Nursing Voices

Wednesday, May 30, 2007

Are Bloggers an Endangered Species?

Some of our best medical bloggers are packing up and leaving blogosphere while others are taking down their public blogs and are going private. I have a theory about what’s going on. Do you believe in conspiracy theories? Here’s one that even Fox Mulder from the X-Files would find intriguing.

Doctors and nurses are telling their readers the truth about what’s happening in the health care system, and big business is not amused. The health care industry wants consumers to think that everything is hunky-dory in Hospital Land, and they don’t want health care bloggers telling patients and their family members about what’s really happening behind closed doors. We know all about the skeletons in the health care closet. At one time blogs were viewed as cutesy journals written by lovelorn teenagers and computer geeks, but not anymore. Big business has learned the power of blogging, and they don’t want doctors and nurses bashing health care services online.

There is an old adage that says just because you’re paranoid doesn’t mean that they aren’t out to get you. Is it paranoid thinking to believe that some powerful forces want to shut us down?

The Truth is Out There.

Tuesday, May 29, 2007

It's "Skool Days" at Grand Rounds

Look at these poor medical students sitting through another boring anatomy lecture. I think one of the students in the front row is nodding off. Hey, wake up! You don’t want your professor to know that you are sleeping in class. I have a soft spot in my heart for medical students. They study all the time, except when they are blogging, and they are very nice to my colleagues and me. Medical students love nurses. I know why everyone is anxious to leave class. They want to race home to read Grand Rounds. This week’s edition of Grand Rounds is up at Medskool. Go check it out.

Monday, May 28, 2007

Memorial Day

I love a lobster feast. It looks good, too. There’s nothing better than lobster and Coke. Too bad I’m not going to barbeque today. I’m going to work. I know I should stop whining. Nobody held a gun to my head to make me sign up for the extra shift, and I’m getting paid double time and a half for working on a holiday. Yes, I sold my soul to the health care devil, at least for today. I wonder if the typical Memorial Day weekend crowd is starting to drift into the hospital yet. The ER gets swamped with all kinds of injuries related to the holiday. They treat burns, cuts, and sprains, and unfortunately we can always count on someone falling out of a boat and drowning. That’s always a heartbreaker, especially if the victim is a kid. We get the drunks on psych. People who drink too much during the holidays get depressed, or turn into fighters, and they end up on my unit. I love it when they come up from the ER trying to “float like a butterfly and sting like a bee.”

Not on my shift. Kindly take your Haldol and go to sleep, thank you very much.

Enjoy your day off.

Saturday, May 26, 2007

Life is Like a Rusty Buick

Photograph by Mother Jones, RN

Forrest Gump said that life was like a box of chocolates, but Millie would have disagreed. She had a different view on life. I met Millie in 1974 when she was 100 years old, and she was quite a lady. I learned many secrets from her about living a full life.

Millie had been a schoolteacher and a suffragette. She told me that the first presidential candidate she voted for was Woodrow Wilson because he had an honest face. Millie lived through the Great Depression, two World Wars, and witnessed countless scientific breakthroughs that changed our planet forever. She was a very wise woman. One day I asked her to tell me how she lived to be 100 years old. She said that life is like traveling down a bumpy road in a Buick. She said that a Buick has zip and vitality just like we have when we are young, and then, over the years, they wear out as they travel down the road. She said that we get more dents and dings in our body over time just like a car does, and that if we live to be 100 years old, our body is ready for the junkyard. She said that the secret to longevity is the ability to understand that we don’t stop living once our body turns into a rust bucket with worn out tires and too many miles on the engine.

And so it goes. Enjoy your weekend.

Thursday, May 24, 2007

Can We Talk?

As most of you already know, individuals are pulling down their blogs or are going on hiatus because of things that are happening in the blogosphere. Nurse blogger and NJO columnist, Labor Nurse, is creating a discussion about these recent events, and she is calling for your submissions regarding health care blogging. Please send your submissions to:

Come check out Labor Nurse's new column, "You're Being (Web) Paged." The writers at NJO are waiting for YOU!

Wednesday, May 23, 2007

HIPAA and Mister X

This nursing pulp fiction book is a classic. It was published in 1961.

