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RNchat Transcript - October 19, 2009

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Transcript of #RNchat Twitter chat for registered nurses on October 19, 2009. …

Transcript of #RNchat Twitter chat for registered nurses on October 19, 2009.

Topics discussed: Death/Dying and Public Perception of Nursing.


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  • 1. RoRod101: Hi All, My name is Rosita, ok 2 shorten 2 Ro. I am an RN, NP, Nurse Educator & DNP student. Happy to be amongst fellow nurses. #RNchat 10/19/2009 11:30 EllenRichter: Hi friends! Gee, I'm glad I could break away for a while & come to #RNchat 10/19/2009 11:30 EllenRichter: I'm Ellen, a currently-practicing critical care nurse & behind-the-scenes consultant on medical litigation :) #RNchat 10/19/2009 11:32 RoRod101: Hi there Ellen! #RNchat 10/19/2009 11:33 JennyBizRN: Good Morning, Jennifer RN, here telehealth and legal nurse. Twitter addict; Chicago #RNchat 10/19/2009 11:34 rnchat: First topic coming up - it's a bit heavy for a Monday but you're all strong. #RNchat 10/19/2009 11:34 EllenRichter: Hi Ro & Phil & Jim #RNchat 10/19/2009 11:34 2healthguru: #rnchat Phil et al, have you seen this @RWJF series "#HealthCare Without Harm?" >>http://bit.ly/23Ajs9<< 10/19/2009 11:34 lyall: G'day I'm Lyall from Perth Western Australia. I'm an agency nurse & token Gen Y RN :) #rnchat 10/19/2009 11:35 rnchat: T1 Dying - How do help your patients (& family) with the dying process (or how in the past if your're no longer bedside)? #RNchat 10/19/2009 11:36 JennyBizRN: hospice hospice I am all for it, having helped to many friends and relatives into and thru it #RNchat 10/19/2009 11:37 philbaumann: @medxcentral Thank you for your passion for nursing. Why not join the #RNchat as @jimcanto ? Jim's welcome there. 10/19/2009 11:38 EllenRichter: T1 In this day & age, people need help to make conscious decisions that support death by dignity~nurses help provide information #RNchat 10/19/2009 11:38 JennyBizRN: Part of my ICU burnout was at a hospital where it was always "do everything", very hard and frustrating #RNchat 10/19/2009 11:38 RoRod101: T1 I work as an NP part-time in a LTCF specializing in AIDS & unfortunately deal with the dying process & help pts & family thru it #RNchat 10/19/2009 11:39 EllenRichter: Hi Jen & welcome @lyall & hi 2healthguru, thanks for the video link, I'm saving it for afterwards :) #RNchat 10/19/2009 11:39
  • 2. spf2j123va: T1-Dying RT @RNchat I'm @uvason & we are making a strong push to > compassionate care at EOL (end of life) held an interdisc conf. #RNchat 10/19/2009 11:40 RoRod101: T1 Meant to add deal with the dying process alot #RNchat 10/19/2009 11:40 EllenRichter: T1 I help uneasy adult children realize the importance of following their parents wishes at the time when death is imminent #RNchat 10/19/2009 11:40 JennyBizRN: RT @spf2j123va: T1-Dying RT-too long sorry, but like what u had to say #RNchat 10/19/2009 11:41 EllenRichter: @RoRod101 T1 Do you find that most of your LTCF patients have living wills & health care surrogates? #RNchat 10/19/2009 11:42 JennyBizRN: I do my best to make sure everyone I know has a healthcare power of attorney, a MUST #RNchat 10/19/2009 11:42 bhawkesRN: ...Beth here sneaking in for a minute or so.. #rnchat 10/19/2009 11:42 RoRod101: T1 @EllenRichter All of our residents receive counseling regarding advance directives on admission #RNchat 10/19/2009 11:43 EllenRichter: T1 Many times its the family who uses up more health care energy