Dr. Goldberg is into policy, not bedside healthcare, so I think my question threw him for a loop.  I asked about futile care and how it fits in with healthcare reform.  His answer took on a very strong “ethics” angle, which is not the direction I had intended for my question to go!

Despite my derailment, the other bloggers that participated in the call asked excellent questions - they are Kim, RN from Emergiblog, Dr. Wes Fisher,  Dr. Edwin Leap, The Happy Hospitalist, and Dr. Brian Vartabedian.

You can listen to the podcast at Better Health.  Thanks Dr. Val for the opportunity to participate!

Doctors in general are type casted to fit a certain mold of the friendly family-man who helped you when you were a child.  You typically grow up with this mental image of your first pediatrician and the way he gave you lollipops when you behaved yourself during traumatic incidents like shots.  Doctors have typically been painted in the light of a saint, because for many people around the world, they have served to offer them a bit of humanity when the rest of the world turned their back.  The doctors who have helped treat patients in Haiti, African nations, or even war and poverty-stricken area are some of the most outstanding individuals that modern society can produce.

One of the first books I read in college was entitled The Rape of Nanking, which chronicles the destruction that the Japanese army caused on the Chinese city of Nanking.  Some of the main stories that stood out to me at the time (other than the fact that this huge massacre goes largely unnoticed in history books) was the account of the many Western doctors who offered their services to the residents, risking death in order to stay with their patients.  Once the war fully broke out, most foreigners fled the city, although around 25 remained in order to provide some protection for the citizens, establishing the Nanking Safety Zone.  The Zone itself was centered around the U.S. Embassy and was run by Nazi Party member John Rabe who was responsibility for saving nearly 200,000 Chinese citizens from death.  While this is an example of an old historical event, it is still a telling sign of the dedication to many of these aid workers; the Westerners who remained in this zone were true humanitarians who risked death every day in order to provide their services to Chinese refugees.

These types of scenarios are still occurring around the world, with more and more doctors opting to work in non profit sectors, thereby bringing aid to disease ridden nations.  Zimbabwe is one of the African nations which contains a multitude of illnesses with no funds to combat them; Doctors Without Borders “is an international medical humanitarian organization” which helps assist citizens who live in areas like Zimbabwe where diseases run rampant without government interference.  This non-profit organization was created in 1971 in order to help people around the world who are plagued by epidemics and violence; many third-world countries are unable to sustain their own populations and are in desperate need of such aid.  Zimbabwe itself is currently amidst the deadliest cholera outbreak in two decades because of the lack of proper sanitation and water supplies.  Many doctors around the world have flown to such places, leaving the comfort of their Western way of life, in order to make a difference in the lives of these people who have been driven to the brink of survival.

While these specific descriptions of doctors are no longer what many people around the U.S. imagine when they bring up doctors, it still holds firm to my own beliefs.  In a country where there are more lawsuits against doctors than praises for them, we need to remember that the entire purpose of a doctor is to save lives; this may not always be the case because of drastic circumstances, but they are true saviors in a time where many countries need them the most.

This post was contributed by Nicole White, who writes about ultrasound tech schools. She welcomes your feedback at Nicole.White222 at gmail.com

These words are usually uttered by family members who walk into an ICU room to see me calmly managing a patient on drips and vent, hooked up to monitors and other various tubes and wires.  I’m sure these words are spoken many many times every day all over the world.

I appreciate hearing it, but it always makes me think of the jobs that I could never do. Sure, there are lots of jobs that I’d simply be unhappy doing, but there are a few that I’d almost rather starve than do.

I could never be a dentist or hygienist.  I cannot handle dealing with teeth.  If I see my that my intubated patient has a loose tooth, I’m done for.

I could never be an exterminator.  In fact, I was talking to an exterminator the other day (If you don’t live in California, you are probably not aware that it is, in fact, resting atop a gigantic ant hill).  He was friendly and chatty and I myself mentioned that I don’t know how he was able to do what he does because I literally shiver with disgust at the mere PICTURE of a large bug.  He then asked what I did and I replied that I was a nurse.  He looked at me for a moment and said that the site of blood completely freaks him out.  There’s no way he’d ever work in the medical field.

