Transcript of #RNchat - a Twitter chat for registered nurses - for June 30, 2010.

1. rnchat: Attention Twitter Nurses! Remember to join us tonight at 9 PM EST for our weekly
#RNchat where nurses share ideas about different topics!
6/30/2010 02:19
nursekama: @RNchat I'll b there! RT @RNchat: Join us tonight at 9 PM EST for our weekly #RNchat
where nurses share ideas about different topics!
6/30/2010 03:17
EllenRichter: Twitter #Nurses! Mark your calendars! Tonight @ 9 PM EST join us for our weekly health
care chat & share ideas with other RNs! #RNchat
6/30/2010 04:04
JoeCascio: @EllenRichter Hi there. Thanks for the reminder. #Nurses #RNchat
6/30/2010 04:07
EllenRichter: Attention Twitter Nurses! Remember to join us tonight at 9 PM EST for our weekly
#RNchat where nurses share ideas about different topics!
6/30/2010 06:07
nursingpins: RT @rnchat: RT @daily_briefing: Nearly 2,000 Texas nurses voted to unionize, despite
state's anti-union climate | http://bit.ly/bF8hGr #RNchat
6/30/2010 10:35
EdieBrous: RT @EllenRichter: Twitter RNs! Please RT & spread the word--tonight at 9 PM EST will
be our weekly #RNchat hour where nurses meet online to share ideas!
6/30/2010 11:47
cerner: Survey: EHR Adoption Among Top 3 Concerns for Medical Practices http://bit.ly/aSLG1s
#RNchat #HCSM
6/30/2010 12:42
EllenRichter: Don't forget! Tonight @ 9 PM EST I will moderate this week's session of #RNchat so
come & join us! Lets hear what U have to say! :)
6/30/2010 13:11
LaurenWolfe: RT @cerner: RT @EAHolzhauer: Workplace Wellness Programs for Waistlines and
Bottom Lines http://bit.ly/aKNoKP #RNchat #HCSM
6/30/2010 14:05
SaraRC1: RT @EllenRichter: Attention Twitter RNs! Spread the word! Two more hours until #RNchat
tonight (Wednesday) at 9 PM EST ~Pull up a keyboard & join us! :)
6/30/2010 16:03
Aggiern95: RT @EllenRichter: Attention twttr RNs! Spread the wrd! 2 more hrs until #RNchat 2nite
(Wednesday) at 9 PM EST (cont) http://tl.gd/27s0ad
6/30/2010 16:06
onlinenursing: RT @EllenRichter Don't forget!Tonight @ 9 PM EST I will moderate this week's session
of #RNchat come & join us!Lets hear what U have to say!
6/30/2010 16:15
NUR3563: RT @EllenRichter Don't forget!Tonight @ 9 PM EST I will moderate this week's session
of #RNchat come & join us!Lets hear what U have to say!
6/30/2010 16:15
EllenRichter: I'm finishing shift report & getting ready to drive home from the hospital now! Looking
forward to joining our weekly #RNchat in 1 hour! :)

