September 4, 2008, 12:33 pm

All I Have to do is Dream


I know that I always say Emergiblog is 99% apolitical, but I absolutely had to post this photo.

The man on the far left is my husband, John.

In the middle is my son Kendall, who was an undergraduate at Notre Dame when this was taken.

And that is not an imposter on the right, that really is John McCain!

Kendall had the opportunity to intern for Senator McCain for a semester.

I have a great respect for John McCain, but at the time this was taken I never, ever, ever thought he’d be the nominee for President. I am thrilled, and proud, to have this photo hanging in my home.

Well, if you didn’t know before, now you know I’m a conservative Republican.

And Kendall? He’s in his third year of law school and Editor-in-Chief of his Law Review.

And a staunch Democrat.

Go figure! LOL!

[I now return you to the 99% apolitical Emergiblog…]


Aw man.

I hate dreaming about work.

It’s like pulling an entire shift and not getting paid for it.

Well, I had a doozy last night.

My dreams are always surreal, and this was no exception.


Seems I got to work and everything was a mess.

Someone had baked a cake and there was cake mix everywhere. Liquid, gooey batter. A few co-workers were licking spatulas.

Everyone had frosting all over their face and no patient care had been done so I was going to have to take eleven patients.

Now this was a weird unit, part ER and part ICU, made up of four-patient cubicles.

It’s been in my dreams before, but I’ve never seen it in real life.

In fact, this particular mind-unit is always in my dreams.


I was trying to put my nursing shoes on but they had cake batter in them.

And no one cared.  That my shoes were full of batter.  That no patient care had been done.  In fact they had such a laissez-faire attitude that I started chewing them out.

I said things to them that make me cringe right now thinking about it.

I let it all hang out, everything I thought of them, their nursing care and what I thought of their mothers and their parentage in general.

I mean, cake batter in your nursing shoes?  No wonder I went all up in their business!


And these weren’t just current co-workers.

They were co-workers from the last thirty years.  All decades represented.  The ’70s, the 80s, the 90s and the 00s – none were spared! (Oh, and if you are a current or past co-worker and happen to be reading this, you weren’t in the dream m’kay?)

There were people I hadn’t thought about in twenty years.  But boy, did I let them have it with both barrels.

It’s embarrassing just thinking about it.


Then, in all my self-righteous glory, I explained to a bunch of doctors I had never seen before that the unit is never this messy and lord knows I couldn’t clean it up myself and gosh darn it, there was an ER across town that would take me in a split second and wouldn’t put cake batter in my shoes!

I mean really.

I walked haughtily out of the unit with my squishy cake batter shoes.


I honestly have no idea where this dream came from.

My unit is nice, we don’t make cakes there and we never have eleven patients.  I’ve never worked in a unit where cake batter was a problem.

I’ve worked in units where a cake was decimated and eaten in fifteen minutes flat, but that’s different.

Why did I feel the need explain to these doctors I’ve never seen in real life (cute ones, at that) that I, Super RN, could not clean the mess up? Oh poor, poor pitiful me (<—vague Warren Zevon reference; could have been worse, I could have referenced “Werewolves of London”.)

As for chewing out my co-workers, well, yikes – I may have an issue now and then but I never bring their parental background into it!  I don’t even know it!


Usually my work dreams consist of feeling like my feet are stuck to the floor and I can’t move.  That things are going so fast I can’t keep up.

That one is understandable.

This one just made me feel like a schmuck.

Anyone who interprets dreams and wants to take a shot at this Twilight Zone piece of mental imagery, drop me a line.

It’s freakin’ me out!

September 3, 2008, 12:59 pm

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August 30, 2008, 11:19 am

Chopped Liver to the ER, STAT

Oh, this is hilarious!

It is so obviously not a real hospital room!

The solid white backdrop – no oxygen, no light fixtures, no code button, no intercom.

Okay, so maybe they didn’t have those back in the day.

