A nurse is the most profound fulcrum between the patient and the care they require.
So it is the intimacy of the bedside nurse that effects the most powerful force of all.
-Ian Miller

My name is Ian Miller.
I have been working as an Emergency Department nurse in a major teaching hospital since 1987.
I invented bedpan Frisbee, and the word ‘Obnoxicated’.

I have worked as a Clinical Nurse Consultant, a Clinical Development Nurse, a Change Manager and, most importantly in my opinion, a clinical bedside nurse.

I have been writing on impactednurse.com since around 1999.

Everything else I could possibly say about myself is already spilt amongst the pages.
I hope you will find something of interest.

I live in Canberra, Australia with my partner Kelly, and my dog Smudge.

Email: ian@impactednurse.com
Twitter: @impactednurse
Phone/text: 0414708829.

24 Responses to “About”

  1. Just found this site a short few moments ago and I LOVE it!!!! I’m a student nurse living in Canberra (we’ve met in ED when you cared for my little boy…..you won’t remember me, but we remember you!)

    Tonight I’ve nearly wet myself laughing and am so wishing I’d found this years ago when I first started at Uni!!! A huge THANK YOU from me!!

  2. Achieved CNS status today! I wouldn’t have made it this far without Ian and Impacted Nurse. Firstly, because I found this blog when I was considering nursing, and it inspired me. Secondly, because whenever I was angry or disillusioned or bitter or exhausted, this site inspired me to take pride in my profession, and gave me hope that there are other nurses out there going Hardcore. You’re amazing Ian!

  3. Great blog, love the humour and style. Certainly much needed attributes in ED work. Glad to see someone who also sports the micropore tape on the stethoscope look. Would be interesting to see how much tape wastage this prevents!! Keep up the fantastic work.


  4. Ian just had to say g’day. stoked to find your blog. I love your work! I graduated as an Enrolled Nursing Aide in 1982. Now I’m an EEN in short stay/day surgical ward. Same bogged down system.(Gosford)

    Call me cynical, but people are getting more stupid. and fat. and rude. The post-op meal of choice for 20somethings (!) having Lap. Cholecystectomy ? McDonalds and a smoke. and “something for nausea”.

    Despite all that, I was born to nurse. Used to cut school to help the ‘pink ladies’ at local hospital.
    I really love your site and will share with my colleagues.

    FOR THE PATIENTS: Waiting is good. It means you’re not going to die. Think about the person being rushed straight in for attention. That’s the guy in trouble.

    Thanks for your wit, wisdom and your gr8 smile!

  5. Alex… fulcrum.. definition… look it up, mate!! Or didn’t you do physics??

    • I think you’re being a little pretentious. Ian’s use of the word ‘fulcrum’ is fine. A fulcrum is something upon which something is balanced. He says that patients (on the one hand), and the care they require (on the other) are balanced upon the nurse. Everything hinges on the nurse. Sounds good to me :-)

  6. lol nice try Alex but I agree with Ian… doctors prescribe the treatment…. nurses provide it, but not always with a friendly face… sometimes through gritted teeth and more often than not with a full bladder :)

  7. A nurse is the most profound fulcrum between the patient and the care they require. And it is the intimacy of the bedside nurse that effects the most powerful leverage of all. – ian miller.

    err…don’t church it up son… and nice effort citing yourself lol

    Slightly overstating things there… I’d say the medical treatment provided by doctors is the most powerful leverage… but yes patients appreciate a friendly face from the nurses…

    • Alex, you’ve clearly never been in hospital. Doctors might prescribe stuff, but its the nurses that will actually care for you and administer it. Wait for a doctor to do it, and you’ll be waiting forever.

    • Nurses are more than just a friendly face. You see the doctors for such a short period during your stay. We are the ones attending everytime you buzz and, due to our extended length of contact, the first to notice deterioration.
      Need to go to the loo? Let me get you a pan and I’ll wipe you afterwards. Think you’re gonna be sick? Here’s a emesis bag, I’ll measure the output, take note of the quality of the liquid, get the doctor to chart you an antiemetic and then administer it to you in tablet or needle form. Need that medication? Give me two ticks and I’ll sign in some legally binding books to get it for you and then run through a series of checks to make sure you don’t have a bad reaction, and then check in regularly to see if it’s had an effect. Don’t understand what the doctor has told you? Let me explain it to you…
      Not only that – having trouble breathing? Chest feels heavy? Just got a large stab of pain? We are the first ones at your bedside. The first to initiate assessment and interventions. The first ones to call for help.

