Take This Job And...Well...Do It!

I think Nurse Cherry needs an update. What hasn't she done? Hmmmm...
How about "Cherry Ames, Correctional Facility Nurse" or "Cherry Ames, Substance Abuse Nurse". I live in the San Francisco Bay Area so even "Cherry Ames, Transgender Nurse" would not be impossible. She was never a critical care nurse, an ER nurse, an OR nurse, a transplant nurse, a nursing instructor or a clinical nurse specialist. Good grief, what did the woman DO?? Besides sitting around smiling or standing around posing.
I bet she was never burnt out.

Burn out. It's an empty gas tank. Hitting the wall. Going numb. Losing compassion. Not caring. Going through the motions. Dreading the next shift two days ahead. Being in tears the day of the shift. Feeling like you should call in dead. It's having nothing of yourself left to give; it's all you can do to lift one leg in front of the other. It's hell. Been there, done that, wiped up body fluids with the T-shirt.

A few years ago I decided I had had enough. It was night shift from hell at Brand X hospital.
I had a demented, elderly AIDS patient who spent eight hours screaming every known cuss word in the universe and described me in ways I STILL haven't figured out. To sum it up, he thought I was a 'ho. And of course he needed an IV, a foley and an NG. After four hours of this, I actually got him to be quiet for an half-an-hour by telling him, complete with hand on hip and index finger rocking, that...ahem..."...don' you be dissin' me in my 'hood. I don' disrespect you, you don' dis me. You in MY 'hood now so shut yo mouth." This out of a middle aged woman who makes Wonder Bread look ethnic. The poor man closed his mouth and shut right up. I think he was shocked. I know I was. I could hear giggling at the nurses' station.

Across the hall was a four-point-leather restrained drunk patient screaming vile obscenities that made the old man sound like Mr. Rogers. The highlight of the night was looking over and seeing urine flowing from the bed, forming a puddle that made Lake Tahoe look miniscule by comparison.

I left the unit that morning with a mission. I was done with nursing. I wanted a desk job. Nine-to-five. Monday through Friday. Weekends and holidays off. No more blood. No more
tubes. No more death.

I found the perfect job doing pediatric telephone triage. My co-workers warned me that I was an ER nurse at heart and that I would be bored stiff in six months. Yeah, right.

The job was fun, the people were fantastic, talking to the parents and guiding them through their kids' illnesses was fulfilling. I had my own desk, my own computer and I learned more about pediatrics in that first six months than I had in all the years before. I could wear street clothes if I wanted but after one week of nylons at 6:00 am, I was back in scrubs. I was living the life. And then it happened.

I got bored. The slow summer season started and surfing the internet between calls just wasn't cutting it. All my certifications came up for renewal and working in a clinic meant I didn't have to have my TNCC or my ACLS or my ENPC or my NRP........but I couldn't let them go. I missed the ER. I wanted to go back.

Monday through Friday isn't all it is cracked up to be. I was working a day shift when I'm a night owl so I had to make myself go to bed early. I gained 25 pounds because I was sitting on my derriere all day. There is no life working 9-5. You spend all your time on the weekend catching up on what you missed during the week. I thought the grass would be greener on the other side, but it was more like astroturf.

Now I'm back in ER and loving it. I'm glad I had the clinic experience; I gained a lot of pediatric knowledge. I guess the nurse can leave the ER, but the ER never leaves the nurse.

Taking What They're Giving 'Cos I'm Working For A Living...

Yes indeed, I'm working for a living. Unfortunately, it is not on a cruise ship. Oh, I would love to try that line of work but I get motion sickness just bending over to tie my shoes. I have actually been on two cruises as a passenger and each time I lost at least one full day to sleeping in a meclizine-induced coma on what the family called the "Pooped Deck". A ship full of food and I get nausea. Go figure. Then again, I never did see any white-uniformed nurses running around on deck with their medicine trays. Does anyone still use medicine trays anymore? Anyone remember pouring their meds for the entire shift in the morning, stacking them in tiny paper medicine cups with the medicine cards lined up in the order they were to be given? God, I hope someone remembers that, otherwise that makes me a nurse of a "certain age". Someday I'll put my teeth in, turn up my hearing aid and tell you young whipper-snappers about them old days 'afore there was unit dosing.

