Busy day today! I caught up on classmate postings and started my paper. I am more than half way done, but it is so hard for me to write any more . . . so sick of doing papers!

My time wasting consisted of doing some of my favorite Sunday day things . . .watching CBS Sunday Morning, cooking something in the crock pot, reading the NY Times online, checking out anything that seems interesting online. Today I explored some how-to You Tube videos on how to carve a pumpkin in 3-D. I think I can do it! I watched some Thai chefs create roses out of gourds and melons - so beautiful! Since I have studied roses for 20 years and painted them for 10, I think I can really do this. I need to acquire the proper tools and found some online. I also found a guy that does an extraordinary job of carving a face into a pumpkin. His name is John Argevine and he posted a series of videos demonstrating his techniques. So cool . . . next year I am going to go at it and just carve - skip the patterns!

Also, to feed the creative side, I checked out Rapid e-Learning blog and discovered some cool tips when using PowerPoint. I can save PowerPoint as a flash file and pull it into Captivate and all the animation is done! I want to test this and see how this pulls into our learning management system at the hospital. We use HealthStream, but have not purchased the SCORM file integration nor have we bought the new web application to build course content.  I think our e-learning would be better received if we stepped up our content and interactivity.

As for my practicum progress, I cannot read 15 articles and write the bibliography when I have to read 5 chapters, write a paper, do the DQ's, and post 2xday for 4 days out of the week. It is too much! I will need to pick away at it during the week, but at least I am exploring the e-learning resources on how to create the quizzing content using Captivate and PPT. I spent a half hour on that tonight. 

It is now a little after midnight and what a crazy weather day - trick & sleet day! Ice pelting the windows tonight while I cooked dinner. That was the extent of my artistic pursuits today - marinated salmon and with brown rice pilaf from scratch. Delicious and healthy. Later today, I should cook something that takes time - something in the crock pot maybe . . . pork & sauerkraut would be good on such a cold and windy weekend.

As for schoolwork, I spent the entire day on the computer working on my class deliverables and researching the family values paper that is due on Monday. I still need to write it, but the basics are done. I worked on a couple journal articles and our textbook to come up with the essence of my paper. Family health does impact society and across the world certain familial characteristics are found to be universal. Change theory, which is something we use at work in the nursing informatics world, also applies to families. Targeting the entire family for education effects change more rapidly than trying to educate only one person in the family. 

The learning team that I am assigned to is an alpha group for sure. I prefer it that way and all four of us are go-getters. One member is a bit too much as she is jumping the gun and not allowing the team to weigh in. I emailed the team my concerns and asked that we all have an opportunity to voice our opinion before anything is posted as a group assignment. Gratefully, one teammate responded immediately and agreed with me. I am not afraid to call people to the carpet and voice my opinion. 

A few weeks have passed since I lurked on the Delphi travel nurse message board and found a good post on Dr. Watson, an IBM physician online resource. There are some excellent articles about this application. Check them out - Dr. Watson even went up against the biggest Jeopardy champ.

It is 3:20 AM and I am awake. I have worked on the annotated bibliography for an hour - better than tossing and turning. So, why am I up at this hour? Because I came home exhausted. I fell sound asleep at 7:30 PM in my chair and I finally just went to bed at 9:45. At least I am being productive since I have so much to get done this weekend. My paper is due on Monday - I just barely started that - my 2nd discussion question, and 2 substantive responses. I would like to have this bibliography done as well. 

Yesterday was a catch-up day. I cleaned up email and explored U-Cern which is a Cerner based support and collaboration to manage and learn about the solutions we use in the hospital. I customized my home page there and added a few widgets so that I can create links to areas that I like to explore, such as references pages.

Also, I attended a meeting for mentors and proteges held by our corporate education department. I have been working with a young man that works on our help desk as he wants to move up in our organization. He excels in communicating and wants to teach in some capacity. We have been working together for about four months and it was going well but we seemed to have hit a wall. He was able to see me work in most of my areas of responsibility, but I think he would like to work with my teammates to learn their different roles. Truly, I wish we had been offered this class in the beginning so that we had clearly defined goals. We had a very good chat after this meeting and I encouraged this protege to plan on expanding his education, at the very least he should spend some of his tuition reimbursement on some classes.  

