Lit for ED Nurses @ENAorg

It’s been awhile since I posted anything.  The time constraints of working full time and being a grad student overwhelmed my time management skills.  As I resurect my blog, i’m going to be more of a curator.

As an ED nurse the breadth and depth of knowlege required is almost overwhelming.  These articles are a bit older but all contain information or ideas that shold be helpful to ED nurses.

(Cabilan, Eley, Hughes, & Sinnott, 2015; Mary Beth Modic DNP et al., 2014; Singh & Koyfman, 2016; G. S. Weingart, Carlson, Callaway, Frank, & Wang, 2013; S. D. Weingart & Levitan, 2012)

Cabilan, C. J., Eley, R., Hughes, J. H., & Sinnott, M. (2015). Medication knowledge and willingness to nurse-initiate medications in an emergency department: a mixed-methods study. J Adv Nurs, n/a-n/a. Retrieved from http://doi.wiley.com/10.1111/jan.12840
Mary Beth Modic DNP, R. N., Anne Vanderbilt MSN, R. N., RN, S. L. S. P., RN, R. S. B., Nancy Kaser MSN, R. N., & BS, C. Y. (2014). Diabetes management unawareness: what do bedside nurses know? Applied Nursing Research, 27(3), 1–5. Retrieved from http://dx.doi.org/10.1016/j.apnr.2013.12.003

Applied Nursing Research, Corrected proof. doi: 10.1016/j.apnr.2013.12003
Singh, M., & Koyfman, A. (2016). What Is the Prognostic Value of Intermediate Lactate Level Elevations in Emergency Department Patients With Suspected Infection? Ann Emerg Med. Retrieved from http://linkinghub.elsevier.com/retrieve/pii/S0196064415016005
Weingart, G. S., Carlson, J. N., Callaway, C. W., Frank, R., & Wang, H. E. (2013). Estimates of sedation in patients undergoing endotracheal intubation in US EDs. Am J Emerg Med, 31(1), 222–226. Retrieved from http://linkinghub.elsevier.com/retrieve/pii/S0735675712002410

BACKGROUND:Sedations after endotracheal intubation (ETI) reduce the risk of self-extubation, uncontrolled pain, and myocardial infarction. Although several small single-center studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED), little is known regarding post-ETI sedative drug practices nationally.
Weingart, S. D., & Levitan, R. M. (2012). Preoxygenation and Prevention of Desaturation During Emergency Airway Management. YMEM, 59(3), 165–175.e1. Retrieved from http://dx.doi.org/10.1016/j.annemergmed.2011.10.002

YMEM, 59 (2012) 165-175.e1.  doi: 10.1016/j.annemergmed.2011.10002
Posted in Uncategorized | Leave a comment

I figured out what #FOAMed really is.

I had an epiphany today after having a short chat on twitter. I know what the real benefit/importance of is. I’ve stated in the past that the whole FOAMed concept is just an evolution of technology and not a revolutionary concept. It is the confluence of hardware, software and culture that happened at the same time for the tools to be useful to people.So what is the purpose of FOAMed. It’s what igniting passion in people. The conversation online started with someone mentioning how they loved FOAMed because they were able to reach their RN partner new things. Since I took my Aricept this morning, I was able to remember back in the day when I was able to teach people new things. Guess what, this was before FOAMed. We would constantly look for journal articles spending time in the library looking for interesting things, When we found them, we would copy them and spread them around. We would talk to the trauma docs and other specialist and them come back to the unit and share with our coworkers. Sometimes because it fed our ego’s to know something before anyone else did. Sometimes we just wanted other people to share our passion.

That’s what is happening now. FOAMed has allowed those with passion a mobile library and copy machine. Since you can show them directly something you see on a blog page, you don’t have to take notes when you’re talking to a specialist about a patient or treatment.

That’s what FOAMed is. It a tool that is igniting passion in people, and a tool that is allowing people of passion to share that passion. 

It’s been difficult for me at times to explain myself and verbalize the concerns I had over the whole FOAMed movement. I still have those concerns, and think that Open Source without a balance is risky if it isn’t balanced with good critical thinking skills.

I think I have a better concept of its strengths now and it’s place in the scheme of things. I still hate to tell you this thought, It’s not revolutionary though. 😎.