I love the fact that ER nursing is unpredictable. I hate the fact that ER nursing is unpredictable. I work a "dead-end' shift (3pm - 3am), which means that I am not relieved by another nurse. If the unit is busy it is very difficult to disengage and leave. That's what happened last weekend and I wound up doing a double shift. Good lord, you would have thought I had been through a tackle exercise with the Oakland Raiders. Then I went in to help for four hours the next night and one of the night nurses got sick! I stayed the whole shift. It was like getting up off the mat at the count of eight and getting punched in the face again. By Mohammed Ali. In his prime.

When did I become such a wimp? I used to be able to do double shifts and then double back for another double (for the uninitiated, that is working 32 out of 40 hours) and have energy for two kids under six when I was done! I was WOMAN, did you hear me roar? Now I look in the mirror after twelve hours and the hair is flat, the make-up is gone, the lumbar-sacral area is screaming and the feeling will return to the right hand as soon as the cramp from writing on 50 charts has subsided.

But I love my job. This is what I was put here to do. They say nursing is a calling. It began whispering almost 40 years ago and I still hear it clearly today. There's nothing better. Every now and then I have to take a step back and remember that.

I Can See Clearly, Now.....

Here is what Nurse Cherry looks like in Norwegian! It's also what Nurse Kim has looked like these past few days trying to fix the sudden onset of acute italics and alterations of font color in the old template. In response to my cries for help, blogger.com sent me two form-letters via email. I hope it wasn't too much trouble. I think this template is easier on the eyes and I thank all of you who wrote to let me know what was happening. On my Mac, I was able to fix it, but when I went to a Windows computer at work, the blog was still suffering from an altered level of font -iousness. The only casualty was my Jeopardy parody post. I now know to back up everything I write. I'm picking up this html business like a person learning another language through immersion in the culture. I've decided it stands for Hopelessly Technical Miserable Luck. Who sat around and invented this form of torture? Anyway, thanks for bearing with me as Emergiblog gets its new bearings! I just finished three shifts in two days and the brain fog is setting in. To sleep, perchance to dream up a new post for later........

And the Darkest Hours Are Just Before Dawn...

Oh, my....Google put ads for Vioxx lawyers on the site... not exactly a match with my editorial opinions!

I'm finally getting my cape. And a cap! With an itty-bitty uniform and teeny-tiny white open-toed pumps. I happened to pass by eBay and there were a TON of Barbie nursing outfits (circa 1961) just waiting for a bid. I didn't bid, though. I'm smarter than that. I went right for "Buy It Now!". The outfit comes with black-rimmed glasses, presumably because nurses can't look too glamourous. But Barbie has her pedicure showing with the open toes shoes, and pumps no less. I have wanted this outfit for approximately 40 years; it's costing me the equivalent of four real uniforms. What would we do without eBay?

There is a virtual bus stop in front of every emergency room and it disgorges its charges at regular intervals. It runs 24 hours a day. You can set your watch by its arrival and tell the time by the patients seeking care. Here is what the night shift might receive....


1:00 am: The Earache Hour
What is it about the nighttime that brings out the worst in ear pain? Kids that were fine at home suddenly wake up screaming in pain. Very disconcerting to the parents, but fortunately easy to treat.

2:00 am: The Croup Hour
Sleepy parents and kids sounding like the seal enclosure at Marine World comprise this block of patients. Usually the child sounds better by the time he gets to the ER. That's an ER rule, by the way. "All symptoms in children cease upon entering the ER ." Diarrhea since birth, four years ago? Not now. Total lethargy for three weeks? Now the kid needs medication for attention deficit disorder. Acute abdominal pain since breakfast? The kid picks the "smiley face" on the pain scale. The parents are aghast and then embarrasssed for "overreacting" but the staff believes every word. Those of us with kids have been there.

