In Conclusion

Over the last few weeks I have learned several things related to IT. The Management of Information Systems course has proven challenging for me, as well as the Creation and maintenance of the Blog. To be quite honest, before this class I was not even sure what a blog was, how that differed from a web-site, or even how I could benefit from participating in such a thing. Who has the time? What does it really matter? Who reads these things? Is there anyone really out there?
I felt much like the woman in this picture. There were many times that I knew I was doing something that just was not yielding what I wanted....but what the heck was it!? I ventured to parts unknown to me- youtube , and google earth. Interesting areas I must say, and I do realize now that I was missing out on some entertainment. More importantly I managed to stumble upon items of relevance to research I am doing now for work, see the organ donation article below.
I know the answers to those questions now. I know some people from class read parts and some of my blog articles, but more importantly, I found a new form of communication. In a busy work environment, as a manager I am always looking at ways to increase communication abilities within my departments. The number one compliant from staff is that there is a lack of communication. It does not matter how many pieces of paper are attached to a wall, how many bathroom doors (eventually everyone goes there) have the MUST READ lists of information (talk about your captive audience), there are still those that just did not see the memo. The use of a tool similar to a blog would certainly work towards improving communication within a workplace. I guess the realization that all needs are different, all people are different, and part of my role is to ensure all those different needs are addressed in some fashion or another. This has certainly opened my eyes to the possibilities.
On a personal note, I have to be honest in saying I am not sad to see this course end. I found it most challenging of all thus far. I think there were a lot of factors that have come into play to cause this feeling. One, I am not a computer savvy person, and have managed to "fake" knowledge up until now. Someone was always around to hold my hand and direct me in the right direction- two, the time of year is a challenge. We are coming from our winter Bla, and looking forward to warm weather, longing to do other things than dedicate all free time to studies. Family and children are tired of the work I put into these courses. From the mouth of my 3 year old 'mommy....why do you study so long?'. I think- because mommy is stupid!! But reality is I can not accept failure, but have been forced to this time around. So what is important? That I have finished this blog? yes... That class is almost done....yes...That I am taking the weekend to spend time with my family, walk on the beach, let the waves lap at my toes, stand on the edge of what feels like the world, listening to the surf, the birds, my children's giggles of delight, only broken by a "mommy come see what I found!".... that is what is important to me. I have learned I am but one, but sometimes all it takes is one.
Take care all, see you in September.
Amanda

Over the Phone you say?

Health care over the phone... how does that work?

Telehealth has changed the accessibility of health care for many in our country. As technology has advanced, innovative ways to access health care have been popping up. It may seem a little "out there" to think that you can access health care over a telephone, but many provinces have implemented the idea, and they are not loosing on the deal. Manitoba, BC, and Alberta are but a few who offer this service. New Brunswick does as well. Instead of taking a child to the emergency department at night for some reassurance and advise on managing a health issue, access to a registered nurse is available 24 hours a day, 7 days a week. If further intervention is required advice will be given over the phone as to which facility to access.

After surgery, many patients are able to have follow up appointments in their home. Particularly if they are a distance form the health center. This is an issue for much of Canada given our geographical issues. Savings in time, challenges with accessibility, and consistency can be overcome with a little help from a web cam, phone line, and a laptop.

There are other benefits to the telehealth way of delivering care- reduced visits to emergency departments, decreased wait times, efficient care, patient comfort, reassurance to the public, decreased costs. For those who are far away from a heath center can the costs really be measured? To know that reliable safe effective health care is a call away must provide some comfort to those in isolation.

A communication system that gets the right people at the right place at the right time can make the difference between life and death. If you ever find yourself questioning if you should see a doctor, if you are managing an issue that you would like some guidance on, or need some reassurance, look for your provincial provider. They are a call away!

Have you Signed On?

Why Organ Donation? Why is it important to consider organ donation?

Recently I have been involved in a National Collaborative organized by the Canadian Council for Donation and Transplantation to increase the awareness of this issue as well as attempt to increase and amount of donations within our facility.

I have been aware of the importance of organ donation for some time now. Having worked as a nurse in a Neuro ICU setting, I have some first hand experience as a health care provider in managing the issue. I must say it is admirable to see families and friends think of others in a time of deep sorrow and pain. There appears to be a comfort felt on behalf of the family members to know that their loved one has provided such a wonderful gift to someone who is in need- beyond what anyone can truly comprehend. I do not have any personal experience regarding organ donation. I am not waiting for a transplant, nor is anyone close to me waiting. Yet I think I understand how important it is to those who are waiting.

