Saturday, February 19, 2011

Nurses’ funny hospital chart bloopers, ScrubsMag.com

Back by popular demand! We’ve been running some articles featuring charting disasters (goofy chart bloopers and crazy chart bloopers) lately and must admit…some seemed too wild to be true.

So then we asked our readers: Do you have any good ones to share?

Well, these all-new funny hospital chart bloopers were submitted by you, so they must be real!


1. “A 24-year-old woman oriented to person, space and time.”
—submitted by Liz R.

2. “Pt alive but hope to remedy situation by AM.”
—submitted by Michelle Steinbach, RN, critical care nurse for 14 years

3. “Alert and organized x3”
—submitted by Evelyn Kathleen

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See also: http://www.nursinghumor.com

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Why medical students are burning out and lacking altruism, KevinMD.com

Recently, AAFP News Now released an article titled, Unprofessional Conduct Among U.S. Medical Students Linked to Burnout.

It focused on an article recently released in JAMA entitled, Relationship Between Burnout and Professional Conduct and Attitudes Among US Medical Students.

I had the opportunity to be interviewed for this article and was featured on an inset within the article that shared a minority of my interview. As I am currently rotating on inpatient medicine at a local community hospital, I am once again experiencing our health care system at its finest – a lot of wasteful spending and unnecessary testing. I am taking a look back at what I had wrote down for the interview and decided to paraphrase the majority of my response into the following blog post regarding the health care system and medical education.

When looking at the advances we have made in biochemistry, genetics, and molecular biology, we are being asked to know so much more information in much greater detail – and still within these 4 years worth of medical school.As more requirements are created and more scientific advances are brought forth, more time is needed in lecture and studying for tests like the USMLE and shelf exams. Most traditional programs are 4 years with 2 years of foundational science and 2 years of clinical experience.

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Caring For Elderly Parents: Top 10 Concerns | cdaamerica

By AgingCare.com

Parents care for their children, to strengthen body and mind, and
nurture them forward to independence. Siblings, grandparents, aunts and uncles, cousins and even friends and neighbors often join in the family circle, helping to care for the kids. Such is what caregiving is all about, a nurturing,
supportive commitment by family and extended family members. Many of us have the opportunity to return that same level of commitment and support to Mom, Dad or both as they age.

It is time to return the favor, not just individually, but as a family, to
provide support where necessary and preserve your parents’ ability and
independence as long as possible. What are the 10 most important family concerns in caregiving for a parent? Consider:

1. Rally the Troops

Deborah Halpern, Communications Director for the non-profit National Family Caregiver’s Association, urges that caregiving your parent is not a one-person job or burden. Instead, you should have a family team that includes friends and neighbors, each with a role and responsibility in the caregiving process. There must be a ringleader, according to Halpern, who contacts each family member with the invitation or challenge to”step up to the plate and help.”

Consider the team concept as akin to hiring for different jobs in a company.
Everyone is good at something, while he or she may be inept or less than
qualified in another task or field. When several family members are involved,
even for just a few hours each week, the burden on the primary caregiver is
reduced significantly. Sharing responsibilities also brings more family members
into active contact, sharing, support, monitoring, understanding and visiting
with Mom or Dad.

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Traumatic Brain Injury, Legal Nurse Consulting, Law Resources

Legal Nurse Consultants specializing in Traumatic Brain Injury Issues:

Louise Cardillo, R.N. B.S., Cardillo Consultants:"Legal Nurse Consulting firm for ten years. I am a strong liason between attorney's, clients and experts. The strength of all cases is in meticulous attention to detail of medical records and choosing the appropriate expert. This aspect of consulting will bring your cases to closure with damages often above expectation. Experience in this field is critical to the success of working with a Legal Nurse Consultant. In addition, the nurse must have a strong clinical foundation and education.
1190 Honeoye Falls 5 Points Rd.
Honeoye Falls, New York 14472
E-Mail: louLNC@frontiernet.net
http://www.nursingexperts.com/cardillo/

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Brain Injury Association of America:"The Brain Injury Association of America was founded in 1980 by a group of individuals who wanted to improve the quality of life for their family members who had sustained brain injuries. Despite phenomenal growth over the past two decades, the Association remains committed to its grassroots. The Brain Injury Association of America encompasses a national network of more than 40 Chartered state affiliates across the country as well as hundreds of local chapters and support groups. By acting as a clearinghouse of community service information and resources, participating in legislative advocacy, facilitating prevention awareness, hosting educational programs and encouraging research, the Brain Injury Association of America and its affiliates reach the millions of individuals living with the "silent epidemic" of brain injury."
105 North Alfred Street, Alexandria, VA 22314
703-236-6000, fax 703-236-6001
FamilyHelpline@biausa.org
http://www.biausa.org/