3:00 am: The Alcohol-Induced Head Injury Hour
Brisk bleeding head lacerations attached to intoxicated patients are the hallmark of this hour. They probably fell, they may have been whacked, but every head-injured drunk is a subdural hematoma until proven otherwise; the CT scanner is very busy. The ER rule for this hour is "Nice when drunk, mean when sober." These patients will urinate half a liter for every ounce of alcohol consumed, while asleep (that's before they recieve hydration in the department). The problem, as a nurse would put it IF nursing diagnoses were used in real life, "Alteration in level of consciousness secondary to alcohol consumption resulting in alteration in urine output leading to incontinence." Translation: have a lot of clean linen handy.

4 - 5:30 am: The Wee Hours
Patients are usually few and far between during these hours so the ER nurses study their procedure manuals, work on their certifications and read every nursing journal they can.
(That was for the benefit of my manager.) We actually read, crochet, knit, listen to the radio, have that fresh cup of coffee, surf the internet and I have been known to practice my "moonwalking" dance moves (don't laugh - it's taken me 22 years to get it right). By the way, NEVER, EVER, EVER say the word "quiet" when in the emergency room. It's like dropping the "F-bomb" in church. I just isn't done. Utter the "Q" word and you will ensure an avalanche of patients the numbers of which have never been seen in this lifetime. The bus driver will have to apply for overtime. The nurses will recoil from you. The doctor will rue the day you were born. Save your breath.....save yourself!

5:30 am: The It's-Hip-To-Be-Square Hour
Somewhere, someone over the age of 75 is getting up to go to the bathroom and tripping over an area rug. Their hip will take the brunt of the fall and they will join the legions of people with titanium hips. They are scared and in excruciating pain so the "hover mat" is placed on the gurney before they arrive. It's like floating on a cushion of air and makes transfering from the gurney in xray virtually painless. That, generous medication and the reassurance that a broken hip can be repaired help immensely. Now it's time to wake up the orthopedist on call.
Heck, for that matter it's time to wake up the ER doctor.....

6:00 am: The Code Hour
Before this hour is over, a patient will arrive Code 3 with severe respiratory distress. Their EKG will be abnormal, their lungs full of fluid, their pasty skin drenched with sweat and the proverbial "elephant" on their chest. The emergency staff will hit that patient with every weapon in their arsenal of life until the patient is stabilized; lungs cleared, breathing restored, blood pressure maintained. The patient goes to the ICU. The staff gets ready to go home, only it will take just a little longer to fall asleep; it takes a while for the adrenalin to subside.

7:00 am: Hey-la, Hey-la, The Day Shift's Back
And because I don't work days, I don't know their story. I'll interview a few and see what their day is like and report back from the "frontlines".

But the PM shift.......now THAT is a whole 'nother story.....

When Logic And Proportion Have Fallen Sloppy Dead....The Vioxx Verdict

Forgive a quick detour from the world of the emergency department. We all know elderly folks who carry a full page, single-spaced computerized list of their medications in their wallet. I'll never be one of them because there won't be any drugs. Listening to Hugh Hewitt discuss the Vioxx verdict today cemented my belief that sanity has, indeed, left the jury system

The plaintiff's win is our collective loss. By awarding one-quarter billion dollars in damages, the Vioxx jury ensured more than the plaintiff's financial security. They've contributed to the increase in drug-related lawsuits that are sure to follow as personal injury firms assess the financial incentive of similar cases. They have helped smother the incentive of research and development departments to develop new medications because of increasing financial vulnerability.

Merck lost the case, but we are the ones who will pay. When you receive your next prescription and you are paying a day's wage for a two-week supply, remember this verdict. When you are suffering from a health problem and are unable choose a medication pulled off the market because it became too expensive to litigate, remember this verdict. When you are given a diagnosis for which no treatment is available because there has been no research in that area, remember this verdict.

The obscene amount awarded in the recent case against Merck is another nail in the drug companies' coffin of liability. Until we legislate some form of protection against these unbelievable awards, the personal injury law firms will keep circling drug companies like vultures over an incapacitated animal.

