Archive for July, 2009


July 31, 2009

As a nurse, learning never stops. You have to maintain your license, obtain CE credits, certifications, and facility education requirements. Hospitals have tried several ways to have all nurses compliant. By providing lunch and learns, take home packets, mandatory staff meetings, or coming in on your day off to complete all your requirements. Many nurses get frustrated with this, they don’t want to stay after there shift, or come in on there day off, or read a packet of information. Many hospitals are now using E-learning, which is a form of online education. Each healthcare worker is assigned there list of courses to complete with a due date. Managers are able to track who is compliant. CE courses are even provided. Nurses can access this at work or at home. The company I work for even provides e-learning courses free of charge for hospital nurses. For example if JACHO arrives and ask you to prove if there staff is competent with a product. As the manager you can pull up there e-learning records and show proof of completion. Making our busy nurse lives easier!!

Continuing Education Credits and Courses online

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Stress and workload, comment

July 31, 2009

You are not alone….working full time, family responsibilities, and going to school is stressful. I have heard people comment when I say I am taking online classes "well that is different". But online classes are not any less stressful than going to campus. It takes alot of discipline and organizational skills to take online classes. We all know the effects of stress on our body and health. Focusing on the big picture and your overall goals, will help keep you focused. I found allowing time to your self each day even if its only 30 minute of going outside, or riding my bike, brings my stress level down. Take advantage of the new education opportunities, I feel it is very important for nurses to complete there BSN.

Original Post:
June 15, 2009
Title: Stress and workload
Stress and workload; I thought it was appropriate to discuss stress because that’s exactly what I am feeling about my degree program. It does feature online interaction and computer use. The purpose of my degree program was to prepare myself on how to be a better Community Health Nurse; I did not think it was to send time on academic work. I went to bed last night feeling very stressed. My workday is already 9 hours long and by the time I get to my computer at night I am already tired and stressed. What am I going to do about it? I don’t know. I am sure I am not the only one feeling this way. Many Nurses are already feeling the strain of work, family, education etc. I graduated from Nursing in 1982 at the ripe age of 19; it was a 3-year diploma program. Now it’s all about the degree and it is becoming increasingly difficult for diploma nurses to move forward in their career. With the national nursing shortage one would think the government would concentrate on more effective ways for diploma nurses to bridge over to their degree. I can’t afford to take 2 years off to go back to school and taking a course at a time I will be ready to retire by the time I get my degree.

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Carpal Tunnel Syndrome

July 31, 2009

As nurses and health care workers move away from hand written charting and only document on the computer are they at risk for carpal tunnel syndrome? Over my 7 year career as a nurse I have noted several nurses going in for carpal tunnel surgery, many unit secretaries wearing wrist braces. Carpal tunnel is caused by repetitive motion of the wrist, often found in typists. Symptoms of carpal tunnel are weakness, pain, and tingling in the hand , that may even radiate to the forearm and shoulder. I am curious if any research has been done on the increase risk for health care workers. In a field that one wouldn’t think would be spent typing frequently. As technology advances we do more and more from out computers.

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Documentation of Bedsores, comment

July 31, 2009

I found this post and other comments relative to my new nursing job. As an experienced ER nurse, we found little time to assess or document pressure ulcers. With the new CMS guidelines that came out this past October, Medicare will not longer be reimbursing for facility acquired pressure ulcers. My new nursing role focuses on prevention and education. I was very surprised how little I knew about pressure ulcers from working in the ED. Yet it is so vital that our assessment starts there. The photo proof documentation mentioned in this Post sounds like an excellent idea. One of the hospitals I work with, just installed a whole new soft ware program for nursing documentation. It is really easy to chart your skin assessments and pressure ulcers. With drop down choices, body diagrams. But the wound care nurse still has to validate the floor nurses documentation with her own patient assessment every month. I helped her with this, and it was very time consuming. It was double the work in my eyes. Yet we did find, many pressure ulcers that were resolved and many that were staged incorrectly, as well as several that were missed by the RN. Even though we have many different technologies to help us with our documentation and assessment, it still comes down to basic education.

Original Post:
June 17, 2009
Title: Documentation of Bedsores
Joint Commission and CMS (Medicare) has set a Patient Safety Goal of not allowing bedsores to occur during hospitalizations. My institution uses technology to document existing wounds at the time of admission assessment. We are a totally computerized charting hospital. When we identify an existing wound, we bring up a screen of the body and insert a photo of the wound into the patient’s medical record. This feature allows us to prevent lawsuits and receive the correct reimbursement of that patient’s hospitalization. Health assessment no longer has to rely on a verbal or hand written dictation to describe history and physical assessments!