“Her first impression was a huge head with silver-white hair, and fierce eyes. It was like seeing the Eiffel Tower or the Colosseum for the first time after having looked at it hundreds of times in magazines or on post cards. Lily’s professional smile was frozen on her lips.

Usually she would approach a patient briskly, her hand outstretched, and introduce herself. She had been taught how to do it in nursing school—with just the right amount of cheerfulness. But this was a man who simply didn’t lend himself to this kind of approach. This was a man who had terrorized the White House, a man even the President was said to be afraid of……".

Who was Mister X?

If this were a current book, I’d guess that Mister X is Dick Chaney. He has a huge head, white hair, fierce eyes, and he shoots his friends when he goes quail hunting. I don’t blame President Bush if he is wary of Dick. Look out, George, Dick is watching you. Mister X didn’t want anyone to know that he was in the hospital. Today his secret would be safe thanks to HIPAA.

HIPPA is a great idea on paper, but it can be a pain in the posterior when you’re trying to talk to a patient’s family member over the phone.

Me: Hello, Mother Jones, RN, may I help you?

Family: I brought my wife/husband/child to the hospital last night and they were admitted to your unit. How is my family member doing today?

Me using HIPPA-speak: I’m sorry, but I can’t confirm or deny the presence of anyone on the unit due to confidentiality laws. If that person is here, I can give them a message and ask them to call you back.

Family: HUH? What are you talking about? I was there last night. I know the person is there. WTF?

These phone calls often end badly, and things get more fun when the family member, who now thinks I’m a jerk, comes to the unit for a visit. I humbly apologize for the frustration that I caused them by following the law, and explain, once again, why I can’t give out any information about their family member. I’ve had people ask me why I won’t give out information over the phone even if their family member has signed a release of information form. I tell them that I am protecting the patient’s confidentiality. After all, anyone can claim to be anybody over the phone, and how can I tell whom I’m really speaking to over the phone? I generally am able to make peace with the family, but only after spending copious amounts of time soothing their ruffled feathers.

As a side note, there’s been a lot of chatter in the blogosphere about medical bloggers and HIPPA regulations. Let me make this very clear. I write composite stories about many different people that I’ve cared for over the years. Names, dates, and other identifying factors about patients and their family members have been changed to protect the innocent AND the guilty. You are having ideas of reference if you recognize yourself in any other these stories. These stories are not about you.

Let's hear it for HIPAA. Where would we be without those glorious regulations?

Tuesday, May 22, 2007

A Double Meme

I’ll never forget those immortal words, “Double your pleasure, double your fun.” Chewing gum was fun, except when you got caught chewing it in class. We had to wear the offending wad of gum on the tip of our nose if our teacher caught us breaking the class rules. Of course, I was the perfect child, and never chewed gum at school. There was another reason why I didn’t chew gum. I wore braces, and I didn’t want to get gum tangled up in the wires.

Check out this old Doublemint ad. It says that chewing Wriggles Doublemint gum helps a woman keep the youthful contour of her face. I didn’t know that chewing gum could make a woman look beautiful. Somehow I don’t see women trading in botox and expensive plastic surgery for a pack of chewing gum.

Today, I’m doubling my pleasure by writing a double meme. I received these memes from Liana from Med Valley High and from 24 Hour Nurse from Nursing 24 Hours A Day . Liana wants to know 5 reasons why I blog, and 24 Hour Nurse asked me to write 8 random facts about myself . Here we go.

Five reasons why I blog:

Writing helps me relax. The creative process relieves stress.

I enjoy sharing information with others about things that are important to me.

I enjoy developing “pen pal” relationships with people from around the world.

Writing is a way of advocating for my patients.

It’s fun.

Here are eight random facts about me.

I am a huge animal lover.

I wrote a book about Fiesta dinnerware.

I am a perennial college student.

My kids think I’m the coolest mom on earth because I’m a blogger.

I’m a thrift store junkie.

I play the cello.

My favorite actor is Robert Redford.

My car is a Scion. I named it Milton Harvey.

I’m not into tagging people, so feel free to tag yourself.

