Nurses on Twitter, Twitter on Nurses

Why would a nurse want to use twitter?

First things first, what is twitter? Quite simply, it’s a microblogging tool. Think you have something witty/amusing/relevant to say and can get it in under 140 characters? Then twitter is for you. Want to connect with a community of people without having to write long, drawn out blog posts? I would suggest trying twitter. It’s like a slimmed down version of social networking. You write something, you read something. And you can have conversations with people. Short ones.

Along with twitter comes a great many sites that take twitter feeds and mash the data into something else entirely.

For example: Twittervision takes a map of the world and shows you real time tweets popping up on it. Twits Like Me can help you find friends on twitter. There’s also a very useful site called Summize, that you can use to track words as they occur on twitter. Here’s a very simple example of how I like to “play” with Summize:

This morning I got up at 5:45 AM, went to Summize and typed in “drinking”. Lots of tweets came back about drinking wine, getting drunk, etc. Then, an hour later I typed in “drinking” and got tweets about coffee and tea. It’s like watching the world go to bed and wake up at the same time. Try typing in “eating” somewhere around dinner time. You might just find yourself salivating.

And for a wonderfully compelling and beautiful site that uses data from Summize, I urge you to check out Twistori. But be forewarned. Your eyes might get stuck there for awhile.

Great. But I thought you were going to tell me why a nurse would want to use twitter?

For one, you can use Twitter to expand your online community. There are some tech savvy nurses out there using Twitter, and so why not try and connect with them? As you can see on Orientedx3, I am also using Twitter to get a glimpse of what people really think about nurses; the good, the bad, the fascinating, the irrelevant.

The thing that fascinates me the most about Twitter, and feed technology in general, is how it might be useful in medical situations.

Here’s a place where it could be used: Working in the recovery room, one of the problems I see for nurses is not getting enough background information on their patients. The patient reports that we receive are often short and without substance. Most of the time this suffices, but what happens when your patient takes a turn for the worst and you don’t have the right background information? You need to know the patient’s baseline and perhaps a little more about their history to take care of them.

Well, what if every patient had a feed that was connected to their EMR? It could basically serve as a mini-history of that patient’s hospitalization. It would include small blurbs of relevant info, like if the patients vital signs became abnormal, or if a one time dose of hydralazine had to be given, or if a patient required a blood transfusion. As a nurse, you could view this stream of feeds and get a much better picture of what the story is behind your patient. I could also imagine that the feed would be useful to physicians and pharmacists.

Anyhow, those are my Twitter thoughts for the day. Intrigued? Follow me!

Breathing New Life into OrientedX3

If you go take a look at Orientedx3, you’ll see I’ve been performing some much needed CPR on it. It’s definitely a work in progress, as there is much to be done as far as the style and substance are concerned. But I thought it would be great if all of you out there could tell me what you think about it. My aim is to build a site that is actually useful to people. I’m going to be blogging about it all this week at PixelRN and so feel free to chime in on the discussion. Love it? Hate it? Completely indifferent? I welcome any and all feedback.

First let me tell you about my original vision:

In early 2007 I had the idea to start working on a website/blog that would serve as an aggregator for all things on the web that were related to nursing. I knew this could be done in an automated way through RSS feeds and PHP, but I just didn’t know how to do it. So instead I decided to launch OrientedX3 as a WordPress blog, and just update it manually. This proved to be a lot of work, and then two things happened which completely sidetracked me:

1. Benjamin came along
2. NursingLink hired me as general manager.

I’ve since left NursingLink behind, but fortunately Ben is here to stay. About six weeks ago I started working less and staying at home more, and I decided I wanted to finish what I had started. In the process I came across two other sites that were doing something similar to what I had in mind: Popurls and Alltop. If they could do it, so could I. I was immediately inspired to pick up where I left off.

In the past year I’ve learned a little bit of PHP. Well, enough really to get me into trouble. Certainly not enough to build my own RSS agregator from scratch. But then I found an awesome WordPress plugin called Simple Pie, and I was off and running.

And voila! Here it is. So what do you think?

One thing I have been wondering specifically is: Do you think a site like this could be useful?

One may ask, how is this different from using Bloglines or Google Reader to keep track of blogs and news stories?

I don’t know. I just like the idea of everything related to nursing on the same page. I like to think that this page would be a great answer to the question, “How do nurses use the Internet?” Unfortunately, sometimes I wonder if anyone is really asking this question.

Some drawbacks…

Not all nursing websites are savvy to the concept of RSS feeds, and therefore, I can’t include them on this page. For instance, I enjoy reading what the Center for Nursing Advocacy has to say. I don’t always agree with them, but I like the fact that they are doing something interesting. But there are no RSS feeds to be found on their site. Same with the ANA. Not a single use of RSS. I think this is going to change eventually. The vast majority of people’s eyes glaze over when I mention RSS but I think that feed technology is here to stay. It’s just going to take a little longer to catch on.