I will start tonight with yesterday's doings. We discovered that parts of the interface to our central fetal monitoring are not working correctly. Admitted patients pick up the patient correctly and admit the patient to the correct room. Outpatients, however, do not get picked up. The staff must manually do this and this leaves lots of room for error. What a challenge to get all the right people to the table to figure this out. The engineer from our organization is on vacation. The interface specialist from the vendor is on vacation. It looks like we will not be able to get everyone together until Monday afternoon. 


Today, was our department's Halloween extravaganza. It was really fun and our team did a great job. I spent hours last night and this morning carving a pumpkin. Next year, I will opt for a more simple design as it shows better in daylight. Here is a warning - fog machines do trigger the fire alarm and the firemen will come. We have some photos as proof!

Tonight, I needed to participate in my family dynamics class. The requirements are to post my answer to the discussion question and respond to at least two discussions. I also got a jump on tomorrow's responses; I can save them as drafts and post tomorrow to receive attendance credit. Saturday the second discussion question is due. Monday, I have  a 1000-word paper due on family values. This is not my favorite topic but I will need to pull out the creativity in order to make it more interesting.  

I am going to read another article to keep working on my annotated bibliography - at least get in a half hour. 

Today was a very long day . . . we started at 0645 on the OB unit doing a central monitoring update. Bringing the system down and pushing out the update was the easy part. The portable monitors proved challenging because of the various settings that seem to become fouled whenever the PC needs a break/fix repair. The ADT (Admission/Discharge/Transfer) interface also stopped working. The vendor needed to adjust a script on their side (the receiving end) and this took all day. About 4 PM, the system was completely up and functioning as designed. 

Of course I did not sleep well in anticipation of all this. Once I got home, I needed to organize all my screenshots of the system validation testing and submit this document along with the email trail of issues we encountered. This turned into a 20-page document. Once I sent this into the clinical analyst department, I signed off the progress to my boss. 

With the clock ticking past 6:00 PM, I checked into my next class at U of Phx - Dynamics of Family Systems. I met the requirements for day one and then worked on my practicum. I read two articles tonight and updated the annotated bibliography (1 hour). Now, I am making sure I blog my progress, as this will be so beneficial to meeting my timeline and keeping track of my time.

If I can stay awake, I will start my weekly discussion questions for my class, one is due on Thursday. Tomorrow night I must carve a pumpkin for a contest at work . . . got to have some fun!

Last night I discovered how to share my entire folder of documents for my practicum with my mentor through Dropbox. It worked! She signed up and has an account - there are many documents to review, but I assigned one folder specifically designated for her. 

Today was a personal day with family to recharge. This will be a very busy week with a computer system upgrade that I am responsible for, plus starting another 5-week class on Tuesday. It is called dynamics of family systems and should be similar to life cycles of computer systems. I signed into the class and downloaded all my materials and started outlining my text book. I will have a paper due next weekend and need to write my bibliography. Busy, busy week.

Last night I watched a Cerner Health Conference video that was presented last year on an academic EHR - Academic Education Solution (AES) that Cerner provides to nursing colleges  for a cost (grants are available to fund this solution). What I found most valuable from this presentation is the design structure of the basic PowerChart components of what I teach to the students. I will model my practicum to follow some of those designs. 


However, there was no mention of the resources available for help with critical thinking skills, such as the resource links embedded in PowerChart. To me, this is the beauty of an EHR, such as PowerChart. The information system is customizable to add links to provide resources right at the patient's bedside. I believe if the students learn from the beginning how to conduct a search using the workstation-based learning supports, they learn to practice evidence-based nursing care. Over time, I believe it is logical that patient care outcomes should improve with improved navigational skills of the nursing staff. This would make a decent research study hypothesis!