Monday, May 21, 2007

When Hell Freezes Over and Other Highlights From the Weekend

Photograph by Mother Jones, RN

This is a photograph that I created that expresses the old saying, “When hell freezes over.” I repeated this phrase over and over again last weekend when I was at work.

Thank God it’s Monday. I know, that’s the last thing you want to hear especially if you’re reading this entry from work. My weekend was hell. It was the same old thing. You know, overworked and understaffed, but there was a new element to the mix. I think one of the units staged a sickout, and I overheard nurses from all over the hospital talking about going on strike. I’ve NEVER seen anything like this before. Ever! The phone at the nurses station wouldn’t stop ringing. The nurses throughout the hospital were about to revolt, and the docs were trying to get their problem patients off of the medical units and out the ER before the nurses walked out. Of course, they thought that the psych unit would be the perfect place to dump their patients. One doctor tried to bully me into accepting a patient. I first explained why we don’t take medical patients on the psych unit, but she insisted that she had some sacred power over me—I’m a doctor and you are a lowly nurse—so I repeatedly said my mantra about hell freezing over until she abruptly hung up on me. I think some people have a misconception about what psych nurses do all day. No, we don’t sit behind a desk and play Sigmund Freud with our patients. We are working our butts off just like everyone else in the hospital, thank you very much. I think administration is getting nervous about what’s going on in the hospital because I didn’t get any resistance when I closed our unit to admissions because of lack of staff and other safety issues. And guess what, Mr. Grinch was the administrator on call. He was the one who let me close the unit. It’s going to be interesting to see how things play out this week at work.

Thursday, May 17, 2007

Change of Shift: Volume 1, Number 24

Welcome to Change of Shift. This week’s theme is about TV Land and the nurses who inhabit the television airwaves, but before we get started, stand by for a commerical message. The new edition of "Following the Leaders," is posted at Nursing Jobs. Org. Come check it out.

Do you remember Nurse Dixie McCall from the 1972 television show, Emergency? She looks like she has too much time on her hands. Maybe it's a slow day in the emergency room because her hospital isn't offering free goodies to EMTs who bring patients to her hospital. She needs to read girlvet's post at madness: tales of an emergency room nurse about good customer service.

Forget free coffee and donuts, the one health care team member that keeps things rolling smoothly in the ER is our unsung hero, the security officer. The Forgotten Blue Line sent in this post about working with patients who are out of control. Sometimes you have to throw happy-smiling-face customer service out the window.

Good old Dr. Marcus Welby and his sidekick Dr. Steven Kiley were the doctors of choice back in 1969. They were great doctors, but it was their nurse, Consuelo Guadalupe Lopez, who kept the office running. She was the first Latina character that I ever remember seeing on television. Nurse Lopez was bilingual, and I'm sure the doctors were happy that she was in their office. Nurse M from Code Pink submitted a moving story about language barriers, and what happens when we are unable to communicate with our patients

Carol Hathaway from ER was the whole package: She was pretty, smart, and she married George Clooney. Oh yeah, George Clooney makes me drool. After Carol recovered from her bout of depression, she lived happily ever after with her hottie husband. Every girl should be so lucky. Carol took care of thousands of patients with all sorts of injuries before she married the man of her dreams. I wonder if she took care of many people who were involved in snowmobile accidents. ERnursey talks about taking care of a patient who had an unfortunate experience on a snowmobile in her post, Femur Fracture. Ouch!

Although Carol was a cracker jack nurse, she always dreamed of being a wife and mother. Kris from theChronicles of Kris gives us this post about motherhood and being a nurse.

St. Elsewhere first aired in 1982, and it featured doctors and nurses working at South Boston's St. Eligius Hospital. St. Eligius was a sanctuary for the underdog and the downtrodden. Nurse Helen Rosenthal, pictured standing between Dr. Daniel Craig and Dr. Donald Westphall, was a friend to everyone, and each week she worked hard to keep her unit from falling apart. Sounds familar doesn't it? I guess some things never change. St. Elsewhere was one of the first television shows to discuss AIDS. This was important because most people in the early 1980s didn't know anything about the disease. Nurse Rosenthal and her hospital collegues met the challenges of caring for AIDS patients head on, and delievered compassionate care to their dying patients. May from about a nurse wrotethis emotional post about one of her patients that was dying of AIDS.

