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RNchat: Transcript October 22, 2009


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Transcript of #RNchat (@RNchat), a Twitter chat for registered nurses for October 22,2009.

Topics: Nursing's Relationship with Technology and Patient Safety.

Published in: Health & Medicine
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RNchat: Transcript October 22, 2009

  1. 1. rnchat: Welcome to #RNchat! Please prepend your replies to topics with T1, T2, etc. ...OK, let's start with introductions! 10/22/2009 20:32 RoRod101: Hi All! I am a RN, NP, Nurse Educator, & DNP student. Happy 2 B in a chat w/ fellow nurses :) Luv, Ro #RNchat 10/22/2009 20:32 lorryschoenly: @lorryschoenly here - correctional nurse educator and advocator #rnchat 10/22/2009 20:33 BonnieRN: Geriatric Care Manager & Legal Nurse Consultant here (so etiquette calls for naming topics first as T1, etc.?) Where is list? #rnchat 10/22/2009 20:35 rnchat: T1 Nursing's Relationship w/Technology: How can Nursing improve how it relates to technology? ie: are we "savvy" enough? o_O #RNchat 10/22/2009 20:36 SafetyNurse: #RNchat Barbara Olson, RN patient and medication safety specialist. Happy 2 b here (had to get up from pre-Project Runway nap). Worth it. 10/22/2009 20:36 RoRod101: Hello @BonnieRN & @lorryschoenly! #RNchat 10/22/2009 20:36 lorryschoenly: LOL - Bonnie, that's after the intros ;-) #rnchat 10/22/2009 20:37 RoRod101: @SafetyNurse Hey there! :) #RNchat 10/22/2009 20:38 lorryschoenly: T1 - Starting in nursing school for the newbies is a start #rnchat 10/22/2009 20:39 SafetyNurse: #RNChat Hi @RoRod! Thx 4 RTs since last time 10/22/2009 20:39 EllenRichter: OMG I am late!! Was on a conference call! :) #RNchat 10/22/2009 20:39 rnchat: @BonnieRN It makes it easier to track the conversation, so we know what you're referring to. Also: for search & transcripts. #RNchat 10/22/2009 20:40 EllenRichter: T1 You bet we are savvy enough! I know that nurses can do anything they set their minds to...I talk from 34 years of it :) #RNchat 10/22/2009 20:41 BonnieRN: Thanks Phil, so, T1 is a statement or an answer (sorry I am new to this chat) Heh, Ellen, DF. #rnchat 10/22/2009 20:42 EllenRichter: T1 LOL I remember we would "dipstick" urine to test sugar & acetone for diabetics, now look at us with glucometry (just one example) #RNchat 10/22/2009 20:42 SafetyNurse: #RNChat T1 I don't doubt nurses are smart enough. But I wonder if tech works for nursing in the way it works for other (non-healthcare)
  2. 2. 10/22/2009 20:42 AnthonyBurich: #rnchat T1 I think students in nursing school are definitely ready to learn whatever technology in nursing curriculum is developed & taught. 10/22/2009 20:42 RoRod101: T1 Perhaps some nursing CE on incorporating tech in the classroom #RNchat 10/22/2009 20:43 EllenRichter: @BonnieRN ~GF, hi & welcome! Nice to have you here! #RNchat 10/22/2009 20:43 hillarygayle: Hi, nurses! I'm Hillary, new grad (August 09) working on orthopedic/med-surg floor. #RNchat 10/22/2009 20:44 SafetyNurse: #RNChat @BonnieRN Almost like Jeopardy.... "What is, 'It's not accessible for 200, Alex'? " 10/22/2009 20:44 BonnieRN: T1 - of course we are savvy enough for technology. What technology? Labs? Ho-hum. I thought we were discussing social media tech. #rnchat 10/22/2009 20:44 EllenRichter: T1 I know that technology will help nursing. Once records are 100% electronic, medical histories will not be mysteries on admission #RNchat 10/22/2009 20:45 SafetyNurse: @hillarygayle Hi Hillary #RNChat 10/22/2009 20:46 EllenRichter: Oh, sorry...intro= Ellen, critical care nurse, South Florida, also legal nurse consultant for medical litigation ~Hello folks :) #RNchat 10/22/2009 20:46 rnchat: @BonnieRN We discuss a broad range of topics, not just social media, but you can answer as far as that's concerned too. #RNchat 10/22/2009 20:46 AnthonyBurich: #RNchat T1 We are taught to critically think. Part of that is searching for pertinent info we may not know. There are many apps to help. 10/22/2009 20:47 rnchat: @hillarygayle Welcome, glad you could make it! #RNchat 10/22/2009 20:47 rnchat: BTW, you may find this chat easier to follow if you sign in to & enter: RNchat. #RNchat 10/22/2009 20:48 SafetyNurse: @EllenRichter #RNChat. I agree with you for the far potential. But I hear nurses complain all of the time about the WAY tech serves them. 10/22/2009 20:48 RoRod101: @AnthonyBurich @hillarygayle Hello, please to meet you both. Ro #RNchat 10/22/2009 20:48 EllenRichter: @AnthonyBurich: T1 yes, apps to help us by providing fast, current info will augment & improve care #RNchat 10/22/2009 20:49
