Nurses are already on social media. How do we teach them to use it better?

Nurses are already on social media.  A group of us had a discussion recently about nurses on Facebook vs Twitter.  Anecdotally it seemed to us that more nurses were on face book than on twitter.  The discussion then drifted to reasons why nurses where doing it differently than the doctors are.  Although the discussion isn’t over by any means, we came up with some ideas.

The question I have is how can we teach them to use it better.   Social Media or Web 2.0 is fantastic tool that can be used for many things. Nurses as a whole aren’t using it anywhere to it’s strength.

How can we teach them to use it better.  Probably not by writing a killer blog post, or a journal article, not even a presentation at a conference. Although these things area great, they are only a small part of what we need to do. How do we teach them to use social media better?  We show them on a daily basis while they are standing or sitting next to us.  We show them a youtube video on how to do something,   We show them how to contact someone on twitter or Facebook that has knowledge that you don’t and transfer and share that knowledge.  Its showing them how to sort through journal articles for ones that might interest them, all without spending the money to subscribe to a journal you may only read completely  a couple of times a year.  It’s by demanding out role models start showing people how to used it better.

It’s kind of a shame that it was Doctors who showed me, and the medical staff still has a stronger clinical presence online than nurses do.  Nurses are strong in support and sharing, but not so much in using social medial to learn and advance ourselves clinically and professionally.

So how do we teach them to use social media better, By letting them see how we benefit from it.

Posted in Becoming an expert nurse, FOAMed, nursing, Technology | 3 Comments

#WILTW 4/30/2015

This week I learned I’M not immune to the Dunning-Kruger effect..  This is a theory that people tend to overestimate themselves, and aren’t aware of their own short comings.

Advancing in any profession requires a certain amount of honest self reflection.  As we progress I imagine we go through stages where we think we know it all, and then something happens to point out to us that we donT know as much as we think we do.

Just reading.listening isn’t enough, you have to apply the knowledge either in simulation or on real patients.  Just having absorbed knowledge and not done anything to apply it, just makes y out a trivia master.  Not an “Expert”

We jokingly point out those who aren’t on the FOAMed bandwagon, but some of us who are on the bandwagon are kidding ourselves when we think we’re doing better than others.

As we continue along that path to expert status, it’s very important to keep a close eye on our ego as well as our knowledge and skills.

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What’s on my iPhone 

i just reformatted my , trying to decide if I can justify buying a new 6plus

My devises are my core devises.  They are the foundation of the technical tools for my path to being an expert.  So in this light I thought I’d give you a run down of what’s on my iPhone and why.

After connecting it to my Apple Account and iCloud The first thing I put on my device is

  • Dropbox
  • 1Password. This has all my logins, passwords, registrations no serial numbers etc. I use Dropbox sync so Dropbox had to go on first.

Next I add online accounts

  • Google (calendar, email, contacts)
  • Twitter
  • Facebook

Built in apps

  • Notes
  • Reminders
  • Calendar

Social Media Apps

  • Tweetbot (I do wish they would go to a universal app and not different ones for iPhone and .  Does most of what I want in Twitter app.  Let’s me save to wherever I want)
  • Facebook
  • Pinterest
  • LinkedIn 

Productivity These are the apps I use to keep me productive where ever I am.

  • Keynote (My go to presentation software.  Exports to whatever I need, can do presentations directly from iPhone or iPad to AppleTV.  I travel,with my own projector and Apple TV setup, so I’m self contained and not dependent on anyone)
  • Pages (I admit I tend to use word for writing on MACBook Air.   Since the world revolves around MS Word.  But since Papers 3 cites while I write to it pretty well, I’m giving it a shot again.
  • Numbers
  • MindNode
  • Omnioutliner (Doesn’t everyone outline everything?)
  • Omnifocus (I keep trying to get into the GTD mindset.  Not working so well, but I try.  @MacSparky has a good tutorial on this.  I never seem to get the weekly inbox review done)
  • Pocket informant (I’ve been using this since the Palm days.  To be honest I’m not using it to its fullest, and could probably get by with just the. Jilt in apps)
  • Drafts
  • InShort (Diagraming/Project management app.   Just got this one, recommended  by @MacSparky, I’ll let you know
  • Evernote
  • Calcbot
  • Podcasts ( I include this in productivity.  I can listen no matter where I am. This is the one area I think Android does better than Apple.  You can take notes in Android while listening to podcast.  True multi tasking.

