Friday, October 21, 2005

Nurse Blogging - Herb Caen Style!

....Now I'm pretty thrilled when I find gas at less than $2.85 a gallon, and I've heard of nurses getting excited that their post-op patients are passing gas, but I think this is WAY over the top, don't you? For the life of me, I can't figure this one out. There is nothing about nursing in the text. Nada...

(...something just occurred to me after I posted this....this may not be a nurse, could it be a woman with a white scarf on her head? Shhhhh......keep it between you and me...)

...I usually keep my politics to myself, but some might call me "conservative". As in: compared to me the fine citizens of Mayberry would be flaming liberals. So it came as quite a shock when I glanced at the local news the other day only to see none other than Warren Beatty addressing the California Nurses Association at their bi-annual convention. With Sean Penn in the audience.
The sound that nearly woke you out of a sound sleep was the sound of my jaw hitting the floor. The next day, I was studiously reading over the Propositions for the special election in November when I noticed the name of a CNA bigwig at the bottom of a letter against parental notification laws for abortions. EEEEE...nough! I pay CNA almost $1000 a year in dues. They are a wonderful bargaining agency and I have great pay and benefits (and wonderful staffing ratios) because of their involvement in collective bargaining. But...I don't want my money funding issues that I do not agree with. But, I am required to be a member and I do want to support CNA itself. So I emailed membership. I received a phone call from staff who told me that my dues can be designated to go to the "general fund" and not to any political action committees. I was impressed by the fact that (1)they called instead of just emailing and (2) relieved that I was not tied into funding issues that I do not agree with. I feel much better now....

...Oh man, I'm a Crawly Amphibian in the TTLB ecosphere again. Yesterday I was up to Slithering Reptile. Was it something I said?...

...Speaking of gas, I've noticed an increase in the number of post-op and post-partum patients we are seeing in the ED presenting with abdominal distension and pain. In ancient times, when Jimmy Carter was President and the Bee Gees ruled the world, patients were not discharged after surgery or delivery until they had produced the sacred Bowel Movement. The nurses would assess, many times a day, whether The Bowel Movement arrived. In fact you were stuck on clear liquids until the arrival of Flatus, the precursor to The Bowel Movement. Patients were not discharged until production of The Bowel Movement was verified and subsequently described in minute detail in the nurses' notes, having been observed in excruciatingly fine detail by the RN. This was a required course of study in med/surg nursing. I studied adjectives to describe feces in my classes on post-op patient care. So why on earth am I seeing patients who are a week or more past surgery or delivery who still have not produced The Bowel Movement? Are they getting sprung from the hospital before production these days??? Or to put it in nurse speak, are they being discharged with their "elimination, alteration in" diagnosis unaddressed? Med/surg nurses of the world, where are you? Fight for your patient's right to eliminate before discharge! It's tradition!...

...You know you've been blogging for a long time when you can't remember if you already wrote about a topic or not. Stop me if you've heard this one already. One of the ED docs I know is a whiz kid on just about anything mechanical. So before our last JACHO visit, he made a flashing sound monitor. If the noise at the nurses station gets above a certain decible level, the light bulb goes off. It's really effective because the noise level drops dramatically post-flash. Except....I have this propensity for setting it off. A lot. Now, I was a cheerleader in my younger days but it's not like I'm leading a rousing yell from the sidelines, ya know? I reach up and touch my ear; it goes off.
I put the chart on the desk; it goes off. I say hi to someone in the cafeteria two floors below; it goes off. Oh come on! (it's making me vewwy self- conscious)....

(BTW: Herb Caen was a columnist for the San Francisco Chronicle for fifty years. He wrote about the San Francisco scene....the people, the places. He would write using what I've heard termed "three dot journalism".... back in the '80s I attended an opening of the San Francisco Symphony at Davies Symphony Hall. Post- symphony parties were held inside with the orchestra and outside in a tent with a rock (I believe the group was "Pride and Joy") band. Of course I'm out with the rock band and who do I see dancing next to me? Herb Caen! The man had to be in his 70s but he was out there rockin' to the Motown beat. He passed away a few years back and San Francisco still isn't the same....)

4 Comments:

At 10/21/2005 07:39:00 PM, Blogger Heather said...

I got bumped down in the ecosystem too. Either there is sometjing screwy with their server or you and I are just boring. I prefer to believe the former.

 
At 10/21/2005 07:52:00 PM, Anonymous Catherine said...

Kim -- So glad you brought up Herb Caen . . . as a fellow Sacamenna kid, I grew up reading about Baghdad by the Bay from his column in the Chron . . . after he died, the Chron was never the same and I let my subscription lapse . . . but to this day, I still use his trademark three-dots . . . they're like pauses in speech.

Now back to the BM portion of today's column . . . after my recent surgery, not only was I sent home before I "produced" . . . but they almost sent me home before they knew that I could swallow clear liquids . . . a rather big faux pas after fundoplication surgery . . . guess the surgeon took it for granted that because I could get out of bed to pee, that I was good to go (no pun intended) all around . . . don't these guys read charts or talk to the nurses? . . . Anyway, after less than 20 hours post-op . . . and having gulped down some salty broth and a cup of jello . . . I was TURFED out in true House of God fashion.

 
At 10/21/2005 08:21:00 PM, Blogger Gypsybobocowgirl said...

I grew up in No. Cal reading Herb in the pink section every sunday. I was sad to hear he passed away.

Unfortunately these days, they only require that you urinate before kicking you out. Of course, I opened my IV up full force so I could urinate, and there was no way in hell that I was waiting for no. 2. I was getting out of that noisy hospital before dark!

And I never joined the CNA. Just refused.

 
At 10/21/2005 08:56:00 PM, Blogger kenju said...

So gas is a precurser to a bowel movement? That explains a lot!

 

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