when delivering nursing care at end of life~ We have more than 1 pt #RNchat 10/19/2009 11:44 rnchat: @bhawkesRN Welcome! #RNchat 10/19/2009 11:44 bhawkesRN: @rnchat thanks! nice to be here #rnchat 10/19/2009 11:45 JennyBizRN: We know the sometimes fruitless end of life care is one of the highest expenses of healthcare-so just have that living will/POA #RNchat 10/19/2009 11:45 rnchat: T1 Just as a follow-up: how well does our culture (or your respective country's culture) confront dying? #RNchat 10/19/2009 11:46 EllenRichter: RT @rnchat: @bhawkesRN Welcome! Yes, & we also welcome @spf2j123va :) #RNchat 10/19/2009 11:46 bhawkesRN: RT @EllenRichter: T1 Many times its the family who uses up more health care energy when delivering nursing care at end of life #rnchat 10/19/2009 11:46 JennyBizRN: I don't think Americans do well with preparing for /confronting dying. We can barely handle aging LOL #RNchat 10/19/2009 11:47 TeriRN: Hi guys. Teri here. I'm a travel nurse currently traveling 2 my next assignment. Hope I
  • 3. keep internet long enough. =) #RNChat 10/19/2009 11:47 DinahsDragonfly: Can be a discussion any time w/ pcp any office visit and hospital stay, I have discussed in DM/CM position as routine of my own. #RNchat 10/19/2009 11:49 EllenRichter: T1 Cultural differences span the gamut of emotions when it comes to death & dying. Must understand/support where they R coming from #RNchat 10/19/2009 11:49 TeriRN: T1 EOL care is my specialty Just being available & answering their questions is a big help Getting docs on board is abig issue w/EOL #RNChat 10/19/2009 11:49 DinahsDragonfly: sorry this is Dinah RN CM/DM Telehealth RN #RNchat 10/19/2009 11:50 AbbieCitron: Hi fellow RNs, Abbie here reading along with you. #RNChat 10/19/2009 11:50 JennyBizRN: Hi Dinah! Hello to all of you. I know Dinah as we worked together and she is terrific and knowledgable nurse #RNchat 10/19/2009 11:50 bhawkesRN: T1 I notice docs from different culutres have different beliefs as well re: end of life #rnchat 10/19/2009 11:50 JennyBizRN: @TeriRN yes the docs are often the hardest part #RNchat 10/19/2009 11:51 RoRod101: T1 The process of dying is very complex. It has different meanings for every culture and each individual. #RNchat 10/19/2009 11:51 TeriRN: @EllenRichter That is so true. One reason why nurses need to be up on the cultural differences of their patients. #RNChat 10/19/2009 11:51 EllenRichter: T1 Agree w/ @DinahsDragonfly Living will wishes & health care surrog should be discussed all thru life, even at well-visits to pcp #RNchat 10/19/2009 11:52 AbbieCitron: TI My experiences with this topic is mainly pediatric, just wanted to add the invaluable help of social workers during death & dying #RNChat 10/19/2009 11:52 RoRod101: RT @lyall: T1 Dont be afraid 2 give enough analgesia. Clinical judgement is based on effective tx of sxs. Relieve pain = dignity. #RNchat 10/19/2009 11:53 bhawkesRN: Agree w @lyall I cringe when nurses withold pain med at EOL. Becuz they'll get hooked? ?! #rnchat 10/19/2009 11:53 rnchat: RT @lyall: T1 Dont b afraid 2 give enough analgesia. Clinical jdgmt based on effective Tx of symptoms. Relieve pain = dignity. #RNchat 10/19/2009 11:53 EllenRichter: T1 Its very disheartening when health care surrogates don't follow the pts wishes at EOL~
