RNchat Transcript August 19, 2010


Published on

Transcript of RNchat - a Twitter chat for registered nurses - for August 19, 2010.

Follow @RNchat - http://Twitter.com/RNchat - for regular updates.

Topics included (moderated by @EllenRichter):

T1 One Medicare Never Event is Foley catheter-related UTI. How does your practice strive to reduce this complication? Is it working?

T2 I was recently "family member/visitor" instd of RN. I wanted unlimited visiting time. What do U think? Is it OK to break rules?

Visit http://RNchat.org for more about RNchat!

Published in: Health & Medicine
1 Comment
  • Hello my dear
    I am Modester by name good day. i just went to your profile this time true this site (www.slideshare.net) and i got your detail and your explanation in fact the way you explain your self shows me that you are innocent and maturity and also understand person i decided to have a contact with you so that we can explain to our self each other because God great everyone to make a friend with each other and from that we know that we are from thism planet God great for us ok my dear please try and reach me through my email address (modester4life4@yahoo.com) so that i can send you my picture true your reply we can know each other ok have a nice day and God bless you yours Modester
    Are you sure you want to  Yes  No
    Your message goes here
  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

RNchat Transcript August 19, 2010

  1. 1. rnchat: A reminder to all the wonderful Twitter nurses: Join us tonite for #RNchat @ 9 PM EST moderated by @EllenRichter ~Pull up a keyboard & chat! 8/19/2010 07:34 rnchat: How Many Docs & Nurses Are on Twitter? - http://bit.ly/cpDsYY #RNchat 8/19/2010 14:45 EdBennett: A balanced article on risks / rewards of social media for nurses. Features @PhilBaumann and #RNChat http://bit.ly/c5JuhI 8/19/2010 16:40 rnchat: 10 minutes til #RNchat starts. I'm headed to Tweetgrid.com cuz I like that one, but theres also Tweetchat.com & Twitterfall.com :) 8/19/2010 20:52 rnchat: Thanks to everyone that took the time to retweet the time of tonite's #RNchat to their followers :) 8/19/2010 20:54 rnchat: I'm just keeping a constant caffeine level steady-state by sipping on my 5th cup of coffee today! #RNchat 8/19/2010 20:58 NurseCircle: We're ready for #RNchat! 8/19/2010 20:58 NursesNightOut: Gotta love the enthusiasm! “@dorameulman: Raising my resveratrol level waiting for #RNChat to start #NursesNightOut :))” 8/19/2010 20:59 rnchat: @NurseCircle Awesome. I'm ready too. Lets begin by introducing ourselves in 140 characters! What do U do, where from? :) #RNchat 8/19/2010 21:00 rnchat: @NursesNightOut I like your account name!! :) #RNchat 8/19/2010 21:00 nursekris99: My grape is Greek tonight! #RNChat 8/19/2010 21:01 rnchat: #RNchat is a way for nurses (& all others in health care!) to meet, tweet & share feelings, thoughts, ideas! We welcome silent lurkers! 8/19/2010 21:02 rnchat: I'm @EllenRichter a critical care RN working in south Florida & I also work with attorneys on medical litigation. #RNchat 8/19/2010 21:03 ClearMedNetwork: Looks like the nurses are ready 4 fun...lol “@dorameulman: Raising my resveratrol level waiting for #RNChat to start #NursesNightOut :))” 8/19/2010 21:04 rnchat: I must keep my fingers crossed that my internet connection stays put. It was lost for almost an hour this evening! :( #RNchat 8/19/2010 21:04 nursekris99: I'm Kris: an onocology nurse, patient advocate, and insurance-stalker. I'm also a smart-
