PixelRN

Goodbye to Wordpress!

Notice anything different?

 As you can see I've taken a very bold and radical step. I've migrated my entire blog over to posterous. Why such a bold move? Once again, my former site has been hacked, due to wordpress security issues. Maybe I'm partially to blame. I've been very neglectful of my site and I haven't been diligently upgrading my wordpress code to avoid these annoying hacks. But you know what? This is about being realistic. It was either this or start selling viagra on PixelRN (if you can't beat 'em, join 'em, heh heh.)

 So now I have this low-maintenance, elegant solution. I love the minimalist design of posterous, although I am hankering to customize it (which you can't yet do with posterous). I also wish I had a sidebar to noodle around with, but maybe that was just a distraction all along. This strips the blog down to what it is in the first place: content, pure and simple.

 You know how I found out I was hacked? I was checking out my stats and I found the search term "having an erection while a nurse is around." I checked the cached page and sure enough found tons and tons of links for cheap viagra. And this time it made me mad. Boiling mad. mad enough to bid adieu to wordpress forever.

 Let's just see how long I can keep up my wordpress free existence.

4 Planes in 4 Minutes

Can you tell I live near an airport?

Wordpress Site Hacked Again

Once again my wordpress site has been hacked again. Now I'm kind of rethinking everything. Do I really need wordpress? What if I just use posterous and point my domain towards it? Hence this post. So I'm trying out posterous and tumblr to see which is more flexible.

Surprise! I love being a nurse again.

Having trouble keeping up with my love-hate relationship with nursing? That's okay, so am I. The good news is that I love it again. I'm almost halfway through my MICU contract and things are going surprisingly well. They didn't quite start out that way. Here's a synopsis: Week 1: In the weeds. All the time. Treading water. Hating life. Crossing off the days until this damned contract is over. Week 2: Getting used to it but damn, this job is hard! How does anyone do this for a living? How did I do this for a living? I've had it up to here with poop and sputum and agitated patients on the ventilator and I wished I were back working in the recovery room, checking pedal pulses and getting turkey sandwiches for my patients. Week 3: My confidence has officially returned and it's starting to feel like I never left. I can kind of see why I actually liked this job, although it's not easy. It's still very challenging. Week 4: Wait a sec... I kind of love this job! Even after a crazy shift of codes, deaths, bleeding, confusion, and difficult patients, I walk out the door feeling great. It's probably just the neurotransmitters. I'm high on adrenaline. I drive home with the windows down and the radio blasting, feeling like I really accomplished something. The next day I wake up very tired but still feeling good. I relax more because I feel like I've earned it. So now I'm loving it so much I'm thinking about returning as permanent staff. I can make this work. It's a big pay cut to leave the agency but I love having a work home, and a work family. My MICU coworkers are absolutely the best, and this job is helping me to remember why I chose nursing in the first place. There's just one teeny weeny little complication. Two, actually. I'm pregnant with twins. So I'm not going to commit to anything just yet. It's one thing to put one kid in daycare, but three? You get to the point where financially you're just barely breaking even. So we'll see. I think the important thing for me is to remember how I feel about being an ICU nurse right now, which is that I love it. After Ben was born I kind of got seduced by that whole social media world and was tempted to migrate away from nursing altogether. But I'm wiser now. And up for the challenge of having 3 kids under the age of 5 for a few years (YIKES!).

Birth Blog Work Death

Wow. I've been so busy getting ready for this guy's 2nd birthday...

...that I totally missed another birthday. This blog turned 4 years old on March 20th! I enjoyed revisiting my first post. It's funny to think of myself as a brand spanking new nurse, worrying about how I was going to handle death. I guess that's pretty much why I turned to blogging in the first place. Speaking of death, I've pretty much pulled the plug on OrientedX3, for a variety of reasons. First of all because it got hacked - not once, but twice (thank you, wordpress). And also because I just don't have time to keep updating it, improving it, and promoting it. I'm still very interested in aggregation though, and particularly twitter aggregation. I felt re-energized this week when I came across this site: Exectweets. This is exactly what I had hoped OrientedX3 would evolve into (with nurses instead of executives, of course). So don't be surprised if OrientedX3 returns - perhaps in the form of a NurseTweets.com. Another reason I felt energized is that there are so many more nurses on twitter now and there are easier ways to find them. But I am still stifled by this same question: Is this type of aggregation useful? Is it valuable? Can nurses benefit from this personally or professionally? I don't know. Sometimes I wonder. I haven't worked a nursing shift since January, so I've been feeling a little out of touch with the profession. I'm sure this will change when I start my MICU contract in April. I'm also very excited to meet some like minded professionals at HealthCamp Philly this weekend! Also very stoked to possibly score a decent cheesesteak while I'm there. Oh, and if you think the title of this post sounds vaguely familiar, here's why.

