Transcript of #RNchat for November 4, 2010

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Twitter.com/RNchat
RNchat.org
Moderated by @PhilBaumann

Welcome to #RNchat everyone! Today's topics will be from

rnchat @paloaltomedical - Say Hi to them as we get started with introductions!
nursingpins Thanks @paloaltomedical for your participation. #RNchat
PaloAltoMedical Hi Everyone! Looking forward to the #RNchat!
FreshRN Hello @PaloAltoMedical! Look forward to chatting with you =) #RNchat
pamressler Hello @paloaltomedical #rnchat
PaloAltoMedical @nursingpins Thank you! Glad to be here with you all! #RNchat
IVchat Greetings to all, hello @paloaltomedical!! #RNchat
PaloAltoMedical @pamressler Hello to you too. Thanks for joining today's #RNchat!
--& ;gt; (non-clinical) advocate for patient centered care, involved w/
renee_berry @Y_A_H_A @hcsmSV @KLXmedia ( @paloaltomedical patient) #rnchat
Thx! Looking fwd to chatting w/you too! RT @freshrn: Hello
PaloAltoMedical @PaloAltoMedical! Look forward to chatting with you =) #RNchat
Thanks - Greetings to you too! RT @ivchat: Greetings to all, hello
PaloAltoMedical @paloaltomedical!! #RNchat
T1 Are your job responsibilities changing with the advent of health care
rnchat reform? How? #RNchat
(In case ya missed it :) RT @rnchat: T1 Are your job responsibilities
rnchat changing with the advent of health care reform? How? #rnchat
Think community edu is super important but I may have to lurk on this
renee_berry question bc I wouldn't be able to provide clinical perspective #rnchat
Great question - curious here, too RT @rnchat: T1 Are your job
responsibilities changing with the advent of health care reform? How?
NAPH1981 #RNchat
 T1 - As far as I can see NOTHING has changed - and getting worse with
nursingpins ratios and staffing. #RNchat
We are happy to be joining #RNchat today! RT @RNchat T1 Are your job
PerfectServeInc responsibilities changing with the advent of health care reform? How?
T1 the only change I have seen is the initiation of & ;quot;swing beds& ;
factnurse quot; and not sure that is r/t HCR #RNchat
nursingpins Glad to see NAPH1981 #RNchat
RT @NAPH1981: Great question - curious here, too RT @rnchat: T1 Are
your job responsibilities changing with the advent of health care reform?
renee_berry How? #RNchat
factnurse T1 - our ratios and staffing are getting worse as well #RNchat
Greetings to all, hello @paloaltomedical! RN in community mental Health
Gracetx FT Worth Tx #RNchat
T1 From an admin perspc mor regulatory focus also seeing changs in staffn
visiting_nurse due 2 cuts in MCR reimbursemnt for home health #RNChat
Hey all lurking at the mo and making school lunches, T1 ur reform not
chemosabe relevant down under, our reform coming too, not sure how yet #rnchat
Ooooh I am late. Sorry - Hellow #RNChat - Terri here - just finished an
onlinenursing elluminate class with students.
T1- nothing changed yet. But lots of planning and meetings with community
Gracetx stakeholders to see what it means for us #RNCHAT
T1 I'm from California where we have state-mandated nurse/staffing ratios,
FreshRN so we don't have as much as a problem with it I think... #RNchat
@nursingpins I am going to agree with Vernon - no changes yet, too many
NUR3563 scared of not making $ - so decreased staffing. #RNChat
factnurse T1 what changes can I as a staff nurse expect to see? #RNchat
onlinenursing @chemosabe hey down under! Good to see you! Here in #RNChat
IVchat T1 - affecting outpt. services as well. #RNchat
chemosabe @onlinenursing thanx Terri, 0550 Fri here #rnchat
RT @visiting_nurse T1 we haven't seen cuts yet but anticipate them 2 cuts
Gracetx in MCR reimbursemnt for Community MH #RNChat
RT @IVchat: T1 - affecting outpt. services as well. #RNchat (Yes - diabetic
onlinenursing foot clinic closed at local hospital) #RNChat
 @factnurse you can expect to see more patient navigators, team-based care,
NAPH1981 coordination, etc ... #hcr #RNchat
RT @naph1981: @factnurse you can expect to see more patient navigators,
CGreaves team-based care, coordination, etc ... #hcr #RNchat
RT @NAPH1981: @factnurse you can expect to see more patient navigators,
FreshRN team-based care, coordination, etc ... #hcr #RNchat
awesome, so important RT @NAPH1981 @factnurse you can expect to see
renee_berry more patient navigators, team-based care, coordination #hcr #rnchat
RT @NAPH1981 @factnurse you can expect to see more patient navigators,
PerfectServeInc team-based care, coordination, etc ... #hcr #RNchat
@NAPH1981 Who is responsible for implementing those changes?
