This came from a site describing how to make a nursing costume.

Have I ever tried to make one?

Oh, hell yeah!

I’ve made a ton of them!
And they look better than that one!

I have proof!

Is that cool, or what?

(This is what happens when I don’t have any classes to study for!)

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Next Thursday will mark the 3rd anniversary of Change of Shift, which will be hosted right here at Emergiblog.  I’m out and about looking for submissions from the nursing blogs I have come to know over these many years, and would love to have as many nurses submit as possible! After all, Change of Shift doesn’t exist without YOU, be you doctor, nurse, administrator or patient!

I’ve been wasting time working hard on a permanent new logo to start off the new year, so join in the celebration! Click the “contact” button on the top bar and send in your nurse-related stories.  This has the makings of a great edition!

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Why shouldn’t we have to pay for our health care?

Why….we don’t have that sort of money!!!  How dare you even suggest that we should pay!!!!

We manage to buy cigarettes. We manage to buy fast food.  Often. We manage to get all the channels we want via cable or satellite television. Some of us even have satellite radio in our cars. And GPS.  Our cell phones are really nice, but all that texting costs a pretty penny.   We drop a few bucks at Starbucks every week without thinking twice.

And then we roll our eyes when we have to pay for….god forbid…..health care!

*****

Think I’m heartless?  Think I’m an elitist?

Think I’m talking about the Medicare patients in my ER who bring in a super-sized number 8 from McDonalds for the entire family and hold out their right arm for a BP while they text rapidly with their left hand?

I could be.

But I’m not.

The patient rolling their eyes at having to pay was me.

*****

Yeah.

Me.

Showed up for a colonoscopy yesterday and the receptionist went over what would and would not be covered by my insurance.

My out-of-pocket payment would be $216.

And my first thought was “why the hell am I paying anything out of pocket for this? I have insurance!”

I was ticked.

*****

But why was I ticked?

Why shouldn’t I have to incur out-of-pocket expenses?

I have insurance.  Good insurance. Insurance I don’t pay a single penny for. It’s a benefit I get from my employer for working 24 hours a week.

Did I think I was entitled to full coverage because I was insured?

Entitled?

Me?

*****

Isn’t that term used to describe some patients who get their health care for “free” through a public plan?

Well, I get my coverage for “free”, too, and god help me, the emotion I felt in that office yesterday was “entitlement”.

Now I understand.

And I won’t use that term again.

Ever.

Welcome to the World of the Entitled

Either that or Nurse Nellie caused the headache.

But we know that nurses never cause doctors to have headaches, so that can’t be what’s happening.

Ha!

Trust me, there have been a few doctors over the years that have given me major headaches and I have no doubt that I have been the impetus behind a few MD migraines myself!

**********

Man, re-entry sucks.

Four days of Nascar. If it didn’t have four wheels, it did not exist for me last weekend.

You don’t just attend a Nascar race; you absorb it.

Eventually, you re-enter the real world. The adjustment takes a day or two.

I’ve re-entered, but I’m not sure I’m adjusted just yet!

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Change of Shift is up tomorrow at RehabRN. Get those last minute submissions in! You can submit through Blog Carnival (button on the right sidebar) or send them directly to “hotelrehab at nyms dot net”.

I’ll be hosting in two weeks – it will mark the start of the fourth year of Change of Shift!!! Time for a new logo!

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The guy in the Anacin ad must be doing what I’ve been doing for the last two days.

Trying to get a grip on healthcare reform.

That alone is enough to give you a migraine.

There is so much information and conjecture and opinion and debate, it is difficult to know where to start.

Who gets covered? What gets covered? Who pays? Who decides the charges? Who decides the fees? Who has an agenda: political, financial or otherwise? Private or public plan?

And the most important question of all: Who is fighting for what is best for the patient?

Because, when all is said and done, WE are “the patient”.

