September 11th, 2009 by Emergiblog in Better Health Network, Opinion
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I’ve received some emails from nurses who would like to start a blog. Some are a bit nervous about starting, others are not sure how to begin. There are a million sites out there on how to start a blog; in fact, I wrote a post specifically on how to be a “nurse blogtitioner”.
But their emails got me thinking about the blogosphere in general and the most important considerations in starting/maintaining a blog.
1. The blogsosphere can never be saturated.
Think you have nothing to add to the dialog? Think that everything about your topic has been said? Think again. If you aren’t blogging there is still a voice that needs to be heard. What exactly do you bring to the discussion? You! No one has had your experiences or can express your opinions. More importantly, no one else can bring your voice. And unlike a meeting or an email, there are no time limits or physical boundaries to the blogosphere. There is room for everybody, and that means you!
2. The heart of the blogosphere is interactivity.
If you read blogs, you probably leave comments. Comments are the soul of the blogosphere. With them, the blogosphere is a conversation. Without them, the blogosphere is simply a virtual collection of “articles”. By starting a blog, you bring the dialog to your “home turf”, so-to-speak. You are the host/hostess of a virtual “salon”, providing information on your sphere of expertise, initiating the debate and most importantly, learning from those who comment on your posts.
3. The blogosphere is the great equalizer.
There is no hierarchy of blogs. Don’t confuse size with importance. Some blogs may have a million readers a day and some may have ten, but in the blogosphere, no one is “better” than anyone else. Your blog, with that first post, is just as important and just as relevant as anything you see on “Instapundit” or the “Huffington Post”. It’s unique and cannot be replicated, because it is based on your outlook and experiences.
Here are some things to keep in mind as you start your blog:
1. Content is King
Maybe you look at the blogs with the sidebars and the graphics and the ads and the widgets and think, “Man, I don’t know how to do all that!”. You don’t have to do all that! All you have to do is start posting. One post. Later, if you want, you can add a blogroll or a few widgets. But the way to start is to begin writing, and keep writing. People will come for your content. Everything else takes a back seat to that.
2. Promotion, Ur Doin’ it Right
You’ve just put up your first post. A few folks might stumble on your site by accident, but you need to get out the word that you’re on the web. This is where you start promoting your blog. The best way to do this is find a carnival for your niche and submit a post. For those of us in the medblogging community, examples would be Grand Rounds, Change of Shift, Patients for a Moment and The Handover. Make your url part of every email signature and blog comment you send. Write it, and they will come…but they need to know you’re there.
3. Prolific Perfection…Not
Blogging can be addicting, and in a good way. It can be challenging, therapeutic, frustrating, and energizing – all in one post! But…you do not have to be the “perfect” writer. Just find your style and run with it. And while consistent posting makes it easier for readers to find your blog, you control your posting schedule. “Prolific” is what you say it is, be it once a week or once a day. But know this: the more you write, the easier it becomes to write; the more you are interacting with the blogosphere, the more inspiration you will find and the more you will want to write. It’s the blogosphere “circle of life”!
So…if you ask me, should I blog?
I’ll say YES!!!!
Been there, still doing that, and if I can do it, you can do it.
It will clarify your outlook.
It will recharge your batteries.
It will change your life.
Really, the bottom line?
You’ll never know unless you write…
That first post.
*This blog post was originally published at Emergiblog*
September 2nd, 2009 by BarbaraFicarraRN in Better Health Network, Health Tips
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Have you ever been in a public bathroom and noticed the number of people that don’t wash their hands?
It doesn’t matter where you are.
You can be in a mall, an airport, a hospital, a restaurant, a school, a concert, work, a sporting event and the list can go on and on.
People are not washing their hands.
Hand Washing Isn’t Sexy
Okay so this topic isn’t so sexy. Not like FOX NEWS Health’s Featured Story: “Catwalk Confidence” that highlights a fitness class to teach women to “strut their stuff” in stilettos or FOX NEWS “FOXsexpert” who lets you know that size does matter.
It’s Not Sexy but It Does Matter
It matters because simple hand washing can stop the spread of germs, and can prevent infections including the Swine Flu.