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Nursing Assessment Meets Technology – Nursing Education, comment

July 30, 2009

I work at an institution that received a federal grant to start up a simulation lab. This lab has three manikins that are very lifelike. One is an obstetric manikin and can simulate vaginal births. One is pediatric. The last manikin is an adult and we have sent over 1000 nurses thru this lab this year. We do ACLS scenarios and mock Code Blue. The program can be written to do anything. You can hear the lung fields and heart. When you feel the pedal area, you can even feel a pedal pulse. It is an awesome way to train students and new graduates as well as the experienced nurses. I am impressed that your institution was able to obtain a federal grant in this day and time of economic hardship to establish an innovative simulation lab. This technology is truly awesome in that it gives students who come into the nursing field having no idea about basic assessment skills, which have never experienced actually hearing a real heartbeat, or breathe sounds let alone participate in an actual code blue situation. This lab will allow the students to establish some level of comfort prior to entering the clinical area for their first encounter with real patients. Although I am sure this technology is as close to simulating a real patient as possible remembrance of those first day jitters in the clinical area is something that will stay with you for a lifetime.

Original Post:
June 4, 2009
Title: Nursing Assessment Meets Technology
I work at an institution that received a federal grant to start up a simulation lab. This lab has three manikins that are very lifelike. One is an obstetric manikin and can simulate vaginal births. One is pediatric. The last manikin is an adult and we have sent over 1000 nurses thru this lab this year. We do ACLS scenarios and mock Code Blue. The program can be written to do anything. You can hear the lung fields and heart. When you feel the pedal area, you can even feel a pedal pulse. It is an awesome way to train students and new graduates as well as the experienced nurses.

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Internet Education and a changing belief among traditional nurse educators, comment

July 29, 2009

I personally have mixed feelings about online education. I feel there are a variety of pros and cons dealing with this issue. The pros are that the student has high flexibility are far as the time constraints go and the student has the ability to take test and complete work according to their work schedule. The main negative is that the student has very limited amount of instructor interaction. Therefore if the student is having issues or a problem they can’t figure out they may become more anxious about completing assignments.

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Health Care Informatics Education

July 27, 2009

Health Care informatics is a complicated and growing field. The education for the informatics field is evolving as well as the technology that drives it. Education for the informatics specialist is varied; classroom, computer-based technology, distance learning, etc. There are also different levels of education. Informatics curricula are being incorporated into BSN programs, MSN, PhD, post degree certificates, etc.

Training the end user has changed also. Part of the implementation process includes education. This education differs depending on the product and whether it is vendor taught or Informatics Specialist instructed. Complexity, continuity, and degree of practice change add another dimension to the educational process.

Standards exist for accreditation, HIPAA, CMS, OSHA, etc. Additionally, there are standards for health care informatics that address documentation, user authentication, training of individuals, etc. Many of these standards are not incorporated into attaining, maintaining or utilizing the technologies. This deficit makes integration of applications and usability complicated. Ongoing support and maintenance is difficult and the end user feels the effects when the applications do not run as smoothly as anticipated.

Reading the books in Dr. Johnson’s program has helped cement certain thoughts in my mind. Currently I struggle with these issues. Finding the right path to define and add to my knowledge base in informatics, training the end users and maintaining or adding to their knowledge base in a timely fashion, and having the tools working consistently. Each section has its own complexity. The role of the Informatics Nurse is vital to pull all the diverse pieces of procuring, training, evaluating, and supporting the technologies together and facilitate a smooth transition into a new phase for the institution. Understanding all the processes, the downfalls, the positive results, the needs of the end users is so very important but taking the appropriate steps to intervene and improve the implementation of new technology is critical to the ongoing success of health care informatics.

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History, Just In Time Learning, Genomics, EHR, Future

July 21, 2009

The history of informatics is documented as far back as the 1800s. The evolution of informatics was driven by the need to communicate, to record and to manage information. Health care informatics is a fairly new field but the changes leading to its development have been global.

Health care informatics education is transforming also. The changes are driven by the technology that supports education, the professions involved, health care therapies, and outcomes-based research. The technology includes computers with very fast processors and the multitude of locations that computers are being placed; such as smart IV pumps and cardiac defibrillators. In addition, high speed network access has opened the door to immediate teaching and learning to take place.

There is a concept known as “just in time” learning. This concept refers to the technical vs. academic education and focuses on small bits of knowledge instead of studying a domain of knowledge. One of the questions is whether an individual can combine all the knowledge bits into a cohesive whole. Patricia Benner’s concept of Novice through Expert defines a novice nurse as one who collects too much information and cannot organize it. It would be curious to determine if traditional education leads to greater ability to process all the information; to critically think.

The majority of my informatics learning over the past 20 years has taken place as “just in time” learning. I always perceived that all the information should connect in some format and have struggled with it for a number of years. Trying to combine nursing concepts with technology was not easy. Returning to school, taking informatics courses and being involved in discussions has brought all the bits of information together. It has helped me connect all the dots.