*****

Okay, so I’ve come up with some foundations; these are things that I feel must be at the heart of any health care reform debate:

1.   Every citizen must have health care coverage.

2.  Every citizen needs to own their health care coverage.

3.  There should be a choice between private and public plans.

4.  Every citizen must be able to choose between a private or a public plan and switch between as necessary.

5.  Each plan must cover basic health care: physicals, screening, immunizations, well care.

6.  Each plan must cover chronic or catastrophic illnesses. (Diabetes, asthma, MS, cancer – just a few examples)

7. After basic health care and chronic/catastrophic illness, each citizen should be able to choose how they want to be covered. I have heard this called the “cafeteria plan”.

*****

Gee, I don’t ask for much, do I?

We don’t have to invent the wheel here. Other countries have gone before us; there are models of universal coverage we can study.

The operative word here is “study”. Take what is good, understand what does not work and use that knowledge to form a unique form of universal health care that meets the needs of the citizens of the United States.

*****

Probably the easiest way to tackle health care is from a personal angle.

I just found out what my COBRA payment would be if I left my job tomorrow.

I’m hoping my jaw heals before I go to work on Thursday.

But that’s a topic for the next post.

Healthcare and the Headache

He did it.  He actually did it!

Kasey Kahne won the Infineon road course today.

I was SO THERE!

I am sunburnt, can’t walk for the blisters and am so dehydrated I may not void for a week.

Okay, that was TMI.

But all of that pales in comparison to the thrill of watching MY race driver hold off Tony Stewart over and over and over again to win a road course that no one on earth expected him to win

But that’s Kasey.

I am so damn excited right now I can hardly stand it.  The race has been over for almost six hours and I haven’t come off the high I get just watching this guy drive.

And, oh, by the way, I took this photo! Oh yes. I was thisclose.

Holy mama!

This is me and Brent, one of Kasey’s team guys.

Part of my race package was a chance to walk around “cold” pit row – meaning while the guys were setting up in the morning.

Brent was nice enough to stop what he was doing and take a picture with me.

He’s a great guy and let me tell you, anybody in a Bud uniform is a BFF of mine!

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Alas, my Sonoma race weekend is coming to a close which means I’ll be returning you to my regular blog tomorrow.

You didn’t think I gave up on nursing for good, did you?

Kasey Kahne Wins Infineon and This Nurse is Nuts for Nascar!

Me!

Don’t let my presence in the #18 fool you, I am not a fan of Kyle Busch.

It was the only car available.

Tomorrow I will be meeting Kasey Kahne.

Lord have mercy!

This is where I am.

Infineon Raceway in Sonoma, CA. The heart of the wine country.

Just off the raceway there are lush vineyards that produce world famous wines.

The track itself looks like the Sahara Desert.

And it is just about as hot with very little shade.

It can also be a wee bit hazardous to your health, and I’m not talking hearing loss (although nothing, and I mean nothing, compares to feeling your sternum vibrate when those machines rev their engines…).

I had just a mild case of dehydration and it wasn’t very pleasant.  Fatigue. Headache. Nausea. Fuzzy thinking. I thought I was hydrated, but apparently I was mistaken.  Two liters of water and one baseball cap later, I was fine.

Yeah, I had to wear a baseball cap. I never wear those things. I look like a dork. And I didn’t want to wear it earlier because my hair was just so and I didn’t want to show up on the SPEED channel with squished hair.

So, tomorrow I’ll wear it.

After I meet Kasey Kahne…..

And She’ll Have Fun Fun Fun Till Her Daddy Takes the T-Bird Away…

There is a new blog carnival in town and this time it’s all about the patients!

Which means it’s all about you and me, because all of us, at one time or another, are the patients.

The new carnival, Patients for a Moment is the brainchild of patient blogger Duncan Cross.  The first edition is up and if first impressions are lasting, this should be one successful carnival!

Head on over, check it out and most definitely consider sending in a post for edition #2!

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Side note: Tuesday was my 30th wedding anniversary; my husband and I were treated to dinner by my son and daughter-in-law. Absolutely wonderful!

But…I missed the premier of “HawthoRNe” (and I have a DVR!).

So, many thanks to those who are leaving comments – I am hoping to catch the first episode on the internet.  From what I am hearing, it’s not all that realistic.

Did you see it?  What did you think?

Patients for a Moment: A New Blog Carnival Hits the Scene!

Although I can’t figure out why she is smiling.

Her cap looks like conjoined coffee filters!

