RNchat Transcript for November 4, 2010

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Transcript of #RNchat - a Twitter chat for registered nurses - for Thursday, November 4, 2010.

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

Topics were provided by the kindness of Palo Alto Medical Foundation (@PaloAlto on Twitter) through Erin Macartney (@emacartney):

T1 Are your job responsibilities changing with the advent of health care reform? How?

T2 How do you personally maintain excellent standards of care in the face of budget cuts and pressures?

T3 What areas of health innovation do you think are most important to patient care?

Chat was moderated by Phil Baumann, RN (@PhilBaumann on Twitter)

Published in: Health & Medicine
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RNchat Transcript for November 4, 2010

  1. 1. Transcript of #RNchat for November 4, 2010 Follow @RNchat for Regular Updates Twitter.com/RNchat RNchat.org Moderated by @PhilBaumann rnchat Welcome to #RNchat everyone! Today's topics will be from @paloaltomedical - Say Hi to them as we get started with introductions! nursingpins Thanks @paloaltomedical for your participation. #RNchat PaloAltoMedical Hi Everyone! Looking forward to the #RNchat! FreshRN Hello @PaloAltoMedical! Look forward to chatting with you =) #RNchat pamressler Hello @paloaltomedical #rnchat PaloAltoMedical @nursingpins Thank you! Glad to be here with you all! #RNchat IVchat Greetings to all, hello @paloaltomedical!! #RNchat PaloAltoMedical @pamressler Hello to you too. Thanks for joining today's #RNchat! renee_berry --& ;gt; (non-clinical) advocate for patient centered care, involved w/ @Y_A_H_A @hcsmSV @KLXmedia ( @paloaltomedical patient) #rnchat PaloAltoMedical Thx! Looking fwd to chatting w/you too! RT @freshrn: Hello @PaloAltoMedical! Look forward to chatting with you =) #RNchat PaloAltoMedical Thanks - Greetings to you too! RT @ivchat: Greetings to all, hello @paloaltomedical!! #RNchat rnchat T1 Are your job responsibilities changing with the advent of health care reform? How? #RNchat rnchat (In case ya missed it :) RT @rnchat: T1 Are your job responsibilities changing with the advent of health care reform? How? #rnchat renee_berry Think community edu is super important but I may have to lurk on this question bc I wouldn't be able to provide clinical perspective #rnchat NAPH1981 Great question - curious here, too RT @rnchat: T1 Are your job responsibilities changing with the advent of health care reform? How? #RNchat
  2. 2. nursingpins T1 - As far as I can see NOTHING has changed - and getting worse with ratios and staffing. #RNchat PerfectServeInc We are happy to be joining #RNchat today! RT @RNchat T1 Are your job responsibilities changing with the advent of health care reform? How? factnurse T1 the only change I have seen is the initiation of & ;quot;swing beds& ; quot; and not sure that is r/t HCR #RNchat nursingpins Glad to see NAPH1981 #RNchat renee_berry RT @NAPH1981: Great question - curious here, too RT @rnchat: T1 Are your job responsibilities changing with the advent of health care reform? How? #RNchat factnurse T1 - our ratios and staffing are getting worse as well #RNchat Gracetx Greetings to all, hello @paloaltomedical! RN in community mental Health FT Worth Tx #RNchat visiting_nurse T1 From an admin perspc mor regulatory focus also seeing changs in staffn due 2 cuts in MCR reimbursemnt for home health #RNChat chemosabe Hey all lurking at the mo and making school lunches, T1 ur reform not relevant down under, our reform coming too, not sure how yet #rnchat onlinenursing Ooooh I am late. Sorry - Hellow #RNChat - Terri here - just finished an elluminate class with students. Gracetx T1- nothing changed yet. But lots of planning and meetings with community stakeholders to see what it means for us #RNCHAT FreshRN T1 I'm from California where we have state-mandated nurse/staffing ratios, so we don't have as much as a problem with it I think... #RNchat NUR3563 @nursingpins I am going to agree with Vernon - no changes yet, too many scared of not making $ - so decreased staffing. #RNChat factnurse T1 what changes can I as a staff nurse expect to see? #RNchat onlinenursing @chemosabe hey down under! Good to see you! Here in #RNChat IVchat T1 - affecting outpt. services as well. #RNchat chemosabe @onlinenursing thanx Terri, 0550 Fri here #rnchat Gracetx RT @visiting_nurse T1 we haven't seen cuts yet but anticipate them 2 cuts in MCR reimbursemnt for Community MH #RNChat onlinenursing RT @IVchat: T1 - affecting outpt. services as well. #RNchat (Yes - diabetic foot clinic closed at local hospital) #RNChat
