My Strong Medicine

There has been a lot of buzz around the Blogosphere (more specifically the medical circles of the Blogosphere) lately about medical professionals’, their personal and/or professional blog habits and HIPAA. Do we professionals follow any specific guidelines when blogging about our job, our co-workers, or our patients? How about the information we share on our  social networking websites? What about privacy, and identity management?

I believe some of my fellow med-blogger’s have touched on this subject from more than one direction. Phil Baumann, a fellow RN, touched on the gravity of our actions and what subject matter we discuss when using Twitter. Other med-blogger’s, including Not Nurse Ratched, PixelRN, and Emergiblog have shared their insight and opinions concerning this issue as well.

And then last week fuel was added to the fire when 2 employees from a New Mexico Hospital lost their respective jobs after they took pictures of patients receiving treatment and then posting the images to a social networking Web site.

In an ironic twist of fate, at work this week we were doing some ‘Fall’ cleaning in our unit and we stumbled across some very old photos. Photos of the department from years ago. I’m talking everything from 2 yrs ago up to maybe a couple decades at least.

One particular photo stuck out. It was a photo of a previous staff nurse on the job. And in the photo was the nurse at one of the bed stations, and in the far background of the photo was a picture of a patient.

It was a harmless photo. From the looks of it, I think they were simply trying to burn off the last pictures of a roll of film and just started snappin’ photos. (I’ve done this more times than I can remember) But the gravity of that picture hit me like a ton of bricks!

Do you think that picture would have been taken in this day and age? Do you think the camera would have even been near the patient bedside?

It made me reflect on the subject at hand.

Internet – Blogosphere – Medical Profession- HIPAA – Identity

I’ve been listening to the voices, and reading the posts lately and I still have the same opinion I did when this all originally surfaced.

Your actions as a professional in the (Virtual) electronic world should reflect your actions as a professional in the  (sorry…)  REAL world.

You already know how to act in a prudent, ethical and responsible manner as a professional. You get an annual reminder from the facility that employs you. I know I do!

After you’ve been working in the medical profession long enough you develop a sort of sixth sense for what is right and what is not. For what is within the limits of the law, and what is breaking the law. You intuitively know WHAT you can and cannot say, WHERE you can or cannot say it, and TO WHOM you can or cannot say it to.

How can being on the internet make things so gray and vague? How does pushing buttons on a keyboard or clicking a mouse change the rules?

It’s very simple.

We all know the arms of HIPAA extend past the walls of our employer. You must act as a professional in a professional manner even when you are not on the clock.

So.

Whatever it is you are sharing or typing, where ever you may be located on the world wide web, and with whomever your sharing it with. If you are at all confused or unsure of the legality of your actions.

Ask yourself this one simple question:

Would you be doing it if you WEREN’T on the internet?

Then don’t do it AT ALL.

Nuff’ said.

Carpe Diem

As a Registered Nurse we are required to take a Microbiology class, or something similar. We need to be familiar with and have a working knowledge of this microscopic world to have a better understanding and an appreciation for the disease process and how it affects us.

We learn some very shocking things about fomites and vectors. We learn the intricacies of viruses and the spread of disease. And it’s here that we nurses’ develop our undying and sometimes addictive habit of washing our hands. In fact, not just washing our hands.. but becoming a closet germ-a-phobe.

Not only do daily interactions with people become ‘protective’, but public bathrooms become the most uncomfortable places on earth. (And don’t even get me started on what a microbiologist can tell you about sexual intercourse! - just takes the fun right out of it)

So, here’s the reason for my post, the public bathroom.

What is it with the inconsistency in the bathroom door handle? Why is it in some places you pull the door to get in, and push the door to get out, but in other locations you have to push the door to get in, and then pull the door to get out???

I think it’s a cruel joke masterminded by some jaded construction/maintenance worker.

Why is the push/pull important you ask?? (I know all my non-nursing readers want to know)

Take a minute and think about it.

You wash your hands (I hope) after you do your business. Dry them with the automatic dryer, or hopefully have one of those automatic towel dispensers. You dry your hands, and then proceed to exit the bathroom.

Is there a handle there? Or did you get lucky enough to simply have to push the door open? (which you can easily do with your backside or your hip)

Because if there is a handle there.. All your efforts to clean your hands are going to be negated the minute you touch that handle.

Think about the rest of the public..

Did they wash their hands after their deed? Did that youngster even SEE the sink after they did their business? What about those members of society that just don’t believe in personal hygiene? How many different microorganisms do you think are on that handle?

When is the last time you had a head cold?