Posted in Uncategorized | Tagged | Leave a comment

What I’m reading this week. #FOANed

Posted in #FOANed, Lit of Note | Leave a comment

What I’m reading today

Posted in #FOANed, Education, Lit of Note | Leave a comment

Another post on my thoughts on the role of #FOANed.

What tricks do you have to get nurses involved in ?
There are no tricks! First look at what FOANed actually is. FOANed is the discussion in the hallway about something that interested a group of people. Nothing more, nothing less. It’s not earth shattering, revolutionary or anything like that. It IS evolutionary. It’s the logical evolution of behaviors and technology.
I consider myself one of the 1%or 5%. The group of people who tend to be at the forefront of change. Because I’m a geek I’m always playing with tech as soon as I can get my hands on it. But the tech is only part of it. Back in the 80s I wrote letters to authors asking about things in their papers, that led to phone calls. I save money and went to conferences and talked to people in the hallway. When the Internet kicked in, I started emailing people,mother that progressed to Listservs. Listservs allow you to send out an email,many automatically have it available to anyone who wants it. Sounds a lot like Twitter doesn’t it. Then I used compuserv AOL and Yahoo groups. I just about flipped over RSS feeds, it came to me and I didn’t have to remember to check web sites frequently. Somewhere in there Adobe came up with a file format called a Portable Document File of PDF. This allowed us to share documents. Now that was a game changer.
The point of all this, is to point out that I a geek, and I use and FOANed every day. Well I use the components of it. I constantly see people pushing this as a GAME CHANGER. I disagreed with people on Twitter last night and 149 characters at wasn’t adequate to get my point across.
None of this is new! That term FOAMEd that came about over a pint did something. It gave a name to the current evolution of a concept. It allowed us to use one phrase to describe something, and not have to get bogged down in phrasing. Like every “new” concept it had to happen at the right time with the right technology. The key player here is the technology and not the concept. By giving it a name it merged the tech and the concept.
So these is my personal thoughts.

There are a lot of things going on that are being pushed under the FOANed FOAMed banner. There is a lot of overlap here.

Open source – people are gird of paying $$$. Just like people are tired of paying the cable company and are dropping their cable and using technology to get their media over the Internet, people, are tired of paying for research, journals, etc. They want it free and open to all.  
Open source also means that people are producing their own content and sharing it. Because it open source, if you find something interesting, you can share it with others legally. Remember in most cases it’s not legal to take a PDF of an article and share it with everyone. There are specific rules. 
Communication – Mobile operating systems I.e. IOS and Android combines with the current evolution of hardware allows me to communicate with people. I could communicate and share before, but the affability and ease of use, now makes it say for me to chat and share with people all over the world and not just in my little limited neck of the woods. This communication in lived Twitter of course, but somewhere along the line you need more than 140 characters.

Curation – storing and sharing the things that interest you. This is producing anything. But it is an important part of the open source movement. You can find things anywhere. YouTube, Pinterest, Google, PubMed, RSS feeds.

Sharing – just sitting at home sucking up information is only a small part of this movement. It’s strength is that smart people share. What makes Scott Weingart, and Amal Mattu, and 

Ian Miller so great(this is by no means an inclusive list)? They are sharing, they blog, they podcast, they tweet. They encourage discussion. And if you contact them offline, they will respond and share.

My issues with the current state of affairs. As nurses those of us who use the Internet and its communication tools to advance our professional development are the 5% right now. We are the people who at a conference, stick around and ask the the presenter questions, we are the nurses who picked up the doctors journals when they left them laying around and read them. We looked stuff up in the old edition of Rosen or Tintinalli that was there in the ED. We made sure we were standing close by when teaching rounds were being held. Those same options were there for every other nurse, they just weren’t utilizing them.

Just telling nurses to use FOANed isn’t going to change anything. Without addressing an underlying behavior change, FOANed isn’t going to change anything. I’ve already seen it. Nurses and doctors picking up on FOANed and FOAMed and going gang ho and then getting busy and distracted and falling off the wagon.

My problem with the discussion I had last night wasn’t the other people involved, it was my inability to verbalized my thoughts in 140 character bursts.