  • 4. Not sure how thats allowed! Educate HCSs! #RNchat 10/19/2009 11:54 TeriRN: @lyall T1 I let my pts & families know that if the pt has signs of pain their is no such thing as too much in EOL as long as tx s/s #RNChat 10/19/2009 11:54 AbbieCitron: so true RT @RoRod101: T1 The process of dying is very complex. It has different meanings for every culture and each individual. #RNChat 10/19/2009 11:54 JennyBizRN: RT @bhawkesRN: Agree w @lyall I cringe when nurses withold pain med at EOL. Becuz theyll get hooked??! YES that makes me cringe so! #RNchat 10/19/2009 11:54 EllenRichter: lyall: T1 Dont be afraid to give analgesia. Clinical judgement is based on effective Rx of symptoms Relieve pain=dignity ~How true! #RNchat 10/19/2009 11:55 JennyBizRN: @EllenRichter isn't it usually the family at that last minute? #RNchat 10/19/2009 11:55 EllenRichter: Hi @AbbieCitron & @TeriRN :) #RNchat 10/19/2009 11:55 rnchat: Wonderful discussion! Our next topic is coming up in a few minutes. #RNchat 10/19/2009 11:56 DinahsDragonfly: RT @JennyBizRN: Hi Dinah! Hello to all of you. I know Dinah as we worked together and she is terrific and knowledgeable/ Hi&thanks #RNchat 10/19/2009 11:56 TeriRN: @bhawkesRN You hit on one of my pet peeves. If tx the s/s then there is no addiction or getting hooked just comfort & dignity. #RNChat 10/19/2009 11:57 EllenRichter: @JennyBizRN T1 The health care surrogate is whoever the pt chose in their living will & yes many times its family--they get scared! #RNchat 10/19/2009 11:57 rdjfraser: @EllenRichter @TerriRN I definitely agree, I spoke with Joan Lesmond who did her PhD on the topic, really interesting #RNchat 10/19/2009 11:59 rnchat: T2 Public Perception of Nursing - What's your sense of the general public's view of Nursing? Accurate? Misinformed? What would help? #RNchat 10/19/2009 12:00 EllenRichter: @rdjfraser Oh yes I know that death & dying is a whole science to itself, multifaceted, complex & very interesting to participate in #RNchat 10/19/2009 12:01 TeriRN: @AbbieCitron I call in the SW & chaplain often They R a valuable part of the hospice team. Sometimes need 2 talk not meds #RNChat 10/19/2009 12:01 JennyBizRN: As telehealth RN public LOVES us and loves to talk to us #RNchat 10/19/2009 12:01 lyall: Yay @rdjfraser Now I'm not the only Gen Y RN here :) #rnchat
  • 5. 10/19/2009 12:02 EllenRichter: T2 ~Most of my pts in ICU say "I never KNEW a nurse did so MUCH!" People have no idea of our scope & responsibilities #RNchat 10/19/2009 12:02 JennyBizRN: It also depends, if patient has been in hospital they see what we do. TV portrayal is way off. #RNchat 10/19/2009 12:03 EllenRichter: @TeriRN ~Yes, I agree hospice isnt only for meds, it can be for communication & emotional support which are important as well #RNchat 10/19/2009 12:03 AbbieCitron: RT @EllenRichter: T2 ~Most of my pts in ICU say "I never KNEW nurses did so MUCH!" People have no idea of our scope/responsibilities #RNChat 10/19/2009 12:04 TeriRN: T2 Thanks to past & recent shows w/nurses there is a BIG misconception of what RN's do. #RNChat 10/19/2009 12:04 bhawkesRN: T2 Instead of saying "I'll be ur nurse today" try "I'll be coordinating your care today" #RNchat 10/19/2009 12:05 TeriRN: T1 I'm already working on my son & daughter to do LW's. I've had too many young pts w/o one & no one willing 2 make decisions. #RNChat 10/19/2009 12:06 EllenRichter: RT @bhawkesRN T2 Instead of saying "I'll be ur nurse today" try "I'll be coordinating your care today" ~Psych 'em out, eh :) #RNchat 10/19/2009 12:07 AbbieCitron: Like this approach! RT @bhawkesRN: T2 Instead of saying "Ill be ur nurse today" try "Ill be coordinating your care today" #RNChat 10/19/2009 12:07 RoRod101: T2 @EllenRichter Public really does have a misconception of our scope & responsibilities & it doesn't help da way