Within my own profession, I can imagine doing almost any type of nursing.  That isn’t to say that I’d enjoy it or even be good at it.  But there is one branch of nursing that I will never go into.  There is one patient population that I cannot even begin to cope with taking care of, and that is burn patients.  I don’t know how you can cause someone so much pain day in and day out, even if it’s in the name of healing.   Any burn unit nurses out there?  How on earth do you work in such a unit?

What are some jobs that you could never do?

I’ll start out with a couple of posts about an entity that most nurses everywhere deal with:  families.  Family members can be a huge help, or they can be the bane of our existence.  Usually they lie somewhere in between, being neither overly helpful (which is good if the family “helps” by silencing IV pumps and ventilators) or especially annoying.  Nurse Ausmed starts us off with a potpourri of family scenarios.  Just as patients come in all shapes in sizes, so do families!   Next is Chris at the Man-Nurse Diaries who submitted what turned out to be part 1 of a 3 part series about the same patient:  Never Say Your Family is Crazy Unless You Really Mean It describes a seriously dysfunctional family unit.  You will also wonder how on earth these four people have managed to make it this far.

Our carnival mama, Kim, submitted a hil-a-rious post from the past: Oh, the Games People Play.  First of all, congrats on obtaining the coveted Cherry Ames game, and second of all, the sentence “Team Patient arrives supine on a movable gamepiece” had me laughing hard enough to wake the toddler!!   Go read Kim’s play-by-play of her shifts in the ER.

If the blog Reality Rounds was an ice cream sundae, I would have some serious weight issues.  I really enjoy this blog - the writing style flows so well.  This week’s submission “Code Lactate” describes the author’s first day back at work after 12 weeks of maternity leave.  Talk about having to get back in the saddle in a hurry!  You know how nurses sometimes barely get enough time to pee or scarf down lunch?  It can be even worse for a brand new mom!

Now on to traveling.  Nurses have a great opportunity to travel and work at the same time.  In the post “Is travel nursing a vocation or vacation?” The Pulse describes the pros and cons of 5 different destinations.  Dubai anyone?  Speaking of traveling, have you ever thought about the travels of your favorite pen?  Kathy at Nurse Connect describes the average day in the life of your…. pen.  Your favorite “cool pen.”  I bet you had no idea!

Shrtstormtrooper at Fundus Chop (you know there’s a story behind that name. Oh, wait - there really is!) writes about her ridealong with EMS.  She points out that even in ER, you have at least some very basic information about the patient who is about to grace your threshold  This is not the case with EMS, where the little info you’re given may differ vastly from the actual situation you encounter.

Much has been written about Information Technology in the health setting.   Barbara from Florence dot com writes about “meaningful use” of such technology and what that means to different types of patients.

Bedside nurses do a lot of bending and twisting and turning.  The Back Pain Blog submitted a post entitled “Herniated Discs and Bending” which describes the ways in which a disc can herniate… and not herniate.  It also includes some tips on how to keep your back and spine healthy while doing all the crazy maneuvers we nurses sometimes have to do!

Are you confused by heart blocks?  Not Nurse Ratched provides us with a helpful Heart Blocks Cheat Sheet, complete with further commentary and simplification in the comments by the one and only Ambulance Driver.

Laura at Nurse Connect wrote the post “Are Nurses Health Coaches?”  I believe so, and Laura well describes the ways in which we are.  The problem comes when the patient is discharged and leaves our care.  At that point they no longer have the regular influx of information and encouragement that they did while they were in the hospital.

Do you think you have what it takes to be a nurse?  In her characteristic tongue-in-cheek style, Head Nurse lays it all out for us - the top mad skilz one needs in order to be a successful nurse.

What if you could work in an environment wherein you didn’t have to have an iron nose?  AJN’s Off the Charts posted Virtual Nurses in a Virtual ICU.  A virtual ICU is basically a second set of eyes to monitor the patient; however, this second set of eyes may be hundreds of miles away!  This may be a great use of nurses who have vast experience and knowledge but can no longer physically work at the bedside.  But is it better than just beefing up staff at the patient’s actual location?