It’s hard to see, but there is a piece of tape on the glass bottle that says “Saline”. It looks like the tubing coming from the IV is rubber and about the size of a garden hose.

Is there anyone out there who has been in nursing long enough to remember rubber tubing?  I’m embarrassed to say that glass bottles were still in use when I started (and no pleurivacs, either – just three glass bottle water seal drainge!)

It seems that they practiced make-up application and used hair arranging as a therapeutic intervention.  That patient looks really sick, doesn’t she?

Heck, I don’t look that good and I’m healthy!


I have a problem.  With nursing.  WTF have we accomplished in the last 30 years?

Awhile back I handed a chart to our unit clerk.  On the chart, I had checked the standard blood tests required for a patient presenting with chest pain.  I then turned to tell the doctor about the patient.

Before, I had a chance to say a word, the clerk swiveled in her chair, put the chart in front of the doctor and asked, “Is it okay if I order these?”.

After I picked my jaw up off the desk, I said jokingly,  “Betty, are you questioning my author-i-tay?”.

Then I heard something even more astounding.  Betty told me that one of the doctors instructed her to run any and all nurse initiated orders by him first.  So, in order not to get in trouble, she did that with all the doctors.

WTF?  This is wrong on so many levels.

  • First of all, every nurse in my department is a seasoned veteran.  Together we have over a millennium of nursing experience.  I’m serious.  We don’t frivolously order labs or x-rays on a whim, we have the education and experience to know what needs to be ordered when.  Particularly with chest pain patients.  Especially with chest pain patients!
  • Then, to top that off, we have a very substantial nursing protocol for us to use on patients presenting with numerous chief complaints that covers us for the very thing I was trying to order.
  • The doctor in question has never, EVER said anything to the nurses about not ordering tests.  I find having the unit clerk question the order to be surreptitious.

Let’s make it clear here.  I’m not perfect.

But I’m also not talking major radiological, invasive studies.  I’m talking labs and extremity x-rays.

Which brings me to my next issue.


The supervisor on duty that night (a good manager and someone I respect very highly), was astounded that we were “allowed” to order anything!  That we were treading on thin ice.

My response?

“Julie, are you telling me that an experienced, educated, professional registered nurse is out of line ordering x-rays for obvious fractures or initiating a cardiac workup when a patient obviously requires it?”

That was exactly what she was telling me.

Oh dear Lord.

That could explain why a very esteemed colleague of mine stood in the very same facility and watched her father die while the telemetry floor nurses would not get an EKG, order a chest x-ray, call respiratory therapy or draw blood work because “the doctor would be coming in”.

Shouldn’t we, as nurses, have those things ready when the doctor shows up?  Isn’t that the point of working in the hospital, to facilitate the care of our patients, to intervene when they go critical, to be prepared for the unexpected?  Especially in the emergency department, of all places, especially in an emergency department that prides itself on door to dilatation times that are so fast they can give you vertigo?

Am I nuts here?

What the hell are we nurses these days?  Chopped liver?



How can we fight for our professionalism when our own nurse leaders at the grass roots level don’t support it?

How are we really being perceived when doctors pay lip service to us one minute and then have the unit clerks run our basic protocol-driven nursing actions by them before initiation?

What the hell is going on with my profession?


Please excuse the language, but I am pissed off.

This profession needs to get its you-know-what together if we are ever going to be taken seriously by anybody.  We can differ, but we have to present a solid front to the public, our community and to the medical profession.

And that front needs to be, say it with me….professsional! I don’t care if you spend your shift emptying bedpans or writing national nursing policy.

Nursing is an autonomous, distinct profession with it’s own research and evidence-based practice.  How long before we start to get treated like it.

Nurses, we had better take the reigns here because no one else seems to (a) want us to do it or (b) even think we might actually KNOW something.

How the hell do we ever expect it to change if we don’t do it from the grassroots up?

Even if it means taking it one person, one institution at a time.

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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