  2. 2. a$$, if you haven't noticed... ;) #RNChat 8/19/2010 21:05 dorameulman: Hi everyone I'm Dora I work in a 29 bed MICU #RNChat 8/19/2010 21:05 jtknowles007: Hi, I'm John. I'm a nursing student from Indiana. !fb #RNchat 8/19/2010 21:05 rnchat: You can join our chat or follow along at websites like tweetchat, tweetgrid or twitterfall! Or use Twitter's search & our hashtag #RNchat 8/19/2010 21:06 NursesNightOut: @nursekris99 We like smart $@&es! lol. #RNchat 8/19/2010 21:07 rnchat: The topics will be labeled T1, T2, etc. Please remember to add topic label & hashtag #RNchat to ea tweet so we can track your responses! 8/19/2010 21:08 rnchat: Nice to see all of you who joined! Welcome :) #RNchat 8/19/2010 21:10 dorameulman: @RNchat lots of us on here tonight so much fun. Most nurses are smart a$$'s that's how we survive #RNChat #Nurses NightOut :) 8/19/2010 21:10 rnchat: First topic coming up. #RNchat 8/19/2010 21:10 rnchat: T1 One Medicare Never Event is Foley catheter-related UTI. How does your practice strive to reduce this complication? Is it working? #RNchat 8/19/2010 21:11 ClearMedical: @RyanJonSheets @SteveCarran @Biebert @TRCochran you should check out the #RNchat discussion right now. Neat stuff! 8/19/2010 21:11 rnchat: @dorameulman Having fun while still being a nurse is always fun, even if its during off time like now! ;) #RNchat 8/19/2010 21:12 dlwdillon: RT @jrobinsonRN: I'm Jennifer, a legal nurse consultant from TX #RNChat 8/19/2010 21:13 rnchat: T1 One Medicare Never Event is Foley catheter-related UTI. How does your practice strive to reduce this complication? Is it working? #RNchat 8/19/2010 21:13 CaliPNP: I'm Sue. I'm a PNP in Radiology in a teaching hospital. #rnchat 8/19/2010 21:14 nursekris99: T1: Luckily, I'm outpatient. But we see folks sent home w/indwelling and no care intructions til they see urologist in 2 weeks! #RNChat 8/19/2010 21:15 dorameulman: T1 my unit does well we don't have many UTI's. Unless like yesterday pts pull them out
  3. 3. with the balloon still inflated :-O #RNChat 8/19/2010 21:15 rnchat: T1 At my facility our goal is to remove Foley caths on all patients. They need a VERY good reason to stay beyond 2 days. #RNchat 8/19/2010 21:15 nursekris99: @dorameulman HAHA! I had one on Tuesday do the same thing! #RNChat 8/19/2010 21:16 rnchat: T1 I also see patients undergo some inpatient surgery without ever having a Foley inserted. Only if they cant void do we put 1 in. #RNchat 8/19/2010 21:17 rnchat: T1 @nursekris99 Thats sad to see. No home catheter-care instructions are given at all? Yikes. #RNchat 8/19/2010 21:18 dorameulman: T1 in ICU I would say 95%of pts have a foley. #RNChat 8/19/2010 21:18 nursekris99: My folks are usually post-op, prostate seed implant. Needed until swelling goes down. #RNChat 8/19/2010 21:18 nursekris99: @RNchat T1 Minimal instruction combined with rural education makes for multiple F/C problems in my population. #RNChat 8/19/2010 21:21 rnchat: T1@dorameulman You are in MICU. I bet many pts require it for unstable hemodynamics--thats a good reason to keep it #RNchat 8/19/2010 21:21 jrobinsonRN: T1-am still seeing lots of foley infections in records I review, while pts w/o foleys aren't having urine output monitored-bad news #RNChat 8/19/2010 21:21 rnchat: T1 @jrobinsonRN The push for SCIP postop protocol for UTI prevention is fairly new, like 2 yrs old? Maybe your charts are older? #RNchat 8/19/2010 21:23 TeriRNBSN: T1: We use foley's as a last resort if it will aid in patient comfort. We teach families foley hygiene to help reduce UTI's #RNChat 8/19/2010 21:24 rnchat: T1 Surgical Care Improvement Project (SCIP), a national quality improvement project designed to improve surgical care in hospitals #RNchat 8/19/2010 21:24 jrobinsonRN: @rnchat charts aren't older, SOL for suits in TX is 2 yrs #RNChat 8/19/2010 21:24 rnchat: T1 @jrobinsonRN But if your record reviews are just non-acute medical pts with catheters, thats bad. Change needs to occur! #RNchat 8/19/2010 21:25 dorameulman: T1 we get them out as soon as poss but for us they're almost always necessary. I use