"Remember what the Dormouse said....
Feed your head......."

Oh, the Games People Play

I never knew this game existed until I did a web search for the character! There are actually pristine, unopened Cherry Ames games on eBay.
No, I didn't buy one. Seventy-five dollars is a wee bit too much to pay, although I did spend that much on a vintage Barbie outfit about ten years ago. Hey, it came with the original shoes and Barbie fans know it's all about the shoes!

Those who study human behavior should spend a shift in the emergency department. The games played in the ER make the Olympics look like a tetherball tournament. Some of the participants are patients and some are staff. Some are gold-medalists in their specialty and some arrive a few feet short of a full balance beam. Let's take a look at "The Emergency Olympic Games":

"The Suck-Up"
Usually the player is suffering from an acute lack of an opiate prescription for chronic pain symptoms with a nebulous origin for which they have not been evaluated by a doctor but they have an appointment with a specialist next week but they ran out of their Vicodin and they just cannot bear it. Said patient is overwhelmingly complimentary to Team Nursing . The targeted nurse is SO much nicer than any other nurse anywhere in the whole world and gee, that other nurse was so rude they wish ALL nurses were just like you! These compliments are dispensed within 3.5 seconds of spotting the nurse, often making said RN feel an acute need for a shower. The player realizes she is out of medal contention when the targeted nurse responds with, "Gee, thanks, but I just came in to get a Betadine swab...."

" Mean Medical Matchup"
This game is closely related to the Suck-Up, utilizing the same team. Player has been evaluated by the ER doctor, who, having the audacity to disbelieve their story, has gone for the gold and verbalized his lack of belief to the patient. Bottom line: no prescription. The patient prepares for this event with the "Which Doctor is On Tonight?" drill, using a telephone to assess the playing field before engaging the opponent.

"Peek-a-Boo Bypass"
This event requires a large team that converges on the patient's playing field soon after the patients arrival. Anyone can make the Peek-a-Boo team, although it is usually composed of family members and friends of many generations. Upon arrival, Team Nursing announces the event rule: only two members of the Peek-a-Boo team on the field at a time. This is met with a courteous response and extraneous members go to the bench in the waiting room, where the goal is getting back onto the playing field without Team Nursing noticing. This is accomplished by one Peek-a-Boo team member returning to the patient at a time until the bedside number has quadrupled. Stealth and dexterity are assets to this goal. Occasionally Team Security will act as referee.

"The Two Guy Offense"
The preliminaries for this event take place off the Emergency Stadium grounds. The player reports a spontaneous assault by Team Two Guys. The members of this team are always unknown to the patient and the initiation of contact always unprovoked. The goal of Team Patient is to obtain care from Team Medical with minimal disclosure of the playbook. The involvement of Team Police is always declined as so as not to incur a penalty. Team Two Guys apparently has many expansion franchises.

"The Two Beer Defense"
Team Patient enters the arena via Team Paramedic, having received a report of "player down" on the sidelines of a local Team Seven-Eleven. Team Patient arrives supine on a movable gamepiece.Upon arrival in ER Stadium, body fluids are released for assessment by Team Nursing who immediately take defensive positions. Performance-enhancing ETOH is suspected as the characterisic Odor Offense is noted. Team Medical waits for the Designated Cleaners and takes the field. Minimal interaction takes place between the teams for many hours at which point Team Patient verbalizes that he only had "two beers". Team Medical knows to multiply this number by 58. Team Patient is taken out of the medals race on a credibility technicality.

"The Decible Debate"
Team Patient attempts to propel themselves off the bench and onto the playing field by increasing their verbal intensity. Team Nursing counters with internal auditory blocking mechanisms. The goal: Team Patient enters playing field at appropriate interval. Team Patient rarely medals in this event.

"The Titanic Panic"
Team Patient arrives, usually via Team Paramedic, complaining of numbness, chest pain, shortness of breath and near-syncope occurring at the preliminary event at Home Arena which involved a "Decible Debate" with another member of Team Family. The Peek-a-Boo team arrives to act as cheerleaders for the event. No medal is awarded, as the full cardiac work-up that ensues turns out to be negative. An Acadamy Award nomination, however, would be appropriate.

