Archive for May, 2011

Technology in Education, comment

May 30, 2011

At our office, we talk about the use of technology in seminars and conferences. In my college course, we briefly studied Technology in Education. Wanting to make a more professional presentation, I came across a Professional Speaking Course taught by Dr. Johnson. This course sounds exactly like what I desire. I have major stage fright. This course may help me to overcome it.

Original Post
March 2, 2011
Professional Speaking Course
I appreciate the college-level Professional Speaking class taught by Dr. Johnson. It is difficult to find an online college-level class such as this one. I have been searching for years for a course like the one he teaches. There are many public and general speaking classes. The class by Dr. Johnson addresses issues particular to the business and professional person.

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Healthcare Informatics Employment, comment

May 30, 2011

To the nurse writing about Acuity levels, I feel your frustration. This is a big reason I left clinical nursing to obtain a career in Healthcare Informatics. I do not worry about our nurse to patient ratio, acuity levels, or about working extra and not getting paid. In Healthcare Informatics, I handle policies, statistics, computer programs, and machines. I miss the clinical nursing. However with clinical nursing I was missing time with my family, with my health, and with my sanity. Now I feel better about myself and the work I am doing to help patients in a different way.

Original Post
March 23, 2011
Acuity levels
Using higher acuity as a talking point for our need for lower nurse:patient ratios has had no effect. I am totally frustrated, as are the nurses on my unit, on how to get the point across to administration. We are unable to provide the total amount of care our patients need.

We use HPPD, hours per patient day, to set up our allocation tables. And even though my Telemetry unit is at 8.35 HPPD and another unit may be at 7.5; we all end up with a 1:5 nurse patient ratio.

Looking for a way to assign acuity levels to the patients doesn’t seem to hold much impact. As I researched this, I found articles that found inconsistent results with changing ratios to acuity, with inconsistent results in outcomes.

So where do I go from here? Patients are barely getting the attention they need……..the patients are sicker, older, heavier, more are diabetic…..nurses can only find time to complete the tasks and not much more…nurses are so frustrated, they are looking for jobs elsewhere?

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The Importance of Health Assessment, comment

May 25, 2011

The quantity and quality of nursing charting can be improved by using Computer On Wheels, or an electronic hand-held or similar device. Your health assessment skills will definitely take a turn for the better.

Original Post
March 3, 2011
The Importance of Health Assessment
As a seasoned nurse I think I perform a pretty good assessment. However, reading the first four chapters of our textbook and doing the first lab exercise has reminded me about a basic concept that in our fast pace world we tend to loose sight of. That is the concept asking open ended and non-judgmental questions and then listening to the answers and asking follow up questions. Today’s healthcare environment doesn’t allow for much time but I realize I can better utilize the time I have by improving my assessment skills of asking questions and listening more to the answers I receive.

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President Obama will not release public pictures of the dead Osama bin Laden, comment

May 17, 2011

The speed and outer boundries of healthcare informatics resources used in the case of Osama bin Laden has to be mind blowing!

I imagine that the USA armed service personnel had pictures and documentation stored on electronic devices to identify Osama bin Laden on the spot. These items had to include markings, scars, and maybe birthmarks. The same things we identify patients by in the hospital and other settings.

There also may have been a small portable lab setup present to quickly identify blood type. This does not identify a specific person. But it allows the personnel to quickly keep searching if the wrong blood type is shown. Again, this blood typing is used in the USA for quick close identification.

Telemedicine had to be in place also. It may or may not have been used during the raid. If the armed service personnel needed an answer or needed to send data, then Telemedicine or some form of it had to be quickly accessible.

I will let other healthcare informatics professionals discuss the aspect of rapid DNA analysis.

Original Post
May 11, 2011
President Obama will not release public pictures of the dead Osama bin Laden, comment
I wished I were part of the team that performed an autopsy on Osama bin Laden. There were more than the usual number of personnel for a single autopsy and/or there were several shortcuts to accomplish such an autopsy in a very short time. An autopsy will continue weeks, months, and sometimes years after a person is dissected and buried. Looking at television videos, I will guess that Osama bin Laden may have arthritis. This will show up in the forensic investigation of his death especially if it is chronic.

Original Post
May 5, 2011
President Obama will not release public pictures of the dead Osama bin Laden
Is President Barack Obama correct on this decision not to release disfigured photos of the dead Osama Bin Laden? Yes, he is.