  4. 4. Condom Caths when I can on men. #RNChat 8/19/2010 21:25 Rampracer: WHEELIE cATHOLIC: The Cripper Arrives! - http://ow.ly/2sbIR #sci #rnchat #hcsm 8/19/2010 21:27 TeriRNBSN: T1: When I worked in Sub acute we tried to get the foley's out ASAP also. Then we set up a bowel and bladder program. #RNChat 8/19/2010 21:28 rnchat: T1 We need to realize that catheter-acquired UTIs will not be reimbursed and can cause chronic problems too #RNchat 8/19/2010 21:28 ERNurseJoy: We put stickers on foley bags that tell when/who inserted them- inpatient units don't have to dig in the charts find insertion dates #RNChat 8/19/2010 21:29 jrobinsonRN: Apparently foley care has gone the way of the dinosaur. Am wondering if they even teach it in CNA & nrsg school anymore. #RNChat 8/19/2010 21:30 TeriRNBSN: T1: We left foley's in our pt's w/stg 3 & 4 Decubs until healed. #RNChat 8/19/2010 21:30 rnchat: T1 @TeriRNBSN Yes, bladder programs are much more difficult than just keeping a Foley but its the right way to prevent catheter-UTIs #RNchat 8/19/2010 21:31 jrobinsonRN: @TeriRNBSN Not much you can do if you are going to get those decubs healed if pt is incontinent. #RNChat 8/19/2010 21:31 nursingpins: Hey all - got called in - will read back. #RNchat 8/19/2010 21:31 TeriRNBSN: @jrobinsonRN From some of the CNA's I watch bathing patient's I wonder if they are trained in proper way to do pericare period. #RNChat 8/19/2010 21:32 dorameulman: T1 we get lectured in our huddles about this. #RNChat falls are our new pet peeve plus restraints! 8/19/2010 21:32 jrobinsonRN: @TeriRNBSN If they are trained, then it's gotta be pure laziness. #RNChat 8/19/2010 21:32 TeriRNBSN: @rnchat It helps if all are on board in doing what is best for pt. I hate to see nurses & CNA's not follow the plan. A pet peeve #RNChat 8/19/2010 21:33 TeriRNBSN: @jrobinsonRN You can pretty much tell it is laziness. Saddens me. And if I said something management came down on me not CNA. #RNChat 8/19/2010 21:35 rnchat: T2 I was recently "family member/visitor" instd of RN. I wanted unlimited visiting time. What do U think? Is it OK to break rules? #RNchat 8/19/2010 21:35
  5. 5. nursekris99: T2: I feel if pt benefits from presence of family, they should be in there! I broke rules to let folks stay a lot back in the day #RNChat 8/19/2010 21:37 rnchat: T2 LOL I love this topic. I'm a big fan of unlimited visiting, as long as the health care folks can do their work. But many disagree #RNchat 8/19/2010 21:37 TeriRNBSN: T2: As a hospice nurse I say YES! I feel it helps the pt w/orientation, less need for restraints & accommodates the changing world. #RNChat 8/19/2010 21:37 jrobinsonRN: T2 - Don't have a problem w/open visiting if no interference in care of ALL pts, not just the ones they R visiting #RNChat 8/19/2010 21:37 nursekris99: T2 However, if family disruptive or interferes with good care, they gotta GO. Also, family need a break when they don't realize it #RNChat 8/19/2010 21:38 dorameulman: T2 fantastic I've been eager to discuss this topic. We have Family Centered Care throughout our hospital including all the ICU's #RNChat 8/19/2010 21:38 nursingpins: T2 My ideas have changed over the years - think family should