These are just some of the Emergency Olympic events to which I have a front row seat and perpetual season tickets......

Cap-tivated!

Truth be told, I became a nurse so that I could wear THE CAP! Oh, how I wanted that cap. I would make one out of paper and pin it to my head, posing in front of the bathroom mirror with a towel around my shoulders for my cape. I never did have a cape, but I definitely wore that little piece of starched white fabric. Our caps had green and gold ribbons arching across the top. I may have been your average Jane, but I felt like Miss America when it was on my head.

Of course, I graduated in 1978 (at the ripe old age of 20!), and with the expansion of nursing care came the end of the cap-wearing tradition. I wore mine for about 6 months. Years of nursing fantasies, based in the 1940s world of Cherry Ames, were quickly supplanted by the reality of the profession. My cap was the first casualty.

Fast forward to 2000. I was working night shift in an emergency department when my colleagues and I decided to celebrate National Nurses' Day by wearing classic white uniforms with our caps! Yeah, baby! Now, the last time I had actually seen my cap had been in 1979, carefully preserved in a halo of dust under the front seat of an old green Volkswagon bug I no longer owned. Where on earth would I find another one - specifically one that looked like my nursing school cap. I mean, you can't just wear any cap, you have to wear your school cap! I was determined to find it.

I found it. At a uniform shop located in a tiny trailer in a small parking lot in the next town sat an exact replica of my cap. I carefully glued the forest green and gold grograin ribbons to the top, pinned the cap to my head and posed in front of the bathroom mirror. Only this time I didn't wear a towel for a cape; it was the 21st century, after all, and I was more like a middle-aged Mrs. America. The old thrill was still there. The next night we faced the patients in traditional white uniforms with caps carefully anchored.

One younger doctor commented that I looked like his mother did when she was a nurse (uh....thanks?) and another revealed that he always had a fetish for women in white (o......kay).
The older docs loved it. The PM shift made fun of us (Nancy Nurse? Excuse me, my name is Ames.....Cherry Ames.....).

But, the patients! The patients respected us! Their behavior was astounding. They spoke to us in lower tones. They spoke to us respectfully. They addressed us as "Nurse" and not "hey you" or "uh...where's the doc?" The age of the patient didn't matter, even teenagers who probably never even knew that RNs wore caps mentioned them. The change in demeanor was so dramatic from our normal experience that I thought perhaps the nursing staff was acting differently while wearing the caps. I decided to try an experiment and perhaps write a column on our experiences.

While my colleagues went back to their normal scrub uniforms, I worked in white, with my cap for a week. We noticed that I was the go-to person if the patients had a question because I was easily identifiable as a nurse. The deferential attitude of the patients persisted. I then went back to wearing whatever color scrubs I wanted, but always with the cap. In fact, I got so used to having it on that I would forget I was wearing it, so there was no impact on my behavior by this time. The patient behavior did not change! I was treated differently when I wore the cap; the patients respected what the cap stood for. I was floored.

Patients are bombarded with so many different personnel when they are in the ER, it's often hard to keep track of who is a nurse vs. a lab tech vs. a housekeeper vs. the doctor. Wearing a nursing cap gave my patients an anchor, a visual reminder of who I was and what my responsibilities were. However increasing number of male nurses entering the profession render nursing caps inappropriate. They say caps were a magnet for infection. They would get pulled off in the ICU. Caps weren't practical. Of course, all that is true. But I sure loved wearing them.

(Addendum: I continued to wear the cap until I changed jobs soon after the experiment. The cap again found its way under the front seat, this time of my Saturn. And the column I never wrote? It turned into a blog!)

