Genetics Interview #27: Kim McAllister of Emergiblog

Perfect timing yet again. Kim at Emergiblog is here today. She and I were both included in FOXNews.com’s best health blogs list. But unlike me, she got 30 comments congratulating her! That should tell you what a great person Kim is but this interview should convince you further.

1. A couple of months ago, I posted about Beatrice Vance at my heart disease blog, A Hearty Life. Ms. Vance had died in the waiting room of her local emergency department despite experiencing symptoms of a heart attack. Quite a heated discussion followed in the comments where various nurses weighed in. What’s your take on Beatrice Vance’s death and the way emergency rooms are generally run when patients come through the door?

It is easy for us to sit back and act as “arm chair quarterbacks” when the game is over and discuss what should have been done with all the visual acuity of hindsight.

This one is hard for me because I work in a facility that is well known for its cardiac care at all levels, from the ER on up. Someone comes in with chest pain and no matter what their sex or age, they are placed on a monitor and an EKG is done within five minutes. Every time.

I don’t know how Ms. Vance presented. Whether or not she presented with the “classic” symptoms is immaterial. You have to have a high index of suspicion in women. Was she downgraded in acuity because she was female? We don’t know. But I know for a fact that it happens because I felt that way when presenting with chest pain to my local ER last February. Female, age 48, hypertension and high cholesterol with strong family history for heart disease. The doctor said I had “no risk factors”.

So I know that there are cases where women are not taken as seriously as men when it comes to symptoms of a heart attack. Whether it happened here is hard to tell.

The chilling aspect of this for me is that the death was ruled a homicide. My humble dictionary calls it “the deliberate and unlawful killing of one person by another”. There is no way that this was a homicide. She died of a myocardial infarction. Was her death preventable? Maybe. maybe not. But you can hardly say it was a deliberate killing.

I’m sick that she died, though. And I’m sick that somewhere, somehow the system set up to catch patients such as Ms. Vance allowed her to slip through the cracks. No nurse reading this story feels anything but sorrow. It sure will keep any complacency from creeping into my practice, that’s for sure.

2. I loved your post advising people how to become a nurse step-by-step. But before they take that first step, how do you think we could encourage people to consider nursing as a career?

You have to tailor your approach for different groups of the population.

Some people will be attracted by the service aspect of the career; they will see nursing as a “calling”, which is what it was in my case. Certain groups will want to make a difference in the world, to spend their lives in the service of healing the sick and promoting health. Nursing is a perfect career for these individuals.

Other folks are more pragmatic. For them, you need to promote the tangible aspects of nursing, such as flexible hours, the ability to earn a decent living working part time, a good salary (in CA at least), good benefits, job stability, the ability to specialize and change specialties when they want to.

I did an informal survey at work for my blog. I asked all the women and all the men if they considered nursing a “calling” or a “job”. Not one single man stated that he felt “called” to nursing. They stated what nursing could do for them in terms of pay, benefits and hours. About 75% of the women said they knew that they would be a nurse and that it was a “calling” for them.

There needs to be more outreach. To high schools for one. Through the media for another. I’d like to see a Discovery Channel series that follows a different nurse each week. They gave us “Trauma in the ER”, how about giving us “Nursing: Up Close and Personal”. (I’m ready for my close up, Mr. Spielberg! )

That’s one of the reasons I think we need the Office of the National Nurse - we need a high-profile registered nurse working to recruit new nurses and work to make sure these future RNs have access to an education. This is very threatening to the leadership in some nursing organizations. But while they sit and debate how many doctoral degrees the profession needs, there is an acute nursing shortage that needs addressing. If they won’t step up to the plate, let’s get someone who will.

I’m actually working on the first book in a series of mysteries for boys ages 9-13 that have a male ER nurse as the protagonist. The girls have Cherry Ames, albeit a very old series, but there is nothing out there to encourage boys to think of nursing as a viable career. So I decided to write one. Whether it gets published is another matter, but it most definitely is in the works. Think of it as the Hardy Boys meet Cherry Ames.
I think we really have to start getting kids to think about nursing early. I was nine when I made the decision to be a nurse.