be able to stay anytime now. #RNchat 8/19/2010 21:38 TeriRNBSN: T2: Not every one is a 9-5 worker anymore. We need to adapt to meet the needs of the pt & family. #RNChat 8/19/2010 21:38 nursekris99: T2 Family does pt no good if they're exhausted and burnt out. #RNChat 8/19/2010 21:39 jrobinsonRN: @nursekris99 T2 - true, but if no one else avail to stay, no way I'd leave my family alone even if I'd been there for days w/o sleep #RNChat 8/19/2010 21:40 nextHealthMedia: Isn't unlimited visiting a basic tenet of Planetree hospitals? #RNchat 8/19/2010 21:40 DebErupts: Advocate for unlimited visitation. #RNChat 8/19/2010 21:41 rnchat: T2 I think family and S.O. should be taught to give some of the care if they choose to stay past visiting hrs. It can benefit both! #RNchat 8/19/2010 21:41 nextHealthMedia: There's no less miserable alternative than a Foley in the works as of yet? If you haven't had one... #RNchat 8/19/2010 21:41 TeriRNBSN: @rnchat I agree. Also starts the DC process so that families are comfortable w/care when they go home #RNChat 8/19/2010 21:42
  6. 6. nursekris99: @RNchat T2 TOTALLY agree about family help! Our job is to get pt to a point where they don't need us any more! #RNChat 8/19/2010 21:42 DebErupts: There was no way I was going to leave my frightened daughter alone after her spinal cord injury. Family took turns being with her. #RNChat 8/19/2010 21:43 rnchat: T2 So glad to see so many advocates of unlimited visiting! I think families do better as a whole when they are involved in the care! #RNchat 8/19/2010 21:43 jrobinsonRN: @rnchat T2 - too many think hospital is 5star hotel - they don't want to learn how to do their care even when dcing home soon. #RNChat 8/19/2010 21:43 CaliPNP: T2 Only time family shouldn't be in is report time in NICU setting (my last life). Parents would listen to other pts' report. HIPPA #rnchat 8/19/2010 21:44 dorameulman: T1 family at bedside 24/7 helps ICU pts I've learned to get the family to help me with mouthcare turning etc #RNChat 8/19/2010 21:45 rnchat: T2 @DebErupts I can relate. I could never leave a frightened family member in the hospital alone! We take shifts among ourselves #RNchat 8/19/2010 21:46 DebErupts: When my daughter was hospitalized they did bedside reports and allowed me to participate. #RNChat 8/19/2010 21:46 rnchat: T2 @CaliPNP Great point about eavesdropping and HIPPA violations during change of shift. Thats not good either. #RNchat 8/19/2010 21:46 rnchat: T2 @dorameulman I do the same thing! Teach them little things like mouth care, ROM, help with turns, even on critically ill. :) #RNchat 8/19/2010 21:47 nursingpins: As @DebErupts says - Pt family can be much more helpful than prev. thought. #RNchat 8/19/2010 21:47 dorameulman: T2 occ we have family drama's always interesting. Plus what's that yellow no green no red no. Constant questions are difficult #RNChat 8/19/2010 21:48 DebErupts: Daughter had trach, jaw wired shut, no use of hands. Communicated by nodding head to letter board for 2 wks. Family very important! #RNChat 8/19/2010 21:49 rnchat: T2 I think with children, its almost expected that the parents will sit vigil at their bedsides but adult pts need some of that too! #RNchat 8/19/2010 21:49 jrobinsonRN: @dorameulman yes, constant interuptions make things difficult - have to find a balance, set boundaries with some families #RNChat