  3. 3. NAPH1981 @factnurse you can expect to see more patient navigators, team-based care, coordination, etc ... #hcr #RNchat CGreaves RT @naph1981: @factnurse you can expect to see more patient navigators, team-based care, coordination, etc ... #hcr #RNchat FreshRN RT @NAPH1981: @factnurse you can expect to see more patient navigators, team-based care, coordination, etc ... #hcr #RNchat renee_berry awesome, so important RT @NAPH1981 @factnurse you can expect to see more patient navigators, team-based care, coordination #hcr #rnchat PerfectServeInc RT @NAPH1981 @factnurse you can expect to see more patient navigators, team-based care, coordination, etc ... #hcr #RNchat FreshRN @NAPH1981 Who is responsible for implementing those changes? #RNchat factnurse @NAPH1981 Okay, I guess that makes sense #RNchat nursingpins T1 You will see more patient advocates - which will will help improve patient care. #RNchat renee_berry @NAPH1981 were you involved in advocating for increased #RN patient navigators in #hcr ? #rnchat onlinenursing @factnurse you can expect to see more patient navigators, team-based care, coordination, etc - sounds like a job for nursing! #RNChat renee_berry RT @nursingpins T1 You will see more patient advocates w/ #hcr - which will will help improve patient care #rnchat rnchat Shoulder tap: Next topic coming up in a moment! #RNchat rnchat T2 How do you personally maintain excellent standards of care in the face of budget cuts and pressures? #RNchat visiting_nurse RT @Gracetx: same hre sum of the community benefit programs R in jeopardy/cut services staff nurses R having 2 make more visits #RNChat NAPH1981 T1 @FreshRN theyre delivery system reforms included in #hcr. some need additl regulations from HHS before they can be implemented #RNchat PaloAltoMedical RT @nursingpins: T1 You will see more patient advocates - which will will help improve patient care. #RNchat NAPH1981 T1 others are grant programs that states and/or other entities can apply for and implement #RNchat chemosabe T2 personally or within work unit? #rnchat
  4. 4. FreshRN Good question! RT @rnchat: T2 How do you personally maintain excellent standards of care in the face of budget cuts and pressures? #RNchat onlinenursing T2 #RNChat - same as always: Look for evidence,/research, listen to advocate for pt. family, be innovate, be cost cutting. renee_berry interesting q RT @rnchat T2 How do you personally maintain excellent standards of care in the face of budget cuts pressures? #rnchat nursingpins T2 - It is very hard to maintain standards - unfortunately I have seen the integ. of nursing decline because of ridiculous staffing. #RNchat renee_berry RT @onlinenursing T2 same as always: Look for evidence/research, listen to advocate for pt. family #innovate #rnchat IVchat T2 - difficult, only a few (conscientious ones) would care to keep up b/c of low staffing, increased pt. load. #RNchat PerfectServeInc @onlinenursing That can be tough to be innovative and cost cutting at the same time. #RNChat Gracetx T2-challenge have to figure out what might not get done when hv less staff. OR what can unskilled staff do if we have less nurses? #RNchat NAPH1981 @renee_berry we have been lobbying to include everyone in care coordination - nurses, physicians, social workers, you name it! T1 #RNchat nursingpins T2 Many corners are being cut and many things are not being done. #RNchat Gracetx Exactly! RT @PerfectServeInc @onlinenursing That can be tough to be innovative and cost cutting at the same time. #RNChat factnurse @nursingpins I concur. We are lucky if we get to eat and go to the bathroom. 12hr days are usually 14hrs at least now. #RNchat IVchat so true.. RT @nursingpins: T2 Many corners are being cut and many things are not being done. #RNchat nursingpins T2 Hospitals will be the biggest obstacle to safe staffing and hc improvement. They will not allow it without mandate. #RNchat chemosabe @factnurse We are lucky if we get to eat and go to the bathroom. 12hr days are usually 14hrs at least now _ paid overtime? #rnchat visiting_nurse the documntatn declines 2 RT @IVchat: so tru.. RT @nursingpins: T2 Many corners R being cut many things R not being done. #RNchat