3. What are the most important things you want patients to understand about nurses?

That nurses are there to support them through their illness and to help them achieve and maintain optimum wellness.

That nurses take a holistic view of our patients and realize that they are more than just a diagnosis in a bed. We see their physical, psychological and spiritual needs and are educated to care for the whole patient.

That nurses are there as patient advocates and when they are unable to speak for themselves, it is the nurse who can speak for them or facilitate communication between doctors, obtain spiritual support when requested/needed and generally make sure that the patients needs are met. This is true in or out of the hospital.

(And that nurses love chocolate. Any kind. In any form.)

4. What kind of training in genetics do nurses typically get? How does genetics figure into your nursing experience in Emergency and Clinical Care?

I received no training in genetics back in 1976-1978 when I was in nursing school. I’m not sure if there is any class in genetics even now (I know there is no required genetics class in my online BSN program). My training in genetics, which I absolutely loved by the way, began in a seventh grade science class. I had a bit more in my Biology class in the ninth grade. I don’t remember a whole lot of information in my Anatomy and Physiology classes, either.

Things may be different today. Today my kids bring home their own DNA that they grew in a tube. I will tell you this. If I had known that you could have had a career in genetics, that subject would have given nursing some serious competition when it came to considering a career.

Who knew back in the 1970s that genetics would be the hot topic it is today? Or that the human genome would be mapped?

In my day-to-day duties, there is little, if any, genetics-related work.

But my interest in the topic still remains to this day. It is fascinating.

5. Since you started blogging in August 2005, you’ve managed to build quite a strong reputation. What advice do you have for other health and medical bloggers who have a message they want to get out there? How do you imagine medical blogs evolving over the next year or more?

No one is more surprised than I am when it comes to how Emergiblog has grown over the last year and a half. If I think about it too much I get writer’s block! LOL!

For other health/medical bloggers I would say:

1. Don’ t wait for the readers to come to you. Get yourself seen.

2. Contribute to any carnivals you can, Grand Rounds, Pediatric Grand Rounds, Radiology Grand Rounds, Change of Shift (for nurses and nursing stories). Heck, I even sent one post to the Carnival of Satire and had two or three posts in the Carnival of the Vanities. Don’t be shy!

3. Even better: offer to HOST a Carnival or Grand Rounds. Boy, will you get readers! Don’t be intimidated, it can be done!

4. Read other blogs. Comment on them. People will come back to you to read who commented.

5. If you like a particular blog, link to it on your blog. Chances are the person you link to will link back to you!

My standing joke is if you want to be seen, write about spleens and Dorothy Hamill. I did one post on ruptured spleens waaay back in the beginning of Emergiblog. I still get hits from Google through that post. I mentioned Dorothy Hamill ONCE. I still get hits for her name from Google. Sometimes I think 50% of my readers are actual readers and the other 50% are looking for a photo of Dorothy’s haircut!

The medical blogosphere is a very accepting place. Start a blog and soon you will be part of the atmosphere - surprisingly fast!

As to the evolution of medical blogs, I see more and more medical related blogs becoming “communities”, such as b5Media. Other examples include scienceblogs.com and Healthline. Emergiblog is part of “Nursing Voices” which is a part of nursingjobs.org. That particular group of nursing blogs was organized by Shane Pike, my “web guy”. We aren’t connected by sites, but together we do share advertisers.

I’m also seeing more clinical and technology related blogs such as Dr. Enoch Choi and Dr. Steven Palter (docinthemachine.com). And the number of literary/diary bloggers in the medical community continues to grow each day.

It’s all good!

It IS all good because you’re part of the blogosphere, Kim. Thank you for your generosity, good humor, and excellent insights.