2. 6/30/2010 17:01
incentive1: RT @cerner: RT @EAHolzhauer: Workplace Wellness Programs for Waistlines and
Bottom Lines http://bit.ly/aKNoKP #RNchat #HCSM
6/30/2010 17:36
EllenRichter: Oooooh...I got home late from work! I must walk my dogs before #RNchat so bear with
me! See you in 20 minutes! :)
6/30/2010 17:37
chemosabe: I'm ready when y'all are #rnchat
6/30/2010 17:49
nursingpins: I Found #RNchat but Will I Find a Nursing Position http://www.youtube.com/watch?
v=Q15J8BlGKSQ #rnchat
6/30/2010 17:52
rnchat: Signing onto TweetGrid so that I can dust the room for tonite's #RNchat ....whew, boy was
I rushing to make it JUST in time! :)
6/30/2010 17:55
rnchat: @chemosabe Hi out there, my friend! You at work again? :) #RNchat
6/30/2010 17:56
chemosabe: r we on yet #rnchat
6/30/2010 17:59
rnchat: LOL thank goodness I had enough time to make a fresh pot of coffee. I've been up 17 hrs
& need a little boost! Looking forward to #RNchat
6/30/2010 17:59
rnchat: For those who may think this is @PhilBaumann tonite, its not! Its @EllenRichter filling in
while Phil is busy being Phil! :) #RNchat
6/30/2010 18:01
rnchat: OK yes, @chemosabe we are on now. Its 9 PM & thats my start time tonight! :) Hi folks &
welcome to our weekly #RNchat session!
6/30/2010 18:03
onlinenursing: Hey #RNChat friends. Terri here from MO (NP, Faculty, Student myself)
6/30/2010 18:03
nursekama: @rnchat Hello @EllenRichter, its been awhile since I've participated in #RNchat, looking
forward to it this evening! #rnchat
6/30/2010 18:03
nursingpins: Hi Terri #rnchat
6/30/2010 18:03
rnchat: #RNchat is a way for nurses & all others in health care to meet, tweet & share feelings,
thoughts & ideas~ We welcome silent lurkers!
6/30/2010 18:04
onlinenursing: Hi Ellen, Vernon, and @nursekama ....; @chemosabe... nice to meet you! #RNChat
6/30/2010 18:04
rnchat: I see all of you who joined us! Hi & welcome. Too hard to tweet each of your names now!

3. :) #RNchat
6/30/2010 18:05
rnchat: Seems like everyone knows the routine...but for anyone new, say hello & tell us a little
about yourself! #RNchat
6/30/2010 18:05
chemosabe: Sorry Ellen and all, tyring to use work pc with old ie, having to do this via twitter it's self
#rnchat
6/30/2010 18:06
rnchat: My name is Ellen & like Vernon, I'm a critical care nurse. I am in south Florida. I also
work w/ lawyers as a Legal Nurse Consultant #RNchat
6/30/2010 18:06
rnchat: @chemosabe Hang in there. Try Twitterfall.com It works ok on the old systems (in my
humble opinion) #RNchat
6/30/2010 18:07
chemosabe: hi i'm glen and the international participant at mo, @ work in Brisbane down under in day
onc unit #rnchat
6/30/2010 18:07
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!
6/30/2010 18:08
nursekama: My name is Kama and I'm an advanced practice nurse working in tertiary mental health
care in southwestern Ontario. :) #rnchat
6/30/2010 18:09
rnchat: OK lets start with the first topic T1 #RNchat
6/30/2010 18:09
rnchat: T1 How do we educate pts, families & other health care professionals about end-of-life
options that are more humane? #RNchat
6/30/2010 18:11
onlinenursing: @rnchat T1- great question. I try to do it, by laying out the options & discussing pain and
QoL #RNChat.
6/30/2010 18:12
chemosabe: T1 oncology nurses could be accused of this frequently, particularly when haematologists
are involved #rnchat
6/30/2010 18:14
rnchat: T1 I see end-stage pts get hospitalized with well-worded living wills yet DNR status is
withheld by reluctant families #RNchat
6/30/2010 18:14
nursingpins: T1 Hospitals should offer ongoing EOL programs (Emps. and familys) but for the time
being we must edu each family one at a time. #rnchat
6/30/2010 18:14
onlinenursing: T1 also love hospice. recently had pt. w/no health insurance,dying of CA. Could not get
hospice-Very sad.Hospice RN's great eductrs #RNChat
6/30/2010 18:15