  3. 3. hillarygayle: T1 We're currently switching our hospital over to Meditech charting software. Feels like everyone but me HATES it. #RNchat 10/22/2009 20:49 SafetyNurse: #RNChat T1 So I'm wondering, do I encounter the 10% who will complain about anything or is this legit? 10/22/2009 20:49 AnthonyBurich: #RNchat My intro - Anthony Burich, 1st year nursing school student, Northern California, future RN. Loving the program! 10/22/2009 20:49 EllenRichter: @safetynurse T1 I bet if nurses had more input into programs & technological advances they use, there would be less complaining #RNchat 10/22/2009 20:50 BonnieRN: @hillarygayle hi Hillary - nice to have a new grad present. #rnchat 10/22/2009 20:50 AnthonyBurich: #RNchat T1 Any technology that can streamline the nursing process while maintaining safety and privacy should be welcomed. 10/22/2009 20:50 SafetyNurse: @AnthonyBurich #RNChat T1 So information "hunting and gathering" is part of what nurses expect to do while OTJ? 10/22/2009 20:51 RoRod101: RT @EllenRichter T1 I bet if nurses had more input into programs & technological advances they use, there would be less complaining #RNchat 10/22/2009 20:51 AnthonyBurich: @RoRod101 Hi Ro, pleasure to meet you as well! #rnchat 10/22/2009 20:51 EllenRichter: @safetynurse T1 LOL, oh no, nurses love to complain & many hate change because in the beginning, change interferes with care #RNchat 10/22/2009 20:51 hillarygayle: @EllenRichter absolutely does. esp in my hospital, where last night I had 7 patients, 5 post-op. #rnchat 10/22/2009 20:53 RoRod101: @EllenRichter T1 If the nurses will be users it makes sense to have their input #RNchat 10/22/2009 20:54 SafetyNurse: @EllenRichter But it's a been a long time, Ellen. Is it just vanilla change-hate? Or is there something missing in design/workflow? #RNChat 10/22/2009 20:55 EllenRichter: T1 My dad had surgery last week & the OR nurse took our cell # & texted us when surgeon was closing so we could go back 2 waiting rm #RNchat 10/22/2009 20:55 hillarygayle: @safetynurse Small town, small hospital. Change interferes with care b/c of high ratios on our floors. #rnchat 10/22/2009 20:55 EllenRichter: T1 So, texting was used as health care communication for families of patients in the OR #RNchat
  4. 4. 10/22/2009 20:56 rnchat: Next topic coming up in a few minutes. Feel free to discuss first topic or move on to next. It's all good. #RNchat 10/22/2009 20:56 EllenRichter: @safetynurse T1 good question! I think its a combo of both...hate change AND design fail #RNchat 10/22/2009 20:57 AnthonyBurich: @SafetyNurse Is it possible to be familiar with specifics for every drug, diagnosis, etc? I think we need to seek unfamiliar info. #rnchat 10/22/2009 20:57 SafetyNurse: @EllenRichter That's a win! #RNChat 10/22/2009 20:58 EllenRichter: T1 In almost ALL situations where big changes are happening, it cause major ripples; with hc technology we must endure it for now #RNchat 10/22/2009 20:58 SafetyNurse: @AnthonyBurich T1 Oh, I agree, Anthony. I think the app suggestion is great. Just think its use should be part and parcel... #RNChat 10/22/2009 20:59 rnchat: T2 Patient Safety: How well are we doing w/Pt safety? What grade would you give the profession? What needs most improvement? #RNchat 10/22/2009 20:59 EllenRichter: @anthonyburich T1 I dont know a nurse who practices without Google or a PDA program at their fingertips, too much to memorize #RNchat 10/22/2009 21:00 SafetyNurse: @AnthonyBurich T1 of what's considered a norm. Not just available to me (a patient) if I get a "smart" nurse or a "dig native" nurse #RNChat 10/22/2009 21:00 SafetyNurse: @rnchat OMG Phil! Patient safety tonight, too??? Should I yell BINGO now??? #RNChat 10/22/2009 21:00 BonnieRN: T2 - Fall prevention is always an issue. So many concerns really in safety. #rnchat 10/22/2009 21:01 SafetyNurse: @EllenRichter Woohoo! That's a nice observation. #RNChat 10/22/2009 21:01 rnchat: @SafetyNurse :) #RNchat 10/22/2009 21:01 AnthonyBurich: @EllenRichter @safetynurse T1 I think the design fail of past projects fosters the change hate of present. #rnchat 10/22/2009 21:01 rnchat: @SafetyNurse I figured they actually can dovetail, so if you want to add your pt safety perspective, feel free. #RNchat 10/22/2009 21:02 EllenRichter: RT @AnthonyBurich: @EllenRichter @safetynurse T1 I think the design fail of past projects fosters the change hate of present. #rnchat ~YES!! 10/22/2009 21:02