Lastly, here’s this edition’s Top Lists:

Top Ten Reasons to Date a Congential Heart Defect Survivor!

Top Fifty Nursing Blogs (they wisely included me in the list this time!)

100 Best Sources for Nursing News

And for those of you that will be graduating in a month or so:

100 Useful Job Search Tools for Recent College Grads (those tools geared towards healthcare professionals starts at number 59)

I hope you enjoyed this edition of Change of Shift.  It will next be hosted at Florence dot com on June 11th.  Barb requests that you get your submissions in by no later than June 9th at 10pm EST.

Have you been keeping up with the Adventures of Bob the Nurse?  Keith is looking for more people to host Bob!  If you are interested in visiting with Bob and taking pictures of his adventures, contact Keith through his blog Digital Doorway.

Change of Shift will be hosted here on Thursday, so get your submissions in!  codeblogrn at gmail, or use Blog Carnival.  Looking forward to reading some more!

The next Change of Shift is here at codeblog in two weeks.  There is no theme, just send some good posts :)  to codeblogrn at gmail.

Mine is not a story as such but a poem about a woman I cared for on m general ITU who had suffered lung trauma after smoke inhalation.

Weariness, like a wave,
Cascading through my head.
Causing thoughts, too deep to voice,
To be thrown up deep inside.

Awake! A cold rush of air to the lungs,
Feels good to breathe,
In… and out. In…. and out.
So easy, calm… effortless.

Beside me she lies there still,
Looks calm – thoughts racing inside.
What has life come to?
A monitor and peering eyes.

If she could talk, what would she say?
Will I get through this day?
The power of life, the call of success
Would make my answer, a sure yes.

Copyright Richard Greenall 2007

That blog is The Adventures of Bob the Nurse and was started by none other than Keith at Digital Doorway.

Bob the Nurse is an action figure that lives a very, well, adventurous life.  His blog is a photo blog depicting his various antics.

I’m very fond of this concept (you know, stealing your neighbor’s garden gnome and taking pictures of it in front of Niagara Falls or some such place).  When I moved to California, I stole borrowed took the coffee pot from the dialysis office with me.  I bought it a little wig and some googly eyes and took pictures of it at interesting places along the way as I drove here from the midwest.  The dialysis nurses were some serious pranksters, so this was my final prank on them.

So I find The Adventures of Bob the Nurse very amusing.  My favorite picture so far is this one.  I think it’s hilarious.

Keith explains the concept for Bob the Nurse in this post.  If you think you can broaden Bob’s horizons even more and would like to have him as a guest, contact Keith or leave a comment on Bob’s blog.  I have already offered - there are lots of places around here I can take Bob :)

I typically do not ask for themed submissions, but I did this time.  The theme of this CoS is being human - describing those moments of human error or letting our less-than-professional side show.  I described my own less-than-professional moment here.  Yes, it’s an old post, but relevant to theme.

Not many people bared their souls with this theme, which I found disappointing.  Either ya’ll are able to maintain composure all the time, or you just aren’t into admitting the times you haven’t. :)   In any case, Kim from Emergiblog (our founding mama!) wrote a post that definitely epitomized this concept in Oh, The Humanity!

NPs Save Lives wrote an excellent post about the disparity between the snap judgments we sometimes make as nurses and the real story in Human Responses From a Family Nurse Practitioner.  It’s very easy to make a snap judgment about people, but you can only find out the real story once you’ve dug a little deeper.  Sometimes the real story supports the original judgment, but most of the time it doesn’t.

Do you know what an STL is?  Find out in Barbara Olson’s post at Florence dot com: STL’s Happen.  They happen every single day across the world.  You have had your own share of STL’s.  We have to work hard to overcome these when we are doing repetitive tasks.

~~ Zen break ~~  Take a moment to bask in the Buddha with Bob the Nurse.  I adore the idea behind Bob and wish I had come up with it myself.  This is not the last you’ll see of Bob in this here post!