I’d also like to have a bigger section that tracks what nurses are saying on forums, but the big ones, Allnurses and NursingLink don’t use feeds for their forums. As you can see I’ve included NursingVoices, and Nursing Informatics Online.

Tomorrow: I’ll explain my fascination with Twitter, and why I chose to include it on OrientedX3.

EKG Interpretation: The Tap Dance Way

Check out this cute video of University of Pennsylvania School of Nursing faculty and students demonstrating the art of EKG interpretation through tap dancing. Now if they could throw a Wenckebach in there, I’d really be impressed. (via Beka at Medscape Nurses)

It was recently brought to my attention by my dear friend Max that I haven’t blogged in over two weeks. Just wanted to let you all know that I am still alive and kicking. I’m picking up a shift here and there in the Recovery Room, but also working on some web-related projects which I will hopefully be posting about soon. In the meantime, I will leave you with a picture of a Bonsai tree I’ve been working on in illustrator:

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Back to the MICU, and back to Liverland

So this MICU shift was very difficult after all, and it wasn’t for the reasons that I suspected. I thought it would be the tasks that got me down, i.e. not enough time to get things done. Surprise, surprise, turns out it was the patients.

Imagine a patient with End Stage Live Disease. She currently has hepatic encephalopathy and suspected GI bleeding. She was recently extubated. They usually put an oral gastric tube in and then yank it out at the same time when the patient is extubated. But then the patient continues to have this hepatic encephalopathy, which is a Catch-22 because then she is unable to swallow her lactulose, (which would help to restore her mental status.)

You attempt placing a nasogastric tube, twice, both times unsuccessfully, both times with the patient screaming at the top of her lungs. So at the end of the day, her baseline mental status hasn’t returned, and you have no way of giving her nutrition or lactulose. But she isn’t sick enough to stay in the ICU so you transfer her to the floor.

Typical situation for this disease, I tell myself, and that’s just the way it is. But I feel so frustrated, and so helpless for two reasons. (1) I CAN’T GIVE THIS PATIENT HER LACTULOSE AND THAT IS THE ONE THING THAT WOULD MAKE HER BETTER and (2) Trying to place this NG tube when she is not mentally stable enough to cooperate is very traumatic to her. And inevitably, the docs will always order a lactulose enema out of desperation. GUESS WHAT? If your patient can’t swallow a cupful of medicine, you can be damn sure she won’t be able to retain a pint of lactulose IN HER BUTT. So that never works.

The weird thing is that even though I hadn’t worked since last August, I had the exact same patient scenario: Liver Failure, recently extubated, mentally, in liver land, and unable to swallow lactulose.

Is it a failure of our healthcare system?
Is it a failure of my nursing skills to place an NG tube?
Is it a failure of our normal routine to yank out the OG tube when extubating?
Is it a failure of medicine in that we have failed to discover a better way of reducing a patient’s ammonia level (which is what lactulose does)?

In the end it doesn’t really matter because it was a failure, and I left that day feeling like I had done nothing for my patient except cause discomfort, and transfer her to lower level of care.

One thing is for sure, I vow never to complain again about working at Chez Recovery. It took a shift back in the MICU to make me realize just how good I had it there.

Back to the MICU

So I’ve had an ab fab week of being a stay at home mom, and caring for my one year old wonder. I’ve also made some progress on my Orientedx3 redesign, and I hope to be able to launch it in a week or two. I won’t get into too much detail here, but suffice it to say that it’s going to be a very cool way to explore nursing related content, with blogs in the forefront.

I’m also working on building some WordPress themes from scratch and it’s been a really fun and invigorating project. A project that makes me feel as though I am getting closer to being a successful web designer, and farther away from being an unhappy nurse.

One kind of cool but geeky thing I realized is that PixelRN is on page one of a google search for “nursing websites.” It’s kind of meaningful to me because I’ve always believed that nurse bloggers are putting out the best nursing related content on the web, and most of the other nursing websites are light years behind us. It’s also meaningful because the way I discovered nurse blogging was by doing a google search on “nursing websites.” In a way it makes me feel like this blog has come full circle.

At any rate, I am working a shift in the MICU tomorrow, my first time since last summer. I have a feeling it’s going to be a make or break kind of a shift, in that I am either going to rediscover my passion for working in the ICU, or I will be reminded why I wasn’t so keen on going back there in the first place. More importantly, I hope I remember how to care for really, really sick people. I’ve been fetching ginger ale and crackers for post cardiac cath patients for far too long now, and I’m worried that I might have lost my edge.

