Hello!  Welcome to Change of Shift, the carnival dedicated to nurses and nursing!

I’ll start out with a couple of posts about an entity that most nurses everywhere deal with:  families.  Family members can be a huge help, or they can be the bane of our existence.  Usually they lie somewhere in between, being neither overly helpful (which is good if the family “helps” by silencing IV pumps and ventilators) or especially annoying.  Nurse Ausmed starts us off with a potpourri of family scenarios.  Just as patients come in all shapes in sizes, so do families!   Next is Chris at the Man-Nurse Diaries who submitted what turned out to be part 1 of a 3 part series about the same patient:  Never Say Your Family is Crazy Unless You Really Mean It describes a seriously dysfunctional family unit.  You will also wonder how on earth these four people have managed to make it this far.

Our carnival mama, Kim, submitted a hil-a-rious post from the past: Oh, the Games People Play.  First of all, congrats on obtaining the coveted Cherry Ames game, and second of all, the sentence “Team Patient arrives supine on a movable gamepiece” had me laughing hard enough to wake the toddler!!   Go read Kim’s play-by-play of her shifts in the ER.

If the blog Reality Rounds was an ice cream sundae, I would have some serious weight issues.  I really enjoy this blog - the writing style flows so well.  This week’s submission “Code Lactate” describes the author’s first day back at work after 12 weeks of maternity leave.  Talk about having to get back in the saddle in a hurry!  You know how nurses sometimes barely get enough time to pee or scarf down lunch?  It can be even worse for a brand new mom!

Now on to traveling.  Nurses have a great opportunity to travel and work at the same time.  In the post “Is travel nursing a vocation or vacation?” The Pulse describes the pros and cons of 5 different destinations.  Dubai anyone?  Speaking of traveling, have you ever thought about the travels of your favorite pen?  Kathy at Nurse Connect describes the average day in the life of your…. pen.  Your favorite “cool pen.”  I bet you had no idea!

Shrtstormtrooper at Fundus Chop (you know there’s a story behind that name. Oh, wait - there really is!) writes about her ridealong with EMS.  She points out that even in ER, you have at least some very basic information about the patient who is about to grace your threshold  This is not the case with EMS, where the little info you’re given may differ vastly from the actual situation you encounter.

Much has been written about Information Technology in the health setting.   Barbara from Florence dot com writes about “meaningful use” of such technology and what that means to different types of patients.

Bedside nurses do a lot of bending and twisting and turning.  The Back Pain Blog submitted a post entitled “Herniated Discs and Bending” which describes the ways in which a disc can herniate… and not herniate.  It also includes some tips on how to keep your back and spine healthy while doing all the crazy maneuvers we nurses sometimes have to do!

Are you confused by heart blocks?  Not Nurse Ratched provides us with a helpful Heart Blocks Cheat Sheet, complete with further commentary and simplification in the comments by the one and only Ambulance Driver.

Laura at Nurse Connect wrote the post “Are Nurses Health Coaches?”  I believe so, and Laura well describes the ways in which we are.  The problem comes when the patient is discharged and leaves our care.  At that point they no longer have the regular influx of information and encouragement that they did while they were in the hospital.

Do you think you have what it takes to be a nurse?  In her characteristic tongue-in-cheek style, Head Nurse lays it all out for us - the top mad skilz one needs in order to be a successful nurse.

What if you could work in an environment wherein you didn’t have to have an iron nose?  AJN’s Off the Charts posted Virtual Nurses in a Virtual ICU.  A virtual ICU is basically a second set of eyes to monitor the patient; however, this second set of eyes may be hundreds of miles away!  This may be a great use of nurses who have vast experience and knowledge but can no longer physically work at the bedside.  But is it better than just beefing up staff at the patient’s actual location?

Lastly, here’s this edition’s Top Lists:

Top Ten Reasons to Date a Congential Heart Defect Survivor!

