure of one thing: they will make your job as a registered nurse harder.


And if it shouldn’t, like nurse-patient ratios, the administration will find a way to turn it around and use it against you. That is a whole post in and of itself.

Ostensibly they are all for patient safety, but in reality they exist because somewhere, someone does not want to reimburse for something and so ponderous regulatory hoops will be put into place before the money will flow, usually in the form of “documentation”. New forms, new regulations, more work, less patient care…

Makes ducking body fluids seem like a Disneyland “E” ticket….


So, you still here?


You must really want to be a nurse.

Okay, then.

Oh, and all that soft-focus stuff?

About living to care and giving life meaning?

It’s true.

We’ll talk about that in another post.

Just wanted to make sure we were all on the same page….

July 15, 2011, 12:17 pm

There’s Been A Change In Plans…

Need magazine subscriptions? Check out these guys for great prices and no auto renewals.

Apparently a few nurses did not complete their HIPAA modules!

My goodness, ladies, remember yourselves!

You just know that one in the back follows all the rules, all the time. Doesn’t eat at the nursing station. Has the best cap. Her charts are perfect.

She’ll peek later.


When I applied to the University of Wisconsin to begin my BSN program, I took a leap of faith. I didn’t know how I was going to afford it, how much work it was going to take or, basically, what the hell I was getting into.

I was nervous. I was excited. And I was at peace with the decision from day one. Everything fell into place.

I was meant to be there.

Now I’ve been accepted into the MSN program at California State University at Dominguez Hills.


Have you ever had misgivings about a decision and pushed them into the background, discounted them as “butterflies”, ignored the nagging little voice in your head? Until one day, something happens and you realize you are not being honest with yourself.

That’s what has happened to me.

It seems so trivial.

But it made me realize I made a mistake.


What triggered this realization?

On July 12th, the trustees of the California State University system approved a 12% increase in tuition for the fall semester. A semester I had already been charged for, by the way. California has budget cuts, I get it. This state is basically a financial cesspool. But the trustees also approved a $100,000 raise for the president of San Diego State. This esteemed academician will now make $400,000 a year.

Going into debt for this degree ran against the grain of every bone in my body, but I was going to take a small student loan to get started. But not anymore. Not for this program. I will not take on debt for a 12% increase in tuition so a university president can get a 25% raise in the same year. I don’t know about you guys, but $300,000 AND A PROVIDED RESIDENCE is a damn good living, even in San Diego and even in California. I’m sure there are people willing to do the job for $200,000.

(You can best believe my would-have-been nursing professors don’t even see half that.)


CSUDH is a great program with a good reputation. They are a pioneer in nursing distance education. One of my colleagues graduated with her MSN in Nursing Education from the program and she absolutely loved it.

But this is neither the time nor the program for me, and all the doubts about attending and the misgivings about financing that I suppressed, ignored or rationalized came to the forefront with this one news headline.

I’m still going for the MSN, but something tells me I’ll be looking outside the state of California.

Graduate school is an enormous decision, frankly, more than I appreciated. I am going to take my time, research the programs, evaluate the options. And I’ll know when the decision is right because it I’ll be at peace with the decision.

You’d think I’d have learned by now to listen to that nagging inner voice…

July 6, 2011, 12:56 pm

Who’s The Grown-Up Here?

Get great prices on nursing scrubs every day.

Ah, the benefits of sand therapy!

Time for little Bettina’s daily afternoon face plant!

Not only does it appear my colleague is about to lose her grip on her patient, I’m concerned about her choice of body mechanics.

I predict a lumbar strain in 3…2…1……

(This photo is from the Library of Congress collection.)


Call for submission: I am putting together a July issue of Change of Shift. I have a few submissions in the books, if you have a nursing blog, or have a nurse-related blog post on a non-commercial site and would like to have a submission included, please click the “Contact” button up top and send it on in!


I love my pediatric patients. While it is hard to see children feeling sick, they can be bright spots in occasionally hellacious shifts.

I’ve blogged before on my observation that the kids seem to be the adults in the some families.

  • They don’t want to undress for an exam, so they fight the parents who are helpless in the face of taking a shirt off a three-year-old.
  • They have to be restrained so they don’t run rampant in the ER, and they slap their parent across the face. The parent doesn’t respond.
  • They are told they need to cooperate with a procedure and they answer their parent with a loud, clear, “F*** YOU!” At the age of five. The parent retreats.

Interestingly, I see it in families at all economic levels, in a variety of ethnic groups and cultures, and in families where the parents are both younger (teens, twenties) and older (forties).

Unfortunately, it is becoming less rare.

Part of me wants to go into a rant on the lack of discipline of the younger generation (….and get off my lawn while I’m at it!)

But this is serious.

These kids are my patients.

And this lack of parental assertiveness, this fear of standing up to their children, is affecting their health.


“She doesn’t want it.”

“He wouldn’t take it.”

“He just wasn’t up to taking any medicine.”

This is the response of many parents when asked if their children received any medication for their fevers.

Parents who are sitting in the emergency department with a sick, febrile child are allowing said children, ages 18 months to 5 years old, to decide whether or not they will take medication for fever!

But it gets better/worse…they take the same stance with their antibiotics.


And this makes me seethe.

Parents, are you out of your minds?

A child is dependent on you to protect them and to do the right thing to keep them from harm. When it comes to illness, that means making the child take their medication.

  • That’s right. Make them take it.
  • As in force them to take it.
  • As in hold them down, restrain their movements, ignore their screaming, administer the medication and don’t stop until it has been swallowed.

I don’t care if they don’t want it.

I don’t care if they don’t like it.

I don’t care if they aren’t “up to it”.

They do not have a choice. They are children.

They will cry, and get over it.

They will scream, and get over it.

They will kick, and get over it.

They will be mad at you, and you will get over it.


If you choose to allow your child to intimidate you, slap you or cuss you out without discipline, that is your perogative.

Good luck when they are adolescents, you (and society) will reap what you have sown.

But that child cannot make decisions for himself and you had better damn well step up to the plate as a parent and take responsibility for making sure that child takes the medication he needs.

Not medicating your child because they don’t want it or don’t like it is flat out abdicating your parental responsibility.

Someone needs to be the grown-up in this situation.

That needs to be you.


The technique of giving medication to a little one who tends to gag, throw up or (as they get a bit older) spit can be tricky. I have a way of administering oral medication that seems to stop that in its tracks.

Disclaimer – this is NOT medical advice, it just worked for my kids. I use a medication syringe and place a tiny amount of medication inside the cheek. A tiny amount. That way, it doesn’t go to the back of the throat and cause gagging and it isn’t on the tongue so they can’t spit it out. When they swallow (and they will, even if they are screaming, they will reflexively swallow eventually) I repeat.

It takes a little longer to give the medication this way, but it works with all ages (until they are able/willing to drink from a med cup) and it gets the medication down. No gagging, no vomiting, no spitting! : )

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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