Archive for December, 2009

Stress and workload, comment

December 28, 2009

I also agree with both the original poster and the commentor regarding the stress of completing our nursing degrees and dealing with life in general. I also have a full time job where I travel around the country. I find that our textbooks are too heavy to take on the road so most times, I leave it at home and do my work on the weekends. My family responsibilities have changed as my children have completed their educations and now I feel that I must complete my own education. I am taking the degree completion RN program and find that when I have time to study and read, it is very enjoyable. I do feel stressed during my tests but that was like that 30 years ago in my diploma nursing program. I read that "A state of stress turns on the stress response mechanism" in Thibodeau’s Anatomy and Physiology. Our body helps us respond to stress and usually that works for me. I know that I will feel a lot less stressed when I finish my current class and then my Capstone class. I really feel that I have increased my knowledge and enjoyed learning "again" so much that I learned so many years ago. I think that we will all be better nurses due to this online learning. We should all be so proud of ourselves for pushing through our "stress" and making graduation happen!

Original Post
June 15, 2009
Title: 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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Patient Education, Computers, Internet; comment

December 28, 2009

I agree that the medical knowledge is much easier for everyone to obtain. It has made it much easier to provide patient education to our patients in the occupational healthcare setting. We simply go to a program called Dynamed and can quickly obtain the information we need, print the patient education flyers, and even obtain continuing education credit for completing the entire reading on the topic. This has made it very easy to provide concise, complete, and up to date information on a variety of topics. I remember 20 years ago in the ER, we had a "card" file on about 20 diagnoses that we gave to patients for information on their diagnosis. It was very generic and non-specific compared to today’s Internet information.

Original Post
May 27, 2009
Title: Patient Education, Computers, Internet
The Internet has made access to medical knowledge much easier for everyone to obtain. At one time the information was only available through books, available at the Dr.’s office, hospital library, or medical library. The information is now available to patients as well as anyone who wants to find more information on a medical subject.
At the click of the mouse, a nurse can find out if 2 medications are compatible in IV form. Before she would have to look it up in an IV handbook, if one was available, or call the pharmacy.
I find that some patients are more informed about their own health, and can participate in their own healthcare, especially when multiple disciplines are concerned. Patients can also look on the Internet and see if there are any natural treatments to assist in their care and then discuss them with their physician. When you pick up an RX, there is printed information about the drug with it.
The Internet has made it possible for many to obtain medical information to either help them as a patient or health care provider.

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Ethics, comment

December 28, 2009

Review of Health Care Informatics, An Interdisciplinary Approach by Englebardt and Nelson.

Ethical dilemmas in the workplace can be a very difficult situation to deal with as a nurse. We are often put in the position to be the patient’s advocate and that can be a very tough place to be for the nurse. I, too, have been in a situation where my doctor made a decision on an occupational drug test that was clearly unethical. I had to go to our Medical Director to get advice and when he became involved, the original doctor became very upset. However, that being said, I did the right thing and the outcome was correct. It is very difficulty to make a decision to "go over the doctor’s head" but I was being ethical and I slept much better because I had done it. Unlike the previous poster, the doctor did not understand even after much discussion.

Original Post
May 18, 2009
Title: Ethics
Really enjoyed the chapter on ethics from my textbook in Dr. Johnson’s class; I was lucky enough to attend a 2 day seminar in Ottawa that was mostly focused on ethical dilemma’s in the workplace. We presented different scenario’s which were really useful for future guidance. Of particular interest was the Nurse-Doctor relationship; when to step out of bounds as a patient advocate. We are often faced with difficult decisions regarding treatment of our pts. Do we agree or disagree with what the Dr. has prescribed? In one case I knew if I followed through on the treatment plan that the pt. could suffer undue harm therefore I was left with no choice but to report the problem to a senior medical advisor. It caused an uncomfortable situation for the Dr., and myself however after much discussion he was able to understand I was only acting on behalf of the pt. The chapter really gave me some knowledge of how to handle these situations.