FreshRN #RNchat
factnurse @NAPH1981 Okay, I guess that makes sense #RNchat
T1 You will see more patient advocates - which will will help improve
nursingpins patient care. #RNchat
@NAPH1981 were you involved in advocating for increased #RN patient
renee_berry navigators in #hcr ? #rnchat
@factnurse you can expect to see more patient navigators, team-based care,
onlinenursing coordination, etc - sounds like a job for nursing! #RNChat
RT @nursingpins T1 You will see more patient advocates w/ #hcr - which
renee_berry will will help improve patient care #rnchat
rnchat Shoulder tap: Next topic coming up in a moment! #RNchat
T2 How do you personally maintain excellent standards of care in the face
rnchat of budget cuts and pressures? #RNchat
RT @Gracetx: same hre sum of the community benefit programs R in
visiting_nurse jeopardy/cut services staff nurses R having 2 make more visits #RNChat
T1 @FreshRN theyre delivery system reforms included in #hcr. some need
NAPH1981 additl regulations from HHS before they can be implemented #RNchat
RT @nursingpins: T1 You will see more patient advocates - which will will
PaloAltoMedical help improve patient care. #RNchat
T1 others are grant programs that states and/or other entities can apply for
NAPH1981 and implement #RNchat
chemosabe T2 personally or within work unit? #rnchat
 Good question! RT @rnchat: T2 How do you personally maintain excellent
FreshRN standards of care in the face of budget cuts and pressures? #RNchat
T2 #RNChat - same as always: Look for evidence,/research, listen to
onlinenursing advocate for pt. family, be innovate, be cost cutting.
interesting q RT @rnchat T2 How do you personally maintain excellent
renee_berry standards of care in the face of budget cuts pressures? #rnchat
T2 - It is very hard to maintain standards - unfortunately I have seen the
nursingpins integ. of nursing decline because of ridiculous staffing. #RNchat
RT @onlinenursing T2 same as always: Look for evidence/research, listen
renee_berry to advocate for pt. family #innovate #rnchat
T2 - difficult, only a few (conscientious ones) would care to keep up b/c of
IVchat low staffing, increased pt. load. #RNchat
@onlinenursing That can be tough to be innovative and cost cutting at the
PerfectServeInc same time. #RNChat
T2-challenge have to figure out what might not get done when hv less staff.
Gracetx OR what can unskilled staff do if we have less nurses? #RNchat
@renee_berry we have been lobbying to include everyone in care
NAPH1981 coordination - nurses, physicians, social workers, you name it! T1 #RNchat
T2 Many corners are being cut and many things are not being done.
nursingpins #RNchat
Exactly! RT @PerfectServeInc @onlinenursing That can be tough to be
Gracetx innovative and cost cutting at the same time. #RNChat
@nursingpins I concur. We are lucky if we get to eat and go to the
factnurse bathroom. 12hr days are usually 14hrs at least now. #RNchat
so true.. RT @nursingpins: T2 Many corners are being cut and many things
IVchat are not being done. #RNchat
T2 Hospitals will be the biggest obstacle to safe staffing and hc
nursingpins improvement. They will not allow it without mandate. #RNchat
@factnurse We are lucky if we get to eat and go to the bathroom. 12hr days
chemosabe are usually 14hrs at least now _ paid overtime? #rnchat
the documntatn declines 2 RT @IVchat: so tru.. RT @nursingpins: T2 Many
visiting_nurse corners R being cut many things R not being done. #RNchat
 @NAPH1981 awesome, I'd love to learn more abt your efforts! I've been
renee_berry fascinated w/ @HospiceAction community legislative action #rnchat
RT @IVchat: so true.. RT @nursingpins: T2 Many corners are being cut and
FreshRN many things are not being done. #RNchat
@visiting_nurse T1 #RNchat TX is going to cut 10-15-20% of community
Gracetx health programs bcuse state funds shortage. Myb #her will help?