Mind Your Manners and Call Me in the Morning

Nurses can get a job anywhere these days, but you know you're old when the military doesn't want you. During Desert Storm I had recruiters calling, willing to accept me with just an AA degree and offering to pay for my BSN. Hubby opined that it would not be prudent as we had three small children. He verbalized this rather unambiguously as "hell no!" and so my duty to country during that conflict consisted of watching CNN. After 9/11 I was ready to go anywhere, fast but nobody wanted me. I was, to use the politically incorrect term, old! Sure, I'm old enough to be most soldiers'....uh....older sister. So what? Why is serving your country something reserved for the young? Well, I decided I could serve my country by serving my country's soldiers so I adopted two soldiers through the Soldiers Angels organization. It's the best way to contribute when you are fighting from the homefront.

It has occurred to me that most people are unclear about how to behave in an emergency department. Most patients arrive accompanied by at least one significant other. Some arrive with multiple generations of significant others. (There is an unwritten rule that any child arriving in an ER with a fever must come with both parents, all four siblings under the age of six and at least one grandmother, usually two, one aunt and a family friend. Grandfathers and uncles are apparently exempt.) It is for patients and their entourages of support that I present the following pointers. It's like those old movie shorts from the '50s. You know, the ones they used to show in class with topics like "Hygiene is Fun!" or "Dare To Date!". This one would be entitled "Emergency Room Ettiquette and You!" Let's begin.

1. Turn off your cellphone. Yes, this means you. Cell phones interfere with monitors and infusion pumps that administer medications. You cannot call out on the phone, and if it rings you cannot answer it. If you need to make a call, step outside or ask the staff for a cordless phone. There are at least 4, 879 signs stating "CELL PHONE USE PROHIBITED". They are there for a reason. Read and heed.

2. Stay in your designated room/area. Do NOT wander the halls looking into other patients' rooms. This is not the Learning Channel; this is not "Trauma in the ER". George Clooney is not around the corner. Respect the privacy of the emergency room patients.

3. Respect confidentiality. By law, the ER staff cannot discuss a medical condition with anyone other than those designated by the patient. It's natural to be curious/concerned about "the baby who is so sick" or "the guy who was bleeding" but the details are not for general consumption. Know that your medical situation is treated with the same confidentiality.

4. Keep the number of people in the ER to a minimum. When you bring a child who is ill, leave your other children home. Have Grandma or your spouse babysit them there. Emergency departments are a hotbed of bacteria and viruses - do you really want your kids exposed to all that? Adults, bring no more than one or two people with you. The emergency room is not the place to have your entire family tree paying you a visit. Either you will be admitted and they can visit then or you will be discharged and they can see you at home.

5. Call your nurse. If you have a question or need an update, use the department's call-bell system to summon the nurse to your room/area. Don't wander the hallway or send a family member looking for a nurse. Let your nurse come to you. It makes for better continuity of care and a less congested department.

6. Do expect to wait. Plan on it. Bring a book. It is never convenient to be sick and the emergency room cannot run on a strict schedule. It is impossible to give a time frame for care because anything can happen at any time. Taking your frustration out on the staff or yelling won't get you in any faster. This is one case where the "squeaky wheel" doesn't get the grease. The ER staff knows that your injury/illness is very stressful for you, but patients who have more urgent problems will be taken in first, regardless of when they arrived. Remember that when it seems that someone who looks fine is being "roomed". Ambulances will also take precedence over a non-urgent problem. If you have a question or wonder why you are waiting ask your nurse (or the Triage nurse if you are in the waiting room). They will do their best to keep you informed.

In conclusion, emergency room etiquette is just good manners and common sense. Bring a dose of both when you come for treatment and you'll find that your trip to the ER is a lot less stressful.

Circadian Rhythm Caper

"Department Store Nurse"??? You mean I could have worked for Nordstroms? Saks Fifth Avenue? Neiman Marcus? All these years I've missed out on employee discounts? What on earth would the job description say? "Wanted: young, beautiful RN to standby in case someone faints in Hosiery. Ability to pose in white uniform and cap so that doorman can administer side-long ogles a plus. Advanced training in analgesia for headaches secondary to over-enthusiastic fragrance sprayers required". I bet she even got to park up front.....