The White House Health Care Summit: A Nurse's Perspective

On Thursday, President Obama held a summit to discuss our current state of health care. It was attended by representatives of various health care organizations as well as a sampling of senators and representatives. I also had the pleasure of attending. (Okay, I didn't really attend but I watched the live stream and tweeted about it, so that's kind of like attending, right?) At any rate, I think our health care woes can be summed up rather succinctly: We want better health care, for more people, and we want it to cost less. If only the answers were that simple. As you would expect at an event with plenty 'o congressmen in attendance there was lots of complaining and pontificating. Despite that, I managed to suss out some interesting ideas for you ; ) Nurses were well-represented by Rebecca Patton, president of the ANA. As a nurse, I'm proud to say that she was one of the few people bringing actual ideas to the table, rather than just complaining about the situation. She presented the idea that nurses should be allowed to use the full extent of their clinical skills. I took this to mean nurse practitioners should be allowed to practice, and RNs should be utilized more for their clinical skills rather than just doing endless rote tasks and paperwork. She also suggested that more public reporting of outcomes and staff ratios should be required. I think this is a great idea, although it doesn't address the issue of lowering health care costs. A facility that has a low nurse-patient ratio is certainly going to have higher costs, unless they choose to cut corners somewhere else. Daniel Smith, president of the American Cancer Society discussed raising the tobacco tax. The argument against this is if you raise the tax on cigarettes, you will disincentivize people to smoke, hence you will not raise more revenue in tobacco tax. But if the tax hike is significant enough (say by 75%) and the amount of smokers reduces by only 15%, you're going to have a net increase in tobacco tax revenue. Bonus points: This could facilitate a reduction in lung cancer and COPD; thus saving more money down the road. The idea was also presented that we utilize more home care services for chronic illnesses and end of life care. I couldn't agree more. First of all, it cuts down on nosocomial infections, and secondly, I think people would rather receive treatment in their own homes, particularly if we can show that this improves outcomes. Also, what a great way to utilize your nursing workforce. We still have a long way to go towards improving our health care system. There was also a lot of talk of "we're all going to have to pay our share, and sacrifice a little bit," (Wait - wasn't the the whole point to NOT sacrifice better care, and to NOT have to pay more?) Really this just means that some of us will be required to pay higher taxes to fund all of this. One group that was conspicuously missing from the health care summit was doctors. That's unfortunate. After all, doctors are the one group that really spend their time at the intersection between reimbursement and patient care. Shouldn't we be listening to some of their ideas and solutions?

Meet me at HealthCamp Philly!

