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Grand Rounds 4.31: How … – Blogs – Revolution Health

Grand Rounds is up over at Dr. Val’s! Click the link above to check it out!

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This poor man was trapped in an elevator for forty-one hours while security cameras looked on! UGH!

I missed A LOT of work over the weekend. In fact, I didn’t work at all! We’re talking THREE twelve hour shifts missed by your’s truly. Thirty-Six hours of sick time taken all in one massive chunk. My manager must adore me right now…*cringe*

But today, I’m finally starting to feel better. I have no sense of smell (except for that strange, sickeningly sweet smell of infection that is stuck in my sinuses), My intercostal and abdominal muscles ache from all the coughing, and I’m a bit dizzy. However, in general, that is a vast improvement.

I find it amazing that colds always seem to come when they are needed the most. They are natures way of telling you that life is way to stressful, you’re running on empty, and you just need to stop and lie down for a couple days: preferably with season four of ER fully available for your viewing pleasure.

I left the house only once briefly. I decided that since I was missing so much work, it was only fair that I went and got a sick note (they never did ask for one). I got to the local walk in clinic and was greeted by a fresh sign stating, “We are full, please go the the nearest Emergency Room.”

I contemplated actually going to the ER. I wanted to see the look on the triage nurse’s face when I told her I had a particularly bad cold and needed a sick note for work. I didn’t have the guts though. Not to mention, the ER shares a wall with the ICU that I work in–I’m sure I would have been seen and put to work.

Today, I’m actually going to venture out of the house and visit a friend of mine for coffee. It will seem strange to actually see the light of day in it’s full glory. The fresh air may seem overwhelming, and the noise of being in public may stun me. I will let you know if I survive the onslaught of stimulation.

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Wachter’s World : Snooping At Britney’s Chart: Why Should Docs and Nurses Have Different Rules?

Should doctors and nurses be subject to different penalties for precisely the same infraction? Of course not. Are they? Sure.

Just ask Britney Spears.

Britney was hospitalized at UCLA at least twice in the past few years – once when she gave birth to her first son in 2005, and again in early 2008 for psychiatric care. Both times, dozens of UCLA staff members peeked at her medical records, despite having no clinical reason to do so.

I’m glad somebody brought this up! I have been pondering this very issue lately: particularly in light of the mentioned Britney Spears incident.

Great article!

I wanted to take a quick moment to thank everyone for their kind comments regarding Change of Shift. I also want to thank many of you for your ever appreciated link love. Hopefully, I will again have the chance to host Change of Shift.

About a month ago I had a really crappy couple of days. I was in the middle of my classroom  portion of my ICU training. Interspersed throughout these classroom days was a smattering of “buddy” shifts. All in a span of forty-eight hours, during these buddy shifts, I lost three beloved expensive items.These items were, in order: My very expensive Littman stethoscope, my very expensive and very amazing book Fast Facts for Critical Care Nurses, and My brand new iPod Touch.I blamed this absent-mindedness on the stress of being a new orientee. However, the truth is that I had gotten into the habit of accidentally leaving things around at work–and expecting to find them right where I left them the next day–or even sometimes nicely tucked away.This was almost the case in the ICU. My Fast Facts was quickly found in a desk drawer sporting a nice label proclaiming, “This belongs to Sean…one of the new ICU nurses.” My iPod was found as well. After giving up on finding it I heard an announcement that boomed through the entire hospital, “Could Sean, owner of a lost iPod, please call the ICU?” Apparently, the Unit clerk had found it and spent her morning going through the iPod looking for a name.Unfortunately, my stethoscope was never found. I loved that stethoscope for no other reason than it was a present to myself following graduation from nursing school: a nice symbol of completion. I have searched and explored every nook and cranny in that ICU, and it has yet to turn up.So, I declared it to be a sacrifice to the gods of the ICU, begging for good luck in return. Yesterday, I went out and bought a new Littman Master Cardiology. I freakin’ LOVE this new stethoscope. It’s just so gosh darn beautiful!What do you want to bet that the next time I go to work, I will immediately find my old stethoscope? That’s just Murphy’s Law for you…

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On the first day of orientation to the ICU, my manager nonchalantly mentioned that all new employees get sick about six weeks after starting–thanks to all the stress and anxiety thrust upon them. I chuckled, assuming it was a gross generalization; and of course it wouldn’t happen to me.