In a recent story on CBS news, it’s reported that in a new survey it found that “87 percent of respondents wash their hands after using public bathrooms, but one percent of those only rinsed with water.”
It also reports that “people haven’t changed their hand washing habits in light of the swine flu outbreak.”
Whether the study is accurate or not who knows, the fact is that there are some people who are not washing their hands, and some people only rinse with water? What’s up with that?
Are You Doing It Right?
If people are washing their hands, are they doing it right? Are they lathering up long enough? Do they sing “Happy Birthday” twice? Turn off the faucet with a paper towel?
Take Notice Next Time You Use A Public Bathroom
You’ll be shocked by the number of people who do it wrong or worse, don’t do it at all.
Why Are People Not Doing It?
Why do people not wash their hands? Why aren’t they changing their hand washing habits in light of the swine flu? Hand washing is so simple. If it can keep nasty germs away and prevent the swine flu and other viruses, why aren’t people doing it? Why?
CDC Offers Great Info
It’s no secret that hand washing is the single most effective way to stop the spread of infection. The Center for Disease Control (CDC) offers helpful information.
Here’s a simple step-by-step guide:
- Wet your hands with warm running water
- Apply soap.
- Rub hands together vigorously to make a soapy lather.
- Rub all surfaces including your wrists, between your fingers, back of your hands and under your fingernails and cuticles, and around any rings.
- Rub your hands for 15-20 seconds.
- No timer is needed; just imagine singing “Happy Birthday” x 2.
- Rinse your hands well.
- Dry your hands using a paper towel or air dryer.
- Use your paper towel to turn off the faucet if possible.
- Always use soap and water if your hands are visibly dirty.
Love the Alcohol Based Hand Sanitizers
If soap and water are not available use alcohol based hand sanitizers. They work great, and they are easy to carry with you.
With the start of school fast approaching, moms and dads encourage your kids to wash their hands after using the bathroom and before eating.
What’s Your Experience?
Do you wash your hands? Do you notice people washing their hands in public bathrooms or not? We would like to hear from you. Any suggestions to help spread the word?
*This blog post was originally published at Health in 30*
August 31st, 2009 by MotherJonesRN in Better Health Network, Opinion
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I hate it when I can’t get into conversations that are happening on my own blog. My job at UGH (undisclosed government hospital) has a way of getting in the way of my real life. Jeanne T. has asked a lot of valid questions about healthcare reform. She also asked me to answer some of her questions. Here we go:
Have you read HR: 3200?
I have not read all of H.R. 3200 – America’s Affordable Health Choices Act of 2009. Reading War and Peace is more entertaining than reading a congressional bill, so I only got through about 150 pages of text before my brain cells started imploding. However, I did learn a few things about the proposed legislation. No one is going to kill your grandma or reduce Medicare benefits. This new legislation will save money by cutting billions of dollars in overpayments to insurance companies and eliminating waste, fraud, and abuse. Maybe that’s why the insurance industry is spending billions of dollars to defeat this bill.
Question: Do you currently have money taken out of your paycheck
for Social Security?
Do you believe that you will receive Social Security assistance when you pass the age of 65, 70?
What is the reason that you and I will not receive Social Security checks?
Answer: Do I have money taken out of my check for Social Security? Is the Pope Catholic? The good people at UGH take money out of my check every two weeks for Social Security, and I know that I’ll never see that money again.
I’m a nurse for life, which means I’m not going to retire. In other words, I’m going to die with my Nurse Mates on. Unfortunately, I believe that my peers are going to receive meager monthly social security checks after they retire. I know where you are heading with this question. “If the government can’t run the Social Security Administration, what makes you think that they can run a public health care system?” It’s all President Franklin Roosevelt’s fault. The social security system is the ultimate Ponzi scheme, and Roosevelt set it up as a safety net to help out old folks just before they died. The average life expectancy back when Social Security was set up was around 60 years old. President Roosevelt got messed up because he thought he we would always have more money coming in than going out. He didn’t know that our life expectancy was going to go up, and he had no idea that future administrations were going to tack on more entitlement programs. Now Roosevelt’s Ponzi scheme is out of control, not so much because of government mismanagement, but because we aren’t dying off quick enough to make the system work. Hey, wait a minute. Maybe we need to rethink those death panels. Just sayin’.
