Eight years and 935 posts later, and with a part of me dreading this even as I write, it is time to say good-bye.

It’s been 10 months since my last entry. Many times over those months, I’ve run into a situation and thought, “this would make a great blog post!”

Yet, I did not put my thoughts into writing.

The passing of time has not rekindled the passion to write, and when the desire to write is gone, one is no longer a blogger.

Damn, that was hard to write.

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There are still topics I could write about: the metamorphosis of my hospital into a corporate appendage, the uselessness of electronic medical records (very sad realization, that), the feeling that as nurses advance their education, basic nursing care is being forgotten (oh, the stories!).

Topics like this used to rev me up, make me head for the keyboard and blow out a rant.

Now, all I want to do is reach for the Prilosec.

Even if I still had the urge to write, I wouldn’t want to sound like a bitter, sarcastic nurse who is angry all the time. And I would sound like that (I wrote the paragraph above four times before it stopped sounding like I was ready to punch the wall.)

That isn’t fun to read, and it certainly does nothing to help the profession.

These days, frankly, I’d rather spend my time off in Portland with my grandson, catching up on Doctor Who episodes from the last 50 years and cheering my head off for NASCAR every weekend.

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But it was a hell of a ride!

I have met and made friends from around the world.

I connected with nurses who shared their stories and was inspired. In fact, it was student nurse bloggers who inspired me to go back for my BSN.

I connected with physicians who shared their stories and was shown a wider perspective.

I connected with patients who shared their stories and I became a better nurse.

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And now, some thank-yous:

Shane Pike has been with me from almost the very beginning, keeping things running behind the scenes. Emergiblog would not have been what it is without him. “Thank you” doesn’t even cover it.

The “medbloggers” were able to meet at BlogWorld for four years, thanks to Rob Halper and Marc Monseau, who spearheaded the Johnson & Johnson sponsorship of our track. Thank you both! For BlogWorld and the chance to speak in Orlando!

Of course, those meetings would never have happened if Rick Calvert, CEO of BlogWorld (now known as New Media Expo) had not seen my rant decrying the lack of medbloggers at conferences. He said, “We have room for you here!” Not only did I meet my fellow medbloggers, but also my “Blogfathers” Hugh Hewitt and James Lileks! Thank you, Rick!

Bora Zivkovik gave me my first link. I remember waking up and seeing that 35 people had read the post overnight and realizing that I didn’t have that many family members who knew I blogged, so something must have happened! Thank you, Bora, for the encouragement that link provided!

Terri Polick, aka Nurse Ratched’s Place, is my “Blogdaughter”, BFF and partner-in-crime all these years. Thanks for all the fun/commiseration/support! We had quite a ride, didn’t we?

And last, but certainly not least,

My heartfelt thanks to everyone who has stopped by to read Emergiblog. A blog without readers is just a diary. Emergiblog was a success because you came to read.

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(The actual blog will remain up. Comments to all old posts have been disabled (this post is still open.) The “Contact” button still works. I’m still on Twitter as @emergiblog and if you can stand cat pictures and a lot of NASCAR talk, I’m also on Facebook. )

…for a clean, crisp empty sheet of nursing notes!

Oh! to see perfectly horizontal black lines, inviting me to hover my delicately-balanced pen above, poised to create a work of art.

Oh! to eloquently describe my nursing care in cursive so beautiful my great-grandmother would cry.

What would I give?

I’d give my (expletive) Cerner workstation a shove into the San Francisco Bay.

Yeah, we finally entered the 21st century at work.

Computerized charting. What a crock.

Boy, do I have a rant all ready to explode for this one.

But that’s the next post.

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What do you do when you lose your voice?

Your blogging voice.

It used to be so easy.

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When I started blogging in 2005 I just talked about what it was like to be a staff nurse. That was my “voice.” The stories flowed off the keyboard. Blogging was a creative outlet.

Blogging was fun.

Today, an old-school Catholic nun sits in my head, rapping my knuckles with her ruler if I even consider posting something that isn’t “prim and proper”.

The trouble is, “prim and proper” is not my style.

Now, I can write “prim and proper” with the best of them. But a blog is not the place for that. This blog is not the place for that.