Research

  • QxRead (By QxMed. Great app for getting the journals you read, or topics your interested in.  Integrates with proxy servers somI can download actual article, read, annotate, save etc.
  • Papers 3 (This is becoming my reference manager.  Although Endnote probably is a it more robust, papers 3 cites a bit better, and it works with most of my Mac OSX writing platforms, pages,scrivener, drafts)
  • Pubmed
  • Feedly (RSS reader)

Blog/Podcast

  • WordPress (Writing this blog post on app now.  Gets the job done.  Still experimenting though. Mothers are a couple of 3rd party apps that do a good job too)
  • Blogsy
  • Podcast (Just now starting to look into podcasting and this and Bossjack get good reviews.  I’ll let you know)
  • Bossjock
  • Doodle cast Pro (This is my go to production app right now. Take Keynote presentation, export to app in PDFs, then record the presentation, voice over AND writing on the screen)

Games

  • Bejeweled 

Books

  • Kindle 
  • Olive Tree
  • New stand 

Medical

  • Davis drug guide (unbound medicine version)
  • Epocrates
  • QxCalculate

Media

  • Netflix
  • YouTube
  • Amazon
  • HBO

Utilities

  • Swiftkey (Alternative keyboard)
  • Swipe

Personal

  • GlucoseBuddy
  • Misfit
  • Urban Spoon
  • Fandango
  • Sleep cycle
  • YNAB (You Need A Budget app.   Syncs with my desktop program.  Trying to do the becoming debt free thing)
  • Banking apps (USAA RULES!)
  • Run keeper (Or walk keeper as it were)

School Stuff

  • connect (Adobe connect for webinars)
  • Panopto (recorded lectures)
  • Txt book reader depending on class

Last but not least, I set my setting to only allow certain apps to use cellular data.  If I’m not careful I can break the bank.  Wifi at work can sometimes be spotty, so I have it set so I don’t use cellular by accident.

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Path to Expert Nurse. Have an idea where you are going. #FOANed

Define your goal at the start.

As I’ve worked on my thesis I’ve been looking for a definition of Expert that I really like, that embodies what I feel the expert nurse should be. It’s been a long search and I’m no closer to identifying a definitive definition.

I’ve realized thought that the definition may be maybe more personal than I expected. For the purpose of a personal pathway to being an expert nurse, your personal definition of where you want to be may take precedence over some academic definition. In some cases it might actually be harmful to be trying to reach this mythical academic definition. There are many darn good nurses out there who won’t meet that textbook definition.

In her book “Becoming Nursey” Katy Kleber identifies her expert nurse as Gandalf the grey.

Good nurses breathe instinct. They breathe discernment. Good nurses can pick out seemingly insignificant things about a patient, interpret an intricate clinical picture, somehow predict a poor outcome, and bring it to the doctor’s attention, literally saving someone’s life.

My personal definition is a cross between Margret Houlihan and Radar O’Reilly from M*A*S*H and Dixie McCall from Emergency. I know what a mashup. For me it’s the knowing things of Radar, the strength or personality of Margret and the quit calmness of Dixi. This finctional mashup is tempered by some real world examples. Some Docs, some nurses, some people not even in health care.

The key for me is realizing this is a jounry along a path and not a destination.

So pick the nurse you want to be and start your path.

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Did you know it was easy to produce your own #FOANed Content?

DoodlecastPro-2015-03-30-04-03-07

You don’t need a studio or expensive equipment to produce your own FOANed content.  Everyone has access to PowerPoint.   Make your slides, concert them to PDF and in my case I send them to my iPad to an app call DoodleCast.  You then play then as a slideshow and record your audio over it.  Then bingo, you have your own content.  You can save it to YouTune and link to it as needed, or to your local drive.

Give it a try!

PlayPlay
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Do you want to provide certification prep classes for your staff but can’t afford it.  Well here’s an idea.  There is a ton of free, open source material out there that you can use.  You just have to put it together.  Set up a document on your intranet, you can use a word document, a PDF or a web page, doesn’t matter, just use what you have available and are comfortable with.

Download the test blueprint from the certifying agency.

Past the URL of the YouTube video, the web page the wiki article etc, so interested people can access the content.  Once people start using it, you can hold some informal on demand discussion on the subject.

The motivation for your staff is up to you.

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Other things to think about

The nursing and medical stuff you need to know are obvious, but there are other things to think about that can keep you from achieving that expert status.

  1.  Finaances – I”ve discovered that the stressors of life can distract you from acieving mastery.  Setting a budget, paying off debt made a big difference.  Now I can go to conferences it I wasn’t and not depend on someone else to pay for.  I can take a class that I want, etc.  I use “YOU NEED A BUDGET” which is an app as well as a system, but any of them would work.

  2. Hobbies – You need a hobby, or hobbies and you need to actually partake in them.   You can’t focus on nursing 24/7  or you’ll burn out.