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Brain Injury Information Page:"The Brain Injury Information Page provides information about brain injury, concussion, coma and head injury, for TBI survivors, spouses and caregivers. Our goal is to provide education and assistance with the process of diagnosis and proof of brain injury, sometimes called head injury. This page features articles, information and graphics about traumatic brain injury. Our View of Advocacy: We of the Brain Injury Law Group make our living as advocates. But advocacy implies more than being a lawyer. It means dedicating oneself to the community we serve - the survivor, the family member of the survivor, the medical professional. To that end, we have created this home page, to provide information, resources and links, to help you learn and solve the problems you face."
http://tbilaw.com/

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Florida Institute for Neurologic Rehabilitation, Inc. (FINR):"Brain injury and head injury rehabilitation information and resources from The Florida Institute for Neurologic Rehabilitation. FINR helps Brain injury survivors, both children and adult. The Florida Institute for Neurologic Rehabilitation, Inc. (FINR) is dedicated to excellence in the provision of rehabilitation, education and vocational services to both children and adult survivors of brain injury. Through the provision of individualized assessment, restorative service and foundational retraining in behavior, psych-social, cognitive, physical functioning, communication, daily living, education and vocational area, FINR seeks to assist its clients in attaining their maximum level of functioning and quality of life in the most normalized and least restrictive environment."
http://www.finr.net/

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Traumatic Brain Injury Information Page, National Institute of Neurological Disorders and Stroke (NINDS):"Traumatic brain injury (TBI) occurs when a sudden physical assault on the head causes damage to the brain. The damage can be focal, confined to one area of the brain, or diffuse, involving more than one area of the brain. TBI can result from a closed head injury or a penetrating head injury. A closed head injury occurs when the head suddenly and violently hits an object, but the object does not break through the skull. A penetrating head injury occurs when an object pierces the skull and enters the brain tissue. Several types of traumatic injuries can affect the head and brain. A skull fracture occurs when the bone of the skull cracks or breaks. A depressed skull fracture occurs when pieces of the broken skull press into the tissue of the brain. This can cause bruising of the brain tissue, called a contusion. A contusion can also occur in response to shaking of the brain within the confines of the skull, an injury called "countrecoup." Shaken baby syndrome is a severe form of head injury that occurs when a baby is shaken forcibly enough to cause extreme countrecoup injury. Damage to a major blood vessel within the head can cause a hematoma, or heavy bleeding into or around the brain. The severity of a TBI can range from a mild concussion to the extremes of coma or even death. A coma is a profound or deep state of unconsciousness. Symptoms of a TBI may include headache, nausea, confusion or other cognitive problems, a change in personality, depression, irritability, and other emotional and behavioral problems. Some people may have seizures as a result of a TBI."
http://www.ninds.nih.gov/health_and_medical/disorders/tbi_doc.htm

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National Resource Center for Traumatic Brain Injury:"The mission of the National Resource Center for Traumatic Brain Injury is to provide relevant, practical information for professionals, persons with brain injury, and family members. Many of our products were developed by nationally recognized experts. We have more than 20 years of experience developing intervention programs, assessment tools, and investigating the special needs and problems of people with brain injury and their families."
Virginia Commonwealth University's Medical College of Virginia
http://www.neuro.pmr.vcu.edu/

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The Perspectives Network, Inc.:"The Perspectives Network, Inc.'s primary focus is positive communication between persons with brain injury, family members/ caregivers/friends of persons with brain injury, those many professionals who treat persons with brain injury and community members in order to create positive changes and enhance public awareness and knowledge of acquired/traumatic brain injury."
Mailing Address: P. O. Box 121012, W. Melbourne FL 32912-1012
E-Mail Address: TPN@tbi.org
http://www.tbi.org/

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Rehabilitation Research Center (RRC) for Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI):"The Rehabilitation Research Center (RRC) for Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) conducts research to better understand and improve outcomes after TBI and SCI. Outcomes studied include the functional, vocational, and life satisfaction areas that are important to people with and without disabilities."
Rehabilitation Research Center for TBI & SCI 950 South Bascom Avenue, Suite 2011 San Jose, CA 95128 San Jose, California
phone number is 408/295-9896 Fax the RRC at 408/295-9913, tbisci@tbi-sci.org
http://www.tbi-sci.org/