So, here it is, six weeks into my new job in the ICU, and I’m sick as a dog (see cold virus above). After feeling run down and super duper stressed out all week, my body finally gave in to illlness.

I felt bad, but I had to call in sick for tomorrow, and will possibly have to on Saturday. Ugh! I would much rather have been the epitome of the perfect employee who never gets sick. Or perhaps even the do-gooder that toughs it out and goes to work suffering.

Nope! Instead, I have a date with my blanket and bed tomorrow…

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Welcome to Change of Shift for April 17th, 2008. I have enthusiastically dubbed it, “The European Dreams Edition.”I know I’m not alone in feeling a slight bit of cabin fever after a long winter. Everyone at work and on the blog-o-sphere seem to be a wee bit cranky these days–myself included.

Over the last few days and weeks I have found my mind wandering to my newest dream: a European adventure. I never did get that one opportunity in my youth to backpack across this most exciting continent in order to “find myself.” 

Perhaps I’m having a bit of an age crisis, considering I’m about to turn thirty, but I can’t stop ruminating on the idea of strapping on a backpack and running shoes, buying a Eurail pass, and living out that famous of youthful rituals–Europe. It’s gotten to the point that as work gets more stressful, the more my mind escapes to my new fantasy. And look! It’s even having an effect on Change of Shift!

Now, without further adieu, I would like to present some fantastic blogs that have popped up over the last couple of weeks. Some fell into my lap, and others I went looking for. I hope you enjoy each and every one!

The Eiffel Tower has certainly become one of the ultimate symbols of European ambiance. I’ve heard stories that when it was first built, all of Paris despised it and wanted it torn down. Everyone thought it was an eyesore! Now, it is the epitome of beauty!First impressions certainly are important. NoFo writes about his experience as a patient in his local emergency department. In a similar post, Blobby writes about his experience as a patient.

When I think of progress, I think of London and the rest of England: the home of the industrial revolution! In this way, I suppose we can thank London for all the technology and equipment that we must use on a daily basis in our jobs as nurses. Ian over at ImpactEDnurse reminds us, it’s not always about the technology!Speaking of technology, a Guest Poster over at chaarka’s blog discusses how cell phone technology is helping physicians. It reminds me of when plastic surgeons or enterostomal therapy nurses take pictures of wounds to track their progress.What about my favorite technology: restraints? DisappearingJohn has written about his experience with restraints.

Traveling around Europe causes me great trepidation! There’s so many roads, rails, taxis and buses. Learning the routes, prices, pros, and cons is a large undertaking! It causes such anxiety!Speaking of anxiety, how about the painful experience of orienting to new units/jobs as a nurse? OUCH! As a brand new ICU nurse, I’m really noticing just how challenging it is to leap out of one’s own comfort zone to try something new.

I wrote a post about things I have learned as a new ICU nurse, and another post about preceptors in the ICU. Brainscramble wrote a post about trying to navigate the world of nursing as a student nurse, and learning that being an advocate for a patient is difficult–and extremely important. Here’s the follow-up post.Stuffed Nurse does a great job at helping us get through our first year as a RN.Maybe if I had followed these steps when starting in the ICU, I wouldn’t be so stressed out now–with my mind always on Europe!

Or perhaps having a mission statement would have helped me. I have a personal philosophy of nursing (see tabs above), I have a yearly learning plan I need to complete in order to maintain my license, but I don’t have a mission statement. PixelRN looks at this idea in her post about nursing mission statements. Very interesting stuff!

What is Europe without art, museums, and architecture? In fact, I’ve heard that travelers to Europe quickly burn out from all the museums and tourist attractions. They are quickly whisked past the hundreds of sites they are “supposed to see” with little time to stop and smell the roses.It costs A LOT of money to see all these attractions. In fact the cost of traveling to Europe is HUGE. One of the reasons I haven’t done my dream European backpacking trip is because I was in nursing school for almost five years–and we all know how much money that takes! In fact, Not Nurse Ratched even wrote a post about it!