Question: Can the US government run a public health insurance agency?
Answer: Yes, I believe our government can do whatever we have the will to do. We put a man on the moon didn’t we? If those blood sucking, profit driven, insurance companies who make their money by keeping us away from healthcare providers can run insurance companies, why can the US government? Uncle Sam wants to keep us around until we’re too old to work so we can keep paying into the social security system. See above.
Question: How do you feel about politicians writing healthcare reform versus healthcare professionals?
Answer: I think that healthcare providers are in a better position to understand the lingo and the fine details that go into healthcare bills, but that doesn’t necessarily make them more trustworthy when they champion causes. The letters “MD” does not mean anything if the person lacks integrity. In my opinion, Dr Howard Dean is a man of great integrity. By the way, there are three nurses in Congress: Eddie Bernice Johnson (D-TX), Carolyn McCarthy (D-NY), and Lois Capps (D- CA). I’ve had the honor of meeting each one of these fine ladies. They rock! Johnson and Capps support public option healthcare reform. McCarthy’s website reports that she supports H.R. 3200 – America’s Affordable Health Choices Act of 2009.
That’s it for part one. I’ll write part two later. Like I said, working at UGH has a way of getting in the way of my personal life. It’s been nice talking to you. Keep the conversation going while I’m working this weekend at UGH.
*This blog post was originally published at Nurse Ratched's Place*
August 21st, 2009 by CodeBlog in Better Health Network, True Stories
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Just over a month ago, our unit had several H1N1 flu patients. And they were sick. Really really sick. They were also fairly young – 30’s to 50’s. I wondered at the time why the media hullabaloo about the flu had died down when I was seeing more and more patients in my unit who had it.
Last time I worked there was only 1 flu patient and they weren’t too sick (yet?) to require a ventilator. I was really glad to see the decrease in this particular patient population. I won’t lie – it’s frightening to be a nurse caring for someone with a highly communicable disease. Masks, gloves, gowns are all provided by the hospital, but I can’t ever shake the feeling that I’ve somehow come in contact with it despite these precautions.
And what of the times that we admit patients and don’t know they have a communicable disease? At least one coworker I know of contracted H1N1 from taking care of a patient who had it before we knew they had it.
I’m sure she was quite shook up – every single patient who turned up positive for the flu in our unit in that time period ended up literally fighting for their lives on a ventilator.
The most harrowing patient we had was a woman in her 30’s who was pregnant. Like the other patients, every time she coughed on the vent, her oxygen saturations would decrease to the 80’s and would take a long time to come back up. Unlike the others, though, she was so fragile that sometimes merely coughing on the vent caused her to go into asystole.
I’m somewhat jaded about coding people at this stage in my career. I remember, as a brand new ICU nurse, talking to a well-seasoned ICU nurse. She said that hearing “code blue” being announced overhead didn’t give her any kind of adrenalin rush anymore. At that time, I couldn’t imagine being in that frame of mind. Being new, I was expected to go to every code blue that was called so as to get experience. My heart started going into SVT at simply hearing the word “code.” If the word “blue” came after I practically had to defib myself before running off to defibrillate the patient.
I eventually got to a place where I could fairly confidently go run a code without freaking out. I’ve been an ICU RN for 11 years. In those 11 years, there have been some awful codes. Two stand out in my mind, and the absolute worst was on the pediatric floor. When I heard “code blue, pediatrics” overhead, my first (naive) thought was, “little kids code???” My second thought was to wonder if it was really an adult overflow patient. Sometimes the gyn surgeries went to the pediatric floor if there was no more room on the surgical floors. You know, maybe one of them got a little too much morphine and the nurse called a code. A little Narcan, a few bagged breaths and everyone would sigh with relief and go on with their day.
No such luck. After running full speed up 3 flights of stairs, I arrived at the room that had the most people spilling out of it only to find a bald, thin 5 year old in the bed. I thought I was going to be sick. PICU nurses – bless you all. I could not do that for any length of time.
She didn’t make it. Having been a nurse for a couple of years at that point, my naivety about the world already had a few chips and cracks in it. But on that day a huge chunk fell out.