And to be honest with you, I have not been all that enamored of health care in the last year or so, of watching my wonderful small community hospital become an appendage of a corporate behemoth. Or of reading about health care in terms of partisan politics every single day in the news.

I wanted to rant and blog. But I didn’t know what to say, or how to say it. Sister Super-ego wanted prim and proper, but I couldn’t produce prim and proper.

So when I went to “speak,” nothing came out.

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I don’t know where Sister Super-ego came from, or where I got the idea that everything produced on this blog had to look like it was ready for a peer-reviewed journal.

This blog never was and never will be a “professional publication”.

It’s just the story of the life and times of an emergency department nurse.

Time to get back to my “roots.”

If anyone is still reading, thanks for hanging in there!

For the life of me, I cannot remember where I found this photo, but it looks straight out of Doctor Who circa 1963.

There were nurses in one episode of Doctor Who: a race of humanoid feline nuns called the Sisters of Plentitude.

I was about to say, “You can’t make this stuff up!”, but obviously someone did!

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You would think that after 18 years online and more than 7 years as a blogger, I’d know better.

But no, I actually fell for a scam this week.

No money changed hands.

Worse.

They ticked me off.

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It has been a long time since any sort of scam-type email has come through to me.

They have improved! They don’t misspell. The grammar almost passes muster.

It seems a company wanted to use “Emergiblog” as their domain name and keyword in….wait for it…China/Asia.

You’re already smacking your head, right? “Doh!” Ding, ding, ding….scam!

The email wanted to know if I was connected with this “company” and if they were my distributor in China/Asia, because there was a conflict.

The company is a UK construction firm.

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Hmmmm.

I sent a cordial email back that said (a) I was not affiliated with the company who wanted the name and (b) I did not want the name registered by anyone else and (c) it would be a cold day in hell before I’d give the name up.

And that was that.

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Then, a second email arrives from a Yahoo address in….wait for it….China (with broken English, “Dear Sirs,”…ding…ding…ding!) saying basically, we got your message and we are going to do it anyway even though the guy who sent the first email advises us to find another name.

Okay….now you’ve done it.

Now you have pissed…me…off.

And you do not want to piss….me….off….

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The first rule of internet correspondence is that one remains cordial.

So, I sent a cordial response stating “oh, HELL no,” indicating that legal representation was being obtained.

You can’t swing a cat two feet in this family without hitting enough lawyers to form a firm.

It wouldn’t be hard to get exactly what I need.

But…

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I decided to let Web-guy extraordinaire, Shane, know what was happening.

About ten seconds later, I got the response:

“Oldest scam in the book.”

Followed by my Facebook blogger pals telling me the same thing.

How could I not have seen this?

It was only as large as a neon, freaking billboard!

I smacked my head so hard I had LOC for ten minutes.

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It won’t happen again.

I’m chagrined it happened at all.

How embarrassing.

The only consolation is that the threat to my blog identity brought out my killer instinct, even if I’m not blogging as much as I would like to.

One does not mess with another’s domain name.

It just isn’t done.

When things get absurd and all I want to do is smack my head, they make me laugh.

Case-in-point:

We were informed that Half-and-Half would no longer be provided to staff or patients. Those choosing to use creamer in their coffee would be offered Coffee-Mate, or could choose to “BYOH&H.”

“Corporate” decided this would make a good cost-cutting measure.

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“Corporate” is like the “Not Me” character in the “Family Circus” comic. Blamed for everything, but never actually seen.

Normally, this would have engendered an eye-rolling, how-much-money-do-they-think-they-will-save, 5-minute conversation and that would have been that.

However, the email noted:

Half-and-Half would be available for all physicians and administrators!

Say what?

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I thought it was a joke. It sounded like a “Scrubs” script where Carla and Lavern refuse to let the doctors have break room coffee until they get their Half-and-Half back.

But, no.

This was legit.

And I was pissed.

Not at the loss of the half-and-half, but the principle of the thing.

Surely the idea that physicians and administrators were more important than staff or patients, or were superior groups to be coddled and pampered was a remnant of the 1950s, something to be looked back on as a relic of a less enlightened time!