What can I do?

I think we all know people who have benefitted from such wonderful gifts, a "true gift of life". Not many can go untouched in their lifetime without meeting someone is is waiting or who has benefitted. There are literally thousands of people waiting for transplants today. The collaborative to which I belong has made progress in increasing awareness and donors. The collaborative relies on a listserv to keep up to date in each participating organization's process, and we 'steal shamelessly' from each other. The information that is distributed through this important communication tool is saving lives! We need to educate our staff, and provide them with the tools to identify those patients who may meet the criteria to be an organ donor, to have the knowledge and skills to approach family members and loved ones in such a difficult time, and most of all to offer to those who wish to participate the chance to do so.

The most important thing that can be done right now is to talk to your family. The people around you need to know what your wishes are. I have seen those who knew what their loved one wanted if they were ever in the situation, and the stress is significantly less. Most provinces and states have central registries that maintain information related to a person's wishes for organ donation, and legislation in some areas exist in support. In New Brunswick a data base is maintained via our Medicare card. It is known when we access health care services if we wish to donate.

Ultimately you need to talk to your loved ones. Let them know what your wishes are. Organ donation is a wonderful gift. What would you give for another day, another moment, to hold your child, to watch a child graduate, to smell fresh air, many things we take for granted everyday.

Nursing Ethics

Nursing Ethics is the discipline of evaluating the merits, risks, and social concerns of activities in the field of nursing. These are many defined codes of ethics for nurses. Nursing ethics and health care ethics are closely linked, and contain such issues as beneficence and non-maleficence.

The vary nature of nursing provides daily encounters with ethical decisions. Our first priority is to not cause harm, and yet occasionally this occurs. When it does, the reality of all the breakdowns in a system come to light. It is rarely one mistake that causes an outcome such as this. It is typically a series of breakdowns that permit something to happen.

There are many issues that cause nurses and medical personnel to struggle with decisions we make. Are we doing what is best for the patient? What does the patient want/ What does the family want? These are issues that we manage often in the particular setting that I am involved with. End of life, or threat to life is real. Quality vs quantity is the consistent question. Each persons response to what they would do when faced with such difficult decisions is unique. We often use the phase "we make what is the most reasonable and responsible decision at the time". It may come to pass that days or even weeks later, the decision may not have been the best. Can we beat ourselves up as medical personnel and families/patients over decisions that were made? We shouldn't... but we do. The what if? How come? But what if we..? often linger for some time. Especially when we have to look our loved one sin the eyes, or even not be able to look them in the eyes, and ask such deep profound questions. End of life discussions, quality of life discussions, are ones that occur all too often.

The field of Nursing Ethics is so large that it reveals several pages of papers, resource people, standards, policies etc. when accessed via the web. It is obvious that there is a multitude of information out there, but does that make it any easier?

In Canada, each Provincial Association has an ethics committee, New Brunswick is no different. As a member of the association, we have access to resources at the provincial level to assist us when we need guidance. Each organization also has a Chief Nursing Officer, whose responsibility (among many) is to provide direction within the facility on such issues. An issue does not need to be complex to be ethical. Each decision we make has an ethical component to it. Some are just more apparent that others.

In staying abreast of updates, I encourage you to search Nursing Ethics, you will find a multitude of information. Go ahead- challenge yourself.

Safer Healthcare Now!

Safer Health care Now is a National initiative to decrease hospitalized patient complications and mortality rates in Canada. This initiative is an extension of the USA lead 100K Lives Campaign that was created by the Institute for Health care Improvement from Massachusetts, USA. The philosophy is that with the implementation of 6 key strategies in patient care delivery, the USA would save one hundred thousand lives in one year. They managed to surpass their objective, and were empowered to continue the vision further and this evolved into the 5 million Lives Campaign. This campaign has the objective to protect patients from 5 million incidents of medical harm over the next two years.
The six initiatives have a significant impact on the employees and medical staff of an organization, and they also require the support of various services and systems within an organization as well. To achieve the goals outline by the collaborative each team has established leaders. The leaders are able to communicate with their counterparts, as well as support representative through the use of discussion panels online. There are also chat areas set up to help encourage communication within each facility regarding status, challenges of implementation, and above all results. Everything is electronically communicated within a national scope. Participants and leaders also benefit from the technology of teleconferencing, which has linked all participating sites together.