One big reason why some medical shows like St. Elsewhere look so realistic is because they have medical consultants who help script the scenes. Monkey Girl said that more shows need to hire consultants. Read her post about teeth.

It's too bad that St. Eligius hospital was just the figment of someone’s imagination. We need more hospitals that are willing to care for the poor. Keith at Digital Doorway writes about a center that is doing great things. The center's program was developed Massachusetts General Hospital.

Who could forget daytime television nurse Jessie Brewer from General Hospital. She was caring, kind, and best friends with Dr. Steven Hardy. I watched General Hospital everyday during the summer when I was staying at my baby sitter's house. It first aired in 1963 when I was 8 years old, and it's been on ever since. Jessie always gave compassinate care to her patients. Raecatherine writes about the compassionate care she gives her patients , and how she deals with death.

Everyone at General Hospital had major problems they were trying to solve in their lives. Pixel RN sent in a post about a nurse who lost her nursing license because she was accused of diverting narcotics for her own use.

The Nurses first aired in 1962. The story takes place in a large hospital and revolves around Head Nurse Liz Thorpe and her student, Gail Lucas. Each week Liz and Gail wrestle with moral and ethical issues. In the real world, nursing isn't always so serious. We know how to laugh and have a good time at work. Soon-to-be student nurse, Faith Walker, from The Oracle submitted a story about how she handled a smelly situation at work.

I think my all time favorite television show was M*A*S*H. My favorite doctor was Hawkeye, and of course, there was good old Hot Lips Houlihan. I know a lot of nurses aren't really happy with Hot Lips, but if you can look past her blatant slutty behavior with Dr. Frank Burns and a whole list of other military officers, you will see a very good nurse. I think I liked the show so much because the entire camp was a little crazy. The show had a theme song about suicide. The song said that suicide is painless. Nurse William said it's not painless for the ones left behind. Read his post about a nurse's suicide. On a lighter note, check out this post sent in by Laura from Adventures in Juggling. The video looks like something the members of the 4077 would put together. You've got to see it to believe it.

Before signing off from today's broadcast, I want to thank Kim for allowing me to host Change of Shift. Kim is hosting the next edition of Change of Shift on May 31st at Emergiblog. See you then.

Monday, May 14, 2007

Grand Rounds is a Work of Art

Daniel Goldberg at Medical Humanities Blog is hosting Grand Rounds. It's a work of art. Check it out. And remember, Change of Shift is coming to Nurse Ratched's Place on May 17th.

Sunday, May 13, 2007

Lucy, Chocolates, and Our Failing Health Care System.

I’m depressed. Yes, even psych nurses get depressed. Another nurse I work with is leaving our unit at the end of the month. She’s been a nurse for years, and she can’t take it anymore. She plans to leave nursing.

She told me that she’s been thinking about this for a long time. Do you remember the Lucy show episode where she’s working in a chocolate factory? You remember, it's the episode where the conveyer belt keeps moving the chocolates faster and faster until Lucy can’t keep up anymore, and she starts stuffing the candy in her shirt and into her mouth. My friend says that she feels like Lucy. She observed that the patients are widgets on the conveyer belt, and that she hates not being able to give them the care that they deserve. The pace on our unit is getting more chaotic, and we both see patients getting shoved through a profit driven system, sometimes with tragic results. She’s had it, and she turned in her resignation last night before leaving work.

Maybe I should start working on that great American novel I always wanted to write, and start thinking about a new career. But on the other hand, if I left nursing, I wouldn’t have anything to write about for my blog, so I think I’ll stick around a little longer in the asylum we call the health care system.

Friday, May 11, 2007

Blast From The Past: Gas Wars

If you’re old enough to remember when gas stations looked like this, then you’re old enough to remember gas wars. I know that my younger readers are thinking that I'm getting senile, and that I really meant to say something about the movie Star Wars, but let me explain. There was a time when gas stations would DROP gas prices in an attempt to put their competition out of business. The other stations would drop their prices, too, hence the term gas war. I started thinking about the good old days as I drove past my favorite gas station today. Gas prices are up to $3.10 a gallon. I have a great idea for any nurse recruiters who may be reading this post. Instead of offering some pansy recruitment incentive like free parking or employee discounts in the hospital cafeteria, I think you should give all of your nurses a prepaid gas card every month. What do you think? If you use my idea, you can thank me by filling up my gas tank. Thank God my Scion gets good gas mileage.