In the colosseum, gladiators used to fight all sorts of animals that the Roman soldiers had brought back from their conquests. Can you imagine being put into the ring with a lion?Well, what if you were a veterinarian trying to sedate a lion? Isn’t that pretty much the same thing? How much propofol is that? Read about one veterinarian’s experience with this in her clinic at spindyeknit

Moscow! The home of Communism for decades, and a land currently undergoing drastic changes. Pondering this great city makes me philosophize about just exactly how a person defines freedom. Certainly, some define freedom as including, almost definitively, capitalism.Braden over at 20outof10 (I love that name…I think only health care professionals would understand) writes about the “free” products one can receive. How does this system affect the market on a larger scale? Very thought provoking!

Speaking of change, I have often heard that traveling to Europe will change your life in profound and mysterious ways. And you often hear of people going to Europe to “find themselves.”Kim at As the Pump Turns is a dialysis technician who will soon be a nursing student. She writes about a life-changing event for one of her patients and how it has effected her personally. What a neat perspective!

Whenever I think of Greece and Athens, I think about the great philosophical debates between Plato, Aristotle, and Socrates.As we know, there are a lot of debates taking place in the field of medicine. Over at The Nurse Practitioner’s Place, a debate about Nurse Practitioners is described.

OK, I know, a little bit of overkill on the Berlin pictures. But, of all the cities in Europe, it is the one that fascinates me the most. What a history! Just imagine: a massive city, completely divided by a heavily guarded wall, each side isolated and allowed to develop independently under completely different governments and lifestyles. Then, in 1989, the wall came down and the two cultures were allowed to clash and mingle.And all the conflict! The Hapsburgs, Hitler, Communism, democracy…wow!

Now, in many ways, when I think of Germany, I think of leadership and the effects it can have on people. Here is a great post on The 7 Attributes of Leadership. Do you see these attributes in your manager? How about in your charge nurse? Anyone?I certainly can’t think about leadership and management without thinking of discipline. Ermurse wrote a fascinating article about disparities in healthcare and staff discipline.

Of course, Germany has been a major player in A LOT of war. But is there a war on nurses? Mother Jones wrote two very powerful posts over at Nurse Ratched’s Place regarding violence against nurses. There’s a part one, and a part two.

When people think of Amsterdam, they can’t help but think of their progressive thinking attitude toward drug use. Perhaps you agree with it, and perhaps you don’t.What I do know is that harm reduction techniques work in the fight against addiction. Here’s a post from Canadian Medicine explaining the story of a safe injection site in Vancouver.

When thinking of Amsterdam, I also think of little cafes with laid back atmospheres. I envision travelers from around the world gathering together to share their stories. One of the greatest places for nurses to do this is at the forums of Nurse Connect. There are some bloggers over there too! Here’s some posts from Katy:Sexism in healthcareThe Dating GameHealthcare Conspiracy scenario. And here’s some posts from Laura:Bringing up Baby DocsPink Collar Professionals: Powerful Stuff or Powder Puff?Patient Satisfaction: What really defines it?

Well, readers, that’s all for this edition. I had a great time gathering posts! Thank you for indulging in my fantasies and dreams of a European adventure.Next week’s edition will be hosted over at Life in the NHS. So, please send any and all submissions that way.

Hey everyone! This is the last call for Change of Shift Submissions. Send me anything you would like included. You have about three hours! Hurry hurry!

Please send all last minute submissions to owner@nursesean.com

Dr. Wes: Welcome to Grand Rounds – Vol. 4, No. 29

Dr. Wes, who is endlessly fascinating to read, is hosting Grand Rounds this week. Check it out by clicking the link above!

During my ICU training, I have gained an absolute fascination for cardiology and cardiac electrophysiology. So, it’s no surprise that I’m absolutely enamored with this edition, who’s theme has a decidedly “cardiovascular bent.”

What are you waiting for? Run, don’t walk!