  7. 7. 8/19/2010 21:49 nursingpins: Like @rnchat - I teach family to help too - who knows, we may event be able to give them a couple more pts. LOL #RNchat 8/19/2010 21:50 CaliPNP: @RNchat T2 we used to have NICU parents mixing up info telling it to another pts' parents & getting everyone into huge conundrum #rnchat 8/19/2010 21:50 RNMark: T2 Have had families challenge and argue about each and every nursing intervention. Unlimited visiting could hazard pt care. #RNChat 8/19/2010 21:50 jrobinsonRN: @nursingpins T2 OK, I must have worked in wrong place, have had too many pt/family refusing to participate in self/family care #RNChat 8/19/2010 21:51 rnchat: T2 @NurseCircle Now thats cool! Let us know what kind of responses you get on FB! :) #RNchat 8/19/2010 21:51 dorameulman: T1 we allow family to stay for procedures ie EGD's or even codes and assign a pt rep or nurse to help them #RNChat 8/19/2010 21:51 jrobinsonRN: @RNMark Yes, so have I - that is where you need to set boundaries - I like family involvement but not shy about setting rules up #RNChat 8/19/2010 21:52 rnchat: T2 @nursingpins LMAO...imagine if staffing ratios increased because of all the family helpers assisting us! ;) #RNchat 8/19/2010 21:52 nursingpins: That has been a big prob. in the past @RNMark - will always be a prob. for some - but things are changing believe it or not. #RNchat 8/19/2010 21:52 RNMark: T2 How do we bring equity and sanity to visits? Behavioral contracts? BTW best experience I had included 30 family in one room. #RNChat 8/19/2010 21:52 rnchat: T2 @RNMark Absolutely agree. There are those family members we want to string up & flog but most times they are just stressed to max #RNchat 8/19/2010 21:53 DebErupts: Kept track of every damn thing they did. Families can prevent errors and assist with care. Use them! #RNChat 8/19/2010 21:53 nursingpins: Will just be another assignment sheet to fill out - family assignment. - hospitals will limit them too. #RNchat 8/19/2010 21:53 nursekris99: T2: Could see insurers refusing to pay if skilled nursing was assisted by family. You know they would!!! LOL! #RNChat 8/19/2010 21:55
  8. 8. rnchat: Wow, I cant believe its almost an hour! We never even got to T3! Think I'll save it for next week! We can stay with T1 & T2 for now! #RNchat 8/19/2010 21:55 RNMark: @RNchat Flogging takes too much time and cant be delegated. #RNChat 8/19/2010 21:55 nursingpins: Family staying all the time is a big issue with some nurses - many older nurses are against it - new nurses quicker to accept it. #RNchat 8/19/2010 21:56 DebErupts: Limiting visitors to a few at a time is reasonable. Need to use common sense. Provide a lounge for family members to hang out. #RNChat 8/19/2010 21:56 rnchat: T2 @nursekris99 The family may help with skilled nursing care but the RNs still do all the documentation & thats what insurance sees #RNchat 8/19/2010 21:56 jrobinsonRN: T2 Taking time to educate families can help a lot with their behavior and whether or not they are help or hindrance. #RNChat 8/19/2010 21:57 rnchat: @RNMark LMAO! ;) I just saw your flog response! #RNchat 8/19/2010 21:57 nursingpins: RT @DebErupts: Limiting visitors to a few at a time is reasonable. Need to use common sense. #RNchat 8/19/2010 21:57 nursingpins: The biggest issue in nursing is unsafe ratios - it is killing nursing! #RNchat 8/19/2010 21:58 jrobinsonRN: T2 hospitals that still have semi pvt rooms are a problem w/ visitors #RNChat 8/19/2010 21:58 RNMark: @rnchat TY #RNChat 8/19/2010 21:58 rnchat: T2 So, I guess I won't feel bad that I pushed my way into unlimited visiting hours with my dad after his surgery. I know it helped #RNchat 8/19/2010 21:59 jrobinsonRN: T2 - nurses are still responsible for care - CANNOT just expect family to do things w/o followup and ensuring appropriate care given #RNChat 8/19/2010 22:00 rnchat: T2 @jrobinsonRN Yes semi-private rooms make unlimited visiting tough. I admit, my dad was in a private room. ICU rooms are private #RNchat 8/19/2010 22:00 nursekris99: @RNchat Yes, they see the documentation. But just saying the industry, if able, would turn a great thing into a not-so-great thing #RNChat 8/19/2010 22:01 jrobinsonRN: @rnchat U actually tried to be nice about it - when my fam. in hospital, staff know up front who I am & I'm not leaving - period. #RNChat 8/19/2010 22:02