I received this email from Mother about getting good mileage. It makes me think that a few reachers have too much time on their hands:

Subject: a study that makes sense

A 2006 study by Texas A&M University found that the average American walks about 900 miles per year. Another study by the American Beer Institute found that Americans drink an average of 22 gallons of beer a year. That means, on average, Americans get approximately 41 miles per gallon - not bad!

Before you go out and start doing a little weekend research of your own, don't forget to send in your submission for Change of Shift. The deadline is May 13th. Email your post to nurseratchedsplace at yahoo dot com.

Enjoy your weekend.

Wednesday, May 09, 2007

I’m Coming Out

Are you old enough to remember Pat Boone? I remember watching his TV show back in the 1950s on our family's old black and white TV. We used an old fashioned antenna that sat on top of the television so we could get better reception. The antenna looked like a set of bunny ears with tin foil hanging from their tips. The Pat Boon Show was sponsored by Chevrolet, so when my dad bought his 1958 Chevrolet Biscayne, I named the car Pat Boone. What can I say, I was only four years old and I thought that any guy that drank milk, and sang songs to me from inside of a television set was cool.

I picked up this book up at a local thrift shop, and after reading it, I can understand why the book’s previous owner gave it away. Let’s just say that it was far from being a work of great literature. You may be asking yourself why I’ve posted a picture of this book on my blog. Well, I’m coming out of the closet. No, not that closet, I’m coming out of the blogger closet. Nursing Jobs. Org has launched a nursing column that features a different nurse blogger each day of the week. Writers include Kim McAllister from Emergiblog, Susan McNicholas from Donor Cycle, and Labor Nurse from the Life and Times of a Labor Nurse. I’m launching my feature column, Following the Leaders, on May 10th, and like Kim and Susan, I’m dropping the veil of anonymity. I'll always be Mother Jones RN at Nurse Ratched's Place, but when when my web guy, Shane, asked me to write under my real identity at Nursing Jobs. Org, I couldn't refuse his request.

Come visit us at Nursing Jobs. Org. We’ll be looking for you.

Tuesday, May 08, 2007

Happy Nurses Week

In honor of Nurses Week, Mr. Grinch is giving each nurse at our hospital a crappy trinket, so I decided to treat myself to a little gift. I deserve something nice. I bought an IL Divo CD at Best Buy for $11.95, which is $10.95 more than what Mr. Grinch is spending on my gift. IL Divo is the whole package. Each member of the group has a wonderful voice, and each one is eye candy dressed in an Armani suit. Score!

Happy Nurses Week.

Monday, May 07, 2007

Delinquent Kids, Stupid Parents, and My Jerry Springer Weekend

Do you remember that old saying, “Spare the rod and spoil the child?” You know where I’m going with this, don’t you? There are nights when I just want to scream, “Hey, Mommy and Daddy, get a clue. There isn’t anything wrong with your child, it’s just that your kid is a demon seed, and that you’re too stupid for words.” I’m sorry if I not sounding compassionate, but after this weekend, I’ve come to the conclusion that some people shouldn’t have children.

The phone was ringing at the desk as I was admitting a new patient to the unit. We don’t have a unit secretary on evening shift, so I excused myself so I could answer the phone. The first thing I heard when I put the phone to my ear was screaming and crashing furniture, and then I heard a woman pleading with someone not to hurt her.

Me: Hello? Hello!

Woman (crying): Is there a doctor there? My daughter, (former patient’s name), is out of control. She lives with me and I’m afraid for my life.

Me: No doctor here. You need to call 911.

Woman: Please, put down the knife! No, no…. The phone goes dead.

