Politically Active

This is the letter I sent to my Representative regarding SB 263:


Ryan:

I don’t get wrapped up too much in political wrangling but when this issue came up and I realized I actually know my representative I had to contact you. I am a Registered Nurse. I work at McKay Dee Hospital in the Emergency and Acute Psychiatric departments. I have a Bachelors Degree in Nursing, minor in Philosophy (WSU) and am better than half way through a Doctorate in Nursing Practice at the University of Utah. I tell you this so you know that I am coming to the issue of nursing education with quite a bit of experience on the subject. If you aren’t familiar with this bill, SB263 seeks to modify the Utah Nurse Practice Act specifically Part 6: 58-31b-601. At present this allows DOPL and the Board of Nursing to dictate the requirements of nursing education programs by division rule making.

I don’t know the exact motivation that Mr. Davis and Mr. Newbold have in mind when bringing this forward but it seeks to amend provisions within the practice act as to who can accredit and approve nursing education programs. I have no general objection to amending the Nurse Practice Act with regard to specifying accreditation and approval and I can even understand why there are some schools that are nervous about being restricted by rules rather than specific legislation. However, none of the schools currently operating as accredited in Utah are affected by the current rules. They appear to be promoting this legislation to preempt rules they are concerned might be offered in the future. There is no urgency in addressing the issue of accreditation and therefore we have all the more reason to ensure that the legislation be carefully and properly crafted.

That said I do have a concern with the way in which the current version is offered. As drafted it effectively cuts out DOPL and creates a gap in oversight of nursing programs. Currently Utah operates under the same model of accreditation approval as every other state. By changing the accreditation process in this way Utah will be be utilizing a completely different model of monitoring than any other state. The Utah Nurses Association and the State Board of Nursing are unclear as to how this proposed change might affect the schools currently operating in the state. Nursing is a highly technical, highly skilled, pivotal position within our healthcare system. We cannot afford to have nurses entering the workforce who have recieved inadequate schooling and training. This does a disservice to not only the student but places a burden on our healthcare facilities as they try to re-train new nurses and a burden of risk on our community members who are recieving medical care at the hands of nurses.

With all of this in mind SB 263 falls short of an appropriate piece of legislation – one that is well understood, well thought out and maintains or improves the integrity of the program it is designed to govern. SB 263 is none of these things. I encourage you to vote No on SB 263.

If you have any questions or concerns please feel free to contact me.

Sincerely,

Jeremy Norton BSN, RN

If you feel like jumping on the Bandwagon you can find talking points from the UNA here and you can find out who your representative is here.

New Things - Module 6

Hard to believe that 12 weeks and 6 modules are done.

*(Please note that the previous statement is merely commentary and should not be construed as a pining for the semester to continue.)

It is also hard to come up with only one thing  that I learned in this module. If I had to pick, I think that I would emphasize the realization that I had as to how powerful and ultimately necessary information technologies are, especially when we talk about healthcare reform, controlling healthcare costs and the role of support systems. I think I expected this to be a course more about charting and documentation storage systems (which would have been really boring) but instead the totality of informatics is much broader and more integral to healthcare than I anticipated it would be. I admit, I'm not going to run out and add an informatics degree to my education plan, my plate is full enough. But the role that informatics plays and the ways  that I can be involved with it as a provider were very pertinent to my future plans.

Now.... what to do with this blog?... I think it needs another re-purposing.

Module 5 - Decision Making

I consider myself good at making important decisions. The irony in this is that I'm actually pretty lousy at making small decisions. Important decisions usually have some amount of data or information associated with them that allows for comparison. When you are making the comparison you can give weight or credence to one aspect over another. A system of analysis can be put into place that ranks the data on importance and pertinence leading you to eliminate some choices and promote others as you ultimately make a final decision.

Small decisions on the other hand are problematic. I can almost never make up my mind (for example) on which restaurant  I ought to eat at without resorting to something like a coin toss. (By the way, if you grab what you think is a penny it behooves you to verify that it actually has a 'heads' and a 'tails' otherwise, as it turns out, you haven't made any real progress). I think this is because everything is weighted fairly equally in small decisions where bigger decisions actually have parts with some weight behind them. Equally weighted 'big' decisions are the stuff moral dilemmas are made up of.