  5. 5. EllenRichter: T2 I review medical records involved in litigation, so I see many glitches in patient safety. I see the fails~ They are still there. #RNchat 10/22/2009 21:03 SafetyNurse: @rnchat Wonder how "schooled" nurses feel abt #ptsafety. When I went to school, it ws "side rails up x 4." Stuff now proven to kill. #RNChat 10/22/2009 21:04 EllenRichter: T2 At least the organizations themselves & the regulating agencies are FOCUSED more on patient safety this past decade #RNchat 10/22/2009 21:04 SafetyNurse: @AnthonyBurich T1 Amen. #RNChat 10/22/2009 21:05 bhawkesRN: Beth Hawkes Staff Development here sorry I'm late #rnchat 10/22/2009 21:06 EllenRichter: T2 Today's student nurses seem very cognizant of pt safety, pt identification, & precautions such as falls, isolation, allergies #RNchat 10/22/2009 21:07 SafetyNurse: @hillarygayle T2 Ummm... wondering what "patient safety" looks like from ur perspective.... what u were taught? What u c OTJ? #RNChat 10/22/2009 21:07 RoRod101: @bhawkesRN Hey there! Glad you could make it. #RNchat 10/22/2009 21:07 SafetyNurse: @bhawkesRN Hi Beth #RNChat 10/22/2009 21:07 EllenRichter: @bhawkesRN You will be docked 30 minutes #RNchat 10/22/2009 21:07 BonnieRN: Hi Beth, perfect timing. Staff development specialist and reviewing T2 Safety Concerns or Pt. Safety. #rnchat 10/22/2009 21:08 bhawkesRN: Thanks all! #rnchat 10/22/2009 21:08 rnchat: @bhawkesRN Welcome, Beth! #RNchat 10/22/2009 21:09 bhawkesRN: T2 Focus on basic nsg care reduces risk. #rnchat 10/22/2009 21:10 EllenRichter: T2 Medication safety is still a tough area because so many are involved: doctor, pharmacist, nurse, can occur 4-fold #RNchat 10/22/2009 21:10 RoRod101: @EllenRichter T2 Patient safety begins in while in nursing school. SimMan is used in the lab to simulate caring 4 a pt #RNchat 10/22/2009 21:10 AnthonyBurich: #RNchat T2 Teachers are really drilling many different #ptsafety protocols into us. But I read many students state X in reality Y for NCLEX 10/22/2009 21:12
  6. 6. EllenRichter: @bhawkesRN T2 Unfortunately basic nsg care is very complex! So there is potential risk for error even with basics #RNchat 10/22/2009 21:13 bhawkesRN: T2 @AnthonyBurich ? X in reality Y for NCLEX? afraid I don't follow #rnchat 10/22/2009 21:13 SafetyNurse: @EllenRichter Great % (I think >1/2) of harm-causing med errors originate in "admin" phase of med use, making nurses very vulnerable #RNChat 10/22/2009 21:14 RoRod101: T2 SimMan is used 2 teach in a safe environment but the opportunity is there to teach if something goes wrong 2 prevent in real life #RNchat 10/22/2009 21:14 EllenRichter: @BonnieRN ~I know, its tough. I miss so much. When I read the transcript afterward, I see how many tweets passed me by! #RNchat 10/22/2009 21:15 bhawkesRN: T2 For example, if we round q 1 hr to assist with voiding, we have fewer falls. If we ambulate we have less pneumonia and DVT. #rnchat 10/22/2009 21:15 BonnieRN: T2 - Nurses have always been the last line of defense. #rnchat 10/22/2009 21:15 SafetyNurse: @RoRod101 T2 Do your students get to view real med products (boxes, labels) to becoem aware of look-alike, sound-alike risk points? #RNChat 10/22/2009 21:16 EllenRichter: @safetynurse T2 I do believe that student nurses struggle with med administration the most. So much info to know abt each drug #RNchat 10/22/2009 21:17 AnthonyBurich: @bhawkesRN Read student posts that teachers tell them things done certain way OTJ but differently if answering a question on NCLEX. #rnchat 10/22/2009 21:18 vulturegirl: RT @ReconChesty RT @BonnieRN T2 - Nurses have always been the last line of defense. #rnchat / Very True!! 10/22/2009 21:19 RoRod101: @SafetyNurse T2 They must pass (pass/fail) a medication administration simulation before giving meds. #RNchat 10/22/2009 21:20 bhawkesRN: @anthonyBurich Oh, gotcha. thanks #rnchat 10/22/2009 21:20 SafetyNurse: @EllenRichter T2 ....and a med admin process that often doesn't support reliability. #RNChat 10/22/2009 21:20 EllenRichter: T2 In general, nursing profession has aggressively moved towards creating a safer environmt in hospital care but we're not there yet #RNchat 10/22/2009 21:23 SafetyNurse: T2 Wondering what you guys see when a nurse makes a mistake? #RNChat 10/22/2009 21:24