Conjoined coffee filters that somebody sat on!

Maybe she doesn’t realize it’s squished, and would die of embarrassment if she knew!

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I wanted to take a moment and thank the two companies whose support of Emergiblog through their advertising is appreciated more than I can say. Both Scrubs Gallery and NurseConnect provide support for many of the nurse bloggers, and I am proud to have them on Emergiblog. If you have not had a chance to check them out, please do!

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Sitting on my table: Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All at Risk, by Sandy Summers (of The Truth About Nursing) and Harry Jacobs Summers. I saw this book at Sandy’s site and could not resist. Sandy is a tireless advocate for the image of nursing, and I’m looking forward to reading what she has to say. For every book purchased, Sandy sends a copy to a media representative. You can pick up a copy of Saving Lives… by clicking on the link.

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The emergency department “regular”.

Every emergency department has them.

A patient can become a “regular” for many reasons. Maybe they are a recurrent cardiac patient. Perhaps they suffer from chronic pain. Sometimes, they become a “regular” because they utilize the ER as a clinic and bring the whole family in over the course of a month. Some regulars are drug seekers. Others are homeless and know they can find respite in the department for at least a couple of hours and maybe get something to eat.

If you work in an emergency department long enough, you will know who they are.

And you will get to know them.

*****

Recently, it dawned on me just how well you get to know them.

I work in a community hospital. It’s one of those hospitals that patients actually request to go to from all over the county. We have our shifts from hell, but it is far from the county-trauma-eight-hour-wait-time environment of the huge medical centers. There is time to talk to the patients, find out more about them than what hurts, what is swollen or what prescription they have lost.

Over time, the conversation stops being scripted and “starts getting real”, as they say.

*****

This particular shift was steady, but not crazy. And almost all the patients I cared for were “regulars”. Easily 90%. For some, it was their usual health issue. For others, something different.

I found out a lot that night over the course of that shift

Someone’s youngest would be starting kindergarten in September; someone’s oldest had just graduated from high school. Someone had gotten into a recovery program and had been clean for a month. Someone had just welcomed their first grandchild, another was mourning the loss of their mom the week before. Someone had lost their job earlier in the week. Someone had gotten married since their last visit. A baby sister was on the way for one of my patients. Another patient had enrolled in the local junior college.

We saw them, treated them and sent them on their way with a wave and a prescription.

Hopefully they left in better shape then they arrived, even if all they needed was reassurance.

All I know is that I thoroughly enjoyed that shift.

*****

I had done all the usual things.  Saline locks, blood draws. Medications and re-evaluations. IVs and education.

But I had also congratulated success, commiserated over frustrations and offered consolation over losses. We covered birth and death, struggles and successes, dropping old lifestyles and starting new beginnings.

That shift, I saw my patients in a different light.

*****

The best part of nursing has nothing to do with disease or diagnoses or procedures or prescriptions.

The best part of nursing is the patients themselves.

I thoroughly enjoyed catching up with my “regulars”.

I hope I was therapeutic for them.

They were most certainly therapeutic for me.

I See You in a Different Light

Those of you of a certain age will surely remember that famous line used in the second season of the “Saturday Night Live Weekend Update” skit.

For you youngsters who have never seen it, Dan Akroyd and Jane Curtin were the co-anchors. They would engage in a point-counterpoint debate, and Dan would always start off his counterpoint with the endearment, “Jane, you ignorant slut….”

Pretty funny at the time.

Not so funny when you use it in the blogosphere.

*****

No one has ever said that to me in a comment, probably because my name isn’t Jane.

But, a few have come close.

And I wondered. I’ve been doing this for four years.

When did the blogosphere get so nasty?

Nothing wrong with controversy and strong debate. It’s what the internet is all about; it’s why bloggers blog and it’s what makes for a vibrant discussion and for those with an open mind, it can be exhilarating.

But something is missing lately.

Manners.

*****

Given the barriers to full communication inherent in internet interactions (lack of facial expressions, tone of voice, body language), it is easy to appear curt or insulting without meaning to. In large discussions with many commenters, a response can be confusing: was it meant for the blogger or was it a response to a previous comment?