With my new patient standing at the nurses station with his mouth hanging open, I once again excused myself while I went into a private office to call the police. I called 911, and I identified myself as a psychiatric nurse. I told the police dispatcher about the phone call, and I asked him to send an officer out to the mother’s house to make sure that she was all right. The police brought the patient to the ER, and I found out later that the patient had destroyed the inside of her mother’s house because mom wouldn’t let our former patient drive the family car. Guess where she went after she was released from the hospital. That’s right, mama took her devil child back into her home because she didn’t have anywhere else to go. Silly me, I guess I’m just old fashioned, but I always thought that people who destroyed private property and threatened to kill others usually were sent to jail. Oh my, what was I thinking? I guess I’m just being a drama queen.

About three hours later, I received another phone call at the nurses station from a parent who was dissatisfied with the care her child was receiving on our unit. The problem? We have tile floors on our unit. She admonished me for the hospital’s stupidity. I asked the outraged parent what she had against tile floors, and she said that her darling had just threatened to beat his head against our “bad” floor tile if she didn’t immediately come to the hospital to take him home. I suggested that her son was merely trying to manipulate her, and that he was safe on our unit. She started screaming at me that her “angel” wasn’t a bad boy, just misunderstood, and that he would NEVER try to manipulate her. Ok, whatever, Stupid Mother. What do I know anyway? One day she'll be telling a judge that her child is an angel and that he is misunderstood as he is being sentenced to jail.

There is an upside to having dumb parents raising evil brats. I’ll never be out of a job, and Jerry Springer will never run out of dysfunctional families for his show. Thank God for job security.

Sunday, May 06, 2007

Call for Submissions: Nurse Ratched’s Place is Hosting Change of Shift

This poor guy looks like he is suffering from a terrible case of writer's block. Notice his stiff neck, the tension in his shoulders, and how his hand is supporting his head. I think he's going to start pulling his hair out of his head any minute. I know the feeling. Don't you hate it when your creative energies pack up and leave town?

It's time to dust off the old keyboard and start typing up your submission for the May 17th edition of Change of Shift. Send your post to nurseratchedsplace (at) yahoo (dot) com by May 13th. I hope you’re not suffering from writers block because I'm looking forward to reading your submissions.

Friday, May 04, 2007

One Last Thought

Insanity: doing the same thing over and over again and expecting different results.

Albert Einstein.

Einstein was one smart cookie. Stay sane and enjoy your weekend.

Thursday, May 03, 2007

A Special Announcement

I received word from one of my readers that The Value Care, Value Nurses campaign is holding a national nurse conference call this Monday, May 7th at 12:30pm ET. The call will feature U.S. Rep. Jan Schakowsky, who will be discussing her recent nurse-to-patient ratio bill and answering your questions.

Anyone can join. The call is free. Click here for more information.

Check it out.

Wednesday, May 02, 2007

Past American Idols

No, this post isn’t about past American Idol contestants, or Simon Cowell kissing Lakisha Jones. This post is about teenage idols of the past. In 1950, Life Magazine asked American teenagers to list the individuals they admired most, and guess what! Clara Barton and Florence Nightingale were mentioned on the list. The American public has always admired nurses, but I was surprised when I learned that teenagers use to idolize nurses. Then I remembered some nursing history that may explain the results of this survey.

In 1943, the U.S. government established the United States Cadet Nurse Corps. According to the Rochester General Hospital website, its primary purpose was to ensure that the United States had enough nurses to care for the needs of its citizens on both the home and war fronts. Our government actively recruited high school girls to join the Cadet Nurse Corps. Many girls saw this as an opportunity to help the U.S. during a time of war, as well as a way of paying for a nursing education. A student nurse who joined the Cadet Nurse Corps was eligible for a government subsidy that paid for her tuition, books, and uniforms as well as a small living stipend. In return, participants in the Corps pledged to actively serve in essential civilian, military or other Federal and government services for the duration of the war. The results of the Cadet Nurse Corps included a dramatic rise in the number of nursing students, a greater public recognition of nurses, and changes in the manner in which nurses were educated and trained. I think that lawmakers should resurrect this program in order to help solve our national nursing crisis.

Maybe more kids would choose Clara Barton and Florence Nightingale as the next American Idol if they were given this type of opportunity to enter the nursing profession.

Sorry, Simon.