Health Care Informatics Online Educational Certificate Program

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Nursing Assessment and Simulation Labs

December 14, 2009

Gaining much popularity in physician and nursing schools, and in healthcare organizations, simulation labs have proven of benefit. There are especially beneficial applications of the use of simulation labs in the nursing arena. Where physicians often deal in data that is independent of the patient, nursing data is not as abstract. It is generally part of the patient response to a situation or disease process and is often patient specific. The use of simulation labs can identify and replicate patient specific responses. This allows the nurse to use more complex data for identifying patient response patterns. The important development of critical thinking skills is often enhanced. More recently, nursing schools have used their simulation labs to bridge the gap between theory and practice by having student participate prior to their clinical rotations. Hospitals benefit by having students more prepared for real time situations. Students note feeling more prepared and comfortable for their rotations. Applications for hospital organizations is great also. Working with an interdisciplinary team in a simulation setting to critically address an issue is always in the patients best interest.

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Assessments and Point of Care Charting

December 14, 2009

Charting patient assessments is often a time consuming task, but vital to the care of the patient and record keeping. Nursing often jot notes down on a piece of paper, to only later record them into the computer system. Much may be lost in the translation. In addition, actions may be taken on the charting that in currently in the computer, though it may not always be the most current reflection of the patent’s status. Point of care systems have become paramount for charting in acute care settings, especially on critical care units. They often interface with medical devices to collect data automatically. These systems are often flowsheet orientated and provide graphing and trending capabilities. Optimally these systems create less redundancy, offer quick responses and interface with other clinical operations such as the laboratory and pharmacy departments. The computer availability is also an important consideration. Central computers have not always enhanced charting as they may take nurse from the bedside. Point of care charting should be convenient points of access to the system. Computers on Wheels (COWS) are found in many organizations. The portable, efficient system allows the nurse to chart in the patients room when appropriate. Bedside systems at the point of care focus on quickly capturing information that a nurse may otherwise jot down on their notes. Computer location should be given thoughtful consideration before investments are made in addition to the device’s speed and ease of use.

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Medical information and the Internet, comment

December 14, 2009

I totally agree with you regarding the medical information on the Internet. Have you ever tried to research a medical issue and found so many different sources that even as a medical professional, you don’t know what to trust? I have become very leery of the purpose of each site that I visit for information. Sometimes, they are just trying to sell something like vitamins. I have become aware of the need to check what audience that they are serving in order to determine the validity of their information. Another important issue to check when looking for information is the date that the information was provided since it is very important that medical information is up to date and not stagnant. I always suggest to my patients that they run the information about their diseases past their doctor to determine if it is appropriate to their own personal medical issues.

Original Post
September 25, 2009
Title: Medical information and the Internet
It is becoming increasingly difficult to gauge the reliability of health information on the web. Just until recently, it was extremely difficult for many people to search for healthcare information, but advances in technology, such as the Internet, are making it more accessible. Patient centered medical information on the Internet could provide healthcare professionals with the opportunity to learn more about patients’ and relatives’ concerns and to refer them to such reliable sources of information when and where appropriate. However, little has been done to assess, control, and assure the quality of this medical information that has flooded the web. Difficulty in judging the validity of this influx of medical information thus poses a problem for people using the Internet. The Internet can be a good source of information on common health problems, but advice obtained through the web should not be a substitute for routine care by a family doctor or other medical professional.

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Patient Interaction with their Disease, comment

December 14, 2009

Although I believe you have a great idea about patient’s interacting more with their disease, I am very wary about how the patient would get this disease information. It would be hard for each individual institution to have their own body of knowledge and keep it up to date and accurate. As we both know, the Internet medical information is often more like "mis-information." I don’t know how many times that I have heard people quote Internet medical knowledge to be factual when in fact, it is very bizarre. I like the idea of a "pathophysiology" session for each patient. Remember the old days, when as nurses, we were able to educate our patients regarding their diseases? When we had time to sit at their bedside, and do our "patient teaching" without worrying that we really didn’t have time? I believe all patients have the right to information and details about their disease. I think disease management companies with health educators that are dedicated to assisting the patients with daily disease management are a step in the right direction and hope that someday they become an integral part of our insurance companies offerings. I think we both agree that our patients need quality disease education.