4. nursekama: @rnchat Interesting question for mental health areas...we sometimes have trouble
bringing up end-of-life care w/ pts & family period #rnchat
6/30/2010 18:15
philbaumann: Hi #rnchat - I'm in SF and @doctoranonymous just took a compromising pic of me. ...Wait
for et ;)
6/30/2010 18:15
rnchat: @nursingpins T1 Yes seems like its an uphill battle to be dealt with 1 family @ a time.
We must make EOL care universally understood #RNchat
6/30/2010 18:16
rnchat: @philbaumann LOL ut oh...hope its not censored! :) Howdy in SF! Having fun, eh?
#RNchat
6/30/2010 18:17
rnchat: @onlinenursing T1 Yes I love hospice philosophy too. It makes such sense. Shame that
pt couldn't get it. Should be universal too! #RNchat
6/30/2010 18:18
chemosabe: T1 "why do they nail coffins shut?" #rnchat
6/30/2010 18:18
nursingpins: T1 EOL discussions must be started by med. team - still not discussed by most families -
most have not even chosen a funeral home. #rnchat
6/30/2010 18:18
chemosabe: T1 "to keep the haematologists out" #rnchat
6/30/2010 18:18
rnchat: @nursingpins T1 We had a case last week where hospice consult written 6 days before
family would consent. They just didnt understand #RNchat
6/30/2010 18:19
rnchat: @chemosabe We love all humor, no matter where it originates ;) #RNchat
6/30/2010 18:19
chemosabe: T1 saw a consumer post about this just today on macmillan.co.uk #rnchat
6/30/2010 18:20
onlinenursing: @chemosabe Or-why do wecontinue 2 torture terminal pts w/surg,tests,chemo?send me
home,feed me chocolate/wine,let me be with my fam #RNChat
6/30/2010 18:20
rnchat: T1 Its very disheartening for a health care professional to keep doing interventions like
bloodwork when its unnecessary & painful #RNchat
6/30/2010 18:21
chemosabe: actually that should be www.macmillan.org.uk #rnchat
6/30/2010 18:21
chemosabe: T1 sometimes family and patient r not ready to accept that there is nothing more to b
done #rnchat
6/30/2010 18:22
onlinenursing: @rnchat I meant that last answer 4U.Hate 2 B moribid but death rate is 100%, 1 per
person.We can either make it good death or not #RNChat
6/30/2010 18:22

5. nursingpins: T1 Hospice is in the position and most knowledgeable about EOL events - they could
standardize the edu program? #rnchat
6/30/2010 18:23
onlinenursing: @chemosabe So true! #RNChat (not ready)
6/30/2010 18:23
rnchat: @nursekama T1 But suicidal thoughts doesnt mean terminal or end stage illness. Is EOL
discussion appropriate with those patients? #RNchat
6/30/2010 18:23
pheroumenos: Daniel. hospice nurse. Relationships/education must be developed w/ community,
referrers over time and must advocate in the now. #rnchat
6/30/2010 18:24
onlinenursing: RT @nursingpins: T1 Hospice is in the position and most knowledgeable about EOL
events - they could standardize the edu program? #rnchat
6/30/2010 18:24
NUR3563: RT @nursingpins: T1 Hospice is in the position and most knowledgeable about EOL
events - they could standardize the edu program? #rnchat
6/30/2010 18:24
rnchat: @onlinenursing T1 Oh I think we all understand what it means to want to go home, eat
chocolate & drink wine if we are terminally ill #RNchat
6/30/2010 18:25
nursekama: @rnchat T1 No exactly, that was my point. But most hospitals mandate ALL clients must
have EOL options documented in case of crisis. #rnchat
6/30/2010 18:25
chemosabe: T1 we used model of "shared care" so pt did not feel they were being dropped and txing
team stayed involved #rnchat
6/30/2010 18:26
rnchat: @nursekama T1 Ohhh....ok I see. So its NOT appropriate with that diagnosis, but its
mandated #RNchat
6/30/2010 18:26
rnchat: @chemosabe T1 Even in US hospitals, there are units that let hospice care write orders &
the same staff cares for the patient #RNchat
6/30/2010 18:27
nursekama: @rnchat T1 With the increase of physical comorbidities within the mental health
population I work w/, EOL options must be discussed. #rnchat
6/30/2010 18:27
rnchat: Ok 2 minutes til topic 2 (T2) :) #RNchat
6/30/2010 18:27
chemosabe: T1 again tho this started as not withdrawing agg tx in eol. cood b down to Dr or RN not
willing to say no more #rnchat
6/30/2010 18:28
rnchat: T1 When was the "hospice concept" in health care first started....anyone know....just
curious? #RNchat

