August 26, 2008, 10:41 am

Alas, Grand Rounds; I Know Them Well

Doubt thou the stars are fire;
Doubt that the sun doth move;
Doubt truth to be a liar;
But never doubt Grand Rounds.

I hope Will shall pardon my paraphrase of Hamlet’s words in Act II, scene ii.

Hamlet totally rocks, as does Teresa at Rural Doctoring for the Shakespeare theme of this week’s Grand Rounds!

And just for the record, Lawrence Olivier gives the best performance of Hamlet I’ve ever seen ( with all due respect to Kenneth Branagh), although the critics of Olivier’s time disagree with me.

I wonder what Zippy thinks?


Rima from The Doctor Blogger has submitted a proposal called The 3G Project to the American Express Members Project. The projects that get the most votes will be funded. Rima does not receive the money, but the institution administering the project does.

In fact, here is a bit about what the project hopes to accomplish:

Teach health ed to pre-school age kids living in disadvantaged homes while parents and/or grandparents are present to also learn in a non-threatening setting. Kids hear the information early and all generations can work together to make healthy choices. Use a digital web based approach to “Teach the Teacher” what to say and how to say it.

Right now, Rima is around #27 and needs to make the top 25.

She can do it if we go to the site and nominate the project. I have put in my nomination. It costs nothing and takes a few keystrokes to accomplish. You do not have to have an AmEx card to vote.

Preliminary votes must be in by September 1st.

Good luck to Rima and The 3G Project! Be sure to keep us posted!


This is so exciting!

Emergiblog advertiser/sponsor and nursing community has reached their 300,000th member!

That is not a typo – that is an amazing accomplishment!

Congratulations to! Here’s to continued growth and a deep “thank you” for your support of Emergiblog.


Another round of thanks to all who have volunteered to host Change of Shift! We are up into January dates now! Holy cow – I’m going to have to put up dates way into 2009!

Of course, the next edition is being held at the newly renovated Nurse Ratched’s Place, so be sure to send your links in via Blog Carnival or to “motherjonesrn at yahoo dot com”

August 25, 2008, 8:01 am

Urgent!!! Help/Supplies Needed


This is a quick post to let you know what I found on Healthcare Today.

You really need to see this.

The 73rd Calvary in Iraq working in a convoy support center are running a burn unit!

These are non-medical guys, they work on trucks, but they are seeing/treating about 40 kids a day with burn injuries.


They volunteered. The Iraqis built a primitive but effective triage center and our guys are working to help these kids heal.

These are not war-related burns – there is a high incidence of domestic burns secondary to boiling water and oil from cooking.

Because they are not war-related, the guys of the 73rd cannot use Army supplies to treat the burns (a rules-of-engagement thing).

They need donations of physical supplies (not money or checks).

Lots of them.

I found bulk gauze rolls and non-adherent dressings on, but they need other supplies as well.

Read the post.

Watch the videos.

And then donate.

How could I not?

And if you can find bulk supplies of Medihoney, please let me know – they need that really bad!

August 24, 2008, 4:28 am

My Charade is the Event of the Season

How could we ever forget the old commercial:

“Remove wrenched ankle..HA-HA-HA!”

I wanted to punch that kid, and I was about the same age!

I was not a good player of “Operation”, either, I always made the nose light up.

Good thing I didn’t go into surgery, folks would be running around with electric, red noses.

The price of the game today? $14.99 on

Did they increase the fee paid for removing that ankle?

I bet the “fees” haven’t changed from the original game. Guess it isn’t so far from real life as I thought.


I am a hollow shell.

How’s that for a dramatic beginning?

It’s how I feel right now, and it hasn’t changed since I last left my unit..

I expended so much mental and emotional energy during my run of night shifts. And no one was critically sick.


Let’s make things clear from the outset, so you don’t think I’m a burnt out old hag.

The vast majority of patients who present to the emergency department are patients who are anxious about something that is happening to their body. It may be serious. It may be nothing.

But they don’t know that.

My job is to validate their feelings, help relieve their symptoms, plan an approach to help them solve the problem and make sure they have the resources to follow up.

This is what I do as a nurse. I engage my patients. I am there for them and my physical and emotional energies are directed at helping them get through a stressful time, be it a life-altering event or a minor illness.

It can be exhausting, but it’s a good exhaustion. A sense of accomplishment. The feeling that maybe my presence and my nursing care made a scary time easier.


But what are you supposed to do when you are being “played”?

When the BS is so thick the unit needs twenty-five septic tanks just to handle triage.

When you might as well be a waitress at the IHOP because all you are basically doing taking the patient’s order, and the patient knows you will do it because they are, well, the “patient”.

When all you are is a legal conduit for drug administration with a clean needle.

When the story you are being told as “history of present illness” has so many holes in it swiss cheese is a block of marble in comparison.

And they know you know it.

But you have to treat them.

And they know it.


I’m not a perfect nurse by any stretch of the imagination (and I have a unit full of colleagues to confirm it!), but I put my heart and soul into my patients.

And I hate being manipulated. More specifically, I hate being part of a system that can be manipulated, at will, by anyone who knows the right buzz words.

Trust me, I see right through the act.

Do they see right through mine?


I am acting, you see.

These patients will never, ever see the anger, frustration, and fatigue (emotional and physical) that being manipulated engenders.

They will get a smile, a warm blanket tucked in, their meal delivered, detailed discharge instructions discussed with them.

Because while I may not be a perfect nurse, I am one hell of an actress.

The performances I put on during a recent run of shifts were worthy of Emmys, Tonys, Oscars and Grammys. (Okay, hold the Grammys, I don’t sing.)

The patients got everything they needed, when they needed it. They also got everything they demanded, when they demanded it.

My charade really was the event of the season.

And I walked away feeling like my soul was dead.


To paraphrase a famous Prince song: this is what it sounds like, when a nurse dies.

I don’t like that feeling.

Thank God I’ve been in the profession long enough to know it doesn’t last.

But it hurts like hell to be numb.

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