  5. 5. renee_berry @NAPH1981 awesome, I'd love to learn more abt your efforts! I've been fascinated w/ @HospiceAction community legislative action #rnchat FreshRN RT @IVchat: so true.. RT @nursingpins: T2 Many corners are being cut and many things are not being done. #RNchat Gracetx @visiting_nurse T1 #RNchat TX is going to cut 10-15-20% of community health programs bcuse state funds shortage. Myb #her will help? visiting_nurse so u dont kno if it is not getting done or not documentd T2 Many corners R being cut many things R not being done. #RNchat chemosabe @nursingpins T2 Hospitals will be the biggest obstacle to safe staffing and hc improvement _ industrial action by hcw? #rnchat Gracetx So true!!!! Scary! RT @nursingpins T2 Many corners are being cut and many things are not being done. #RNchat nursingpins T2 It is documented - but it is not done. #RNchat FreshRN Wow RT @nursingpins: T2 It is documented - but it is not done. #RNchat visiting_nurse Yikes! RT @Gracetx: T1 #RNchat TX is going to cut 10-15-20% of community health programs bcuse state funds shortage. HospitalFocus5 RT @PaloAltoMedical: RT @nursingpins: T1 You will see more patient advocates - which will will help improve patient care. #RNchat Gracetx ExactlyRT @visiting_nurse so u dont kno if it is not getting done or not documentd T2 Many corners R cut things R not being done. #RNchat PerfectServeInc At fully staffed, or decreased staffing? RT @nursingpins T2 It is documented - but it is not done. #RNchat IVchat scary...RT @nursingpins: T2 It is documented - but it is not done. #RNchat Gracetx I find not doc not done too often RT @nursingpins T2 It is documented - but it is not done. #RNchat chemosabe T2 adage downunda is if it is documented it didn't happen! #rnchat nursingpins @PerfectServeInc short staffed. #RNchat visiting_nurse not sure HCR will help tho bcuz many nonprofits rely on Medicare to subsidize Medicaid community health programs RT @Gracetx: T1 #RNchat factnurse I find doc not done more often than I would like to admit #RNchat FreshRN T2 Nurses and patients are obviously both suffering...something needs to be done #RNchat
  6. 6. nursingpins RT @FreshRN: T2 Nurses and patients are obviously both suffering... something needs to be done #RNchat rnchat Shoulder tap: Final topic coming up in a couple minutes! #RNchat factnurse @nursingpins I'm afraid advocates can advocate - but will it do much good if there isn't enough staff to take care of pt #RNchat CernerPhysician RT @dorameulman: #NYC health department shows EMR's help primary docs improve care. http://bit.ly/bnFI1H #health #MDChat #RNChat #hcsm Gracetx In Austin yest./dept state health sd plan on T1 #RNchat TX is gonna cut 10- 15-20% of community health programs bcuse state funds shortage. rnchat T3 What areas of health innovation do you think are most important to patient care? #RNchat WillowRN @rnchat T2 Denver RN here - my hospital had a major layoff this year, our pt loads are too heavy. Too much goes undone. #RNchat visiting_nurse Many claims being denied due 2 vry issue w/ increase in noncompliance w/ accrd standrds @Gracetx: I find not doc not done 2 oftn #RNchat nursingpins @factnurse Patient advocate groups will pressure hospitals to post their unsafe staffing and more #RNchat PerfectServeInc RT @rnchat T3 What areas of health innovation do you think are most important to patient care? #RNchat FreshRN RT @nursingpins: @factnurse Patient advocate groups will pressure hospitals to post their unsafe staffing and more #RNchat renee_berry RT @rnchat T3 What areas of health innovation do you think are most important to patient care? #rnchat CGreaves RT @rnchat: T3 What areas of health innovation do you think are most important to patient care? #RNchat WillowRN T3 I think before we innovate any further, we need to solve the problem of staffing hospitals. More nurses would be innovative #RNchat visiting_nurse 2ndRT @factnurse: @nursingpins I'm afraid advocates cn advocate - but will it do much gd if thr isn't enough staff 2 take care of pt #RNchat factnurse @nursingpins thats good #RNchat nursingpins T3 The biggest inov. I've seen are touch pads that allow patients to see x- rays and all kinds of info at the bedside. #RNchat