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TBIchat.org:"Homepage for brain injury survivors & caregivers with pictures, stories, poems, art gallery, message board, question of the week board, homepages, & email lists."
http://www.braininjurychat.org/

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Traumatic Brain Injury LawyerShop:"Traumatic Brain Injury Lawyer Shop is a resource that allows you to find information from lawyers in your area who provide legal services pertaining to traumatic brain injury, TBI, closed head injury, concussion, and coma. While most legal directories offer some information about traumatic brain injury and TBI, the most valuable information comes from an attorney or lawyer who has experience involving traumatic brain injury lawsuits, coma lawsuits, concussion lawsuits or closed head injury lawsuits."
http://www.tbilawyershop.com/

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Traumatic Brain Injury National Data Center (TBINDC):"The Traumatic Brain Injury National Data Center (TBINDC) at Kessler Medical Rehabilitation Research and Education Center is the coordinating center for the research and dissemination efforts of the Traumatic Brain Injury Model Systems (TBIMS) program funded by the National Institute on Disability and Rehabilitation Research (NIDRR). The TBI Model Systems consist of 17 comprehensive systems of care distributed throughout the United States that conduct innovative research and provide “model” care to persons who experience traumatic brain injury. The TBIMS program seeks to improve the lives of persons who experience traumatic brain injury, their families and their communities by creating and disseminating new knowledge about the course, treatment and outcomes relating to their condition."
Traumatic Brain Injury National Data Center c/o Kessler Medical Rehabilitation Research and Education Corp.
1199 Pleasant Valley Way West Orange, NJ 07052
http://www.tbindc.org/

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Prepaid Legal Services: There are many matters that you encounter on a daily basis which have a legal aspect, for instance, motor vehicle accidents and other types of injury claims, estate planning, probate and estate administration, matters pertaining to employment, sale or purchase of real estate, consumer transactions, auto repairs and sales, family and juvenile law, landlord/tenant issues, insurance matters, business, bankruptcy, tax and workers compensation. Literally, everything we do today touches upon the law in one way or another. With Prepaid Legal, you'll receive unlimited phone conversation/consultations on any legal matter at no additional cost.

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See also:

MedMal Consulting:'MedMal Consulting is a Physician owned and operated full-service medical malpractice evaluation and medical negligence consulting support firm. MedMal Consulting has doctors, legal nurse consultants, and medical legal litigation support personnel to assist with every aspect of your medical negligence case. Established in 1992, Dr. Herman and MedMal Consulting have over 18 years of experience in the medical legal field and have assisted in obtaining more than $147 million dollars in verdicts and settlements in medical malpractice cases."
MedMal Consulting, Inc.
P.O Box 391153
Cleveland, Ohio 44139
Phone: (216) 744-8907
Fax:(440) 248-8257
eMail: info@medmalconsulting.com
http://www.medmalconsulting.com/

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Send comments and mail to Andrew Lopez, RN

Last updated by Andrew Lopez, RN on Monday, December 6, 2010

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Friday, February 18, 2011

7 Best Practices For Hospitals and Social Media | Hospital Financial and Business News

Kevin Troutman is a partner at Fisher & Phillips LLP in Houston and serves as the chair of the firm's Healthcare Practice Group. Additionally, Mr. Troutman has more than 17 years experience in healthcare management positions, once serving as the senior HR manager for 22 hospitals in five states. Mr. Troutman outlined seven best practices for hospitals to consider regarding social media and hospital employees.

1. Update your policy to include social media. Roughly one-third of employers have enacted policies that address employees' use of social media sites, says Mr. Troutman. While this number is growing, employers still aren't catching on as quickly as expected, especially since sites such as Facebook or Twitter will never phase out but only evolve. "Hospitals need to address social media — they can't just proceed as though they don't exist," says Mr. Troutman. He said most hospitals already have strong confidentiality policies in place, but these need to be amended to include specific parameters for social media use.

2. Decide how much restriction employees will face while at work. Some hospitals have enacted prohibited social media policies for employees, while others have restricted their use all together. While this decision may vary from hospital-to-hospital depending on the work environment, Mr. Troutman shares some general advice. "Encourage employees to minimize the use of personal websites or personal activity while they are on work time. You have to recognize that, once in a while, employees will need to send a personal e-mail. But generally, the policy should be this: while at work, you do work. "

3. Train supervisors so they don't inadvertently create problems. In the ambiguous realm of friending, private messages and wall posts, supervisors need to anticipate potential problems regardless of their intention. For instance, a supervisor sending a friend request to a lower level employee could set up potential claims of fraternization, harassment, or — in extreme cases — stalking. Mr. Troutman shared an instance where a supervisor signed into a Facebook account under another username to look up an employee's social media activity, which could be considered defrauding the employee or invading his/her privacy.