For example, if a student receives report on a patient who has a disease process that they have never heard of or they are not familiar with the etiology, they have the ability to research this disease using a variety of embedded tools. 

• Up-to-Date is one resource that is phenomenal; using this tool is similar to searching in a brick and mortar library. 
• Micromedex is a drug search database and an excellent tool to check on IV drug compatibilities, contraindications, etc. 
• The homegrown link we use - Resources/Forms for Printing - is invaluable and designed to save time. Every resource is compiled here for easy access plus links to documents that are frequently printed for the patient. (Example: Advance directive in English and Spanish). This also links into our computer job aides for additional application functionality help.
• Medical Calculators - great tool for critical care areas
• Pathways and protocol site - another homegrown site designed by a multidisciplinary committee for the DRG's to locate the pathways easily

My plan is to teach the navigation of these embedded tools to the nursing students via an audio-graphic presentation using WebEx. This will allow me to reuse this teachable moment for future classes as well as a provide a resource for a just-in-time refresher. That is the heart of my practicum and I hope to demonstrate this journey through this blog!

Innovative ideas

As a member of our IT department's fledgling innovation team, I watch for interesting ideas that can be modeled into the health care arena. Analogous thinking produces innovative uses from one industry to another.

Today on MSNBC, there is an article (right click on links and choose Open in New Tab or Open in New Window) about how many parents research a child's illness prior to going to an ED. I feel new employees or student nurses can apply this increasingly common research technique, as they need to learn on the fly, and who will be doing their clinical rotations at our organization. I want to create and provide those very important resources for their review before AND after orientation. People that possess a certain level of curiosity want to investigate unknown variables prior to exposure to stressful situations. Knowing information ahead of time reduces the stress of new experiences. Making analogies for understanding new concepts is what I want to inspire in our new student nurses. 

Also, I plan to use Dropbox to share my practicum progress with my mentor. As I update the folder on my computer, it automatically updates in Dropbox and notifies my mentor with sharing rights that she has a new file to review. This great and free application is simple to use when sharing files. It removes multiple steps when sending files or folders for people to review. 

This past week, I spent a significant amount of time exploring Tom Kuhlman's blog on elearning. What a great guy and I love his very helpful tips. More importantly - I love his name! I wonder if it is his stage name? Hmm . . . 


So, I "waste" time each day exploring certain subjects that provide me with creative ideas that hopefully, will lead to innovative ideas, too. I explored an artist's website today  - Peter Fiore - and found a week-long seminar he is teaching next summer in the Hudson River Valley.His color use is phenomenal. I am really excited about this, as he teaches oil painting based on “plein air photography” with studio painting. Oils are his medium and he uses anything for a paintbrush including palette knives. This artistic quest forces me to open myself to new ways of analyzing any detail . . . and see objects in a different light or to consider the complementary side, too.

Nursing Practicum Progress

Finally, I am nearing the end of my journey (approximately 30 classes since 2005) to obtain my masters in nursing informatics from the University of Phoenix. Part of the requirement is to complete a practicum and I want to record my progress with this assignment. I just finished the initial 3 week course; my instructor was the same one that I had for a class in my BSN journey. She received her DNP in the interim - it is amazing how an education is built over time and with defined goals. That is exactly what I need to do for my project.


My project is to investigate a method to improve how to deliver education to nursing students on how to navigate the electronic medical record (EMR) and use the embedded tools. I want to use a more innovative approach to supplement the education we currently provide. I will use a blended method of e-learning plus classroom time to teach basic functionality (scheduled time in the PC lab to practice). 

As I progress over this 6-9 month project, I will report in to an APN who also works in our critical care unit as well as teach nursing students. She is an awesome teacher and I am so glad she will work with me this year. When I am ready to submit my project journal, I will attend Part B of the course for the final 2 weeks of this capstone course.  


So, my first week of work is to conduct a literature review and I need to get started. Once I have created an annotated bibliography, I will schedule time to discuss the findings with my mentor.