RNchat Transcript August 19, 2010
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RNchat Transcript August 19, 2010

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

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!

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RNchat Transcript August 19, 2010 Document Transcript

  • 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. 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. 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. 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. 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. 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. 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. 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. 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. 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