A large impact on the education process for Informatics nurses has been distance learning. Not all colleges have an Informatics curriculum and not all people are living in areas that have easy access to higher education. Distance learning, computer based training, and discussion boards have all supported the education process for health care informatics.

The science of genomics will change the delivery and ethics of health care therapies. Genomics will allow for pharmaceuticals to be customized to the individual, such as cancer treatments. This technology will have a huge impact on the response and sensitivities to treatments. This technology comes at a cost and how will it be paid for?

In addition, the Electronic Health Record is an example of an information system that will be composed of large amounts of data and will be able to generate data for use by insurers, researchers, health care providers, etc. How the information is collated, stored, retrieved, and used has not been determined.

Englebardt and Nelson state that “Technology will pervade all aspects of health care”, p. 500. Technology already permeates so much of health care. Whether this is a future trend or just the conclusion of a current trend is to be determined. The point being, with all the advances in technology; the impact on concepts, practice, work flow, usability, budgets, etc. it is incredibly important to have health care informaticists educated now and for the future to implement the technologies, define the processes, research the needs, and answer the multitude of questions that technology presents to health care providers.

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Is Online Learning Easier?

July 20, 2009

While at work last night we had a discussion of the different types of programs where nurses can earn their BSN and/or MSN. I was surprised that the majority of nurses said they preferred the traditional classroom over online or distance programs. The view was there would not be the instructor support to help with elements of a course that the student was not able to understand. I look at this experience totally opposite, with the entire Internet at my disposal; I can research any topic and find the answers myself. In a classroom I would be limited to what the instructor was putting forth. Yes, I can always later do the online research but how often will that happen. I think in the classroom, instructors consciously or subconsciously teach to how they will test to insure the success of their students. With online learning, I am responsible for learning the material and have no idea what specific topics will be on an exam. It isn’t that it is easier to do an online degree program; it requires the desire to look for and learn the information as opposed to having it spoon-fed.

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Internet Education and a changing belief among traditional nurse educators, comment

July 17, 2009

l solidly report the view that nursing has evolved into the twentieth centuries. While it is now possible to do most of our education on line, one should give credence to students who are family women and men who still hold jobs and go to school. Then most educators had negative or substandard opinion about on line degrees but now, nurses are virtually coerced into going to obtain BSN degrees as soon as possible. Many have the same responsibilities and we are thankful that the due recognition that online classes deserve have finally emerged. My workplace for instance encourages as many nurses as possible to initiate their education online. We are grateful to our predecessors who worked hard to recognize that nurses can have options to still go to school while raising families and going to work. Online is the way to go. Motivation is the key to success. One has to stay on task because the luxury of converging in a classroom is eliminated. The course outline is listed and the responsibility is on the student to turn in works as at when due. Same degree of commitment is expected through online classes and as at traditional schools. Nurses have embraced this method of knowledge acquisition and it is well documented.

Original Post:
July 13, 2009
Title: Internet Education and a changing belief among traditional nurse educators, comment
Finally! nursing has almost entered the 21st century but still lags behind in becoming united in recognition of what the gold standard should be for entry-level nurses. For years, nurses were told they had to have a BSN in order to advance their careers. For as long as I can remember working full time, raising a family, and attending classes at night was just too much pressure for a majority of nurses to endure. Therefore, many nurses accepted that they would never be able to advance their education level above the ADN or Diploma Degrees. Thankfully, the Internet has allowed a large number of nurses and other professionals to advance their educational level while still working full time and managing a household. I must admit that at first I did not think degrees obtained online was as good as or equal to the ones earned at traditional brick and mortar institutions. Since having to personally balance work, education, and family my attitude has taken a 360-degree turn. The online degree is just as or more challenging than the traditional route because individuals must manage their time more efficiently, stay focused, and self motivated. The class work is just as challenging if not more and demands sacrifices to be made in order to succeed. For all those who still think online degrees are less important and easier to obtain than traditional ones should try taking an online class to evaluate for themselves whether or not this degree should be weighed the same as the traditional degree.

Original Post:
June 29, 2009
Title: Internet Education and a changing belief among traditional nurse educators
I can’t help but be amazed how far nursing has come in accepting Internet based BSN programs. I spent the past week at a top university meeting with the director for their nurse anesthesia program. In the past I recall nurse educators that held a belief that if one didn’t get their BSN in a traditional university it was something less that a "real" degree. But these same educators hurt themselves when they view that a BSN is the gold standard as opposed to ADN/Diploma nurses. The problem became when those of us with life responsibilities could not drop everything and attend traditional classes so we didn’t try to obtain our BSN. To maintain the BSN as the gold standard for registered nurses the traditional nurse educators had to accept non-traditional programs. The director I met with not only embraces a BSN earned via the Internet but voiced belief that a BSN learned through independent learning is more challenging due to the discipline it takes to complete such programs. Finally, nursing is entering the twenty-first century. I’m grateful it did during my career; it makes my ability to achieve my goals more realistic.

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