TV portrays nurses #RNchat 10/19/2009 12:08 DinahsDragonfly: My pt's have always stated how much they rely on what I/we tell them - education, CM/DM. learn more from us/me the nurse. They trust #RNchat 10/19/2009 12:08 TeriRN: @bhawkesRN Do U find success w/ that? It seems it still blurs what each team mem. does. Have many tell me the CNA is their nurse =( #RNChat 10/19/2009 12:08 rnchat: @EllenRichter @bhawkesRN I like your take charge approach - rather than waiting for something to change, be the change. Nice! #RNchat 10/19/2009 12:08 EllenRichter: @AbbieCitron LOL yes I like that too! #RNchat 10/19/2009 12:08 bhawkesRN: T2 Even pts who see what we DO may not recognize all the assessment, planning and intervention #RNchat 10/19/2009 12:08
  • 6. TeriRN: @EllenRichter Same here w/hospice I love talking about EOL & dispelling the myths & misconceptions of what we do. Definitely success #RNChat 10/19/2009 12:09 rnchat: T2 Follow-up: if you had a magic wand, how would want nurses to be portrayed (given the variety of nursing, of course). #RNchat 10/19/2009 12:10 DinahsDragonfly: Too often told that no one else told them this or that before and it made a difference in their health outcome.= PT EDUCATION #RNchat 10/19/2009 12:10 lyall: T2 When you do stuff to pts (tasks) explain to pt what ur doing while ur doing it. It shows we have skills & knowledge. #rnchat 10/19/2009 12:10 JennyBizRN: @DinahsDragonfly SOO TRUE, esp in telehealth we often are amazed when we tell them things #RNchat 10/19/2009 12:11 AbbieCitron: All in all, I think most pts realize when they have a good nurse caring for them & are appreciative. #RNChat 10/19/2009 12:12 lyall: @DinahsDragonfly hear hear. Pt education is a great opportunity to improve outcome & demonstrate nursing skill & knowledge #rnchat 10/19/2009 12:12 TeriRN: T2 Exactly the way we do our jobs. We aren't all over the hospital on all floors, not even the CNO. #RNChat 10/19/2009 12:13 bhawkesRN: T2 magic wand: seen as: competent, evidence based, compassionate, professional members of the hc team #RNchat 10/19/2009 12:13 AbbieCitron: RT @lyall: @DinahsDragonfly hear hear. Pt edu. is a great opportunity to improve outcome & demonstrate nursing skill/knowledge #RNChat 10/19/2009 12:13 EllenRichter: T2 If I had a magic wand I would wisk away doctor-nurse chain of command & raise nursing 2 an independent yet participatory professn #RNchat 10/19/2009 12:14 lyall: @AbbieCitron I agree but I don't think they really know WHY their nurse is good #rnchat 10/19/2009 12:14 RoRod101: T2 RT @AbbieCitron: All in all, I think most pts realize when they have a good nurse caring for them & are appreciative. #RNchat 10/19/2009 12:14 TeriRN: @DinahsDragonfly I hurt when I realize I'm the one left to tell the pt & family that they are dying & may have 6 months left. #RNChat 10/19/2009 12:14 RoRod101: RT @bhawkesRN: T2 magic wand: seen as: competent, evidence based, compassionate, professional members of the hc team #RNchat 10/19/2009 12:14
  • 7. TeriRN: RT @bhawkesRN: T2 magic wand: seen as: competent, evidence based, compassionate, professional members of the hc team //Amen #RNChat 10/19/2009 12:15 JennyBizRN: @EllenRichter great statement Ellen, what Nursing needs! #RNchat 10/19/2009 12:16 bhawkesRN: Agree! RT @lyall: @AbbieCitron I agree but I dont think they really know WHY their nurse is good #RNchat 10/19/2009 12:16 TeriRN: RT @DinahsDragonfly hear hear. Pt edu. is a great opportunity to improve outcome & demonstrate nursing skill/knowledge #RNChat 10/19/2009 12:16 EllenRichter: @TeriRN