Top Fifty Nursing Blogs (they wisely included me in the list this time!)

100 Best Sources for Nursing News

And for those of you that will be graduating in a month or so:

100 Useful Job Search Tools for Recent College Grads (those tools geared towards healthcare professionals starts at number 59)

I hope you enjoyed this edition of Change of Shift.  It will next be hosted at Florence dot com on June 11th.  Barb requests that you get your submissions in by no later than June 9th at 10pm EST.

Have you been keeping up with the Adventures of Bob the Nurse?  Keith is looking for more people to host Bob!  If you are interested in visiting with Bob and taking pictures of his adventures, contact Keith through his blog Digital Doorway.

Keith at Digital Doorway sent Bob off to vacation here in California!  We’ve had lots of fun hosting our visitor, as you can see in the pictures here, here, and here!  (That last one is my personal favorite!)

Change of Shift will be hosted here on Thursday, so get your submissions in!  codeblogrn at gmail, or use Blog Carnival.  Looking forward to reading some more!

…. Which is up over at Emergiblog!  The only Star Trek I ever really watched all the way through was Voyager (ok… and lots of the Captain Picard one), but between her effusive praise and my husband’s nagging encouragement, I have a feeling I’ll be seeing this new Star Trek movie at some point!

The next Change of Shift is here at codeblog in two weeks.  There is no theme, just send some good posts :)  to codeblogrn at gmail.

Happy Spring everyone!  Welcome to this edition of Change of Shift.

I typically do not ask for themed submissions, but I did this time.  The theme of this CoS is being human - describing those moments of human error or letting our less-than-professional side show.  I described my own less-than-professional moment here.  Yes, it’s an old post, but relevant to theme.

Not many people bared their souls with this theme, which I found disappointing.  Either ya’ll are able to maintain composure all the time, or you just aren’t into admitting the times you haven’t. :)   In any case, Kim from Emergiblog (our founding mama!) wrote a post that definitely epitomized this concept in Oh, The Humanity!

NPs Save Lives wrote an excellent post about the disparity between the snap judgments we sometimes make as nurses and the real story in Human Responses From a Family Nurse Practitioner.  It’s very easy to make a snap judgment about people, but you can only find out the real story once you’ve dug a little deeper.  Sometimes the real story supports the original judgment, but most of the time it doesn’t.

Do you know what an STL is?  Find out in Barbara Olson’s post at Florence dot com: STL’s Happen.  They happen every single day across the world.  You have had your own share of STL’s.  We have to work hard to overcome these when we are doing repetitive tasks.

~~ Zen break ~~  Take a moment to bask in the Buddha with Bob the Nurse.  I adore the idea behind Bob and wish I had come up with it myself.  This is not the last you’ll see of Bob in this here post!

Nurse Ausmed wrote a fantastic post about floating in Little People in a Big Hospital.  I know I’m preaching to the choir here, but in case I’m not, here’s a telling line: “So, an outsider might be wondering, what’s the big deal? Nursing is nursing is nursing, right”  Um, NO! Nursing is highly specialized these days.  I know helping out units that are short staffed is the right thing to do, but trust me - you do not want my adult ICU skill set in your pediatric ward.  And hug an ER nurse today - they have to be knowledgeable about almost everything!

Beka blogs at In Our Own Words: Medscape Nurses.  She wrote a post about “compassion fatigue” entitled Feeling Numb Today… Anyone Else? It includes a link to an article describing what this is along with her own description of what it feels like after an especially difficult weekend working in the ICU.

Man Nurse (aka “The Exposed”) at the Man-Nurse Diaries relates a story about a recent needlestick in his post Needlestuck.  It was an accident, but will have some significant ramifications for his life over the next 6 months.  It happened under less-than-ideal conditions, and it could happen to anyone of us.

I am definitely a fan of the witty and/or well-placed comeback line.  RR over at Reality Rounds nails her comeback as described in the post Enter Dr. God: Act One.

