Module 6- Plagiarism

Obtaining a doctoral degree has been a very challenging path. It requires many hours of researching topics of interest. Along with research comes the synthesis of ideas that create your own thought. But is it... I appreciated a podcast I listened to regarding the protection of private works, personal writings etc. There is the need for respect of others works but collectively to engage in the process of synthesis it is difficult to be 100% original. It is based on other's works.
When Malcolme Gladwell reflects within this pod cast from the National Radio Broadcast that it was once considered flattery when someone used your work to progress knowledge but now it is termed plagiarism. The discussion on Shakespeare borrowing from other's writings was a revelation. The concept of using existing knowledge ie. other's works to further knowledge seems plausible.
However, the bottom line expectation that you provide credit to that knowledge seems reasonable and practical. So....just learn how to reference other's works when writing. Don't get caught in a plagiarism trap. Someday you will generate the idea that led to new knowledge and others will credit your work.
 Podcast can be viewed by going to podcast and searching plagiarism. I couldn't link, sorry.

Clinical Decision Making

If you have an opportunity to view a website that was part of our class on Informational Technology in the Decision Support for Care Delivery I would recommend this link: http://www.youtube.com/watch?v+dddFfRaBPgg.
Decisions that affect the health of another individual can be at times anxiety producing.  There are times when questions are presented along a very familiar pathway and the decision is straightforward. But there are times when variables change, new information must be interpreted and decisions are not as straightforward.

This video gives insight into how we manage information and use either intuition or reasoning or both.
Very informative.

Module 4 Teaching in Nursing

I have found that nursing is a highly integrated 'teaching' profession. The emphasis to 'teach' the patient about their health, teach the public about communicable diseases, teach students about normal maturation and teach the novice nurse as a role model have been closely woven in our profession. I recently heard a highly respected cardiologist at a conference make the profound statement, " we did a study and concluded that congested heart failure patients do better when taught about their disease". Okay, I wanted to get into a debate but held my tongue and rolled my eyes.

I cannot envision a role in nursing that does not involve teaching. I am not sure all nurses are teachers but I know that my baccalaureate coursework had us on 'index cards' provide patient education on everything we did that would involve direct contact with the patient. I know that patients appreciate this aspect of our profession. A frequent comment by patients is that "you take the time to explain what it is and what you want to do".

We have at our disposable so many technologies to expand our abilities to be effective teachers. I have added a link that may be interesting for those who use PDA's I phones or other sources of mobile devices. Enjoy.
Mobile device link

Module 3- Information Retrieval or Becoming a Pubster

Pubmed is a fascinating electronic index. If you have a question related to caring for patients it allows you to search and find an article that may give you the answers. For those who have had the pleasure of doing research through the iconic library books, copying at the cost of hundreds of dollars, writing on index cards... this is nothing short of miraculous. There is some tediousness to the process of learning the method of searching. I highly suggest starting at the information videos that the library offers and then just practice.

The National Guideline Clearinghouse was a site that I have rarely used to search for an answer to a clinical question. I have been at the site doing specific research on my Capstone but it was to download a published guideline that I had knowledge of. Searching in the compare mode was excellent. I gained as much from the headings that the comparison guidelines use to present their information as the actual information. This is a very strong evidence-based site that is easily accessed and has clear instructions on finding information. At this time in the evolution of EBM there is a paucity of guidelines but I am sure that over the next decade this site will provide guidance for clinicians who are looking at effective, quality care guidelines.

Google is the People's choice awards. Fast, efficient source for data...but data is information not knowledge. There is a real concern about the misinformation and propaganda that can be found on this site. Given that information, a prudent researcher/clinician looking for specific information will need to make sure and check the sources of the data and determine its evidence level as it is left for the reader to determine.

So PUBMED on into the wee hours of the night. You might still be thirsty  but you will be well on your way to more articles than you will know what to do with.