Actually sometimes I LIKE being the one left to tell the pt & family theyre dying because I will B most compassionate! #RNchat 10/19/2009 12:17 mkopp1: T2b RNs r the hands on care for MDs. We need to know the details just as much as the MD. We r the pt's care provider too #rnchat 10/19/2009 12:17 bhawkesRN: RT @EllenRichter: T2 I would wisk away doctor-nurse chain of command & raise nursing 2 an independent yet participatory professn #RNchat 10/19/2009 12:17 JennyBizRN: Still amazes me, pts leave hospital/MD offc and call us at telehealth w so many?s, but they trust/appeciate/understand what we do #RNchat 10/19/2009 12:17 bhawkesRN: T2 isn't there a country where the RNs have to approve hospital admits? #RNchat 10/19/2009 12:18 EllenRichter: T2 @mkopp1 I agree with U. I have great relationshps w/ the MDs I work with but its always an initial uphill battle to prove myself #RNchat 10/19/2009 12:18 JennyBizRN: This is the part I get to see, that I didn't in hospital nursing #RNchat 10/19/2009 12:19 lyall: RT @bhawkesRN: T2 magic wand: seen as: competent, evidence based, compassionate, professional members of the hc team #rnchat 10/19/2009 12:19 EllenRichter: RT @mkopp1: T2b my magic wand: an important part of the healthcare team, caring, knowledgable, an advocate. ~Yes you have that rite! #RNchat 10/19/2009 12:20 KPNurseRecruit: Hats off to all the nurses today improving the patient experience (and outcomes too!) with meaningful patient education! #RNChat 10/19/2009 12:21 JennyBizRN: Next week I will miss this, my hours change....again #RNchat 10/19/2009 12:21 EllenRichter: T2 my next magic wand swing would pay nurses based on fees for services, even in a hospital #RNchat 10/19/2009 12:22
  • 8. JennyBizRN: RT @EllenRichter: T2 my next magic wand swing would pay nurses based on fees for services, even in a hospital YES YES YES YES #RNchat 10/19/2009 12:23 rnchat: @JennyBizRN Next chat will be announced in a few minutes. #RNchat 10/19/2009 12:23 EllenRichter: RT @KPNurseRecruit Hats off to RNs today improving the pt experience (& outcomes too!) with meaningful patient education! I agree!! #RNchat 10/19/2009 12:24 DinahsDragonfly: RT @EllenRichter: raise nursing 2 an independent yet participatory professn; aGREE need more visibility as that "type" of profession.#RNchat 10/19/2009 12:24 EllenRichter: @JennyBizRN LOL glad you liked that T2 suggestion! I've been crying about that for years! :) #RNchat 10/19/2009 12:24 EllenRichter: With our T1 & T2 a & b answers, it seems that the Twitter nurses are all on the same page on many thoughts, ideas & subjects! :) #RNchat 10/19/2009 12:25 DinahsDragonfly: RT @lyall: I don't think they really know WHY their nurse is good/Agre but 1st they know we come from caring/love-they tell me this #rnchat 10/19/2009 12:26 bhawkesRN: @EllenRichter As long as we are hourly employees..... we will remain hourly employees! :) #RNchat 10/19/2009 12:26 EllenRichter: Geez, an hour has passed?? Where does it go? Great chat folks! Wow, & a nice turn- out! TY @PhilBaumann for this #RNchat 10/19/2009 12:27 AbbieCitron: Tweeters not on chat asking me what is best way to say thank you to good nurses? Notes to supervisors? Thoughts? #RNChat 10/19/2009 12:27 JennyBizRN: RT @EllenRichter: Geez, an hour has passed?? Where does it go? Great chat folks! Wow, & a nice turn-out! TY @PhilBaumann for this #RNchat 10/19/2009 12:28 TeriRN: RT @EllenRichter: Geez, an hour has passed?? Where does it go? Great chat folks! Wow, & a nice turn-out! TY @PhilBaumann for this #RNChat 10/19/2009 12:28 RoRod101: I greatly enjoyed conversing with all of you. It was also a pleasure to meet some new tweeples. Nurses are Awesome! :) #RNchat 10/19/2009 12:28 BonnieRN: RT @EllenRichter T2 my next magic wand swing would pay nurses based on fees for services, even in a hospital #RNchat 10/19/2009 12:28 rnchat: We're coming up on one hour. Speedy, speedy! Great discussion today & nice turnout! Wrapping up in a few minutes. #RNchat 10/19/2009 12:28 AbbieCitron: RT @EllenRichter: Great chat folks! Wow, & a nice turn-out! TY @PhilBaumann for this