Nurse Ausmed wrote a fantastic post about floating in Little People in a Big Hospital.  I know I’m preaching to the choir here, but in case I’m not, here’s a telling line: “So, an outsider might be wondering, what’s the big deal? Nursing is nursing is nursing, right”  Um, NO! Nursing is highly specialized these days.  I know helping out units that are short staffed is the right thing to do, but trust me - you do not want my adult ICU skill set in your pediatric ward.  And hug an ER nurse today - they have to be knowledgeable about almost everything!

Beka blogs at In Our Own Words: Medscape Nurses.  She wrote a post about “compassion fatigue” entitled Feeling Numb Today… Anyone Else? It includes a link to an article describing what this is along with her own description of what it feels like after an especially difficult weekend working in the ICU.

Man Nurse (aka “The Exposed”) at the Man-Nurse Diaries relates a story about a recent needlestick in his post Needlestuck.  It was an accident, but will have some significant ramifications for his life over the next 6 months.  It happened under less-than-ideal conditions, and it could happen to anyone of us.

I am definitely a fan of the witty and/or well-placed comeback line.  RR over at Reality Rounds nails her comeback as described in the post Enter Dr. God: Act One.

Are you charged with making sure your fellow nurses get their breaks?  If so, you might find this post by Kathy at Nurse Connect interesting: Take a Break.  I spend some shifts as the designated “break nurse” and I have definitely come across these types of situations… that’s all I’ll say.  (Hi, coworkers!!)

And now… another break to see what our favorite male nurse action figure is up to…. (Where is his stethoscope??)

The swine flu has been in the news a lot lately, and it looks as though a very astute school nurse was one of the first to alert us to the situation.  Actually, it looks like many nurses were involved.  Great job!  Although she didn’t submit it, I wanted to include a post from Nurse Jo at Head Nurse: Can we all just take a deep breath through our masks? It contains some very sage advice!

Patrick at travelnursingblogs.com writes about how where we live impacts our happiness in It’s Time to Find Your Place in the Sun.  I will tell you right now that I was completely shocked to read what state has the happiest inhabitants.

And Bret writes about How to Beat Nursing Burnout in the 2nd of a multipart post, offering suggestions on how to combat professional burnout… and there is also some great advice in the comments.

Now, onto one of my favorite subjects - TECH!!  There were several submissions for this category and I think they’re all fabulous.  First up is Keith at Digital Doorway writing about This Modern World…. a post that advises just how to connect in this big huge world of connectivity.  Confused?  Don’t be - although it is easier than ever to connect with others, sometimes we lose the sense of humanity behind the computer screen.

Online Nursing Degree Guide compiled a list of 25 Amazing Nurses on Twitter (I’m sure if it had been 26 Amazing Nurses on Twitter, I would have made the list!) I follow many of the nurses on this list and they are indeed very interesting. Another great resource from this site is the 25 Top iPhone Apps for Nurses list.  Do you use your iPhone at work?  Some of these apps would definitely come in handy.

Keeping with the top 25 theme, Medicine 3.0 gives us a list featuring 25 Excellent Social Media Sites for your Health including sites for News & Information, Fitness Tools and Patient Activism.

Nursingschools.net has compiled a very extensive list of 100 Scholarly Open-Access Journals for Nurses.  If your interest or specialty is not listed somewhere in here, then you are a nurse practicing on Mars.

Running Wildly wrote a very touching post about Hope - how important it is for healing and how devastating it is not to have any.  Never underestimate how much power hope has for our patients.

RehabRN writes a beautiful tribute to one of her favorite coworkers in On to Sunny Skies… Suzy sounds like a dream to work with.

Lastly (but not leastly), Laura from Nurse Connect writes Elements of Nursing Style wherein she gives some excellent tips on communicating through charting.

I hope you enjoyed this edition of Change of Shift!  Thanks to everyone who submitted posts.

I know.  It’s getting a little tiresome to read about all this flu business, but the first confirmed death in the US was reported today. A very young confirmed death.  :(

(hat tip to Better Health for the link)