From a clinical standpoint I realized that I have no significant objection to 'cookbook' medicine as the use of algorithms and decision systems is sometimes called. I think the competent, confident clinician can use their clinical judgement and be guided rather than threatened by the additional support provided by these systems. It was however, a bit of a wakeup call for me reading about Heuristics and Biases because I tend to be a very intuitive person when I have to make rapid decisions and according to our reading the majority of individuals don't actually 'get it right' when they rely on  these decision makine shortcuts; makes me want to brush up on my formal logic and be a little more careful in my critical thinking. This is not to say that all decsions should only be made in a logical fashion, but when it comes to important snap decisions I could probably be a little more prepared.

Unit 4 (and four weeks to go but whose counting?...)

There is a certain amount of symmetry that I felt just had to be acknowledged in the timing of this particular blog post. Really the fact that there is only 4 weeks and 3 days, 2 modules and 1... (well I'm sure there is one of something left this semester related to this class) also had to be pointed out. There. Pointed.

This weeks topic is two-fold. We want to have a short dialogue about the role of teaching in our profession and we also want some input on mobile devices (read: smart phones). Apparently I have Algernon in my pocket tonight, I can't think of any other reason why I'm speaking in the plural here... So, on to teaching.

My current professional role is as a team-lead on an inpatient psychiatry unit, and as a staff nurse in an ED. As a team lead I have been assigned to mentor 5 of the staff nurses so I assist them with their goals and encourage them to improve their clinical knowledge etc. This involves some teaching as does the primary role of a team-lead on any unit - putting out fires. This requires the ability to educate patients, family members and nursing staff as the primary strategy for defusing a situation. In the ED I get to provide ongoing education to my patients: the reason for a particular therapy, the interpretation (read: plain language) of their diagnostics, appropriate follow up, medications, etc. The truth is there isn't any nursing role that I can think of that doesn't require some teaching in some fashion even the occasional  nurse in the middle of nowhere who gets elected to be the County Coroner probably has some obligation to public health teaching (although technically you don't need any medical background to be a Coroner so technically it wouldn't be a nursing job, even if you were a nurse... Moving on...)

And on that note... on to 'mobile devices'. Just a quick reminder for anyone who needs it (or if you just need a good laugh) this is my phone. I'm baby-stepping into the 21st century and just added texting to my plan. I'm steeling myself for a data-plan addition this fall and then will embrace assimilation by the Borg having the internet in my pocket.

My informatics class has a 'Mobile Device' wiki. Right now it looks like a large directory of sites without much text, but they look worth using for some research.

Check out my poll on the right side of this page and help a guy out by giving me some input. If you select Droid and have a model I should seriously consider leave me a comment with your suggestion. If you select 'or...' please let me know what I'm missing out on by not considering it. If your name is CeCe please only vote for the IPhone once. I promise to count it as 10 votes if you leave me a comment (or at least leave me a comment saying how many times you voted eh?).

Anticipatory...

The emphasis from this weeks readings and assignments in N6004 - Intro to Information Technology center on the use of technology to access and manage information resources especially those related to the development of evidenced based practice.
The assignment for this weeks blog is to discuss how I anticipate this information will help me in my graduate coursework. I jumped right into the readings before I looked at the assignments so I've already developed a pretty good idea, based on prior experience and the course reading how information management and storage systems are going to benefit me throughout my coursework.
1) Efficient storage and retrieval systems are essential to manage the massive amount of data and information available to us via the electronic databases currently available. Learning the specific tools and rules of operation that each database employs means I will be able to spend less time digging and more time synthesizing information. Getting back 25 hits on a search topic rather than 2500 makes all the difference in the world.
2) Personal use reference management software such as EndNote, Biblioscape or Qiqqa  makes the writing, citation and referencing process smoother. There is a learning curve but I can see the benefit of a good program that applies the right citation and reference format as I type, leaving me free to focus on the analysis of information rather than what APA 6th edition says about the third citation in the same paragraph of an article written by 12 authors and 1 organization published on a website that no longer exists. Ok, probably even EndNote couldn't handle that scenario but you get the idea. I've tried two different strategies for hand insertion of references, the 'type citations as I go and edit later' option; as well as the 'go back and figure out the citations later' method. They are both tedious, produce iffy results and don't quite get to what the APA had in mind with regard to consistency in citation, at least, not without a lot of work.
With these ideas in place and anticipating the benefit that comes from understanding information management I am going to take the opportunity to explore some of the reference management software out there. I was required to use EndNote two semesters ago and was only moderately impressed with the user interface. It seemed like a powerful platform in desperate need of an update. I hope to take the time to look at a couple of the different software options although, truth be told I probably will stick with EndNote, at least for now as my schedule doesn't really accommodate learning curves very well right now.