Is the open source movement important. You bet your bippy it is. But by focusing on one word, an important word mind you, but one word, we are doing our fellow nurses an disservice. The choir is already on board, it’s time to change a basic nursing mindset. We need to start pushing one basic concept, and that is WE ARE RESPONSIBLE FOR OUR OWN PROFESSIONAL DEVELOPMENT. Just repeating the same day over and over again will not make us an expert nurse. We have to do like Bill Murray in Groundhog Day. We have to learn something everyday. The cost of conferences, and journals and now time are just an excuse. We need to get our peers interested in life long learning. We need them to WANT to read beyond the abstract and conclusion. We want them to think critically about things they see and read

The advantage of the current tools is that they can be customized to fit just about any need. Curation and sharing is just as important and producing original content.

So what an I proposing. A multi phase assault on nursing. Only part of it is online. It starts by leaving interesting articles laying around the nurses station, then discussing them with coworkers and docs. The. Show them RSS feeds. Show then NursePath, and then any specialty blogs or podcasts. Get a discussion going face to face at work on things YOU find. If you get to the point where others are finding things before you do, then bring in Twitter, show them that can discuss things with people all over the world. That way you can bring others in along the adoption curve.

FOANed without face to face interaction with our peers is putting the cart before the horse. You need both.

Open Source is important, sharing online is important, FOANed is important. But changing behavior is even more important.

So to those I offended last night, does this rant make my point clearer? I should never have tried to carry on that conversation at work, at 0300 hours. Although I had issues with that one NursePath post this is one I really like.  
http://thenursepath.com/2015/10/04/changing-the-model-to-more-affordable-access-medical-education/
p.s. My thesis is on using Web 2.0 to support professional development.

Posted in Uncategorized | Tagged , | 2 Comments

Nurse Curator as an integral part of a staff development program.

I’m trying to come up with a job description and a program of “Nurse Curators”. In my vision each unit would have one, and then there would be one in and one in administration.

The roles of these nurses would be to go out and look for articles, YouTube, blog posts, Facebook posts, Twitter feeds, that the average staff nurse wouldn’t find or even think to look for. Information that will help develop the individual nurse as well as improve patient care. The education and admin curator would be looking for information on nursing and health care in general. Information on billing, politics, public opinion, and other global issues.

The nurses would be charged with not thinking outside the box, but using a BIGGER box. For example. The nurse curator in the ED would be looking not only in emergency nursing journals but the MD journals, quality journals, education journals, certification tools, pediatric, orthopedic, cardiac and other specialty journals looking for things that would directly affect the delivery of care in the emergency setting.

I”m working on final wording in my draft and a graphical presentation. Does anyone have any idea’s on role specifics or things I might have missed in my idea. My end goal is to present this to the VA as a system wide program. So taking potshots at the idea will be very helpful.

Posted in Becoming an expert nurse, Education | Tagged , , , , | Leave a comment

Trick of the Trade: Squeeze test for confirmation of IO placement #FOANed

Do you use IO’s? Here is another suggested method for confirming placement. Any comments or suggestions?

Curated from Trick of the Trade: Squeeze test for confirmation of IO placement

Posted in Clinical | Leave a comment

How to Create a Robust and Meaningful Personal Learning Network [PLN] | #FOANed

Education based but easily focused to nursing and become that “Expert” nurse. Having a good plan will set you up for whatever medicine and nursing throw at you in the future.

Curated from How to Create a Robust and Meaningful Personal Learning Network [PLN] | Online Learning Insights

Posted in Becoming an expert nurse | Leave a comment

Trick of the Trade: IV-Push Antibiotics in the ED

Anyone else doing this?
The majority of my patient population is lucky to have a single IV and when trying to get the blood cultures, were sometimes coming close to the 3 hour window. I’ve pushed Rocephin before, but everything else goes in over at least a half hour.

Curated from Trick of the Trade: IV-Push Antibiotics in the ED

Posted in Clinical | Leave a comment

Packing Your (Conference) Bag – FIELD TRIPS by TOM BIHNFIELD TRIPS by TOM BIHN

To those of you going to conferences this summer and fall. I found this blog post.

Curated from Packing Your (Conference) Bag – FIELD TRIPS by TOM BIHNFIELD TRIPS by TOM BIHN

Posted in Conferences | Leave a comment