Er, no.

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This was such a slap in the face to the staff, and in writing, no less!

Combined with everything “Corporate” has done (or been blamed for) over the last year, it was just too much.

Then one day, I walk in and see the “Will Work for Half-and-Half” jar.

With donations in it!

I LOL’s until I had chest pain.

That’s the kind of humor that permeates my department.

And that is why I work where I work.

Working with colleagues who have a great collective sense of humor is worth its weight in…well, Half-and-Half!!!!

And right now, that stuff is like gold in my ER….

We’ve come a long way from my 1962 Barbie with the starched white uniform and blue, red-lined cape. She carries a hot water bottle and wears the best cap ever.

Now, Barbie wears scrubs with sparkly pants and carries charts with hearts on them.

Give them credit, this comes with an otoscope and a stethoscope.

I was about to give hell for the hooker-high open-toed shoes, then I realized my Barbie wears open-toed white pumps.

No controversy here, moving along.

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I’ve been busy!

First, I was blogging for multiple sites, which left me little time or energy for my own blog. It was a great experience, and I learned much about writing under pressure. I will say this: blogging with deadlines is totally different than having your own “space” and just putting down thoughts and communicating with readers.

Writing became something I had to do instead of something I wanted to do. I didn’t want to lose my passion for blogging, so I made the decision to scale back to writing solely for Emergiblog. I want to thank Masters In Nursing.com and AllHealthCareJobs.com for the opportunity to be on their writing staffs.

Then, life has gotten a bit exciting!

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My youngest daughter, Rebecca, graduated from nursing school last month!

She sat for the NCLEX at the end of May, and passed with the minimum number of questions needed.

Am I a proud mom?

You better believe it!

And the minute she passed the NCLEX, the job interviews started coming!

We are keeping our fingers crossed.

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In March, we became grandparents for the first time!

Ewan was born to my oldest daughter, Lillian, and son-in-law Jim. I was in the delivery room when he was born. The last delivery I saw was in nursing school and I fainted at that one! I’m happy to say I did not faint when Ewan was born!

He’s a big guy, 9 pounds, 12 ounces and 22 inches long at birth. At 2 months he weighed 13 pounds. Nana (me) is getting pumped biceps just lifting him.

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As if that weren’t enough, I’ve been spending the last month on a different type of baby:

I’ve been fostering these four feral kittens, caught by my son around his apartment complex.

It’s fun! I feed them, pet them, scoop their cat box, and in return they treat me like a human cat tree and eat my earrings.

Fortunately, they all now have homes and I will be saying good-bye by the end of the week.

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Oh, and did I mention I’m working a ton of overtime?

Yep, things have been jumping around here, but in a good way.

My writing mojo is back now that the pressure is off to produce on deadline. My goal for my MSN is on hold – somehow, there are just other things I want to focus on right now.

School will always be there.

Babies grow up.

How well I know that…

The host for Grand Rounds this week is none other than USATODAY!

Our very own Dr. Val took 100 (!) posts, representing the best of the medical blogosphere, and will

roll them out in four sections over the course of the day. The theme: patient-centered topics.

The sections are:

1. Health Tips

2. True Stories

3. Mythbusters & Controversies

4. Healthcare Costs

Emergiblog is in the Health Tips section! : )

You can find Grand Rounds here: in the “Your Life” section, in the Healthy Perspective blog!

Many thanks to USATODAY for hosting Grand Rounds and to Dr. Val for a fantastic job!

No one ever wants to go to the emergency department, but unfortunately illness and injuries don’t keep Monday through Friday office hours.

Here are four tips that will make your visit go smoother and keep you safer as you enter the world of the emergency department:

1. MAKE A LIST, BRING THE LIST

Bring in a copy of your medications, including all vitamins and supplements, and dosages!

Of all the things you can do to prepare for a visit to the emergency department, this is the most important!

Your safety can depend on the accuracy of this list!

Patients often think their medications are “on file” in the hospital record or that the ER has access to their doctor’s office file. This is not the case.