First off, what is HealthCamp Philadelphia? It's a free mini-conference that gives health care providers and technically minded people the chance to come together and discuss their ideas. So why am I going? First of all, I'm looking forward to meeting some of my favorite tweeps like @holaolah, @LizScherer, and @PhilBaumann in person. Secondly, I'm hoping to have a discussion about the way patient information is exchanged between health care providers. In nursing we like to refer to this as "report." Technology should theoretically allow our reports to be exchanged in away that is timely, accurate, and efficient. We have computerized nearly all the aspects of our health care delivery from ordering, to charting, to health records. Yet our nursing reports still consist of handwritten notes and rushed phone conversations! Why is this? To explain my frustration, I offer you a typical MICU scenario: A doctor goes to the computer and places an order for your patient to go to radiology for a procedure. You haven't seen the order yet because you are in your other patient's room, doing an assessment. You get a phone call. It's the procedural nurse. "Your patient is coming to radiology, right? We haven't gotten your transport sheet yet." "I haven't even seen the order yet." "Well, try to hurry up and send us the transport sheet." (The transport sheet is basically a patient report sheet that you fill out by hand and fax to the appropriate people.) So you finish the assessment while thinking about what meds you will need to give before your patient can leave the floor. You get another phone call. This time it's the transport team. "Your patient is going to radiology, right? We haven't gotten the transport sheet yet. We'll have a team ready in 15 minutes but you have to fax us the transport sheet." "Just got the order. I'll get it to you as soon as I can." As an ICU nurse, you have to grab this piece of paper from the nurses station, open up your electronic chart, and start writing down the information on a piece of paper so it can be faxed to 2 different parts of the hospital. Do you see the folly in this? (I guess you could say the transport sheets are kind of like my TPS Reports.) The flow of patient care has just been interrupted not once, but twice, by people telling you to "Hurry up and fax us the transport sheet!" You're already working with electronic charting. Why do you have to transcribe something with pen and paper? Isn't the whole point of making things ELECTRONIC so that you don't have to do it that way? If another health care provider needs access to this information a patient report should be automatically generated and sent to the appropriate areas of the hospital. Then, if anyone has any questions about the patient, they can call you to get clarification, hopefully without too much interruption. So what's the answer? There are many different ways to solve this problem. I'll focus on one: I believe that twitter could serve as a model for relaying patient information efficiently, timely, and accurately. (And obviously you would address the issue of patient privacy as well.) Bonus points? The 140 character limit forces you to enter the most relevant and concise facts about your patient, so you're not flooded with information that you don't need at that particular point in time. And that's just one use for twitter in the health care arena. Check out Phil Baumann's slideshare presentation of 140 more! Is twitter an oversimplified way of solving this complicated problem? Perhaps. But the point is that we have to start discussing this. The technology exists to make hospitals so much more efficient, and yet I can tell you from a nurse's perspective, we aren't seeing much in the way of innovation. Hopefully in the near future we will be seeing more of these Healthcamp-like events where people can get together and start the discussion.

The Latest in CPR Techniques

(Foreman performs the life saving "titty twister technique" after House OD's on methadone) Renewed my CPR today. In the beginning I was so blase about it. I couldn't believe that the content could actually take up 4 hours and I complained about it. But once I was there I had a better attitude because I remembered that this is pretty important stuff, and so it's important to practice and brush up on your skills every once in awhile. By the end of the class I was really starting to thing that I am ready to go back. I'm not afraid. It's going to be a good thing. Oh sure there will be some tough days (and nights) but I've done it before and I'll do it again. A couple surprises, though: 1. They didn't mention the Stayin Alive factor. Something I find incredibly useful in keeping pace. 2. They didn't mention the "titty twister method." For those of you unfamilliar with this it was on House last week. House went into respiratory arrest and Foreman brought him back with an heroic titty twister. My initial thought? This would be perfect for those who like to fake seizures.

Why I Probably Won't Quit Nursing

I know, I know. Last October I told you I probably would quit nursing. Anyone who knows me, knows that I change my mind a lot. Last week my husband told me I was "whimsical," which I'm pretty sure he meant as a euphemism for "fickle," but hey, I'll take it. It is what it is. So back to nursing. It really just comes down to 3 things: 1. The economy is in the crapper. It's going to get a lot worse before it gets better. I need to save for the future. 2. I don't want to lose my nursing skills, because as of now, they are the most valuable skills I posses. 3. Staying at home with Ben has been great. But he's about to turn 2 and I think we need a little break from each other. I can tell he's starting to get a little bored with our routine. Okay, maybe I'm projecting. Maybe I'm the one getting bored.  Either way, I think a couple days a week of daycare could be good for him. This week I signed a MICU contract. I'll start in April. I'll be glad to get back into the routine, see some old freinds, get back my skills and self-confidence. And I'm kind of glad that I never fully gave up on this whole blog thing, because I have a feeling I'll be have some more stories to tell you. That is, unless I change my mind again.

I am still here.

I'll be going back to the MICU for a contract that starts at the end of April. For a variety of reasons. Still twittering at times but overall have been feeling burned out on the whole social media thing. I made the mistake of following a bunch of Chris Brogan types and all of a sudden my twitter stream turned into this big circus of social media types high fiving each other all day long. After awhile I started to prefer those who tweet about what they are eating. My blog was hacked (again) while I was on vacation. This time it was because I didn't update from Wordpress 2.6 to 2.7. Needless to say, I'm not really feeling the love for Wordpress. But what's the alternative? My husband got me a Nikon D90 for Christmas! I'm really excited to get outside and start shooting away (that doesn't sound good, does it?) but unfortunately it's been so dang cold around here. I have been utterly obsessed with economics, politics and the Great Depression 2.0. I've gone from confusion to outrage to fear to bewilderment and now I'm think I'm starting to make peace with the whole idea. Hence the MICU contract. Don't you just love it when a blog post comes full circle?