  7. 7. EllenRichter: @safetynurse We laugh at work b/c our computerized medication system will not let us override tylenol but we can override dilaudid! #RNchat 10/22/2009 21:24 bhawkesRN: T2 I would like to see peer review as a way to address some pt incidents. #rnchat 10/22/2009 21:25 EllenRichter: @safetynurse T2 when a nurse errs, it is supposed to be opportunity for learning, but we all know fear & shame preside #RNchat 10/22/2009 21:25 chuymatt: I have seen good things in clinicals. We had one RN give kayexalate v. kaopectate to someone who was low K c diarrhea. #rnchat 10/22/2009 21:26 RoRod101: @EllenRichter T2 I agree, the nursing profession has aggressively moved towards creating a safer environment when providing care #RNchat 10/22/2009 21:26 EllenRichter: RT @bhawkesRN: T2 I would like to see peer review as a way to address some pt incidents ~peer review=great way to learn! #RNchat 10/22/2009 21:27 BonnieRN: T2 - I am sorry but pear review reeks of discipline. We need learning opportunities and mentoring of trusted colleagues... #rnchat 10/22/2009 21:27 chuymatt: by end of shift it was nailed down to pharm error with the handwritten order... after 2 days of administration. #rnchat 10/22/2009 21:27 SafetyNurse: @EllenRichter T2 maybe I will shamelessly beg Phil to add "when things go awry" for a future chat topic #RNChat 10/22/2009 21:28 SafetyNurse: @chuymatt Happens all the time, sorry to say. Welcome to LASA-related errors (look- alike, sound-alike drug names) #RNChat 10/22/2009 21:29 bhawkesRN: T2 I agree peer review must be approached professionally. Possibly like the medical model which is not primairily disciplinary. #rnchat 10/22/2009 21:29 EllenRichter: @chuymattT2 Those types of med errors happen all the time, & many take days before someone spots the problem! #RNchat 10/22/2009 21:29 rnchat: We'll be wrapping up. Yes, time warps inside the #RNchat. 10/22/2009 21:29 SafetyNurse: @BonnieRN ...and measures to prevent a recurrence with another practitioner after memory of the event fades... #RNChat 10/22/2009 21:30 rnchat: Feel free to keep chatting if you'd like (just swipe your credit card). I'll post a few administrative details in a moment. #RNchat 10/22/2009 21:31 BonnieRN: @bhawkesRN Agree 100% #rnchat
  8. 8. 10/22/2009 21:31 chuymatt: @SafetyNurse I KNOW that there are systems to prevent that kind of contraindicated med error with all inclusive EMRs. #rnchat 10/22/2009 21:31 EllenRichter: @bonnieRN Dont be too hard on peer review! As long as there are no repercussions, nurses CAN learn from med errors & near-misses #RNchat 10/22/2009 21:31 rnchat: Transcript of tonight's #RNchat will be posted in a bit. 10/22/2009 21:31 RoRod101: Where did the time go? Great chat! Enjoyed tweetin' with you all. #RNchat 10/22/2009 21:31 BonnieRN: @EllenRichter the follow up of learning is key... #rnchat 10/22/2009 21:32 EllenRichter: Yes, as usual, thanks to @philbaumann for getting us nurses together on Twitter...its working out wonderfully! :) #RNchat 10/22/2009 21:33 SafetyNurse: @chuymatt You are correct, there are higher level safeguards available. Matter of hard- wiring them into care. #RNChat 10/22/2009 21:33 bhawkesRN: @BonnieRn we have plans to implement peer review in 2010. I'm excited and want to be part of the group. But then I'm a joiner :) #rnchat 10/22/2009 21:33 EllenRichter: RT @BonnieRN: @EllenRichter the follow up of learning is key... #rnchat ~Cant agree more! :) 10/22/2009 21:33 SafetyNurse: Bye all, thanks for the great conversation(s)! #RNChat 10/22/2009 21:33 rnchat: If you haven't tried tools such as or or give them a spin. #RNchat 10/22/2009 21:34