You are the ultimate source for knowing exactly what you take and when, and the ER staff will depend on you for that information. Even if your medications are memorized, in the stress of an emergency visit, you will forget medications or dosages.

Don’t take that chance. Take the time to make that list now, before you need it. Keep a copy on your computer, and keep it updated. Carry a copy with you at all times.

2. ROOM FOR TWO…

Emergency departments are hectic, crowded places, and visitors are limited to one, maybe two people at the bedside. Everyone else waits in the waiting room.

You should bring someone with you, but limit your companions to two. If you receive pain medication, they can provide a ride home. They can help you get what you need while you are in the department. If English is not your first language, they can help translate. They can provide updates to family and friends on your condition.

Nothing is worse than seeing six adults escort a patient into the ER, only to have four or five of them biding their time in the waiting room until the patient is discharged. Even the simplest complaint can take longer than expected to resolve if the ER is busy.

Do your family and friends a favor. Bring one or two, and keep the rest updated by phone.

3. THE WAITING IS THE HARDEST PART

Let’s be honest. A trip to the ER means waiting.

Emergency departments are working hard to decrease the amount of time you wait to be seen, but sometimes it can’t be helped.

You wait to be seen by the triage nurse. You wait for the nurse practitioner/physician. You wait for the labs to be drawn, the EKG to be done, for radiology to be ready to do your x-ray…for the results of the lab, of the CT scan…for the specialist…for the discharge instructions.

In ER, we wait quickly!

The best hedge against having to wait is to bring something to do while you wait!

Bring a book, a Kindle, a magazine. Crochet. Knit. Do a crossword puzzle.

Have an iPad? Watch a movie, surf the web.

Here’s where that cell phone comes in handy. I’ve seen parents entertain kids with videos and games on their cell phones.

4. …ABOUT THAT CELL PHONE…

Cell phones are absolutely fantastic in the ER for keeping boredom at bay while waiting and for keeping family and friends up to date on your condition. But…

Don’t let them interfere with your healthcare by taking your attention away from what’s happening around you!

Texting during physical exams, answering calls or texting during the triage interview, continuing to talk on the phone when the doctor is standing at the bedside to discuss your case, all these things take away from the one thing you are there to focus on: your health.

Give the nurses and doctors your undivided attention. Just remember, there isn’t a text or a phone call as important as your health!

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Hopefully, you won’t have to visit an ER in the near future. But if you do, these four tips: (a) Bring the list, (2) limit your companions to two, (c) bring something to do while you wait and (d) keep that cell phone in perspective, will make your trip to the ER a little less frantic!

Considering it’s been a full two months since my last post, I’d say I took a rather extended “tea time”!

I didn’t intend to take a hiatus, the hiatus just sort of took me!

I’ve actually been blogging regularly, both Masters In Nursing.com and All Healthcare Jobs.com, but it’s time to sweep away the cobwebs and spend some time at “home.”

This post was originally written for my column at AllHealthcareJobs.com. It’s about emergency nursing, so I thought I’d get back into the swing of things by posting it here at Emergiblog.

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Working in the emergency department is never dull. Oh, we have our moments of down time, but they can be shattered instantaneously by the blast of an ambulance ring-down or a critical walk-in patient (or three!)

Not all cases are serious, life threatening or traumatic. Some chief complaints are downright odd. If the truth were told, some of the reasons people present to the emergency department are downright humorous.

Humorous to everyone, that is, except the patient. No matter how off-the-wall the complaint, it is always serious to the patient.

People come to the emergency department because they are (a) in pain, (b) worried, or (c) have come to the end of their ability to cope with a problem. Sometimes it’s all of the above, but every ER patient is worried.

They are worried that they are sick, worried that what they have is serious, worried that they are pain, worried that nothing they have tried has helped.

Or, they are worried because they looked up their symptoms on the internet and are convinced the tiny red dot on their forearm is melanoma and their friend’s sister’s co-worker’s cousin had the same thing and it’s 3 am and they can’t sleep because they are worried.

This means that while the stated reason for the trip to the emergency department may make me want to roll my eyes and smack my head, the real reason the patient is sitting in front of me in triage is worry.

And worry is never funny.

