Ever want to know who my favorite reindeer are?  How about my most embarrassing moment at work?  I dished it all over at Addicted to Medblogs!

And that picture?  That is soooo totally me, right down to the white fur-lined knee-high platform boots :)

Not to be confused with “Change of Shift,” for which you should head over to Emergiblog to get info on how to submit your entry for the next edition! It’s quite easy - all Kim wants is your very first post!

We were recently on vacation and on our way to returning the rental car, we stopped to fill it with gas. I thought I’d go in and get the boy some pretzels to munch on until we could get him some real food. I picked out a bag and went up to the counter to pay for them. The clerk informed me that they were doing “shift change” and that I’d have to wait if I planned on buying that bag of pretzels.

Seriously? I have never been in that situation before. I was quite surprised. My face must have shown it, because she said that she’d allow me to have the bag if I provided exact change.

In the hospital, we have shift change at least every 8 hours. Our shifts are so varied, though, that it’s possible to have nurses coming and going every 4 hours. We even had shift change at 3am at times until that shift was eliminated. The biggest shift change is undoubtedly at 7am, the next at 3pm and the next at 11pm. We have a rule that there is to be no family in the unit while shift change is occuring, and we aren’t too keen on taking phone calls from family members either. For the former, patient privacy is the main concern. We talk to each other at the desk, but the desk is really out there in the open and anyone standing around can hear private information. For the latter, it is a courtesy to the nurses. The off-going nurse wants to give report and go home. The oncoming nurse wants to get report and start her shift. Constant phone calls that interrupt this just prolongs report and so we encourage people not to call for updates during these times.

I don’t find this unreasonable. Most other people don’t either. There’s rarely anyone around or calling at 7am, but the 3pm shift change is another story. There are usually lots of visitors and phone calls during that time. Most people understand, but there are a few that get angry at being told they have to wait until report is over.

I gotta tell you though. Shift change at a gas station was a new one for me.

Maybe you won’t be after reading this.

Like the title says, this post has nothing to do with nursing. Or medicine.

Ok then! I just read this on Yahoo! news:

“His father, Yosef Cavalin, frets about the piano-playing, noting that his only child recently broke his arm pursuing another passion, martial arts. He has won several trophies for his age group.

“Finals are coming and everything and he cannot play with both hands. He’ll just try to play with the right hand,” he says. “I don’t know how his grade’s going to be in piano. It worries me a bit.”

Um. Your kid, who 10 and is excelling in college level science courses, broke his arm while winning trophies in karate. And you’re worried about his piano grade? I can confidently say that no one is going to take the kid to task over a B in piano that he earned while playing one handed. I’m just saying.

And secondly, I have a plea. Go read this. I have thus far managed to snag some on Ebay here and there, but it’s not even available there anymore and I’m down to the last bottle. (If you keep it in the fridge, it keeps it from going icky.) It is truly unobtainable. So now I guess I have to switch to something else. Any ideas? It has to be leave-in. And it has to smell delightful. :)

Hmm… I guess I will tack on something nursing-related (kind of) seeing as how it just happened about 90 seconds ago. I started a business a couple of months ago and it doesn’t even matter what that is - what matters is that I haven’t sold a thing, have not brought in one penny. (I’m not ready yet! But that is besides the point.) Just now I received a call from some Congressman (well, his “aide”) who is proud of my business accomplishments and would like a business leader like me to get some sort of Congressional merit honor badge club ring and go to Washington to represent business leaders, blah blah.

I have been a bedside nurse for over 10 years. I have seen and done some incredible things. I have helped fellow humans through some truly horrible illnesses and have been there for them. I have been hit at, hit on, spit on, kicked at, thanked, hugged, and I’ve even had a couple of thank you letters to the hospital with my name mentioned. I have been a business owner for 40 days and have not yet managed to actually do any business. Yet this is what they want to send me to Washington for. This country is MESSED UP.

My last post referred to making new buttons for some blogs that I noticed that had gotten facelifts. Makeovers. New ‘do’s. However you want to say it.

One of those blogs belongs to PixelRN. A web designer in her previous life, she did a great job redesigning her blog. She explains how she did it in this post. She should put out a shingle, maybe redesign the sites for a few other bloggers, don’t you think? (hint/wink/hint) :)

Another post she did was about RSS feeds, and it is also very well done. If you are a blogger, you really really really need to know about RSS. For me personally, it doesn’t matter how good your blog is… If I can’t subscribe to your blog to read in Google Reader, I’m probably not going to read it. There’s another side to that. You can choose how much of your post shows up in a reader. Some bloggers make their entire posts available to be read, and some only allow a few sentences to show, thereby requiring the reader to click on “read more of this post” in order to read the rest of it. This also drives me nuts. I realize that we all like to have our stat counts be nice and high, but I almost never click through unless the first few sentences really grab my attention. That is not always easy to do!

(Addendum: Although Rebirth only provides partial feeds in Google Reader, I always faithfully click and read her entire posts. Because she rocks. And I don’t want her to stop blogging, as she has recently threatened to do.)