Original Post
August 20, 2009
Title: Patient Interaction with their Disease
Wouldn’t it be cool if patients who are admitted to the hospital for a chronic illness could be connected with an online program that teaches them about their disease? Maybe the patient could check out a laptop for a few hours and then there could be information given to them about their disease. Medications and the important information that goes along with them could be reviewed (this could be tailored specifically to the medications the patient is taking/will be sent home with). Also a little pathophysiology lesson could be given in an interactive exercise that reviewed anatomy and then changes at the cellular level due to the chronic disease. The program could then go into warning signs of an exacerbation of the disease and when to contact their health care provider or call 911. At the end it could talk about how the patient can work to control their illness at home. The program could include print offs of the medications and disease information. If the patient had questions they could take notes and ask their health care provider before their discharge. I think it is so important for a patient to feel that they can have control over their chronic illness. I think that if patients were better educated about their disease processes that hospital admissions/exacerbations would decrease. I firmly believe in educating patients about their illnesses and believe that a user-friendly computer program would greatly benefit patients.

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Online Advanced Nursing Physiology

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The use of learning aids, comment

December 14, 2009

I agree wholeheartedly with the post about the value of the chapter learning aids for the Advanced Physiology course. I believe even as an "old-timer" nurse that they are very valuable. I have not taken an A/P college course for 32 years and through study of this course, I am finding out that I really needed the review. I believe the tables summarize very well the information that I need to review. I am amazed at the quality of this text compared to the texts that I had in my previous educational experience. Also, a visual learner, I appreciate the illustrations and find them very valuable in "seeing" what is being taught. I am finding that studying and testing in an online course situation, is in fact a great way to get the educational credentials that are needed in today’s workforce. I appreciate the organization of this text book and find that the time that I am taking to use the textbook is lessened due to the valuable format. I am in Dr. Johnson’s class using ANATOMY & PHYSIOLOGY, 6th Edition, by Thibodeau and Patton.

Original Post
September 14, 2009
The use of learning aids
The use of the chapter learning aids for the Advanced Anatomy and Physiology course are excellent tools for any student, whether you are a novice or expert nurse. I am sure I am not the only student who has not done an in depth review on A& P for quite some time. The tables really help to summarize the information and the boxes give you a visual description of the illustrations; which definitely enables me to take the material I have read and apply it to the concepts. On line study is difficult at times, it allows the convenience of working at your own pace but at times the lack of classroom interaction proves challenging for me. I am more of a visual learner and I really appreciate all of the added material and tips this course has to offer. It is a lot of information to process but the aids definitely help!

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Nursing Electronic Charting

December 8, 2009

The use of electronic charting has increased the accuracy and completeness of nursing documentation, eliminated redundancy, automated the collection and reuse of nursing data and facilitated the analysis of clinical data. The ability to quickly retrieve nursing data promotes decision-making at all levels of healthcare delivery. In addition, the use of electronic charting has provided consistency with the Joint Commission indicators, and federal or state mandated and facility specific data. The ability to effectively manage and communicate data using computer systems and telecommunications has catalyzed the emergence of the science of nursing informatics. With that being said, patient charting still requires substantial time to record the variety of complex care delivered to the patient. One would think that a nurse could quickly go in and check a few boxes and be done with it. However, that is not so. There may be several programs to access, multiple tabs to click and numerous entries to account for. Charting thoroughly on patient assessments, medications, treatments, teaching, changes in condition, physician contact, care plans, etc. can account for a significant amount of time. Though charting methods have improved remarkable over the years, it remains a vital, but incredibly complex and time consuming component of the delivery of patient care.

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