Module 2- Information Systems in the Workplace or WE NEED AN INFORMATICS NURSE SPECIALIST

At the onset of  enticing the physician owners to buy-in to the concept of Electronic Medical Records, the administrative team did their initial homework. They had several physician owners on the committee to investigate the options. We had a meeting where the selected vendors presented their 'product'. Unfortunately the concept was like a foreign language in 2003. I personally had minimal experience with EMR so anything seemed plausible.
Once the EMR was selected (NEXTGEN) the administration developed a strategy for implementing. Since the physician at my clinic was one of the more "technology-savvy" our clinic got to launch the program.  Immediately there were so many clinical errors that the providers became quite frustrated. Everything from spelling to organizing templates.....it had not been scrutinized by a INS....
Having utilized the Informatics Center at the College of Nursing, I suggested to the administrator that they needed to add an informatics nurse specialist to help the "nerds" apply the clinical process. Unfortunately, and to the tune of lots of $$$$$$$ they choose the 'nerds' over the 'nurse'.
I feel very strongly that a informatics nurse specialist should be involved with EMR in most settings. The clinic had the other members IE. from coders to department managers but the error in thinking is that physicians understand the process of clinical care..... this is to the detriment of patient care. I wish that I had been more vocal in this suggestion. And, now that I am learning more about the selection process I realize that I could of recommended that I be a part of the committee.
Evaluations are ongoing. NEXTGEN is always updating and every time they "improve" we have to update and that means $$$$$.
Bottom line:  A informatics nurse specialist would of saved our clinic time and money.

Module 1- N6600

By now readers will know that I am a nurse and  what trajectory my career has taken. I provide primary care to a busy family practice clinic in Ogden. I love being a part of the health care decisions that my patients make. I have found my NP practice very challenging and rewarding.  In addition to my practice I am completing the MSN to DNP program at the University of Utah this semester. It has been a tremendously fast-paced, knowledge driven program and I hope I can finish it with the same enthusiasm that I started one year ago! Finally, there will be a few in this class that I have the opportunity to teach in one of their specialty courses. This rounds out my very busy schedule at this time.
Our clinic has a very active Informational Technology department. We are using Electronic Medical Records and have been since 2004. We are connected to both hospitals via internet and are able to access ER records, labs and xrays. What a tremendous aid in treating patients. Our clinic accesses Up-to Date service that allows us to instantaneously search for medical problems and focus on treatment that has evidence-based information for us. Patients can access our clinic website. All providers and employees can access the clinic intranet and find electronic information from insurance to OSHA regulations, policy etc. All providers must carry tablets into exam rooms which allow us to directly access their files.
I feel that technology has produced time-saving technics that directly impact in a very positive way how we provide care to our patients.
As we all struggle to understand the intricacies of Blackboard, I am trying to learn how to interface with technology in the class that I am instructing. This process is much slower as it requires interactions at every level. I am a novice at designing the classroom but hope to tackle it with success as the semester continues.

Becoming a Nurse

Now that you know nurses buy cars, you may be wondering what else 'a nurse' may be doing in 2010. Nurses are incredible professionals. It has been a profession that I am so proud to be a part of. I started my education in a nursing home in Arizona. I had just quit college after 4 quarters of confusion. I needed a job and they needed a nurse's aide. Prior to that "opportunity", nursing was not on my radar or in my universe. I immediately felt challenged in a new way. The RN (registered nurse) mentored me unaware that she was molding a future nurse. I lasted 6 months in that position. I wanted to be a nurse and I needed an education. I applied to Montana State University and was accepted immediately for the next term. I am sure there are numerous blogs regarding the horrors of applying to a nursing program. Mine was simple. I was simply meant to be "A NURSE". So...taking my career to every level, I have been a professional nurse in a small rural hospital, in a Long-term Care facility, in a rural Mental Health facility, a vascular lab, every facet of in-patient care.. Then back to education....I wanted to become a Nurse Practitioner. I applied and was accepted to the Master's Program at the University of Utah and received my Adult Nurse Practitioner Certification. I worked in an indigent clinic with the State of Utah for 7 years and...needed to go back to school again.... I applied to the University of Utah and obtained the pediatric portion of my education and obtained my Family Nurse Practitioner Certificate...I have been working in a privately owned clinic in Ogden in Family Practice and Womens Health but.... oh I needed to go back to school again.....there's the Doctorate of Nursing Practice... WHY NOT! At this time I am working 36+ hours a week, finishing my Doctorate (December 2010) and agreed to be Adjunct Faculty at the UofU for the College of Nursing for one class. So blogging will be my decompression....no APA formatting so I should do fine. deb PS...I realize that you don't comment on your own blog but go up to the little create a post link. Oops.

August 29, 2010 1:33 PM