6. 6/30/2010 18:28
chemosabe: t1 some hlth pros too "soft" to b the villain & say "no more" #rnchat
6/30/2010 18:29
pheroumenos: Nursekama. T1. Seems determinant would be the degree to which EOL discussions
promoted/exaccerbated self harm. #rnchat
6/30/2010 18:30
MatthewBrowning: T1 Florence Wald was the "Mother of Hospice" a CT and I believe Yale nurse ;-)
http://bit.ly/9jTa9d #RNChat
6/30/2010 18:30
chemosabe: T1 Hospice goes back to the knights of St john in the ?1300's #rnchat
6/30/2010 18:30
rnchat: T1 Sadly, we still have physicians that do not want to sign a DNR form, claiming they do
not feel the patient is "ready" for it #RNchat
6/30/2010 18:31
nursingpins: T1 I think hospice is the best thing adopted by w. medicine - it is still early for us and
needs to be fine tuned. #rnchat
6/30/2010 18:31
rnchat: T1 I just recently read about (I think Montana) has the ability for doctors to write a lethal
prescription for terminal patients #RNchat
6/30/2010 18:32
nursekama: @kidpsychnurse Just saw your message now: Tertiary health care defined
http://bit.ly/92Xeq9 We're specialized mental health care #RNChat
6/30/2010 18:33
rnchat: @MatthewBrowning Nice link! Thanks! :) #RNchat
6/30/2010 18:33
MatthewBrowning: Actually a Dean of #Yale 's School of Nursing for a long time #RNChat
6/30/2010 18:34
nursingpins: T1 @rnchat I have seen many reluctant team members too - all members need more
hospice education - many emotional blocks. #rnchat
6/30/2010 18:35
rnchat: Great contributions to T1....thanks everyone for good tweetin'---we could talk about this
for hours! Moving on to T2 #RNchat
6/30/2010 18:35
rnchat: @physicianwriter Thanks for the link! Will read after the chat! Feeding pts with dementia
via feeding tubes http://bit.ly/agw0Dv #RNchat
6/30/2010 18:37
rnchat: T2 Who can keep up with all the advances being made in pharma? What programs,
tools, aids do you use @ work to get info on pt meds? #RNchat
6/30/2010 18:38
philbaumann: @onlinenursing @rnchat I'm having a good time. Definitely gotta get #rnchat out here! ;)
6/30/2010 18:38

7. rnchat: @philbaumann I'm trying! I think we need to have a Midnite EST chat to get the folks in
Cali! :) #RNchat
6/30/2010 18:39
chemosabe: T2 diff downunda i'm sure, but, we rely on reps and participation in clin trials #rnchat
6/30/2010 18:40
MatthewBrowning: #rnchat LOL! RT @doctoranonymous: What happens in SF.... http://twitpic.com/21dd5f
6/30/2010 18:40
rnchat: T2 At my facility, our computer terminals all have Micromedex program which links us to
4 authoritative medication information sites #RNchat
6/30/2010 18:41
onlinenursing: @rnchat T2 -great question!!Pharm moving so fast.Better 2 know gen. drug classes than
specifics. #RNCHat
6/30/2010 18:41
onlinenursing: RT @MatthewBrowning: #rnchat @doctoranonymous: What happens in SF....
http://twitpic.com/21dd5f BAW HA HA HA
6/30/2010 18:42
chemosabe: feeling paranoid, my line manager just emailled employers email and internet use policy
#rnchat
6/30/2010 18:42
rnchat: T2 There isnt a day I work where I don't look up indications of a new drug or drug-drug
IV compatibilities or side effects, etc #RNchat
6/30/2010 18:42
chemosabe: T2 my employer also has ckn (Clinical Knowledge Network), with jounral, monograph and
pharma access #rnchat
6/30/2010 18:42
pheroumenos: T2. Use a drug guide for smart phone and Google. Hear girls waking, must go.
Goodnight. #rnchat
6/30/2010 18:43
rnchat: @chemosabe The social media & internet use policy is circulating at my facility too. Dont
get in trouble now!! #RNchat
6/30/2010 18:43
onlinenursing: #RNchat T2 - Also keep memberships 2 update with AANP, ANA, MONA, APNO, STTI
(micromedex great idea! - any free software out there ?)
6/30/2010 18:43
nursingpins: T2 Hosp pharmacies are great help with existing orders - we need a quick ref. for major
incomp. of new drug orders (standard ref. #rnchat
6/30/2010 18:43
rnchat: @PhilBaumann Love the picture!! Did you buy the shirt to match the phone case or visa
versa!? :) #RNchat
6/30/2010 18:44
nursekama: T2 Hmm..we have Micromedex, Uptodate.com, Lexi-comp, eCPS with eTherapeutics, and
a few others on our computers... #rnchat
6/30/2010 18:44