I am so exhausted I can't feel my fingers on the keyboard. Why, you ask? Another emotionally exhausting day saving lives? A whirlwind of one emergency after another, juggling critical patient after critical patient with nary a thought for myself, doctors requesting my expertise at every turn and patients clinging to my arm, thanking me for just....being?

Nope.

I worked a day shift.

Let's get one thing clear right off the bat. I am what is known as a night owl, a vampire, a creature of the dark. To me, 0700 is the middle of the night! I don't even go to bed until 0300 and that's only if I'm ill. I have not voluntarily worked a day shift in years. It's easier for me to STAY up until sunrise than to GET up at sunrise. You get the picture. So... when my sick colleague called to ask if I would work a twelve-hour-shift commencing at 0700 this morning I said, what the heck!
He's pitched in for me a few times and it's so hard to find coverage when you need a day off. I could do this favor. I thought.

Had I been able to get any sleep, it might have worked. Early to rise means early to bed, and being the holistic-homeopathic-earth-nature-mother that I am, I decided to dope myself up to high heaven with my drug of choice, Benadryl! Fifty freakin' milligrams down the hatch.

Nothing. Wide awake. 11:00. Have to get up in four hours. This called for drastic measures. Yes, I went for the Melatonin. Figured "Mel" would meet "Ben" and I'd be comatose.

Nothing. Up to the couch. Two episodes of "Aqua-Teen Hunger Force" on the Cartoon Network. Ever seen that cartoon? It's a milkshake, a meatball and a large order of fries (with a goatee) who live together. See what you miss going to bed early? Finally, the faint stirrings of fatigue floated into consciousness. I was asleep.

Four hours later I was jolted awake by an alarm playing "Wake Up Little Susie". Staggered to the mirror. Hair not sticking up. Good. A quick fluff with the blow dryer and I'm outta here. No make up. They're lucky I put on clothes.
No traffic. Thank god. Too early for rock and roll. Too early for talk radio. Too early for sound.

I dragged my senseless self into my department. Only one patient and she's ready to admit. Big sigh - time for some coffee to start the day. It is then that I discovered I was scheduled to work with Miss Susie Sunshine, RN! Bright, cheery, energetic, caring, compassionate, competent. She is the sweetest woman I know.
I wanted to wring her neck. I've seen methamphetamine addicts with less energy.

I never did recover. My patients were great; I only had a few as it was not busy. Spent 90 minutes in a class on JACHO accreditation. Stimulating. Not.
Then my very own Florence Nightengale arrived to take over at 4:00 pm. Bless her everloving heart. I didn't have to do twelve hours after all. I was released. I was exhausted.

In retrospect, my day was very productive. I made the decision that I will never, ever do a day shift again. Ever. I learned that you can take the nurse off the night shift, but you can't take the innate circadian rhythm out of the nurse. I'll stick to PMs and Nights. Oh, and I'll take vacation during JACHO accreditation.

Entering the Blogosphere

Welcome to my blog! Specifically, welcome to Emergiblog! Initially envisioned as a place for ventilating, commiserating and celebrating with other ED nurses, it has evolved into a forum for anyone who has ever been in an emergency room, on either side of the gurney.

Some of the topics that will be discussed include "Emergency Room Etiquette", "The Top Ten Ways to NOT Get Seen Immediately", or "Privacy Privations: How to Cover Your Rear When the Gown Opens in the Back". And we've all met one of these: "Emergency Nurses From Hell: How to Alienate Your Patient on Contact". Another topic could be " 'I've Been Waiting for Hours': The Effect of the Emergency Department on the Space-Time Continuum". This is only the beginning!

The existence of this blog can be directly attributed to radio talk show host and "Godfather of the Blogosphere" Hugh Hewitt. His enthusiasm for blogging is contagious. Through Hugh's site I discovered newspaper columnist James Lileks whose daily "Bleat" proves that everyday life can make for an engaging read. If I write one fraction as well as he does, I'll be a happy blogger.

Please, please feel free to add your comments to any topic. There are a million stories in the emergency universe. I have a few and yours are probably better so dive on in!