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Grand Rounds: Volume 8, No. 17

How’d we get to Volume 8 already?!  I think hosting this Grand Rounds finally ties me up with GruntDoc, who has hosted 7 times.  Grand Rounds is the weekly round-up of blog posts by medical bloggers.

Whereas in the past the host would post nearly every link they received, it appears that we are now moving towards more curated content.  I said in my previous post that I wasn’t going to institute a theme, but I was definitely more drawn to the personal-story type posts.  Thanks to everyone that submitted!

Ever been put in an awkward position?  How about if it was a position that you created yourself?  Bongi, who blogs at other things amanzi, describes a situation he found put himself in that he calls “buff and turf” – and it didn’t turn out very well for him.  He leaves it to our imagination to come up with what the other surgeon’s response was.

Working with children is hard.  Well, I think it’s hard.  I can relate to my own kids just fine, but finding common ground with a child you’ve just met and have only minutes to spend with is what I consider a unique talent.  The medical student that blogs at d.o.ctor used a classic technique to try to bond with her small scared patient.  Did it work?  Read on to find out.

What would you think if your nurse told you, “Buck up.  You’re going to feel terrible for a year?”  Would you believe it?  Jessie Gruman describes her insights as she worked her way through an entire year of feeling very “sick-ishly.”  I can tell you I found insight #3 somewhat surprising.  It’s something I simply wouldn’t have considered.

I shamelessly grabbed this next post from Twitter – Jordan, who blogs at In My Humble Opinion, wrote a touching post about mothers.  In Praise of Mothers wasn’t quite the post that I was expecting (and apparently the first commenter wasn’t expecting it either); it was even better.   And I’ve tried several times here to explain why, but I can’t.

And I shamelessly grabbed this one from Google Reader – Dr. V at 33 Charts shares his answer to the question, “How Often Should A Physician Blog?”  You could easily take the word “physician” out and apply the answer to any blogger.  I have been blogging for over 9 years now.  My posting frequency in the very beginning was about once a week.   Now it’s more like once a month.  He has some great insights that I found myself completely agreeing with.

What happens when you check up on a patient only to find that you’re the “last to know?”  In Duly Notified, Dr. Wes encounters an unsettling bit of difficulty when he opens the electronic chart of a long-time patient.

The next submission is an interesting read.  When someone suggests that you “build a coping system,” does your brain sort of shut off a little?   Yeah, yeah, coping.  Easy to suggest, a bit more difficult to implement.  But Will wrote a post that makes it seem doable.  He breaks it down into easy-to-digest sections and provides lots of suggestions.

Solitary Diner describes her “middle of the night chart review.”  Who amongst us medical professionals haven’t found ourselves in this position?  It’s a right of passage.  Welcome to the world of health care!

Medical Lessons brings up an interesting point – can cancer awareness initiatives go too far?  Where’s the line?  What if it seems silly to adults but might actually be helpful to children?  Should Barbie be bald in the name of cancer awareness?  (My take?  Sure, why not.)

Here are a couple quickies:  Insure Blog covers the situation of an autistic young man when a program his family has come to depend on is restructured – leaving them out.  Behaviorism and Mental Health explores a different perspective when addressing the problem of increased violence in California’s state psychiatric hospitals.

I hope you’ve enjoyed reading these posts I’ve selected for this Grand Rounds.  The calendar tells me that Volume 8, No. 18 will be held at USA Today (!), written by Dr. Val Jones.  Send submissions to val.jones at getbetterhealth dot com.  As always, thanks to Nick at Blogborygmi and Dr. Val at Get Better Health for keeping the whole thing going!




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Grand Rounds

Dr. V at 33charts is hosting Grand Rounds this week!  Go read his carefully curated links.  I liked what he said at the end about each host essentially bringing their own flavor to the ‘Rounds.  (paraphrasing there!)  There have been a few warbles here and there about how it should be hosted, but I’ve always thought that each blogger should do what feels right for them.

Having said that, codeblog will be hosting Grand Rounds next week.  It’ll be my 7th time hosting and I’m excited.  Mostly excited because now someone will tie up GruntDoc‘s 7-time-hoster record :-)  But!  Also excited to read what you send my way.   I have never requested that submissions conform to a certain theme, and I’m not going to officially request it now, either.  All submissions will be considered, but my favorites are the personal stories and anecdotes from the world of health care.  My past entries for Grand Rounds have been silly & gimmick-y, but I have a feeling that I’ll employ a simpler format this time around.