  • 9. #RNChat 10/19/2009 12:29 DinahsDragonfly: RT @EllenRichter: because I will B most compassionate! ; agreed 100% Dr's often are at loss- feeling of failure, poor talk #RNchat 10/19/2009 12:29 mkopp1: RT @AbbieCitron: Tweeters not on chat asking me what is best way to say thank you to good nurses? Notes to managers & direct to RN #RNChat 10/19/2009 12:29 EllenRichter: @AbbieCitron Most hospitals (facilities) have an internal way that nurses can be praised & rewarded by patient & family comments #rnchat 10/19/2009 12:30 TeriRN: @AbbieCitron Send goodies to the staff, notes to their supervisor. I have a file of TY notes from patients to me. #RNChat 10/19/2009 12:30 rnchat: Thank you all: NOTE: I'm sorry if I get testy/defensive about potential spammers. I'll work on another approach. Doing my best. #RNchat 10/19/2009 12:30 mkopp1: Sorry to pop in late. Was carried away with packing for our family trip to disney world this Thurs. Will muss you all next week!#rnchat 10/19/2009 12:31 bhawkesRN: Thank you @RNchat for coordinating. Love chatting with you all #RNchat 10/19/2009 12:31 DinahsDragonfly: RT @JennyBizRN: Agreed Jen, they leave w/ questions & then ask the nurse for the answers/interpretations, support, what next. #RNchat 10/19/2009 12:31 EllenRichter: Yes I see a few new "faces" here that I will be following! :) #rnchat 10/19/2009 12:32 rnchat: THANK YOU!!! All of you are creating a remarkable community here. It's clear you're all terrific nurses. #RNchat 10/19/2009 12:32 EllenRichter: @mkopp1 Oh, have fun! & it seems like you were here for most of it & had great comments :) #rnchat 10/19/2009 12:33 lyall: @DinahsDragonfly true however RNs often get credit for being nice whereas Drs for knowledge/skill. We aren't good just coz we r nice #rnchat 10/19/2009 12:33 TeriRN: RT @EllenRichter: Yes I see a few new "faces" here that I will be following! :) // me too! =D #RNChat 10/19/2009 12:33 lyall: Cheers everyone. It's half past midnight so goodnight all. #rnchat 10/19/2009 12:34 DinahsDragonfly: RT @bhawkesRN: approve hospital admits?/yes,I set up program fromour ER for Coord to adm or send to TCU or Home Care, office visits.#RNchat 10/19/2009 12:34
  • 10. rnchat: Our next chat is this Thursday 10/22 20:30 EDT. Transcript up in a bit on our website. #RNchat 10/19/2009 12:34 EllenRichter: Thanks to YOU, Phil! RT @rnchat THANK YOU! All of U are creating a remarkable community here. Its clear youre all terrific nurses #rnchat 10/19/2009 12:35 lyall: @rnchat Can you please advertise times in UTC so international nurses can calculate time more easily? #rnchat 10/19/2009 12:35 AbbieCitron: @mkopp1 Have a great trip to Disney World! #RNChat 10/19/2009 12:36 EllenRichter: Ohh, a nite chat, my favorite ~RT @rnchat Our next chat is this Thursday 10/22 20:30 EDT. Transcript up in a bit on our website. #RNchat :) 10/19/2009 12:37 spf2j123va: RT @EllenRichter@KPNurseRecruit Hats off to RNs improving pt experience (& outcomes too!) w/ meaningful patient education! I agree!! #RNchat 10/19/2009 12:37