  8. God love you for working in the ED! Too many type A personalities for me! I work in ortho in Pennsylvania, but I’m curious to know what it would be like for an American-trained nurse to try his luck in Oz. I understand there is a special visa category for nurses. Thanks!

  9. Just about to start work at a Sim Centre (admin) and looked up cannulation to check that I could spell it. I know about it, had seen students practising it on fake arms with food dye blood but am keen to stay away from the pointy bits.
    Loved what I found here.

  10. Blood y hell THE Ian Miller. Iwas innocently searching the web for the singapore ED waiting room and who did I find but the bald buddhist love god from Canberra Hospital. Hope all is well and hello to anyone left from 2000-01. Jim Cooper

  11. Heard about this site a week or so ago. Hope you don’t mind, but I have used your tomes of wisdom for new grads. Not enough fun and laughter at work anymore – they may help!
    Keep up the good work!

  12. Absolutely unreal site…the information and the way is delivered is fantastic! Being an Educator I find this site of great value and a great resource. You ROCK! Keep up the GRAND work!

  13. THANK YOU! I just ran across your site the other day and read the book. Awesome, reassuring, synchroncity, maybe zeit geist? I want to encourage you to do what you do. I want to thank you for inspiring me to write again and giving comfort to me and, hopefully, thousands of others. GO KNOWLEDGE AND COMMUNICATION! (cheers)

  14. I’m not a nurse, but I work around a lot of them…
    You are very entertaining and offer a lot of insight into why the nurses I AM around behave the way they do….

  15. I love your attitude! It is refreshing, given the veneer of corporate crap required to work in the American healthcare anti-system!

  16. Yay! I heard about this bogspot and wanted to see it but it wasn’t there,and now it’s back.

  17. Hi! Just found out that this site is back on-line. I don’t know what happened before but all this best with this resurrection.

    Peter McCartney

  18. Had any experience with the removal of penis rings that refuse to come off in your A&E. Get plenty of them in Darlinghurst. What is your procedure?

  19. I am a registered nurse who has been in the ED for about five years now and I am glad I found a familiar place where I can learn from my peers and share my thoughts as well.

  20. Thank you, thank you, a thousand times thank you! I am a recent graduate from nursing school in the US, working in the same ED in which I’ve worked as a tech for 5 years. While some of the terms may not be the same, the stories and sentiments are. Your blog is a wonderful read (though it’s a bit of a busman’s holiday for me…)

  21. Loved the Intubation thingy.

    Not one to shy from asking the hard questions. Answer me this. Sterile ETT tube, Sterile KY gel, Sterile airway south of the glottis, Q: Should the Introducer be sterile? If not why not? If so, why is it always just sitting in a dust jacket on the back room of every Qld ED Resus bay, and not in a sterile pack?


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  • impactednurse.com will soon be gone. (3)
    • Zeke said: Are you keeping an archive of this site on the nurse path site?

    • jelly said: Just work a few more hundred Sundays!

    • matgrad said: Bye Ian will miss the site but as you say everything has its day. Good luck for the future.

  • Nurses are F*cking C*nts. Verbal abuse in our workplace. (32)
    • Rose said: I have read this article and found it very relevant to me and my own experience.Unfortunately a lot of people think that it is quite OK and acceptable to take out their anger and frustration against a sometimes inadequate health system on nursing staff. I also think that gender is an issue as I often feel that female nurses are...

  • Nominate Now: Social Media Nurse of the Year. (21)
    • Belynda Abbott said: I would like to nominate 3 amazing nurses that contribute to nursing and social media in many different ways: 1. The amazing Philip Darbyshire @PDarbyshire and http://www.philipdarbyshire.co m.au/index.php?option=com_easy blog&view=entry&id=44& amp;Itemid=13&utm_source=b uffer&utm_campaign=Buff...

  • When a patient leaves with cannula in-situ. (17)
    • Andy said: Good thinking! At my hospital the Oncology staff are trained/instructed to bleed CVADs before every use regardless, to remove potential clots, discard, flush, then use. Another excuse if you need it ;)

  • bully nurse. (40)
    • G Boucle said: This is not surprising at all to me! Nurses can and do bully patients, I was on the brunt of this after a surgery with spinal fusion on 5 segments! The pain was blinding, they bickered in front of me over who would change the cath bag on the floor already filled and looking about to burst, I found this extremely upsetting....

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    • Contrarian said: I have seen at least one, maybe two live performances of the Art of Bleeding (they were performing at the periphery of other attention-immersive events). Of course the nurse-slut costume is a standard image, but they turn it on its head and dissect it. So, yes, as they say, while the nurse slut draws in the viewer, the viewer is...