E-mail me at codeblogrn at gmail to submit; please put “grand rounds” as the subject.  I’d appreciate if you could get them to me by Monday afternoon at the latest.  Thanks!

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Change of Shift & The Doctor Anonymous Show

First of all, hightail it over to Reality Rounds for the latest edition of Change of Shift!  She did a splendid job of making it very spooky by renaming our blogs.  (I am Corpseblog!)

And tune in tonight at 6pm PST to the Dr. Anonymous show, where he will be interviewing me.  Talk about scary :-)  I am excited to finally be asked (I’ve waited years!) but also nervous because I am not exactly well-practiced in live interviews!

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Grand Rounds Volume 6, Number 6

Welcome to Grand Rounds!  This is volume 6, number 6…. and the 6th time I am hosting… during the week of Halloween.  Does anyone else find that creepy coincidentally satanic fascinating?!

(Incidentally, if you are reading this through RSS, I am aware that the formatting is less than optimal.  Very sorry about that and we are trying to fix it!)

For this edition, I thought we could go out Trick or Treating on Medblogger Lane.  I’m sure we will find some colorful stories along the way…

The first house we come to seems amiable enough.  The porch light is on and when the door is answered, some good old fashioned chocolate is put into my Trick or Treat bag!  Even though she is diabetic, apparently Amy at Diabetes Mine prefers to give out the real stuff instead of the sugar-free kind.  The reason may surprise you.

The next house also has the porch light on, but no one answers the door when I ring the bell.  Finally I notice a note that says I should just take some candy from the bowl.  Not Nurse Ratched is horribly sick with H1N1 and doesn’t want to spread any germs.  Read her first-hand account of what it’s like to be knocked out by this flu.

Dr. Bates from Suture for a Living is at the next house.  She has some great candy but it was kind of a pain to get.  She said that the candy was password-protected and that I had to prove that I had a professional responsibility to eat the candy, and would not eat it out of mere curiosity.  Take a gander at what happens when HIPAA is peering over your shoulder when you go looking around where you shouldn’t.

If I thought that was hard, I was not prepared at all for what I’d have to do to get the sweets from Barbara at Florence dot com.  First, I had to document that we did a time-out so that the correct candy would be given.  After that I had to document that the candy was received.  She actually made me eat some in her presence so I could document that the candy had no adverse effects on me.  Then she had me stick around to report off to the next trick-or-treater about everything that had just transpired.  You might be tempted to skip this house, but you can’t.  She shares her perspective about a recent study that claims nurses spend 35% of their time documenting documenting documenting.

The next house was just crazy.  When I arrived, they would only open the gate to let me in if I was wearing a face mask.  Laika from MedLibLog wasn’t taking any chances after watching this very descriptive video that shows how the flu virus is transmitted and starts taking over the cells in your body.  When I finally got past the gate, Dr. Val from Better Health informed me that she would love to give me some candy, but unfortunately the Big Candy Store down the block ordered it all up and now there wasn’t any left.  So I wouldn’t feel as though I wasted a trip (and a mask!), Dr. Anonymous sat me down and told me all about the candy H1N1 flu, including busting some myths about the vaccine and informing me of when it might be available.

On my way to the next place, I passed someone dressed up as a shark.  That reminded me of Dr. Auerbach’s post at Healthline.com about shark attacks – why they attack and steps we can take to avoid being attacked.  I was especially amused at reading this: “…it is important to note that any shark, including the seemingly docile nurse shark, will bite a human if sufficiently provoked.”  I’m sure there are a few doctors out there who learned that the hard way.

I finally arrived at the Medblogger Lane Haunted House.  It was with much trepidation that I walked through the front door…

…and had to stifle a scream as I entered the room!  A mad scientist was performing various experiments on poor unsuspecting subjects.  You would think that a little playful squirt of lime would result in no harm, but Dr. Charles explains how it could end up badly.  The adjacent hallway was dark and a little spongy.  It seemed strangely reminiscent of a certain screening exam.  The Clinical Cases & Images Blog gives us the quick and easy Cliff Notes version of colorectal screening guidelines.  Allergy Notes describes the scary effects of sulfite hypersensitivity.  In another room Sharp Brains had specimens in jars and was performing tests to find out if caffeine had a sustained lifetime benefit or harm.

The last room had people who have had very scary things happen to them.  Trauma Junkie described a typical day in the life for a patient with Cystic Fibrosis and shares his newfound wisdom about how sometimes the patient teaches the practitioner.  Chris at Life in the Fast Lane relates a story with a very important lesson: sometimes we need to dig a little deeper and ask a few more questions before the medical mystery can be solved.  And Robin at Survive the Journey describes what it’s like to parent a child who has Cushing’s Disease, from diagnosis and management to terrifying flare-ups and hospitalizations.