  3.  It’s a lot harder to do it alone than with friends.  Having friends to help and challenge you as well as support you makes this journey a lot easier and enjoyable

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Nursing isn’t taking to FOAMed like the medical community is.  So I was thinking.  How about a CEN (Certified Emergency Nurse) prep course for nurses using #FOAMed concepts.  The tools are there.   We could do it cheaply in cost, but in time on the other hand, that might be a bit expensive.

Not only would nurses who complete the proem be ready to take the CEN exam, but they would also be well grounded in SOME and FOAMed.

Any thoughts, idea’s

Posted on by cbutton | 4 Comments

It’s been a bit since I’ve updated this. I’ve been busy and I guess I”m not really a blogger.

So the next step in becoming a Master/Expert in nursing is getting in the habit of reading and updating your knowledge base.

As an emergency department nurse I have to be current in a wide range of subjects and they aren’t covered completely in a single journal. I counted them up this afternoon and I read 94 different journals. Now I don’t read every single one of them from cover to cover. There are a number of tools that can be used to sort through them.

Currently I’m using a program called Read by QXmd (http://www.qxmed.com) that gives me the abstract and table of contents of each of those journals, I can pic and choose the ones I want to read. I supplement that with suggestions from people I respect and listen to on Twitter, Google+ and Facebook. I then use an academic login to the school library to actually read the articles. There journals I actually read from cover to cover I actually subscribe to. I subscribe using a combination of professional organizations. ENA and AACN as well as a few others. I subscribe to generic nursing journals using www.Amazon.com journal subscription service. That way I don’t have to worry about it.

Choosing journals. As I said earlier as an ED nurse I need to be knowledgable in a wide range of topics. I start with the Journal of Emergency Nursing, Critical Care Nurse and American Journal of Critical Care. I get these from my professional organizations. I then read a couple of the Emergency Med MD Journals. That way I know what the Docs are reading and can predict what they are going to be doing, expecting of me. I then branch out to specialty area’s like Pediatrics, Ortho, Cardio, and pre-hospital medicine. From there it branches down to more specialized care and things I”m interested in. The farther down the list I go, the less I actually read. I book mark and store for reference. It’s amazing how many times we’ve heard a zebra in the ED and I’ve been able to grab my iPad and find a reference for some infectious disease or medication no one has ever heard about.

I now schedule myself 8 hours a month for nothing but journal reading. Since I’m a Mac Fan, I’ve got iPhone and iPad so I’ve always got the stuff close at hand when I’ve got a down time or spare moment.

Besides knowing things, you eventually start to get some respect because you start to speak the same language. When calling report to specialty floors, I can speak their language. They start to recognize it. And eventually you get to a point were the docs start asking my opinion on things.

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Time to stop limiting scope of practice! – Repost

Over the past few years state Boards of Nursing have passed rules limiting registered nurses ability to give certain medications. The primary medications are medications used for procedural sedation and rapid sequence intubation.

As i reviewed what documentation that was freely available from the BON’s it was obvious that these rules were based on the fact that themanufacture labeled the medication and anesthetic on the bottle. Not based on any fact, and in a few cases based on information that is at best outdated.

Primary example is the use of Ketamine. At our hospital, the surveyors from DNV (JC Clone) told our DON that it was illegal for nurses to give Ketamine. Didn’t qualify it, just made a blanket statement. Now it’s ok for me to push the paralytic, but I can’t push the Ketamine. I don’t know about you, but I”m scratching my head.

I understand the purpose of BON’s, but the implementation of them is shaky at best. A bunch of nurses who don’t practice nursing, making decision on how I’m going to practice. Some times their decisions don’t make sense. In one state I worked in, it was legal for me to pull a PA Catheter, but it was outside my scope of practice to take out the stitches that secured the inducer before I took it out.. DUH.

The use of medications like Ketamine are becoming a standard of care. Limiting nurses from being able to safely administer medications is actually keeping patients from getting the appropriate care that they need.

So what do we do?

1. Completely redesign and repurpose BON’s. Not going to happen anytime soon.

2. Get an interdisciplinary team together to establish scope of practice and instead of saying NO, establish standard for a safe environment to administer meds.

On a daily basis, I give many medications than can kill my patients. Oxygen, used incorrectly is a toxin. I give medications that have a high risk of anaphylaxis. I give medications that can stop my patients heart of cause him/her to have a stroke. we don’t limit those medication.

In the same states that limit specially trained RN’s from giving those medication, allow EMT-Paramedics with less training to give those medications. In GA the paramedic scope of practice allowed Paramedics to give medications that are approved by the Medical Director.  This means that when I transfer a patient, the paramedic can basically run with whatever meds I’ve got running.

Maybe it’s time for us to get involved.  Talk to our legislators, lobby our BON’s.  Don’t just take it sitting down, stand up and make your voice heard.

 

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