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Community colleges make push for state lawmakers to allow them to offer some four-year programs | MLive.com

Registered nurse Stephanie Palmer wants to earn a bachelor’s degree in nursing, but she’d like to do it at Jackson Community College.

It’s close to her home and less expensive than a four-year college. Plus JCC offers greater scheduling flexibility for working parents like her, said Palmer, 35, of Michigan Center.

That can’t happen under current state law.

But officials from JCC and other community colleges on Friday lobbied state lawmakers to allow traditionally two-year colleges to offer a handful of four-year programs, saying it will help the state’s economy by making it easier for people to prepare for good, in-demand jobs. The House and Senate community colleges subcommittees was holding a joint session on JCC’s Summit Township campus.

The House last year passed legislation to allow community colleges to offer bachelor’s degree programs in four majors, including nursing. The legislation stalled in the Senate. It is expected to be considered again this year.

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This would work nicely with the push for more BSN prepared nurses.

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Released hospital patients' many unhappy returns

Patients who are released from the hospital too early or without proper planning and instructions often wind up back in the hospital after a few days, a problem that's costly to taxpayers and distressing to patients.

A study released today calculated that reducing hospital stays by a single day for Medicare and Medi-Cal patients in California adds up to $227 million a year.

An estimated 81,000 Medicare patients in California - or 20 percent - end up back in the hospital within 30 days of being discharged for some reason related to the same condition, the study found.

"Right now, when you go to the hospital, it's the do-it-yourself model. It's up to you to figure out what to do," said David Grant, author of the study for the California Discharge Planning Collaborative, a group of labor, senior and other advocacy organizations.

Patients, especially those who are elderly and lack social support, are often readmitted because they don't understand their discharge instructions, fail to take their medications or have complications that they can't handle.

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C. Difficile Spreads from Hospital to Community, ACG from MedPage Today

Clostridium difficile infection has spread from the hospital to the community but has proved manageable thus far, according to data reported here.

From 1991 to 2005, the incidence of community-acquired C. difficile in Olmsted County, Minn., quadrupled but still remained less common than the hospital-acquired gastrointestinal infection, Sahil Khanna, MD, of the Mayo Clinic in Rochester, Minn., said at the American College of Gastroenterology meeting.

"Patients with community-acquired C. difficile infection were younger, more likely to be female, and less likely to have severe infections," Khanna observed.

Epidemiologic studies have shown an increasing incidence of both nosocomial and community-acquired infections. However, few studies have looked at the incidence of community-acquired C. difficile, said Khanna.

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Medtees - T-Shirts that Empower Patients With Illnesses

T-Shirts for the Irreverent Patient
It's been a tough year, help them laugh about it. MedTees make a great gift idea for the Holiday season that says “We’re all in this together!”

Best Sellers

Pacemaker/Defibrillator Patients

Psychology/ADD/OCD

Heart Disease

Cancer Patients

Diabetes

Rehabilitation

Burn Patients

Amputee Patients

On the lighter side :)

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Sick doctors who work are doing more harm to their patients than good

Doctors: if you’re sick, don’t go to work.

The stereotype of doctors is that they go to work, despite whatever symptoms ail them. Calling in sick places strain on colleagues. Especially in residency, where team members are expected to pick up the slack.

In a recent column, the New York Times’ Pauline Chen discusses the image of self-sacrifice that a sick doctor going to work portrays:

Hacking, febrile or racked with the sequelae of chronic illnesses, doctors who are sick have continued for generations to see their patients. Although published reports for over a decade have linked patient illnesses like the flu, whooping cough and resistant bacterial infections to sick health care workers, as many as 80 percent of physicians continue to work through their own ailments, even though they would have excused patients in the same condition.

In today’s age of H1N1 influenza and other assorted public health worries, presenteeism is being looked at. Interestingly,

researchers in the business world have begun to question this assumption. Instead of focusing on problems incurred by absenteeism, these researchers have analyzed the impact of what’s been called presenteeism, or working despite being ill. And it turns out, at least in early studies, that those employees who choose to go to work sick are expensive. Presenteeism costs companies more than $150 billion a year in lost worker productivity.

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