After all that, I was ready to get back to some more trick or treating!  The next house I came upon was giving out gift certificates to iTunes!  I thought that was perfect because I could use it to check out some of the Anatomy software apps on Dr. Penna’s list.  As I was leaving, I overheard a conversation about a laptop being stolen from Blue Cross Blue Shield and the potential damage that could result.  Dr. Joseph Kim from Non-Clinical Jobs lets us know what to do in case we find ourselves in this predicament.

I finally arrived at a huge scary house… you know, the kind that is decked to the nines in Halloween decorations… the one that makes your heart go just a little faster as you’re walking up to the porch.  I rang the bell, said “Trick or Treat!” and waited.  And waited some more.  Surely a house as big and fancy as this would have great candy, right?!  Finally a piece of paper was slipped under the door.  It asked if I had any conditions that would be exacerbated by procuring and ingesting sweet edibles.  It further stipulated that I needed to meet a minimum threshold of candy before they would provide me with any more!  What was this?  Some kind of confectionery deductible?  I concluded that I had unwittingly arrived at the House of Insurance.

Instead of filling out the forms that had piled up outside, I decided to sneak in the back door to see if I could find out anything interesting, and boy did I ever…

Insure Blog was trying to figure out how Washington would handle 14 million new patients finding themselves on Medicaid if the Baucus health care bill is enacted.  Louise at the Colorado Health Insurance Insider was pondering the composition of hospital boards of directors – are they comprised of objective participants, or is there some significant conflict of interest going on?  And in the corner was a group led by Leslie at Getting Closer to Myself discussing the merits of marrying for love… or insurance coverage.

By this time it was getting late and I decided to head home.  I spotted a big bonfire along the way and decided to stop by to see what was going on.  Several people were gathered around the fire sharing experiences and information.  Jolie Bookspan at the Fitness Fixer described several ways to treat knee pain that do not involve scalpels. Jenni at ChronicBabe informed us about fibromyalgia and contributed a list of resources that provided education on how to live and even thrive with the disease.  Jeffrey at Nuts for Healthcare explained that fibromyalgia remains controversial in the medical community; however, while drug companies have been accused of fear-mongering to a desperate population for a handsome profit, recent neurological research has begun to unravel the biological manifestations of the disease in the hope to pinpoint a cause.

Novel Patient proudly described how she painstakingly stood up against her chronic illness and disappointing new diagnosis.  Rachel at talesofmy30′s divulged her secret for learning to love her body after enduring disordered eating patterns and a type 2 diabetes diagnosis.  Stacey at ACP Internist spoke about a possible reason as to why medical students are not going into primary care.  David Harlow at HealthBlawg gave a detailed account of his experience at the Connected Health Symposium 2009 conference held last week in Boston.  To finish the evening, Barbara at In Sickness and In Health shared with us a story she told her father while he was ill in the hospital.

That’s all for this edition of Grand Rounds.  Next week, Grand Rounds will be held at nonclinicaljobs.com.

Have a safe and happy Halloween everyone!

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Grand Rounds

Grand Rounds is up at Sharp Brains today!

Next week, Grand Rounds will be held here at codeblog for the 6th time (Yes, GruntDoc, I counted!)  Use the submit your story/contact form at the top of the page, or email to codeblogrn gmail.  There is no theme, but it will be very close to Halloween, so if you want to submit something super-scary, I’m all for it!

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Change of Shift – Fourth Year!

Change of Shift has entered its fourth year!  Yep, we’ve had 3 years of posts written by and for nurses in this biweekly carnival.  Kim has been thanked to the hills and back, so I’ll just say – GREAT JOB!  Organizing a carnival is not for the faint of heart.  Well, neither is being a nurse for that matter….

Kim is hosting this anniversary edition and it has some great posts that were both sent in and sought out.  Enjoy!!

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Change of Shift Vol 3 Number 24

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.

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Bob the Nurse Visits California!!

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!

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Beam Yourself Aboard Change of Shift…

…. 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.

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Change of Shift Vol. 3 Number 22

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.

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  • profileI am Gina. I have been a nurse for 15 years, first in med/surg, then CVICU, inpatient dialysis, CCU and now hospice. This blog is about my experiences as a nurse, and the experiences of others in the healthcare system - patients, nurses, doctors, paramedics. We all have stories!

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