The spirit of international and US laws prohibit the public release of photos of the deceased. Note that the US is unhappy when pictures of dead Americans are broadcasted publicly.

Morally speaking, most Americans would not want pictures of their disfigured passed away loved one broadcasted publicly. The moral, social and spiritual beliefs of a victim and family members should be taken into account. Also the moral, social, and spiritual belief of the country in possession of the pictures should be taken into account.

Ethically speaking, members of the Forensic Medical and Nursing profession are not permitted to show public pictures of the deceased. This brings me to another point. Forensic physicians, nurses, and personnel should be involved with the handling of Osama bin Laden and others. Forensic healthcare personnel are trained to be objective. They will confirm the cause of death, the time of death, the identification, and identify extra factors. The forensic healthcare personnel are removed from political and military biases. Their training includes caring for victims of war on both sides and innocent bystanders.

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Importance of Skin Assessment in Elderly and Child Abuse, comment

May 17, 2011

This is one area where healthcare informatics can be of great help. Instead of nurses trying to remember what to assess and what to write down, the health electronic record will indicate what assessment needs to be done and documented. If the nursing and hospital administration wants skin assessment done, they can include it in the program. And they can set the computer program to indicate to the nurse when this assessment should be done. Thus, the nurse does not have to guess in most circumstances.

Another part of the medical electronic record is the use of cameras. Some camera systems are able to insert an image of the skin assessment directly into the electronic chart. This is a huge time saver for of all nurses. No more writing essays on what was seen on the patients skin.

Original Post
October 18, 2010
Importance of Skin Assessment in Elderly and Child Abuse, comment
Skin assessment is a more valuable tool than we give it credit or time for. There are so many clues to a long list of health issues; from the varience in color, turgor, texture, temperature and thickness, to hair distribution, and condition of the nails. All of these variances from norm could be linked to some health issue. Issues like nutritional deficiency, allergy, local or systemic disease; such as melanoma or systemic lupus erythematosus; or they could be signs or the ‘remnants’ of abuse.

Unfortunately, I don’t think the nurse on the floor routinely gives skin assessment the time or attention needed to pick up on these clues. The most opportune time to find these signs would be on admission, during the initial assessment. What I see on the floor, is short staffing more often than not, trying to care for more patients than can be fully cared for during their shift, and bed shortages, requiring ’quick’ turnover. I am also afraid that the gains in my staffing numbers over the past year are in jeopardy with the reforms and cuts in reimbursement that I think are coming. Thorough assessments are an essential part of health care, of preventative medicine, and all of our professional practices; so I truly hope there will be the time and ability going forward to complete this valuable task.

Original Post

May 26, 2009

Title: Importance of Skin Assessment in Elderly and Child Abuse

In studying skin assessment, one cannot help feeling overwhelmed. Without a desire to pursue dermatology, the unlimited amount of skin lesions, pustules, macules and papules can lead one to skim over information out of the pure necessity for mental sanity. The mind can only hold so many pictures at once. However, I do see the need to ensure the memorization and ability to recognize and diagnose normal skin variations. In reading articles and working with children and the elderly, one unfortunately sees the reality firsthand of physical abuse and neglect. This can often be recognized by assessing the skin. Breakdown, malnutrition, physical abuse, bruises, injuries at different stages of healing can all be noted by a thorogh assessment of the skin. As follow up care and the big picture should always be a part of our thought process in nursing assessment, the ability to note whether a skin assessment finding is simply normal or abnormal is vital to our practice.

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A cool hangout area on our patio

May 10, 2011

Guest post written by Nicole Simmons

My roommates and I have been getting along really well together since we moved in together. We all knew each other from college and just happened to be moving to the same place after for work so it really worked out perfectly! I’m excited for this warm weather that’s coming up and I think that will make us hang out a little bit more outside. But first we have to do a little makeover for our patio area.

There are some old plastic patio chairs that are proabbly almsot as old as we are sitting out in our patio area and we’ve decided to buy some nicer stuff that will make us want to actually use that space. I used our internet to find some ideas for decorating that would make the area mroe inviting and a reflection fo our design tastes.

I found some really cute ideas, including putting some curtains up outside as another way to block the sun. We’ve picked out some cute pieces of furniture and maybe even am umbrella. I think this is going to be a great little area for us to hang out in!

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