Unfortunately, the availability of information on the Internet seems to have done more to escalate worry than to alleviate it, as patients look up symptoms, see the worst possible diagnoses as possibilities, and feel an ER visit is imperative.

So much of what we do in emergency care is reassurance. Reassurance and education. We examine patients and reassure them that they are okay. We educate them about their problem, giving them information that will help them cope or ally their fears, so they need not worry.

As an ER nurse, I may find a chief complaint humorous after the fact. But when a worried patient is in front of me, it is not a laughing matter. For that patient, at that moment in time, it’s the most important thing in the world. It’s important enough to get them out of bed and into an ER in the middle of the night.

That needs to be respected.

Wish you could have been in the front row of each keynote, attended every session, had a chance to hear the superstars of the blogosphere?

Me, too! There were sessions I missed!

This is year is different – over 100 sessions of Blog World New Media Expo 2011 are available online through the new Blog World Virtual Ticket!

This means you can still “attend” the same conference that was held in LA for a fraction of the cost!

This includes all the Social Health sessions, including the HIPAA session I co-presented with Jamie and Terri and the fantastic Whiteboard session.

You can get all the information by clicking on the widget in this post or the link above, they will take you to the Blog World Virtual Ticket page.

(I’m a Blog World affiliate gal, so if you buy through the link/widget I receive a percentage.

Not enough to make me rich, but hey, anything will help get me back to Charlotte Motor Speedway for the NASCAR All-Star Race and the Coca-Cola 600 in 2012.

Kasey Kahne tends to win when I’m there.

Just sayin’.)

Because right now I don’t feel like posting something funny, or cute.

I need to see this ad again.

Having a bit of a burnout/compassion fatigue/why-the-hell-am-I-still-working-in-ER-at-my-age life crises.

Been there, done that a few times.

A case manager is in this ER nurse, why is it invisible on my resume?

Feel like chucking it all and moving to Portland and being a totally cool full-time grandmother who takes her grandson to all the NASCAR races…

Okay, he isn’t born yet, but you get the idea.

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Reader’s Digest has published an article, “50 Secrets Nurses Won’t Tell You“. The link will take you to the article itself, and Sandy Summers has written a review of the article at The Truth About Nursing.

There are some interesting “secrets” here – and you’ll recognize a few of the names!

Gina from Code Blog is in there, and so is Jo from Head Nurse!

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I’ll be the first person to tell you that I am not a perfect person, and not a perfect nurse, but two of these “secrets” really ticked me off.

Royally.

The first one:

3. “Feel free to tell us about your personal life, but know that we’re here for 12 hours with nothing to talk about. So the stuff you tell us will probably get repeated.” A nurse in St. Petersburg, Florida

Seriously?

I have steam coming out my ears.

Maybe my colleague works in a thumb-twiddling clinic, but we have plenty to talk about in my emergency department. We talk with the patients, not about them, and we are too busy hauling our derrieres around to gossip. When we do, finally, have a chance to sit down, the last thing we think about are the personal lives of patients, unless it directly affects their care.

But thanks, now everyone who reads this “secret” thinks that nurses are lazy asses who have nothing to do but gossip on their 12-hour shift.

Good stuff.

Remind me to stay away from St. Petersburg…

4. “A lot of my patients are incontinent, and I’m supposed to just use a wet washcloth to clean them. But if it’s a patient who’s been really nice and appreciative, I’ll go all the way to intensive care to get some of the heated wet wipes, which are a lot more gentle. Somebody who’s constantly yelling at me? I just use the washcloth.” A nurse in St. Petersburg, Florida

So… excellent patient care is only given to those who “deserve” it. Everyone else gets “good enough.” Got that, general public?

They didn’t teach me that in nursing school, good thing this “secret” filled me in.

For anyone in the general population who is reading this – these are not nursing “secrets”. These are descriptions of the personal practices of one nurse. I read all 50 secrets and I’ll go with the other 48.

Rest assured, your personal life is not customarily dismantled at the nursing station and your care is not based on your disposition.

Nurses are too damn busy to gossip and too damn professional to base your care on how nice you are.

I guess 48/50 ain’t bad.