so u dont kno if it is not getting done or not documentd T2 Many corners R
visiting_nurse being cut many things R not being done. #RNchat
@nursingpins T2 Hospitals will be the biggest obstacle to safe staffing and
chemosabe hc improvement _ industrial action by hcw? #rnchat
So true!!!! Scary! RT @nursingpins T2 Many corners are being cut and
Gracetx many things are not being done. #RNchat
nursingpins T2 It is documented - but it is not done. #RNchat
FreshRN Wow RT @nursingpins: T2 It is documented - but it is not done. #RNchat
Yikes! RT @Gracetx: T1 #RNchat TX is going to cut 10-15-20% of
visiting_nurse community health programs bcuse state funds shortage.
RT @PaloAltoMedical: RT @nursingpins: T1 You will see more patient
HospitalFocus5 advocates - which will will help improve patient care. #RNchat
ExactlyRT @visiting_nurse so u dont kno if it is not getting done or not
Gracetx documentd T2 Many corners R cut things R not being done. #RNchat
At fully staffed, or decreased staffing? RT @nursingpins T2 It is
PerfectServeInc documented - but it is not done. #RNchat
IVchat scary...RT @nursingpins: T2 It is documented - but it is not done. #RNchat
I find not doc not done too often RT @nursingpins T2 It is documented -
Gracetx but it is not done. #RNchat
chemosabe T2 adage downunda is if it is documented it didn't happen! #rnchat
nursingpins @PerfectServeInc short staffed. #RNchat
not sure HCR will help tho bcuz many nonprofits rely on Medicare to
subsidize Medicaid community health programs RT @Gracetx: T1
visiting_nurse #RNchat
factnurse I find doc not done more often than I would like to admit #RNchat
T2 Nurses and patients are obviously both suffering...something needs to be
FreshRN done #RNchat
 RT @FreshRN: T2 Nurses and patients are obviously both suffering...
nursingpins something needs to be done #RNchat
rnchat Shoulder tap: Final topic coming up in a couple minutes! #RNchat
@nursingpins I'm afraid advocates can advocate - but will it do much good
factnurse if there isn't enough staff to take care of pt #RNchat
RT @dorameulman: #NYC health department shows EMR's help primary
docs improve care. http://bit.ly/bnFI1H #health #MDChat #RNChat
CernerPhysician #hcsm
In Austin yest./dept state health sd plan on T1 #RNchat TX is gonna cut 10-
Gracetx 15-20% of community health programs bcuse state funds shortage.
T3 What areas of health innovation do you think are most important to
rnchat patient care? #RNchat
@rnchat T2 Denver RN here - my hospital had a major layoff this year, our
WillowRN pt loads are too heavy. Too much goes undone. #RNchat
Many claims being denied due 2 vry issue w/ increase in noncompliance w/
visiting_nurse accrd standrds @Gracetx: I find not doc not done 2 oftn #RNchat
@factnurse Patient advocate groups will pressure hospitals to post their
nursingpins unsafe staffing and more #RNchat
RT @rnchat T3 What areas of health innovation do you think are most
PerfectServeInc important to patient care? #RNchat
RT @nursingpins: @factnurse Patient advocate groups will pressure
FreshRN hospitals to post their unsafe staffing and more #RNchat
RT @rnchat T3 What areas of health innovation do you think are most
renee_berry important to patient care? #rnchat
RT @rnchat: T3 What areas of health innovation do you think are most
CGreaves important to patient care? #RNchat
T3 I think before we innovate any further, we need to solve the problem of
WillowRN staffing hospitals. More nurses would be innovative #RNchat
2ndRT @factnurse: @nursingpins I'm afraid advocates cn advocate - but
visiting_nurse will it do much gd if thr isn't enough staff 2 take care of pt #RNchat
factnurse @nursingpins thats good #RNchat
T3 The biggest inov. I've seen are touch pads that allow patients to see x-
nursingpins rays and all kinds of info at the bedside. #RNchat
 I've been very impressed w/ e-patient movement, advocating patients to
renee_berry participate in their care http://ow.ly/34D5Y #rnchat
RT @nursingpins T3 The biggest inov. I've seen are touch pads that allow
PaloAltoMedical patients to see x-rays and all kinds of info at the bedside #RNchat
T3- need to b open 2 nontraditional collaboration w public community
Gracetx health. Use promotoras etc. #RNchat
Do you think that will help patient care,or patient communication? RT