  9. 9. dorameulman: T2 I've felt the urge to flog many times lol. We have no visitors between 6-8 to allow for shift change. It's bliss #RNChat :) 8/19/2010 22:02 nursingpins: We as nurses need to support pt. advocacy groups too - they will help expose unsafe practices allowed by hospitals. #RNchat 8/19/2010 22:02 nursekris99: T2: I really love when family show interest in helping the pt. If nothing else, gives me confidence that pt may do well at d/c #RNChat 8/19/2010 22:02 rnchat: I'm want to thank everyone who participated. Great, great responses to the topics!! Terrific nurses on Twitter! ;) #RNchat 8/19/2010 22:03 jrobinsonRN: @nursekris99 Family shouldn't be doing skilled nursing tasks, that is what educated nurses are for. #RNChat 8/19/2010 22:03 rnchat: @DebErupts Oh geez....that sounds like it was a nightmare! #RNchat 8/19/2010 22:03 RNMark: @jrobinsonRN I never voluntarily tell staff that I'm an RN when I visit. I've gotten strong negative vibes. #RNChat 8/19/2010 22:04 DebErupts: Family should not be doing skilled nursing procedures due to liability issues, unless part of discharge teaching. #RNChat 8/19/2010 22:04 nursingpins: Thanks Ellen - got to run - teaching ACLS to a group of family members -:) #RNchat 8/19/2010 22:05 rnchat: Totally agree RT @nursingpins We as RNs need to support pt. advocacy groups - they help expose unsafe practices allowed by hospitals #RNchat 8/19/2010 22:05 rnchat: @nursingpins Vernon! Enjoy! Thanks for participating while at work! :) #RNchat 8/19/2010 22:06 DebErupts: To @RNMark @jrobinsonRN Can you imagine the reaction when I tell them I'm a Nurse Attorney. Usually keep it to myself. #RNChat 8/19/2010 22:07 rnchat: Well, everyone enjoy the rest of the week! TGIF in a few hours. See you next time! Anyone new, please follow me @EllenRichter :) #RNchat 8/19/2010 22:08 rnchat: @DebErupts Yes, that nurse-attorney title must shut people up pretty fast! ;) #RNchat 8/19/2010 22:08 nursekris99: @RNchat Thank you Ellen!! Great discussions! #RNChat 8/19/2010 22:08 rnchat: @nursekris99 No, thanks to you all, who made the discussions come to life! :) #RNchat
  10. 10. 8/19/2010 22:09 dorameulman: @RNchat thanks Ellen enjoyed #RNChat tonight. Nurses ROCK :)) 8/19/2010 22:10 rnchat: Be on the look-out for @PhilBaumann's tweet with the link to the transcript of tonite's chat. There are always tweets I missed! :) #RNchat 8/19/2010 22:10 jrobinsonRN: @nursingpins ACLS to family huh? LOL #RNChat 8/19/2010 22:11 rnchat: @dorameulman Yes, nurses DO rock! Even the wise-a$$ ones! ;) #RNchat 8/19/2010 22:11 DebErupts: Thank-you, it's been fun. #RNChat 8/19/2010 22:12 jrobinsonRN: @DebErupts Bet the looks on the faces when you do tell them you're RN, JD is priceless :) #RNChat 8/19/2010 22:13 rnchat: I'm signing off the @RNchat account! Enjoy your night, folks! Keep up the discussions if you so desire! G'nite!!:) #RNchat 8/19/2010 22:13 maryannagordon: RT @nursingpins: The biggest issue in nursing is unsafe ratios - it is killing nursing! #RNchat 8/19/2010 22:18 DebErupts: @APBBlue LOL! I forget others are reading our #RNChat 8/19/2010 22:20