8. rnchat: T2 I find myself wishing I could dream up a better pharmacy program that totally
integrated ALL the patients' drugs & medications #RNchat
6/30/2010 18:45
nursingpins: T2 hard to beat that (give a new med then go look it up rush) but many are given but few
are looked up till too late. #rnchat
6/30/2010 18:46
nursekama: T2 Oh and I currently have Lexi-comp and Skyscape Apps on my iPhone... #rnchat
6/30/2010 18:46
rnchat: T2 I also love having Epocrates on my smart phone! And even having the web on my cell
makes medication searches much easier! #RNchat
6/30/2010 18:48
nursingpins: T2 hopefully there will event be a standard drug program for all hospitals to use with
latest info. #rnchat
6/30/2010 18:48
onlinenursing: Free andriod app - Physicians desk reference online T2 - #RNchat http://bit.ly/csnGSj
6/30/2010 18:49
MatthewBrowning: T2 I started teaching MDs & APRNs about ePocrates on Palm devices since 2000- was
priceless in practice #rnchat
6/30/2010 18:49
rnchat: @nursingpins T2 Like for example, I had a pt on IV protonix, oral pepcid & NGT carafate.
He needed only one. Nothing picked that up. #RNchat
6/30/2010 18:50
rnchat: Nice link!! Thanks! >> RT @onlinenursing: Free andriod app - Physicians desk reference
online T2 - #RNchat http://bit.ly/csnGSj
6/30/2010 18:51
nursingpins: T2 @rnchat - good examp - I see that too. Some hospital pharm. pick that one up - some
dont. Would be nice to run lists of meds. #rnchat
6/30/2010 18:52
onlinenursing: RT @MatthewBrowning started teachng MDs & APRNs about ePocrates in 2000/priceless
in practice #rnchat http://bit.ly/6QRHNv Great resource
6/30/2010 18:53
rnchat: @nursingpins T2 I cant agree more about having standardized drug programs & other
standardized care programs--no reinventing wheel! #RNchat
6/30/2010 18:53
onlinenursing: RT @ahier: Leapfrog report on safety of ePrescribing systems in hospitals (pdf)
http://bit.ly/djnkFL #RNChat (good read T2)
6/30/2010 18:54
nursingpins: T2 so many meds interact with clotting agents -would be nice to run a list for flags -
humans can no longer be expected to know all. #rnchat
6/30/2010 18:55
rnchat: T2 I like medication programs that have the ability to print up patient info handouts that
pts can sign w/ nurse & put copy in chart #RNchat
6/30/2010 18:55

9. rnchat: Gosh where does the hour go, friends? I cant believe how fast it flew by! LOL, I didnt
even finish my coffee! :) #RNchat
6/30/2010 18:57
rnchat: (Great link via @onlinenursing) RT @ahier Leapfrog report on safety of ePrescribing
systems in hospitals http://bit.ly/djnkFL #RNchat
6/30/2010 18:58
nursekama: Good discussion tonight, thanks for the outstanding moderation @rnchat (Ellen)! I'm
signing off...cheers! #rnchat
6/30/2010 19:00
rnchat: @nursingpins T2 Great point! The sheer # of available drugs is way to long for any
human to keep track of! We need good programs! #RNchat
6/30/2010 19:01
nursingpins: T2 modern medicine can no longer be most effective without the help of stored
information - we will just overlook too many things. #rnchat
6/30/2010 19:01
J_Bohlen: RT @nursingpins: T2 modern medicine can no longer be most effective without the help
of stored information - we will just overlook too many things. #rnchat
6/30/2010 19:02
chemosabe: T2 NZ only has one drug of each class available on gov funded program #rnchat
6/30/2010 19:02
rnchat: I want to thank all those who diligently retweet the dates & times of our chats each week.
Much appreciated! We have such good chat! #RNchat
6/30/2010 19:02
rnchat: @chemosabe T2 Well, having only 1 of each class of drug in the whole country surely
makes it simpler for everyone. Less med errors? #RNchat
6/30/2010 19:04
chemosabe: @RNchat don't know the stats, would be interesting to sus out #rnchat
6/30/2010 19:05
wantnews: RT @rnchat: T2 Who can keep up with all the advances being made in pharma? What
programs, tools, aids do you use @ work to get info on pt meds? #RNchat
6/30/2010 19:05
rnchat: Anyone who misses an #RNchat session can check out http://RNchat.org site for older
transcripts!
6/30/2010 19:06
rnchat: Be on the look-out for the transcript of tonight's chat! Give @PhilBaumann a chance to
have fun! Look for the link later this week! #RNchat
6/30/2010 19:07
nursingpins: Great job as always Ellen - thanks - nite all #rnchat
6/30/2010 19:08
wantnews: RT @rnchat: Anyone who misses an #RNchat session can check out http://RNchat.org
site for older transcripts!
6/30/2010 19:08