  7. 7. renee_berry I've been very impressed w/ e-patient movement, advocating patients to participate in their care http://ow.ly/34D5Y #rnchat PaloAltoMedical RT @nursingpins T3 The biggest inov. I've seen are touch pads that allow patients to see x-rays and all kinds of info at the bedside #RNchat Gracetx T3- need to b open 2 nontraditional collaboration w public community health. Use promotoras etc. #RNchat PerfectServeInc Do you think that will help patient care,or patient communication? RT @nursingpins T3 The biggest inov. I've seen are touch pads.. #RNchat renee_berry T3 Also fascinated with the strength of the #hcsm community encouraging stronger sources for reliable online #health information #rnchat nursingpins T3 communication helps care in all areas #RNchat renee_berry agree RT @Gracetx T3- need to b open 2 nontraditional collaboration w/ #PublicHealth community #rnchat factnurse I think anything that shortens the hospital stay will benefit the patient #RNchat jodyms RT @renee_berry: T3 Also fascinated with the strength of the #hcsm community encouraging stronger sources for reliable online #health information #rnchat IVchat T3 - patients are already innovative...seeking out info using social media.. #RNchat renee_berry T3 think this is a great #innovative resource for #oncologists #communication skills http://ow.ly/34DcS #cancer #rnchat PerfectServeInc T3- Are there issues with nurses spending too much time trying to reach physicians, etc? Improve coordination of care--& ;gt;more time? #RNchat nursingpins T3 I've seen more informed patients in the last year than the prev. 10. #RNchat WillowRN T3 #RnChat what would be great is incorporating the pts TV into a demo system, so pt could view xrays, call RN, etc from the touch screen. CGreaves RT @renee_berry: T3 think this is a great #innovative resource for #oncologists #communication skills http://ow.ly/34DcS #cancer #rnchat NAPH1981 same! RT @renee_berry: impressed w/ e-patient movement, advocating patients to participate in their care http://ow.ly/34D5Y #rnchat
  8. 8. renee_berry cool cc @epatientdave RT @nursingpins T3 Ive seen more informed patients in the last year than the prev 10 #RN #rnchat nursingpins @PerfectServeInc reaching phys is only a minor problem - that I have seen. #RNchat grimalkinrn @thesournurse I totes posted that to the wrong account, but you should lurk on #RNchat when you get a chance, lots of good info. PerfectServeInc Thanks! RT @nursingpins @PerfectServeInc reaching phys is only a minor problem - that I have seen. #RNchat WillowRN #RnChat T3 Also, forget touchpads, could we just get more manageable beds and call lights?? THAT would be huge. visiting_nurse tech that allows more intensive services to be provided in home environment supportive of Hospital @ Home program by Hopkins T3 - #RNchat hcsmSV Yes! RT @nursingpins: T3 I've seen more informed patients in the last year than the prev. 10. #RNchat #hcsmSV renee_berry T3 experience as patient: & ;quot;buzzers& ;quot; for urgent care so you can go wait in your car, was awesome when I had migraine @paloaltomedical #rnchat PerfectServeInc Wow Rt @renee_berry T3 & ;quot;buzzers& ;quot; for urgent care so you can go wait in your car, was awesome when I had migraine @paloaltomedical #rnchat jodyms RT @hcsmSV: Yes! RT @nursingpins: T3 I've seen more informed patients in the last year than the prev. 10. #RNchat #hcsmSV IVchat lots of patients w/ blogs, twitter, FB RT @nursingpins: T3 Ive seen more informed patients in the last year than the prev. 10. #RNchat FreshRN @renee_berry T3 is it like those buzzers they give you when you're in line for a busy restaurant? #RNchat renee_berry @FreshRN exactly, I was in excruciating pain, got to go sit in quiet.. Talk about patient-centered, can't express enough gratitude #rnchat FreshRN @renee_berry oh, that's awesome! I haven't seen that yet personally but I hope to soon #RNchat jodyms Five yrs ago you wouldn't have seen this RT@kevinmd RT @efalchuk: Five Tips 4 Diagnosing Yourself on the Web: http://bit.ly/cSgC9X #RNCHAT