On the other hand, I may have gained an edge. I can now start IVs, and the turn ‘n’ burn atmosphere of the recovery room has made me hone my time management skills. Either way it should be interesting, but not too interesting, if you know what I mean.

Should a Nurse have a Mission Statement?

I’ve been reading a lot of books lately on successful business strategies and the topic of mission statements often comes up.

It got me wondering, can nurses benefit from having a mission statement? Many of you already do, but you don’t even realize it. A mission statement can be derived from your philosophy of nursing. For example, what does being a nurse mean to you? What makes a good nurse? Answer these questions and there is the beginning of your mission statement.

Why Would a Nurse Want a Mission Statement?

Quite simply, because it adds meaning to what you do. This can be a great help, especially to those who are suffering from nurse burnout. If you take a moment to reflect on your mission statement, it could serve as a source of inspiration on those days when you just feel like you are just running around in circles, and not really accomplishing anything.

Here’s an example: As a recovery room nurse I often felt dragged down by all the repetitive, meaningless tasks that I was required to do (charting vitals Q 15 minutes, fetching ginger ale and crackers, removing IVs, etc). What if instead of dwelling on these things, instead I focused on the following mission statement:

For all of my patients, I am going to help them to be in control of their health care process. This would include:

  • Making sure they know when and with whom to schedule a follow-up appointment.
  • Making sure they have the proper educational tools; e.g. if they have a nephrostomy tube placed, do they know how to care for it? If they have a pacemaker placed, are they aware of what the settings are, and what these settings mean?
  • Do they need copies of their lab values for their personal records?
  • Have the doctors answered all of their questions related to the procedure?

Sure, most of these things are part of the job anyway, but if I view them in the context of my mission statement, it might make my job more meaningful, and hence, more satisfying.

If you had to choose a mission statement as a nurse, what would it be?

Cherokee Scrubs: A Test Drive

orangesToday I will be reviewing the Cherokee V-neck tunic scrub top and the Cherokee v-neck scrub pant, both in mandarin orange, from My Nursing Uniforms. It’s taken me awhile to write this review. That’s because there was something slightly unfavorable about these scrubs and I wasn’t sure how to approach it. The color I chose is a little bit “out there,” so to speak. It was described as Mandarin Orange, but I think a more apt description would be Safety Belt Orange. In fact, the first time I wore them, one of my not so tactful colleagues felt the urge to ask me if I had just gotten out of prison. My not so tactful husband asked me if I was going to work out on the roads that day.

Despite these snarky comments, I also got many compliments on the color. Whether these people were just being polite, or they think that neon orange is a good color on me, I will never know. I can safely say, however, that this shade of orange is definitely a conversation starter.

There are also some things that I really like about these scrubs and I would definitely purchase them for myself, but perhaps in a more muted color. What else did I like? Two things: the cut and the pockets. If you’ve read my other reviews, you know how I feel about pockets, I need them to do my job. The Cherokee tunic top actually has two deep pockets and an inner longer pocket that is great for storing pens. I also like the tunic cut. It is a little longer, going down a little past the waistline. The pants were slightly too long for me. They are mediums and I am 5’4″ and the hem drags on the floor.

All of this considered, I would definitely consider these scrubs PixelRN-worthy – just in a different color and a slightly shorter pant.

(In the interest of full disclosure, I will let you know that my friends at My Nursing Uniforms are compensating me for this review, although the compensation was not dependent on a positive or glowing review – what I am telling you here is my honest of opinion of these scrubs.)

Chez Recovery and Beyond

So two more weeks left of working at Chez Recovery, and I am ready to move on to bigger and better things. The funny thing is, after all the complaining I’ve been doing, the job is really starting to grow on me. I think this has something to do with the law of leaving a job – the closer you get to the end, the more you start to like it. I think it also has to do with the great group of nurses that I met there, and have really enjoyed getting to know.

Anyhow, I think my complaints can all be boiled down to 3 neat little concepts:

  1. 40 hours a week is too many hours to work as a nurse. 20-24 would be more like it.
  2. I would like the job a lot more if I had some added responsibilities like say, training as a charge nurse. Since I’m leaving in two weeks, this most likely will not happen.
  3. I am not sure I still have a passion for nursing.

I’ve been toying with the idea of picking up where I left off with web design, and thinking about doing some freelancing. I’d like to start setting up sites for businesses using WordPress, and help these businesses to get more traffic by adding blogs, as well as other types of Web 2.0 apps to their sites. If you own a business and think you might be interested in this sort of thing drop me a line (Beth-AT-pixelRN-DOT-com) and we can discuss some ideas.

AND on another exciting note I am planning on relaunching OrientedX3, but in a in a much different form. More news to follow in the weeks to come.

And then there’s this guy. I’m looking forward to spending a lot more time with him. He just celebrated his first birthday and has the cake on his face to prove it:

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