PerfectServeInc @nursingpins T3 The biggest inov. I've seen are touch pads.. #RNchat
T3 Also fascinated with the strength of the #hcsm community encouraging
renee_berry stronger sources for reliable online #health information #rnchat
nursingpins T3 communication helps care in all areas #RNchat
agree RT @Gracetx T3- need to b open 2 nontraditional collaboration w/
renee_berry #PublicHealth community #rnchat
I think anything that shortens the hospital stay will benefit the patient
factnurse #RNchat
RT @renee_berry: T3 Also fascinated with the strength of the #hcsm
community encouraging stronger sources for reliable online #health
jodyms information #rnchat
T3 - patients are already innovative...seeking out info using social media..
IVchat #RNchat
T3 think this is a great #innovative resource for #oncologists
renee_berry #communication skills http://ow.ly/34DcS #cancer #rnchat
T3- Are there issues with nurses spending too much time trying to reach
PerfectServeInc physicians, etc? Improve coordination of care--& ;gt;more time? #RNchat
T3 I've seen more informed patients in the last year than the prev. 10.
nursingpins #RNchat
T3 #RnChat what would be great is incorporating the pts TV into a demo
WillowRN system, so pt could view xrays, call RN, etc from the touch screen.
RT @renee_berry: T3 think this is a great #innovative resource for
CGreaves #oncologists #communication skills http://ow.ly/34DcS #cancer #rnchat
same! RT @renee_berry: impressed w/ e-patient movement, advocating
NAPH1981 patients to participate in their care http://ow.ly/34D5Y #rnchat
 cool cc @epatientdave RT @nursingpins T3 Ive seen more informed
renee_berry patients in the last year than the prev 10 #RN #rnchat
@PerfectServeInc reaching phys is only a minor problem - that I have seen.
nursingpins #RNchat
@thesournurse I totes posted that to the wrong account, but you should
grimalkinrn lurk on #RNchat when you get a chance, lots of good info.
Thanks! RT @nursingpins @PerfectServeInc reaching phys is only a minor
PerfectServeInc problem - that I have seen. #RNchat
#RnChat T3 Also, forget touchpads, could we just get more manageable
WillowRN beds and call lights?? THAT would be huge.
tech that allows more intensive services to be provided in home
environment supportive of Hospital @ Home program by Hopkins T3 -
visiting_nurse #RNchat
Yes! RT @nursingpins: T3 I've seen more informed patients in the last year
hcsmSV than the prev. 10. #RNchat #hcsmSV
T3 experience as patient: & ;quot;buzzers& ;quot; for urgent care so you can
go wait in your car, was awesome when I had migraine @paloaltomedical
renee_berry #rnchat
Wow Rt @renee_berry T3 & ;quot;buzzers& ;quot; for urgent care so you
can go wait in your car, was awesome when I had migraine
PerfectServeInc @paloaltomedical #rnchat
RT @hcsmSV: Yes! RT @nursingpins: T3 I've seen more informed patients
jodyms in the last year than the prev. 10. #RNchat #hcsmSV
lots of patients w/ blogs, twitter, FB RT @nursingpins: T3 Ive seen more
IVchat informed patients in the last year than the prev. 10. #RNchat
@renee_berry T3 is it like those buzzers they give you when you're in line
FreshRN for a busy restaurant? #RNchat
@FreshRN exactly, I was in excruciating pain, got to go sit in quiet.. Talk
renee_berry about patient-centered, can't express enough gratitude #rnchat
@renee_berry oh, that's awesome! I haven't seen that yet personally but I
FreshRN hope to soon #RNchat
Five yrs ago you wouldn't have seen this RT@kevinmd RT @efalchuk: Five
jodyms Tips 4 Diagnosing Yourself on the Web: http://bit.ly/cSgC9X #RNCHAT
 T3 another nice innovation with touch pads - phys can see x-rays EKG's
nursingpins from anywhere. #RNchat
factnurse Innovation: 1st I've ever done this. #RNchat
RT @FreshRN: @renee_berry T3 is it like those buzzers they give you when
IVchat youre in line for a busy restaurant? #RNchat
T3 best innovation - transforming care at the bedside - good old fashioned
chemosabe pt focussed care!!! #rnchat
rnchat Fast fast hour! We'll wrap up in a few moments. #RNchat
RT @chemosabe T3 best innovation - transforming care at the bedside -
PerfectServeInc good old fashioned pt focussed care!!! #rnchat
@chemosabe and innovation can be an extension of pt. centered care.