Comments are the heart and soul of the blogosphere so it is important to make your comment count.

Here are five ways to do that:

1.  Keep your focus on the topic up for discussion. Remember, it is your opinion on the topic at hand that adds value to the discussion.

2.  If you are referring to a previous comment (as opposed to the blog post itself), be sure to make that clear.

3.  Do not insult the blogger or previous commenters by resorting to name calling. Let me assure you that likening the blogger to a female dog or questioning the legitimacy of their birth is sure to dilute your point. Trust me on that one, m’kay?

4.  Sarcasm is an art form. Use it sparingly; it rarely comes across on screen unless you are an extremely talented writer.

5.  Identify yourself. Even a pseudonym is okay – lots of folks use them.  Anonymous comments don’t carry the same weight as those whose authors are not afraid to put their name/pseudonym behind their words. Which brings me to the next point:

6.  Use a legitimate email address. If what you have to say is articulate and adds to the discussion, why go to the trouble of using a phony email address to make a comment?

*****

As you may have guessed, I’ve been receiving some rather interesting comments from some rather interesting sources.

In four years, I have never had to moderate comments. I take all comers – agree, disagree, vehemently disagree…you name it, it’s here.

I don’t plan to start moderating them now.

But I will say this: if I get comments from folks with emails like “yousuck@yousuck.com” (I’m not kidding on that one). Or “lightenup@lightenup.com” (yep, that was a real one), they will be deleted immediately.  Even if they are articulate and responsive to the topic.

If you aren’t willing to use a legitimate email and your name/pseudonym, why bother to comment? Anyone can hide behind a fake email or the popular name “anonymous”.

You may have great things to add to the discussion but your opinion loses its value when you don’t take credit for it. Back up your opinion with your name/psuedonym.

I stand behind everything I write with my name.

Is it wrong to expect anything less from anyone else?

“Jane, You Ignorant &*$#!” – The Art of Commenting in the Blogosphere

If you like your media RNs drug-addicted and sex-crazed, there is a show for you over at Showtime.

If you prefer to view nursing in a different light, you may want to check out HawthoRNe on TNT.

Jada Pinkett Smith plays a chief nursing officer at the fictional Richmond Trinity Hospital.

She’s smart, tough, caring, takes on the medical establishment, stands up for her staff and fights for the underdog.

And, uh, she does patient care.

Say what?

*****

In all my decades, I have never known a Chief Nursing Officer to don scrubs and do patient care.

And Christina Hawthorne does it all!

Unrealistic?

Yeah.

Am I going to watch?

Absolutely.

*****

HawthoRNe has personal problems that don’t include drugs or sex.  She is widowed, single mother and her teenage daughter is a pain in the ass.  She, like her Showtime counterpart, is a strong woman who isn’t afraid to break the rules.

And as so many commenters pointed out in the great discussion following my “Nurse Jackie” post, no television show is going to be perfect in its portrayal of any profession (my hubby used to rail at “LA Law” every week!).

So, you can call me naive, an idiot, a pollyanna, out-of-touch, crazy or whatever name you like…

I’m taking the more idealistic portrayal of nursing offered by “HawthoRNe”.

Let’s see what TNT can do with the drama that surrounds the nursing profession.

And kudos to Pinkett Smith for bringing it on (she’s the executive-producer).

P.S. Now, what are the chances of getting Will Smith on one of the episodes ( you knew I was going there, didn’t you)?…

HawthoRNe – You GO Girl!

As far back as I can remember, he was always graduating/accomplishing something.

At the age of seven, he announced his candidacy for the office of President of the United States.

As a Democrat, no less.

This photo was taken just a couple of weeks ago at Notre Dame following the law school graduation.

The transformation from the first photo to this photo seemed to occur overnight. Hug your babies, folks, because they grow-up faster than you can ever imagine.

We managed to get 4/5 of the family together that weekend. That’s me, Kendall, hubby John and daughter Lillian.

Next graduation: me in 2010 with a BSN, followed by daughter Rebecca in 2012 with her BSN. Yep, I am living with the future of the nursing profession.

Let’s hope she keeps her unit cleaner than her room.