Are you charged with making sure your fellow nurses get their breaks?  If so, you might find this post by Kathy at Nurse Connect interesting: Take a Break.  I spend some shifts as the designated “break nurse” and I have definitely come across these types of situations… that’s all I’ll say.  (Hi, coworkers!!)

And now… another break to see what our favorite male nurse action figure is up to…. (Where is his stethoscope??)

The swine flu has been in the news a lot lately, and it looks as though a very astute school nurse was one of the first to alert us to the situation.  Actually, it looks like many nurses were involved.  Great job!  Although she didn’t submit it, I wanted to include a post from Nurse Jo at Head Nurse: Can we all just take a deep breath through our masks? It contains some very sage advice!

Patrick at travelnursingblogs.com writes about how where we live impacts our happiness in It’s Time to Find Your Place in the Sun.  I will tell you right now that I was completely shocked to read what state has the happiest inhabitants.

And Bret writes about How to Beat Nursing Burnout in the 2nd of a multipart post, offering suggestions on how to combat professional burnout… and there is also some great advice in the comments.

Now, onto one of my favorite subjects - TECH!!  There were several submissions for this category and I think they’re all fabulous.  First up is Keith at Digital Doorway writing about This Modern World…. a post that advises just how to connect in this big huge world of connectivity.  Confused?  Don’t be - although it is easier than ever to connect with others, sometimes we lose the sense of humanity behind the computer screen.

Online Nursing Degree Guide compiled a list of 25 Amazing Nurses on Twitter (I’m sure if it had been 26 Amazing Nurses on Twitter, I would have made the list!) I follow many of the nurses on this list and they are indeed very interesting. Another great resource from this site is the 25 Top iPhone Apps for Nurses list.  Do you use your iPhone at work?  Some of these apps would definitely come in handy.

Keeping with the top 25 theme, Medicine 3.0 gives us a list featuring 25 Excellent Social Media Sites for your Health including sites for News & Information, Fitness Tools and Patient Activism.

Nursingschools.net has compiled a very extensive list of 100 Scholarly Open-Access Journals for Nurses.  If your interest or specialty is not listed somewhere in here, then you are a nurse practicing on Mars.

Running Wildly wrote a very touching post about Hope - how important it is for healing and how devastating it is not to have any.  Never underestimate how much power hope has for our patients.

RehabRN writes a beautiful tribute to one of her favorite coworkers in On to Sunny Skies… Suzy sounds like a dream to work with.

Lastly (but not leastly), Laura from Nurse Connect writes Elements of Nursing Style wherein she gives some excellent tips on communicating through charting.

I hope you enjoyed this edition of Change of Shift!  Thanks to everyone who submitted posts.

The newest, most sparkly edition of Change of Shift is up at Emergiblog this week!

And the next sparkly edition will be hosted here at codeblog.  Send submissions to codeblogrn at gmail.  If you want some inspiration on what to submit, I have a little theme in mind. It’s about being human.  We nurses do our best, but sometimes the human in us comes out and we are less than professional at times.

Or maybe that’s just me :)  Anyway, if you’ve had a human moment as a nurse, I’d love to hear about it.  Even if you don’t have a nursing blog and want to write something, feel free to submit and I’ll post it in entirety.

(To clarify, though - your post need not conform to the “theme.”  Submit whatever you like!)

I just had to link to this recent edition of Grand Rounds, up at Running a Hospital.  Paul Levy is the author of this blog, and for this edition, he asked people to submit stories based on this:

In the spirit of Dr. Ernest Codman, I asked doctors, nurses, and other providers to write about incidents in which they made or were present for a medical error. What were the circumstances, and what did you do in response to the situation? How did you feel about the event, and how did it change your practice of medicine afterward.

As I wrote in the comments of his post, it was easily one of the most riveting and interesting editions of this carnival.  Definitely take a few moments to head over to his blog and check it out.