Using Portals to Access Information

The use of Web Portals has become increasingly popular in use to exchange information. The portals allow people with common interests to access information that is meaningful to them. Portals have intricate designs, and are able to provide businesses and individuals with benefits that are difficult to measure.

In an effort to enhance educational information access by nurses, the Canadian Nurses Association (CNA), has developed a nursing portal entitled Nurse One. This nursing portal facilitates access to online CPS (drug book), e-therapeutics texts, electronic medical library, as well as self assessment tools that guide Rn's through their required continuing competencies. With each provincial association in Canada having varied standards for licensing regarding continuing education, the Nurse One portal will prove to be a valuable asset to nurses everywhere. The province of New Brunswick has just formalized a continuing education program for all registered nurses who actively practice nursing in the province. This will require nurses in the province to be accountable for their own continuing education, and encourage those who currently participate in such activities to maintain a record. It is the expectation that those who do not participate in continuing education will be expected to. There are many opportunities locally to participate in ongoing education, everything from small one hour sessions on improvements or changes in current practice, to online journal articles to read and keep abreast of larger issues. The challenges of participating in National Conferences will continue to exists, but with innovative ideas and empowerment, these obstacles can be overcome.

If you are a nurse looking for a different avenue to obtain some education, access the CNA Nurse One website- it is worth it!

Has Nursing Education Changed?

Nursing education over the years has changed dramatically. The profession started many years ago, and gained awareness when Florence Nightingale evoked changed. A young woman of a respected family in England, she claimed to have heard the word of God. Much to her parents' dislike, she pursued what is now the nursing profession. At the time however, nursing was less than a respected profession.

Florence Nightingale went to Turkey, and worked at the bedside of injured soldiers in a hospital. She advocated for change in the delivery of care. She implemented basic things such as clean linen, and cleaning equipment. Because of this, the infection rates and mortality rates in the hospital decreased dramatically in the first 6 months she was there. Relatively basic changes made a huge impact- who would have thought?

Are things really so different today? Florence Nightingale made her dramatic changes in 1854. Today issues and challenges surrounding infection control are around proper hand-washing on the part of medical staff. This is not a new idea, and yet is still important today. Granted, things have certainly changed significantly since Florence went into practice. We have seen the education criteria change for nursing over the years. Once a 2 year program, now a 4 year degree. The changes have been dramatic even since the year 2000. The government of Canada maintains statistical data that shows the trend in nursing is for higher levels of education, even at the masters and Phd level.

Those early days discussed little of ongoing education for the bedside nurses. Mention is made in literature that Florence Nightingale moved to more of an administrative role later in her practice. She realized that change within the profession requires assistance from others. She gained support from the doctors, as well as government to support the growth of the profession. Her passion for caring for people remained. She was known to walk the halls at night of the hospital, checking on the young men who benefited so deeply from her vision and passion. But for her, many would not be there. It is from these nightly walks that she is known as The lady with the lamp.

To answer the question in the title, my opinion is yes, and no. Has it evolved and moved forward? Absolutely. Today we do things that would have only been a dream for those in 1854. Our standards have evolved, and our practice has been enhanced. The original basic components of clean linen, clean environments, but most importantly compassion and caring, the need to feel as though our time has truly made a difference in the life of a person, this has not changed. It is a challenge in our busy workplaces, but we all aspire for that brief moment in time when we know with our hearts that we were right where we were suppose to be. Providing caring, understanding and compassion for someone who just needs to be acknowledged. That is still the heartbeat of nursing, and has not changed in the least since 1854.

Nursing Informatics- What is it?

Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice, according to the American Nursing Standards committee in 2006.

I recently attended a conference on Nursing Informatics that was held locally, and again I was surprised by the content. This area of nursing is one that is often taken for granted. We have all become capable of using the IT tools that have been provided to us to complete our everyday tasks, but seldom do we think about those who were involved in the construction and implementation of these large systems.

An example of one such system is the PHR or the Patient Health Record. Our organization is at different levels of adaptation with regards to a PHR than others. For example, one of our smaller satellite sites is fully automated with the patient care record, meaning that medical staff document on an 'online' chart. One nursing unit within our larger facility is as well. There are plans in the future to get the rest of the organization "on board" with this. But there are many obstacles to overcome first. They are; acceptance on behalf of the users, education, and network support.