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You walk into the unit, put down your backpack, fill your pocket with pen, scissors, and tape, sling the stethoscope over your neck, swipe your namebadge into the infernal timeclock and enter stage right.

It’s showtime!

Get the triage, hook up the monitor, grab the EKG, slam in the saline lock – grab the bloods in the process, hang a liter of normal saline, put up the side rails, hook the call bell to the side rail, throw on a warm blanket, medicate for fever and slam the chart in the “to-be-seen” rack.

Repeat x 30 over the next eight hours.

Feel like burnt toast, look like burnt toast, act like burnt toast.

*****

Where’s the patient?

You know, the person you just triaged, hooked, slammed, hydrated, side-railed, blanketed, medicated and lined up for evaluation?

Oh.

Did it ever occur to you that the reason you feel like burnt toast is because you are so focused on what you are doing you have lost sight of the “who” you are doing it to?

*****

Well, it occurred to me.

Because that is exactly what had happened.

Oh, my physical care was fine.

But I had stopped looking patients in the eye. I was spitting out standard responses instead of listening to what my patients were saying. I was expending the bare minimum of energy required to complete tasks.

I was doing; I wasn’t caring.

And I was burnt.

*****

But I discovered something.

And this is huge.

I was not focusing on tasks because I had burned out, I burned out because I had started focusing on tasks.

Let’s face it. The ER, while seemingly exciting to those outside the ambulance doors, can actually feel redundant to those of us who deal with the same issues every day. The same complaints. The same symptoms. Over and over and over.

So, what makes each case interesting? What makes each case unique?

The patient behind the story. The person under the symptoms.

Lose sight of the person and you lose sight of the profession. Lose sight of their humanity and you lose sight of your own. Lose sight of your own and you become a burnt shell.

*****

You would think that after three decades of this, I’d have figured this out by now.

I guess you never stop learning.

This time, my teachers were an elderly man with a DVT who talked to me about his time on the LAPD, back in the day.

And the young woman who described, quite vividly, how it felt to go from the pinnacle of health to the devastation of a cancer diagnosis, overnight.

Or the 18-month old who tucked their head under my chin and fell asleep as Mom described  the terror of witnessing a first-time febrile seizure.

*****

Who would have guessed that sometimes patients are the cure for burn out and not the cause of burn out.

The patients didn’t change, they were always willing to talk.

All I had to do was stop and listen.

That simple.

Go figure.

Sweeping Away the Ashes

Mr. Coffee called and they want their filter back!

*****

Could have used Nurse Latte-Head this week.

Breakfast in bed, a pretty new bed jacket.

(Remember “bed jackets”? Do they still make those?)

The good news is that I can now breath without Herculean effort.

The bad news?

I can’t smell anything and I can’t taste a thing. My taste buds are gone, kaput, buh-bye.

Makes it very easy to diet.

Actually, we utilized my lack of taste-sensory organs to conduct a scientific experiment at work.

I am well known for my inability to tolerate spicy food. Makes me nauseated and diaphoretic. My esteemed colleague, Stand-Up Comedy Dude, wondered how a lack of taste would affect one’s ability to eat hot, or spicy, food.

Never one to turn down an opportunity to utilize myself as a guinea pig, I promptly threw down a packet of Crushed Red Pepper Flakes on a saltine.

Whoa.

My mouth got warm and my sinuses cleared slightly.

Rather anti-climactic, actually.

On the one hand I could handle any combination of body fluids for the rest of the shift with no olfactory assault, but on the other hand I couldn’t lean over a patient too closely or I’d be guilty of causing an olfactory assault (and singe their eyebrows in the process!).

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Now that school is out (insert it’s-my-blog-bragging-rights-here: 4.0 for the semester, whoo hooo!) and I’m at a loss for what to do with all this…how do you call it…free time, I intend to plop my rear-end at a Starbucks at every opportunity and indulge my blog addiction with a newly rediscovered fervor.

And I’ll start with this week’s Grand Rounds, up at David’s Health Blawg.

Don’t forget to send your submissions to the next Change of Shift to Barbara over at Florence dot com (email: blynnolson at gmail dot com)!

Breathing is Underrated (I’m Back!)