Welcome!  This is fifth time I’ve hosted Grand Rounds here at code blog.  Although my previous four attempts were fairly creative, I decided to keep this edition simple.  All submissions were included - if you do not see yours here, I did not get it for some reason!

The first post is one that I immediately balked at even including because the opening paragraph sounded absurd to me.  But the more I read, the more I realized there were some good points and it quickly became one of the more intriguing posts submitted.  Head over to Duncan Cross to read Don’t Walk and find out why research/fund-raising organizations are not as helpful to those they purport to assist as we’d like to think.

The biggest news this week, of course, has been that of Natasha Richardson’s death from a seemingly innocuous skiing accident. Several medbloggers stepped up to give us insight into what may have happened.  PalMD wrote A simple bump on the head can kill you, which explains basic anatomy (and a very… realistic picture) of the brain and how traumatic brain injuries affect it.  Inside Surgery wrote Natasha Richardson’s Brain Injury to provide us with a detailed rundown as to what happens to patients who have suffered a traumatic brain injury - from pre-hospital to in-hospital care all the way to recovery and/or end of life.  Lastly, Dr. Crippen weighs in on the comments floating around regarding Richardson’s care in Canada in a post neatly titled The wussification of the American medical profession.  The term “gobstopping pomposity” will be with me for a long time.  I have made it a life goal to use that expression flawlessly in a sentence someday.

That wasn’t the only well-publicized tragedy this week - in Oakland, 3 police officers were killed while on duty.  Med student Thomas, author of the blog Hope for Pandora, shares with us why this particular news story personally affected him in Thoughts and Prayers.

This being a submission site for personal stories, I was very interested in the submissions that were of that nature.  Dr. IcedLatte wrote about a situation in which a patient’s blood draw ultimately led to a hysterectomy.  Ill and Uninsured in Illinois describes his 15 hour stay in a hospital ER waiting for a diagnosis and treatment.  And Kerri at Six Until Me lets us peek into some past diary entries giving us a taste of life as a teenage diabetic.

Speaking of diabetes, Amy at Diabetes Mine submitted a post explaining that many Type 2 diabetics are in serious need of education about their monitors and the numbers displayed thereon.  Testing in Pairs is a booklet that will help in educating these patients.

Steve at Adventures of a Funky Heart posted about Erik Compton, who is on his 3rd heart transplant.  Erik and his sidekick John Paul did some serious golfing in a PGA level golf tournament.  Sans golf cart, thankyouverymuch!

Next up are a couple of advice posts.  Clinical Cases and Images gives us 4 Ways to Use Twitter to bring new life to your blog, and Dr. P at The Blog That Ate Manhattan describes her “tickler system” for her EMR.  She also brings up the fact that medical disciplines all have their own systems, none of which talk to each other.  Find out what her suggestion is for integrating the whole mess!

Getting into scientifics, has it ever occurred to you that disinfectant wipes could actually be contributing to the spread of drug-resistant bacteria in our hospitals?  Paul at Healthline explains how this could be happening.  ACP Internist tells us why we still need to work on finding a better predictive test for ovarian cancer. Doc Gurley advises us on a new, effective allergy-saver health tip now that we’re on the brink of pollen season. And Allergy Notes notes the onset of action for a medication that treats seasonal allergic rhinitis.

On the back front (ha!!), Dean at The Back Pain Blog attempts to answer a reader question about herniated discs and the risk of bending. Jolie the Fitness Fixer gives us a real-life case study from a patient who considered his back pain a double edged sword: taking it easy led to muscle weakness, but his back pain was making exercise very difficult.  Dr. Bates at Suture for a Living deviates from her usual plastic surgery/sewing posts to urge us to make exercise just as much a part of our lives as brushing our teeth, backing up (ha #2!!) her assertions with a recent study.  If all else fails, the author at How to Cope With Pain offers a suggestion on how to make guided imagery even more effective for certain patients suffering from pain.