Nursing Informatics is nonetheless prevalent in our practice. CNIA is a national organization that is dedicated to the advancement and education of informatics as it relates to nursing. The future of doing business in the health care sector is included in the move to an IT environment. The challenge is to encourage people to embrace IT, accept IT, understand IT, and above all use IT.

Choosing the Right Path

As I did some research into my own continuing education, I found more information than I was prepared for. By merely typing in a few key words, the world seems to be at your doorstep. I struggled with which path to choose. I knew I wanted to complete a masters degree.....I had always wanted that since my early 20s. I thought that I wanted to study education, and therefore did some extensive research. I found some wonderful schools that offered what I thought I was looking for. One that was particularily interesting to me was the St. FX Adult Education Program. I gave this some serious thought for several months. Recognizing that I am not currently in an education role at this time, and the probability of changing my career path in the near future was small, I let go of the idea of an education degree.
This lead me to consider a masters degree in nursing, something which I felt I would not do. For whatever reason, I was never interested in persuing a MN. I had no reason behind this decision on my part, I had a rewarding BN experience, I like nursing, but for whatever reason I just wanted to do something "different". That being said, I went 'online' yet again, to see what was out there. I knew of Athabasca University, as many of my co-workers were pursuing the Advanced Nursing Practice stream. I knew that was not for me. I had made a personal decision that I was done the portion of my career caring for patients directly. I really enjoy being in a mangerial role. I enjoy encouraging people in their own career development. I enjoy the challenge of managing the financial portions for which I am resoponsible, and I really enjoy being a voice of change. That lead me to the leadership stream of the MN. I thought "this is for me". This is what I am going to do.
Having made my decision, I decided to discuss the program with those I knew were currently enrolled. I did not do this before, I did not want people to think I might be interested in pursuing a masters course because then they would ask how's it going, and if I decided not to pursue it, there would be too much explaining, or so I thought. These conversations were eye openers to me. The more I heard, the more apprehensive I got. I am a struture person, nothing wrong with that I am sure, but the notion of me controlling when I do things, trying to juggle the balance of getting online to participate in my our education, I could see disaster. I felt that this would never hit the target in my household. Full time working mom of 2 active boys, looking for time to get online to complete a degree. Knowing myself, I knew that I would only start at 10 o'clock at night. What was I going to get out of that? I can see for those who are well organized, who MAKE it a priority, it would be wonderful. But that is just not me.
So again, I think about what I really want. What do I like? Where am I? Where do I want to be? Does it mean a masters in Nursing, or something else? I need to attend classes, be part of a visible interactive group. And then I remember....MBA. So sitting less than 2 miles from the Universite de Moncton, I log on to their website. I find what I am looking for. Something in my community, that I can physically attend, that is a reasonable time for me. And so here I am.
What I learned from this year and a half of searching for the right program for ME, is that one google search opens doors all around the world. There is something for everyone. I just had to go around the world to find something in my backyard.

Providing Education in a Busy Workplace

As a manger of two busy nursing units, I am often challenged to facilitate the continuing education of my staff members. As with any profession, continuing education is vital. Nurses need to know how to operate new equipment, document new assessments, and even broaden their scope of practice. Facilitating those who are interested in continuing their education is a challenge from several vantages. There are staffing issues, who can I find to replace the person when they are off? There are financial obstacles, who will pay for the education session? For those who are interested and driven to attend, these issues are not barriers. However, for those who are not as motivated as others, these can be huge.
How can an organization facilitate learning in a busy workplace?
In my organization, the Department of Organizational Learning has put in place a comprehensive e-learning database. This database covers a variety of learning requirements. This allows staff to access educational sessions through the use of power-point on any computer in the building as it is available through our intranet. Examples of topics covered are; hand washing, our emergency fire and disater response plan, proper body mechanics when moving patients, as well as a variety of advanced nursing competencies (theory portion). This has proven to be highly successful for those educational sessions that can be delivered in this format. The challenge is that not every topic can be covered in this manner.
What else can we do then?
In an effort to ensure important educational information is communicated, our organization uses learning lunches as a format to offer educational sessions to staff members. This allows staff to participate in vital educational session while in the workplace. This includes new equipement updates, and educational sessions on infectious diseases, to name a few. By using these two ideas we can capture our audiance while they are at work, thus decreasing the requirement of adding another obligation to those while juggling home and work life.