10. rnchat: XOXO Thanks everyone! @EllenRichter signing out of this account! See you all later! :)
#RNchat
6/30/2010 19:09
wantnews: RT @nursingpins: T2 modern medicine can no longer be most effective without the help
of stored information - we will just overlook too many things. #rnchat
6/30/2010 19:11
wantnews: RT @rnchat: T2 I like medication programs that have the ability to print up patient info
handouts that pts can sign w/ nurse & put copy in chart #RNchat
6/30/2010 19:18
EllenRichter: RT @RNchat Anyone who misses an #RNchat session can check out http://RNchat.org
site for older transcripts!
6/30/2010 19:28
KPNurseRecruit: RT @onlinenursing: Free andriod app - Physicians desk reference online T2 - #RNchat
http://bit.ly/csnGSj
6/30/2010 19:32
Tombolo_MN: Such an .mportant conversation! RT @EllenRichter: @Tombolo_MN Thanks for retweeting
information about the date & time of this week's #RNchat
6/30/2010 19:46
KPNurseRecruit: Hated to miss the #RNChat again tonight. I was in Recruitment Intake meeting until 7 (CA
time). Will read transcripts. Peace!
6/30/2010 19:47
wantnews: RT @EllenRichter: RT @RNchat Anyone who misses an #RNchat session can check out
http://RNchat.org site for older transcripts!
6/30/2010 19:47
drjfpmd: nice #health talk RT @RNchat Anyone who misses an #RNchat session can check out
http://RNchat.org site for older transcripts!
6/30/2010 19:52
PrescribedRxN: Workplace Wellness Programs for Waistlines and Bottom Lines http://bit.ly/aKNoKP
#RNchat #HCSM
6/30/2010 21:11
holisticnurses: RT @drjfpmd: nice #health talk RT @RNchat Anyone who misses an #RNchat session
can check out http://RNchat.org site for older transcripts!
6/30/2010 21:15
thibaudguymard: Workplace Wellness Programs for Waistlines and Bottom Lines http://bit.ly/aKNoKP
#RNchat #HCSM via @PrescribedRxN
6/30/2010 22:54
andrewspong: How Nurses Use the Internet and Technology (abstract; Manhattan Research)
http://ow.ly/25BOK | Anyone read this yet? #hcsmeu #hcsm #rnchat
6/30/2010 23:24
rnchat: @andrewspong Interesting work from @manhattanresear - er, uh, I like how they don't
know about RNchat ;) #hcsmeu #hcsm #rnchat
6/30/2010 23:27
philbaumann: @andrewspong Interesting work from @manhattanresear - er, uh, I like how they don't

11. know about RNchat ;) #hcsmeu #hcsm #rnchat
6/30/2010 23:27
andrewspong: RT @philbaumann: @andrewspong Interesting work from @manhattanresear - er, uh, I
like how they don't know about RNchat ;) #hcsmeu #hcsm #rnchat
6/30/2010 23:34
andrewspong: @PhilBaumann Not exactly credentialing the authoritative nature of the report there, I
agree :D #hcsmeu #hcsm #rnchat
6/30/2010 23:35
anjelikadeo: RT @andrewspong: How Nurses Use the Internet and Technology (abstract; Manhattan
Research) http://ow.ly/25BOK | Anyone read this yet? #hcsmeu #hcsm #rnchat
6/30/2010 23:47