Guess what? Most cases of the common head cold are due to someone not washing their hands. Whether you or someone else. The microorganism(s) that cause the common head cold are transferred and transmitted from one person to another by simply touching the same object that a sick person handled. (Go back and review the fomites and vectors link)

So I ask the same question? Why do some establishments have the proper combination and others don’t? What is even more bizarre is that the facilities that have you pull the handle to get out of the bathroom are sometimes, more often than you’d expect, HOSPITALS.

By the way, I didn’t even mention the process of washing your hands and then drying them. Ever stop and think about what your wet hands touch after you’re done washing them and are looking for something to dry them?

You successfully cleaned them. Now you have to dry them. Most of the time you have to pull that handle on the paper dispenser to get your paper. Guess what? You just dirtied your hands all over again by touching the dispenser handle.

Sorry.

This is how we nurses’ think.

While we are on the subject. I have a feasible and tangible solution for combating the ever increasing costs of healthcare these days. I think everyone should take a microbiology class as a required high school class.

Just imagine if you knew then, what you learned in nursing school about the spread of germs?!

In my humble opinion, we might be a much healthier society.

Carpe Diem

I have this problem with the healthcare profession.

We should practice what we preach. Or better yet, we should practice what we teach.

Patient education is a corner stone of the healthcare profession. No matter what your medical specialty is, no matter what facet of healthcare you contribute to, you teach. You teach your clients, you teach your patients, you educate your fellow colleagues, etc. The list goes on.

Here’s my conundrum.

How in the world can you one educate another if they cannot themselves follow their own advice and suggestions??!!

For instance:

How does a dentist educate his patients on proper care of your teeth, if he himself has a mouth riddled with cavities?

How does a respiratory therapist take a ’smoke’ break and then have the audacity to educate a patient on smoking cessation techniques. All the while smelling like cigarette smoke?

How does a personal trainer/athletic trainer educate and discipline his clients and/or athletes on weight loss suggestions and training techniques, when they themselves take the elevator instead of the stairs??

And finally, how does a nurse educate their patients on maintaining and improving one’s health and then during their lunch break they have the nearest fast food burger, take the escalator instead of the stairs and squeeze in a cigarette or two before returning to the floor??!!

I understand the difficulties in time management, overwhelming tasks and uncooperative working environments, but seriously? You wonder why you are always tired, and can’t walk up those flight of steps when I see you drinking a cup of coffee and some sort of Danish, donut, or candy bar every chance you get?

I liken it to a nurse licking their fingers, instead of washing their hands, after cleaning up a patient’s bodily fluids. Or telling a patient the importance of washing one’s hands to help prevent the spread of germs and bacteria, while the nurse goes in and out of all their patients rooms and never even uses a hand sanitizer.

Do what I say, not what I do. Right?

Carpe Diem

Here is why Med-Bloggers need to be careful with what information they share on the internet through what ever avenue they use. Everything from social networking sites, forums and personal blogs are still subject to the laws that police and protect the health care system.

Follow the link below:

2 NM hospital workers fired for taking photos - Yahoo! News

Happiness is a state of mind, not a situational result. Carpe Diem

I’ve touched on Bad Days. I’ve touched on how we all have them. We all hate them. We all need LESS of them.

I’ve also touched on how I don’t have bad days.

I vaguely remember having this conversation with a professor of mine decades ago in college.

How do you know what light is, if you’ve never experienced dark? Isn’t the absence of darkness = light?

How do you know what just is, if you’ve never experienced unjust? Isn’t the  absence of unjust = just?

What is good? Isn’t the opposite of evil?

Yeah, I’m stretching my definitions a bit. But in general, we often define a thing or things by their opposites.

So if we all know what a BAD day is, what is a good day? (For you that is)

Does a good day have to be stress free? Nothing is out of sort for you? Nothing upsets you. Nothing veers from the plan of the day? Everything is in alignment, the sun and the moon and stars are perfectly in sync for you that day?

Probably not.

I often think of two things at the beginning of my morning before the pulse of the day is underway. And then remind myself of these throughout my day.

1. I cannot control the uncontrollable.

2. It’s my choice.

Life is 10% what happens to me, and 90% how I react to it.

You know what a bad day is. You know what can make your good day become bad. A bad day is simply a BAD reaction multiplied and repeated throughout your day. Remember,  a bad day is simply the opposite of a good day. Think about what makes your day a GOOD day, and repeat the habit. Repeat the state of mind. Repeat, and reap what you sow.

Enjoy this roller coaster we call life. It will have it’s ups. It will have it’s downs. It’s the journey, not the destination that makes the ride worthwhile.

Carpe Diem