Some people have woes of a different type - Empty Wallet Syndrome. Louise at the Colorado Health Insurance Insider ponders those who find it perfectly acceptable to pay more than $150 every month for a car, but hate the idea of paying $150 to see a doctor. Jeffrey, who writes Nuts for Healthcare, is concerned about the fragile link between employment and healthcare: employer-sponsored insurance implodes when the economy is bleeding jobs, which further underscores the need for portable and equitable health insurance.  Healthcare Technology News’ blogger Rich is hopeful about provisions for adoption of EHR’s in our economic stimulus plan but wonders if it will be enough to push hospitals to realize their potential.

Rita at Supporting Safer Healthcare compares Management by Wandering Around vs Management by Metrics and shares her thoughts about the trend that healthcare is moving toward being “all about the numbers.”  Am Ang Zhang at The Cockroach Catcher describes some appalling practices at a UK hospital where incompetence is rewarded and data skewed to cover up rising mortality numbers.  Dr. Hickey at Behaviorism and Mental Health wonders what the average Joe would think if he knew that his counseling sessions for stress were coded as an actual mental disorder - becoming a permanent part of his insurance record.

Robin of Survive the Journey relates a Twitter conversation about “metabolic syndrome” and provides a very thorough discussion about this possible misnomer.  InsureBlog’s Henry Stern reports on a recent Aetna study of Consumer Driven Health Care that turns conventional wisdom on its ear.  Toni at Everything Health wonders why we are stuck in the 1950’s carrying around flimsy insurance cards and crumpled lists of meds when we could be acting like the 21st centurians that we are - and carry all of this information on a swipe-it ID card.

At In Sickness and In Health, Barbara points us to a link about Mother Jasmine - a “dog so saintly, birds perch on her nose.”  Canadian Medicine’s Sam posts about the Canadian Space Agency and how they held a somewhat strange process to pick their new astronauts.  2 doctors and 1 med student have made it to the final 16.  Nancy at Healthline reminds us that HIV/AIDS still needs our attention, especially where women and girls are concerned.  Lastly (because he was last to submit!  Sorry!) Tony at Hospital Impact blogs about Time Magazine’s 10 world-changing ideas and his perspective of their impact on healthcare.

That’s it for this edition of Grand Rounds.  I hope you enjoyed reading these posts as much as I did!  Next week’s rounds will be hosted at Running a Hospital.  And if you are interested in hosting a future edition of this carnival (or are curious as to who’s up to host next), contact Dr. Val at Get Better Health.

The submissions are starting to roll in!  Send your submission to codeblogrn gmail com and please put “grand rounds” in the subject.  There is no theme, so feel free to submit whatever you wish!

And I wanted to link to Change of Shift, hosted at Emergiblog.  It’s Volume 3, Number 19.  Coincidentally, today is 3/19.  Spoooooooky!

But for this week, Grand Rounds is up at ACP Internist, with a nifty newspaper title theme!

As for next week, as the title says, Grand Rounds will be hosted here at code blog for the 5th time.  Please send submissions to codeblogrn gmail com and put “grand rounds” in the title of the e-mail.  There will be no theme, so feel free to submit whatever you want!

Just as an aside… I consider this guy to be one of the funniest people on twitter :-)

Happy St. Patrick’s Day everyone!

A long long while ago, Rosalinda Alfaro wrote to me and asked if she could possibly include this post in her next book about Critical Thinking.  I said sure, I signed some papers, and then didn’t hear back for a year or so.  I found out a few months ago that the editors agreed to include it, so there it is!  In print!  In a book!  About critical thinking in nursing! Who would have thought…

Anyway, this is the book: Critical Thinking and Clinical Judgment: A Practical Approach to Outcome-Focused Thinking. I am very excited!

Change of Shift is up at Digital Doorway this week.  The theme is Life in a Fishbowl and Keith managed to make sense of it all while also tying it in with nursing posts.  :)