nursingpins #RNchat
rnchat Before we leave, give us your parting thoughts or wishes. #RNchat
RT @renee_berry: T3 think this is a great #innovative resource for
erlanovation #oncologists #communication skills http://ow.ly/34DcS #cancer #rnchat
@PhilBaumann #IsCool T3 how about TweetChats for improving #health
systems #AWESOME #innovation opening doors/spreading good ideas
renee_berry #rnchat
By all enjoy thursday nite, i'll try enjoy fri at the coal face! @nursing pins, of
chemosabe course tech is helping transforming care! #rnchat
IVchat Nurses rule!! Thank you for the chat! Bye! #RNchat
factnurse So glad I did this. How often is the chat? #RNchat
PerfectServeInc Enjoyed our first #RNchat today. We will be sure to attend more!
Same RT@NAPH1981 @renee_berry: impressed w/ e-patient movement,
Gracetx advocating patients to participate in their care http://ow.ly/34D5Y #rnchat
Thanks for another opportunity to share ideas and discuss important
FreshRN topics! Together we can make a difference #RNchat
THANK YOU, everybody! And thank you @paloaltomedical for the topics.
rnchat Transcript will be up soon! Next chat TBA. #RNchat
Official End of Chat

Additional Remarks:
nursingpins Thanks to RNchat and all interested. - and what @FreshRN said. #RNchat
 Don't forget it's National #Hospice Month this November http://ow.
renee_berry ly/34Bzs #myPassion Thanks for a great Chat! #rnchat
Love it RT @WillowRN T3 #RnChat wd b great incorporating pts TV into
Gracetx demo system, pt could view xrays, call RN, etc from the touch screen.
Final thoughts: Thanks to nurses for providing patient-centered care and
PaloAltoMedical advocacy! #RNchat
nursingpins Thanks to @paloaltomedical #RNchat
TY too! RT @rnchat: THANK YOU, everybody! And thank you
@paloaltomedical for the topics. Transcript will be up soon! Next chat TBA.
PaloAltoMedical #RNchat
Looking forward to next time! RT @rnchat THANK YOU, everybody! And
renee_berry thank you @paloaltomedical for the topics. #rnchat
RT @renee_berry: Don't forget it's National #Hospice Month this
November http://ow.ly/34Bzs #myPassion Thanks for a great Chat!
WhatNursesDo #rnchat
RT @PaloAltoMedical: Final thoughts: Thanks to nurses for providing
renee_berry patient-centered care advocacy! #RN #nurse #rnchat
Gracetx RT @nursingpins: Thanks to @paloaltomedical #RNchat
T3 #RNChat (late joining)-research team approach similar to onc. Will
DrDeanBurke require hi tech to coordinate and communicate. doc, nurse,soc.ser
Thanks to @RNchat for hosting and allowing us to join in today. We
PaloAltoMedical appreciate everyone who participated ( watched). Voices!! #RNchat
Thanks to you too. Enjoyed learning and sharing! RT @nursingpins:
PaloAltoMedical Thanks to @paloaltomedical #RNchat
rnchat @PaloAltoMedical Thank you! A great chat! #RNchat
Great to chat with @paloaltomedical today during #RNchat. One of our
PerfectServeInc board members is on staff at @paloaltomedical --& ;gt;Dr. Aigen.