  9. 9. nursingpins T3 another nice innovation with touch pads - phys can see x-rays EKG's from anywhere. #RNchat factnurse Innovation: 1st I've ever done this. #RNchat IVchat RT @FreshRN: @renee_berry T3 is it like those buzzers they give you when youre in line for a busy restaurant? #RNchat chemosabe T3 best innovation - transforming care at the bedside - good old fashioned pt focussed care!!! #rnchat rnchat Fast fast hour! We'll wrap up in a few moments. #RNchat PerfectServeInc RT @chemosabe T3 best innovation - transforming care at the bedside - good old fashioned pt focussed care!!! #rnchat nursingpins @chemosabe and innovation can be an extension of pt. centered care. #RNchat rnchat Before we leave, give us your parting thoughts or wishes. #RNchat erlanovation RT @renee_berry: T3 think this is a great #innovative resource for #oncologists #communication skills http://ow.ly/34DcS #cancer #rnchat renee_berry @PhilBaumann #IsCool T3 how about TweetChats for improving #health systems #AWESOME #innovation opening doors/spreading good ideas #rnchat chemosabe By all enjoy thursday nite, i'll try enjoy fri at the coal face! @nursing pins, of course tech is helping transforming care! #rnchat IVchat Nurses rule!! Thank you for the chat! Bye! #RNchat factnurse So glad I did this. How often is the chat? #RNchat PerfectServeInc Enjoyed our first #RNchat today. We will be sure to attend more! Gracetx Same RT@NAPH1981 @renee_berry: impressed w/ e-patient movement, advocating patients to participate in their care http://ow.ly/34D5Y #rnchat FreshRN Thanks for another opportunity to share ideas and discuss important topics! Together we can make a difference #RNchat rnchat THANK YOU, everybody! And thank you @paloaltomedical for the topics. Transcript will be up soon! Next chat TBA. #RNchat Official End of Chat Additional Remarks: nursingpins Thanks to RNchat and all interested. - and what @FreshRN said. #RNchat
  10. 10. renee_berry Don't forget it's National #Hospice Month this November http://ow. ly/34Bzs #myPassion Thanks for a great Chat! #rnchat Gracetx Love it RT @WillowRN T3 #RnChat wd b great incorporating pts TV into demo system, pt could view xrays, call RN, etc from the touch screen. PaloAltoMedical Final thoughts: Thanks to nurses for providing patient-centered care and advocacy! #RNchat nursingpins Thanks to @paloaltomedical #RNchat PaloAltoMedical TY too! RT @rnchat: THANK YOU, everybody! And thank you @paloaltomedical for the topics. Transcript will be up soon! Next chat TBA. #RNchat renee_berry Looking forward to next time! RT @rnchat THANK YOU, everybody! And thank you @paloaltomedical for the topics. #rnchat WhatNursesDo RT @renee_berry: Don't forget it's National #Hospice Month this November http://ow.ly/34Bzs #myPassion Thanks for a great Chat! #rnchat renee_berry RT @PaloAltoMedical: Final thoughts: Thanks to nurses for providing patient-centered care advocacy! #RN #nurse #rnchat Gracetx RT @nursingpins: Thanks to @paloaltomedical #RNchat DrDeanBurke T3 #RNChat (late joining)-research team approach similar to onc. Will require hi tech to coordinate and communicate. doc, nurse,soc.ser PaloAltoMedical Thanks to @RNchat for hosting and allowing us to join in today. We appreciate everyone who participated ( watched). Voices!! #RNchat PaloAltoMedical Thanks to you too. Enjoyed learning and sharing! RT @nursingpins: Thanks to @paloaltomedical #RNchat rnchat @PaloAltoMedical Thank you! A great chat! #RNchat PerfectServeInc Great to chat with @paloaltomedical today during #RNchat. One of our board members is on staff at @paloaltomedical --& ;gt;Dr. Aigen.
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