Since then I’ve come to be more like that seasoned ICU nurse that I spoke with so early in my career. Along with the semi-jaded “oh crap, a code blue” comes a confidence in one’s abilities, so it’s not all bad.
However, watching that woman go into asystole, knowing that we would have to crash c-section her if she stayed in it? That took me back to the days when I was new and inexperienced. I’ve never seen anything like that happen. Although I was perfectly comfortable with my (pre-arranged) personal role, the overall situation would be completely new to me.
Although HIPAA prevents me from saying much more, I will say that I did not have to experience that situation; not because I was off when it happened but simply because it never happened.
If it had, it surely would have made my top 3.
*This blog post was originally published at code blog - tales of a nurse*
August 18th, 2009 by Emergiblog in Better Health Network, Health Policy, True Stories
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She didn’t eat her dinner Friday night.
By 4: 30 am Saturday, the previously healthy 65-year-old female had a fever and lower extremity weakness. A family member heard her repetitive moaning. The patient got up to void, but could barely negotiate the one step up to the hallway. As she negotiated the hallway, she staggered.
By 5:00 am she was in the ER.
*****
The patient was taken to an exam room. Vital signs were taken and it was noted that the patient’s fever was “extremely high”. The doctor came into the room and the temp was re-taken. Extremely high. The patient had no insurance and was not verbal; the doctor discussed options with the family member.
The goal: find the source of the fever and begin treatment. A CBC, Chem 14, a urinalysis, an IV and hydration would be started. No lactate level would be done; the doctor stated it would be pointless to run a test that she already knew would be elevated based on clinical presentation. Blood cultures would be drawn, but not sent immediately. As the doctor explained, they are expensive and it would take days before the test results would be back.
In this facility, payment was expected at the time of treatment and a detailed estimate was provided to the family. The low end of the estimate was the deposit.
*****
By 8:30 am Saturday, the fever was still raging; the lab tests were normal. The patient was in ice packs with a fan in an attempt to lower the fever. An IV antibiotic was initiated; hydration was on-going. An internist and a neurosurgeon were consulted as the patient was experiencing lower back pain in addition to the profound weakness. The patient was admitted.
Further tests were proposed: lumbar x-ray to rule out spondylitis and, given the patient’s age, a chest x-ray to rule out occult pneumonia. The pros and cons of each test were fully explained along with rationale and the cost.
*****
The radiographic exams were normal. A loose bowel movement that morning had been blood-tinged. The patient had been medicated for pain. A second antibiotic was started. The next step would be an abdominal ultrasound, as no obvious source for the fever had been found. The rationale for the test and the cost were discussed and the family gave the go-ahead.
The spleen. Enlarged and mottled on ultrasound. A call was made to the family to discuss needle aspiration to rule out lymphoma.
*****
Monday morning the patient’s fever was down. She was eating. She was voiding. She was still weak, still moved slowly and awkwardly. She would be discharged home on oral antibiotics with the results of her spleen aspirate pending.
*****
It’s been a week now and the patient is acting 100% normally.
The patient was my dog, a 10-year-old, 70 pound Shepherd mix. We still don’t know what nearly killed her last weekend. The spleen aspirate was abnormal, but not lymphoma. The fact that the fever responded to antibiotics (as did the weakness) leaves us with the feeling that it was an infection in such an early stage that the source was not obvious.
I realize veterinary medicine is not human medicine, and a million holes can be found in my attempt to draw a parallel between them. But a few things crossed my mind during this experience:
(a) Tests were not done just for the sake of testing or because a printed standard said they should be. This was not template medicine dictated by any outside organization or government regulations.
(b) The doctor/patient relationship was unencumbered by insurance company approvals, government regulations, billing, coding or the number of patients that had to be seen in a certain time frame.
(c) there was full transparency regarding what each test would cost.
Maybe the human health care system can take a few pointers from what the veterinary world has been doing all along.
(P.S. I just realized you can read this story from the vantage point of ME being the third-party payer standing between the vet and my dog, deciding what would be “covered” – i.e. paid for. Interesting either way….)
*This blog post was originally published at Emergiblog*