Remember this baby?

Well, he turned into this 1 year old:

I have never done anything so simultaneously frustrating and rewarding. Mostly rewarding :)

I was tagged by PixelRN, so here goes:

1. I have a few goals in life: I want to someday design and build my own house, see the northern lights and visit the 7 wonders of the world. That last one might be a little difficult, though, seeing as how I’m not very fond of traveling.
2. For one summer in college, I worked at Eastman Kodak in a lab. I’m amazed that I can’t remember exactly what I did, but I know it had to do with testing the silver emulsion for…. something. Anyway, it was a fascinating job and I still remember my coworkers there, although I don’t keep in touch with them anymore.
3. I make mosaics.
4. If I could have any job in the world, I would want to be an astronaut.
5. I was married on Halloween.
6. I love playing video games. I can remember playing Mah Jongg on my dad’s old 386 and Missile Command on the Atari. I’ve graduated to Nintendos and Xbox’s now, but it has truly been a life long “hobby.”
7. Last and least, I have ADD. I’m sure no one noticed, but I posted only 7 times during my pregnancy last year. That’s because I wasn’t taking my meds and the desire to write pretty much vanished. I was diagnosed and started treatment in college. One semester I was about to flunk out of the nursing program and the next semester I was on the dean’s list. Pretty
impressive turnaround. Think what you will about ADD, but finding out how to manage it changed my life.

Honestly, I don’t know who to tag - I feel like I’ve read this meme from pretty much everyone, but I guess I don’t remember seeing one from Kevin MD or GruntDoc.

Nursing ratios are very important. When I worked in IL, I once had to take 3 critically ill patients. I had never been so busy at work in my life and I constantly felt as though I was way behind. I was very scared of possibly missing something. There simply was not enough of me to pay very close attention to each patient.

There were a few nights on med-surg that I took 9-10 patients, mostly fresh post-ops. That’s a lot of patients. And that was over 10 years ago. Even in the last decade it seems like patients have been getting more and more complicated what with their chronic medical problems.

Here in California, there’s a law protecting ICU nurses in particular; it says that we can only take 2 patients in ICU. Even if they require a lower level of care and are overflow from full med/surg units, even if they have transfer orders - if they are physically in ICU, they are to be 1RN:2pts. California has been moving towards staffing ratios on transitional care units and med-surg floors as well.

There’s a bill that’s been introduced - the Registered Nurse Safe Staffing Act of 2007 (HR 4138). It would provide a staffing system that has input from nurses who give direct patient care. This is a very good thing. It is something that we do in my ICU all the time and I can’t imagine it any other way.

PixelRN has also written about this issue, perhaps a bit more eloquently than I. WashingtonWatch.com provides information on the current status of the bill and a wiki where you can put forth your arguments for or against the bill. There’s even a link on their sidebar where you can write to your state representative. I plan on doing so right after posting this. They don’t know if you support it if you don’t tell them! They all have email; it’s very fast.

There have been more and more regulations lately from JCAHO, the most recent and notable being those which state hospitals will not be reimbursed for care related to preventable complications such as pressure ulcers and UTI’s. We do the best we can with what we have. More nurses = more care = less complications.

This is one regulation from the government that actually makes sense. I’m so glad it’s been taken to a national level. We really need to get behind this bill.

When I started out in nursing, the hospital I worked at required CNA’s to wear cranberry, RT’s to wear teal, and RN’s to wear royal blue, etc. We could wear certain scrub tops that were approved and that matched the royal blue pants. The hospital did not pay for them.

When I moved and got a new job, there were no standard uniforms. We could wear whatever we wanted. Some people took this too far and started looking a bit unprofessional - scrub pants with little t-shirts that actually showed off belly buttons, that sort of thing. One or two nurses wore street clothes, but they actually looked fine to me. It wasn’t like they were wearing jeans or anything. It looked appropriate in my opinion.

A committee was formed to discuss the possibility of requiring standard uniforms. Most of us in ICU (and the rest of the hospital) were completely and totally against it. We liked our individuality and we didn’t want to look the same. I realize that there are professions that wear standard uniforms (police, EMT’s, firefighters, the military, etc), but some of us felt as though we should not be told what to wear.

Patients often comment on our scrub tops, usually compliments :). Then again, it was argued that if we told patients at the outset that all RN’s are wearing blue, they’d be able to discern who they were talking to. Or, you know, the person could just tell them that they were the RN. Why make things so hard?

Most of us felt it was up to the manager to take care of those who were dressed inappropriately.

The idea was eventually shot down, but I found it most interesting that the hospital was prepared to buy everyone’s uniforms for them, the number of which was to be based on how often one worked. I couldn’t believe that they’d spend so much money on dressing everyone.

So what do you do? Once again, there’s a poll up at Nursing Voices if you care to weigh in there!

To my sweet Secret Pal: YUM!!!!. I had to hide the box from my husband :-)

My interview with Bertalan is up at ScienceRoll!